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

I rise to support the Health Insurance Amendment (Pathology Requests) Bill 2010. This bill amends the Health Insurance Act 1973 to improve patient choice with respect to pathology services. Currently the act requires that, in most cases, in order for a Medicare benefit to be payable for a pathology service rendered by or on behalf of an approved pathology practitioner, a request for the service must be made to that particular pathology practitioner or the approved pathology authority, who is the proprietor of the laboratory at which the service is rendered. This means that a patient is effectively required to attend the approved pathology practitioner or authority named on the request form. This restriction does not apply to other diagnostic services that attract Medicare benefits.

This bill removes this restriction so that, while there will still be a legislative requirement for a request for a pathology service to be made, there will no longer be a requirement that the request be made to a particular approved pathology practitioner or approved pathology authority. This legislative change will allow patients to take a pathology request to a pathology provider of their choice and will encourage providers to compete on price and convenience for patients.

This measure was announced in the 2009-10 budget with an effective date of 1 July 2010. There was $140,000 allocated for this measure in the 2009-10 budget. This included funding for a communications strategy. The Rudd government has made a major commitment to health reform for all Australians. Part of that reform is to increase competition and patient choice, and that is what this bill does.

As further evidenced in the budget delivered by the Treasurer last night, this government is taking action on its major commitment to health reform. In the budget the government is acting to ensure more Australians can more easily access appropriate health care by making a strategic investment to support and recognise the work of nurse practitioners. As part of the government’s nursing package, $390.3 million will be provided to better support practice nurses and for the first time provide funding for GPs in urban areas to help employ practice nurses. Annual incentive payments of $25,000 per full-time GP for a registered nurse and $12,500 per full-time GP for an enrolled nurse will be made available to eligible accredited general practices.

The government will transform the way Australians with long-term illnesses are treated, starting with improving health outcomes for the nearly one million Australians living with diabetes, too many of whom end up being treated in hospitals unnecessarily. The government is committing $449.2 million to improve care for people with diabetes. For the first time Australians with diabetes will have the option of signing up with a GP practice. The practice will be responsible for managing all aspects of their care and be paid in part for keeping patients healthy and out of hospital.

Through these key reforms this government is committed to delivering better health outcomes for all Australians. The 2010-11 budget will deliver a massive $1.2 billion boost to GP and primary health care, including $355.2 million to building and upgrading GP superclinics. This will honour the Rudd government’s commitment to deliver real improvements in front-line health services for patients across Australia. The Rudd government will upgrade around 425 primary healthcare facilities into GP superclinics and construct around 23 new dedicated GP superclinics. This strengthens the Rudd government’s $275.2 million GP Super Clinics Program, which is delivering 36 GP superclinics across the country.

GP superclinics take pressure off public hospitals, provide better integrated and more accessible care, help attract health professionals to areas of need and give health professionals of the future more training options. The government is delivering a GP superclinic in the northern area of my electorate, which has the full support of not only the local community but the division of general practice, doctors in general, the University of Newcastle and the area health service.

Once this new GP superclinic is fully operational in the Warnervale area it will employ more than 100 health professionals. It will take demand off the emergency department of Wyong Hospital, which is now one of the busiest in the state—in fact, the fourth busiest in New South Wales. Already, even though it is only a temporary GP superclinic, there are 2,000 patients on its books, which reflects the need for additional doctors and health professionals in the growing suburbs on the Central Coast. To further alleviate the pressure on emergency departments, including the one at Wyong, the budget outlined by the Treasurer last night allocates new money towards limiting to four hours the time in which patients will be seen to in emergency departments. This will be done by increasing the capacity of the emergency departments.

Of the new GP superclinics, about nine large clinics will be built where doctors, nurses and health professionals will be supplemented by more specialised services such as renal dialysis, minor surgical procedures, rehabilitation services and radiology. The remaining new GP superclinics will be built along the lines of the 36 clinics already under construction. By providing patients with more convenient one-stop shops the government will help and encourage patients to get the primary care they need to stay fit and well, particularly if they suffer from chronic illnesses.

Three types of funding will be available to help existing general practices expand their facilities, with grants of up to $500,000. These larger grants will be available to those practices that also establish teaching facilities. Additional services will be made available as a result of the infrastructure investment, with space made available in GP clinics for allied health services; group education, such as diabetes management; counselling; and community health promotion.

The injection in super GP clinics builds on the additional primary care being committed to by the Rudd government, including funding for a record number of GPs, more support and training for around 4,600 full-time equivalent practice nurses and a new innovative approach to improve the treatment of diabetes in GP practices. These infrastructure investments are part of the government’s move to take over full funding and policy responsibility for primary care.

We are also improving Medicare and making Medicare more accessible to Australians. The figures show that Medicare is working. In the December quarter 2009 a total of $3.9 billion was paid in Medicare benefits for 77.1 million services. This represented 3.5 services and about $179 in benefits for every Australian. In that quarter 73.9 per cent of all services were bulk-billed, up 0.2 per cent on the September quarter 2009 and up 0.1 per cent on the December quarter 2008. A total of 79.6 per cent of non-referred GP attendances were bulk-billed, up 0.8 per cent on the September quarter 2009 and up 0.6 per cent on the December quarter 2008. Medicare is working, and so is private health insurance. Yet amazingly, no matter how much evidence there is about the continuing improvements to both of these health insurance systems, those on the other side cannot accept the truth—they simply ignore the facts and figures.

Even more evidence was released recently that proved the opposition got it wrong when they predicted a huge drop in private health insurance membership. Private health insurance membership figures released in February revealed that the number of Australians taking out cover continues to grow. More than 45,000 extra people are now covered by private hospital insurance and more than 55,000 extra people have general treatment or ancillary cover. A total of 44.7 per cent of all Australians were covered by private hospital insurance in the December 2009 quarter, continuing to be the highest proportion of people with hospital insurance since December 2001. The opposition said that up to a million people would drop their private health insurance because of the Rudd government. Instead, the people have emphatically proved their claim wrong with 474,000 more taking out hospital cover under the Rudd government. Yet the opposition do not accept that they are wrong—they never do. It is time that the opposition came clean and admitted they got it wrong on private health insurance.

The government is making the private health insurance system fairer and more sustainable. Under changes proposed by the government the private insurance of singles on incomes of over $120,000 or couples earning more than $240,000 will no longer be subsidised by the taxpayers. That is fair, Madam Deputy Speaker Saffin. Treasury modelling estimates that after these reforms 99.7 per cent of people will remain in private health insurance. This measure is part of the government’s reform of the health system. It will save $1.9 billion over the next four years and allow the government to invest more in better services, new medicines and improved technology.

We are embarking on the largest reform of our health and hospital system since the introduction of Medicare. We are intent on delivering better health services and better hospitals by establishing a National Health and Hospitals Network. Under this plan there will be a national network to bring together eight state-run systems with one set of tough national standards to deliver better hospital services. The network will be funded nationally, with the Australian government taking on the dominant funding responsibility for the hospital system. The government will end the blame game, eliminate waste, and shoulder the burden of funding to meet rapidly rising health costs.

And while it will be funded nationally, the network will be run locally through local hospital networks. These networks will bring together small groups of hospitals where local professionals with local knowledge are given the necessary powers to deliver hospital services to our communities. These changes will be achieved by the Commonwealth taking the following actions: we will take 60 per cent of funding responsibility for public hospitals; we will take over full responsibility for GP and primary healthcare services; under our plan the local hospital networks will be run by health and financial professionals who will be responsible for running their local hospitals, rather than central bureaucracies; local hospital networks will be paid directly for each hospital service they deliver, rather than block funding grants being handed over to the states; and we will bring fragmented health and hospital services together under a single National Health and Hospitals Network through strong transparent national reporting. These reforms have been put to the states and territories and have been agreed to at the COAG meeting on 11 April.

The people of the New South Wales Central Coast, where my electorate is, would welcome a stand-alone health system and a local hospitals network that is truly local, unlike the present structure in which our health system is just part of northern Sydney’s health system. We are fighting hard on the Central Coast to gain a true regional identity, one that sees all the major institutions including health and education become their own local organisations and not just systems that are part of either Sydney or the Hunter.

After nearly 12 years of neglect of Australia’s health system by the coalition, this government is getting on with what Australians have been crying out for for a long time: to fix our health and hospital system. Over the coming months the Rudd government will make further announcements about important investments in more doctors and nurses, increasing the availability of hospital beds, improving GP services, and introducing personally controlled electronic health records, which was announced last night in the budget.

My constituents of Dobell on the lovely Central Coast have consistently told me how important it is for the blame game to be over and for us to get on with the job of improving the health system. Those on the other side must let us get on with this task and not block it like they have done so many other times. The establishment of the National Health and Hospitals Network will build on the record investments in health and hospitals made by the Rudd government over the past two years, including a 50 per cent increase in hospital funding, increasing GP training places by 35 per cent and training more nurses.

The government’s actions are in stark contrast to those of the Liberals, who ripped $1 billion from our hospital system when they were in government, capped GP training places and ignored the shortage of nurses in our community. And now the opposition is standing in the way of further reforms that would make the private health rebate system fairer for families. To private health insurance there would be a sensible moderate change that asks high-income earners to contribute more for their insurance so that it is sustainable for us to provide generous support to lower and middle-income earners. On Tuesday, 9 March this year the private health insurance rebate, the last piece of three pieces of legislation, was rejected by the Senate. This decision blows a $2 billion hole in the budget and by the middle of this century that will be $100 billion. This is money that needs to be better spent within the health system, providing for the growing health needs of the community.

But unfortunately this is not the only piece of legislation that is being blocked in the Senate when it comes to health and important priorities for the community. The Liberals are blocking other changes in the Senate. They have twice blocked changes that we took to the last election to make sure that we could provide more than a million extra dental services to the most needy in our community. This is an opposition which is determined to say no. It is an opposition that is taking a reckless approach to the Senate, and it is about time that the public understood the lengths that the opposition leader will go simply to oppose for opposition’s sake.

We have a major task ahead under these reforms, and the bill I am speaking in support of today is but one part of that reform. Let me go back to some of the details of what the Health Insurance Amendment (Pathology Requests) Bill 2010 will achieve. The bill will amend the current legislative requirements concerning when Medicare benefits are payable for pathology services to allow patients to take a pathology request to an approved pathology practitioner or approved pathology authority of their choice. Doctors will still be able and encouraged to advise patients on their choice of pathology provider. It is anticipated that in most cases patients will attend the approved pathology practitioner or approved pathology authority recommended by their doctor.

Peak representative bodies for the pathology industry have expressed concerns over how this initiative will affect continuity of care for patients. Doctors are free to inform patients that taking the request form to the doctor’s preferred pathology provider may allow better tracking of their results. Pathology providers will still be allowed to produce branded request forms—that includes a provider’s company logo and address—and provide these to requesting practitioners. Changes to relevant regulations are planned to mandate that requests for pathology services include a clear and understandable statement, which is obviously positioned, making patients aware that requests can be taken to any approved pathology practitioner or approved pathology authority.

This proposal will be implemented from 1 July 2010 with a transition period of 12 months in respect of the changes to the regulations to minimise any regulatory impact on practices. The Department of Health and Ageing will undertake a communication campaign before the changes are implemented to ensure that the changes are well understood by practitioners.

The Liberal Party, the opposition, have stood in the way of almost all the reforms that this government has put up in terms of health. People in my electorate simply want them to get out of the way and let this government get on with providing better health care for the people of the Central Coast. Not only have they been blocking it; they are also now telling untruths. It is unfortunate that I have to report that the Liberal Party candidate for the seat of Robertson has today misled the local community in relation to an announcement made by the Prime Minister two weeks ago for a cancer unit on the Central Coast for which the federal government is providing $28.6 million. This cancer centre is one that for which we have signed a contract with the state government and is to be up and running in 2013. The member for Dickson—

See this speech in context