Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Hansard source

I move:

That Senate amendments (1) and (10) be disagreed to.

The reasons the government are disagreeing to these amendments are several. One has already been referred to in the brief statement that was made by you, Mr Deputy Speaker Washer, on behalf of the Speaker—that there is a serious issue about the constitutionality of these amendments being moved in the Senate. We have, of course, been on this merry-go-round before. The amendments were moved in a different way in the Senate and we received advice that it was not constitutional. We have already flagged that before. I said in the chamber previously that I was happy to provide that advice. We then received information that governments—ours and previous governments—have always had longstanding advice not to release the actual advice. I have released a minute from the department which details the advice. I have also released and presented to the Senate both that minute and some general advice about the presentation and introduction of items in the Senate that do have financial consequences. So we are having a little bit of a groundhog day again because the opposition are determined to oppose the reduction in the rebate payable for cataract surgery.

We disagree strongly with the opposition’s view on that matter. Nevertheless, if the opposition wants to continue to take that approach on those particular regulations, it is clearly a political stunt. It would be a stunt to try to use any other health bill that might be before the parliament at any time in the future to try to move amendments that are completely unrelated to the substance of that bill. We engaged with the opposition in good faith to negotiate amendments that related to this bill. I think the public would be pleased that the parliament could work in a way to change and improve legislation that is being debated. To use this as an opportunity to pursue another argument totally unrelated to the matter detailed in this bill in a way that is unconstitutional really shows some odd obsession of the opposition with this issue. Senators have given notice that they intend to seek to disallow the measure in the Senate in the coming days. Of course, we will oppose that, but using this sort of legislation—and potentially derailing the introduction of this important compliance measure while we have a fight and argument over something totally unrelated to the bill before us—does not do the opposition or the parliament any credit.

We feel very strongly that it is important for us to be able to, in a bill like the one that is before the parliament now, make sure we protect the integrity of the system. Of course, on many separate occasions, we will be before this House seeking to extend Medicare rebates, pay them for new items and introduce them for new technologies and we will want to be able to reduce the rate that is payable for a Medicare rebate if there are circumstances that show that it is being paid at a rate that is no longer appropriate. If we do not do that, the sustainability of the Medicare system long term will be under threat. The ability of the current government or of governments of the future to fund new initiatives if we can never reap the savings of the benefits of technology, advances in research or breakthroughs et cetera will be hampered. We will have a financial situation and a financial burden in the health system that will not be manageable. As someone who in the previous government held a position of some responsibility for financial matters, I would have thought that the member for Dickson would have absolutely understood this.

I think it was put very well by Dr Rob Walters, as reported in the Canberra Times. Dr Walters is a GP. It is very difficult for people in the medical profession to speak out. They are not interested in attacking each other or in pointing the finger about the sorts of incomes that people earn, but he made this very clear and important point. He said:

The real issue here is the sustainability of public funds—in other words, the Medicare pie … When technology catches up and makes the procedure, as in this case, easier then you move the lines in the pie so funds are available for other health services.

I think that sums up the position that the government take. It is quite clear that we do not support the opposition’s amendments. I think it is obvious that the opposition is this week trying to divert attention onto every possible issue other than the CPRS. That was just another stunt in the Senate. They wasted several hours that could have been used for a better purpose.

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