I've been involved with Campbelltown Hospital for over four decades, and I've seen the hospital develop into a major teaching hospital. In fact, for a few days the week before last we were the busiest hospital in Australia in terms of emergency department presentations, and our neighbouring teaching hospital, Liverpool Hospital, wasn't far behind.

We've had a massive population growth in Macarthur. We're now the biggest electorate in the country by population, and there will need to be a redistribution; in fact, it is already proceeding. Our development is still continuing, though. Thousands of people are moving into the area—there are new suburbs, often named after the old farms that were there before the development, like Gregory Hills, Emerald Hill, Warren Park, Willowdale et cetera—but we've had very little infrastructure, including health infrastructure.

It's distressing to me that lots of my constituents are writing or coming into my office to voice their concerns about the health care that they are getting from our hospital system. I want to congratulate the staff at Campbelltown Hospital for the work that they are doing. Every day, they are inundated with patients, many of them very sick. They are having to deal with this avalanche of patients with very little additional staff or infrastructure. We've built a new hospital, but many of the beds are not filled, because of the lack of staff.

I've written to the New South Wales Minister for Health, Ryan Park, requesting an urgent review of the infrastructure and the staffing of our hospital to try and keep up with the demand. There are so many people presenting to our hospital, often very sick, and they are having to wait a very long time to get the care that they need. They have to wait for a very long time to get that care. Some of the examples of concerns that my office has been contacted about are a mother trying to breastfeed twins in the waiting room of the hospital, but standing up because there was no seat available. And there were people with sepsis having to wait for hours to get any treatment started because there was no doctor available. I'm very worried and concerned about what is happening.

This should not be a blame game, however. This situation has evolved over decades, with the rapid development in south-west Sydney and the lack of planning and infrastructure. We need to address this now, and we need to address it at the local, state and federal government levels. The federal government is doing some things, the state government is doing some things and even our local council is doing some things to help with health infrastructure, but it isn't working. People get sick of doctors saying that this is a crisis or this is an emergency et cetera, and I don't want to take that approach. This has evolved over a period of time and it's replicated in other places. We've heard about the ambulance ramping in South Australian hospitals and about the long waits for ambulances and long queues in emergency departments in Victoria, Western Australia, Queensland and, in fact, around the country. We've heard concerns in Deputy Speaker Archer's own state of Tasmania about getting access to specialist care being diabolical in parts of Tasmania.

I'm contacted every day, literally, by constituents who cannot afford the gap fees to see specialists such as cardiologists, neurologists, vascular surgeons, ENT surgeons and ophthalmologists. There's a huge problem with access in Australia, not just to primary health care but to specialist care, and we need to address this in a comprehensive, systemic way. I think that the federal department of health has really failed in its responsibility over the last couple of decades. The recruitment of doctors to work in emergency departments or in general practice has been hampered by the farcical Modified Monash Model, which tries to predict the areas needing support in recruiting doctors. Apart from the inner cities, every area in Australia is an area of need and needs to be seen as such. We need to recruit doctors, be they from overseas or even from the inner cities, to work in the areas of need, such as our outer metropolitan areas and our rural and regional areas. They need support for that and it's time that the department of health owned up to its responsibilities.

There's also a huge problem in attracting medical students to go into general practice training schemes, and there are issues with how people can transition from the hospital system into a general practice training scheme. I can tell you that if you work as a hospital registrar in medicine, or surgery or paediatrics, you'll have to take a 40 per cent drop in pay to go into a general practice registrar position. That's ridiculous! It's an active disincentive for people wanting to go into general practice at a time when we have a huge shortage of general practitioners around the country. That should have been addressed years ago. The departments of health at both the state and federal levels knew about this and they've done very little other than some very marginal changes in GP recruitment. We've had the bonded training schemes for medical registrars, which haven't worked, and a lot of time has been wasted in trying to get students who were recruited when they were very young out of these bonded schemes when they've finished their training. They haven't worked and the department of health needs to look at other solutions.

As I said, we're faced now with a system where increasing pressure is being put on our emergency departments, not just by the increase in population but by the fact that people cannot get in to see a general practitioner. They cannot afford it or the appointments just aren't available, so they're putting more pressure on our emergency departments. The urgent care centres will help a little, but, when you look at the urgent care centre in Macarthur, for example, they see about 20 patients a day. We have over 300 presentations to our emergency departments. So it really is time, when we have a National Cabinet, for state and federal health ministers to sit down and work through this and organise a plan of management for these emergency problems. It is not going to get better without systemic change.

We have lost the concept of Medicare as a universal healthcare insurance program. People now cannot get in to see specialists for things like heart checks, removal of cataracts et cetera, because they can't afford it. We are very rapidly developing an American-style system that is leading to a two-tiered system, where wealthy people can afford very high-quality care, and poor people either don't get care or have to go on a long waiting list. The waiting list for cataract surgery in my electorate of Macarthur, in the public system, is over two years. Children who have obstructive sleep apnoea because of large tonsils and adenoids have to wait 12 months just to get in to see an ENT surgeon, and their families have to pay for it, because there is no public ENT clinic at our hospital because of the downgrading of our outpatients system. That's occurring around Australia, not just in my electorate of Macarthur, and more and more people are being forced to pay large fees to get private surgery done.

This is similar to what happened before the advent of Medicare, or Medibank, as it was when it was started by Gough Whitlam. In my time as a medical student, before the introduction of Medibank, I saw that the biggest cause of bankruptcy in Australia was medical costs. We are headed back to that system unless there is systematic and systemic change. I am really calling on both state and federal health ministers—Liberal, Labor, doesn't matter. We need to get together and we need to have change; otherwise we will end up with a two-tiered, American-style health system, and that is something that should be avoided at all costs.

I am happy that our Minister for Health and Aged Care, Mark Butler, is doing what he can to try and modify the Medicare system so that people are more able to access bulk-billing, but I am very fearful that, unless urgent change happens across state and systems, we will end up with a very poor system.