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

‘Too many rules’—yes, that was the phrase. The member for Herbert then went on to talk about public hospitals, saying, ‘There are too many rules in public hospitals’—gosh, when there are problems in an operating theatre, suddenly there are all these rules that mean things cannot get done. The public hospital system is the backbone of the health system in this country. Having represented health workers in both the public and the private health sectors—and my union’s membership was equally divided between the two—I can say that health workers, whether they work in a public hospital, a private hospital, a private clinic or a public clinic, are committed to the work that they do and try to deliver the best outcomes they can for patients. For putting a general slur on the workforce in public hospitals, the member for Herbert should hang his head in shame. For too long we have had people like the member for Herbert out there badmouthing people who are working hard to deliver great health outcomes, without a lot of resources, to people in our public and private hospital systems. To go on some philosophical crusade about unions in the health sector is simply ignoring the facts.

The public health sector deals with the majority of cases. It deals with the most serious issues that come into our health system and also deals with the most complicated issues. This is often why there are different costs. Private hospitals tend to deal with operations of a simpler nature, which, because of that, can be done with fewer complications and often at a cheaper rate, whereas the public hospitals have always dealt with the most difficult issues and have always dealt with the more complicated issues. They do so on the basis of trying to provide the best level of health care that they can for the Australian public.

Other than the member for Herbert—and I think that any other speakers from the other side should immediately disassociate themselves from his diatribe—I would hope that everyone in this place recognises the great work which our public hospitals do and which those people who work in the public hospital system do. It was typical to hear him moaning about the fact that there is a lack of services in the electorate that he represents—after having been in government for 12 years and done nothing about it. Now, when this government is actually out there doing things, including dealing with the specific issue that he was on about, his complaint is that there is a tender process with too many rules. That was a contribution on health which should go down in the annals of this place as one of the poorest ever.

I rise in support of the Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009. This bill amends the Health Insurance Amendment (Diagnostic Imaging Accreditation) Act 2007, which I will refer to as the DIA Act, to provide transitional arrangements for new entrants in the broadened scope of the diagnostic imaging accreditation scheme. The legislative framework for the diagnostic imaging accreditation scheme is being implemented in two stages. Stage 1 of the scheme commenced on 1 July 2008 and covered only radiology services. Stage 2 of the scheme will commence on 1 July 2010 and will cover all diagnostic imaging services—both radiology and non-radiology services—listed in the Health Insurance (Diagnostic Imaging Service Table) Regulations 2009.

This means that from 1 July 2010, for the purposes of Medicare, all diagnostic imaging services and the diagnostic imaging services table would need to be carried out at an accredited practice, or deemed accredited practice, to be eligible for Medicare benefits. This bill will amend the DIA Act to provide transitional arrangements that will allow practices providing non-radiology services and practices combining non-radiology and radiology services not accredited under the scheme in operation before 1 July 2010 to register for, and enter into, stage 2 of the scheme. From 1 April 2010, for unaccredited practices which provide non-radiology services, the transitional arrangements proposed in this bill will provide a registration period which would operate for around three months from 1 April 2010 to 30 June 2010 and which would give deemed accreditation to practices for 12 months, and an application process which would allow a deemed accreditation practice to submit documentary evidence for 12 months from 1 July 2010 to 1 July 2011.The arrangements will also provide for an accreditation decision to be made by an approved accrediter. Presumably, these rules and regulations are things that would cause the member for Herbert some difficulty.

The stage 1 scheme was introduced on 1 July 2008 to ensure Medicare funding was directed to radiology services that are safe, effective and responsive to the needs of healthcare consumers. The stage 1 scheme only applied to sites rendering radiology services. These sites accounted for around 84 per cent of the total number of diagnostic imaging services performed annually under Medicare. Non-radiology services, such as cardiac ultrasound and cardiac angiography, obstetric and gynaecological ultrasounds and nuclear medicine imaging services, account for around 16 per cent of diagnostic services performed annually under Medicare. These were not included in the stage 1 scheme. This was because prior to 1 July 2008 non-radiology services were managed by three separate memorandums of understanding which—unlike the radiology agreement that did not mandate the introduction of an accreditation scheme—links to the payment of Medicare benefits by 1 July 2008. Each of these memorandums expires on 30 June 2008. Consequential amendments will be made to the Health Insurance Regulations 1975 which currently exclude non-radiology services from the scheme.

The Rudd government is committed to making our health system better for all Australians. That includes the infrastructure, the training of doctors and other health professionals and Medicare, just to name a few aspects. This government is committed to improving the public health system. Let us start with hospitals, which are the most visible face of the health system. It is not a secret that many of our public hospitals are under severe pressure as our population ages and the burden of chronic disease takes hold. Having said that, if I were to get sick, Australia would be the country that I would want to get sick in because, despite the problems and the areas that we need to improve and despite there being a large amount of work to be done, Australia has a world-class and a first-class health system. That is something we should acknowledge right from the start whenever we enter into this health debate.

In my area, the Wyong Hospital is the fifth busiest emergency department in the state of New South Wales. As we are coming into autumn, it is going to become even busier. The Rudd government is strengthening our health system after years of neglect and buck passing by the former Howard government. The government is investing $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 which the coalition entered into. We are investing $600 million in our elective surgery program. Stage 1 committed to a target of 25,000 extra elective surgeries in 2008 and delivered more than 41,000 procedures. Under stage 2, more than 150 hospitals across Australia will receive funding. We have invested $750 million in taking pressure off emergency departments and more than 30 hospitals will benefit directly. We are also 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 government has provided $275 million to construct 34 GP superclinics across the country.

In my electorate of Dobell on the New South Wales Central Coast, one of these GP superclinics is being established. It has already been well received and although it is only on a temporary site for the moment, it has over 1,700 patients on its books and sees close to 1,200 patients a month. This is only while it is in its present temporary capacity. The operators of the GP superclinic have well-advanced plans. In fact, the site has been finalised and the operators have exchanged contracts for the land on which the new and permanent GP superclinic will be built. It will be built in Hamlyn Terrace, just near the new town centre of Warnervale.

In relation to that investment, the way in which this government has invested in GP superclinics has been to involve the private sector. We saw a great partnership here with this GP superclinic in my electorate; the federal government spent $2½ million on the GP superclinic and that encouraged the successful tenderer to spend $16 million. So in my electorate we are getting a GP superclinic which is going to employee 104 staff, is going to cost $18.5 million and which has only cost the taxpayer $2½ million. That is a great scheme. Furthermore, it has encouraged the provider so much and they are so committed to this model of the GP superclinic that they have provided a further $14 million to build a similar project at Tuggerah in my electorate. So, for the Commonwealth’s $2½ million investment on the Central Coast, we are getting $30 million being spent by the private sector on the GP superclinic.

This government is also providing $500 million for subacute care to help older people leave hospital and free up beds. As for the workforce, the government will invest $1.1 billion in training more doctors, nurses and other health professionals. This is the single biggest investment in the health workforce ever made by an Australian government. It will see 812 additional ongoing GP places from 2011 onwards—a 35 per cent increase on the cap of 600 places which has been imposed since 2004 by the opposition. So this government is making sure more GPs are trained and out there so that they can help deliver the vital primary care that is needed in our towns, cities and right around the country, whereas the previous government put a cap on them.

We are increasing by 50 per cent the spend in terms of the agreement between the states and the Commonwealth on public hospital funding. Those opposite, when they were in government and when the current Leader of the Opposition was the health minister, ripped a billion dollars out of health. The difference between the two in health is stark. If we go back to the contribution of the member for Herbert, we can see why there is such a different approach in terms of this particular debate.

This government will deliver $134.4 million for better targeting existing incentives and providing additional non-financial support to rural doctors. The reform introduces these incentives on the principle that ‘the more remote you go, the greater the reward’. Under the initiative 2,400 more doctors and 500 communities around Australia will become newly eligible for rural incentive payments.

Recognising that prevention is better than cure, the government will invest a record $872 million, the single largest investment ever in preventative health, to help keep people fit, healthy and out of hospitals. We are providing child health checks for four-year-olds to promote early detection of chronic disease risk factors. There will be $12.8 million to fund 190 schools around the country to construct either a kitchen or a garden under the Stephanie Alexander Kitchen Garden Program.

Dental care is an issue that is very close to my heart. In my previous job before I was elected I spent a lot of time campaigning to make sure that Australians got proper dental care. Our commitment as a government is a total of $650 million for two dental programs. The teen dental program commenced last year and provides a $150 annual payment to eligible families. To the end of December, 258,203 teenagers had received a dental check-up under the program, with 7,598 dentists—that is, 70 per cent of all dentists—providing services.

Unfortunately, due to the coalition standing in our way in the Senate, the Commonwealth dental program, which would provide up to one million consultations, has not been able to commence. We are putting money into dental programs. The first thing that the other side did when they came to government was cut the Commonwealth Dental Scheme, and what they are doing now is frustrating this government’s attempts to make sure that dental care is provided in a better manner to those in our community who cannot afford dental care. So, again, we have a stark contrast between those on this side of the House and those on the other side of the House.

In aged care, we are committed to providing $44 billion over the next four years to aged and community care. No government has invested more. This has already seen a record amount of aged and community care places allocated. We are rolling out an additional 2,000 transitional beds: a $293.2 million program to reduce the pressure on hospitals. Construction work is underway due to the government’s $300 million zero real interest loan program to create more than 1,300 new beds. We are providing $192 million in a year for the National Respite for Carers Program, which funds a national network of more than 600 community based respite services. Since being elected we have improved and strengthened quality measures by increasing announced and unannounced visits to homes by 3,000 a year and by investing more than $127 million in the aged care workforce.

For the future, the government has also embarked upon a path to build the health and hospital system that Australia needs for the 21st century. The government has committed to an overhaul of the health system to ensure that it can cope with future challenges, including an ageing population and rising health costs. Unlike those opposite—including the current opposition leader—who neglected health during their 12-year term in government, this government is about taking real steps to make sure that our health system is the best we can possibly have.

My electorate of Dobell on the lovely New South Wales Central Coast is a good example of the demands on our health system. Not only do we have a fast-growing population of young families who have moved to the area to seek new opportunities including a great lifestyle, but we have many senior citizens in the area, and the ageing demographic is increasing quite quickly. I mentioned young families. Many of these people are having children for the first, second or third times. Of course, they need their health services to be of the best standard possible. When mothers are expecting children, they deserve to have safe, effective and responsive services when it comes to diagnostic imaging.

This bill will provide transitional arrangements to enable approximately 1,400 unaccredited practices around Australia that are currently providing non-radiology services—and these make up around 16 per cent of the total diagnostic imaging services under Medicare—to register for ‘deemed accreditation’ and transition incrementally into the stage 2 scheme by 1 July 2010. Accreditation is a way of ensuring that patients receive a quality diagnostic imaging service irrespective of who provides the service or where the service is provided. There is no doubt that accreditation is important when it comes to diagnostic imaging.

This legislation is important in terms of making sure we have proper accreditation. It is part of the Rudd government’s agenda to make sure that in Australia we take concrete steps, as we have done in the last two years, to ensure that we have the best health system that we possibly can. We are coming from some way behind because from those on the opposite side we had 12 years of neglect. We had billions of dollars ripped out of the system. There was neglect in dental care and there were caps on GP places. These are all issues that we have addressed squarely and fairly, straight off. We have record investments in hospital infrastructure. This particular bill is part of that broader picture of the Rudd government addressing the health needs of this nation, and I commend it to the House.

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