Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Hansard source

I am being told by the Minister for Local Government, Territories and Roads at the table that this is a long bow. He might want to read his Prime Minister’s statements throughout the 1970s, the 1980s and into the early 1990s, where he opposed the creation of Medibank, opposed the creation of Medicare and then went to a number of elections promising the complete abolition of Medicare. That is his genuine view, whatever view he wanders around publicly expressing now for the purpose of hoodwinking the electorate.

This bill amends the Medicare Levy Act 1986 to increase the Medicare levy low-income thresholds for individuals and families. The dependent child/student component of the family threshold will also be increased. The increases are in line with movements in the consumer price index. The increase to the Medicare levy low-income threshold for pensioners below pension age is made so that they do not have a Medicare levy liability when they do not have an income tax liability. The bill also amends the A New Tax System (Medicare Levy Surcharge—Fringe Benefits) Act 1999 to increase the Medicare levy surcharge low-income threshold in line with movements in the CPI.

The member for Hunter has moved a second reading amendment to this bill. It talks about the big issues in our health system. I will direct some of my remarks now to the contents of the second reading amendment and the reasons it ought to be carried by this House.

When you look across our health system, it is clear that the Howard government is squandering opportunities for reform and cutting back areas of our health system which need appropriate support. The Howard government is committed to the sale of Medibank Private, irrespective of public opinion, irrespective of the impact on premiums and irrespective of what that will mean for the future for people with private health insurance. Polling tells us that the vast majority of Australians want Medibank Private retained in public ownership. As revealed in a recent Newspoll survey, 64 per cent of people did not believe that Medibank Private should be sold. Furthermore, 74 per cent of people thought that the sale of Medibank Private would lead to increased premiums.

It seems to me remarkable that we can have a Prime Minister who will wander out one day, as he did last Friday, and say that the Howard government is backflipping on the sale—the privatisation—of the Snowy Hydro because it has been overwhelmed by public opinion. The only reason the Prime Minister gave for the change in his view about the Snowy Hydro was that he was convinced by the weight of public opinion. If it is public opinion that changes the Prime Minister’s mind when it comes to privatisation issues then the Prime Minister must change his mind on Medibank Private, given that the overwhelming weight of public opinion is against the sale.

We have not seen any indication yet that the Prime Minister is prepared to backflip on the sale of Medibank Private, but if he does not we should all remember for all time that this is a government that ran out and sold an important public asset despite public opinion and in the face of that public opinion. This is a government that is making false and irresponsible claims about the effect of the sale. The Minister for Health and Ageing and the Minister for Finance and Administration are out there saying that the sale of Medibank Private will put downward pressure on premiums. The Minister for Finance and Administration has said that the sale would put less upward pressure on premiums. But all of this is about creating an impression that somehow the sale of Medibank Private will lead to either reduced premiums or, at worst, moderations in premium increases. But we have heard this all before, and it is a pocket of empty promises. This is the government that campaigned for the 2001 election by saying that its policies would lead to reduced premiums for private health insurance, and we have actually seen premiums go up by a staggering 40 per cent in the time in between. When you have a government that once made you a promise which it broke in a startling fashion, why should you believe the government when it makes effectively the same promise in relation to the Medibank Private sale?

We know that the sale of Medibank Private is all about grabbing the money, and our suspicion in that regard has been confirmed by the Minister for Finance and Administration, as recently reported in the Australian. The Howard government wants to earn, and expects to earn, about $1.5 billion from the sale. It is only worried about getting a good price. It is most certainly not worried about the future for Medibank Private premium holders. As revealed in a leaked tender document for ‘Project good guys’, a PR project for Medibank Private, there is a frank acknowledgment by Medibank Private that members are discontented with the sale and they expect a class action. Indeed, there is a frank admission that Medibank Private can give members no guarantees about what will happen to them after the sale. If you rang up Medibank Private today and said: ‘I’m a premium holder; I’ve paid good money over years and years into Medibank Private. What is going to happen to me after Medibank Private is sold?’ the truthful answer that Medibank Private would give you is: ‘We don’t know, and there is no guarantee we can give you. We can’t give you any guarantee about premiums, and we can’t give you any guarantee as to whether or not your policy will be honoured, when you choose to use it or when you have to use it.’ That is a disgraceful position for Medibank Private members to be in.

The government also claims that the sale of Medibank Private will lead to increased competition in the private health insurance sector, yet it is keeping this parliament and the Australian people in the dark about the mechanics of the sale. It seems far more likely than not that Medibank Private will be disposed of in a trade sale, which is likely to lead to increased market consolidation in the private health insurance sector, fewer players and less competition rather than more competition. So the claims about competition are completely spurious.

What is remarkable about all this is that the Department of Health and Ageing do not know, are not involved and do not care about the sale of Medibank Private. In last week’s Senate estimates hearings—the last sitting week—we heard about how indifferent the minister and his department are about the sale of Medibank Private and its effect on its members. Only recently did the department of health confirm that they did not receive a copy of the second Medibank Private scoping study, which determines how and when Australia’s biggest private health insurer will be sold. In answers to questions put on notice in November last year, the department of health have admitted that they are hardly involved in the updated scoping study and will not receive a copy of the report when it is completed. But again last week the department confirmed that they have not commissioned any work on the impact of the sale on premiums and they have no intention of doing so.

It is truly amazing that Australia’s biggest private health insurer could be sold, that the government could sell it and that the department of health and the minister for health are just moseying around like Brown’s cows completely unconcerned about this matter—not even in the loop for information and not pressing to be in the loop. It says something pretty clear about the incompetence of the minister for health that he would rather wander around in blissful ignorance than involve himself in the sale of Medibank Private and in making sure that, whatever happens, Australia’s health system is the best it can be. He has washed his hands of the responsibility to look after Australia’s health system. He has just completely disconnected from the sale of Medibank Private, and that is a gross act of incompetence.

It is not just incompetence in the sale of Medibank Private that we see from this government and this minister for health; the Howard government is failing to deliver in the area of the Pharmaceutical Benefits Scheme, which is obviously one of the major federal government programs to make sure that Australians are kept as healthy as they can be and that they have the ability, through having access to appropriate medication, to be well enough to be participants in the economy and in the community. The Howard government is not worried about health outcomes under the Pharmaceutical Benefits Scheme; instead, it is interested only in slashing the PBS budget and making Australians pay more and more out-of-pocket costs for their essential medicines. This is not about making the PBS sustainable into the future, and it is not about getting expensive new medicines listed on the PBS; it is all about the Howard government’s obsession, as revealed in today’s debate by the member for O’Connor, with the Americanising of our health care system and the undermining of the PBS.

The Howard government introduced a 21 per cent increase in PBS copayments in January 2005 and followed this with the subsequent introduction of a 12.5 per cent generic policy accompanied by a number of special patient copayments and then slashes to the PBS safety net. Since then we have seen the net rate of growth of the PBS drop from around nine per cent to below two per cent for the 2005-06 financial year—lower than the inflation rate of three per cent. That is despite all of the doom and gloom rhetoric of the Treasurer about PBS costs being out of control, being unsustainable, about them going to bankrupt the nation and about having to cut them back—the sort of thing that the Treasurer says very frequently.

As opposed to the Treasurer’s scare campaign, the truth is that the current growth rates in the PBS are lower than the inflation rate—that is, expenditure on the PBS is reducing in real terms. The Treasurer’s drive to slash back the PBS can no longer be explained by real concerns about growth rates in the PBS; it is not about that anymore. It is an obsession about getting rid of what has been a tremendous scheme to ensure that Australians can access medicines at affordable prices. The threat to the PBS in this country is not from runaway growth rates; it is from the Howard government.

We know that many people at the moment need prescriptions for mental illness treatment and to assist them to manage their heart attack risks. They need to take statins, which are drugs to help protect people at risk—especially those with diabetes—from heart attacks. We know that the prescription uptake of statins is going down and that the uptake of a range of mental illness medications is going down. That is not because there has been an outbreak of wellness in our community but because the combined effect of the Howard government’s policies has meant that a category of chronically ill Australians can no longer afford to take their medication consistently—and, of course, in managing chronic and complex conditions, like mental health conditions or cardiovascular risks, medication only works if taken consistently.

The minister and his minions have come up with a whole raft of explanations for the decreasing prescription uptake rate for these Australians. Firstly, they said that the data did not include hospital drugs—it never has. Secondly, they said that the data did not take into account the fact that Vioxx has been withdrawn from sale—this has had no real impact. Then they said that the decline was due to a decrease in the prescribing of antibiotics—once again, this has had no real impact. Then they said that the data did not include drugs with prices below the copayment—it never has. Then my personal favourite excuse that they have managed to tumble out is that the data did not take into account the number of public holidays. What rational human being would say that the number of public holidays is somehow making such a huge change to prescription patterns in Australia? That is just laughable. Public holidays have not changed significantly, although perhaps they will under the government’s extreme industrial relations laws.

But the government’s excuses cannot hide the mounting evidence that increasing numbers of Australians cannot now afford their needed medications. That is going to be a health crisis in the making. If people are not taking their needed medications, they do not suddenly get well. They end up presenting at hospital at some time in the future, sicker than they needed to be. It is just ridiculous. At the same time, the minister for health is sitting on a number of listings for the PBS for drugs that the PBAC, the expert committee that looks at drugs on our PBS, says should be listed. A number of drugs have been ticked off by the PBAC and the minister for health has yet to list these drugs on the PBS—and, once again, that is without explanation.

Finally, I turn to another aspect of the second reading amendment—it relates to a matter raised in question time yesterday by the minister for health—that is, Australia’s medical workforce crisis. We had the minister for health in this place yesterday boasting about the number of doctors he has imported into this country in recent times. He boasted that, in the last 10 months, Australia has approved visas for 1,704 doctors, 2,555 nurses and 1,150 other health professionals. He boasted that we have imported more than 5,000 health professionals into our health service. A country like this turns away more than 5,000 kids each year who desperately want to be doctors and nurses and who are appropriately qualified to take the course. What the minister was boasting about yesterday is actually a national disgrace. We are refusing to train Australians to work in our health system and, meanwhile, we are scouring the developing world to see if we can poach doctors and nurses.

Yesterday the minister for health referred quite hysterically to visa class 457 and said that the Howard government relies on that visa class to import our medical workforce. There was then an attempt by the minister for health to create a scare campaign to say that, under a Labor government, we would abolish this visa class and we would not be able to get these needed health professionals. The truth is that, under a Labor government, we would still be able to issue visas to these needed health professionals. At no point have Labor said that it would abolish visa class 457, but I will tell you what we would do: we would train sufficient Australians to meet the needs of the Australian health system—something this government has not done, will not do and apparently does not believe in doing. The minister for health thinks it is a matter of boast that he imports doctors and nurses. We think it is a national disgrace. We should be training Australians first and training Australians now. With those words, I commend the second reading amendment. (Time expired)

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