Kelvin Thomson (Wills, Australian Labor Party) Share this | Hansard source

The Liberal Party said that it would give Australia 'calm and methodical government'. Instead we have had a stampede—a veritable running of the balls—replete with cries of, 'Emergency, emergency!' Here, the element of emergency is the cry that the system is unsustainable. This is clearly nonsense, given that there is no plan to put the money raised by this measure back into the sustainability of the system. Instead, it is to be directed towards medical research. So this is completely disingenuous.

Rather than seeking to discourage people from going to the pharmacist and getting appropriate medicines, the government would do better, if it were genuinely concerned with sustainable health going forward into the future, to look at the issue of preventative health and improving the support that we provide for people before they reach the situation where they need to go to the doctor or the pharmacist. As an alternative to the government's approach, I particularly want to draw to the attention of the House proposals that have been put forward by the Public Health Association of Australia, where they focus on obesity, which they describe as 'one of Australia's most important public health issues'. They talk about the various medical consequences of it and they say:

In only 15 years, from 1990 to 2005, the number of overweight and obese Australian adults increased by 2.8 million … If the trends continue, it is predicted that almost two thirds of the population will be overweight or obese in the next decade.

The National Preventative Health Taskforce identified that one-quarter of our children are overweight or obese, up from just five per cent of our children in the 1960s, that almost one-third of children do not meet national guidelines for physical activity and that only about one-fifth meet dietary guidelines for vegetable intake. What they call for is a national nutrition policy:

… developed through an open, engaging and transparent process and in a manner that is linked with other policies such as the National Food Plan and other key policy areas such as physical activity, women's health, indigenous health and the national curriculum.

Having a program of prevention is far superior to the proposals here, which are that ordinary consumers should carry the cost of the government's desire to increase the cost of pharmaceuticals and, frankly, discourage people from purchasing them.

I oppose the National Health Amendment (Pharmaceutical Benefits) Bill 2014. Among numerous case studies on broken promises, misleading claims and the poor priorities of this government, this bill stands out. This bill has the potential to actually make Australians less healthy. It has the potential to compound the health issues and health cost barriers that many Australians are already experiencing. It can be summed up in the words, 'Show me the money.' If you are from a low socioeconomic background, it is your own bad luck. If you are a single mother needing health care, this government says, 'Show me the money.' If you are a pensioner, the government says, 'Show me the money.' If you are a veteran or elderly citizen, it says, 'Show me the money.' If you are unemployed, a student, a concession card holder or a disability support recipient, this government's response is, 'Show me the money'—an ideological drive to introduce a two-tiered, user pays system.

If you cannot afford health care, this is a recipe for leaving you on your own, bereft. If you lose your job and you are denied Newstart allowance for six months, this government says, 'That's just too bad.' If you are a pensioner facing cuts to your pension payments, it says, 'That's just too bad.' If you are being taken off the disability support pension and at risk of going hungry or becoming homeless, the government still thinks it is just too bad. If you are a medical student having to pay record amounts towards your HECS or HELP fees, then, again, that is too bad. If you cannot afford to visit your doctor because you now have to pay more for your medicine, and you have this bill increasing the cost of prescriptions, too bad—the government says, 'Show me the money.'

This bill increases the Pharmaceutical Benefits Scheme co-payment for general payments by $5 to $42.70 and by 80c to $6.90 for concessional payments from 1 January next year. It also increases the concessional PBS safety net threshold by two prescriptions per year and the general safety net threshold by 10 per cent each year for four years from 2015 to 2018. I need to point out to the House that these increases are in addition to the usual increases of CPI and indexation. The bill is intended to raise $1.3 billion over four years from the pockets of ordinary Australians—I repeat: $1.3 billion over four years, from a government that claims to be concerned about cost-of-living issues.

I oppose this bill for a number of reasons: first, that the government must be held to account for its election promises and for misleading the Australian people, saying one thing before the election and doing another thing afterwards; second, for the negative impact that this will have on the household budgets of Australian people, particularly low-income and disadvantaged people; third, for the negative health impact that this will have on Australians—again, particularly disadvantaged and low-income Australians; and, finally, because of the opposition that has been expressed by stakeholders in the wider community to these increased health costs. The members opposite told their constituents before the election that the cost of visiting a doctor and of buying medicine and the cost of living would not rise under them. So much for their 'no surprises, no excuses' pre-election claim. So much for their elevating of the pre-election promise into a sacred trust.

This bill is an attack on Australia's universal healthcare system and its PBS system. Many key stakeholders have raised concerns over this bill, and the House needs to be mindful of them. The Pharmacy Guild of Australia has criticised the increased cost of medicines proposed under this bill for consumers and has argued that it will particularly affect elderly people, especially having regard to other social security changes that have been put in place. The guild stated that it will be tendering a submission to the community affairs committee which will focus on the practical implications of the proposed changes to the PBS co-payments and safety nets. Medicines Australia acknowledge the co-payment increases may lead to adverse health outcomes due to patients not filling in their scripts.

The Consumers Health Forum has expressed great concern over the growing out-of-pocket costs that Australians pay for healthcare and strongly opposes the increase to co-payments and the safety net. The Consumers Health Forum has argued that an increase in co-payments will lead to a fall in people filling in their prescriptions and has quoted American research that states that when co-payments are raised to $40-$50, people are four to five times more likely to not have prescriptions filled compared to when there is not a co-payment. The CEO of the Public Health Association of Australia, Michael Moore, has stated that the measures are inequitable and will affect society's most vulnerable members. He has argued that 'the people to whom this is most important are the vulnerable, such as Aboriginal and Torres Strait Islanders, people from low socioeconomic backgrounds or from non-English-speaking backgrounds and the elderly'.

The Australian Doctor reported earlier this month that while debate has raged over the government plans to get children and concession card holders to pay $7 to see their GP, there has been less discussion on the effects of increasing co-payments for PBS medicines. I have had constituents say to me that the impact of the PBS co-payments is more serious than the impact of co-payments to visit the GP. The Parliamentary Joint Committee on Human Rights, in its evaluation of this bill, noted 'the effect of the bill will be to increase the cost of medications for all consumers, including those reliant on social security payments' and that the proposed measures represent a 'limitation on the right to health and/or regressive measures which is not explicitly addressed in the statement of compatibility for the bill'.

On 23 June, I tabled a petition in this House from the Australian Pensioners Voice, who were calling on the government to increase support for pensioners, particularly in relation to health care. This bill ignores the calls of Australian Pensioners Voice, its members and the 25,000 pensioners and elderly residents who live in my electorate of Wills for more affordable and accessible health care. The people who are in my electorate—whether it is Brunswick, Coburg, Pascoe Vale, Fawkner, Glenroy or Strathmore, whether they are elderly or of working age—should not have to pay more if they are sick and need healthcare services or medicine. We should be debating positive health policy in this chamber rather than getting the policies that are coming forward in this bill and others that are making those who are doing it toughest in this community pick up the tab.

I want to turn to some of the comments made by the Prime Minister and this government in their days of opposition to see how these comments equate to what is happening in the legislation before the House. We had the now Prime Minister saying in September 2007:

What are the four big challenges facing the Australian health system … First of all, there is the challenge of affordability … Affordability is a serious issue.

And then:

Of course the government does not want people to worry about whether they can afford to visit the doctor … No-one likes to see people paying high costs, particularly for their health care. No-one likes that.

In February this year, the Prime Minister was asked at a doorstop whether he would consider a means tested co-payment to help relieve the pressure on the health budget. He said:

Obviously the Budget, generally, is under pressure and it’s very important that we do what we can to fix the Budget, as quickly as we can, but we’ve got to do it in ways which are consistent with our pre-election commitments. Don’t forget, I said we were going to be a no surprises, no excuses Government. You might also remember … that I was the Health Minister in a former government and as the Health Minister in a former government, I used to say that that government was the best friend that Medicare had ever had.

This leopard doesn’t change its spots—I want this Government to be, likewise, the best friend that Medicare has ever had.

At no stage was there the slightest suggestion that, when in government, this government would increase the PBS co-payment for general patients to $42.70 and for concessional patients to $6.90. This bill gives the lie to all the promises and mistruths that were peddled before the 2014 'show me the money' budget.

There are some Liberals who are willing to admit that this approach to health funding is wrong and that it will hurt patients and frontline services. I want to draw the attention of the House to some of the comments of the government's state colleagues. We had Campbell Newman on 14 May saying:

A big red cross is cutting health and education spending. It's not acceptable.

We had Tim Nicholls, the Queensland Treasurer, saying:

We think that they are an attack on the state’s delivery of health and education services and you can rest assured that we will be taking up the challenge in Canberra to revisit some of those decisions.

You had the health minister from Queensland, Lawrence Springborg, saying:

The real impact for us comes in 2017/18 … The real issue for us is the long-term aspects that come from and impacts that come from uncertainty with health funding.

Finally, he said on the GP tax:

… we fundamentally believe in a taxpayer-funded free public hospital system. And this actually in some ways goes counter to that.

It certainly does.

I appeal to members opposite to listen to their Liberal state colleagues: stop attacking the universal healthcare system and protect it. How much you earn should not determine whether you have the ability to access health care and medicines. I oppose this bill on the basis of its cost to Australian families. Just today I visited the Australian Nursing and Midwifery Federation representatives on the lawns at the front of Parliament House to support their campaign against the Liberal budget cuts. Whether you are a health sector worker, a health student or a patient, you are entitled to better treatment than you have received from this government in the form of the budget and this legislation. I urge the House to reject this bill.

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