I met her at a pharmacy in the Goldfields. She was from Malaysia, recently married, and expecting her first child. By her own reckoning, she was about 12 weeks along, though she had not yet seen a doctor. She holds a Temporary Graduate visa after studying here, and her husband, who is also trained in Australia, has an accounting degree. On paper, they are precisely the young, qualified, English-speaking couple the skilled migrant program is meant to attract. In practice, they are struggling: living on very little, setting aside almost everything for the cost and score of a permanent application while still sending money home.
They are in the Goldfields by design. Her husband works as a chef because hospitality roles are on the state and regional nomination lists, and because living and working in regional Western Australia attracts points towards their migration score. He is aiming for a total near 95, the kind of score the current rounds reward. Between them, they have arranged their whole lives, including where they live and how they work, around the arithmetic of remaining in the country.
His wife, meanwhile, had not seen a doctor. She had come to the pharmacy instead because a doctor’s consultation carries a fee, and they had chosen to avoid it. When she described what she had been feeling – cramping, some bleeding, and spells of dizziness – the grounds for concern were immediate. She is not covered by Medicare because Malaysia has no reciprocal health care agreement with Australia, and, as a Temporary Graduate visa holder, she would ordinarily not be eligible.
She is, in the language of rural health, a priority population: culturally and linguistically diverse and under real financial strain. She is also something that language rarely acknowledges: part of the workforce that rural Western Australia cannot function without. The region runs on people like her and her husband, in hospitality and other services that keep towns going, and, above all, in health care itself. As of late 2024, international medical graduates made up 53.5 per cent of the general practitioners working across rural WA, and two-thirds of those who joined the workforce that year. Rural WA also depends on overseas-trained specialists, visiting medical officers, and locums to keep its hospitals open, and most of the state beyond Perth is classified as a workforce shortage area. Remove the temporary migrants and the country health system does not thin. It stops.
Here is the difficulty the theme exposes. Rural WA relies on temporary visa holders to deliver care. Yet, shuts those same visa holders out of it. The two ends of that policy sit in the same town. The overseas doctor who might have examined this young woman is likely in the Goldfields, because overseas-trained doctors have long been steered towards underserved areas by Medicare billing restrictions- restrictions the same Medicare she cannot access. She and her husband, meanwhile, are not building the safety net the system provides for everyone around them; they pay the full cost of a doctor themselves, so they go without. They fill the shortages the state advertises, in the towns least able to attract anyone else. If rural health is serious about priority populations, it cannot keep overlooking the one holding the system up. In obstetric care, the delay that follows is measured in more than money.
It’s 4am, and I’ve been awake for 22 hours. My shift started at 2:30pm and the surgeries haven’t stopped all Read more
Rural mental health professionals face unique challenges – from professional isolation to high caseloads and limited peer support. But innovative Read more
Growing up in rural Queensland instilled in Dr Prue Wallin resilience, compassion, and a deep respect for community—values that shaped Read more
In the Kimberley region of Western Australia, community and connection go hand in hand. At ‘far north Community Services’, a Read more