Julie Owens (Parramatta, Australian Labor Party) Share this | Hansard source

I remember when, in Parramatta, the Labor government funded the expansion of the clinic in Harris Park to allow for after-hours services. We actually funded the renovation of a building so that that service could be open essentially 24 hours a day. They had a whole range of specialists in that building, as well, so people were able to walk down the street, in this high-density area, to an after-hours clinic that profoundly made a difference. Rather than getting in the car and spending several hours at emergency—if they had a car; many don't in that suburb—they were able to get the help they needed.

It reminded me of something that I've had discussions about with health professionals for years, which is that it is almost always true that what is best for the patient turns out to be cheapest for the taxpayer—early intervention and better primary health care, helping people not progress towards diabetes or liver failure by actually getting in early with calcium tablets, vaccinations, cancer scans, colon cancer checks and all those things. What is best for the patient is nearly always cheapest for the taxpayer.

There can be no doubt that the issue that the member for Hunter has raised, which is after-hours GP clinics, is actually both best for the patient and—coincidentally!—cheapest for the taxpayer. It is better for everyone that people can take their families to an after-hours GP clinic and get in quickly rather than go to the emergency department where the costs are enormous because the safety checks and the protocols are horrendous—quite rightly in an emergency department. It is much more expensive, by thousands of dollars, to go to an emergency department and not as effective or as useful. In fact, there are many people that will not be able to take their three children under the age of five to be at the emergency department all night because one of them has a tummy ache. They will wait. It's not good for the patient and, in the long run, not better for the taxpayer either.

Why on earth would the government do something which is worse for the patient and more expensive for the taxpayer? The answer, I suspect, is in the system where one part of the cost is paid by the federal government and the other part of the cost is covered by the state government. If the federal government cuts its GP after-hours services, it's cheaper for the federal government but more expensive for the state government, because the state government pays for the emergency services. They have to do that within their budget. So you take the money out of the federal government cost and whack it over to the state. That's what's happening here. It's worse for the patient, cheaper for the federal government, and more expensive for the state government And there are many, many examples of that. If primary health care isn't sufficient, people end up in hospital, moving the cost from the federal government to the state government. If people can't get the treatment they need in an aged-care facility, they end up staying in hospital for long periods of time because they can't get the treatment or the bandages they need at home or they don't live in an aged-care facility that will take care of them. That means the cost doesn't go to the federal government but goes to the state government. It's not blame shifting, it's cost shifting. It's profound cost shifting, and it's not good for anybody, because ultimately the taxpayer pays for it. Taxpayers either pay for it through federal funding to the states or they pay for it at the federal level. But the taxpayer pays for it, so it is worse for the patient and worse for the taxpayer in the end. But one section of government gets to look good and the other one tends to look bad.

What we've got here is a really dumb decision. It's a decision born of the system that we have that allows for cost transfer between state and federal governments. It's a symptom of not having a holistic approach to health which actually considers the overall cost to the government and the overall benefit to the patient, and that's what we see happening here. This is a nonsense decision. If the government were closing down my after-hours clinic, they would be putting thousands of people's health at risk. The other interesting thing we're hearing about today is the loss of one in the Hunter, but, according to the member for Longman, gaining one in the Longman electorate, which means we're losing one from a Labor electorate and gaining one in a Liberal electorate. What is that about? How many times have we seen that pattern with this government? They look after the ones that vote for them and think, 'Stuff the others.' What we've got here is a transfer of costs from federal government to state government and, essentially, moving the cost from a Labor electorate to a Liberal electorate. It's just wrong, and we should all be outraged.

See this speech in context