Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Hansard source

I rise to speak on the Medicare Guarantee Bill 2017 and the Medicare Guarantee (Consequential Amendments) Bill 2017. Let me be clear: while these bills might have 'Medicare guarantee' in their names, they do not do anything to actually guarantee Medicare. They are a sham, with no guarantee of policy stability and no guarantee of additional funding. In fact, at the same time as the government announced their Medicare Guarantee Fund in the budget, they were locking in cuts of billions of dollars to Medicare.

To understand why this fund is such a joke, we need to look at the government's approach to health, starting with the government's Medicare freeze. The former Prime Minister put in place a Medicare freeze in December 2014. It was the current Prime Minister who extended it to 2020. While this freeze has been in place, we have seen impacts on bulk-billing, with GPs saying they can no longer afford to bulk-bill all patients, and out-of-pocket costs soaring. For years GPs, specialists and health experts have been sending a clear message to the government: the freeze is hurting now and it should have been dropped a long time ago. This is what the AMA said during the election; I quote the AMA president: 'We know there are some GPs that are changing their billing practices. That commences today, on 1 July. The reality is that there are a lot of GPs who decided they could probably take the hit for a couple of years, but they are saying enough is enough.'

And still, after all this evidence, did they drop the freeze immediately? No. Australians will have to wait years until the freeze is finally dropped. These are not the actions of a government that understands the impacts of its health cuts and listens. These are the actions of a government that wants to pay lip service to the idea of doing something, but cannot bring itself to do the right thing. We know the impact the freeze is having on access to GPs, with bulk-billing for GPs dropping since the election and out-of-pocket costs skyrocketing.

But it is not just in the GPs' waiting rooms. It also impacts Australians who need specialist care. In the past 12 months 40 per cent of Australians needed to see a specialist. That is around 7.4 million Australians who need to see a specialist each year. But more than 600,000 Australians will delay seeing a specialist at least once because of the cost, with those in low socioeconomic areas more likely to delay because of cost. Keeping the freeze in place will continue to impact Australia's sickest and most vulnerable patients, such as people undergoing oncology treatment, children needing paediatric care and people undergoing dialysis.

The decision in this budget to keep the freeze in place for years comes when out-of-pocket costs for specialists have skyrocketed. Only last week, new data showed that on average patients are paying an extra $24 out of their own pockets every time they visit a specialist. That is up 42 per cent since the government introduced their freeze in December 2014. Every day the government's freeze continues is another day that Australians will pay more for vital health care.

The budget is woefully inadequate when it comes to hospitals funding. It was a bitter disappointment for our public hospitals that the government did not allocate any additional funding to address the blowout in elective surgery wait times or the queues in our emergency departments. Our public hospitals are in crisis under this government. Elective surgery waiting times are the worse they have been since records began to be kept in 2001. Patients presenting to emergency departments requiring urgent medical attention are being left in emergency departments for too long. In the last financial year, only 67 per cent of emergency department patients classified as urgent were seen within the recommended 30 minutes.

Critically, public hospital capacity is not keeping pace with population growth and is not increasing to meet the growing demand for services. The government's budget has done absolutely nothing to do this—nothing for elective surgery and nothing for strained emergency departments. And not only that; the government has changed the funding formula for 2021, meaning public hospital funding will revert to the level set in the disastrous 2014 budget without a new agreement.

In another sign of the government's appalling approach to public hospitals the Medicare Guarantee Fund does not even include public hospital funding, long considered an integral part of Medicare. How can this fund come close to guaranteeing Medicare when it does not even include hospital funding. Let's look at what this fund does. This fund simply changes the manner of appropriating funds from the budget for the purpose of paying MBS benefits and PBS payments. Currently authority to appropriate funding from the consolidated revenue fund, the only fund that constitutionally exist for the purpose of MBS benefits, is granted through the Health Insurance act 1973. Similarly, authority to appropriate funding from the consolidated revenue fund for the purposes of the PBS payments is granted through the National Health Act 1953. So, basically, the way the system works now is that the funds from the budgets are appropriated through the authority granted by two pieces of legislation directly for the purpose of MBS benefits and PBS payments.

What these bills will do is change this so that the consolidated revenue fund will be appropriated directly—firstly into the Treasury special account, then into the health special account and then on to MBS benefits and PBS payments. Former Health Secretary Stephen Duckett said: 'The Medicare Guarantee Fund is nothing more than a rebadging exercise. It changes the badge on a policy in the hope people might think it is a new policy.' Does this fund guarantee the government will not cut Medicare? No, it does not. Does this fund guarantee the government will not cut hospitals? No, it does not. Does this fund guarantee that the money the government will save through PBS price disclosure arrangements will be reinvested in new medicines? No. Once again, this is another example of desperate smoke and mirrors in an attempt to distract from the fact that the government is cutting billions of dollars from Medicare.

Only Labor can be trusted to fight for Medicare. Only Labor can be trusted to protect Medicare. So that is exactly what we are doing—introducing an amendment that will properly protect the future of Medicare. This amendment will mean the bill cannot be considered until funding to support universal access to public hospital treatment is included in the Medicare Guarantee Fund. As I have noted, it beggars belief that hospital funding, a core pillar of Medicare, has been left out of this fund. This is yet another sign of how this government approaches public hospitals with neglect and disdain. The government has also failed to properly invest in public hospitals, with their budget confirming they plan to return to the disastrous funding formula of the 2014 budget in the 2020-21 financial year. There is a reason this funding formula was so widely rejected and why it needs to be rejected again. The amendment will guarantee immediate and annual indexation of Medicare rebates that have been frozen by this government, including GP rebates and rebates for specialists, consultations, procedures and allied health services. Every day the government's Medicare freeze remains in place is another day that Australians will pay more for critical health care.

Finally, given that we know this government cannot be trusted with anything on health, this amendment will mean that the bill cannot be considered until there is a guarantee that savings from the Medicare Benefits Schedule review and agreements with stakeholders will be reinvested in Medicare and not used as an excuse for further cuts.

This government is hell-bent on gutting Medicare through any means possible. At the last election, Labor committed to reinvesting every single dollar of savings found through the ongoing Medicare Benefits Schedule review back into Medicare. The government has not made the same undertaking, and we know that they will cut into Medicare if they get their way. If the government votes against any of these amendments, it will be more confirmation that their budget was a complete sham. With their disastrous record of cuts to health and Medicare, we know the government can never be trusted to do the right thing.

I understand the amendment has been circulated. I move:

Leave out all words after "that" insert:

"the bill be withdrawn and redrafted to provide actual guarantees for the future of Medicare, specifically by:

(a) setting out the purpose of Medicare, namely to provide a universal public health insurance scheme that provides access to medical, pharmaceutical and public hospital services based on clinical need, not capacity to pay;

(b) including funding to support universal access to public hospital treatment, along with medical and pharmaceutical benefits, in the purpose of the bill;

(c) guaranteeing immediate and annual indexation of Medicare rebates that have been frozen by this Government;

(d) guaranteeing proper Commonwealth investment in public hospitals, so that all Australians can access acute care without financial or other barriers; and

(e) guaranteeing that savings from the Medicare Benefits Schedule Review and agreements with stakeholders will be reinvested in Medicare, and not used as an excuse for further cuts."