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

We had the Prime Minister, immediately after the election campaign, claiming that he had learned his lesson in the election when it came to health and Medicare. He said he would do more to reassure voters about his commitment to health. But in the two months since the election absolutely nothing has changed. As the Prime Minister confirmed in question time yesterday, he has not reversed a single one of the cuts to Medicare or to health care generally. Either the Prime Minister lacks the authority to lead his government or he has not learned his lesson at all, because a Prime Minister who had learned his lesson when it comes to Medicare would not be continuing with the six-year freeze on Medicare rebates. A Prime Minister who had learned his lesson on Medicare would not be continuing with the cuts to Medicare bulk-billing incentives for pathology and diagnostic imaging. A Prime Minister who had learned his lesson on Medicare would not be continuing with the cuts to the Medicare safety net. A Prime Minister who had learned his lesson on Medicare would not be seeking to increase the cost of prescription medicines. And a Prime Minister who had learned his lesson on hospitals would be funding them properly.

The fact is that this Prime Minister's claim that he has learned his lesson on Medicare is as believable as the claim of the former Prime Minister, the member or Warringah, at the last election that there would be no cuts to health and no GP tax. The Australian people know that when it comes to Medicare you cannot trust the Liberals. Just as with the former Prime Minister, the decisions that this government have made to gut healthcare spending, to force people to pay more for health care, to abandon sensible healthcare reforms and to privatise the Medicare payment system will be a millstone around their necks for however long their tenuous grip on government remains.

The government's Medicare freeze, in particular, has entered its second year, and it is clear to everyone that it is bad policy that will force Australians to pay more every single time they see the doctor. That is clear even to the health minister, who was put into witness protection during the election campaign after she said that she does not really like the freeze and that she 'would like to lift the Medicare rebate freeze but Treasury and Finance won't let me'. There is a gaffe if you want to talk about one.

New data this week shows that more than one in four Australians already has to pay to see a doctor and when Australians do pay to see a GP then on average that visit costs around $35; that is the gap payment. We know that those costs are a significant barrier to care for many Australians. Nationally, one in 20 Australians already skips seeing a GP because of cost. Unfortunately, those figures are much higher in some areas. In Tasmania, south-eastern New South Wales, Murrumbidgee and here in the ACT, one in 14 people delays or avoids seeing the GP due to cost. In country Western Australia it is one in 12, and in the Murray Primary Health Network in northern Victoria one in 11 people delays or avoids seeing a GP due to cost. As the Australian Medical Association and the college of GPs have said repeatedly, that figure will get worse if the Prime Minister's freeze on Medicare rebates stretches into what the rural doctors have called an 'ice age'. We are already seeing evidence of that in general practices around Australia. In my own electorate, the Springs Medical Centre has advised its patients that:

Over the past two years … government support for General Practice has significantly reduced.

Unfortunately it is no longer sustainable … to maintain fees at the current levels. To do so would seriously impact on our service quality …

As a result, that practice will now charge even concession cardholders up to $30 every second consultation.

Up in Queensland, in my colleague Cathy O'Toole's electorate of Herbert, the Latitude 19 Health on Magnetic Island has been forced to make a similar decision. They advise:

Due to Medicare restrictions and cuts, we have had to make a difficult decision to become a mixed-billing practice and we are unable to bulk-bill everyone.

Down in Tasmania, in the electorate of Denison, the Grosvenor Street and Collins Street general practices posted a note:

Due to the Medicare rebate freeze we will be changing to private billing for all patients.

On the morning before the election, the Prime Minister claimed that no-one would pay more to see a doctor as a result of the Medicare freeze. If you want to talk about a lie during the election campaign, well there is a big one for you. In practices in Ballarat, Herbert, Denison and around the country, patients who were previously bulk-billed, including concession cardholders, are now being charged—and that is in the second year of the Prime Minister's Medicare freeze; imagine the impact after six years! Unfortunately, it is the most vulnerable in our community who are hardest hit. With growing health inequality in this country, the question has to be asked: why does this government want to make it worse?

Of course, this is not the only cut to Medicare that this government has imposed. The Prime Minister confirmed during the election campaign that it is still his intention to increase the cost of prescription medicines for everyone, including concession cardholders. We already know, from data and from pharmacists across the country, that compliance is a major issue when it comes to medicines and that cost plays a very significant role in that.

We also have cuts to pathology and diagnostic imaging. On 1 October the government is set to cut all Medicare bulk-billing incentives for pathology. The regulations to do this, according to the government's own timetable, are due to be tabled this month. The result of the Prime Minister's decision will be that some of the sickest people in the country—the Australians with chronic conditions; the Australians who need blood and other pathology tests—will be forced to pay more for them. This, alongside the decision by the government to reduce bulk-billing incentives for diagnostic imaging as of 1 January next year, will mean that patients being treated for cancer and other serious health conditions will pay hundreds, and in some cases thousands, of dollars up-front for diagnosis and ongoing treatment. These are this government's decisions on health!

And then, of course, there are public hospitals. Despite the government's eleventh hour deal to get them through the election, the reality for our public hospitals is that they are in trouble. They are barely keeping up with demand, and the pressure this is placing on our dedicated nurses, doctors, other health professionals and all of those who work in supporting them is taking its toll. Basically, instead of increasing public hospital funding, the government has locked in the status quo until 2020.

The government's continued public hospital cuts mean that hospitals are being funded at a level that is simply not sustainable, and its abandonment of funding and targets for emergency department waiting times and elective surgery is having an impact. With the government's Medicare freeze and cuts to pathology and diagnostic imaging, the pressure placed on public hospital emergency departments is only set to grow—and if the Prime Minister thinks that the states and territories will quietly sit and wait until 2020 for this to get resolved then he is a fool.

We also have the government's decision to continue to count the cut to the Medicare safety net in its budget figures. We know from the Senate report on this legislation that there are many concerns about the way in which the government is intending to go about it—and it is a cut to the safety net. The College of General Practitioners said that they had:

… significant concerns that the proposed changes will leave all patients with greater out-of-pocket costs.

The Private Mental Health Consumer Carer Network said that they had significant concerns about the measures, in particular the serious associated risks to the lives of those sex abuse victims—something they raised through the course of the Senate inquiry—noting that the measures would 'severely interfere with their real chance of recovery'. The Royal Australian and New Zealand College of Psychiatrists also said it was:

… very concerned about the impact that the proposed new Medicare Safety Net will have on vulnerable people with mental illness who require long-term intensive psychotherapy.

But the government is far from learning the lesson of the election. As the AMA president said earlier this month, we are seeing exactly the same health policies from before the election, and many of them—all of them, I would say—are bad health policies. All of the cuts to Medicare remain. Far from learning the lesson on Medicare, the government is showing it has no idea when it comes to Medicare.

And what is this government backbench doing? What are those brave souls on the backbench, who have discovered that in toppling a former Prime Minister they actually have some power, doing? What is activating them at the moment? Are they going to the Prime Minister saying, 'We are really worried about what is happening to health care in this country and the cuts that are impacting on our constituents'? No. They are bogged down in squabbles about superannuation for wealthy Australians, watering down race discrimination laws and trying to scuttle same-sex marriage. Well, if the government backbench will not stand up for Medicare, this side of the parliament definitely will—every single day.

The test of this Prime Minister on health is absolutely clear: if you have truly learnt your lessons of the election, you will unfreeze the Medicare Benefits Schedule, drop the decision to increase the price of prescription medicines, get rid of the cuts to pathology and diagnostic imaging, properly fund our public hospitals and drop your plans to slash the Medicare safety net—and, while you are at it, stop pretending that you were not planning to privatise the Medicare payments system and tell us what you are going to do to improve delivery. (Time expired)

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