Sharon Claydon (Newcastle, Australian Labor Party) Share this | Hansard source

It is with pleasure that I rise to speak on this bill before the House, because, whilst we may have a new Prime Minister in this parliament, the bill we are in fact debating here today, the Health Insurance Amendment (Safety Net) Bill 2015, is certainly further proof that, despite a new face, there are many things that remain the same. Here we see evidence of that same unfair, callous approach that has existed since this Liberal government was elected and certainly in this area of health.

The bill implements the unfairness that originated with the 2014-15 budget. It gives effect to those budget measures. 'Simplified Medicare safety net arrangements' was very much a theme, if I recall, of that budget as well as this government's general approach to the health portfolio. When we talk about simplifying measures, what that really meant was cuts to the safety net of some $270 million.

We have seen cuts across every part of the health system in these last two years. The Abbott-Turnbull government has taken more than $60 billion in cuts from Australia's public hospitals, including some $155 million from hospitals in my region. It includes attempts to increase the cost of medicines for every Australian, including unfair changes to the Pharmaceutical Benefits Scheme safety net. It includes $370 million in cuts to the preventive health programs, programs that we know are vital to getting Australians' health back on track. There is the abolition of the Australian National Preventive Health Agency and Health Workforce Australia. Those are two huge issues that are looming in this nation that this government has taken the razor to.

There is the government's ongoing effort to implement a GP tax in one guise or another. This is, I believe, the fourth reincarnation of what has always been a very bad public health policy that this government simply refuses to put to rest. So let's try GP tax version 4 now, through the perpetual freeze of the MBS, which represents a cut of some $2 billion from Medicare. We are of course seeing cuts of hundreds of millions of dollars from public dental health schemes, another incredibly critical service that people in my electorate of Newcastle have voiced their concerns about to me on many occasions. There are cuts to the general practice training programs and there are cuts to mental health—and, most alarmingly, cuts to Indigenous health programs.

How this government intends to meet its close-the-gap targets is a mystery to most people outside of this parliament. If there is a failure to meet those targets, you can rest assured that my colleagues and I on this side of the House will be holding this government to account.

The cuts are really deep and they are at every level of health. The bill before us today, the so-called 'simplified' safety net, involves abolishing the existing original Medicare safety net and the extended Medicare safety net. Labor is opposing this bill, because we have serious concerns about the adverse impact these changes will have on thousands of unwell and vulnerable Australians.

While the bill does lower the safety net threshold for all patients, restrictions on the out-of-pocket costs that contribute to a patient reaching the safety net are introduced, and the amount patients receive back once they reach the safety net is also reduced. In particular, Labor is concerned about the impact these changes will have on: radiation oncology patients, patients needing ongoing access to psychiatrists, and patients accessing IVF services. I would like to spend a little time now highlighting some of the concerns I have around detrimental impacts that these changes will have for radiation oncology patients—people with cancer.

Radiation oncology patients, who had previously been bulk billed for elements of their treatment, will now see significant new out-of-pocket expenses. Cancer is an issue that touches so many Australians. In my region of Newcastle and the Hunter we have quite high rates of cancer. There are very few families in my electorate who are not touched in some way by this disease.

If you look at the rates of prostate cancer, for example, there are about 20,000 Australian men diagnosed every year, including 1,200 in the Newcastle and the Hunter region. Around 3,000 of those men die from prostate cancer every year, including about 160 in the Hunter. That is a lot of men to be losing on an annual basis.

When we look at the melanoma rates, there are around 11,000 Australians diagnosed with melanoma every year, including 600 in the Hunter-New England region. It is the second most common cancer in the Hunter, behind prostate cancer. There are very high rates in our communities. We have way above average rates of melanoma. Indeed, the Cancer Institute New South Wales figures show the Hunter ranks fourth highest in the state.

And then, of course, there are the disturbing figures around breast cancer. Five hundred and fifty women are diagnosed with breast cancer in the Hunter each year. It is the third most common cancer in the Hunter. These patients are now forced into increased out-of-pocket expenses. According to one example, a patient with a malignant melanoma receiving stereotactic radiation treatment could face new out-of-pocket costs of some $7,400. A patient with prostate cancer receiving volumetric modulated arc therapy could face new out-of-pocket costs of some $8,000. Similarly, a patient with breast cancer being treated by private providers might see a 200 per cent increase in their out-of-pocket expenses for radiation oncology. These are massive imposts on people who are very unwell, feeling especially vulnerable and already have so much to deal with.

Due to the debilitating nature of these illnesses—not to mention the incapacitating effects of the treatments that people have to undergo—many cancer sufferers are unable to work and earn an income for prolonged periods of time often extending into remission. Having to come up with thousands of dollars to meet extra out-of-pocket costs is not something that anyone experiencing cancer should have to undertake.

There is barely a week that goes by in my electorate where I do not have an invitation to attend a fundraiser for a family who are doing it tough and trying to raise money to complete their medical treatment. There are examples of morning teas, trivia nights, film screenings and, increasingly, crowdfunding. That is before these additional cuts come into play. That is before these additional out-of-pocket expenses kick in. It is an enormous financial burden already for people undergoing prolonged treatments for cancer.

I have an example of a young man in my electorate suffering terminal brain cancer. He is not eligible to go for a disability support pension. There is no financial support available for him while battling this illness. Additional thousands of dollars to add to an already hefty bill is the cruellest of cuts from this government. These are people who do not have a treasure trove of savings to call on. Nobody makes plans for a cancer diagnosis; it is a very unexpected matter for most people to have to deal with. This additional burden, as I said, is just one of the cruellest consequences of the bill before the House today.

Health professionals agree that the impact of the changes proposed in this bill will negatively impact their patients. The Australian Medical Association is opposed to these changes. The President of the AMA, Professor Brian Owler, has said:

… the new Medicare Safety Net arrangements, together with the ongoing freeze of Medicare patient rebates, mean that growing out-of-pocket costs will become a reality for all Australian families, including the most vulnerable patients in our community…

The Royal Australian College of General Practitioners have also warned of the impact of these changes, especially in the context of the government's GP tax through its ongoing freeze of Medicare indexation. The college's president, Professor Frank Jones, has said:

… coupled with the indexation freeze, the legislation will actually increase the cost of care to vulnerable groups. Safety net thresholds will increase by CPI annually while rebates are frozen.

Concerns have also been raised by the Royal Australian and New Zealand College of Psychiatrists. Cancer groups and others have also raised consistent concerns about the thousands of patients that will be adversely affected by these changes.

Breast Cancer Network Australia Chief Christine Nolan said:

Many women are dismayed to learn that despite paying years of private health insurance premiums, they cannot claim for radiotherapy costs from their private health fund unless they are in hospital during their treatment.

These women must rely on the Medicare Safety Net to maintain their costs for radiotherapy at a reasonable level. Breast Cancer Network Australia is concerned about any proposed changes to the Safety Net that may increase treatment costs and add to the financial burden of a breast cancer diagnosis.

In these last few minutes I would like to take a look at some of the detrimental impacts these cuts will have on patients needing ongoing psychiatric care. Psychiatrists, especially those providing psychotherapy services to very vulnerable patients, have warned the government of the very serious impact on patients they care for. Dr Shirley Prager, the President of the Association of Practising Psychiatrists, has said:

I am very concerned about the impact the new Safety Net proposals will have on patients who need long-term ongoing mental health treatment as these patients will find their health care with a psychiatrist increasingly unaffordable. If the new Safety Net is legislated a significant group of high need patients who require consultation with their psychiatrist more than once a week will lose the appropriate level of support provided by the current Safety Net arrangements. Many of these patients are poor and unable to work as a consequence of illness, and the intensive psychiatric help that they urgently need to re-build their fives will be lost under the new Safety Net.

Dr Prager has also said:

I believe that patients who need to access a psychiatrist in these circumstances will suffer significant and increased financial hardship, or may, very frequently, be forced to give up much needed treatment to the overall detriment of their own personal health and well-being. The consequences are potentially disastrous.

Again, in my region, many people have revealed, for the first time, through the Royal Commission into Institutional Responses to Child Sexual Abuse, the terrible trauma that they have experienced in their lives. They are now seeking some assistance in their healing process; those people are reaching out for our help. The cuts that we see in this legislation before the House tonight really go to denying those people the very treatment they need to complete the healing process.

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