Wilson Tuckey (O'Connor, Liberal Party) Share this | Link to this | Hansard source

In concluding my remarks on the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006, when this bill was before the House I was talking about the huge conflict of interest in our health administration resulting from the fact that we virtually have a public sector health insurance scheme known as Medicare, operated by the Health Insurance Commission, competing with Medibank Private which is, at this point, a government-owned private insurance provider. Because these two services are available to the community, there is a dichotomy between those who at least believe they are young and healthy, and those who, as they approach older age, end up with a lot of non-elective surgery requirements which, with modern-day technology, are increasing in their effectiveness and also, unfortunately, their cost.

The response in years gone by to those with arthritic hips was to give them either a pair of crutches or a wheelchair. Whilst that did not give much relief, it certainly had a finite associated cost. Today, fortunately, we can have all sorts of medical interventions, but they have substantial costs. People’s hips and knees are a common area of so-called elective surgery—though, considering the pain that people experience, it is hardly elective. Eye operations, particularly for cataracts, are also available through day surgery. Highly skilled practitioners are required and they expect to be remunerated accordingly. Recently, I had a report of such an operation costing $8,000. I know that in some cases it does cost less.

The fundamental principle of insurance is that you must have an adequate cross-section of low- and high-risk members. Because of the Medicare/private health dichotomy—age is so relevant in health services requirements—a huge percentage of our community, frequently quite highly remunerated, say, ‘I’ve paid my taxes; I’ve paid my Medicare levy’—which this legislation deals with—‘and that’ll do me.’ Notwithstanding other issues I have raised of public hospitals and their budgeting arrangements, if you are young and you get hit by a bus, have a car accident or suffer a sporting injury, or even have a premature heart attack, the public health system will respond promptly to those sorts of outcomes. And that is fine. But people operate in that knowledge and, consequently, make no contribution to the costs incurred by the elderly in terms of elective surgery. Therefore, it has been my longstanding argument that we should go one way or the other—though in my philosophical position there is only one choice. You either have an English public health system—which I oppose—where you aggregate all funds on that side of the ledger, or have everybody involved in a private health insurance concept. In other words, you do not have the public health commission competing with the private insurance sector in a very special form of insurance where risk is so easily identified. It is not like your house burning down, or the other types of damage, from a cyclone or whatever; you can cast the odds on that.

Obviously, you could not just say to the community, ‘As of tomorrow, there is no Medicare.’ In the process of selling Medibank Private, I would also sell the private Health Insurance Commission and hope that thereby it all got into the private health arena. But that of course raises an immediate question: how would many people afford those premiums? We have already got that criteria covered, but in a non-targeted fashion, with the private health insurance rebate—a flat 30 per cent and then jumps to 35 and 40 per cent at 65 and 70 years. My argument is that a better form of targeting would be, for instance, to say to fully-fledged age pensioners: ‘We will increase your pension on the actuarial establishment of your private health insurance premium.’ I would do the same for children. And I would provide, at a very high level, targeted assistance to other persons of pensionable age.

Back in 1988, I did those numbers, and it was surprising how easily they can be achieved—with outlays below the present budget cost. That is not by cheapskating; that is because of the fundamental principle of insurance: if all the money is available to the private insurance sector, they are able to lower fees. The reason fees were running amok during the last year or two of Labor—and I think it was a conspiracy—was that there was no assistance to people in private insurance, and every time the premiums went up the better risks left and the premiums went up further. That has been ameliorated to some extent by the application of the subsidy. I think the subsidy is not targeted and it should be targeted. But I would rather see it targeted in the concept of everyone in private health insurance, with targeted assistance according to their financial position, their age and other factors. It is very much achievable, according to the arithmetic. It would make the services of health cheaper. Above all, it would pay all hospitals, government and private, a fee for service, and that wipes out waiting lists.

When the Labor government sold the Hollywood repatriation hospital to the private sector, their waiting lists—which were 10 months, typically—disappeared in three months by the simple act of the private operator opening the operating theatres on Saturdays. These are the sorts of responses that the private sector can have on a fee-for-service basis. The member for Lalor might think a bit about those words. (Time expired)

Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Link to this | Hansard source

I am glad that I ensured that the member for O’Connor got his remaining time in this debate because, in the few minutes that were available to him in continuation on the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006, he has revealed clearly the until now secret agenda of the Howard government, which is to eradicate Medicare, to eradicate the public health system and to move the whole nation onto a private health insurance system.

Wilson Tuckey (O'Connor, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy Speaker, I raise a point of order. I wish I had that degree of influence. Nobody else supports me, but I—

Harry Jenkins (Scullin, Australian Labor Party) Share this | Link to this | Hansard source

There is no point of order.

Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Link to this | Hansard source

We have now had the member for O’Connor indicate that he is not a man of influence. I believe that he is a man of very great influence within the Liberal Party, having made and broken leaders in the past. Obviously he is a man who knows what the Howard government’s secret agenda is—that is, the abolition of Medicare and ensuring that people can only be assisted by our health system if they have private insurance.

Mr Deputy Speaker, you would be well aware that that is an American style health system, where you must be privately insured in order to get care. There are some very residual low-level assistance programs to people who are poor or old, but there are 45 million Americans, mainly low-income working Americans, who neither qualify for the assistance programs nor can afford the private health insurance, and they simply go without care. That is obviously where the Howard government wants to take this nation. We have had it revealed by the member for O’Connor today, and here we are in this House with that before us. I think every Australian would want to know that John Howard clearly has not given up his long-stated ambition to abolish Medicare, and we have had that confirmed by no less than the member for O’Connor today.

Jim Lloyd (Robertson, Liberal Party, Minister for Local Government, Territories and Roads) Share this | Link to this | Hansard source

That is a long bow.

Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Link to this | Hansard source

I am being told by the Minister for Local Government, Territories and Roads at the table that this is a long bow. He might want to read his Prime Minister’s statements throughout the 1970s, the 1980s and into the early 1990s, where he opposed the creation of Medibank, opposed the creation of Medicare and then went to a number of elections promising the complete abolition of Medicare. That is his genuine view, whatever view he wanders around publicly expressing now for the purpose of hoodwinking the electorate.

This bill amends the Medicare Levy Act 1986 to increase the Medicare levy low-income thresholds for individuals and families. The dependent child/student component of the family threshold will also be increased. The increases are in line with movements in the consumer price index. The increase to the Medicare levy low-income threshold for pensioners below pension age is made so that they do not have a Medicare levy liability when they do not have an income tax liability. The bill also amends the A New Tax System (Medicare Levy Surcharge—Fringe Benefits) Act 1999 to increase the Medicare levy surcharge low-income threshold in line with movements in the CPI.

The member for Hunter has moved a second reading amendment to this bill. It talks about the big issues in our health system. I will direct some of my remarks now to the contents of the second reading amendment and the reasons it ought to be carried by this House.

When you look across our health system, it is clear that the Howard government is squandering opportunities for reform and cutting back areas of our health system which need appropriate support. The Howard government is committed to the sale of Medibank Private, irrespective of public opinion, irrespective of the impact on premiums and irrespective of what that will mean for the future for people with private health insurance. Polling tells us that the vast majority of Australians want Medibank Private retained in public ownership. As revealed in a recent Newspoll survey, 64 per cent of people did not believe that Medibank Private should be sold. Furthermore, 74 per cent of people thought that the sale of Medibank Private would lead to increased premiums.

It seems to me remarkable that we can have a Prime Minister who will wander out one day, as he did last Friday, and say that the Howard government is backflipping on the sale—the privatisation—of the Snowy Hydro because it has been overwhelmed by public opinion. The only reason the Prime Minister gave for the change in his view about the Snowy Hydro was that he was convinced by the weight of public opinion. If it is public opinion that changes the Prime Minister’s mind when it comes to privatisation issues then the Prime Minister must change his mind on Medibank Private, given that the overwhelming weight of public opinion is against the sale.

We have not seen any indication yet that the Prime Minister is prepared to backflip on the sale of Medibank Private, but if he does not we should all remember for all time that this is a government that ran out and sold an important public asset despite public opinion and in the face of that public opinion. This is a government that is making false and irresponsible claims about the effect of the sale. The Minister for Health and Ageing and the Minister for Finance and Administration are out there saying that the sale of Medibank Private will put downward pressure on premiums. The Minister for Finance and Administration has said that the sale would put less upward pressure on premiums. But all of this is about creating an impression that somehow the sale of Medibank Private will lead to either reduced premiums or, at worst, moderations in premium increases. But we have heard this all before, and it is a pocket of empty promises. This is the government that campaigned for the 2001 election by saying that its policies would lead to reduced premiums for private health insurance, and we have actually seen premiums go up by a staggering 40 per cent in the time in between. When you have a government that once made you a promise which it broke in a startling fashion, why should you believe the government when it makes effectively the same promise in relation to the Medibank Private sale?

We know that the sale of Medibank Private is all about grabbing the money, and our suspicion in that regard has been confirmed by the Minister for Finance and Administration, as recently reported in the Australian. The Howard government wants to earn, and expects to earn, about $1.5 billion from the sale. It is only worried about getting a good price. It is most certainly not worried about the future for Medibank Private premium holders. As revealed in a leaked tender document for ‘Project good guys’, a PR project for Medibank Private, there is a frank acknowledgment by Medibank Private that members are discontented with the sale and they expect a class action. Indeed, there is a frank admission that Medibank Private can give members no guarantees about what will happen to them after the sale. If you rang up Medibank Private today and said: ‘I’m a premium holder; I’ve paid good money over years and years into Medibank Private. What is going to happen to me after Medibank Private is sold?’ the truthful answer that Medibank Private would give you is: ‘We don’t know, and there is no guarantee we can give you. We can’t give you any guarantee about premiums, and we can’t give you any guarantee as to whether or not your policy will be honoured, when you choose to use it or when you have to use it.’ That is a disgraceful position for Medibank Private members to be in.

The government also claims that the sale of Medibank Private will lead to increased competition in the private health insurance sector, yet it is keeping this parliament and the Australian people in the dark about the mechanics of the sale. It seems far more likely than not that Medibank Private will be disposed of in a trade sale, which is likely to lead to increased market consolidation in the private health insurance sector, fewer players and less competition rather than more competition. So the claims about competition are completely spurious.

What is remarkable about all this is that the Department of Health and Ageing do not know, are not involved and do not care about the sale of Medibank Private. In last week’s Senate estimates hearings—the last sitting week—we heard about how indifferent the minister and his department are about the sale of Medibank Private and its effect on its members. Only recently did the department of health confirm that they did not receive a copy of the second Medibank Private scoping study, which determines how and when Australia’s biggest private health insurer will be sold. In answers to questions put on notice in November last year, the department of health have admitted that they are hardly involved in the updated scoping study and will not receive a copy of the report when it is completed. But again last week the department confirmed that they have not commissioned any work on the impact of the sale on premiums and they have no intention of doing so.

It is truly amazing that Australia’s biggest private health insurer could be sold, that the government could sell it and that the department of health and the minister for health are just moseying around like Brown’s cows completely unconcerned about this matter—not even in the loop for information and not pressing to be in the loop. It says something pretty clear about the incompetence of the minister for health that he would rather wander around in blissful ignorance than involve himself in the sale of Medibank Private and in making sure that, whatever happens, Australia’s health system is the best it can be. He has washed his hands of the responsibility to look after Australia’s health system. He has just completely disconnected from the sale of Medibank Private, and that is a gross act of incompetence.

It is not just incompetence in the sale of Medibank Private that we see from this government and this minister for health; the Howard government is failing to deliver in the area of the Pharmaceutical Benefits Scheme, which is obviously one of the major federal government programs to make sure that Australians are kept as healthy as they can be and that they have the ability, through having access to appropriate medication, to be well enough to be participants in the economy and in the community. The Howard government is not worried about health outcomes under the Pharmaceutical Benefits Scheme; instead, it is interested only in slashing the PBS budget and making Australians pay more and more out-of-pocket costs for their essential medicines. This is not about making the PBS sustainable into the future, and it is not about getting expensive new medicines listed on the PBS; it is all about the Howard government’s obsession, as revealed in today’s debate by the member for O’Connor, with the Americanising of our health care system and the undermining of the PBS.

The Howard government introduced a 21 per cent increase in PBS copayments in January 2005 and followed this with the subsequent introduction of a 12.5 per cent generic policy accompanied by a number of special patient copayments and then slashes to the PBS safety net. Since then we have seen the net rate of growth of the PBS drop from around nine per cent to below two per cent for the 2005-06 financial year—lower than the inflation rate of three per cent. That is despite all of the doom and gloom rhetoric of the Treasurer about PBS costs being out of control, being unsustainable, about them going to bankrupt the nation and about having to cut them back—the sort of thing that the Treasurer says very frequently.

As opposed to the Treasurer’s scare campaign, the truth is that the current growth rates in the PBS are lower than the inflation rate—that is, expenditure on the PBS is reducing in real terms. The Treasurer’s drive to slash back the PBS can no longer be explained by real concerns about growth rates in the PBS; it is not about that anymore. It is an obsession about getting rid of what has been a tremendous scheme to ensure that Australians can access medicines at affordable prices. The threat to the PBS in this country is not from runaway growth rates; it is from the Howard government.

We know that many people at the moment need prescriptions for mental illness treatment and to assist them to manage their heart attack risks. They need to take statins, which are drugs to help protect people at risk—especially those with diabetes—from heart attacks. We know that the prescription uptake of statins is going down and that the uptake of a range of mental illness medications is going down. That is not because there has been an outbreak of wellness in our community but because the combined effect of the Howard government’s policies has meant that a category of chronically ill Australians can no longer afford to take their medication consistently—and, of course, in managing chronic and complex conditions, like mental health conditions or cardiovascular risks, medication only works if taken consistently.

The minister and his minions have come up with a whole raft of explanations for the decreasing prescription uptake rate for these Australians. Firstly, they said that the data did not include hospital drugs—it never has. Secondly, they said that the data did not take into account the fact that Vioxx has been withdrawn from sale—this has had no real impact. Then they said that the decline was due to a decrease in the prescribing of antibiotics—once again, this has had no real impact. Then they said that the data did not include drugs with prices below the copayment—it never has. Then my personal favourite excuse that they have managed to tumble out is that the data did not take into account the number of public holidays. What rational human being would say that the number of public holidays is somehow making such a huge change to prescription patterns in Australia? That is just laughable. Public holidays have not changed significantly, although perhaps they will under the government’s extreme industrial relations laws.

But the government’s excuses cannot hide the mounting evidence that increasing numbers of Australians cannot now afford their needed medications. That is going to be a health crisis in the making. If people are not taking their needed medications, they do not suddenly get well. They end up presenting at hospital at some time in the future, sicker than they needed to be. It is just ridiculous. At the same time, the minister for health is sitting on a number of listings for the PBS for drugs that the PBAC, the expert committee that looks at drugs on our PBS, says should be listed. A number of drugs have been ticked off by the PBAC and the minister for health has yet to list these drugs on the PBS—and, once again, that is without explanation.

Finally, I turn to another aspect of the second reading amendment—it relates to a matter raised in question time yesterday by the minister for health—that is, Australia’s medical workforce crisis. We had the minister for health in this place yesterday boasting about the number of doctors he has imported into this country in recent times. He boasted that, in the last 10 months, Australia has approved visas for 1,704 doctors, 2,555 nurses and 1,150 other health professionals. He boasted that we have imported more than 5,000 health professionals into our health service. A country like this turns away more than 5,000 kids each year who desperately want to be doctors and nurses and who are appropriately qualified to take the course. What the minister was boasting about yesterday is actually a national disgrace. We are refusing to train Australians to work in our health system and, meanwhile, we are scouring the developing world to see if we can poach doctors and nurses.

Yesterday the minister for health referred quite hysterically to visa class 457 and said that the Howard government relies on that visa class to import our medical workforce. There was then an attempt by the minister for health to create a scare campaign to say that, under a Labor government, we would abolish this visa class and we would not be able to get these needed health professionals. The truth is that, under a Labor government, we would still be able to issue visas to these needed health professionals. At no point have Labor said that it would abolish visa class 457, but I will tell you what we would do: we would train sufficient Australians to meet the needs of the Australian health system—something this government has not done, will not do and apparently does not believe in doing. The minister for health thinks it is a matter of boast that he imports doctors and nurses. We think it is a national disgrace. We should be training Australians first and training Australians now. With those words, I commend the second reading amendment. (Time expired)

Justine Elliot (Richmond, Australian Labor Party) Share this | Link to this | Hansard source

There certainly are many pressing health matters, particularly in my electorate of Richmond, which has many elderly people. A lack of federal funding for these health matters causes so much concern and ill will amongst those people who, particularly at their age, desperately need extra health care.

I rise today to support the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006 and the amendment moved by the member for Hunter. The bill contains some routine annual amendments to the Medicare Levy Act that are required for the indexation of annual thresholds. The bill amends the Medicare Levy Act to increase the Medicare levy low-income thresholds for individuals and for families. The dependent child/student component of the family threshold will also be increased. The bill also increases the Medicare levy low-income threshold for pensioners below the age pension age so that they do not have a Medicare levy liability where they do not have any income tax liability.

I support the second reading amendment moved by the member for Hunter in this House, which states that the House:

(1)

condemns the Government and Minister for Health for squandering the opportunity to fundamentally reform our health system;

(2)

condemns the Government for failing to invest in rebuilding our health system, including Medicare, for the future, focused on prevention, early intervention and an ageing population; and

(3)

condemns the Government for its failings in relation to our health system, as evidenced by delivering a Budget containing hidden cuts and the related decision to sell off Australia’s biggest not for profit health insurer, Medibank Private”.

As I said, I support this bill and the amendment moved. These changes to the Medicare levy are an annual event and they ensure that people are not disadvantaged by increases to the consumer price index. But it is the lack of funding within our health care system and the massive disadvantages listed in the amendment that I just spoke of that I specifically want to refer to today.

This government and the Minister for Health and Ageing should be concentrating on fixing our health system, a system that has many flaws. In particular, we need a health system that will be able to cater for our ageing population. This really is a pressing issue in the electorate of Richmond. Because 20 per cent of the population is aged over 65 years, health and health care are such important matters. I will discuss this later on.

The recent budget was very disappointing for a variety of reasons but in particular for health. What we should have seen from this government were a number of major health reforms. The first one should have been the restoration of the Commonwealth Dental Scheme, to get the 650,000 Australians waiting for dental care off waiting lists. The average wait for some people is often two years, which is an incredibly long time to wait to get your teeth fixed. It is outrageous that in this country currently people have to wait for two years on average and sometimes for longer.

We also needed to see from the government in the recent budget an investment in our medical workforce supply. We desperately need to have a far greater medical workforce. We also need to see more funding for the PBS. Instead, we got cuts which will greatly impact upon people. A study by Access Economics shows that the budget provided for spending on health will increase more slowly than government spending generally. This means that spending on health will fall as a percentage of all government spending. The budget growth rate in health spending is only 4.5 per cent, which is well below the rate of health inflation.

Given that the government is spending less in real terms on health for each Australian, at the end of the day the result will be that people will have to make up the shortfall by paying for it themselves or, as is often the case, people will have to opt to go without care because they simply cannot afford it. People that I speak to, particularly elderly people, often say that that is the option that they have to choose—to go without care. It is an outrageous situation that families with young children have to make a choice between paying bills or taking their children to the doctor. I quite often hear that this is the case. In this day and age, it is an outrageous situation that families have to make those choices about the health care needs that they are confronted with. It certainly is a worsening situation, particularly for people on low incomes and the elderly.

Access Economics has also outlined that the minister for health has failed to deliver an agenda for the future of our health system by planning for how our health system is going to cope with an ageing population. It really is a lost opportunity to build a reformed health system, particularly a health system that is focused very much upon prevention and early intervention. We really need to see some national leadership on that front, and we did not see that delivered by the Howard government in the budget.

As I said, the government should be providing for the health of our ageing population. It is vitally important. Twenty per cent of Richmond’s population is aged over 65—one of the highest proportions in the country. Inadequate funding for health and also for aged care and the constant cuts to the PBS make it very difficult and very stressful for elderly residents as they desperately try to meet all their health care needs. The Howard government really has a shameful record, particularly when it comes to health. I certainly see it first-hand every day in the concerns that people have.

There are many pressures on local seniors within the electorate of Richmond, especially the 13,000 on fixed pensions. As I said, 20 per cent of the population is aged over 65—one of the highest proportions in the country—so of course our health needs are major. We often hear predictions that, in 2040, 20 per cent of the Australian population will be aged over 65 years. That is in 2040, but in 2006 that is what we have on the ground in Richmond. We have that now. We see first-hand how desperate the need will be and how there is a need to plan for the future, when that will be the situation across the board. We have to get it right on the ground for these people now.

There is indeed a national crisis in our health workforce, and we are not seeing the Howard government doing anything effective to fix that problem. Again, this situation is only going to get worse with an ageing population. Every day, locals tell me about the difficulties they have in finding a GP—and they have lots of difficulties in finding one who bulk-bills. This is a major concern. In all areas, but particularly in regional areas, finding doctors who bulk-bill can be extremely difficult and, of course, very stressful for elderly people.

The full-time equivalent GP numbers monitored by the Department of Health and Ageing show a very critical shortage across the nation. The national average of people per full-time equivalent GP has hit 1,451. The government’s own recommended figure is closer to 1,000 people per GP. The Department of Health and Ageing regards areas with a figure of more than 1,400 as an area of need under the More Doctors for Outer Metropolitan Areas program. The figure for Richmond is 1,314, and the figure for the neighbouring electorate of Page is especially dire, at 1,589.

Given that the Northern Rivers has one of the highest proportions of elderly people in the country, this crisis is worsened. The demand for GPs obviously increases with age. Local GPs are often telling me that, when they are seeing a large number of elderly people, the demands on them are much greater and often more complex because of their health needs. The time constraints often make it very difficult, particularly with the complexity of their health problems.

GP numbers are dwindling as a result of an underinvestment by the Howard government in university places and GP training places. Indeed, the situation is much worse in regional areas because the Howard government does not provide enough incentive to attract them to areas where we desperately need to be seeing more GPs. The situation is exacerbated even more so by the enormous HECS debts that many young doctors now have when they leave university. They often have little choice but to stay in the cities to earn more to pay off these massive HECS debts. They cannot afford to move to regional areas, and the government is not providing enough incentive for them to come to our areas to service the great need for more GPs.

Instead the Howard government is continuing to rely on importing overseas trained doctors. This is a very shameful situation. The Howard government should be providing leadership when it comes to addressing the critical shortage in the health workforce. But the reality is that the Howard government is not providing leadership. The message is clear: it should be investing in universities, training more GPs, training Australians first and training them now. I certainly see first-hand in Richmond how desperate this need is and how we have to have more of them trained.

Another major health issue in Richmond is dental health. This is an issue that I have raised many times in this House and will continue to raise because it is one that elderly people speak to me about constantly. There is a dire need for federal funding for dental health, and under the Constitution it is indeed the responsibility of the federal government. Particularly for those elderly people within my electorate, it is shameful that the Howard government are not prepared to invest federal funding in this area. Let us remember that it is seniors who built this nation. They are the ones who worked hard, paid their taxes and defended our country. They have done the hard yards and they have retired. There is no doubt that the elderly are one of the groups most disadvantaged by the Howard government not providing federal funding for dental care.

As we all know the Howard government scrapped the $100 million a year Commonwealth dental health scheme. The reality is that dental health can affect your overall health. That is why it is so important that people have access to dental health services. In the past, the minister for health himself has said in relation to Labor’s dental health scheme:

The Keating government’s program did reduce waiting times. No doubt about that.

That is the reality. We need to have federal funding back to fix this problem. There are only about 240 public dentists to cater for more than 2.5 million health care card holders, children and the elderly across Australia. This compares with more than 3,000 private dentists that treat the rest of the population. We always hear the Howard government blaming the states. I am sick of their buck-passing. It is time for them to fix the problem. It is their responsibility under the Constitution. They are obligated to provide this dental health care.

It is often heart wrenching to hear stories from people, particularly our local elderly, who are in pain because they cannot access the dental care they need and are often unable to eat. A lot of them are often too embarrassed to even go out because of critical dental problems. I have provided many examples. One of them, Mrs Julia Morton, an 83-year-old pensioner from South Tweed, waited years and years to get her teeth fixed. Eventually she gave up and ended up paying for them herself on her credit card. She says she is lucky because she had some help from her family, but she is concerned for the many other local pensioners who just cannot access that. It is outrageous that she had to wait many years and was being forced to rely on her family to get her teeth fixed so she could actually eat. There are so many pensioners who just cannot afford to get the urgent dental work that they need.

It is not just the dental health of Australians that is at risk—it is not just about getting their teeth fixed; many studies have shown that poor dental health can lead to a range of general health problems, including strokes, heart disease and chronic infections. It can also make diabetes a lot more difficult to manage.

It is time the Howard government stopped trying to pass the buck and showed the national leadership necessary to provide locals with the dental care they urgently need and deserve. As I said, I have raised this issue on many occasions. I would like to see government members stop trying to pass the buck, admit that it is a federal responsibility and take some action. I will certainly continue raising it in this House until we see the federal government prepared to stand by their constitutional obligation and make sure there is funding for dental care.

Another major health concern for Richmond residents is the Howard government’s constant attacks on free prescription medicines, which also puts the health of my local elderly at risk. We have basically seen a war being waged on our PBS by the health minister and the Treasurer. This has resulted in a dramatic drop in the number of prescriptions being filled. Indeed, 2005 saw a drop in the number of scripts being filled. Almost two million fewer scripts were filled in 2005 compared to 2004, and the trend looks set to continue in 2006. Two million fewer scripts is a huge amount. With an increasing as well as an ageing population, such as in Richmond, it is quite crazy to argue that people would be requiring fewer medicines, because in fact they need more. The reality is that they just cannot afford to access them.

The health minister’s mismanagement of our PBS has also led to delayed listings and a significant drop in the number of scripts being filled. Many groups have been calling on the health minister to expand PBS access to some cholesterol-lowering drugs. This matter has been with the health minister for over two years. In July the PBAC will assess an application for Herceptin, which assists with breast cancer, to be listed on the PBS. How long is it going to take the health minister to enact a recommendation for Herceptin, which is so desperately needed within the community? Just last week a local woman, Trudie Douglas, came to see me. She has advanced breast cancer and desperately needs to access Herceptin. Her husband, Ian Douglas, was involved in a serious car accident on New Year’s Eve and obviously also has his own very complex health needs. They are in a situation where they just cannot access Herceptin. They may have to sell the house. They are looking at $60,000 to get access to Herceptin. It really is a heart-wrenching situation. It is people like Trudie Douglas that need to see the health minister doing something about their health needs. We have had so many different groups calling on the health minister to make sure that action is taken to have Herceptin placed on the PBS so that women like her can access decent health care. This attack on the PBS does put the health of local elderly at risk.

Another example I would like to speak about is the removal of calcium from the PBS, which we saw last year. There was a huge outcry in relation to this, particularly in my electorate. We held a major forum where so many people spoke about their concerns about it being taken off the PBS. It was because of this community campaign and because of the pressure that was put on the health minister right across this country that calcium was returned to the PBS—but just for renal conditions, not for osteoporosis. Those people suffering from osteoporosis—or those who want to prevent it, as we have been told we all have to do—desperately need to have access to calcium. It is shameful that the Howard government does not put calcium back on the PBS for those suffering from osteoporosis. Again, this very much affects the elderly in my electorate, who desperately need to access calcium.

As I said, we saw so many cuts to the health budget, including the $1.3 billion cut from the PBS last year and the $500 million from Tony Abbott’s ‘rock solid, ironclad’ Medicare safety net. While PBS medicine affordability declines, we can expect at the end of the day to see a lot more hospital admissions and greater health care costs in the future because that money is not going into prevention and early cures. We are going to see much worse health conditions. We also saw changes in last year’s budget that greatly impact on pensioners, who now have to wait until they use 54 scripts a year before they are entitled to free medicine, with this number going up to 60 by 2009. All of these changes to the PBS make life so much harder for the elderly, who of course are very stressed with their complex health problems.

Another issue I wanted to speak about was the sale of Medibank Private. The Howard government is committed to the sale of Medibank Private. There are certainly many concerns about competition and also about health insurance premiums and how much more they are going to rise once it is sold. Families and pensioners are already doing it so tough, with petrol prices increasing, interest rates going up and wages being lowered due to the government’s extreme industrial relations changes. Now, on top of that, we are going to see health insurance premiums go right up, with the sale of Medibank Private.

The government are going to spend a huge amount on a major marketing campaign for Medibank Private. I think it is incredibly unfair. When Australians are finding it hard to get to a doctor and our hospitals are under pressure, how can the Howard government justify spending millions on the sale of Medibank Private? A number of months ago we saw the Medibank Private office in Tweed Heads close, which greatly impacted—

Peter Lindsay (Herbert, Liberal Party) Share this | Link to this | Hansard source

Order! Member for Richmond, this bill is about the Medicare levy surcharge. Could you relate your comments to the Medicare levy surcharge, please.

Justine Elliot (Richmond, Australian Labor Party) Share this | Link to this | Hansard source

Yes, absolutely, Mr Deputy Speaker. As I said earlier, this is in reference to the second reading amendment and the failure of the government to make sure that there was proper investment within our health care system. There are so many areas of need, and the sale of Medibank Private will indeed greatly impact upon people’s incomes and their access to health services.

I want to make a point about some of the hidden cuts to the health budget. We have seen $1.5 million ripped out of the More Doctors for Outer Metropolitan Areas measure and $6 million ripped out of the Better Access to Radiation Oncology program. Again, these hidden cuts will greatly impact upon people in regional areas such as mine. Right across the board, when it comes to funding for the health needs of our present and our future generations, we have not seen any national leadership or vision that is going to fix a lot of the problems that we have in our health system.

In fact, it is only going to get worse in the coming years, particularly with an ageing population, when the health needs are so great. To not see funding being placed in prevention and cure is going to make a huge difference. But, as I stated, there are some particular areas of need, especially restoring the federal dental plan, and the failure to do this will continue to cause so many problems in my electorate and right throughout the country, as will the cuts to the PBS. We are seeing first-hand that people are not accessing those medicines. They are staying in their homes, getting sicker and exacerbating the situation.

I fear that the fact the Howard government has failed to take action on this will continue to impact upon the elderly, and they are the ones who desperately need support from this government to ensure their future health care needs at a time in their lives when their health needs are very complex. We certainly need to see a greater investment in a whole range of areas, particularly for the future, because we do have a rapidly ageing population. We have the opportunity to get it right in Richmond at the moment, with 20 per cent of the population aged over 65, and we have to get it right now for those elderly people who are very stressed and unable to cope.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006. One of the more notable things about this year’s budget was how little attention was given to health. Perhaps it was the absence of the Minister for Health and Ageing around the time of the budget—I do not recall seeing him do too many interviews that week. Perhaps the government did not want to create too many distractions from its plan to address income tax bracket creep and superannuation suggestions. But it did lack the drive, the vision and the determination to advance our nation’s health that some had hoped for.

The Access Economics report written for the AMA identifies the budget as spending slightly more than 18 per cent of its value on health outlays next financial year and factors in growth over the forward estimates of 4.5 per cent. The implication is that, as a percentage of total outlays, the proportion spent on health may actually decrease. The situation is even worse for public hospitals, with the budget only providing for 3.6 per cent growth in spending. Health inflation will run well ahead of this figure, meaning a cut in real terms in funding to public hospitals. All this comes with the pressures of an ageing population.

A 4.5 per cent increase would not even renew the government’s subscription to private health insurance. The cost of private health insurance has been increasing year in, year out by seven per cent. It has increased by well over 30 per cent since the year 2000, absolutely eating away at the government’s rebate—cancelling it out altogether. A 4.5 per cent increase is more of an inflationary adjustment—a minor alteration over time to prevent the budget from slipping too far backwards. But the issues our country faces increasingly over time are not likely to be solved with the status quo in real terms, so I cannot say I recognise where the government is heading, other than towards either a decrease in the level of services available to the public or a greater reliance on fees and charges for services from our constituents.

The sale of Medibank Private is an important issue. It is an issue that will affect the way that we look at health in this country. The sale of Medibank Private will have a great impact on the Australian public. The budget has confirmed the sale of Australia’s biggest not-for-profit private health insurance fund, Medibank Private. However, it does not go into how the sale will impact on Medibank Private members. Will there be increases in their premiums? What safeguards have been put in place? The government may well expect competition to reduce, the brakes to come off private health insurance premiums and the annual increases to surpass those of recent years, which have topped seven-odd per cent per annum. I regret that the budget does not instead have a plan to keep premiums in check. It does not have a policy of delivering a sustainable private health system that will not continually rip the incentive out of the pockets of mums and dads, grandmums and granddads across the country. I regret that it does not have any reason for people within my electorate of Hindmarsh to expect not to have their health expectations decreased without paying more and more.

With repeated premium increases well above the CPI, private health insurers are failing to offer value for money products, and the situation may get noticeably worse after the sale of Medibank Private. Many people actually believe they should be paying for private health insurance, if they are able. And they want to be able. They save and go without and scrape together the moneys required to keep often long-term policies going. I fear for those people’s hopes that the sale of Medibank Private will not lead to the loss of their ability to afford to do what they believe is the right thing to do.

The budget allocates some $50 million to a general marketing campaign for private health insurance, which will be jointly funded with the private health insurance sector. When Australians are finding it hard to get a doctor when they need one and hospitals are under pressure, how can this government justify spending $49 million out of the health budget to pay for advertising for private businesses?

On 26 April 2006 the Minister for Finance and Administration said that the sale will increase competition and put downward pressure on premiums. During the 2001 election campaign this government claimed their policies would lead to reduced premiums; however, since 2001 private health insurance premiums have increased by almost 40 per cent on average.

The Minister for Health and Ageing has tried to bury a series of health cutbacks in the budget papers. Under the boasts of increased health spending lie cutbacks that will hurt average Australian families. The biggest hidden cut is a $260 million cut to the Pharmaceutical Benefits Scheme. The budget refers to the cut as a ‘parameter variation’, but this means that budget estimates on PBS spending have been cut because fewer sick Australians are filling prescriptions than were originally expected. This continues a long series of cuts to the health budget, including $1.3 billion from the PBS last year and $500 million from the minister for health’s ‘rock solid, ironclad’ Medicare safety net. While PBS medicine affordability declines, we can expect more hospital admissions and greater health care costs in the future.

This budget also makes cuts to the government’s 2004 ‘Strengthening Medicare’ election campaign, an advertising campaign that cost $20 million. Both the workforce measures and bulk-billing incentive measures for concession card holders and children, which were key aspects of ‘Strengthening Medicare’, have not been funded beyond 2009. This proves that ‘Strengthening Medicare’ was nothing more than a pre-election con, just like the ‘rock solid, ironclad’ guarantee about the Medicare safety net that we heard.

It is clear from this year’s budget that the health minister is not running health in this country. Most health initiatives in this year’s budget are being driven and delivered by someone other than the health minister: 62 per cent of the total health budget is allocated to measures driven by the Council of Australian Governments and 20 per cent of the total health budget is allocated to measures driven by the sale of Medibank Private. The minister for health should be concentrating on fixing our health system and building the health system of the future, a health system that will be prepared for an ageing population.

There are many other areas where this budget did not deliver. It did not deliver on after-hours medical services to take pressure off emergency departments. We have all seen people who do not have a doctor available in their area or who cannot afford to pay the gap turning up at emergency departments and putting pressure on hospitals. The budget should have reinstated the Commonwealth Dental Scheme to get the 650,000 Australians waiting an average of two years for dental care off waiting lists. We all know that dental care is a Commonwealth responsibility; it is clearly stated in the Constitution under section 51 that it is the responsibility of the Commonwealth, along with health. The budget should have redesigned and invested in our medical workforce supply and distribution systems and reformed the relationship between the Commonwealth and state governments to reduce waste and stop the buck-passing and blame shifting in our health system.

There is also the issue of a shortage of doctors. Within Adelaide’s western suburbs the number of GPs has decreased from 280 in 2000 to 193 last year. That is a loss of 87 GPs in the past five years. This trend shows no sign of slowing. The number of practices fell from 164 to 103 in the same period, through either closure or consolidation. According to the Adelaide Western Division of General Practice, which serves 220,000 people, the vast bulk of the decreases in doctors results from retirement. Those left need to work harder to keep up with the demand. The average GP in the area is in his or her 50s, and more doctor retirements can only be expected to make the problem worse.

There are 2,800 training positions available this year through Backing Australia’s Future. There are also 246 available from last year’s ‘Strengthening Medicare’ package. The federal government announced a funding boost of $250 million in early April 2006 to fund new health professional places by 2009, including 400 medical places. The AMA  responded that the shortage is still a long way from being over—160 of the 400 are quarantined within Victoria and the remaining 240 may be accessed by any state or territory, including Victoria. The 240 places will be determined by COAG. Adelaide university wants 40 of those 240 places but Queensland is demanding 325 training places to meet demand. So as you can see there will still be a huge shortage of doctors. We need to be training more doctors to meet the demands, which will only grow with the ageing of the population in the future.

Access Economics has also supported Labor’s view that the minister has failed to deliver an agenda for the future of the Australian health system and has squandered an opportunity to build a reformed health system with a focus on prevention and early intervention that would meet the needs of average Australian families. The Access Economics report describes the Howard government as ‘slow moving’ and explains that the government has ‘passed up opportunities to improve health outcomes’ and is ‘ducking’ areas like obesity and increasing pressures on public hospitals. The 2006-07 budget is full of hidden cuts and squanders the opportunity to fundamentally reform our health system and invest in creating a much better health system for all Australians in the future.

Ann Corcoran (Isaacs, Australian Labor Party, Shadow Parliamentary Secretary for Immigration) Share this | Link to this | Hansard source

I rise to speak on the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006. Way back in 1984, when Medicare was introduced, a levy was struck to help to meet the costs of this new and very welcome universal health care scheme. I remember the introduction of its predecessor, Medibank, and the changes that that system brought us. Medicare did the same when it was introduced in 1984, after the Fraser government dismembered and then effectively abolished Medibank. In his second reading speech on the introduction of Medibank back in 1973, the Hon. Bill Hayden said that the purpose of Medibank was to provide the ‘most equitable and efficient means of providing health insurance coverage for all Australians’.

The objectives of the original Medibank were a universal health care system, the equitable distribution of costs and an administratively simple system to manage. The original intention was that Medibank would be funded by a levy of 1.35 per cent of taxable income. However, this levy was removed by the hostile Senate and Medibank was funded out of general revenue. On its introduction, doctors were given the option of continuing to bill their patients and doing the follow-up work in chasing slow payers or bulk-billing the Health Insurance Commission at the end of each month for the patients they had seen. If this option was taken up, the doctor was paid 85 per cent of the schedule fee for all the services they had provided for their patients in that month. Many doctors immediately saw the advantage of this in administrative savings and a return to a focus on medicine rather than bookkeeping and chasing slow payers.

Not long after the introduction of Medibank, the Whitlam government lost office and the Fraser administration arrived. Under Fraser, Medibank was firstly changed to include a levy of 2.5 per cent, with an option of not paying it by taking out private health insurance. In 1978 medical benefits were reduced to 75 per cent of the schedule fee and bulk-billing was restricted to holders of pensioner health benefits cards and those deemed by the doctor to be, in the minister’s words, ‘socially disadvantaged’. The health insurance levy and the compulsion to insure were abolished in 1978. In 1979 Medibank benefits were limited to the difference between $20 and the schedule fee. In 1981 access to free hospital and medical care was restricted to pensioners with a health care card, sickness beneficiaries and those meeting stringent means tests. An income tax rebate of 32 per cent was introduced for those with private health insurance. Essentially, at this point Medibank had died.

In 1984 the Hawke government tossed all this out and reintroduced Medibank under the new name of Medicare. One difference was that this time the government was able to introduce a levy—one per cent in this case—to help fund the system. There was a low-income threshold of $7,110 for a single person and $11,803 for a family, below which the levy was not payable. For the record it should be noted that in 1995 the one per cent levy was increased to 1.5 per cent and in 1997 a surcharge of another one per cent was introduced for high-income earners who did not have private health insurance.

Medicare was to be a health care system that ensured that everyone could get good, affordable health care. For a long time Medicare was an excellent system. At its height in the middle 1990s we saw something like 80 per cent of doctors bulk-billing. Unfortunately, over the last 10 years it has been allowed to deteriorate and it is no longer the shining star of health services that it once was. This decline is a direct result of the present government’s deliberate actions or lack thereof, and this is a shameful decision by this government. The Australian government’s Medicare website describes Medicare as follows:

Medicare ensures that all Australians have access to free or low-cost medical, optometrical and hospital care while being free to choose private health services and in special circumstances allied health services.

I am here to tell the government that this is no longer the case. I have said it before and I have to say it again, because the situation has still not improved. A number of factors are slowly but surely creating a divide in Australia between those who have access to good health services and those who need access but are not seeking or getting those services because they do not have the money to pay for them. The contributing factors to the reducing effectiveness of our health care system in providing affordable care for everyone include the absolute refusal of this government to reinstate the Commonwealth Dental Scheme; the crazy, back-to-front and inequitable Medicare safety net scheme; the changes to the Pharmaceutical Benefits Scheme; the reluctance or at least slowness of the government to get new drugs onto the PBS; the threatened sale of Medibank Private; the government’s refusal to enter into serious negotiations with the state governments to end the buck-passing and the waste of money that occurs because of the dual nature of our health delivery system; and the simply mind-boggling stupidity of this government’s cuts to university funding and the deleterious effect this is having on the numbers of doctors, nurses and other medical professionals we are training.

The latest interesting move was last week’s news that the government is negotiating with the banks to see whether they will process Medicare refunds. Let us just deal with that thought first—the news that the four major banks are negotiating with the Minister for Human Services about processing Medicare transactions as part of the government’s smartcard project. I understand these negotiations involve fees for the banks to process our refunds. The obvious question that follows from all this is: who will ultimately pay these bank fees? If the intention is that these fees will be able to be passed onto Medicare clients then this is clearly not acceptable. Other options that spring to mind are that the government intends meeting these costs out of the health budget or out of the smartcard budget, which has already blown out. Or does the government mean to close down Medicare offices altogether? We need answers to these questions.

The Medicare safety net cannot be talked about without us remembering the rock solid, ironclad guarantee that the Minister for Health and Ageing gave the electorate in the last election campaign period. That guarantee was that the threshold for the safety net would not be increased. Of course, it is history now and the threshold has been increased—right back up to where the government wanted it in the first place, before it had to lower it to get it through the Senate that existed before the last election. The original safety net was introduced in the lead-up to the last election to quieten a fractious electorate, who were becoming more and more vocal about the deterioration of Medicare. This concern was chiefly about the increasing difficulty in many areas, including outer suburban areas, of finding a bulk-billing doctor.

At the same time that bulk-billing was declining, the gap that patients were asked to pay when they visited their non-bulk-billing doctor was growing. This was made even worse because many doctors were asking patients to pay their fees up front. This was putting enormous stress on many people, and we have heard awful stories of people not going to the doctor when they needed to because they did not have in their pockets the $40 or $50 they needed to get in the front door. I want to make it clear that I am not blaming the doctors for all of this. They are in business, they are entitled to make a living and they are dealing in their own way with the deterioration of Medicare.

The government recognised that they had to be seen to be doing something. It would have been better if they had done something useful. The government introduced a safety net arrangement. The government hoped that, if the patient or family could see that the doctor’s bills would not grow beyond a certain level, they would be reassured and stop agitating for issues facing Medicare to be addressed. The safety net does not address the problem of giving access to affordable health care and it was never going to. That point was made at the time by the opposition and by many in the health sector. The argument was and is that the safety net simply writes a blank cheque on health costs, whilst not assisting many of those finding it hard to afford decent health care.

The financial constraints around Medicare are a regulation on how much the doctor is paid—that is, the rebate amount. Whilst there is criticism of the current level of the rebate, that does not take away the function of the rebate as a regulating device. The safety net is no such regulation. It is unregulated and uncapped—in other words, it is a blank cheque. The scheme pays 80 per cent of an unregulated fee for an indefinite time. The scheme was always going to be hard to control, and this is exactly what has happened. The scheme does not assist those who really need assistance. Once a person or household reaches the threshold, the scheme will help, but until that point it is of no help at all. The patient still has to look into their purse to see if they have enough money up front to get in to see their doctor. If the cash is not there right now, no promises of future relief will help. The person on a tight budget is still left looking in their purse first and ringing the doctor second.

It is worth noting some interesting statistics which show very clearly that this scheme is not helping those in real financial need. A recent report showed that 15,520 people in the electorate of Isaacs have spent enough at the doctors to qualify for the safety net. This compares with 27,906 people next door in the electorate of Goldstein, which covers suburbs such as Brighton and Sandringham. The Treasurer’s seat of Higgins has 23,985 people who qualify. The average income in Isaacs is $35,713, whilst those in Goldstein earn on average $51,631 and those in Higgins $55,498. The total received from the safety net in Isaacs is $1.6 million, Goldstein has received $4.3 million and Higgins has received $4.5 million. Just to complete this miserable picture of how the safety net is not helping the people who need it most, those in Isaacs who have qualified received on average $368 per person, those in Goldstein received $524 per person and those in Higgins $652 per person. Clearly, the safety net dollars are not going to those who need them most.

The proposal the government is running at the moment to sell Medibank is causing concern in my electorate. People do not want to see this major provider of health insurance move into private ownership. I join with my colleagues who, after seeing the backflip on the sale of the Snowy Hydro scheme, are calling for a similar backflip on the proposed sale of Telstra and I am saying let us add Medibank to that list. The issue to keepto the fore in thinking about the proposed sale is: what about the users of our health system? The sale of Medibank will not improve access to decent and affordable health care. In fact, it will do the reverse. The sale will reduce the number of players in the field of health insurance. This will reduce competition and lead to an increase in the price of health insurance. Private health insurance premiums have increased dramatically over the last few years. They have gone up 40 per cent in the last five years. We do not need any more pressure on these prices. Australians want Medibank Private retained in public ownership. As revealed in a recent survey, 64 per cent of people did not think Medibank Private should be sold and 74 per cent of people thought it would lead to increased premiums. I have to agree with them.

Access to affordable and good health care includes access to affordable medicines, but this seems to have escaped the notice of this government. The Treasurer has noted in the recent budget that there are savings of $260 million more than the government expected on the PBS. The government was expecting savings following the changes to the PBS safety net and changes to the patient contributions, but not as much as has actually happened. I worry that these savings are nothing to do with people suddenly not needing medicines but more to do with the fact that people cannot afford to buy the medicines in the first place.

At the same time, much needed drugs are not getting onto the PBS. Lantus, a drug for diabetics, is one that a number of my constituents are asking about. This drug releases insulin slowly and suits many people better than the alternatives. One constituent describes it as giving him much better blood glucose readings in the morning and better control of his glucose levels during the day. Although this drug has been approved by the PBAC for listing on the PBS, the minister has still to take it to cabinet for a final sign-off. Meanwhile, my constituents are paying over $100 per month for Lantus—that is, the ones who can afford it.

An issue related to Medicare is the workforce issue being faced by general practitioners. My local GPs tell me that many doctors are no longer prepared to work the long hours that doctors used to work and that many are not interested in working full time. Some simply work part time, whilst others will work as a GP for a few days per week and then work elsewhere, still using their medical skills but not in the local GP practices. This means that some local GPs are facing very long hours each week as well as limited periods for holidays or time off. This adds to the other burdens of the relative falling value of Medicare rebates and the increasing costs which most practices are facing. The answer to these problems is not simple. Nevertheless, the problem must be addressed in a concerted effort by federal and state governments.

So, whilst I am not for a minute disputing the purpose of the bill before us, I do note that much needs to be done to get our health system back up to where it should be. We must address the problem of access to affordable health care—be that access to the local GP, access to affordable medicines or to other health services. We have to stop thinking of health costs as costs. We must see good health as the right of everyone—not just of those who can afford it. It is important for us all to take care of our collective health and to take preventative steps to avoid ill health. For those of us focused on the financial line, this makes good financial sense too. Ill health is expensive and if we can avoid it we should do so. We must quickly act to ensure that everyonehas access to affordable health care. This is not the case right now and it is to our shame that we allow this to happen when it can be addressed.

Roger Price (Chifley, Australian Labor Party) Share this | Link to this | Hansard source

Before I address the specifics of the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006, I would like to point out that this bill is subject to the guillotine motion moved by the Leader of the House, Mr Abbott, earlier this morning. In fact, it is my understanding we need to conclude this bill by 12 noon. The Leader of the House said that the opposition had been offered longer sitting hours, but on the condition of limiting their speeches. I need to place on the record a couple of things. Firstly, the government, when in opposition, never, ever agreed to limit their speeches. They never limited their speeches, so why should we as an opposition agree to limit ours? There have been occasions when I have agreed to the limitation of some speakers and debate, but I am always very reluctant to do it for the very reason that the Manager of Opposition Business stated—that is, all members of this House have a responsibility to scrutinise legislation and keep this government accountable. So why shouldn’t everyone exercise their proper right, as a member of this House, to make a contribution on this bill?

Secondly, one of the most frequent refrains in question time from the Leader of the House is that the Howard government is the best friend Medicare ever had, yet we have already run out of government speakers, who are shy about Medicare and unable to make any contribution to this bill and its impact on their own electorates. I find it ironic. Of course, I would suggest that Saddam Hussein is the best friend the Howard government ever had through the ‘wheat for weapons’ scandal, but that is another issue. The honourable member for Hunter has moved a second reading amendment, which reads:

“whilst not declining to give the bill a second reading, the House:

(1)

condemns the Government and Minister for Health for squandering the opportunity to fundamentally reform our health system;

(2)

condemns the Government for failing to invest in rebuilding our health system, including Medicare, for the future, focused on prevention, early intervention and an ageing population; and

(3)

condemns the Government for its failings in relation to our health system, as evidenced by delivering a Budget containing hidden cuts and the related decision to sell off of Australia’s biggest not for profit health insurer, Medibank Private”.

I want to make it clear that I am totally in favour of the amendment moved by the member for Hunter.

It is clear that the people of Australia value having an affordable and accessible health system that they have been used to for many years in this country. It is my view that the biggest black hole is in the hospital system, where the states are not receiving assistance from the federal government to make our hospital system even better. Locally, over the last couple of years there has been a great deal of community concern that the Mount Druitt Hospital would close or, alternatively, would become a nursing home. This was never going to be the case. Both Richard Amery, the state member for Mount Druitt, and I served on the board of the hospital. Our esteemed late friend, Tony Johnson, as the previous member for Mount Druitt, was instrumental in getting the hospital and it has proved its worth over the years. Indeed, for all the royalists in the gallery, it was opened by Her Majesty the Queen back in the seventies.

Given the background of community concern about Mount Druitt Hospital closing, I wanted to rattle off a few statistics. The number of patients waiting more than 12 months for elective surgery has been reduced by 88 per cent since March 2005, from 59 patients in March last year to just seven this year. The total surgical waiting list for Mount Druitt has been reduced by 22.9 per cent, from 580 patients last year to 447 in March this year. Attendance at the Mount Druitt accident and emergency unit in March 2006 was up 17.4 per cent to 2,137 people. In addition to this, the hospital is dealing with more serious cases. In March this year, there were over 315 admissions to wards for surgery and specialist care from the accident and emergency unit, 37 per cent more than March last year.

It is true that there has been a rationalisation between Mount Druitt and the new Blacktown hospital, recently completed by the Carr Labor government. The specialities that Mount Druitt has are working well. The idea that somehow the accident and emergency unit at Mount Druitt would be shut down has proved way off the mark. As I pointed out, these statistics are showing an even busier hospital. I guess the point I wish to emphasise is that, if the government would only make a greater financial commitment to our public hospitals, even these figures could be reduced quite significantly. The Howard government will throw a lot of money around in health but never, ever to a public hospital.

The other thing I want to point out is in respect of the dental clinic at Mount Druitt Hospital—the May Cowpe Centre. The late May Cowpe was a lovely person, although I suspect she might have been of a different political persuasion from mine. But that matters not. For many years she headed up the hospital’s ladies auxiliary, and they have done a fabulous job. Statistically, I think more money has been raised by Mount Druitt ladies auxiliary than by any other comparable ladies auxiliary. On May Cowpe’s passing, it was only fitting that this building be named in her honour.

The real tragedy is that, in trying to solve health issues that face the people of Australia, the government has consistently turned its back on dental health. A dental health program was in operation when the Howard government took office, which cost $100 million a year to run and in its last full year of operation looked after the dental needs of around 600,000 people. The great tragedy is that the cutting of this program left the May Cowpe dental clinic completely underutilised and there are now unacceptably long waiting lists to access the May Cowpe dental clinic at Mount Druitt.

We may think that teeth are just teeth and that nothing too serious can happen, but there are a whole range of teeth maladies, some of which if left untreated can lead to death. The government has a surplus of over $14 billion and it is a real tragedy that it is so heartless and indifferent to the dental health care of a nation that it will not embrace a scheme that was such an outstanding success and helped 600,000 of our fellow Australians—often aged pensioners and children. It is a black hole that the government is absolutely and totally disinterested in.

One of the early actions of the Howard government was to close the Mount Druitt Medicare office. In question time the Prime Minister is fond of reminding me—not that I need reminding—that my electorate has the highest unemployment of any in New South Wales. I wish it were otherwise. It means that I have a lot of people in my electorate who need access to a Medicare office. People who say that these things are available at Blacktown or Penrith do not understand the geography of Western Sydney. Nothing would give me greater pleasure than to see a Medicare office reopened at Mount Druitt. I did take up a petition when the office was about to close, and I have never seen a petition taken up with such enthusiasm in my electorate as the one to get the Medicare office reopened.

It is a pity that, at the very time the government is contemplating privatising Medicare, it does not have any plans to open a Medicare office in Mount Druitt. Shame! It shows how the Howard government treats people who happen to be represented in the federal parliament by a Labor member. Issues are not treated on their merit and the people are not treated with any degree of consideration or compassion. I am still committed to opening a Medicare office in Mount Druitt.

I also want to place on record my thanks to all those who signed the petition I circulated to have Herceptin listed on the PBS. Many thousands have already signed the petition, and we are working our way through them. It is an awful thing for a family which has a member who suffers from breast cancer to have to contemplate finding $66,000 for each year the family member needs to be treated with this drug. Tragically, I have met some families where a decision has been made to sell or remortgage a house just so the family member can receive this treatment. It must be an awful decision for those families to make. Perhaps I have misrepresented it somewhat—the families have said it is an easy decision for them because they value life over money and therefore have come to these decisions very readily—but these families are placing their financial security at some degree of risk by making such a generous sacrifice. Families should not have to make these decisions in respect of family members who have breast cancer when a drug is available that will put them into remission for a considerable period and will give them some quality of life, notwithstanding the ravages of this dreadful cancer of the breast.

When a government is wallowing around with a surplus of $14 billion—or, as the Treasurer would say, 14 thousands of millions of dollars—it is difficult to understand why they do not have compassion and why they cannot see why a federal government should be trying to assist our fellow Australians. I suppose what is at stake here is the belief that we have on this side of the House that, no matter what your income or your age, we should have access to a vibrant public health system that is able to treat you without serious cost—that, unlike in America, your monetary circumstances should never be a barrier to good health care. I will repeat that. On this side of the House, we believe in having a very strong and robust public health system so that, no matter what your financial circumstances, you as a citizen have as a right the ability to go and see a doctor, have an operation or have, notwithstanding the expense, appropriate medication given to you so that you either may be cured or, in the case of Herceptin, at least have your life prolonged and have some quality of life, despite having a very insidious disease.

So there are quite some differences between the government and Labor, and I have outlined some that impact on my electorate. I finish on this note: I do not understand why the government is trying to rush to privatise it. If we had some evidence that Medibank was not working well—its management were flawed, it lacked vision or it was unable to deliver services—these would be strong reasons to look at whether or not a change in the ownership structure would impact on better service delivery. But the government makes nothing out about it. In fact, in the budget it says it is committed to spending some $20 million trying to convince the people of Australia that selling Medibank is somehow going to be good for them. I am unconvinced. I suspect that the people of Australia will be very apprehensive about this move by the government. And it is absolutely regrettable that, in trying to influence members of parliament in their vote, it has attached some expenditure measures in this budget to the sale of Medibank. I think that that is wrong as well. I will be opposing any sale of Medibank as vigorously as I can in my own electorate. I support the amendment moved by the member for Hunter.

Kim Wilkie (Swan, Australian Labor Party) Share this | Link to this | Hansard source

The Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006 includes changes to the Medicare Levy Act 1986 to increase the Medicare levy low-income thresholds for individuals and families. It also increases the Medicare levy low-income threshold for pensioners below pension age so they do not attract a Medicare levy liability where they do not have an income tax liability. The member for Hunter has articulated Labor’s support for the bill as presented to the House. He has, however, moved an important second reading amendment, which I support and which I have no doubt will attract the support of many in my electorate. The member for Hunter’s amendment reads:

... the House:

(1)

condemns the Government and Minister for Health for squandering the opportunity to fundamentally reform our health system;

(2)

condemns the Government for failing to invest in rebuilding our health system, including Medicare, for the future, focused on prevention, early intervention and an ageing population; and

(3)

condemns the Government for its failings in relation to our health system, as evidenced by delivering a Budget containing hidden cuts and the related decision to sell off Australia’s biggest not for profit health insurer, Medibank Private”.

The government’s decision to sell Medibank Private is a disgrace. It comes on top of 10 years of neglect of our health system, the virtual extinction of bulk-billing doctors and the axing of the Commonwealth’s dental program.

Let us just look at how the government has gone about considering the sale of Medibank Private. Its own report suggests that there will be such a huge public outcry and backlash that it will need to go about this very carefully and fund an enormous advertising campaign to try and get away from the fact that it is withdrawing this service from public ownership and selling it off to private enterprise. This is outrageous. It goes to the very heart of what this government is all about. It is mean and tricky and out of touch. It knows that the population is absolutely opposed to the sale of Medibank Private, but it intends anyway to sneak this through and, in order to try and justify doing so, fund an enormous advertising campaign to con people into believing that this is good for them. We all know that, when this government advertises programs, it is trying to pull the wool over people’s eyes. You have only to look at the amount of money that it spends in the lead-up to an election, trying to sell its dud policies and programs, to know that it is trying to rip us off. This is exactly what will be the case when it is looking at introducing the sale of Medibank Private, which it knows the public does not support.

A number of years ago I presented a petition, signed by thousands of my constituents, calling for the establishment of a Medicare office in Belmont. The federal government continues to ignore this call. With a regional population of 31,500 people, and located nearly 10 kilometres from the nearest Medicare office in Swan, which is in Cannington, the city of Belmont needs a Medicare office of its own. Local residents have been inconvenienced for far too long. Having a Medicare facility in Belmont would mean that, after visiting local medical services and facilities, patients could claim rebates quickly, easily and close to home. The electorate of Swan desperately needs this Medicare office in Belmont to serve the people of the area. At the moment, there is one Medicare office in the electorate, which, as I said, is located in Cannington, leaving the northern part of the electorate completely unserviced except by agencies located in chemists in Victoria Park and East Victoria Park. As members know, while a Medicare claim form can be lodged at an agency, any more complex issues must be dealt with at a Medicare office. It is invariably the elderly, those with young families and those with disabilities for whom the more comprehensive services of a Medicare office are required.

Having gone to the Medicare office in Cannington on numerous occasions myself, I know that they are overstretched and really struggling to meet the demand. It is not uncommon for the queue of people waiting to get their claims processed to be at least 40 to 50 metres long, snaking not only through the office but out into the shopping centre. Of course, this is outrageous. Many of those people are elderly, and they have had to travel long distances just to get there and have their claims processed. As I said, my electorate is home to many such people who rely on public transport and cannot travel great distances. It is simply unacceptable for them to have to travel over 10 kilometres to Cannington in order to access the services of a Medicare office. Indeed, some constituents have told me that it can take more than two hours on public transport for them to attend the Cannington office from the Belmont area. As I said, they then have to stand in line, waiting to get their claims processed.

Quite clearly, locating an additional Medicare office in Belmont would enable the needs of the regional population of 31,500 to be met far more effectively and would make a significant, positive difference to their lives. Under Labor’s election policy at the last election, we committed to providing a Medicare office in Belmont. Unfortunately for the electorate of Swan, the coalition made no such commitment. On behalf of the residents of the northern part of the Swan electorate and particularly the elderly, the chronically ill and those with disabilities, I urge the government to reconsider this worthy proposal in the future.

The reality is that the Howard government does not believe in bulk-billing or Medicare. This is the government that initiated cutbacks to GP training in 1996 and now sheds crocodile tears over the lack of doctors in the bush. Its big answer is to bring in people from overseas, when it should have been training our own people up—it knew that there was a shortage back in 1996.

This is the government that has denied the elderly access to dental treatment after abolishing the Commonwealth dental program. Let us just dwell on that for a second. As has previously been commented on in this debate, if you are elderly and you have real problems with your teeth, you cannot eat solid food. And, if you cannot get dental treatment, you are stuck eating food that you would normally feed to small children. I think it is absolutely unacceptable that, in this day and age, people who have retired, who are normally on a pension, cannot get access to decent dental care. It is outrageous and unforgivable that this government axed that particular program.

The Commonwealth has also removed free hearing aids and hearing services for health card holders, another outrageous development over the last few years. Also, massive price hikes for PBS medicines have outstripped pharmaceutical allowance increases.

Just last December, we saw this mean and tricky government remove calcium tablets from the PBS for all but those patients with renal conditions. The decision by the Minister for Health and Ageing to do this was in direct contravention of the advice of the Pharmaceutical Benefits Advisory Committee and will impact severely on older people with osteoporosis. Here we have a committee, the Pharmaceutical Benefits Advisory Committee, that is set up to look at what sorts of programs and drugs should be funded. It makes the determination that this particular product should be available, and the minister says: ‘No, I’m going to take it off. I don’t care about these people. It’s going to cost money, so they’re not going to have it.’ Again, this is just outrageous.

Bulk-billing has suffered under the 10 long years of the Howard government’s mismanagement. Since 1996, 110 federal electorates have seen a decline in their bulk-billing rates; 52 federal electorates have seen a decline in their bulk-billing rates of 10 per cent or more; and six federal electorates have seen a decline of 20 per cent. In 1996, the average rate of bulk-billing was steady at 80 per cent nationally. In 2005, the bulk-billing rate has struggled to reach 74 per cent after a substantial cash injection. The Minister for Health and Ageing, Tony Abbott, has trumpeted weak improvements in bulk-billing rates in some electorates between 2004 and 2005, but the 10-year comparisons show that one year’s improvement does not make up for the Howard government’s long-term neglect of Medicare and bulk-billing.

The Howard government’s bulk-billing policies at the last election focused only on providing incentives for GPs to bulk-bill children and concession card holders such as pensioners. Newly released data shows that these policies have had a very small effect on the overall bulk-billing rates and have not improved access for the broader community. Note that the Howard government also increased the Medicare rebate for GP services from 85 per cent of the schedule fee to 100 per cent of the schedule fee, but this extra payment was not tied to bulk-billing.

The so-called Medicare safety net was put in place to assist families with high health care costs, in particular those with chronic conditions who faced the burden of growing out-of-pocket costs. However, the so-called Medicare safety net has done little to make health care more affordable or accessible, as it has not improved the ability of lower income individuals or families to access care in the first place. The Medicare safety net does nothing to address the impact of 10 long years of Howard government incompetence on out-of-pocket expenses or costs. Since 1996-97, the out-of-pocket costs of seeing a GP have almost doubled from $8.50 to over $15.

In my electorate, there has been a real need for GP after-hours services. There are clear reasons why we need this service. Over 166,000 people live in the district. Of the 63 GP surgeries, only 13 offer more than five hours a week of extended services—that is, they are open after 6 pm on weekdays or after 2 pm on Sundays or public holidays. Of the 63 GP services, only three offer nine hours or more of service on Sundays and public holidays. There are no formal after-hours primary medical care clinics at all, and there are no public or private emergency departments in the precinct. The general practice division has the lowest doctor hours of service of all metropolitan general practice divisions in Western Australia.

The need for an after-hours primary care facility is critical when you consider that over one-third of presentations to public hospital emergency departments from residents in this division were GP type presentations. Sixty-seven per cent of respondents to a consumer survey indicated that they would use an after-hours service rather than attend a hospital emergency department. In fact, the local Division of General Practice applied for a grant to open up a GP after-hours clinic, and the government knocked back the request. They sat on their hands for months and months. It was not until I raised this issue in the House some time ago that the department said that they had decided they were not going to fund that particular service, which was an outrage. Since I made that speech, to their credit, the Canning Division of General Practice opened a facility in Bentley, albeit without any federal assistance, and they are trying to cater for some of the needs of the people who are there; unfortunately, they are struggling. They really needed to get that grant in order to provide the service in a very comprehensive way. We really need to address these issues, because those people need to get that sort of service. Whilst they are getting it now in a limited way, provided by the GPs themselves, it is about time the Commonwealth owned up to its responsibility and put some money where its mouth is with regard to GP after-hours services.

We will support this bill, because it does go in some small way to providing some relief. But, in real terms in my electorate, the government needs to start looking at reintroducing funding for programs that can address dental health for the seniors in my electorate, provide adequate GP after-hours services and ensure that the Medicare office in Belmont is established. The need is there; people are crying out for the service and it is high time the government listened.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

Like the previous speaker, the member for Swan, I will support the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006. The legislation increases the Medicare levy low-income thresholds for families and individuals. The dependent children and student components of the family threshold will also be increased. The increases are in line with the movement in the CPI and increase the Medicare levy low-income threshold for pensioners below age pension so that they do not have a Medicare levy liability where they do not have an income tax liability. This legislation is a very small step towards alleviating the hardship that many people experience in Australia—the hardship they experience in accessing medical treatment, the hardship they experience in paying for medical treatment and the hardship that has been brought upon them by this government.

One issue that is of great concern to me now—and I know that a number of speakers on this side of the House have mentioned it—is the sale of Australia’s biggest not-for-profit health insurance fund, Medibank Private. If I were a member of parliament who came from Queensland, I would be particularly concerned, because 75 per cent of the private health insurance market is covered by Medibank Private. Coupled with MBF, that is practically the whole of the private health insurance market within Queensland. That is a very big worry when the government is arguing that competition will keep down the price of premiums. I would have to say that that competition has not done much towards keeping down the price of health insurance premiums in Australia to date.

We have had enormous increases, well above the CPI, in private health insurance. As well as those increases, we have found that the value of having private health insurance has declined, with the gap between the cost of the service and the money received by a person who holds the private health insurance becoming larger and larger. Selling Medibank Private will in no way guarantee greater competition; rather, it will lead to reduced competition and a further spiralling of the increase in private health insurance premiums plus an increase in the gap that Australians have to pay when they use their private health insurance to access care in a private hospital within the private health industry.

The minister announced the sale in April this year. During the 2001 election campaign the Howard government claimed that their policies would lead to reduced premiums. Just as they are saying now that we will have increased competition, previously they have argued that their policies will reduce the cost of health insurance premiums. But that that has not happened; premiums have increased. I think we will not be at all surprised on this side of the House when we find that there is less, rather than more, competition.

The budget papers show that $500 million has been committed over the next year for health and medical research. However, 20 per cent of the total health budget is allocated to measures driven by the sale of Medibank Private, and that is linked to the money that is being spent in medical research. That is a worry, because I think that medical research is such an important issue and such an important area that the government should contribute to it well and truly without tying it to the sale of Medibank Private.

The previous speaker mentioned the need for a Medicare office in Belmont. I am going to join him and also call for a Medicare office in Belmont. There was a Medicare office operating in Belmont within the Shortland electorate, and it had a very high turnover of claims. Some 20,000 people in Shortland electorate have signed petitions supporting its reopening. The government closed the office in 1996 when it came to power. The government left open offices with smaller turnovers but which were in Liberal, marginal electorates and closed the office at Belmont.

The Shortland electorate has the 10th highest number of people aged over 65 in Australia. Its outlying areas are quite a distance from the nearest Medicare office, so pensioners on restricted licences who are located in those outlying areas would find themselves unable to drive to the current Medicare office at Charlestown.

The government is selling Medibank Private and has closed Medicare offices within the electorate of Shortland. It is demonstrating its blatant disregard for and putting its own interests ahead of those of the people of the Shortland electorate, whom I represent in this parliament. These actions are all driven by some obscure philosophy that unless people pay for their medical treatment we will end up with a second-class US-style medical system. The government should really see health as priority and be prepared to contribute to it.

A group that has impressed me particularly is the hospital reform group. Its main interest is in ensuring that our public hospitals are looked after. It is a broad group, which includes senior health workers, doctors, nurses, allied health clinicians, academics, managers and consumers, whose main commitment is to public health. A main issue that it highlights is the impact that workforce shortages have had on our hospital system and our ability to look after people when they are sick.

We have a chronic doctor shortage within the Shortland electorate. We have elderly people who cannot find a doctor to give them the medical care and treatment they need. We have pensioners who are sitting in their houses unable to go to a doctor because they do not have the mobility to do so. In most areas, we have doctors who have closed their books. They have not closed their books because they do not want to see patients; they have closed them because they physically cannot see any more patients than they are seeing at the moment. If they were to do so, they would risk being investigated by the Health Insurance Commission.

On the issue of workforce shortage, the government has really failed not only the people of Shortland but the people of Australia—and not only in the area of doctors. Within Australia, we have a chronic shortage of nurses and a shortage of all allied health care workers. The government was very short sighted when it came to power in 1996. It cut the places that were available at universities and suddenly we have been hit with this shortage of doctors. The changes it made to the provision of provider numbers have also contributed to these shortages. It is all very well for the government to say that it is acting now; it is too little and too late. Even when new doctors do come on line in 10 years, we will still have problems.

Previous speakers have mentioned issues surrounding dental health. Once again, one of the first acts of this Howard government was to axe the Commonwealth dental health scheme, which immediately cut off access to public dental care for millions of Australians. This has hurt pensioners particularly. As I mentioned earlier, in this parliament I represent an older electorate and many of my constituents have no dentures. People have come to see me because of dental problems—having no dentures, they have to eat soup; some have infected teeth. People have to wait for very long times to access the public dental system that is available. I know that the New South Wales government has done everything in its power to help and has actually increased expenditure in this area. However, it is not unusual to have someone come to me and say, ‘I have a tooth that could be filled but, because of problems with accessing dental services, I am getting all my teeth pulled out.’ Someone said that to me just the other day.

Last year the government commissioned the Podger inquiry and I believe that it has written its report. But that report has never surfaced in this parliament. Last week Andrew Podger presented evidence to this parliament’s Committee on Health and Ageing. When I asked him about that report, he told me that he could not divulge what was in it as it was the property of the government. This inquiry was set up to look at the provision of health care, at the relationship between the states and the Commonwealth regarding health care and at whether it would be better for the Commonwealth to be the sole provider of health care. From listening to what Andrew Podger said when presenting to the committee, I am sure that he has a strong inclination towards that approach.

Andrew Podger undertook an inquiry—paid for by the government with taxpayers’ money—looked at all the evidence and then prepared a report. What has happened? That report sits on a shelf somewhere in the Prime Minister’s office or perhaps in the office of the minister for health and they refuse to release that report. They refuse to tell the Australian people what that taxpayer money has been spent on. They refuse to tell us whether Andrew Podger thinks the current system is the best approach for delivering health services to Australians. What concerns me about this is that millions of Australians are waiting for health services.

Bob McMullan (Fraser, Australian Labor Party) Share this | Link to this | Hansard source

Order! It being 12 o’clock, in accordance with the resolution agreed to earlier today I call the minister.

Peter Dutton (Dickson, Liberal Party, Minister for Revenue and Assistant Treasurer) Share this | Link to this | Hansard source

The Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006 gives effect to the budget announcement to increase the Medicare levy and Medicare levy surcharge low-income thresholds in line with increases in the consumer price index. This bill ensures that low-income individuals and families are not disadvantaged due to small increases in taxable income. If the thresholds were not increased then low-income individuals and families whose income had only increased in line with the consumer price index would face a Medicare levy liability even though they had not in previous years.

These changes ensure that low-income individuals and families will continue to be exempt from paying the Medicare levy or surcharge. From the 2005-06 income year, the Medicare levy low-income threshold will increase to $16,284 for individuals and to $27,478 for families. The additional amount of threshold for each dependent child or student will also be increased to $2,523.

This bill also increases the Medicare levy low-income threshold for pensioners below age pension age. The Medicare levy threshold for pensioners below age pension age will be lifted to $19,583. This threshold has been increased each year since 2001-02, when the government substantially increased the pensioner tax offset, which meant that the level of taxable income where these pensioners started to pay income tax also increased. The increase will ensure that pensioners below age pension age do not face a Medicare levy liability where they do not have an income tax liability.

In conclusion, I would like to thank members who have contributed to the debate on the Tax Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2006, and I commend this bill to the House.

Bob McMullan (Fraser, Australian Labor Party) Share this | Link to this | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for Hunter has moved as an amendment that all words after ‘That’ be omitted with a view to substituting other words. The question now is that the words proposed to be omitted stand part of the question.

Question agreed to.

Original question agreed to.

Bill read a second time.