Go bush and we’ll wipe your student debt, Canberra tells medics

Australia will reportedly write off the university debts of doctors and senior nurses who work in the bush, in the latest effort to overcome a chronic shortage of health professionals in regional areas.

But the initiative’s prospects of success are debatable, after a similar scheme was ditched six years ago.

The new programme, to apply from January, will cancel the tuition debts of doctors and nurse practitioners – nurses with master’s qualifications, who are authorised to diagnose and treat some conditions – if they work at least 24 hours a week in rural or regional areas for periods corresponding to the duration of their studies.

For those who practise in areas classed as “remote”, debts will be waived after they have worked for half the length of their degrees.

Regional health minister David Gillespie told the ABC that student debt cancellation would supplement other existing benefits. Health professionals working in the bush already attract financial incentives of up to A$60,000 (£32,000) a year and scholarships to help them update their skills.

Dr Gillespie said the new initiative, like the existing incentives, was targeted to areas suffering most from a lack of medical services. “The more remote you go, the more significant the…payment is,” he said. “There is an acute shortage of general practitioners in the outer regional and remote areas – more so than anywhere else.”

The new programme offers considerable savings, with undergraduate medical students racking up tuition fee debts of about A$70,000 over their six-year degrees. For medical students at private Bond University, and postgraduate medical students who do not attract commonwealth teaching subsidies, the costs can run to hundreds of thousands of dollars.

But the savings for nurse practitioners would be considerably less, after student contributions for nursing were almost halved under last year’s Job-ready Graduates reforms.

Australian National University policy expert Andrew Norton said nurse practitioners may carry little outstanding student debt, particularly if they had already paid off their undergraduate degrees and their master’s study had attracted commonwealth subsidies. “This limits the appeal of writing off debt,” he said.

A similar debt cancellation programme was abolished in mid-2015 following reports of low take-up, with less than half the programme’s budgeted funds expended. But the HECS Reimbursement Scheme was arguably less generous than the new initiative, repaying just one-fifth of doctors’ debts for each year of rural service, with critics at the time saying “full reimbursement” would have been a more compelling incentive.

Another scheme enables teachers to wipe out up to five years’ of outstanding student debt if they practise in remote areas for four years. But yet another initiative, called the HECS-Help benefit, which discounted tuition fees for maths, science, teaching, nursing and early childhood education students by almost A$2,000 a year, was phased out from the middle of last decade.

Professor Norton drew a distinction between this scheme, “which simply rewarded people for pursuing the occupation they always wanted to pursue anyway”, and one that rewarded them for “pursuing their chosen occupation in a location that might otherwise be unattractive”.

But he criticised all such schemes for restricting their eligibility to people with student debts. “It rules out migrants and people who paid student contributions upfront, or have repaid their debt already.”

john.ross@timeshighereducation.com