Kylea Tink (North Sydney, Independent) Share this | Hansard source

As a child of the seventies, I have no recollection of a time before Medicare, yet, as the member for Solomon's motion notes, today, that time actually did exist just as little as 40 years ago. Today, our public health system is the envy of the world and stands in stark contrast to the toxic, discriminatory and inefficient systems that dominate some other Western economies, including the United States of America. But, as the House notes the 40th anniversary of the introduction of Medicare, I would argue that, rather than simply applauding the government for the work it's done in this 47th parliament, it's important we all reflect on the environment within which Medicare was originally created, as opposed to our current circumstance, and ask ourselves whether Medicare is still fit for purpose in 2024.

At its establishment, Medicare promised universal access to health care, based on the premise that all Australians should be able to see a doctor regardless of their socioeconomic status. It was believed this would lead to better health outcomes and relieve pressure on public hospitals. From the outset, general practitioners have played a pivotal role in stewardship of not only the Medicare system but patients more broadly, and, for many years, they have done an excellent job. Yet, today, many would argue the system no longer provides enough support for general practitioners, and, as a result, it is unravelling.

As health appointments have become increasingly complicated and supportive health services like counselling, diagnostic testing, health screening and specialist referrals have become more demanding, GPs have found themselves being called on to bridge increasingly large gaps with minimal additional compensation. As a result, access to affordable primary care has been diminishing at an alarming rate. From 2013 to 2022, the former government froze Medicare rebates, leading to dramatic increases in out-of-pocket payments for patients and reduced bulk-billing by medical practitioners. As a result, today, about 1.2 million Australians annually defer or miss out on seeing a GP due to cost. This government then claims its recent investment in Medicare urgent care clinics, along with targeted bulk-billing incentives and the promised reintroduction of bulk-billing indexation for selected pathology services, have stemmed that tide. But this is not the experience of my community in North Sydney, where bulk-billing rates have fallen to a record low of nearly 15 per cent this past year. Of 54 primary care clinics in North Sydney, just under 15 per cent offer bulk-billing, and, while many Labor held seats have an urgent care clinic, as we've just heard, that is not the case in North Sydney.

Ultimately, the conversations I have with people in my community suggest there are real problems that need fixing for Australians to continue to have access to the health care we expect. The sorts of issues people have raised with me vary, from frustrations at the difficulty in finding a bulk-billing clinic through to the impact of managing increasing out-of-pocket expenses for patients. At the same time, people routinely urge me to advocate for vital pathology and essential preventative health measures, like basic dentistry, to also be funded under Medicare. While all these issues are valid, the truth is GPs simply can't afford to bulk-bill, because the rebate has not kept pace with business costs, like rent. The out-of-pocket costs for a standard GP consultation in North Sydney are now around $48, yet GPs, as both small-business owners and individuals, continue to struggle. In fact, analysis by the Australian Medical Association in 2022 showed that Medicare has generally failed to keep up with the real-life costs of operating a medical practice. Ultimately, despite what the government may like to say, the system is breaking and, if we are committed to ensuring it continues to meet our contemporary healthcare needs, our government must do more than just applaud itself.

I note the motion moved by the member for Solomon expresses gratitude to allied health professionals, and this is a truly thoughtful gesture, except I would offer the fact that many allied health professionals that I speak to would rather have that gratitude shown by having their services listed on the Medicare benefits scheme. At the end of the day, health care is consistently one of the top issues for Australians, and Medicare was a transformative piece of policy when it was first introduced. But, as the Strengthening Medicare Taskforce noted, reform is needed to ensure all Australians continue to enjoy access to world-class primary health care regardless of the politics of the electorate that they live in or their socioeconomic status.

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