Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

I too rise to speak on the Appropriation Bills, which represent the Abbott government's second budget What is now too painfully clear is that the Abbott government's second budget is not a budget for Australia's future. It is not a budget that invests in the health of the nation; it is not a budget that deals with the very real challenges that we as a country have. It is a short-sighted attempt to do one thing and one thing only—to save the Prime Minister's job—and nowhere is that more painfully clear than when it comes to health care.

Frankly, given the absolute disaster that occurred last year, I could not comprehend how this year's budget could do more damage. Last year's budget, it is worth recalling, ripped $57 billion out of public hospital funding—costs that have now been simply transferred to states and territories. It gutted preventative health programs, attempted to destroy Medicare by forcing all Australians, even pensioners and children, to pay a tax every time they visit the doctor That budget also included cuts to adult dental programs and an increase in the price patients pay to access medicines, as well as changes to both the MBS and PBS safety nets that make it harder and harder for patients to reach. It was a budget that was so disastrous for health care and healthcare reform that it led to its minister being voted the worst health minister in 40 years and, before that year was out, he was gone.

But, I suspect, like everyone who cares about health care in this country, our hopes that the government had learnt its lesson on health have not been realised with this budget. Far from attempting to make at least a start in repairing last year's debacle, the Abbott government's second budget not only entrenches last year's cuts, but it adds a couple of billion dollars more just for good measure.

For the Prime Minister, it seems, too many health cuts are just never enough. Not happy with having slashed over $57 billion out of health last year, he has come back for another $2 billion this year. Still entrenched in this budget is a GP tax and the hikes in the price of medicines. Last week there was a farcical attempt by the minister to abandon those cuts, before the Treasurer forced her into an embarrassing backdown. Had her comments been left to stand, the fraud of including the cuts in the bottom line of budget would lay exposed. Now, many of these cuts are not as obvious as the GP tax or the cuts to hospitals and, as a result, many of them have not received much scrutiny yet particularly from members opposite, who, it is clear, do not understand just what their own government is up to or the impact this will have on their communities in coming months. But make no mistake, this budget will have just as damaging an impact on the health system as last year's, and once again it is real people—patients, doctors and nurses—who will be the victims.

So, I am going to use my time in this debate to go through some of those cuts. Of course, the budget locks in the $57 billion in cuts to public hospitals from last year's budget. Despite going to the election promising that the coalition would fund 50 per cent growth of the National Efficient Price, the Prime Minister has broken that promise and has instead entrenched growth in hospital funding on a formula based only on population growth and the CPI, which will not meet the demand for hospitals into the future. State premiers and chief ministers have called this for what it is: a complete broken promise and the lowest level of funding since the Commonwealth first started funding public hospitals after the Second World War. These are cuts that the New South Wales Liberal Premier Mike Baird has described as unsustainable. He stated that:

The states do not have the capacity to meet those health costs on their own.

The AMA's most recent report card found public hospitals are already not keeping pace with population growth and demand; as a result of this, the government's budget cuts are facing a future funding crisis. As the Victorian health minister, Jill Hennessy, stated:

Tony Abbott's cuts will see sick Victorian patients wait longer for treatment. It's that simple.

The Federal Government needs to play its part and contribute its fair share so Victorians can get the treatment they need.

Quite simply, these cuts cannot be sustained, and the government knows it. The cuts will have a seriously detrimental impact on emergency department waiting times and elective surgery waiting times. They will increase waiting times, and they will put lives at risk, make no mistake about it. What is even more damaging is that—after years of positive engagement by clinicians through states, territories and the Commonwealth—this government has completely walked away from any public hospital reform whatsoever, putting the reform process back years and giving up any hope of actually realising efficiencies across the public hospital system.

Then in this budget, of course, we saw that there was even worse to come. In this budget we have had more than $125 million cut from the Child Dental Benefits Schedule. Could there be any decision more petty and nasty than to cut funding from kids' dental? Well, there actually could, and I will talk about that a bit later. This is a scheme that provides up to $1,000 over two years for eligible kids aged between two and 17 years. In government, Labor recognised the importance of good dental health for a person's overall health, especially for children, which is why we introduced this program. We also invested more than $650 million in public dental programs for adults in order to reduce waiting lists. But this government has already cut more than $50 million in public dental programs; it is now cutting more than $125 million in children's dental benefits in this budget, and cumulatively cutting more than $500 million when taking into account the cuts in its last budget. A few days before this announcement, the minister was boasting of how, as she put it, the government had got its teeth into dental health. It turns out that the only thing the government has got its teeth into is, again, patients.

The cuts to children's health do not stop there. This budget also includes a cut of $145 million from the Healthy Kids Check. This means that parents will no longer have access to one-hour appointments with GPs for these checks, which we know have been invaluable in the early detection of asthma, hearing and speech issues, as well as other developmental issues. This is a short-sighted and callous move from a government that is demonstrating it has no commitment to universal health care. It is a cut to an important children's health program, which goes to demonstrate that this government does not believe in a universal health insurance scheme and simply does not believe in Medicare. This is a cut that will have an impact on patient access, particularly to speech pathology, and it is a cut that Labor condemns.

Not content with cutting $197 million from the flexible funding pool last year, this year's budget also slashes a further $500 million from the funds which support so many vital community health and support organisations. We think the figure is $500 million; that is the media report. We suspect that it might be a bit more. The new measure 'rationalising and streamlining health programs'—read 'cut' in this government's language—includes a cut of more than $500 million from all the groups in every part of the nation that do so much to help in areas like drug and alcohol rehabilitation; mental health services; Aboriginal health organisations, particularly those working in chronic disease; and vital non-government organisations working across the entire health sector, including the Consumer's Health Forum, Alzheimer's Australia, the Heart Foundation and the Public Health Association of Australia. Name a health organisation in this country, and they, generally, are the recipient of flexible funds. That is the program that has been cut. It was no exaggeration on budget night when the Public Health Association described this as a bloodbath for those organisations. This will reach into the heart of every electorate in every state and territory, and rip away the local services that are the very fabric of these local communities.

Which brings me to another measure, which is still sitting within the budget from last year, the unfair increase to the PBS co-payments—increasing the cost of medicine by $5 for every general script and 80c for every concessional script before the safety net is reached. Not content with stopping there, the government also wants to increase the safety net by two scripts per year for concessional patients—that is, pensioners, people with a disability and others who are already doing it tough—as well as increase the safety net by 10 per cent per year for all general patients.

Even for a government which is famous for its chaotic and ham-fisted approach to health, the minister managed last week to set a new benchmark for bizarre health policy announcements, by unilaterally announcing just nine days after the budget that she was no longer pursuing this, because she had suddenly somehow discovered she could not get it through the Senate. That makes a complete fraud of why it is in the budget in the first place but, leaving that aside, this was despite the government knowing for almost a year that it does not have the support of the Senate to get this measure through. But nine days later, the minister announced that she had given up on it and, in the process, blown a $1.3 billion hole in the Treasurer's budget. This backdown lasted less than a day, before Joe Hockey was on morning TV making it clear to the minister that, in the Abbott government, budget cuts come first and health policy a very distant second, and that the PBS hikes and safety increases were well and truly back on the table. That is, of course, unless the minister can find another $1.3 billion of cuts in health, having already cut it to the bone. What an absolute debacle, but what insight it provides into the government's thinking on health policy: no evidence, no planning and no idea of what might constitute decent health policy.

The health system and indeed all Australians deserve a lot better than that. It is worth mentioning that this $1.3 billion measure is still in the books as being part of the Medical Research Future Fund. That fund was supposed to start on 1 January, but that has not occurred. The government knows the increase to the costs of medicines does not have the support of the Senate. It has not even been bothered to introduce it in the Senate, because it knows that it does not have that support.

Of course, still within the budget is the freeze to the MBS schedule: a $1.3 billion freeze. We have had a $7 GP tax, a $5 GP tax and a $20 GP tax, and now are being told that, somehow, there is nothing further to come in relation to this. Well, that freeze is still within the budget. It has already seen GPs change their billing practices across the country, it has seen a reduction in bulk-billing and it still sits within the budget.

You have to say that this government has hit an all-time low with some of the other measures that are here in that $2 billion worth of cuts. There is one cut that I particularly want to mention, and it is extraordinary in its pettiness. There is a very small program for about 900 patients in this country who have the disease PKU. Babies are tested for it at birth. As I said, there are 900 of these patients. It is a rare genetic condition. However, if these babies do not receive a specialised diet from start, they will develop brain damage. They have to have this diet.

For a long time now the federal government has been providing a subsidy, a very small amount of money—$250 per month, about $3,000 per year—to these 900 families to enable them to purchase the food for their children so they do not develop brain damage. The government has cut the program in the budget. This is such a pathetic and small-minded measure. This is a very small cohort of patients with a very rare disease. They are absolutely reliant on this specialised diet. There are three providers of this special food in the country. It is incredibly expensive. Things like a specialised loaf of bread costs $10.

These families are not rich families who are able, somehow or other, to find $10 for a loaf of bread. As we know, for most households with kids, a loaf of bread does not last very long either. They received a letter the day after the budget with basically no warning and no consultation with any of the peak organisations that represent these families and this small cohort of patients. Bang! It is gone! That is the level to which this government is prepared to stoop. Those kids desperately need to have this food subsidised, because it is not replaceable. You cannot just walk into a shop and get a piece of food and know that it will have the right measure of protein for your child, given the damage that it does. These families already struggle. This has been a very small-minded measure.

One of the other measures in the budget which has not received a lot of attention is the scrapping of the GP after-hours access line. It receives some 200,000 calls. These are calls that have been referred from a nurse on-call line. People call that line; the nurse says that the case may be a bit more complicated and they need to talk to a general practitioner. There was no cost-benefit analysis of the program. It took a long time to set up and negotiate with states and territories. On 1 July—bang, scrapped, gone! We have had representations from some of the GPs who have been running that line. It has been servicing many patients who do not have access to regular GPs. They are mental health patients, refugees, rural and regional Australians who have trouble with access. Again, this is a really small-minded decision from an incredibly small-minded government when it comes to health. It is no wonder, when the government does not have any health policy and when it does not have any plans for the future of this nation, that you see this sort of decision making in the budget.

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