Justine Elliot (Richmond, Australian Labor Party) Share this | Hansard source

There certainly are many pressing health matters, particularly in my electorate of Richmond, which has many elderly people. A lack of federal funding for these health matters causes so much concern and ill will amongst those people who, particularly at their age, desperately need extra health care.

I rise today to support the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006 and the amendment moved by the member for Hunter. The bill contains some routine annual amendments to the Medicare Levy Act that are required for the indexation of annual thresholds. The bill amends the Medicare Levy Act to increase the Medicare levy low-income thresholds for individuals and for families. The dependent child/student component of the family threshold will also be increased. The bill also increases the Medicare levy low-income threshold for pensioners below the age pension age so that they do not have a Medicare levy liability where they do not have any income tax liability.

I support the second reading amendment moved by the member for Hunter in this House, which states that the House:

(1)

condemns the Government and Minister for Health for squandering the opportunity to fundamentally reform our health system;

(2)

condemns the Government for failing to invest in rebuilding our health system, including Medicare, for the future, focused on prevention, early intervention and an ageing population; and

(3)

condemns the Government for its failings in relation to our health system, as evidenced by delivering a Budget containing hidden cuts and the related decision to sell off Australia’s biggest not for profit health insurer, Medibank Private”.

As I said, I support this bill and the amendment moved. These changes to the Medicare levy are an annual event and they ensure that people are not disadvantaged by increases to the consumer price index. But it is the lack of funding within our health care system and the massive disadvantages listed in the amendment that I just spoke of that I specifically want to refer to today.

This government and the Minister for Health and Ageing should be concentrating on fixing our health system, a system that has many flaws. In particular, we need a health system that will be able to cater for our ageing population. This really is a pressing issue in the electorate of Richmond. Because 20 per cent of the population is aged over 65 years, health and health care are such important matters. I will discuss this later on.

The recent budget was very disappointing for a variety of reasons but in particular for health. What we should have seen from this government were a number of major health reforms. The first one should have been the restoration of the Commonwealth Dental Scheme, to get the 650,000 Australians waiting for dental care off waiting lists. The average wait for some people is often two years, which is an incredibly long time to wait to get your teeth fixed. It is outrageous that in this country currently people have to wait for two years on average and sometimes for longer.

We also needed to see from the government in the recent budget an investment in our medical workforce supply. We desperately need to have a far greater medical workforce. We also need to see more funding for the PBS. Instead, we got cuts which will greatly impact upon people. A study by Access Economics shows that the budget provided for spending on health will increase more slowly than government spending generally. This means that spending on health will fall as a percentage of all government spending. The budget growth rate in health spending is only 4.5 per cent, which is well below the rate of health inflation.

Given that the government is spending less in real terms on health for each Australian, at the end of the day the result will be that people will have to make up the shortfall by paying for it themselves or, as is often the case, people will have to opt to go without care because they simply cannot afford it. People that I speak to, particularly elderly people, often say that that is the option that they have to choose—to go without care. It is an outrageous situation that families with young children have to make a choice between paying bills or taking their children to the doctor. I quite often hear that this is the case. In this day and age, it is an outrageous situation that families have to make those choices about the health care needs that they are confronted with. It certainly is a worsening situation, particularly for people on low incomes and the elderly.

Access Economics has also outlined that the minister for health has failed to deliver an agenda for the future of our health system by planning for how our health system is going to cope with an ageing population. It really is a lost opportunity to build a reformed health system, particularly a health system that is focused very much upon prevention and early intervention. We really need to see some national leadership on that front, and we did not see that delivered by the Howard government in the budget.

As I said, the government should be providing for the health of our ageing population. It is vitally important. Twenty per cent of Richmond’s population is aged over 65—one of the highest proportions in the country. Inadequate funding for health and also for aged care and the constant cuts to the PBS make it very difficult and very stressful for elderly residents as they desperately try to meet all their health care needs. The Howard government really has a shameful record, particularly when it comes to health. I certainly see it first-hand every day in the concerns that people have.

There are many pressures on local seniors within the electorate of Richmond, especially the 13,000 on fixed pensions. As I said, 20 per cent of the population is aged over 65—one of the highest proportions in the country—so of course our health needs are major. We often hear predictions that, in 2040, 20 per cent of the Australian population will be aged over 65 years. That is in 2040, but in 2006 that is what we have on the ground in Richmond. We have that now. We see first-hand how desperate the need will be and how there is a need to plan for the future, when that will be the situation across the board. We have to get it right on the ground for these people now.

There is indeed a national crisis in our health workforce, and we are not seeing the Howard government doing anything effective to fix that problem. Again, this situation is only going to get worse with an ageing population. Every day, locals tell me about the difficulties they have in finding a GP—and they have lots of difficulties in finding one who bulk-bills. This is a major concern. In all areas, but particularly in regional areas, finding doctors who bulk-bill can be extremely difficult and, of course, very stressful for elderly people.

The full-time equivalent GP numbers monitored by the Department of Health and Ageing show a very critical shortage across the nation. The national average of people per full-time equivalent GP has hit 1,451. The government’s own recommended figure is closer to 1,000 people per GP. The Department of Health and Ageing regards areas with a figure of more than 1,400 as an area of need under the More Doctors for Outer Metropolitan Areas program. The figure for Richmond is 1,314, and the figure for the neighbouring electorate of Page is especially dire, at 1,589.

Given that the Northern Rivers has one of the highest proportions of elderly people in the country, this crisis is worsened. The demand for GPs obviously increases with age. Local GPs are often telling me that, when they are seeing a large number of elderly people, the demands on them are much greater and often more complex because of their health needs. The time constraints often make it very difficult, particularly with the complexity of their health problems.

GP numbers are dwindling as a result of an underinvestment by the Howard government in university places and GP training places. Indeed, the situation is much worse in regional areas because the Howard government does not provide enough incentive to attract them to areas where we desperately need to be seeing more GPs. The situation is exacerbated even more so by the enormous HECS debts that many young doctors now have when they leave university. They often have little choice but to stay in the cities to earn more to pay off these massive HECS debts. They cannot afford to move to regional areas, and the government is not providing enough incentive for them to come to our areas to service the great need for more GPs.

Instead the Howard government is continuing to rely on importing overseas trained doctors. This is a very shameful situation. The Howard government should be providing leadership when it comes to addressing the critical shortage in the health workforce. But the reality is that the Howard government is not providing leadership. The message is clear: it should be investing in universities, training more GPs, training Australians first and training them now. I certainly see first-hand in Richmond how desperate this need is and how we have to have more of them trained.

Another major health issue in Richmond is dental health. This is an issue that I have raised many times in this House and will continue to raise because it is one that elderly people speak to me about constantly. There is a dire need for federal funding for dental health, and under the Constitution it is indeed the responsibility of the federal government. Particularly for those elderly people within my electorate, it is shameful that the Howard government are not prepared to invest federal funding in this area. Let us remember that it is seniors who built this nation. They are the ones who worked hard, paid their taxes and defended our country. They have done the hard yards and they have retired. There is no doubt that the elderly are one of the groups most disadvantaged by the Howard government not providing federal funding for dental care.

As we all know the Howard government scrapped the $100 million a year Commonwealth dental health scheme. The reality is that dental health can affect your overall health. That is why it is so important that people have access to dental health services. In the past, the minister for health himself has said in relation to Labor’s dental health scheme:

The Keating government’s program did reduce waiting times. No doubt about that.

That is the reality. We need to have federal funding back to fix this problem. There are only about 240 public dentists to cater for more than 2.5 million health care card holders, children and the elderly across Australia. This compares with more than 3,000 private dentists that treat the rest of the population. We always hear the Howard government blaming the states. I am sick of their buck-passing. It is time for them to fix the problem. It is their responsibility under the Constitution. They are obligated to provide this dental health care.

It is often heart wrenching to hear stories from people, particularly our local elderly, who are in pain because they cannot access the dental care they need and are often unable to eat. A lot of them are often too embarrassed to even go out because of critical dental problems. I have provided many examples. One of them, Mrs Julia Morton, an 83-year-old pensioner from South Tweed, waited years and years to get her teeth fixed. Eventually she gave up and ended up paying for them herself on her credit card. She says she is lucky because she had some help from her family, but she is concerned for the many other local pensioners who just cannot access that. It is outrageous that she had to wait many years and was being forced to rely on her family to get her teeth fixed so she could actually eat. There are so many pensioners who just cannot afford to get the urgent dental work that they need.

It is not just the dental health of Australians that is at risk—it is not just about getting their teeth fixed; many studies have shown that poor dental health can lead to a range of general health problems, including strokes, heart disease and chronic infections. It can also make diabetes a lot more difficult to manage.

It is time the Howard government stopped trying to pass the buck and showed the national leadership necessary to provide locals with the dental care they urgently need and deserve. As I said, I have raised this issue on many occasions. I would like to see government members stop trying to pass the buck, admit that it is a federal responsibility and take some action. I will certainly continue raising it in this House until we see the federal government prepared to stand by their constitutional obligation and make sure there is funding for dental care.

Another major health concern for Richmond residents is the Howard government’s constant attacks on free prescription medicines, which also puts the health of my local elderly at risk. We have basically seen a war being waged on our PBS by the health minister and the Treasurer. This has resulted in a dramatic drop in the number of prescriptions being filled. Indeed, 2005 saw a drop in the number of scripts being filled. Almost two million fewer scripts were filled in 2005 compared to 2004, and the trend looks set to continue in 2006. Two million fewer scripts is a huge amount. With an increasing as well as an ageing population, such as in Richmond, it is quite crazy to argue that people would be requiring fewer medicines, because in fact they need more. The reality is that they just cannot afford to access them.

The health minister’s mismanagement of our PBS has also led to delayed listings and a significant drop in the number of scripts being filled. Many groups have been calling on the health minister to expand PBS access to some cholesterol-lowering drugs. This matter has been with the health minister for over two years. In July the PBAC will assess an application for Herceptin, which assists with breast cancer, to be listed on the PBS. How long is it going to take the health minister to enact a recommendation for Herceptin, which is so desperately needed within the community? Just last week a local woman, Trudie Douglas, came to see me. She has advanced breast cancer and desperately needs to access Herceptin. Her husband, Ian Douglas, was involved in a serious car accident on New Year’s Eve and obviously also has his own very complex health needs. They are in a situation where they just cannot access Herceptin. They may have to sell the house. They are looking at $60,000 to get access to Herceptin. It really is a heart-wrenching situation. It is people like Trudie Douglas that need to see the health minister doing something about their health needs. We have had so many different groups calling on the health minister to make sure that action is taken to have Herceptin placed on the PBS so that women like her can access decent health care. This attack on the PBS does put the health of local elderly at risk.

Another example I would like to speak about is the removal of calcium from the PBS, which we saw last year. There was a huge outcry in relation to this, particularly in my electorate. We held a major forum where so many people spoke about their concerns about it being taken off the PBS. It was because of this community campaign and because of the pressure that was put on the health minister right across this country that calcium was returned to the PBS—but just for renal conditions, not for osteoporosis. Those people suffering from osteoporosis—or those who want to prevent it, as we have been told we all have to do—desperately need to have access to calcium. It is shameful that the Howard government does not put calcium back on the PBS for those suffering from osteoporosis. Again, this very much affects the elderly in my electorate, who desperately need to access calcium.

As I said, we saw so many cuts to the health budget, including the $1.3 billion cut from the PBS last year and the $500 million from Tony Abbott’s ‘rock solid, ironclad’ Medicare safety net. While PBS medicine affordability declines, we can expect at the end of the day to see a lot more hospital admissions and greater health care costs in the future because that money is not going into prevention and early cures. We are going to see much worse health conditions. We also saw changes in last year’s budget that greatly impact on pensioners, who now have to wait until they use 54 scripts a year before they are entitled to free medicine, with this number going up to 60 by 2009. All of these changes to the PBS make life so much harder for the elderly, who of course are very stressed with their complex health problems.

Another issue I wanted to speak about was the sale of Medibank Private. The Howard government is committed to the sale of Medibank Private. There are certainly many concerns about competition and also about health insurance premiums and how much more they are going to rise once it is sold. Families and pensioners are already doing it so tough, with petrol prices increasing, interest rates going up and wages being lowered due to the government’s extreme industrial relations changes. Now, on top of that, we are going to see health insurance premiums go right up, with the sale of Medibank Private.

The government are going to spend a huge amount on a major marketing campaign for Medibank Private. I think it is incredibly unfair. When Australians are finding it hard to get to a doctor and our hospitals are under pressure, how can the Howard government justify spending millions on the sale of Medibank Private? A number of months ago we saw the Medibank Private office in Tweed Heads close, which greatly impacted—

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