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

In this address-in-reply, I want to do a couple of things. I want to acknowledge the terrific efforts of the campaign committee in Ballarat for their work in retaining the seat of Ballarat for federal Labor, and I also acknowledge the many volunteers throughout the community who have worked on my campaign for a long period of time.

I also want to focus on some of the contemporary issues that are happening right at the moment. We are obviously some months on from the election now—it is the uniqueness of this place that it takes quite some time for us to actually get to the debate here—but I want to reflect on some of the current issues. On Saturday I held one of my regular mobile offices. I have been doing these on a Saturday morning for the past 16 years. This time I started in Sebastopol. It is an area of higher disadvantage than, for example, Central Ballarat, and it is largely characterised by people who have worked or are working in trades, labouring, retail and health services. Sebastopol also hosts a number of retirees, mainly on the age pension but also, reflective of its long working-class history, on part pensions.

Generally at mobile offices, I get two or three people mostly just wanting to pop by and say hello, but on this weekend there was a queue of 20 people. The sorts of issues being raised ranged from people waiting long periods of time to get an outpatients appointment to get on the waiting list for general surgery at our hospital, to an older couple with diabetes who wanted me to ring their GP to see if they could get waived the $70 fee that they now have to pay for every visit that they had not been paying before. I had someone who found that their blood pressure medication had doubled in price and was worried that they could no longer afford it. Another local reported that a cancer skin cream that they had used had also substantially increased in price. A young woman with three children with disabilities said that, as a result of now having to pay a disputed Centrelink debt, for the first time she was having to use emergency relief to pay for food, and also had to use that to pay for her kids' uniforms.

The reason I am raising this as part of my contribution this morning is that I think that my small snapshot of a mobile office on a Saturday morning is reflective of a broader and deeper problem that has emerged since the Turnbull government came into office. That is the problem of growing inequality and deep poverty, particularly amongst groups who were previously managing to get by—if only just. That inequality is particularly evident when it comes to health care. Without a doubt, this government has been systematically unravelling the universality of Medicare.

What do you think happens when you try to introduce a fee for people to go to see a GP? What do you think happens when your next attack is to freeze the patient rebate to doctors and basically force a situation where doctors have to either introduce fees or up the fees that they are charging? What do you think happens when you increase the amount patients have to pay to fill a prescription? What do you think happens when you cut incentives for pathology companies and diagnostic imaging companies to bulk-bill their patients? What do you think happens when you basically say to the states: 'We're not going to pay the agreed share of growth in activity that is occurring in our public hospitals. We are going to pay you a lesser share'? What do you think happens when you cut money to improve emergency department and elective surgery waiting times and to boost subacute care? What do you think happens when you cut funding for aged care? It hurts patients. That is the legacy of this government every single day. And it not only hurts patients, it also hurts some of the most vulnerable patients in our community. That is what happens when you make those decisions.

The latest health minister, in his attempts to establish some credibility, likes to point to savings that Labor made as some evidence to justify the harshness of his own government's decisions. But, frankly, he completely misses the point. Labor was able to find savings in the health portfolio to reinvest in important social safety nets, like increasing public hospital funding and funding the National Disability Insurance Scheme, and we did that without hurting patients. The means-testing of the private health insurance rebate, which is something this government went to the 2013 election saying that they would reverse—well, we are yet to see that—was reinvested in the National Disability Insurance Scheme. Savings in pathology were accompanied by a bulk-billing incentive—something that the government wants to cut—that was designed to keep bulk-billing rates high for pathology, and that is what it did.

It is around nine months since Australians cast their votes and they sent the Prime Minister, and I quote, 'a very clear message'. It has been nine months since an election which taught this government a very clear lesson but, with so many cuts to health still on the table, it is hard to see what they have learnt. Some four days out from the election, the member for Wentworth feigned contrition and said, 'We have to do more to reaffirm the faith of the Australian people and our commitment to health and Medicare.' He promised to work hard to regain trust and to reassure Australians that the commitment to Medicare was a bipartisan one. It never has been, so that would be something new. As always with this Prime Minister, you have to look at what he does, not what he says.

How many health cuts has the Prime Minister actually reversed in the nine months since he allegedly learnt his lesson? None; not a single one. Indeed, every single health cut this government took to the election remains on the table. They are as committed as ever to gutting Medicare and making Australians pay more and more for their health care. The GP tax by stealth is reducing bulk-billing and driving even more patients into already overcrowded emergency departments—nothing has changed; making Australians pay more for vital tests and scans, including pap smears—nothing has changed.; hiking the costs of prescriptions, making even vulnerable patients pay more—nothing has changed; ripping $421 million from the pockets of patients through cuts to the Medicare safety net—nothing has changed. This is not a government that has learnt its lesson. This is a government that simply does not get the impact that its continued cuts are having on our healthcare system and on patients.

For many general practices, the freeze on the Medicare Benefits Schedule has been the final straw. We are already seeing clinics abandoning bulk-billing altogether and being forced to charge patients $10 or $20, even for children and concession card holders. This confirms, as the AMA president on budget night said, 'The poorest, the sickest and the most vulnerable will be the hardest hit.'

We will shortly reach the one-month mark until the government's next budget is due to be handed down in early May. It is a clear test for this latest health minister and the government: will they finally admit that they got it wrong and that their health policies are hurting Australians and drop them all, including the six-year freeze on the Medicare rebates? Keep in mind that so far they have failed the test at every turn; at every opportunity they have had to reverse the freeze, they have done nothing—in fact, they extended it. In 2014 they introduced the freeze, and in 2016 the Prime Minister himself extended it out to 2020.

This latest health minister is keen to pretend that there is nothing to see here and that he is going to fix all of this. We know that he sat at the cabinet table and signed off on every single one of these decisions that have such a negative impact on our health system. For years, GPs, specialists and health experts have been sending a very clear message to this government: the freeze is hurting, and it should have been dropped a long time ago. This is what the AMA president said during the election campaign:

We know there are some GPs that are already changing their billing practices, and that commences today, on 1 July. The reality is that there are a lot of GPs who've decided that they could probably take the hit for a couple of years, but they are saying enough is enough.

But did the government listen? No, of course it did not. It had an opportunity during the election campaign to admit that it got it wrong and to reverse the freeze.

The fact is that, under the government's freeze, years of damage have already been done. For years the Turnbull government has made health care less affordable for every Australian and has made out-of-pocket costs even higher. Australians are seeing the impact of the government's cuts every time they need health care, whether it is during a visit to their GP or at the hospital. This government simply has not made health a priority, and patients are having to pay.

We do not want to let the Prime Minister forget this pre-election promise: that no Australian would pay more to visit the doctor as a result of his Medicare freeze. That is what the Prime Minister said. The government's own statistics show, in black and white, what a complete and utter lie that was. And let us remember in the days after the election when the Prime Minister feigned contrition, cried crocodile tears and said that he had heard the message and learnt his lesson. Again: how many health cuts has he actually dropped? None.

Beyond the freeze, the health approach has been characterised by cut after cut, which has made health care less accessible and less affordable. They still, as I said, have on the table the cuts to abolish bulk-billing incentive payments for pathology and diagnostic imaging. And let us be clear again as to who is the target of that decision: it is the sickest Australians—the Australians with chronic conditions, the Australians who need blood tests, ultrasounds, mammograms and PET scans to diagnose and treat potentially life-threatening conditions. That decision is all about making patients who are being treated for cancer and other serious health conditions pay hundreds and in some cases thousands of dollars up-front for their scans.

They also have legislation, as I said, to cut the Medicare safety net. The evidence against that decision remains. The Royal Australian College of General Practitioners warned of significant concerns that the proposed changes would leave all patients with greater out-of-pocket costs. The Royal Australian and New Zealand College of Psychiatrists told the inquiry into the safety net cuts that the college was very concerned about the impact the proposed new Medicare safety net would have on vulnerable people with mental illness who require long-term intensive psychotherapy. Radiation oncology providers warned that the changes would, on average, more than double patient out-of-pocket costs for radiotherapy. The Department of Health admitted that, based on the current arrangements, certainly for assisted reproductive technology:

… our analysis says that the second and further cycles may leave a patient around $850 out of pocket …

Of course we also know that the government has some further cuts in radiation oncology on the way.

The government also has a measure on the table to increase the PBS copayment by up to $5—the biggest price increase for prescription medicines in a decade. Pensioners and concession card holders will pay more than $7 for each script—an increase of 80c. Everyone else will pay an extra $5 for prescription medicine. The more expensive medicines become, the less likely it is that people will fill these scripts. Around 1.8 million Australians already say they avoid filling prescriptions because of cost, and of course this will only get worse.

Then there are public hospitals. Labor had to bring the government kicking and screaming to accept that they were wrong to abandon Labor's long-term funding formula, which rewarded hospitals for doing more operations and seeing more patients, provided they did this at an efficient price. But the government did not do this properly. They did not put in the money, and in fact short-changed the states and territories substantially. That is why Labor promised in the election to fully restore the National Health Reform Agreement for the next four years, at the originally agreed funding formula of 50 per cent of growth in costs based on the national efficient price. We also said we wanted to provide additional support to public hospitals, to the states and territories, to specifically reduce waiting times in emergency departments and for elective surgery. That boost in funding would have seen an extra $2 billion over the next four years, on top of what the Liberals have promised, to drive efficiency by funding the states and territories on the basis of their actual services performed. This would mean reduced hospital waiting times, more beds, and more doctors and nurses. We encourage the government to do what it promised to do: to match Labor's policy and deliver on the original agreement.

As I said, nine months after the election, the government have done nothing to show that they have listened to the millions of people who voted against every single one of their cuts. We are now close to this Prime Minister's second budget, and we can only hope that it is better than his first. But, at the end of the day, no matter what the government do in the budget, the damage to our Medicare system has, unfortunately, already been done. On Saturday I saw people waiting just to get into an outpatients appointment—let alone get on the waiting list for surgery at public hospitals—people having to pay more as they go to see a doctor, people who were previously bulk-billed, people worried about whether they can afford the price of their medicines, and people worried about whether they can feed and clothe their children. All of that damage is happening now, and we are seeing it every single day in our communities. This government have done that damage, and they have a legacy that will go on for years and years to come.

Rather than develop a decent health policy or a new agenda in health, let alone reverse their billions of dollars of cuts to health care, the government like to spend quite a bit of time focussing on Labor's campaigning tactics, which somehow or other they think were not what the standards of campaigning should be. I am going to use a swear word, which will be bad, but bugger me—that is the worst I can do. I mean, seriously! This is really what this government says. But, frankly, what this government have done when it comes to our health care is absolutely appalling. They attempted to privatise our Medicare payments system, which we stood up and stopped them from doing. They had every intention of sending it out to the private market. The private market were telling us very strongly that they had had indications from the government to put their tenders in, that they were very keen to outsource that payments system and that they were ready and gearing themselves up to wait for the government to release the tender process. Labor stood against that and stopped that happening, making sure that the Medicare payments system stays in public hands and that we have a government that will invest in that payments system and bring it into the 21st century.

But they have also forced patients to rely more and more on their own private means to pay for their healthcare costs. There are many people in this country who firmly believe that they cannot afford health care. When we think back on when Medicare was developed, we remember the words of Bob Hawke, who said there were two million Australians who, in the event of becoming unwell, would face bankruptcy because they could not afford health care. I am very worried that, under this government, this is the pathway that we are now starting to head down again, as they try to shift costs away from the Commonwealth to states and as they try to shift costs away from the Commonwealth to individuals. We have to stand up for Medicare and against this government.

As I said at the start, I want to say thank you to the many people who assisted me throughout the campaign. Nationally, having the role as the shadow minister for health, I particularly want to thank one my previous staff, Alex White, who now works in the leader's office; Andrew Garrett; Stephen Spencer, who now works in Penny's office; and Jo Cleary, who works for me and worked with our national secretariat on the health media. They are an amazing group of people who love health policy and are deeply committed to equality and getting good policy outcomes. I thank them every day for the amazing work and effort that they put in.

In my own home town, the staff in my electorate office, who for many it was their first time through a federal campaign, worked incredibly hard. The volume of work that they were able to get through: the doorknocking, the mobile offices, the staffing of street stalls everywhere—they worked very, very hard. The volunteers in my campaign, again too numerous to mention, are people who each and every single election campaign step up, do the work and stand out at polling booths.

I have to give a particular shout out to Andrew Boatman and Emma Harding, who set up the pre-poll booths. People know Ballarat is a bit cold. In winter it was really cold. It snowed. We were on pre-poll in snow for days, basically. We were freezing. Ballarat is cold, but you normally do not stand out in that weather for hours and hours. So, the setting up of those pre-poll booths by Emma and Andrew every single morning, making sure that our bunting was out, doing all of that work and then staffing those booths was a fantastic effort.

To the Ballarat Regional Trades and Labour Council, to Brett and his terrific team there, again I am enormously grateful for your support and your constant guidance not only as we head into election campaigns but also every single day. We know election campaigns are not just won on election day. It is the work that you do year in, year out that really does make a massive difference in terms of whether you deserve people's votes. I have always said in my own electorate that you have to deserve the votes of people, and that means you have to work hard.

I want to particularly thank the people of Ballarat for again putting their faith in me. Ballarat is an incredibly beautiful and complex place to live in. It is my home. It is where we live, work, our children go to school, and we love the diversity of it every single day. I am very grateful to be able to continue to represent them in this place and to every single day honour their commitment in electing me to make sure that we get the resources that we need to develop and grow our great city.

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