Ross Hart (Bass, Australian Labor Party) Share this | Hansard source

I rise to speak on Health Insurance (Approved Pathology Specimen Collection Centres) Tax Amendment Bill 2018. This bill amends the Health Insurance (Approved Pathology Specimen Collection Centres) Tax Act 2000 to change the frequency of the tax paid by approved pathology collection centres—ACCs. This is an attempt by this government to clean up yet another Liberal mess. Currently, each of the approximately 6,000 ACCs pay a tax of $1,000 when first approved and when its approval is renewed each year. Under this bill, collection centres will instead pay a tax of $2,000 every two years, a move intended to reduce the regulatory burden for both government and industry whilst maintaining the revenue raised by the tax.

The rate of the tax has not been increased since it was first introduced in 1999—nearly 19 years without an increase—which is surprising compared to the profits of the big providers who now dominate this sector. This is a minor change, and Labor will support the passage of the bill. However, as my friend the member for Bruce has just done, we need to examine why this government has put this bill forward.

In 2009, Labor introduced bulk-billing incentives for pathology and diagnostic imaging services. These incentives are an additional payment made to providers who choose to bulk-bill their patients in an out-of-hospital setting so patients do not face out-of-pocket expenses. The policy imperative underpinning this was that you shouldn't put barriers between a patient seeking medical treatment and diagnosis of their condition. It is, or should be, reasonably obvious that significant out-of-pocket expenses operate as a barrier to many people accessing appropriate, timely medical care. This policy meant that of the 114 million pathology services provided out of hospital by 2014-15, over 98 per cent were at no cost to the patient. Unfortunately, it wasn't long before the Liberals were up to their same old tricks. In the 2015-16 MYEFO, the government sought to cut $650 million from the Medicare bulk-billing incentives for pathology and diagnostic imaging, including by abolishing these incentives for pathology. There was no commitment to reinvest the money into health, only a vague statement by the government that the money would be funding other policy priorities.

As to the question of policy priorities, health is clearly not a priority for this government. It hasn't been a priority in the past. In fact, if there was a policy priority, it was towards subverting the issue of public health, including Medicare, until the Liberals belatedly realised that Medicare was really popular with the general population. Inevitably, these costs from abolition of incentives would result in increased charges, which would in turn be passed on to patients, increasing out-of-pocket costs and potentially delaying people's access to critical tests and diagnostic imaging. We on this side of the House fought back, as we always will, against the Liberal cuts to health, and the sector fought back with the memorable Don't Kill Bulk Bill campaign. The campaign was, of course, successful. It was so successful that the Prime Minister took fright and struck a hasty pre-election deal with the sector whereby pathologists accepted the abolition of the bulk-billing incentives in exchange for a government pledge to regulate the rents that pathologists pay GPs to co-locate in their practices. This did nothing to improve the feeling of GPs towards the government after they had already attempted to impose a $7 co-payment and froze the Medicare rebates. This deal with the pathology sector only served to perpetuate uncertainty for GPs about an important element of their business.

As indicated previously, access to diagnostic imaging, including pathology and imaging, is absolutely central to the provision of cheap, effective and timely medical care. Once again, and unsurprisingly, the government has again backflipped on health, not just once, using its 2017 budget to break its deal with the pathologists and ditch the rent regulation plan but twice—secondly on the bulk-billing incentives that they first sought to cut back in 2015-16.

That brings us back to the bill that we have before us today. This bill can be fairly described as damage control—an attempt at an apology to a sector that has suffered under the hands of this government. This bill, again, makes it clear that health is not a priority for this government. We know they would rather give big business an $80 billion tax cut than properly fund health care. All we've seen from them is backflipping and cuts in successive areas of health policy.

Australians need relief from the costs of health care, not increases to their out-of-pocket expenses, especially at a time when they are paying more than ever for private health insurance—another important item in an average family's budget. This is important, whether or not you consider the cost of diagnostic investigation or substantive medical treatments and hospitalisation. In my electorate, the northern Tasmanian health system is already struggling with patient care and access to services. Northern Tasmanian patients are struggling with the fact that it's very rare to find a bulk-billing GP, irrespective of whether pathology tests or imaging are required. On Thursday last week, I raised the importance of properly funding our public health system, particularly for the Launceston General Hospital, the LGH. An estimated 7,092 families in Bass have private health insurance, and every year those people are hit with above-inflation premium price rises that put further strain on their household budgets, even before they are required to pay other out-of-pocket expenses. I know that low-income families who are relying on the public health system find it incredibly difficult to meet out-of-pocket expenses.

Labor is the only party that believe in universal health care and we are absolutely determined to fix our hospitals and facilitate better access to GPs, which includes, of course, access to pathology and diagnostic imaging. The Liberals have cut from Medicare and hospitals every year since the member for Warringah's horror 2014 budget. One of the most significant cuts was the cut to Labor's bulk-billing incentives in a bid to save a total of around $650 million. As I've said previously, their priority is everywhere but health. This is seen every day that they fight to give the big banks and big business billions in tax cuts rather than properly fund health. It's also seen in their language about creating a strong economy in order to pay for Medicare, the Pharmaceutical Benefits Scheme or our public health system. This assumes—in their distorted world—that health and education are not a priority; they are optional—that is, if the economy can afford it.

Like many decisions this government have made since they took office in 2013, the announcement of the axing of the bulk-billing incentive was a shock, especially as their own review of Medicare services was still taking place at that time. Such is the lack of empathy for health and the importance of health care to every Australian that they're prepared to make major changes without the review. Ultimately, it is the patients who are suffering under this government. The Prime Minister has continued the assault, cutting $2.8 billion from hospitals between the next election and 2025. He is giving an $80 billion handout to big businesses and the banks instead of funding health. He's leaving Australians languishing on waiting lists for critical surgeries, such as hip operations, knee replacements and cataract removal, at the same time as he's giving banks, especially the big banks, a $17 billion tax giveaway.

The health of Australians should never take a back seat to a handout for big business. That's why Labor will fight to give Australian patients a fair go, with more funding and better hospitals. Labor will invest an extra $764 million over the forward estimates and $2.814 billion over six years to fix Australia's public hospitals, with funding to be allocated from a better hospitals fund. Labor's plan has been fully costed by the independent Parliamentary Budget Office. The then Minister for Health, the member for Farrer, argued that bulk-billing incentives for pathology were not necessary. She said that this was because the sector was naturally competitive. Again, the government is prepared to force out-of-pocket costs even higher and on to patients, many of whom are having to make a choice and, if they make that choice, they may go without.

The AMA warned that the government's co-payment by stealth would hit the poorest and the sickest the hardest. Did the government care? No, their priorities then and now are with big business and the big banks. In my electorate of Bass, I know that when people are struggling to keep up with the growing cost of living they will prioritise where every dollar goes. Now I fear that, thanks to this government, patients are deferring treatment because of the cost, exacerbating their pain and suffering and ultimately adding to the nation's health bill with much greater acuity on presentation to public hospitals.

Also of concern to me is the change that bulk-billing rates on pathology could have on rural and regional areas like Tasmania. Peak group Pathology Australia has warned that not only would bulk-billing rates fall, but some pathology collection centres may be forced to close. As I said earlier, this is particularly important in northern Tasmania, as we undeniably have a public health system which is under even greater stress. My electorate of Bass shares the northern coastline with the electorate of Braddon, where my friend and colleague Justine Keay is working hard to be re-elected, because she knows that Braddon will be better off under Labor. Tasmanians remember the Liberal promise that there would be no cuts to hospitals in 2013. What they do not know is that the Liberals tore up the intergovernmental agreement which bound the Commonwealth to bear 50 per cent of the increased cost in health.

What have we had since? It's clear that this Prime Minister has just not learnt. The pathology sector's Don't Kill Bulk Bill campaign delivered a petition in 2016 with 600,000 signatures, showing once again that Australian people are deadset against cuts to health. They are simply not going to tolerate it. This campaign reached its target and the PM made a hasty retreat. The PM's dodgy deal asks pathologists to accept the abolition of bulk-billing incentives in exchange for a government pledge to regulate the rents pathologies pay to GPs to co-locate their practices. GPs were furious, they were already upset that the government's attempt to impose a $7 co-payment had been imposed upon them and that they had also frozen their Medicare rebates.

This bill is one of a number of policy changes that the government has offered to the pathology sector, seen by some as part of a two-year apology to the sector for their past sins. This bill is not a health policy. It is conflict resolution writ large. This government has no vision for the future of health care. Its only purpose is cutting services for health and giving those resources away in billions of dollars of tax cuts for big business.

See this speech in context