Lisa Chesters (Bendigo, Australian Labor Party) Share this | Hansard source

Previous speakers on this side of the House have said that Labor will support this bill. It makes three minor technical changes to the administration of the PBS. But we are also using this as an opportunity to flag, loudly and clearly, the problems that we have with our health sector and the impact of the ongoing attacks from this government and those opposite on Medicare and on our universal health system.

I hear weekly from people in my own electorate, which is a regional electorate, about the worry that they have with out-of-pocket costs in relation to health care. Health care is one of the triggers for which many are seeking support from welfare agencies. It could be a car service, it could be an education expense, but too often, people are citing the reason they need help as out-of-pocket medical expenses.

One of the big costs for a lot of people is the cost of medicine. I know the government has dismissed concerns that have been raised by people when they said that the plan to increase every medicine by up to $5 was nothing to be worried about. But for people who need multiple prescriptions, it is a lot. The government continues to put forward, time and time again, the so-called zombie measures from the notorious 2014 budget despite the opposition to them in this place. They are determined to push through these changes which will see a co-payment for general patients of $5.80 for concession card. This is despite the fact we hear, over and over again, that cost is a reason why people are delaying seeking medical help and medical support.

I recently, on the back of the federal election campaign, ran my own series of health inquiries and Medicare forums in my electorate to ask people directly what their concerns were and what their experiences of primary healthcare were across the Bendigo electorate. We held several forums at Woodend, Kyneton, Castlemaine, Maldon, Heathcote, Elmore and across the greater Bendigo region. So we did not just stick to Bendigo, as in the CBD. We went out and asked people. We heard from health professionals, from pensioners from families, from patients, from people working in the sector. We asked them what their experiences of health care and of primary health care were, and what their recommendations were.

The findings of our inquiry are quite alarming. They back up a lot of the evidence that we have heard about regional people accessing health care. In our survey we found that 87 per cent of people believe that the cost of health care has gone up in the last 12 months, including the cost of prescriptions. Maybe it is not just the prescription that they get on PBS but the extras that they also have to pay for to go with that prescription. Forty per cent of the people who attended and participated in the Bendigo electorate said that they had delayed seeing the doctor because of price. One hundred per cent said that they believe that the government should protect Australia's universal health care system and invest more. This is the most alarming statistic that we found: on average, the out-of-pocket patient expenses for going to the GP was $21. This is the gap fee. In a sample of 23 clinics in the Bendigo region, only four now bulk-bill non-concession card patients and only 11 bulk-bill concession cardholders. Only four across greater Bendigo 100 per cent bulk-bill, with only one in the postcode 3550.

This has happened just recently. Under this government, we have seen a collapse in bulk-billing rates in my own electorate of Bendigo. It was actually quite shocking not only to listen to people about how 40 per cent are delaying to see a doctor but to then learn why it is only our community health service that bulk-bills now in the postcode 3550. Across greater Bendigo, if you do not go to a Bendigo community health facility then it is a Tristar, where it is a six-minute consultation. That is the only way you can see a bulk-billing doctor in the Bendigo electorate.

Some of the fees charged by doctors, even for concession cardholders, was as high as $31 out of pocket. We had someone attend the Heathcote hearing who travelled down from Rochester to say that in their town it is $50 out of pocket to see a GP. This is not the inner-city of Melbourne, where incomes are high; this is regional Australia and regional Victoria, where about 30 per cent of households in my electorate are trying to survive on $600 a week. These are households—tens of thousands of people—who are living on fixed income, whether they be people on disability pensions, aged pensions or unemployment benefits, or a group of growing underemployed people. These are people who are struggling to cover the costs of the basics and who are now paying more than ever to see the GP—and, if this government gets its way, even more for pharmaceutical benefits. This is a government that has lost touch with people on the ground when it comes to the cost of health care.

I will state the statistic again. Forty per cent of people that we surveyed in the Bendigo electorate, a regional town and a regional electorate, said that they delayed going to the doctor because of price. One particular person said, 'Yes, I've been to see a bulk-billing doctor,' but it is then the scripts on top of that. It is then the extra that they have to pay if they then have to go to the physio or an allied health service. The cost involved in accessing primary health care is continuing to increase. In one of case studies that we heard, a Castlemaine pensioner who is a two-time breast cancer survivor said, 'I now have Parkinson's. Every time I go to the specialist, like a speech therapist or a podiatrist, or a neuro nurse, it's $8.50 out of pocket.' That is what she pays on top of her service, which is currently bulk-billed. But once she hits her cap she then has to pay upfront. Last month, it totalled $200.

It is a well-kept secret that we really have a user-pays system. What we were hearing loudly and clearly from across the electorate is, whilst the ideal is to have a universal healthcare system, we do not have one currently. It is clearly a user-pays system, with people being asked to pay more and more.

There is also real concern from our GPs about workforce. We did invite a number of GPs to come and speak at our hearings. Seventy per cent of GPs in rural areas are bankrupt at some point. That is what one GP said to us. 'The cost of running private practice is going up, but the rebate remains the same. I've put in every bit of cash that I have to try and support the community. If I was sick tomorrow I would be in financial trouble. We need to increase the rebate.' Let's hope that the government and the health minister hears these concerns and, in the upcoming budget, unfreezes the rebate and lifts the GP rebate.

Burnout is a big problem for doctors in regional areas. They simply do not have patients that can afford to pay the $50 out-of-pocket expense to help the clinic break even. When you have areas like mine, where 30 per cent of people are trying to survive on $600 a week, you have a lot of concession card holders. It is no wonder that some clinics have now dropped bulk-billing concession card holders. If they want to keep their doors open, they are passing the cost onto the patient, and the result of that is what I have told you twice in this speech already: it means that 40 per cent of people in the Bendigo electorate are delaying going to the doctor, because of price. GPs who attended the hearings said that the Medicare rebate freeze is having a significant impact on their working life. For many GPs the rebate freeze was causing severe stress and anxiety, whilst the pressure to undertake shorter appointments was leading to lower job satisfaction, because they were worried about not delivering the advice that the patient needs. They were worried about poor health outcomes for their patients. We learnt in the hearings that we held how some GPs are doing their best and trying to be creative in making ways to ensure that their patient, as well as the GP, gets enough consultation time.

It should not have to be that hard for GPs in rural areas. It should not be that hard for patients in rural areas. We need to make sure that we see this government lift the GP rebate, lift the freeze in the upcoming budget, to ensure that our GPs get fairly rewarded for providing services. We also need to see this government significantly reinvest the money it has cut from primary health care, to ensure that out-of-pocket expenses are lowered. In regional areas like Bendigo, we literally now have a two-tiered system: those who can afford to pay for health care, and those who cannot. If the government gets away with its plan of reintroducing its zombie measures to increase PBS co-payments—up to $5 for general patients and then an extra 80c for concession patients—and cut the PBS even further, it will mean that the most vulnerable, the poorest, the elderly and the sick will be hit once again by this government.

I have to acknowledge that it is great to see some medicines come onto the PBS—medicines like Kalydeco, which I know is making a massive difference to some people with cystic fibrosis who are living in the area. I want to acknowledge Amelia and her family, who campaigned long and hard to see Kalydeco listed on the PBS. Amelia's parents tell me that her life has really turned around. She can now run with her sisters and not be out of breath. She is playing and she is happy, and for the first time in a long time their family have a future. Speaking of Amelia's future, their visits to the doctors are fewer and their visits to the Royal Children's Hospital in Melbourne have reduced. This is a good news story, but unfortunately it is rare. We have fewer and fewer good news stories coming from the Bendigo electorate. We have more and more stories of people delaying buying the medicines that they need, because they simply do not have the money. We have more and more people saying that they are delaying going to the doctor, because they cannot afford the out-of-pocket fees and, as I have already said, there is a growing trend amongst doctors of increasing the out-of-pocket fee, the gap fee, because of this government's freeze.

If we are genuine about a universal healthcare system, it needs to be a system that all citizens can engage in, where all have access to good quality health care. As I said, 100 per cent of people involved in the Save Medicare hearings that we had in the Bendigo electorate—from Elmore to Woodend, from Heathcote over to Maldon—said they want to see the government invest more in health care. A hundred per cent are saying that they believe in a universal healthcare system and that they want to see the government restore the funding that they cut.

Whilst this is a minor bill that makes only three technical changes to the administration of the PBS, it has allowed me to stand and outline to the House the findings of our recent hearings and the report that I released in the electorate last week, Save Medicare: a report into the experiences of central Victorians with our healthcare system. Its findings are alarming, but, equally, its recommendations are quite compelling, and I encourage the government and the minister to listen to the people of central Victoria and to take on board their concerns: reinvest the funding that has been cut from health care, drop the zombie measures which will see co-payments increase, and unfreeze the Medicare rebate, which has been frozen now for too long. We cannot afford to have 40 per cent of people not accessing GP services, because of cost increase. Only through federal government investment will we see that percentage decrease.

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