Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Hansard source

The Senate’s amendments to the Health Insurance Amendment (Compliance) Bill 2009 were an opportunity for the government to see common sense, to admit that its cuts to Medicare rebates for cataract surgery were ill-conceived, ill-considered, short-sighted and punitive to patients, in particular to older Australians. This is now the second opportunity the coalition and crossbench senators have given this government and in particular this minister to reconsider and to restore rebates to their previous levels for what is critically important surgery to many Australians. The Minister for Health and Ageing and the government knew their plans to slash these rebates by 50 per cent were not acceptable to the Senate. They knew for months. Indeed, they have known since 8 September, when the coalition and Senators Xenophon and Fielding announced publicly that they would vote to disallow such drastic cuts to these Medicare rebates. The minister’s response was to do nothing for weeks. Then she started a scare campaign, a deliberate attempt to frighten patients, to say that there would be no rebate at all if the Senate disallowed her changes. That was a claim that directly contradicted evidence given by a senior staff member of her department in Senate estimates hearings. The staff member said that, if the Senate disallowed the changes, rebates would revert back to their old levels. So confusion reigned at the highest levels in the minister’s office and among her senior departmental staff, where there were differing opinions.

The coalition took a responsible course to ensure that there was no confusion and ensure that rebates would be restored. We initiated a private member’s bill that would restore any disallowed rebates to previous levels. We gave the government a simple way out of the mess it had created with its bloody-minded determination to force people to pay hundreds of dollars more for cataract treatment. What was the government’s response? It refused to debate the bill. The minister came into the House to claim that she had legal advice that the bill was unconstitutional. The minister said that she was happy to provide that advice and to this day has refused to make public her so-called legal advice. The coalition has advice from the Clerk of the Senate that directly refutes the minister’s assertion. The Clerk of the Senate said the Health Insurance Amendment (Revival of Table Items) Bill 2009and, as such, these amendments—was perfectly legitimate and that it was in no way unconstitutional. Further, independent legal advice given to the AMA supported that view. Both of those views are on the public record, while the minister’s so-called legal advice is not.

When the Senate refused to allow the government to go ahead with its savage cuts to the rebates and disallowed them, the minister decided she would ignore the will of the majority of senators. She then introduced a new rebate that amounted to a 46 per cent cut to the rebates rather than the 50 per cent reduction outlined in the government’s budget. So, instead of facing extra costs of just over $300, older patients in particular but patients in general in need of cataract surgery were to be just under $300 worse off. That is where things remain today. Australians needing cataract surgery are having to pay $300 or more for treatment than they did just a month ago. Who are these Australians? As I say, they are mostly senior citizens—pensioners, the people who can least afford to pay more for a treatment that is incredibly beneficial to them and allows them to maintain an independent lifestyle. They are cancelling appointments. They are learning that the alternative is to have the surgery carried out in a public hospital and they are learning that they will wait months and months for treatment.

That is what this government has done. It is punishing patients. Its reason for the halving of rebates is that technology has made treatment ‘quicker, easier and cheaper’, in its words. It argues that greedy doctors are being paid too much. But what does it do in the end? It does not punish the doctors; it punishes the patients. It makes them pay more—and all of this at the same time that the Minister for Veterans’ Affairs is declaring that in his portfolio there will be an increase in the rebate payable for cataract surgery for veterans in need of that surgery. It is completely at odds with the advice that the health minister is providing as part of this debate.

Tomorrow, again, the Senate will tell the government that it is unacceptable. Tomorrow the Senate will disallow the government’s hard-hearted reductions of Medicare rebates to patients. Today the government again is being given the opportunity to reverse its course and restore the rebates to the levels of a month ago. The amendments to the Health Insurance Amendment (Compliance) Bill 2009 moved by the coalition and Independent senators Xenophon and Fielding will ensure that Medicare rebates for cataract surgery revert to the higher level. (Extension of time granted)

These amendments have the same effect as the Health Insurance Amendment (Revival of Table Items) Bill 2009. Specifically, they seek to ensure, as did the private member’s bill, that the disallowance process is workable in relation to the General Medical Services Table. The government can end the pain and anxiety it is causing for thousands of senior Australians by agreeing to these amendments. If it refuses, the impacts of its ill thought through measures are on its head. It will stand condemned for its intransigence on this matter and the thousands and thousands of people—in particular, the older Australians—who need cataract surgery will not forget the government’s attitude to them.

The coalition along with the Independent senators will be insisting on this amendment in the Senate. We put the government on notice. They have had plenty of time to sort this mess out. They have refused to negotiate in good faith with the ophthalmologists to try to deliver a better outcome to patients. I am concerned that the government have not been able to put forward any advice in relation to supporting the minister’s advice that these operations are taking much shorter periods of time. There is no evidence the minister has been able to put on the table to back up those claims. This is a perfectly legitimate way for the opposition to proceed in relation to these matters. We are going to hold the government to account, because this is a very serious outcome for older Australians in particular but for those patients who need cataract surgery in general.

I seek leave to table advice from Harry Evans, Clerk of the Senate, which confirms the view that this is a constitutional course of action; and also the advice that has been provided to me that had been provided by Blake Dawson—again confirming the claims made by the opposition in relation to the constitutionality of the action that we have taken. I seek leave to table those two documents.

Leave granted.

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