Wilson Tuckey (O'Connor, Liberal Party) Share this | Hansard source

If the intention of the National Health Amendment (Continence Aids Payment Scheme) Bill 2010 is achieved, it will be a further recognition of the great disadvantages faced by people who have lost certain personal bodily functions and who suffer incontinence. It is extremely expensive because they must equip themselves, at all times, with the appropriate aids. I have no evidence that there is any opposition to this scheme from within the ranks of the opposition. It is worth referring to the explanatory memorandum and making some comparison between the present and the future as proposed by this legislation, but without the detail of the assistance to be given.

This is what the explanatory memorandum tells us: under the CAA Scheme—in other words, the current scheme implemented by the Howard government—eligible people with severe and permanent incontinence are provided with up to $489.95 worth of products each year, indexed annually, to help manage continence. The CAA Scheme is managed by a sole provider on behalf of the Department of Health and Ageing. One can only assume the costs involved in that virtually $500 assistance package are being properly overseen by the health department to ensure that entitlement is stretched as far as possible. That is something that these unfortunate people know about and are receiving at present. So what happens next? Under the CAP Scheme, which is what the legislation is proposing, eligible people will instead receive a payment as a contribution towards the cost of the products. The new arrangement will provide greater choice to the consumer and promote competition and is expected to reduce the administrative costs associated with the continence aids program.

Why will it reduce administrative costs? A person presently has the entitlement to purchase directly from a provider, overseen by the health department. They are able to obtain that on the basis that they are eligible. The new process clearly involves all of the practices of Medicare—that is, each time you incur a cost, as you might in attending a non-bulk-billing doctor, you will have to apply for a refund. The minister, in addressing the House at the end of this debate, might tell me, ‘That is not so.’ Well the parliament does not know. All we are told further on in this explanatory memorandum is that Medicare Australia will deliver the program. The amount of the contribution payment will be specified in the legislative instrument—in other words, delegated legislation—and the parliament is passing this legislation with no knowledge how much that might be.

As is typical in so many matters proposed by the Rudd government, there is a lot of smoke and mirrors around. The people have a program. It is administratively simple. Whilst it could be argued that competitive forces might lower the price of continence aids, with other suppliers involved—presuming that there is competition in the tender to be the sole supplier—if the price is reduced through competition, is the refund going to be a percentage of that or a fixed amount? We do not know. When will these people, with their serious disability, be able to find out?

Clients of the CAA Scheme will be taken to participate in the CAP Scheme—well, that is pretty good—and will be eligible to participate in the CAP Scheme from 1 July, provided they give certain information to Medicare Australia’s CEO to facilitate contribution payments being made to their nominated bank account. In other words, they will pay full tote on purchase and then wait for a refund—back to the bad old days of bulk-billing or not bulk-billing. After 30 June 2011 they must meet the eligibility criteria specified in the scheme. We do not know exactly what they are.

See this speech in context