Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

I rise to speak on the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006. One of the more notable things about this year’s budget was how little attention was given to health. Perhaps it was the absence of the Minister for Health and Ageing around the time of the budget—I do not recall seeing him do too many interviews that week. Perhaps the government did not want to create too many distractions from its plan to address income tax bracket creep and superannuation suggestions. But it did lack the drive, the vision and the determination to advance our nation’s health that some had hoped for.

The Access Economics report written for the AMA identifies the budget as spending slightly more than 18 per cent of its value on health outlays next financial year and factors in growth over the forward estimates of 4.5 per cent. The implication is that, as a percentage of total outlays, the proportion spent on health may actually decrease. The situation is even worse for public hospitals, with the budget only providing for 3.6 per cent growth in spending. Health inflation will run well ahead of this figure, meaning a cut in real terms in funding to public hospitals. All this comes with the pressures of an ageing population.

A 4.5 per cent increase would not even renew the government’s subscription to private health insurance. The cost of private health insurance has been increasing year in, year out by seven per cent. It has increased by well over 30 per cent since the year 2000, absolutely eating away at the government’s rebate—cancelling it out altogether. A 4.5 per cent increase is more of an inflationary adjustment—a minor alteration over time to prevent the budget from slipping too far backwards. But the issues our country faces increasingly over time are not likely to be solved with the status quo in real terms, so I cannot say I recognise where the government is heading, other than towards either a decrease in the level of services available to the public or a greater reliance on fees and charges for services from our constituents.

The sale of Medibank Private is an important issue. It is an issue that will affect the way that we look at health in this country. The sale of Medibank Private will have a great impact on the Australian public. The budget has confirmed the sale of Australia’s biggest not-for-profit private health insurance fund, Medibank Private. However, it does not go into how the sale will impact on Medibank Private members. Will there be increases in their premiums? What safeguards have been put in place? The government may well expect competition to reduce, the brakes to come off private health insurance premiums and the annual increases to surpass those of recent years, which have topped seven-odd per cent per annum. I regret that the budget does not instead have a plan to keep premiums in check. It does not have a policy of delivering a sustainable private health system that will not continually rip the incentive out of the pockets of mums and dads, grandmums and granddads across the country. I regret that it does not have any reason for people within my electorate of Hindmarsh to expect not to have their health expectations decreased without paying more and more.

With repeated premium increases well above the CPI, private health insurers are failing to offer value for money products, and the situation may get noticeably worse after the sale of Medibank Private. Many people actually believe they should be paying for private health insurance, if they are able. And they want to be able. They save and go without and scrape together the moneys required to keep often long-term policies going. I fear for those people’s hopes that the sale of Medibank Private will not lead to the loss of their ability to afford to do what they believe is the right thing to do.

The budget allocates some $50 million to a general marketing campaign for private health insurance, which will be jointly funded with the private health insurance sector. When Australians are finding it hard to get a doctor when they need one and hospitals are under pressure, how can this government justify spending $49 million out of the health budget to pay for advertising for private businesses?

On 26 April 2006 the Minister for Finance and Administration said that the sale will increase competition and put downward pressure on premiums. During the 2001 election campaign this government claimed their policies would lead to reduced premiums; however, since 2001 private health insurance premiums have increased by almost 40 per cent on average.

The Minister for Health and Ageing has tried to bury a series of health cutbacks in the budget papers. Under the boasts of increased health spending lie cutbacks that will hurt average Australian families. The biggest hidden cut is a $260 million cut to the Pharmaceutical Benefits Scheme. The budget refers to the cut as a ‘parameter variation’, but this means that budget estimates on PBS spending have been cut because fewer sick Australians are filling prescriptions than were originally expected. This continues a long series of cuts to the health budget, including $1.3 billion from the PBS last year and $500 million from the minister for health’s ‘rock solid, ironclad’ Medicare safety net. While PBS medicine affordability declines, we can expect more hospital admissions and greater health care costs in the future.

This budget also makes cuts to the government’s 2004 ‘Strengthening Medicare’ election campaign, an advertising campaign that cost $20 million. Both the workforce measures and bulk-billing incentive measures for concession card holders and children, which were key aspects of ‘Strengthening Medicare’, have not been funded beyond 2009. This proves that ‘Strengthening Medicare’ was nothing more than a pre-election con, just like the ‘rock solid, ironclad’ guarantee about the Medicare safety net that we heard.

It is clear from this year’s budget that the health minister is not running health in this country. Most health initiatives in this year’s budget are being driven and delivered by someone other than the health minister: 62 per cent of the total health budget is allocated to measures driven by the Council of Australian Governments and 20 per cent of the total health budget is allocated to measures driven by the sale of Medibank Private. The minister for health should be concentrating on fixing our health system and building the health system of the future, a health system that will be prepared for an ageing population.

There are many other areas where this budget did not deliver. It did not deliver on after-hours medical services to take pressure off emergency departments. We have all seen people who do not have a doctor available in their area or who cannot afford to pay the gap turning up at emergency departments and putting pressure on hospitals. The budget should have reinstated the Commonwealth Dental Scheme to get the 650,000 Australians waiting an average of two years for dental care off waiting lists. We all know that dental care is a Commonwealth responsibility; it is clearly stated in the Constitution under section 51 that it is the responsibility of the Commonwealth, along with health. The budget should have redesigned and invested in our medical workforce supply and distribution systems and reformed the relationship between the Commonwealth and state governments to reduce waste and stop the buck-passing and blame shifting in our health system.

There is also the issue of a shortage of doctors. Within Adelaide’s western suburbs the number of GPs has decreased from 280 in 2000 to 193 last year. That is a loss of 87 GPs in the past five years. This trend shows no sign of slowing. The number of practices fell from 164 to 103 in the same period, through either closure or consolidation. According to the Adelaide Western Division of General Practice, which serves 220,000 people, the vast bulk of the decreases in doctors results from retirement. Those left need to work harder to keep up with the demand. The average GP in the area is in his or her 50s, and more doctor retirements can only be expected to make the problem worse.

There are 2,800 training positions available this year through Backing Australia’s Future. There are also 246 available from last year’s ‘Strengthening Medicare’ package. The federal government announced a funding boost of $250 million in early April 2006 to fund new health professional places by 2009, including 400 medical places. The AMA  responded that the shortage is still a long way from being over—160 of the 400 are quarantined within Victoria and the remaining 240 may be accessed by any state or territory, including Victoria. The 240 places will be determined by COAG. Adelaide university wants 40 of those 240 places but Queensland is demanding 325 training places to meet demand. So as you can see there will still be a huge shortage of doctors. We need to be training more doctors to meet the demands, which will only grow with the ageing of the population in the future.

Access Economics has also supported Labor’s view that the minister has failed to deliver an agenda for the future of the Australian health system and has squandered an opportunity to build a reformed health system with a focus on prevention and early intervention that would meet the needs of average Australian families. The Access Economics report describes the Howard government as ‘slow moving’ and explains that the government has ‘passed up opportunities to improve health outcomes’ and is ‘ducking’ areas like obesity and increasing pressures on public hospitals. The 2006-07 budget is full of hidden cuts and squanders the opportunity to fundamentally reform our health system and invest in creating a much better health system for all Australians in the future.

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