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

I too join my colleagues in rising to speak on Appropriation Bill (No. 1) 2017-2018, which of course is the bill that largely enacts the government's budget measures. Make no mistake: this is not a budget that is designed for all Australians or to help all Australians; it is a budget to try to help the political fortunes of a Prime Minister. It has unfairness at its core, delivering a tax cut for millionaires—a $65 billion tax cut—and a tax hike for every working Australian. How is that fair?

And, in the health portfolio, it is a complete and utter insult. The government would have you believe that the past three years were all imagined—that they did not actually happen. Their attacks on Medicare, their cuts to public hospitals, their cuts to the patient rebate to go and see GPs and specialists and their attempts to increase the cost of medicines for all Australians somehow did not really exist—they are no longer there and somehow or other we have had a complete and utter reset. Frankly, it is a desperate attempt at window-dressing the exact same cuts that the government took to the election.

Only this government could keep the freeze in place for years and think that is fair. Only this government could cut billions of dollars from Medicare and structurally embed that in their forward estimates and somehow think that is fair. That is exactly what this budget does. It locks in billions of dollars of cuts to Medicare—cuts that make our healthcare system less affordable and less able to be accessed by people. The minister thinks that, by making up a national health plan—four pillars—that somehow or other he will seem to get over what has been a disastrous attempt of this government to decimate our universal health insurance scheme. This minister is lots of spin and not a lot of substance.

The former Prime Minister put in place the government's Medicare freeze in December 2014, and it was the current Prime Minister who came up with the genius idea to extend it right the way out until 2020. While this freeze has been in place we have seen the impacts on bulk-billing, with GPs saying they can no longer afford to bulk-bill all patients and out-of-pocket costs soaring. The previous member tried to say that bulk-billing rates are going up. Of course, bulk-billing rates include pathology and a range of other MBS items, but when you look at item No. 23, which is the item number for GPs, you will see that since the election GP bulk-billing has been going down. For years, GPs, specialists and health experts have been sending a very clear message to this government: the freeze is hurting now and it should have been dropped a long time ago. This is what the AMA president said during the election:

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

That is the damage that has been embedded in Medicare under a Liberal government. And still, after all of this evidence, did the government go and drop the freeze immediately? No, they did not. Australians will still have to wait years until the freeze on the patient rebate is finally dropped. These are not the actions of a government that understands the impact of its cuts to health, and listens. These are the actions of a government that wants to pay lip-service to the idea of doing something, but cannot bring themselves to actually do it until just before a federal election. We know the impact the freeze is having on access to GPs, with bulk-billing for GPs dropping since the election and out-of-pocket costs skyrocketing.

The impact is not just in the GP waiting room; the freeze also impacts Australians who need specialist care. In the past 12 months, 40 per cent of Australians needed to see a specialist. That is around 7.4 million Australians who need to see a specialist each year, but more than 600,000 Australians delay seeing a specialist at least once because of cost, with those from lower socioeconomic backgrounds more likely to delay because of cost. Keeping the freeze in place continues the impact on Australia's sickest and most vulnerable patients, such as people undergoing oncology treatment, children needing paediatric care and people undergoing dialysis.

The decision in the budget to keep the freeze in place for years comes when out-of-pocket costs for specialists have skyrocketed. Only last week, new data showed that, on average, patients are paying an extra $24 out of their own pockets every time they visit a specialist, up 42 per cent since the government introduced their freeze in December 2014. Every single day the government's freeze continues is another day that Australians pay more for their vital health care.

The budget is also woefully inadequate when it comes to funding our hospitals. It was a bitter disappointment for our public hospitals that the government did not allocate any additional funding to address the blowout in elective surgery wait times or the queues in our emergency departments. Our public hospitals are in crisis under this government. Elective surgery waiting times are now the worst they have been since records began being kept in 2001. Patients presenting to emergency departments requiring urgent medical attention are being left in emergency departments for longer. In the last financial year, only 67 per cent of emergency department patients classified as urgent were seen within the recommended 30 minutes. Critically, public hospital capacity is not keeping pace with population growth and it is not increasing to meet the demand for services. And yet, the government's budget has done absolutely nothing to address this—nothing for elective surgery and nothing for our straining emergency departments. Not only that, the government has now, from 2021, changed the funding formula for public hospitals, reverting back to the levels set in the disastrous 2014 budget, without a new agreement. That is what the budget says is going to be adequate for public hospital funding post-2020.

Beyond the freeze and the failure to invest properly in our public hospitals, there are some measures which I believe have finally been taken off the table, for now. The health zombie measures, the cuts to Medicare safety nets and the increase in PBS co-payments for both concessional and general patients have been scrapped, for now. That is a good step, although the government has lamented that it was 'regrettable that they had to be dropped'. The Prime Minister said that the government believed the measures had merit, and the Minister for Social Services said that they were largely reasonable efforts to make savings. Hiking the cost of vital medicines for every Australian is not reasonable, nor is it fair. Leaving Australians facing huge out-of-pocket expenses when they are going through stressful medical times in their lives is not reasonable or fair. These cuts should never have been on the table in the first place. Labor has fought against these unfair measures because we know the impact they would have had on Australians who could least afford it. But be in no doubt: if the government gets its chance, if it has the Senate that it wants, these cuts will be back on the table.

The government has also finally scrapped its plans to cut the bulk-billing incentive for pathology and diagnostic imaging. Again, it is not because they wanted to scrap these cuts, but because they could not get the political support to get it through the Senate. We were consistent in our approach: we would disallow those regulations when they came into the Senate. We are pleased to see that they will now not see the light of day in this parliament, but I expect they will be pushed up again at some point.

During the election the government signed a multitude of rushed deals, basically to get itself out of political trouble in the middle of an election campaign. It signed those deals with Pathology Australia and the Diagnostic Imaging Association. It has broken both of those deals. These deals were nothing more than a cynical ploy to get them through the election, proved by the fact that they have now been dumped in this budget. As these dumped deals show, when it comes to this government honouring commitments, agreements or compacts, they are not worth the paper they are written on. The minister's grandstanding about agreements he has put in place with various health stakeholders is absolutely worthless. If groups think that the minister or this government will not come at them again if we get to another budget—if we do not have an election before them—they are kidding themselves. The signing of these agreements shows the utter fatigue and resignation which has settled across the health sector after being treated with complete contempt by the Liberal government. It has been a long fight against measures like the freeze, the hospital cuts and the various zombie measures. That fight is not over. It has been a long fight, with little changing along the way. A new Prime Minister and an election did not trigger any change at all. Groups were desperate for any progress, even if an inferior option was put on the table. Behind these pieces of paper individual GPs, medical practitioners and specialists are furious that the freeze still remains in place. They are furious that they have been dealt an inferior deal, and their patience will continue to pay. They are raising those concerns at every single meeting that I have with them. Labor has heard this feedback, and we will continue to fight against the freeze until it is over once and for all. This freeze is all of this government's making, and it has been patients who have paid every day and will continue to pay every day until it is lifted.

If you want to see why the government cannot be trusted with Medicare, you only have to look at their track record of cuts and neglect. The government knows that it cannot be trusted on Medicare, so much that it has now had to legislate to try and say, 'We won't touch Medicare—we will legislate to guarantee it.' Only a government that cannot trust itself to keep its hands off Medicare would try and come up with something like the Medicare Guarantee Fund to paper over what it has done over the last three years. If you cannot trust yourself, you have to legislate to try and keep your hands out of the piggyback. But does the fund guarantee that the government will not cut Medicare? No, it does not. Does the fund guarantee that the government will keep its hands off public hospitals, which are fundamental part of Medicare? No, it does not. Does the fund guarantee that the money the government is saving through PBS price disclosure arrangements or the deal it has done with Medicines Australia or the generics industry will be reinvested into new medicines? No, the fund does not. As former health secretary, Stephen Duckett, says:

The Medicare Guarantee Fund—

I am going to call it the 'so-called Medicare Guarantee Fund'—

is nothing more than a rebadging exercise: it changes the badge on a policy in the hope people might think it is a new policy.

It is not. Once again, this is another example of a desperate smoke-and-mirrors attempt to distract from the fact that this government has cut billions of dollars out of Medicare and is continuing to prop up its budget with those cuts.

Without a doubt, one of the biggest blows in the budget was the failure to seriously invest in prevention. This is one area we had big hopes for. After all, the Prime Minister said at the start of February:

In 2017, a new focus on preventive health will give people the right tools and information to live active and healthy lives.

What a disappointment this budget was. How quickly things change. Of course, this government is known for its abolition of the National Preventive Health Agency, a $368 million cut. They also cut the National Partnership Agreement on Preventive Health. They also cut around $600 million from the Health Flexible Funds, reducing the capacity of health promotion organisations around the country. It has been a massive blow for public health groups who were hoping the Prime Minister would live up to his word and actually take action on prevention.

On a final note, in the very brief time I have left, as the member for Ballarat I want to acknowledge the budget and its impact on our region. The government's cut of $22 billion from Australian schools—an average of $2.4 million from each school, or 22,000 teachers—will have a severe impact on my area. I have spoken to the local Catholic education office and they tell me firsthand that the impact will see fee rises at Catholic primary schools across my electorate. With 25 per cent of parents choosing Catholic education in my electorate, that is a massive impost on parents.

Once again, Ballarat has also missed out when it comes to major infrastructure projects—there were none. We had many ready to go. There was the waste-to-energy projects in Ballarat and Hepburn Shire; the Ballarat sports and events centre, which we are still hoping against hope the government will actually eventually fund; and the racecourse reserve in Bacchus Marsh. None of these were funded in the budget. Again, it was something we had hoped to see—we hoped that we would get some of this funding.

It has been a bad budget for the electorate of Ballarat and it is a bad budget for the health of Australians. The budget does not lie. Billions are being cut from Medicare. It is all smoke— (Time expired)

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