The Minister for Health, Dr Wooldridge, has breached a very important principle in barring overseas-trained doctors from obtaining Medicare provider numbers for 10 years after their arrival. In any event the proposal might come unstuck constitutionally.
The general principle of Australia’s immigration program has been that once a person is granted residency they are equal before the law with everyone else except for the right to vote and the threat of deportation after being convicted of a crime, and that once a person is a citizen they are equal in all respects.
It is inevitable that most overseas-trained doctors who come to Australia will become permanent residents within a short time and probably citizens after three or four years. At that point they will be banned from obtaining a Medicare provider number, purely on account of their overseas birth, and not on account of some medical or other qualification that applies to all applicants. It is virtually impossible for a doctor to engage in private medical practice in Australia without a Medicare provider number that enables people to claim Medicare rebates for that doctor’s services.
Dr Wooldridge’s proposal is repugnant and discriminatory and should be abandoned. If the government is concerned about too many doctors it should not allow them to immigrate into Australia in the first place or it should cut the places in Australian medical schools. Australia is entitled to make rules about who comes in as a migrant and who does not. Those rules are based on language, education, family ties, and skills need in Australia. But once here, Australian law should provide equal treatment and not impose burdens on a class of people because they come from overseas. There should be an objective test for the issuance of Medicare provider numbers that applies to all.
Once the Government starts regulating the employment of people who have been in Australia for up to 10 years by, in effect preventing them from engaging in private medical practice irrespective of their medical qualifications, it is a short jump to regulating other aspects of other immigrants’ lives. A decentralisation program, for example, might allow some migrants in on condition that they do not work in Sydney or Melbourne for 10 years. Other programs might prohibit migrants from engaging in a range of government work where the government (under pressure from a local group) thought there were too many people of that category already in the country.
It is a bizarre approach. It suggests that Australia will take people in its migrant intake for the sake of taking them, irrespective of whether there is a national need for their skills.
The approach has other worse implications, though admittedly only in a small, isolated way. It is an acknowledgement that there is an employment problem flowing from immigration, yet the government’s response is not to limit the immigration, but to limit the range of employment the migrant can do. The tragedy here is that if the government fails to address economic and environmental concerns flowing from its immigration program, it gives succour to those who oppose immigration on the totally unacceptable ground of race.
In the case of the doctors, the Government will find itself in the totally indefensible position of refusing Medicare provider numbers to overseas doctors, who just happen to have a greater proportion of non-Anglo-Celtic people among them than the general population.
The constitutional point is a moot one, but serious enough. The question is whether the plan offends any implied right of equality before the law contained the Constitution or whether it offends the provision that permits the Commonwealth to hand out medical benefits “”but not so as to authorise and form of civil conscription”.