Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Hansard source

I withdraw the imputation on the Prime Minister. The value proposition of private health in regional Australia is most tenuous where there are fewer private providers. But, suddenly, when there are no private doctors, social workers, physiotherapists and psychologists then of course we are undermining general practice in regional Australia. Eight million Australians live in regional Australia, and I know that is often forgotten by this government, and they rely on the private system to draw health practitioners out there. What happens when they pull back? The first thing that will happen is that they will not treat the public outpatients. There will be no VMOs. They will not do the after-hours on call. And we get appalling situations like in Gladstone, and the member for Flynn knows this, where that fine city is completely bypassed for weeks on end by surgical cover in the absence of a surgeon. As a result of decisions like this, the people of Gladstone will be faced with appalling transfers and expensive locum surgeons and no-one will want to stay in the bush and provide continuity of care, because the private delivery of services that support public hospitals has been undermined.

I do not need to explain how the private health system works to you, Mr Speaker, or to anyone else on this side of the chamber, but for those on the other side who always forget: never, ever airbrush away the fact that it is private providers who are called in to fix public hospital waiting lists when they blow out. When a private patient steps in to a public hospital, it is the health service that bills the private health insurer for profit. This is an entwined, dual health system. You cannot poke one side of the health system without a counterintuitive reaction on the other side of the health system. It is exquisitely balanced. It has been so for 15 years. It was the health minister before this one and the one before that who brought in the three pillars of lifetime health cover as well as community rating.

This 30 per cent health rebate has got us to a system where one in two Australians, not the rich and not the poor, can contemplate paying $11 a week out of their pocket—after the $4 discount from the 30 per cent rebate and on top of the $80 a week we spend on the health care of every Australian—and pay for their own cover and take the burden off the public system. It is a very good investment. Never forget the contributions that have been made as a result of that 30 per cent rebate. For every $4 discount that this federal government provides through the 30 per cent rebate, $11 a week of a person's own money is poured into the system. That has built the infrastructure and without that it would not exist.

We do not have to go back very far to recall what it was like two decades ago under the last Labor mob, when private health insurance participation fell to 34 per cent and could not be rescued through the wit of the other side. They failed to understand the value of private cover and private health. The productivity report last year made it very clear that the cost per service in private hospitals and from independent providers is very competitive—and, to be honest, it is usually cheaper than getting it done publicly. I put the proposition to you, Mr Speaker, because you live in an aspirational part of Australia where a large number of people are privately covered: what is the implication of those people downgrading their health care and taking exclusions for surgery—for example, assuming they will never get cancer or electing not to have allied health cover on their policies? What will happen is that they will turn up at a public facility and add themselves to the long waiting list. We know that the services delivered through the public system are slower and more expensive. Eventually, we will pay the tab for this $700 million that they are trying to claw out of the health system today. We will never forget that the money clawed out today will be paid for in an exquisitely clever cost shift to the state systems which will have to fund locums to replace doctors who leave and public allied health services to replace the private ones. Ultimately, as people add themselves to waiting lists, we will have waiting lists for waiting lists where people will never get a service because they will either pass away or go private. Those are the only two ways to get off a public waiting list in a situation where services are not being delivered.

This is a very serious matter, a matter of life of death, and everyone here feels strongly about it. In contrast, on the other side the government are blinded by the potential for savings. And not because they are passionate about investing savings into the state hospital system. Oh no: that money will never make it there. This is about getting a surplus in the next budget. It is about saving the government's economic reputation and they are using health measures as a Treasury strategy, to find savings to get back into surplus. That is what it is all about. If there were any passion for health on the other side of the chamber, we would have seen it in their stimulus package, but alas, they proved, when the money was there, that they would not spend it on health.

When they inherited the health fund from the Howard government with millions of dollars in it, taken from bona fide surpluses, it was simply shifted across to be used for a completely different purpose but never invested wisely. At the end of this year, that health fund balance will be zero. That money will be gone. It will have disappeared with no plan for the future. The government have no plan for the future and no plan for those who are privately insured.

In conclusion, we have an exquisite dual system of public and private provision. We have doctors, allied health workers and nursing staff who work in both sectors. It is the health providers who work for Australians regardless of which service they choose. Privately insured people use the public system. When waiting lists get too long, public patients use the private system. The two are equal, they are balanced. At the moment they are serving one in two Australians. It is a model which should not be interfered with, tampered with or molested. It should be left as it is. The 30 per cent rebate works exquisitely well and Australians of all incomes—we have talked about the proportion who earn less than $35,000 a year—can rationally choose between taking private cover and sending their children to an independent school. It is that choice that the government have always been opposed to.

I have said the government are committed to downgrading the Australian people at just the time when Australians aspire to upgrade, to have options, to have choices. Those choices will be taken away by the Gillard Labor government.

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