Julie Owens (Parramatta, Australian Labor Party, Shadow Parliamentary Secretary for Small Business) Share this | Hansard source

I rise to speak on the Tax and Superannuation Laws Amendment (2014 Measures No. 2) Bill 2014. I am quite pleased to do so because it gives me an opportunity to talk about a number of things which are either on the government agenda or well and truly included in the budget. The first one is the Medicare levy. This bill ensures that families who were previously exempt from paying the levy will continue to be if their incomes have increased in line with or less than the CPI. As such, it provides more low-income earners with free access to health care and that is a very good thing. It also provides protection for taxpayers who inadvertently failed to realise that there are changes to the tax law. It is a protection provision which gives certainty to taxpayers who are negatively impacted by the unenacted announcements by the previous government, providing that they acted reasonably in anticipating the announcement by previous governments.

This is a very good inclusion in the bill because there is, of course, a great deal of uncertainty out there at the moment with the way this government has handled itself. There are of course bills before the Senate now to abolish the loss carry-back provisions as of July last year which still have not passed the House. There are bills that abolish the instant tax write-off for small business as of 1 January this year that are still before the Senate. There is a debt levy coming as well. There is a range of things on their way and there is the abolition of the quarterly R&D credits for small business. So there is a range of things out in the ether generating quite a bit of uncertainty for business. We are likely to see, because of the lack of clarity by the government on a whole range of things, people getting caught in the middle between what they thought was going to happen and what actually does happen. In particular, I would like to talk about the Medicare levy and the changes this government has included in its budget. I want to say first that these changes are incredibly harsh and we all know that.

We are going to see people in large numbers unable to afford to go to doctors because of the GP tax. I want to point out once again, as I have a number of times in this House, that the pain the government is inflicting on families through this action is not improving the bottom line. The government claims over and over that these are harsh measures. They accept that they are harsh but they say they need to do them because they need to bring the budget back into surplus. Yet, when you look at the figures and at what they are achieving through harsh measures such as the GP tax, they will not bring the budget back into surplus any faster. In fact, the bottom line is slightly worse than it was in the Pre-election Economic and Fiscal Outlook.

We heard from the Minister for Immigration and Border Protection yesterday in question time about how PEFO contains the real figures—the figures that the government and the opposition do not have their hands on. If you compare what the government is achieving in its bottom line in this budget compared to PEFO, you see that the deficit will be $5.8 billion worse in 2014-15, which is this budget year, $12.4 billion worse in 2015-16 and $6.4 billion worse in 2016-17. When they come to the dispatch box and talk about these harsh measures being a way to improve the bottom line, we should all remember that, despite all the bluster and all the rhetoric, they have not managed to improve the bottom line at all. Their principal reason for inflicting so much pain through this self-confessed harsh budget is to improve the bottom line, yet they fail to do so by their own accounts.

The GP tax is a particularly harsh measure. We know anecdotally from people around the country, from doctors' surgeries and from professional organisations, that we are already seeing people cancel appointments on the basis that they cannot afford to go, even though the GP tax has not yet been introduced. It is a very cruel broken promise. It is designed absolutely as an attack on Medicare. We know that the Liberal conservative government has no love for Medicare. We know that because we have seen over decades how they have behaved when they got to the government benches. In the Whitlam years, we introduced Medibank. It was railed against by the conservative parties of the day and they managed to abolish it during the Fraser years. We introduced Medicare again in the Hawke and Keating years and then in the Howard years we saw the rates of bulk billing decline dramatically to such an extent that in some regional towns in particular you could wait several months to see a bulk-billing doctor. We know that they do not like Medicare.

After the Howard years we got back into government and started to work on raising bulk-billing rates again. We succeeded. In fact, in my electorate of Parramatta the bulk-billing rate at the end of 2012-13 was 95.3 per cent and 1,250,000-plus visits to doctors were bulk billed. Were the GP tax imposed on those visits in 2013, my electorate would have lost $9.1 million, which should have gone into my local economy but would have gone directly into the coffers in Canberra. That is an extraordinary amount of money for a community to lose and is an incredible impost on people who are least able to afford it.

In addition, in my community we also lost $80 million from the Westmead Hospital local services and a share of $8 million for the Children's Hospital at Westmead and two of my medical research institutes, the Westmead Millennium Institute and the Children's Medical Research Institute had funding totalling $22 million removed in

December last year and $100 million was removed from Westmead Hospital itself. So we have already had substantial cuts to the bottom lines of two of my hospitals and two of my medical research institutes, and now on top of this we are going to see quite a punitive $7 per visit tax, plus a tax on pathology and imaging.

I was down at one of my very good local health centres recently, a health centre in Harris Park which has a number of GPs plus specialist services. It is open until 10 o'clock at nights. It is open on public holidays. It works very closely with the local emergency department at Westmead Hospital. Emergency knows when it is open and quite often sends people down to the centre. I was talking to them about the red tape burden of this GP tax and the burden that they are expecting it to have on their patients. They were telling me about the high obesity and diabetes levels in Harris Park. In the neighbouring council of Holroyd, which sits up against Harris Park, the diabetes rate is 10 per cent of the population. Ten per cent of the population in that community have diabetes, and well over 50 per cent are overweight or obese. They were telling me about the regime of some of the more serious diabetes cases, who go to the doctor literally every second day to have bandages changed and have their blood tests when they need them. What an impost this would be on a person that actually had to go to the doctor every two days. What would happen? In fact, they had had some feedback from one of those people, who had said they probably could not afford it. The consequences of not affording it, if you have diabetes at that level, is amputation. It is effectively amputation. We will see people who need to go to the doctor who will not because of this $7 GP tax, and we will see people who think that maybe they need to go to the doctor who will put it off because of this $7 GP tax.

The irony in all of this—it would be funny if it were not serious—is that cutting support for primary care does not ultimately reduce your health costs. In fact, in the long run it increases them. It is an almost universal truism that what is best for the patient is actually cheaper for the taxpayer. It is cheaper for the taxpayer to immunise than to have whooping cough. It is cheaper for the taxpayer for people to go and have their blood tests and find out about an underactive thyroid or whatever, or diabetes, than let it go for a while. The earlier a person finds out and the earlier the medical intervention, the cheaper it is for the taxpayer and the better it is for the patient.

What is, of course, best for all of us is a focus on health in the first place, a focus on preventive health and staying healthy. But we have seen this government slash funding to preventive health, abolish the Australian Preventive Health Agency altogether and walk away from the federal responsibility for keeping people healthy. We saw John Howard do that as well. I remember sitting on this side between 2004 and 2007 debating issues of health and hearing the Prime Minister of the day, John Howard, talk about how the federal government does not have responsibility for preventive health. Again, it is an example of a government that considers that its bottom line today is more important than the bottom line of the future or the health of future generations. This is not a government that is prepared to invest now to save costs 10 or 15 years down the track and to save costs for families who ultimately will bear the price of this mistaken policy.

I am not the only one. We on this side are not in any way the only ones who are saying that this is a bad idea. We have had people, from doctors and the professional associations, talking about this, saying that this is a bad idea and that it can only lead to people avoiding visits to the doctor that they otherwise should have. In fact, we know from international experience that people will not seek preventive care or follow-up treatment where a GP co-payment is applied. That is exactly the opposite of what we need in this country. The only people advocating for this are the Abbott government and the Commission of Audit. The AMA, the college of emergency physicians, the Doctors Reform Society, the Public Health Association, the Royal Australian College of General Practitioners, the Consumers Health Forum, the Australian Healthcare and Hospitals Association and countless health academics and economists have advised against this tax, but the government is going to do it anyway. They have advised against this tax for two reasons. It will cause people who should go to the doctor to put it off or not go at all. Ultimately, when that happens, it increases the health cost, not decreases it. I, like so many on this side of the House, urge the government to seriously reconsider this. This is a bad tax that affects the health of our community and affects, ultimately, our health costs down the track. I condemn it. We on this side condemn it.

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