Gordon Reid (Robertson, Australian Labor Party) Share this | Hansard source

I just want to say how proud I am of being part of an Albanese Labor government that is resuscitating health care in this nation. In particular, I want to thank Minister Mark Butler and Assistant Minister Ged Kearney, but, in particular, Assistant Minister Emma McBride—not only the Assistant Minister for Mental Health and Suicide Prevention, and Assistant Minister for Rural and Regional Health, and member for Dobell, but also one of Australia's greatest pharmacists and a proud member of team Central Coast.

Our government has committed to $3.5 billion in tripling the bulk-billing incentives. Let's go through that for a moment—the importance of primary care and our general practitioners, particularly on the Central Coast but right around the country. Primary care is about prevention, with the aim to prevent exacerbation of conditions and deterioration of a patient.

I want to describe two patient journeys of patients with type 2 diabetes, and the importance of primary care—that is, general practice—in this patient population. One journey will be of the patient that has access to primary care. The other journey will be of the patient that does not have access to primary care.

I know that most people in this chamber know what diabetes is. It's a chronic medical condition here in Australia. It's an abnormal process in carbohydrate metabolism leading to hyperglycaemia, which is high blood sugar. There is significant morbidity and mortality associated with type 2 diabetes. We can talk about the micro- and macrovascular complications, whether they be retinopathy, causing blindness; nephropathy, causing renal failure and then going onto dialysis; or neuropathy, leading to peripheral nerve damage, particularly in the legs, which leads to wounds becoming infected and then patients requiring amputation. Then we can go on to those macrovascular complications, where we look at an increased risk of stroke, increased risk of acute myocardial infarction, peripheral vascular disease and the like. Initial management of that patient will include lifestyle changes—including physical activity, weight reduction et cetera—and then, potentially, going onto antihyperglycaemics and then, potentially, insulin. So that's what the disease is and that's the initial management.

Now let's look at the impact that primary care has on this journey, from diagnosis to management. A patient who is able to access affordable primary care will be able to go to their GP, have a thorough history and physical examination undertaken and then undergo further diagnostic testing for diabetes. We look at things like the HbA1c test—that's a blood test that you get fairly frequently for diabetes—the oral glucose tolerance test and the fasting plasma glucose test. The patient will be recommended a treatment plan from there, whether that's the lifestyle modification that I was just talking about, or the oral antihyperglycaemics—metformin and the like—or insulin. All of this is prevention, so that the patient doesn't deteriorate, so that the patient doesn't become significantly unwell and then present to the emergency department or require high levels of care in our inpatient wards or, even worse, in intensive care.

Now let's talk about the patient—this same patient—if they are now unable to access affordable primary care. All those clinical encounters that I just mentioned won't occur if a patient can't get in to see their GP. A patient will continue going about their daily life, either knowingly or unknowingly having elevated blood sugar levels. So they'll experience all of those complications that I've just mentioned: the hyperglycaemia, the insulin resistance—all increasing the levels of morbidity and mortality for that patient. That's why investing in primary care is so important, and that's what this government is doing.

This is just one real-world clinical scenario, so let's do a specific example in my home electorate on the Central Coast, a local example of how tripling of the bulk-billing incentive will benefit local GPs and local patients on the Central Coast. The East Gosford Medical Centre is a local GP practice with a patient load of 3,000 people. With a tripling of the bulk-billing incentive it has been reported that they will be able to bulk-bill 50 per cent of their patient load. Without this incentive that practice would have closed, meaning that 3,000 patients would have been without a GP. That would have meant 3,000 not having medications reviewed, 3,000 people not having clinical reviews for chronic illness, 3,000 people not being screened for preventable illness and 3,000 people potentially requiring emergency department care or admission to hospital. That would have been 3,000 people without a doctor, and, now that they are able to bulk-bill, they will be able to bulk-bill 50 per cent of their patient population and that practice can now remain open. This is why our changes to bulk-billing and health care are so important, and this is a positive impact of Labor health policy.

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