Craig Thomson (Dobell, Australian Labor Party) Share this | Hansard source

I rise to support the Fairer Private Health Insurance Incentives Bill 2009 [No. 2], the Fairer Private Health Insurance Incentives (Medicare Levy Surcharge) Bill 2009 [No. 2] and the Fairer Private Health Insurance Incentives (Medicare Levy Surcharge—Fringe Benefits) Bill 2009 [No. 2]. It is with blinding hypocrisy that we hear the opposition spokesperson on health trying to give this parliament and the government a lecture in relationship to health and the merits of the two parties as to where they stand on their records with the health system. What the Australian people know, what this parliament knows and what is plain to everyone is that when the former Howard government was in charge of the Treasury benches what they did, when the now Leader of the Opposition was the health minister for four years, was rip $1 billion out of the health system.

The contribution of the former health minister, now opposition leader, was to make it harder for public hospitals to operate and harder for them to deliver the services that Australians expect. He also presided over putting a cap on the number of GPs which also led to shortages of GPs in electorates like my own, something that this government has rectified. It is an amazing contribution that the opposition spokesperson on health made today to claim that Labor cannot be trusted when it comes to health care versus the position that the former government took on health. I will come back in a little bit more detail to some of those issues.

What is clear from the opposition spokesperson on health is that last year not only did he give up on his electorate but also he gave up on tough health reform. It is a pretty sorry state that he is still remaining as the shadow health spokesperson when he clearly does not have his heart in that job either.

The government is again seeking to rebalance its range of policies supporting private health insurance. Under these bills for low- and middle-income earners the private health insurance rebate will remain unchanged. Higher income earners will receive a reduced rebate. As income increases the rebate will progressively fall. The changes to the Medicare levy surcharge will encourage higher income earners to maintain their private health insurance. These reforms will provide a fairer distribution of benefits bringing government support for private health insurance in line with the principle underpinning the Australian tax transfer system that the largest benefits are provided to those on the lower incomes.

Currently approximately 14 per cent of single taxpayers who have incomes above $75,000 receive around 28 per cent of total private health insurance rebate paid to singles. Under the new reforms these single taxpayers will receive about 12 per cent of the total PHI rebate paid to singles. Similarly, approximately 12 per cent of couple taxpayers who have incomes above $150,000 currently receive approximately 21 per cent of total PHI rebates paid to couples. Under the new reforms these couples will receive around nine per cent of the total PHI rebate paid to couples.

Treasury modelling estimates that under these reforms 99.7 per cent of people are expected to remain in private health insurance. While the opposition spokesman on health will tell us that the world is going to collapse and that everyone is going to leave private health insurance, that simply does not stack up when economic modelling is done. I repeat: 99.7 per cent of people are expected to remain in private health insurance. This is because those high-income earners who receive a lower rebate will face a higher tax penalty for avoiding private health insurance. This is supported by a recent Ipsos survey which demonstrated that, when people are fully aware of the changes made, only 15,000 people will drop out of insurance. This is actually 10,000 fewer than what the government estimated when we first introduced these bills into parliament.

Private health insurance has shown to be a resilient product. In the latest September quarter figures the coverage of health insurance has grown to 46.7 per cent, up 0.2 per cent on the June quarter. This demonstrates that the government policy changes are not having an impact as predicted by the opposition. The saving from this measure has increased by approximately $90 million to $2 billion over five years from the estimated savings published in the 2009-10 budget, which was $1.9 billion. This is due to an upward revision in the estimated government expenditure on the private health insurance rebate published in the 2009-10 Mid-year Economic and Fiscal Outlook.

While most private health insurance rebates are now expected to be paid, increasing the cost of the private health insurance rebate to the government, the average size of each additional rebate will be smaller if this measure is passed, thus increasing the save from these measures. The estimated increase in government expenditure on the private health insurance rebate published in the 2009-10 Mid-year Economic and Fiscal Outlook—$276 million in 2009-10 and $1.1 billion over four years—underscores the need to implement the government’s reforms to reduce the long-term cost to the budget of a quickly growing expenditure and ensure that support for private health insurance remains fair and sustainable into the future.

It never fails to amaze me how those on the other side constantly come here and express concerns about our public hospitals, the dental system and our health system generally. When we think back to what the former government did by ripping billions of dollars out of the public health system and closing down the Commonwealth dental scheme, the opposition has no credibility with anyone when it comes to health. The government is rebalancing its range of policies supporting private health insurance so that those with a greater capacity to pay for their own private health insurance do so. We are doing that rebalancing through the bills that I am speaking in support of today.

In my electorate of Dobell in the north of the Central Coast in New South Wales we have one of the lowest median wages in the state. Clearly lower income earners, who are my constituents, would not think much of the idea that their taxes are helping to subsidise the private health insurance rebates of high-income earners, especially if those people on lower wages simply cannot afford private health cover. This system will make the rebates fairer. In Dobell working people face many struggles and challenges. They endure long hours each day away from their families because over one-third of them commute to and from Sydney, a two-hour trip each way every day. In many cases rising food and rent costs place additional pressures on their livelihoods and a fairer private health insurance system means we can better maintain the balance between public and private health systems.

There will always be many families who cannot afford private health cover but those families will be more secure in the knowledge that this government is committed to improving the public health system. Let us start with the hospitals, which of course are the most visible face of the health system. It is no secret that many of our public hospitals are under severe pressure as our population ages and the burden of chronic disease takes hold. The emergency department of Wyong Hospital in my electorate is the fifth busiest in the state. In my electorate we are very familiar with the pressures on public hospitals.

It should also be mentioned whenever we talk about health—and I think it is sometimes overlooked by both sides of politics—that in Australia we have a world-class health system. We look after and make sure that people who need to be seen in emergency departments and hospitals are seen. If I or my family were to fall ill, I would rather it be in Australia than in any other country in the world. I think that point always needs to be made in terms of a debate about health. Having looked after health workers for close to 20 years, the dedication and the work that doctors, nurses, allied health professionals, health workers and hospital workers do is something to behold in terms of their commitment to doing their job. Because of that commitment we have a first-class, world-class health system throughout Australia. That is not to say that there are not things that can be improved. It is also important to point out that, when this government came to power, there was a need for some immediate action to strengthen our health system.

Whilst the opposition spokesman said that the government has been all rhetoric in relation to what it has done on health, that simply does not stack up to analysis. I would like to go through some of the issues and some of the improvements that this government has made in terms of our health system since coming to government. In terms of hospitals, the government will invest $64 billion in the hospital and health system across the country over the next five years. That is a 50 per cent increase on the previous agreement by the Liberals. That is a real change: a 50 per cent increase in the money that is going to be spent in health. That is not simply rhetoric; that is real action, putting dollars into our health system and our hospitals to make sure that they can run as smoothly as possible.

We have invested $600 million in our elective surgery program. Stage 1 committed to a target of 25,000 extra elective surgeries in 2008 and delivered 41,000 procedures. They were real procedures. These are real people who are out there, on waiting lists for elective surgery. This is not some sort of spin that has been made up by this side of parliament. Forty-one thousand additional procedures have taken place because of the investment that this government has put directly into health. Under stage 2, more than 150 hospitals across Australia will receive funding to make sure that these extra elective surgeries can take place so that people who have been on waiting lists can be seen in a shorter period of time than would have been the case if the Howard government had been re-elected.

We have invested $750 million in taking pressure off emergency departments, and more than 30 hospitals will benefit from this investment. In terms of infrastructure, we are now undertaking historic investment in nation-building health infrastructure. We are investing $3.2 billion in 36 major projects across our hospitals and medical research institutes, including $1.2 billion in world-class cancer centres. The statement from the opposition spokesperson that the government has done nothing simply does not stack up when you look at the achievements that this government has made and the inroads that this government is making in improving the health outcomes for all Australians.

We have invested $275 million to construct 34 GP superclinics across the country. I am lucky enough that one of those super GP clinics is in my electorate of Dobell, and it has been operating since September of last year in a temporary capacity. They have just exchanged contracts for the permanent site of this new super GP clinic, and the successful tenderer—who is operating now with two doctors, a dietitian, a physiotherapist, a hearing clinic and a podiatrist—will be investing a further $16 million on top of the government’s investment into this super GP clinic on the Central Coast. In addition to that, because the model of the super GP clinic has been such a good model, this same provider is looking at putting in a similar investment of $14 million a little further south in my electorate. So, from a modest investment from the Australian government in two super GP clinics operating in my electorate, we will end up with some $30 million of private investment going into these super GP clinics.

Just in terms of doctor numbers, this will provide an additional 40 doctors in my electorate. We at one stage, when the Howard government was in office, had close to one doctor for every 2,000 residents. Of course, at that time the then Minister for Health and Ageing, now opposition leader, Mr Abbott, had put a cap on GP training places, so it was very difficult to get more doctors into regional areas such as my own and into areas that had a great need for additional GPs. So, whereas some Sydney suburbs had one doctor for every 800 residents, we had one doctor for every 2,000. I am happy to report that, whilst we are looking forward to these additional doctors that will be coming through the government’s investment and the private sector’s investment in super GP clinics, we are already up to one doctor for every 1,500 residents in my electorate. This is because we have lifted the cap on GPs, a very important initiative of this government that is having a real and direct effect on the primary care that people in my electorate are receiving.

In terms of workforce, the government will invest $1.1 billion in training more doctors, more nurses and more health professionals. This is the single biggest investment in the health workforce ever made by an Australian government. We will see 812 additional ongoing GP training places from 2011, a 35 per cent increase on the cap of 600 places imposed since 2004 by the now opposition leader, then health minister, Mr Abbott. The government will deliver $134.4 million to better target existing incentives and provide additional non-financial support to rural doctors. The reform introduces incentives based on this principle: the more remote you go, the greater the reward. Under this initiative, 2,400 more doctors in 500 communities around Australia will become newly eligible for rural incentive payments.

There will be $122.7 million of measures to improve choice of and access to maternity services for pregnant women and new mothers through providing MBS and PBS benefits for services provided by midwives. We will provide access to the MBS and PBS for nurse practitioners at a cost of $59.7 million. The government will also provide 20 nurse practitioner scholarships, 1,134 new annual Commonwealth supported higher education places in national priority areas of nursing and a new incentive of $6,000 for eligible nurses who return to a hospital or aged care setting.

You can see the scale of the investment that this government has already made in terms of health. You can see that without these measures we would be in a much worse situation in terms of our health system and that this government has made a real difference in making sure that money is flowing to the health system. We have also made sure that the often neglected area of prevention has been recognised, and we have invested a record $872 million—the single largest investment ever in preventative health—to make sure that we can look at ways of making sure that people do not fall ill in the first place.

I noticed that the opposition spokesman made some comments about dental care. It was unbelievable that he would have the gall to do so, given the former government’s record of closing down the Commonwealth dental scheme. This government committed a total of $650 million for two dental programs. The teen dental program commenced last year and provides $150 annual payments to eligible families. To the end of December, 258,203 teenagers had received a dental check-up under the program, with 7,598 dentists—70 per cent, that is—providing services. Unfortunately, due to the opposition standing in the way in the Senate, the Commonwealth dental health scheme, which would provide up to one million consultations, has not been able to commence. They closed it down when they came to government in ‘96. We are trying to put services back into dental care, and we are being frustrated in the other place by the opposition.

This government is committed to providing $44 billion over the next four years to aged and community care. No government has invested more than this one in aged care. We are rolling out an additional 2,000 transitional care beds, a $293.2 million program which helps reduce pressures on hospitals. What this means is that older people generally, who are in hospital beds and who could be moved out of those hospital beds, which could be provided to new patients, are able to move to these transitional beds, freeing them up and meaning that our health system has a greater flowthrough. These are very important reforms that this government has made to the health system.

When it comes to health reform, this side of parliament welcomes a debate. We will stack up our record, any day of the week, against the record of those opposite, particularly against the record of the former health minister, the now Leader of the Opposition, who presided over ripping a billion dollars out of the health system, capping GP numbers and doing nothing about the shortages of nurses and health professionals. On this side of parliament we have made real changes. For the future, the government has embarked on a path to build the health and hospital system that Australia needs for the 21st century. The government is committed to an overhaul of the health system to ensure it can cope with future challenges, including an ageing population and rising health costs. I commend the bill to the House. (Time expired)

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