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

I too rise to speak on the Appropriation Bill (No. 3) 2015-2016 and cognate bill, which represent Malcolm Turnbull's first major economic statement. I do feel the need to respond to the member for Solomon to some extent. I think the Northern Territory government, unfortunately, dropped the member for Solomon in it. Her media statements around the Northern Territory government actually attest to that. I felt very sorry that she was, unfortunately, dragged into what clearly was a stunt around the Palmerston hospital. I am delighted and those on this side are delighted because we made the commitment to the funding for the Palmerston hospital in the first place that it is finally under construction, though a bit late, I would have to say. I do feel very embarrassed for the member for Solomon that she got dragged into the stunt by the Northern Territory government and I am glad she hit out at them in the local media about that. But I do look forward to having our Labor candidate, who has been a champion not only for the Palmerston hospital but for the Darwin hospital as well, here as the new member for Solomon in the next parliament.

The appropriation bills give us an opportunity to look at the Mid-year Economic and Fiscal Outlook and to speak about those areas for which we have some responsibility. Of course, I wish to speak about health. Sadly, despite the Prime Minister's promise of new leadership, there has been absolutely no evidence of that when it comes to health policy. Instead, in many ways, what we have seen in the Prime Minister's first economic statement is actually worse than what we saw from the previous Prime Minister and the previous Treasurer.

This year Mid-year Economic and Fiscal Outlook statement has continued the $57 billion worth of cuts to public hospitals. I note some reports today that the government has been forced and will have to go to the COAG meeting in April with the bucket on the table—$7 billion potentially—that represents Labor's funding for the next few years for public hospitals. It is the money Labor committed. What an embarrassed for the government that it now has to put exactly the money that the states and territories would have got under Labor's agreements back to the states and territories because of the absolute mess they have created with public hospital funding—$57 billion worth of cuts. I can tell you now, $7 billion is not going to cut it when it comes to the growth in demand in our public hospitals. If you think you are going to get away with just rolling all of the money in from some of the existing services and not giving the states extra money to meet the demand that is happening in our public hospitals across the country, then you are kidding yourselves and you are on for a very big fight over this issue.

Again, in the Mid-year Economic and Fiscal Outlook we not only had the $57 billion worth of public hospital cuts entrenched in the budget but also the $2 billion four-year freeze on Medicare rebates for GP visits. The government may not think this matters much, but we know that over time what we will start to see is the introduction, in essence, of large co-payments within general practice. That is what is already happening in some areas. Over time, it certainly will have a substantial impact on the fees that GPs charge their patients.

We also saw the continuation of the $800 million in cuts to the health flexible funds. This is a debacle. We saw, in fact, that debacle this week. The hotline for the Australian Breastfeeding Association that thousands of women ring each year to try to get advice about breastfeeding has uncertain funding. The funding was due to run out at the end of this financial year. They had been to the department. There was nowhere for them to put an application in. They were told, very specifically, that they could put in a letter and there might be something coming but there was no time frame, no possibility about what the amount would be or what the parameters were because the department simply does not know what is happening with those flexible funds. I am very pleased the government has provided them with some money for another year. They were getting three-year funding and they have now been bailed out for another year.

This is the chaos that has been created with the $800 million being entrenched in MYEFO into the budget to all of the not-for-profit organisations across the health system. We have recently seen the rural and regional health consumers forum, basically, defunded—it is $60,000. There is nowhere else for these groups to go, and there are hundreds of them. Many of them are coming to me. They are scared. They say they do not want to run a campaign because they know how vindictive this government is when they do.

The Australian Breastfeeding Association have been courageous and they have had a result here. But they have had a result of one year, because, I can tell you now, there was a strong potential for a very strong campaign against this government on this issue and the government has tried to save itself a problem in the lead-up to the election. But these $800 million worth of cuts are causing chaos across the not-for-profit sector when it comes to health and the government has no solution. It is tinkering around the flexible funds. Out of the blue, it created a new peaks fund that no-one particularly knew about. It has also told people that it is going to start creating other funds as well. It is chaos when it comes to this issue.

We have also seen entrenched again in the budget a $1.3 billion hike to the essential medicines. That still sits in MYEFO as a $1.3 billion savings measure, despite the fact that the Senate has clearly indicated it will not pass. It is a fraud to have it there. The minister has said, 'I'm not taking it off the table, because I'll have to find other savings.' Well, yes, she will, but it seems to me that the government cannot continue to claim that this measure is in fact a saving and try to prop up its budget bottom line. Equally, in the same point, is the $267 million attack on the Medicare safety net, which had, in particular, those patients facing fertility treatment so anxious about what that would mean in that area as well as in some of the other areas such as psychotherapy in the mental health space. So, again, that is also still within the Mid-Year Economic and Fiscal Outlook. But, to add insult to injury, this mid-year economic statement adds another $2.1 billion in cuts that will make potentially make health care even less affordable to millions of Australians. Frankly, this mid-year budget review proved 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.

The Prime Minister's first economic statement, delivered just weeks after he came to power, promised to put an end to the backward-looking policies and divisions of his predecessor. But, instead, in health, the government cut $595 million out of health workforce programs. Having already cut the health workforce, it is incredibly short-sighted for the government to have done this. We have seen a program of work remaining from Health Workforce Australia that will basically pretty much finish at the end of this year, and now they have cut further funding out of health workforce. The government have no policy, no plan and no idea about what they are doing in this vital area to make sure that our health system actually functions. What are you going to do about the professions, how they are spread across the country, what their work is, and how you foster the next generation of our workforce in this area? It is critical to reform, and the government have absolutely dropped the ball. We have also seen another $146 million out of health prevention and eHealth. The government are going around saying that they are committed to the electronic health record, yet they have continued with cuts and they have not put money in the forward estimates for it. So they have a big problem when it comes to that.

As we have heard a lot about both in this place and outside, they have also taken a very blunt instrument and ripped another $650 million out of bulk-billing for pathology and have made changes to bulk-billing for diagnostic imaging. Australian women were rightly outraged at reports that, as a result of the Turnbull government's pre-Christmas budget cuts, they might soon be paying a lot more for critical tests. These are critical tests when it comes to cancer diagnosis and chronic disease. It is a very blunt instrument. If the government think that the pathology companies—which they like to beat up on at the moment—and the diagnostic imaging companies are somehow going to just absorb these cuts and be really generous to patients and not pass these cuts on, they are absolutely kidding themselves. They know that these companies will pass these cuts on. You can say that is appalling—it may well be—but that is the commercial reality of what they will do. What will happen as a result? The result will be that it is the patients who will pay—and, in some cases, it will be the sickest and poorest patients who will pay.

The government like to play around with figures on this, but the bulk-billing incentive in pathology was deliberately designed after we had made savings in the pathology area to ensure that pathology maintained its high level of bulk-billing—and that is exactly what happened. It has not only done that; it has increased it by one per cent. So if you think just taking that away without any negotiation with the pathology companies about how they might continue to keep high rates of bulk-billing and that there will not be a change, you are just in there with a wing and a prayer—and the people who are going to pay for that are the patients.

I particularly want to highlight diagnostic imaging. I am bit reluctant to do this on this day, but it is the only opportunity I have to do so. In particular, because it is Teal Ribbon Day, I want to talk about the circumstances of someone who may be diagnosed with ovarian cancer. Ovarian cancer is an insidious disease. It is the silent killer. We know that, for many, many women, the symptoms do not show. They are symptoms that we all generally put down to being of our gender. We might be a bit tired, we might be feeling a bit bloated or we might have to wee a bit more, but we do not necessarily think that these are things that we should absolutely, desperately, go and see the doctor about.

I found it a bit galling, to be honest—when we have these terrible cuts that are happening to diagnostic imaging—to see some of the comments being made about how we need to commit to ovarian cancer and how important this is on this day, when there are some very serious consequences of the decisions that this government is making. For example, a woman diagnosed with ovarian cancer will typically need an ultrasound and two CT scans and, after treatment, a further five CT scans and two ultrasounds for monitoring. As a result of the government's decision to cut diagnostic imaging, these women now face upfront costs of between $3½ thousand to $4½ thousand, because you do not just get to pay the gap; you actually have to pay the full amount upfront and then reclaim from Medicare. So they have to find that money each time for those scans and, even after they receive the Medicare rebate, they are left between $365 and $1,300 out of pocket. They are the figures from the Australian Diagnostic Imaging Association and they cannot be dismissed. That is the commercial reality of what they have said they will need to do in their practices across the country.

I have no doubt that many women, when they hear these examples and when they see what these cuts actually mean for what patients, potentially, will pay in out-of-pocket costs, will be extremely distressed by that—and they should be. What the government has done, in the mid-year economic financial statement, has been a very blunt instrument. It has not been negotiated with either of those sectors. The inevitable consequence of those is, of course, that patients will pay.

I saw the minister's press release; we do pay attention. We get a bit amused by those, I must admit, in my office, because we are in opposition and she does pay us an awful lot of attention for that. It is always very flattering. But in quoting the Grattan Institute on pathology today the minister probably had not read the report. The report clearly stated that if the government proceeds with what it is doing there is the potential for patients to pay for it. This mid-year economic financial statement has entrenched the fact that this government is the worst friend that Medicare has ever had. They do not believe in universal health care and they should be ashamed of what they have done in health.

See this speech in context