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

Just when you think there could not possibly be anything further the Liberals could do to attack Medicare, they prove you wrong yet again. On the front page of today's West Australian newspaper it is revealed the government has a secret plan to privatise Medicare and the Pharmaceutical Benefits Scheme. So, after two years of trying to kill Medicare, now the Liberals are trying to sell it off. This is a direct attack on Medicare services which could jeopardise the patient data of every Australian and the jobs of some 1,400 staff at centres all around the country. This idea, from the same failed commission of audit that gave us the GP tax, that told us we should merge the Organ and Tissue Donation Authority with the National Blood Authority—something I think the government has now finally ditched—would mean that Medicare services would be delivered for profit, not with the best interests of patients in mind. It would mean the most critical, confidential and intensely private health details of all Australians potentially being sent overseas.

Once again this is a case of the government seeing these services which are so vital to all Australians as nothing more than a source of savings. This is the Prime Minister going where even Tony Abbott feared to tread. This is the Prime Minister proving that, no matter who the leader is, the Liberals only ever see health as a source of budget cuts and will always look to make health less affordable for those who need it most—the sick and the poor. In his very first economic statement the Prime Minister took all of Tony Abbott's cuts to health, and then added an extra $2.1 billion to make health care even less affordable to millions of Australians. He took Tony Abbott's $57 billion in cuts to hospitals, his billions of dollars in cuts to preventive health and public dental programs, his GP tax and added another $2.1 billion of his own.    He gutted crucial health workforce programs to the tune of $595 million, ripped another $146 million out of health prevention and took another $650 million out of Medicare by slashing bulk billing incentives for pathology and diagnostic imaging.

The people who will pay for these cuts are the patients, in up-front costs of hundreds and even thousands of dollars that even after the Medicare rebate is paid will see them hundreds of dollars worse off in some cases. This decision to abolish Labor's incentives—incentives that were absolutely working in pathology and diagnostic imaging—will force many pathology clinics and diagnostic imaging practices to abandon bulk billing and begin charging patients for scans and tests. And patients charged these fees must pay the entire amount up front and then claim back the rebate later. These costs are not inconsiderable. According to the Australia Diagnostic Imaging Association, patients would have to pay up to $93 up front for an x-ray, $396 for a CAT scan, a minimum of $85 for a mammogram and up to $186 for an ultrasound. For those unfortunate enough to need a PET scan, the up-front cost could hit $1,000. That is before you get the rebate back, and you have to pay it up front. But patients with serious conditions never need just one scan. Australia has the world's highest diagnosed rate of melanoma and a typical patient diagnosed with melanoma would be referred for a PET scan and an MRI scan of the brain, a total of $2,660 to $3,130 up front and gaps of $260 to $725. A patient with suspected breast cancer who was previously bulk billed faces up-front costs of between $282 and $554 and will still be left $29 to $302 out of pocket after receiving all of the Medicare rebates. Patients will eventually get rebates from Medicare, but they could still be left with hundreds of dollars in out-of-pocket expenses— that is, of course, if they have been able to find the money up front in the first place.

For many of the patients who are now bulk-billed, these sorts of costs are simply unaffordable. People who skip appointments may get lucky and find their condition has not deteriorated, but the odds are that those who do miss important scans will get sicker, require even more extensive treatment and end up costing the health system much, much more. And heaven help those who do end up in hospital, because, as I pointed out earlier, this government has cut $57 billion out of our public hospital system—$57 billion in hospital cuts is such an overwhelming figure it can be hard to focus on what its impact might mean for our hospital systems. Now, thanks to the work of Labor senators on the Senate Select Committee on Health, we know that for just one state, Victoria, it is the equivalent of closing two major hospitals and dropping 23,000 elective surgeries every fortnight. The Queensland health department has estimated its share of the cut is the equivalent of 4,500 doctors, nurses and allied health practitioners. And these cuts will be repeated in every state and territory, with tens of thousands of elective surgeries cut, hospital beds closed, waiting lists blowing out and thousands fewer doctors, nurses and other health workers. No wonder even the Liberal New South Wales Premier Mike Baird has declared the cuts to be unsustainable and a kick in the guts.

But the changes went much further than just ripping out the funding, because at the same time the government also tore up a series of agreements years in the making and agreed by governments state and federal, Labor and Liberal, to not only place hospital funding on a secure basis but also use that funding to drive real reform that would not just improve patient care but do so in a way that made our hospital system much more efficient and eliminated waste. The benefits delivered by the agreements went beyond hospitals—better care in primary care, better prevention care and better dental care, as well as placing hospital funding on a secure footing. They were, in short, the most significant health reform since the introduction of Medicare—negotiated yet again by a Labor government in cooperation with the states and territories, and the Liberals have literally thrown them out and said, 'It's not our problem.'

In just the last few hours, it seems that even those premiers and chief ministers clinging to the hope that somehow the government's floating of the GST might be the answer have finally seen the light. Of course, state leaders are desperate for money for their schools and hospitals. They are telling the truth when it comes to what this government has done. But increasing the price of everything by jacking up the GST and the cost of living is simply not the answer.

It is now very, very clear that this was never about funding schools and hospitals. It was just a massive tax transfer from companies and high-income earners onto low- and middle-income earners. There was never anything in this for schools and hospitals, and the premiers and chief ministers now understand that this is not a government that cares about properly funding our schools and hospitals. The government has today cancelled a special meeting of the Council for the Australian Federation to discuss this crisis. No wonder even Liberal premiers are saying these cuts are unsustainable and simply amount to a massive cost-shift onto both patients and the states.

The growth in hospital costs will not magically be lowered as a result of these cuts. In fact, the latest evidence confirms that they will have a real impact on patients and healthcare outcomes by increasing emergency department waiting times, increasing elective surgery waiting times and reducing the number of hospital beds across the country.

Not content with cutting hospital funding, the government then attacks bulk-billing by slashing rebates for pathology and diagnostic imaging, and of course continuing its freeze on rebates to general practitioners, ensuring that even more people will head to already overstretched and underfunded emergency departments—because when you are a parent with a sick kid who needs to see a GP or get an X-ray and you cannot afford the fees, where do you go? You go to the emergency department of your local public hospital—the same public hospitals that are about to lose $57 billion as a result of decisions that this government has made.

So, while the government has changed leaders, essentially the health policy remains exactly the same: to cut health costs and to shift costs onto patients by attacking bulk-billing and Medicare at absolutely every turn. And now, after two years of trying to kill off Medicare, the government is trying to flog it off. Today's revelations confirm yet again that only a Labor government can be trusted to defend Medicare and that Medicare will never be safe under the Liberals, regardless of who their leader is.

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