Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

The reason for today’s MPI is fundamentally an issue of deceit. It comes across very rarely in politics that you have true barefaced deceit and this is just one of those moments. If you read out the statements by the then opposition health spokesman and the then aspiring Prime Minister, it is absolutely cut and dried. Ordinary people who do not live in this chamber or watch it every day will see the promises and the commitments made in private health to have been rock solid guarantees. You have erosion of that and the kind of deceit where you simply turn about on what you claim before an election in order to win and then tear it down immediately after. You see it very rarely. That is why it has to be highlighted and it will be today.

The second issue here about changing health outcomes being a slow process is quite right. But it was not this side of politics that went to the Australian people and said: ‘We will set a deadline. We will put a line in the sand at full time—to use a football analogy—and, by June 2009, we will be taking over the health system if there are not substantial improvements.’ Look at the words very closely. They did not say, ‘If there is not more investment put into health then we will take over.’ They simply said, ‘We will fix the health system.’ Those blanket promises were taken very seriously by Australian voters. They trusted in the Prime Minister that we would see a change. What you are witnessing today if you are listening in to this debate is a complete shift from outcomes in health that mean so much to every Australian to inputs. Now we have a Prime Minister who is utterly focused, more as a bureaucrat than a leader, on inputs. They are really just trying to conceal the very fact that the health system has not been improved at all. We can promise these enormous amounts of money from billion-dollar funds, from sources which the average Australian does not understand, but that is not making our health better.

If you go right down to my community, where we expected a change in health outcomes, they were promised a new helipad on top of the hospital. It sounded great. But it did not improve the health of the local community, so they built a waiting room for the waiting room. That didn’t improve things, either. The fundamental misunderstanding here is that inputs do not always mean improvement in outcomes.

In the time I have available I want to touch on five issues. PHI will be the main one, and the final one, but let us just look at what has been an utter fixation, verging on needing medical attention, on alcopops. When it comes to health, this government has virtually given no attention to anything except alcopops. We effectively have a minister for alcopops in this government who has abrogated any responsibility for the health system. On smoking, the perfectly legitimate proposal was put, as an alternative funding measure, to increase the tax by around three cents per cigarette. You would have thought the politburo of left-wing health economists would have rallied behind that but, no, they remained mute and this government refused to accept a simple proposition that could have supported our private health system.

I move on to cataracts. I did not choose a life as a cataract surgeon; I chose one here. But I know that many cataract surgeons across Australia spend enormous amounts of time delivering these kinds of services and making a loss in remote and rural areas. These surgeons will tell you, if only the government would listen, that it becomes virtually uneconomical to perform an operation for a Medicare rebate that is less than the mark-up on a pair of designer spectacles from an optometrist. Eventually, if you just keep trying to slash capacity and squeeze funding, there will eventually be some sort of kickback in quality. Without meaning any offence, what we have, effectively, is a health minister who is so far down in the caucus pecking order that it is unlikely we are ever going to get meaningful reform of health. That is just a political reality, and that may well be Australia’s lot for the next three years.

The greater problem here is that we have a health minister who is hostage to Treasury. We have a health minister who is selling Treasury cost-cutting measures more vigorously than any other form of health reform. It seems like the only things that come through the current health minister are basically Treasury minutes to save money. It is quite okay to say we have a global financial crisis, but let me make two points. First of all, there was, effectively, no means testing of stimulus payments. There was no targeting of stimulus payments towards those who needed them most. People who did not pay tax, the disabled and the unemployed effectively missed out. If your philosophical interest is one of looking after the battler, you would think you would have a concern with the stimulus payments and then you would think you would have some solutions after 18 months. When you choose your own deadline on performance, you would think we could see some improvement. I can show you every health report card that has come out in the last 18 months, and there are no significant improvements. That is a real problem for the government. Just ask all of the groups—they have been asked to comment. We know from the Private Hospitals Association the impact these changes will have. We know from the surgeons the impact they will have on waiting lists.

I want to draw attention to the changes to PHI and what they will do to the poorest of Australians. This is so detached from the government’s thinking that they do not realise that when people move from private cover onto the public system, for whatever reason—number them in your thousands if you wish—those people queue up at public hospitals or they turn around and elect to pay a much bigger gap. This is the great challenge of health delivery in all developed countries: even with insurance, there is a gap. What this health minister is doing is making those gaps for ordinary Australians chasing a cataract operation so much larger. What happens when gaps go up? The wealthy pay the gap and the poor do not. So what this health minister is doing in nickeling and diming the average Australian who is paying for their private health cover is simply guaranteeing that the wealthy can still pay for a one-off operation without paying private healthcare, and let it be someone’s grandparents, and the people who cannot pay that even greater gap miss out. A stark reality is that when you scrimp and save on Medicare rebates, the alternative to cataract surgery is blindness; the alternative to other ailments is untreated morbidity or early death; or the alternative is fewer quality years. It is quite a simple equation.

What we know from the report cards from the AMA is that there has been no improvement in the time the Prime Minister promised an improvement. We know there is no improvement in hospital beds, we know things are getting worse with cost adjusted separations and we know that people are waiting longer in the waiting room. We know there is juggling of waiting lists to make it better, but I think everyone listening to this debate knows that we are not seeing the improvements that we need to. I can almost imagine a conversation between the current health minister and the Prime Minister: ‘It is June 2009; where are we now with improvements in health?’ ‘Well, we have been really focused on the alcopop measure, and I need to remind you that that was a health measure, to reduce binge drinking. We have no figures on that whatsoever. We have a binge drinking problem that we had two or three years ago. We just have ordinary Australians drinking less alcopops.’ ‘Okay, well, we might need another reason.’ ‘Well, we have a prime minister out looking for hair dryers in Afghanistan and flying around the world annoying flight attendants, and he really has not been able to truly turn his mind to health the last 18 months.’ Once again, he made the promise to the Australian people of significant improvements in health.

Finally, what we have under the cloak of secrecy and hidden in the detail of the budget are these slashes to the very promises that were made before the election. Ordinary Australians have picked it up. They remember the promises. They did not have to be listening to the radio; they know the promises and they know that they are not being kept. To suggest that Australia is on the one hand performing so well in the global economic crisis and not slipping into recession but that at the same time we cannot afford to deliver basic health care is that dishonest contrast that I think becomes obvious to the Australian people. In answer to the health minister, who said ‘I don’t see why as a government we should be helping people earning over $75,000, tapering to $120,000’, the answer to that is simple: all around the developed world we have had one fundamental tenet in the delivery of social policy, and that is that we do not means test access to health. It is just one area where we try to keep some semblance of equity. That distributive notion upon which I thought that party was founded is actually disappearing. Sure, they can start to attack health, and the next moment they will be means testing education, and then they will be means testing welfare even more. This is the slow and steady creep of Labor ideology successfully veneered over by the Prime Minister at the last election campaign but it is now coming through. It is a very important to point to make, and it has been made in this MPI, because today marks that line in the sand—the promise made by our Prime Minister has not been kept.

In closing, as we go around the country people will see that where there was a promise for improved health care it has not happened. Where there was a promise to protect PHI we have seen thousands of families who are effectively going to be pushed off that cover, and that will have a snowballing effect. It affects people who otherwise were contributing large amounts of money out of their own pocket into health care; it affects those under $75,000, who have to pay higher rebates, and that is completely obvious; and, most concerning of all to me, when it comes to access to surgical services and waiting lists, he or she who can pay the gap will get the service. This is not the health system that anyone in this country deserves. (Time expired)

See this speech in context