Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

There are not too many times that this vitally important topic of health can be raised in this parliament. It is appropriate that we discuss it this afternoon, even though both sides of parliament have very different views on this important topic. The previous speaker was listened to politely and without interruption. We should see the same behaviour from both sides of parliament, because this place is better than to be emitting a constant blather with no intention other than trying to put off an opposing speaker. We can be better than that.

I want to start by touching on the performance of Medicare at the moment, casting some other references to the other pillars of health care, which include private health insurance, the function of the PBAC and the PBS, the history, including the other side's superclinics, and then making a reference to the shifting health debate, which is very much moving away from 'How much money can we shovel in?' to an argument about 'What outcomes can we purchase for the investment?' That is a very subtle change in the discussion, but one that is being led by some of the highest-level thinkers, both in the professions, in the health services themselves and even here, encouragingly, as we see more and more people with a health background entering this fine parliament.

I think it would not go beyond the notice of those who are in the gallery today, watching what they should expect would be a highest-possible-echelon debate about the health system, to ask why some of the highly qualified health individuals from the opposition are not in this debate today. Why wouldn't a highly qualified pediatrician with such eminent standing as the member for Macarthur have been approached to be part of the Labor Party's argument about Medicare? Here is an individual, the member of Macarthur from the other side of politics—I would have thought there might have been a hand that reached out and said, 'Sir, would you be part of this debate? Would you devote five minutes of your afternoon to coming to outline precisely how a hospital system works from the inside?'

It is fine for enthusiasts like us to know roughly when the visiting hours are at the local hospital, but that does not make a health expert. What we need is politicians in this place that have some kind of health background, some kind of health training, some kind of economic understanding to be able to discuss health, because it is an incredibly complicated part of social policy. But alas! The member for Macarthur is up there watching on the CCTV, and we have people reading speeches—reading them word for word. That does not serve the community. That will not serve the community at all.

What we have is a history from the other side of politics where they have promised 64 superclinics and delivered 33. What is the point of simply dropping a Taj Mahal right next door to an existing, functional, privately funded general practice and creating a government-sponsored one right next door? That just crushes business. That was the competitive neutrality problem with an investment in superclinics.

Let's remember the drugs that were relentlessly approved by both sides of politics, proud of our PBAC, until this opposition was in power. What did they do when they ran out of money through self-induced overspending? They deferred the PBAC approval process. That is right. Drugs for schizophrenia, drugs for chronic pain—not approved, even though they had cleared the PBAC bar. We had patients told, 'You will have to wait until we have sorted out our finances.' Then the other side of politics has the temerity to come in here and argue over a 60-cent indexation for Medicare. Let me give you the facts. Seventy-eight per cent of Medicare is bulk billed. Eighty-five per cent of all GP visits are bulk billed. If we assume that they are the poorer cohort of Australians, we have over 20 million Australians enjoying bulk-billed GP practices. I suspect that the other four million of us can afford a couple of dollars to see a GP. That is an utterly reasonable proposition.

But instead of discussing activity-based finance, a shift to outcomes, a nationally efficient price, or even the fantastic editorials written by people like Des Gorman and Murray Horn about shifting the health policy debate away from shovelling money to purchasing outcomes—no, no, no; this kind of quality stuff is not picked up by this opposition. All we are going to argue over is a 60-cent GP Medicare indexation, as if the world revolves around the money in a profession where we do it for the love. This is about shifting from purchasing a health agreement on a piece of paper to purchasing a health outcome; to keeping children out of hospital and having them fully immunised; to having outcomes that are funded by a government willing to do it. That discussion can occur with both sides of politics and with general practitioners and other providers. As long as you have your smartest people on the other side of politics sitting in their offices, not invited to be part of this debate, we will continue to have talking points from ministers' offices thrown around here with no greater gain for this community.

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