Kim Wilkie (Swan, Australian Labor Party) Share this | Hansard source

The Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006 includes changes to the Medicare Levy Act 1986 to increase the Medicare levy low-income thresholds for individuals and families. It also increases the Medicare levy low-income threshold for pensioners below pension age so they do not attract a Medicare levy liability where they do not have an income tax liability. The member for Hunter has articulated Labor’s support for the bill as presented to the House. He has, however, moved an important second reading amendment, which I support and which I have no doubt will attract the support of many in my electorate. The member for Hunter’s amendment reads:

... 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”.

The government’s decision to sell Medibank Private is a disgrace. It comes on top of 10 years of neglect of our health system, the virtual extinction of bulk-billing doctors and the axing of the Commonwealth’s dental program.

Let us just look at how the government has gone about considering the sale of Medibank Private. Its own report suggests that there will be such a huge public outcry and backlash that it will need to go about this very carefully and fund an enormous advertising campaign to try and get away from the fact that it is withdrawing this service from public ownership and selling it off to private enterprise. This is outrageous. It goes to the very heart of what this government is all about. It is mean and tricky and out of touch. It knows that the population is absolutely opposed to the sale of Medibank Private, but it intends anyway to sneak this through and, in order to try and justify doing so, fund an enormous advertising campaign to con people into believing that this is good for them. We all know that, when this government advertises programs, it is trying to pull the wool over people’s eyes. You have only to look at the amount of money that it spends in the lead-up to an election, trying to sell its dud policies and programs, to know that it is trying to rip us off. This is exactly what will be the case when it is looking at introducing the sale of Medibank Private, which it knows the public does not support.

A number of years ago I presented a petition, signed by thousands of my constituents, calling for the establishment of a Medicare office in Belmont. The federal government continues to ignore this call. With a regional population of 31,500 people, and located nearly 10 kilometres from the nearest Medicare office in Swan, which is in Cannington, the city of Belmont needs a Medicare office of its own. Local residents have been inconvenienced for far too long. Having a Medicare facility in Belmont would mean that, after visiting local medical services and facilities, patients could claim rebates quickly, easily and close to home. The electorate of Swan desperately needs this Medicare office in Belmont to serve the people of the area. At the moment, there is one Medicare office in the electorate, which, as I said, is located in Cannington, leaving the northern part of the electorate completely unserviced except by agencies located in chemists in Victoria Park and East Victoria Park. As members know, while a Medicare claim form can be lodged at an agency, any more complex issues must be dealt with at a Medicare office. It is invariably the elderly, those with young families and those with disabilities for whom the more comprehensive services of a Medicare office are required.

Having gone to the Medicare office in Cannington on numerous occasions myself, I know that they are overstretched and really struggling to meet the demand. It is not uncommon for the queue of people waiting to get their claims processed to be at least 40 to 50 metres long, snaking not only through the office but out into the shopping centre. Of course, this is outrageous. Many of those people are elderly, and they have had to travel long distances just to get there and have their claims processed. As I said, my electorate is home to many such people who rely on public transport and cannot travel great distances. It is simply unacceptable for them to have to travel over 10 kilometres to Cannington in order to access the services of a Medicare office. Indeed, some constituents have told me that it can take more than two hours on public transport for them to attend the Cannington office from the Belmont area. As I said, they then have to stand in line, waiting to get their claims processed.

Quite clearly, locating an additional Medicare office in Belmont would enable the needs of the regional population of 31,500 to be met far more effectively and would make a significant, positive difference to their lives. Under Labor’s election policy at the last election, we committed to providing a Medicare office in Belmont. Unfortunately for the electorate of Swan, the coalition made no such commitment. On behalf of the residents of the northern part of the Swan electorate and particularly the elderly, the chronically ill and those with disabilities, I urge the government to reconsider this worthy proposal in the future.

The reality is that the Howard government does not believe in bulk-billing or Medicare. This is the government that initiated cutbacks to GP training in 1996 and now sheds crocodile tears over the lack of doctors in the bush. Its big answer is to bring in people from overseas, when it should have been training our own people up—it knew that there was a shortage back in 1996.

This is the government that has denied the elderly access to dental treatment after abolishing the Commonwealth dental program. Let us just dwell on that for a second. As has previously been commented on in this debate, if you are elderly and you have real problems with your teeth, you cannot eat solid food. And, if you cannot get dental treatment, you are stuck eating food that you would normally feed to small children. I think it is absolutely unacceptable that, in this day and age, people who have retired, who are normally on a pension, cannot get access to decent dental care. It is outrageous and unforgivable that this government axed that particular program.

The Commonwealth has also removed free hearing aids and hearing services for health card holders, another outrageous development over the last few years. Also, massive price hikes for PBS medicines have outstripped pharmaceutical allowance increases.

Just last December, we saw this mean and tricky government remove calcium tablets from the PBS for all but those patients with renal conditions. The decision by the Minister for Health and Ageing to do this was in direct contravention of the advice of the Pharmaceutical Benefits Advisory Committee and will impact severely on older people with osteoporosis. Here we have a committee, the Pharmaceutical Benefits Advisory Committee, that is set up to look at what sorts of programs and drugs should be funded. It makes the determination that this particular product should be available, and the minister says: ‘No, I’m going to take it off. I don’t care about these people. It’s going to cost money, so they’re not going to have it.’ Again, this is just outrageous.

Bulk-billing has suffered under the 10 long years of the Howard government’s mismanagement. Since 1996, 110 federal electorates have seen a decline in their bulk-billing rates; 52 federal electorates have seen a decline in their bulk-billing rates of 10 per cent or more; and six federal electorates have seen a decline of 20 per cent. In 1996, the average rate of bulk-billing was steady at 80 per cent nationally. In 2005, the bulk-billing rate has struggled to reach 74 per cent after a substantial cash injection. The Minister for Health and Ageing, Tony Abbott, has trumpeted weak improvements in bulk-billing rates in some electorates between 2004 and 2005, but the 10-year comparisons show that one year’s improvement does not make up for the Howard government’s long-term neglect of Medicare and bulk-billing.

The Howard government’s bulk-billing policies at the last election focused only on providing incentives for GPs to bulk-bill children and concession card holders such as pensioners. Newly released data shows that these policies have had a very small effect on the overall bulk-billing rates and have not improved access for the broader community. Note that the Howard government also increased the Medicare rebate for GP services from 85 per cent of the schedule fee to 100 per cent of the schedule fee, but this extra payment was not tied to bulk-billing.

The so-called Medicare safety net was put in place to assist families with high health care costs, in particular those with chronic conditions who faced the burden of growing out-of-pocket costs. However, the so-called Medicare safety net has done little to make health care more affordable or accessible, as it has not improved the ability of lower income individuals or families to access care in the first place. The Medicare safety net does nothing to address the impact of 10 long years of Howard government incompetence on out-of-pocket expenses or costs. Since 1996-97, the out-of-pocket costs of seeing a GP have almost doubled from $8.50 to over $15.

In my electorate, there has been a real need for GP after-hours services. There are clear reasons why we need this service. Over 166,000 people live in the district. Of the 63 GP surgeries, only 13 offer more than five hours a week of extended services—that is, they are open after 6 pm on weekdays or after 2 pm on Sundays or public holidays. Of the 63 GP services, only three offer nine hours or more of service on Sundays and public holidays. There are no formal after-hours primary medical care clinics at all, and there are no public or private emergency departments in the precinct. The general practice division has the lowest doctor hours of service of all metropolitan general practice divisions in Western Australia.

The need for an after-hours primary care facility is critical when you consider that over one-third of presentations to public hospital emergency departments from residents in this division were GP type presentations. Sixty-seven per cent of respondents to a consumer survey indicated that they would use an after-hours service rather than attend a hospital emergency department. In fact, the local Division of General Practice applied for a grant to open up a GP after-hours clinic, and the government knocked back the request. They sat on their hands for months and months. It was not until I raised this issue in the House some time ago that the department said that they had decided they were not going to fund that particular service, which was an outrage. Since I made that speech, to their credit, the Canning Division of General Practice opened a facility in Bentley, albeit without any federal assistance, and they are trying to cater for some of the needs of the people who are there; unfortunately, they are struggling. They really needed to get that grant in order to provide the service in a very comprehensive way. We really need to address these issues, because those people need to get that sort of service. Whilst they are getting it now in a limited way, provided by the GPs themselves, it is about time the Commonwealth owned up to its responsibility and put some money where its mouth is with regard to GP after-hours services.

We will support this bill, because it does go in some small way to providing some relief. But, in real terms in my electorate, the government needs to start looking at reintroducing funding for programs that can address dental health for the seniors in my electorate, provide adequate GP after-hours services and ensure that the Medicare office in Belmont is established. The need is there; people are crying out for the service and it is high time the government listened.

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