Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Hansard source

The minister says, 'Rubbish'. Well, maybe the minister does not understand her own legislation.

The Royal Australian College of General Practitioners President, Dr Frank R Jones, expressed concern 'that the 150 per cent cap on safety net benefits, when coupled with the existing freeze on schedule fees, would increase costs for vulnerable groups'. The minister will no doubt say that is rubbish as well. But clearly it is not rubbish. Medical practitioners who have an interest in looking after their patients understand it is not rubbish and understand that the people who will be hit hardest by these proposals will be the most vulnerable in the community. I am surprised that the minister should sit there and say that is rubbish, because it is clearly not.

A person in the adviser's box over there is shaking his head. It will fall off if you keep shaking it, my friend. You may not like the criticism but it is valid, and you need to comprehend that the criticism is valid. You may not like the fact that people do not agree with you, but people do not agree with you. I certainly do not agree with you.

I am particularly concerned about the impact on cancer patients and psychiatric services. I will go to the psychiatric services in particular, because they relate very well to this AMA report launched today. This report is about the community appreciating the impact of the need to engage health services for the most vulnerable in our community—in this case, Aboriginal and Torres Strait Islander Australians. This particular document addresses those Aboriginal and Torres Strait Islander Australians who are incarcerated. It identifies the higher level of cognitive impairment and other mental health issues that the bulk of Australia's Aboriginal Torres Strait Islander incarcerated men and women suffer from.

That raises particular issues around the provision of services, not the least of which are psychiatric services. The question of access to services is something which I hope the minister acknowledges. We have an enormous problem with the high incarceration rates of Aboriginal and Torres Strait Islander Australians, and we know that Aboriginal and Torres Strait Islander Australians continue to experience a life expectancy of around 10 years less than non-Aboriginal and Torres Strait Islander Australians. That is a national tragedy, as we know. I have to say—and I compliment the government—we are all involved in a bipartisan way in trying to close the gap. That is understood. But there are elements of government policy which are counterintuitive, because what they are doing is undermining that objective. This particular piece of legislation is one of those counterintuitive pieces of legislation which is counterproductive regarding the prospect of closing the gap and, in particular, in terms of addressing the health issues of Australia's Aboriginal and Torres Strait Islander people who are in jail. The AMA's press release today states:

Aboriginal and Torres Strait Islander people comprise 27 per cent of all sentenced prisoners, and 29 per cent of people awaiting sentencing. They are 13 times more likely to be imprisoned than their non-Indigenous peers. The imprisonment of Aboriginal and Torres Strait Islander people is rising …

That really is something that is of great concern to all of us.

The situation for young Aboriginal and Torres Strait Islander people is even more distressing. In 2012 and 2013, Aboriginal and Torres Strait Islander 10- to 17-year-olds were 17 times more likely to have been under youth supervision than their non-Indigenous peers. This is unacceptable, say the AMA. And it is unacceptable, as I am sure everyone in this chamber would acknowledge.

What this report card does, quite significantly—and this is what is important about it from my perspective as someone involved in health—is recognise that shorter life expectancy and poorer overall health for Indigenous Australians is 'most definitely linked to prison and incarceration'. They say that these health issues must be targeted as part of an integrated effort to reduce Indigenous imprisonment rates. What this means is that we have to make sure that people get access to the services. If you make it more difficult through imposing additional costs—in this case for access to psychiatry services—then you are impeding the possibility of people with a mental illness getting proper services. The minister smiles at me.

Ms Ley interjecting—

'You don't know what you're talking about,' she says. Let us be very clear. As Dr Shirley Prager, the president of the Association of Practising Psychiatrists has pointed out:

If the new Safety Net is legislated a significant group of high need 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 lives will be lost under the new Safety Net.

Is that true or not true? I might just ask the minister to respond. I am assuming that the Association of Practising Psychiatrists know what they are talking about, and I am assuming that this association has spoken to the minister, or the minister has taken the time to try and seek their counsel. The Australian Institute of Health and Welfare report The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples 2015 states, among other relevant data, that mental health related problems accounted for 11 per cent of all problems managed by general practitioners for Aboriginal and Torres Strait Islander patients in 2008-13.

We need to understand that we cannot work together, as we are trying to do, to effect change in Aboriginal and Torres Strait Islander health outcomes while at the same time introduce legislation that makes it more difficult. That is all I am saying to the government—just look at it. Do not take my word; take the word of the AMA, the psychiatrists association, GPs around the country. Don't they know what they are talking about? They might not agree with you, but at least you should acknowledge their arguments and say quite clearly that you are going to address them. Frankly, I have not seen them addressed in any contributions to this debate. I hope, in the summing up, that the minister might actually address them and assuage the concerns of so many tens of thousands of Australians who will be impacted by this piece of legislation. It is not good enough. We have a responsibility in this country and in this parliament to make sure we look after all Australians, and that is why we will be opposing this legislation.

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