David Hawker (Speaker) Share this | Link to this | Hansard source

I have received a letter from the honourable member for Gellibrand proposing that a definite matter of public importance be submitted to the House for discussion, namely:

·              The Government’s failure to take responsibility for the health care of all Australians.

I call upon those members who approve of the proposed discussion to rise in their places.

More than the number of members required by the standing orders having risen in their places—

Nicola Roxon (Gellibrand, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

This is a very significant matter of public importance because it is an opportunity for us to debate what is happening currently in health care in Australia. We do have, compared to many countries around the world, a good health system—no-one on either side of the House disputes that—but it is a system that could be so much better if the federal government paid a little attention to the growing and gaping gaps and dints in our healthcare system. A couple of them in particular that I want to talk about today are the way we treat our elderly Australians and the pressures that are being put on our hospital system when people who would be more appropriately cared for in an aged care setting are forced to stay in hospitals for long periods because aged-care beds are not available. We have heard horror stories of do-it-yourself dental care in which elderly Australians use their toolshed in the backyard to go and file down their dentures because they have been waiting for so long for a set of dentures that fit them properly. I am also going to talk about the nearly half a million people who end up in hospital every year with diseases that are preventable, which this government is not taking any action on.

The situation with our elderly Australians has come to the fore in the last couple of days. It is an issue that has been bubbling away for many years, but a couple of stories in the papers have graphically brought home how desperately these families suffer because the government is not making a sufficient number of aged-care beds available. When the stories are raised in the media, the Minister for Ageing—and I am sure the Minister for Health and Ageing at the table will happily be able to answer questions on his colleague’s behalf—says: ‘Don’t look at me. This is nothing to do with me.’ If an issue is raised about aged care, he immediately tries to find somebody in the states to blame.

The story in the West Australian on Monday was of an elderly woman who has been in a hospital bed for a long period, having been assessed as eligible for an aged-care bed but unable to get one. The minister, who does not even know that his government’s own department assesses that there is a 500-place shortage in WA, says, ‘I am told by industry representatives there’s a glut,’ as if therefore there is nothing that he needs to do. I know that every day in their electorates Western Australian members on our side of the House deal with their constituents’ complaints about finding a place because there is such a serious shortage.

Not only is it inappropriate care for the patients and for their families, but the cost to the community of that care is extraordinary. This story that appeared in the West Australian obviously used figures that are applicable for this particular example. The woman, great-grandmother Ann Duim, was staying in a bed at the Royal Perth Hospital, which cost $1,600 per day, with no choice of being able to get into an aged-care facility. Not only was she in a hospital setting, which was inappropriate and very difficult for her family to visit, but the comparative estimated cost of a bed in an appropriate aged-care facility is $250 a day. That is an extraordinary difference on which we are wasting collective health expenditure when we could use that money for much better purposes.

Whenever the Leader of the Opposition or I or other members of our team say that we should make sure we spend every health dollar sensibly so that we can make it go further, the Minister for Health and Ageing loves to accuse us of wanting to cut the health budget, when nothing could be further from the truth. But when his government’s decisions mean that we are spending $1,600 for one day on one person in one hospital bed—and when that person could be in a more appropriate aged-care facility which would be better for their care, better for their family and significantly cheaper for the taxpayer—surely that is something that we should be exploring. The costs across the country are not necessarily all as dramatic as that example in Western Australia, but around the country the average cost of a hospital bed is $967 a day. That is almost nine times more than the average cost of a nursing home bed. And still the government says: ‘We don’t have to worry about that. If there are nearly 3,000 elderly people in hospitals around the country who should be in aged care, that is not a responsibility for us.’

I think that it is extraordinary that the government, particularly the Minister for Ageing, does not seem to have any interest in fixing this. I am sure people on this side of the House will remember that, of course, the Minister for Ageing does not want to be the Minister for Ageing. He is the only Minister for Ageing who does not want actually to meet and talk to the elderly people in our community. I have decided that we should be calling the minister ‘Peter Pan’: the little boy who did not want to grow up. He does not want to talk to adults in the community and talk to families about appropriate care for their grandparents and great-grandparents. It is really embarrassing to have a Minister for Ageing who does not have any interest in going to aged-care facilities and talking to elderly people and their families, and to have a Minister for Health and Ageing who does not think the government should have responsibility for fixing this problem.

I am hoping that the minister might also think about the situation of a family in Townsville, the Buck family, whose father, Fred Buck, has been in respite care in Townsville. He has been unable to get a bed in Townsville and instead is going to be given a bed in Malanda. For people who do not know where Malanda is, it is in the Atherton Tableland. It is a four- or five-hour drive from Townsville, one way, for the family to visit this elderly man who is in desperate need of appropriate care. The family has estimated, generously I think, that the trip each way to make a short visit to their father—not taking into account the time and the wear and tear on their car—costs them $300 by the time they pay for petrol and accommodation.

That is a ridiculous situation. When this issue was raised in Western Australia the Minister for Ageing said, ‘No, the industry tells me there is a glut. I will not worry about it.’ Similarly, the member for Herbert—a member of the coalition—says, ‘This has nothing to do with us; the state government should fix this. Peter Beattie should fix this problem.’ I think the member for Herbert has been in this House long enough to know that aged care is a Commonwealth responsibility. He is a member of the government that can fix this problem and it is one of his constituents who is being forced into this terrible situation. He is quite wrongly blaming the states rather than saying, ‘This is an issue I should take up on behalf of my constituents. I should see the minister for health and I should see the Minister for Ageing and get this problem fixed.’

Mr Buck received a national medal for 25 years of service to the Queensland Ambulance Service, he had no sick days, he was never late for work and he was and is well-known in the community. Despite having provided that service to the community, being integrated into the community and having access to his family for such a long time, he is now being turned away from appropriate care. Surely, Minister, we can do better for our elderly citizens.

The member for Hindmarsh was approached by a constituent, an elderly gentleman, who, despite the government’s promises about the chronic disease program for dental care, has a chronic condition and has not been able to get assistance. As I said, he is taking his dentures out to his toolshed and using a file on them to stop them rubbing and cutting his mouth because he cannot get them fixed. We have elderly members of the community at a time in their life where we should be treating them with more compassion being unable to access basic health services and aged-care beds locally.

There is an example in the Speaker’s electorate of an 87-year-old man who has to drive 120 kilometres from Portland to Penshurst—or 240 kilometres for the round trip—three times a week to see his wife, who has had a stroke. They have been married for 64 years and are unable to get an aged-care bed in their home town. Not surprisingly, their family worry just as much about their father making the trip as they do about their mother. We must be able to offer a better system. Unfortunately, the ministers responsible do not seem to be taking this issue seriously.

Excuse me—unfortunately, having shadow responsibility for the health portfolio does not give one any immunity from the flu! It would be great if the minister could fix that as well as aged-care facilities! I do not know why the health minister cannot fix the common cold. It seems to be a problem that many of the professionals are not able to fix either, so I am not sure I should hold him responsible. That is one I will not hold you responsible for, Minister, but I am afraid you will have to put up with my sniffing as I speak.

The Labor Party is aware that the figure for bed shortages around the country is now more than 2½ thousand. It would be good if the minister could confirm or deny these figures. The department’s assessments show that Western Australia is 500 beds short; Victoria, 440-odd beds; the Australian Capital Territory, 326 beds, which is a very large figure for a small population; and Queensland, 688 beds. Obviously the example in Townsville illustrates the situation perfectly. These are examples of the problems being faced by real people.

The minister might say that we have a Minister for Ageing, so I do not need to deal with this as a responsibility. But, Minister, we are concerned about it for a range of reasons. We are concerned about it because people cannot get the appropriate care they need near their homes. We are also concerned because it means that people are staying for very long periods in hospital when that is not appropriate and the cost is being met by the rest of the community. It means that people who have conditions for which they should be in hospital cannot get into hospital because the beds are being taken up by people who more appropriately should be in aged-care facilities. The minister has shown no interest in trying to fix this problem. The government often talks about aged-care places and groups community care packages together as if they were the same as aged-care residential places. We know they are not. In talking on this matter of public importance, Minister, it would be good if you would confirm the bed shortage figures. We know and hear from our constituents every day about the great crisis.

Labor made some commitments last week to fix this problem between the states and the Commonwealth. We see aged care as a key area in the blame-game argument. Things done at the federal level cost not only the community but also the states. Labor has committed to reforming the transition of patients from hospital to residential aged care as a priority for older Australians who need nursing home care. We will make reform of the interface between our hospitals and nursing homes a priority area in the forthcoming negotiations between the state and territory governments for the Australian health care agreements, which expire in the middle of next year. We will examine further whether additional transition and step-down care would assist along with other measures that might increase the speed with which aged-care bed licences can be operationalised. We would like the minister to tell us what the government is planning to do in this area rather than simply to say that this is a problem that can be left with the hospitals.

As I said, this is not an issue only in aged care given that one in 10 hospital admissions relates to dental conditions that could have been prevented. People are ending up in hospital because they cannot get dental care, Minister, because your government closed down the Commonwealth dental care scheme when it was elected. About 50,000 people now end up in hospital for treatment of dental conditions. Children as young as five and six are being admitted to hospital and having general anaesthetics to have teeth extracted. We know that the figures indicate that children’s teeth are getting worse. Australia’s dental care system used to be at the top of the pile compared to systems in the rest of the world, but we are gradually dropping. We are burdening our children with problems that we will not be able to fix without major intervention at a cost to them individually and to their families and the community.

Minister, you would be aware that the blame-game report that your colleagues unanimously signed on to, along with a number of colleagues on the side of the House, recommended ‘that the Australian government supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups’.

I am wondering whether the minister might be prepared to answer in this debate why it is that the government has so far not responded at all to the report The blame game: report on the inquiry into health funding, and why it is, in announcing their dental package as part of the budget, they did not even take account of that recommendation. What they have done is put in place a specific chronic disease program which is just for private dentists and is limited in all sorts of ways; it does not supplement at all state and territory funding for public dental services. It does not ensure that reasonable access for appropriate services is maintained for disadvantaged groups. I know colleagues on this side of the House put a lot of work into that report and are still waiting for a response from the government. Minister, I am sure members on your side of the House will be wanting to know how it is that putting money into this program of yours, which has failed spectacularly so far, serving only 338 people in South Australia over three whole years and 68 people in Tasmania—are there any Tasmanians here?—is going to do anything for those people. It is about time you answered some of these questions. (Time expired)

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

Listening to the shadow minister’s speech, I was reminded of the not very successful 1990 Liberal Party election campaign: ‘There are questions that have to be answered.’ We know what good it did Andrew Peacock, regrettably. This kind of rigmarole from the shadow minister will I think be equally successful for the current opposition.

I was thinking today during question time: why is it that we have now gone almost through the parliamentary week and we have not had any questions on the big issues—nothing on broadband, nothing on water, nothing on Iraq? There was some pretence of asking questions about AWAs but based on plainly false premises, on plainly false claims that the government was trying to do something that it had utterly no intention of doing and for which Labor had no evidence of any intention of doing. I asked myself: why don’t they ask questions about the big issues? We now know that they do not ask questions about the big issues because they have nothing to say on them.

The shadow minister is a decent human being. I know she has been put into a very difficult position by her colleagues this afternoon because this MPI was never meant to go ahead. It was plainly a mask for the censure motion on the alleged improper reception at Kirribilli House that the opposition was building up to. Presumably, the Leader of the Opposition realised that he had no grounds for a censure, that he was making a goose of himself, that the ‘Saint Kevin’ persona which he has tried so carefully to construct over the last six months was in serious danger of being destroyed by this trawl through the rubbish bins of Kirribilli House. Presumably for those reasons that censure motion was dropped and instead we had another empty performance from the shadow minister for health.

To her credit, the shadow minister for health conceded that Australia has a basically good health system. I tell you what: it is better than good; it is among the best in the world and certainly it is better than any in the world. Of course it is not perfect. If the shadow minister were prepared to identify any specific areas of maladministration, specific areas of positive improvement, I would be delighted to take her seriously and do what I could to implement any suggestions she had. What she in fact says is that one person or two or three people did not get into an aged-care institution as quickly as they would have liked. I know how frustrating it is for those people and I very much regret that we cannot abolish scarcity, that we cannot abolish old age or tooth decay, that we cannot abolish the fact that no government has unlimited funds, not even a government which has run the economy as successfully as this government. It got to the ridiculous point in the shadow minister’s presentation that she was on the verge of blaming the government for being unable to cure the common cold.

Let me say what this government has done. In 1996, there were some 145,000 operational aged-care places in this country. Today—I am quoting from memory—there are 208,000 operational aged-care places in this country. Yes, there has been a large expansion in community aged-care packages and that is not inferior care; that is care that we are giving to people in increasing quantities because that is what they say they want. People say to us that they would like to stay in their own home for as long as possible and that is precisely what community aged-care places are designed to achieve. There has been a greater than 50 per cent increase in the quantum of aged-care places under this government. I accept that there will still be some people who cannot get immediately what they want in precisely the right area, but does the shadow minister seriously suggest that there will instantly be a bed available for everyone everywhere? Is that what she is really saying? Has she discussed this with the operators of these aged-care institutions? Has she heard them say how uneconomic it would be for them to permanently maintain half-a-dozen spare beds in their aged-care facilities just in case some of those elderly people currently in acute wards in public hospitals were assessed by an ACAT team that very afternoon as being eligible for an aged-care place?

The proposition implicit in the shadow minister’s presentation is as silly as it would be for me to stand up and say that there should be no waiting lists whatsoever for elective surgery. I happen to think that elective surgery waiting lists for some procedures in some states are far too long, but I would never have the temerity, the foolhardiness, the unreality, to suggest that we are ever going to be able to provide this kind of service without some form of waiting list. I ask people to compare the time taken to get into an appropriate aged-care facility or to obtain an appropriate aged-care package under this coalition federal government with the time taken to get your knee replaced or your hip replaced for free as a public hospital patient in those institutions which are the responsibility of the Labor states and territories. I do not in any way seek to minimise the frustration of people who spend a little longer than they would like in a public hospital waiting for an aged-care place, but it is fatuous of the shadow minister to say that this government does not care or has done nothing. We have done a great deal.

I turn briefly to the dental situation that the shadow minister was so concerned about. Like her, I lament the fact that 650,000 people are on public dental waiting lists but, unlike the shadow minister, I am prepared to say that the people who are primarily to blame are the people who have not operated those public services well. The shadow minister’s first policy was to restore the Keating government’s dental scheme. I ask her: is $100 million a year—that is, a below 20 per cent increase in what the states currently spend—suddenly going to fix the problems of 650,000 people on those public dental waiting lists? No, it is not. When that scheme was in place and the Leader of the Opposition was the director-general of all he surveyed in Queensland, notwithstanding that scheme and notwithstanding the genius of the Leader of the Opposition at that time as the de facto Premier of the Christian socialist state of Queensland, public dental waiting lists were still three years.

The shadow minister came up with a second policy, which was that everyone on average weekly earnings or below would get free dental care. There are 16 million people in Australia who are living in households earning less than average weekly earnings. To give those people one hour of dentistry a year at $295 an hour—the figure cited by the shadow minister—would cost, and I am no mathematician, $4.8 billion. So it is not surprising that that policy lasted one day. There was an internal memo sent out to all ALP candidates saying, ‘Labor will announce details of its dental policy in due course.’ We had an explicit repudiation by head office of the lunacy as announced by the shadow minister in an article by Jason Koutsoukis. I suppose that was all Jason’s fault. He got it wrong; you did not say it.

Nicola Roxon (Gellibrand, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

Ms Roxon interjecting

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

Okay. It is all Jason’s fault. The shadow minister cannot make a mistake; it is all Jason’s fault. Why did her colleagues repudiate the shadow minister rather than just say the Sunday Age had got it wrong? It is interesting that, since that time, the shadow minister has been put on a very tight rein. Instead of putting out press releases almost daily we have had just two press releases in the fortnight or so since this monumental gaffe. Both of them were joint press releases with some other, more senior, shadow minister who presumably was there to keep the current shadow minister for health—

Nicola Roxon (Gellibrand, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

Haven’t you got anything to say for another five minutes?

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

Please, Mr Deputy Speaker; I heard her in respectful silence.

Ian Causley (Page, Deputy-Speaker) Share this | Link to this | Hansard source

I have to agree with the minister for health. The member for Gellibrand must control herself.

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

Perhaps it was misguided respect. Nevertheless, I gave her that courtesy. She probably did not deserve it, but I think she should at least listen to the response.

Turning to our policy on dental health, I accept the shadow minister’s critique of the allied health professional initiative as it applies to dentistry as it has been working. It is precisely because it has not been working that the government very substantially changed it in the recent budget. The problem with it was not difficulties with referral; it was that it just did not cover the kind of treatment that people with chronic disease typically need. Instead of getting just three consultations, under the new policy people will get one consultation funded by Medicare and then up to $2,000 a year of Medicare funded treatment. This is a dramatic change designed to ensure that this policy works. It was designed in close consultation with the dental profession. In fact, what we put in place as a result of this budget was more than the Australian Dental Association had asked for.

Another issue that the shadow minister raised was that we are not doing enough for chronic disease. Let me point out for the record that Medicare does cope with this—not perfectly but far better than ever before—through things like the health check items, of which there were 285,000 in the last financial year; the GP care plans, of which there were 650,000 in the last financial year; the team care plans, of which there were 250,000 in the last financial year; and the allied health professional consultations, which, except in respect of dentistry, have been working well, and of which there were 500,000 in the last financial year. Most recently there was the new diabetes prevention program announced in the budget for checks, followed by diabetes management consultations, followed by a lifestyle improvement program subsidised by the government under Medicare.

Maybe we could do more. Please, if we are so derelict in our duty, tell us precisely what that might be. Instead of telling us how we should better do the things that are the responsibility of others, what about telling us what the opposition will do with the programs that the government currently runs. One of the great innovations of this government, one of the very welcome innovations, is the extended Medicare safety net. It is all very well for the opposition to pose questions to me, but what about their policy on this vital program for the health and wellbeing of so many people? We have had some suggestions that the government was digging dirt. I have to say that David Epstein is the king of dirt. Walt Secord almost destroyed the life of a migrant family in Western Sydney by inventing a story. Why has the Leader of the Opposition got this scum on his staff? (Time expired)

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

I rise to speak in favour of the sentiment and effect of this matter of public importance. It is a lay down misere that the government have failed to take responsibility for the health of all Australians. They admit that they refuse to take responsibility and we heard the minister say that primarily the people to blame are the states, as he always does. As we hear so often, it is a constant passing of the buck and blame game. They refuse to take responsibility. They admit that they do not want to and that nothing that any number of Australians say and nothing that any number of Australians are forced to endure as a consequence of inadequate federal involvement in the funding or provision of health services will change their minds. Changing their minds is probably off limits on some issues—and the Howard government call Labor a bunch of fanatics.

What do you call a bunch of people, the Liberal Party, who are obsessive about not bending to demonstrable public need for that which will alleviate pain and suffering? What do you call it when a government prefers to see pain and suffering endured by hundreds of thousands of Australians—most of them elderly and of limited means—rather than compromise their conviction that it is the states’ fault? It is pain imposed with principle—a very limited apology and a pretty sick policy given the circumstances—and it is totally unjustifiable and indefensible on any even vaguely humanistic grounds. It is possible to work in politics and public administration with such focus on ideals, rules of law and abstract notions of what should be happening in the best of all possible worlds such that members, let alone ministers, can lose touch with the consequences of their ideology. It is possible, in some cases probable, that ministers and their deputies can lose whatever connectivity they may once have had with the very real and relentless efforts of government policy on individual lives.

Today I would like to increase the government’s contact with the experiences of Australians—the real people, who do not have $1 million in assets or a portfolio of managed funds or family trusts and who do not have a spare $100, let alone the spare thousands that may be needed to secure adequate health care in today’s Australia. People’s experiences, as we know, speak more loudly and more clearly than any political doubletalk or smoke and mirrors. These are the circumstances that people are forced to endure every day, year in year out, and they present the substance that MPs should be listening to, identifying the way forward. The minister asked what we would do. Listening to the people who talk to you every day out there in the real Australia would be a good starting point.

Mr Ted Crowder, a retired toolmaker in his late 70s, has been waiting for his dentures to be readjusted and fixed for a number of years. He featured last weekend in the Sunday Mail. The title of the story was, ‘Forced to be a DIY Dentist.’ Here is a copy of the page, and if any of the members are interested I am sure that the minister’s office or the library could get you copy. The picture shows Mr Crowder with his wife, Maureen. She does not look happy at all and you cannot blame her when they have been waiting for years and years for dentures. In fact she looks pretty upset, and you cannot blame her. Mr Crowder has shrinking gums, consequently losing the fitting of his dentures. He was told in 2005—that is more than two years ago—that he needed new dentures, but he continues to wait for treatment not only for new, adequately fitting dentures but no doubt also to remedy the ulcers that have appeared in his mouth through the misfitting dentures that are continuing to cause him pain and distress. Such is the discomfort of Mr Crowder, who, as I said, is a retired toolmaker, that he resorted to becoming a do-it-yourself dentist, taking his dentures out to the toolshed, pulling out the tools that he used as a toolmaker and tailoring the dentures with files and other items from his toolbox so that they can better fit into his mouth and gums and by some chance offer him a little bit of comfort. It is incredible when you think about it. A private clinic would charge Mr Crowder $1,500 to $2,000 for new dentures—money that he just does not have. Perhaps he is lucky to at least have his tools and his trade.

We have all heard recently in the media, on Today Tonight, about an elderly woman who also took matters into her own hands, regarding not dentures but rotten teeth. This woman was not able to secure the treatment that she clearly saw herself as needing. She had rotten teeth and gums. She resorted to self-administering some pain relief—with, conceivably, some antiseptic—and, with the use of an adequate amount of whisky, she resorted to self-supplying her dental instrument, a pair of pliers, and maybe a bit of cotton wool for the aftermath. She resorted to self-treatment by ripping out her our own decaying teeth—one by one. Rip! Can you imagine the pain?

This do-it-yourself dentistry is gaining in prevalence under the federal government since the abolition of the Commonwealth Dental Health Program in 1996. Another constituent of mine, Mrs Hargraves, is another case in point. She was given an appointment for new dentures in 1996. She was told at the time that the staff did not have much time. A mould was taken of Mrs Hargraves’s gums very quickly, virtually as she was being ushered out the door because of the waiting list. The dentures were made up and sent to her in the post, without any appointment for a fitting. And of course they do not fit, causing incredible pain to her gums. She has been refused an appointment to have these misfitting dentures tailored to her gums because, she was told, she had already had her appointment—she has had her chance at dental health and she is not going to get another one until some time in the distant future. That was more than 10 years ago and she has had misfitting dentures ever since. I am not aware of Mrs Hargraves having any formal training in plastics or cabinetmaking or toolmaking but she has resorted to developing her own skills with abrasive paper or sandpaper, as it used to be called, to sand down these dentures so they can fit a little better in her mouth and not cause pain and hurt. So, like Mr Crowder, we have an elderly individual forced into the toolshed to try to customise her misfitting dentures with whatever garden variety equipment she can find to hand. She is being a do-it-yourself dentist to minimise goodness knows what pain from ulcers and sores in her mouth and perhaps be able to eat properly for her general wellbeing. One can only guess what condition her gums are in.

I have another example. I received a letter from a Mrs Roma Thompson which I would like to read into Hansard:

Dear Mr Georganas, thank you for the opportunity to add my name to the petition for dental care. I have been waiting several years for dentures, and having been told not long ago it could be another three years was not good news. I am eighty-five years of age and another three years—who knows? Another lady of the clinic at the same time was also told three years waiting time and she was ninety years of age. I would think the waiting time would be much longer now as it was last year I was there.

Another woman has been advised that, despite her deteriorating lower gum, despite her denture being hopelessly ineffective, falling out of place and continuously being very difficult to manage, and despite her being at very high risk of soon having to live without any bottom teeth at all without long overdue dental care, she will not get an appointment until 2011. The waiting list, the number of years of poor dental health that people are being forced to endure, as well as enduring the effects on their overall health as best they can, is often well over five years. But even a short wait can be too long. Another constituent, Lona Wilson, went to the dentist nine months ago for a temporary filling. The filling fell out almost immediately. She now has to wait in excess of another year to see a dentist, enduring extreme pain.

Through this current term of office I have received letters, emails and surveys from hundreds upon hundreds of people, primarily elderly people, who have been forced to wait year after year after tedious and painful year for dental care. Many of them are still waiting. Why? Because when it comes to Commonwealth dental care this government does not care. If it did, something would have been done about it. The budget initiatives that the minister spoke about will do very little for the 650,000 people on that waiting list. Over recent weeks we have had thousands of petitions from the electorate of Hindmarsh tabled in this place in support of proper Commonwealth public dental care, and there certainly will be more to come. People are hearing about the petition on the grapevine and calling my office even months after it was distributed— (Time expired)

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

Mr Deputy Speaker, I seek your indulgence to make a brief statement.

Ian Causley (Page, Deputy-Speaker) Share this | Link to this | Hansard source

Please proceed.

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

At the close of my contribution to the MPI discussion I referred to two opposition staffers as scum. I should not have done that. I apologise. But they are notorious dirt diggers and I wonder why Saint Kevin has employed them.

John Forrest (Mallee, National Party) Share this | Link to this | Hansard source

There is no doubt when we are debating issues of people’s health we can all get involved. I listened carefully to the member for Hindmarsh’s contribution. He talked about people who are obviously very genuine Australians, and I would have many in my electorate as well. I would simply respond to the member for Hindmarsh by saying I came into this chamber in 1993 after a long period of neglect on this very issue and now, after being part of a strong government that has delivered, the situation for my constituents is a jolly sight better than it used to be. There will always be, as the Minister for Health and Ageing himself said, circumstances which do not meet people’s expected needs.

The shadow minister referred specifically to two issues. I had thought the MPI might have been on the broader subject of general health care but she focused on aged care and dental care. If I can again refer back to the period when I came to the parliament, the number of aged-care places for every 1,000 persons aged 70 or older was then about 70. It is now 108 places, with a target to be 113 places by 2011. One of the motivating circumstances prior to 1993 which caused me to think about coming to this chamber and getting it fixed and made better was the trauma that I had had with the placement in an aged-care facility of my own father. I can still hear my dear mum, bless her, saying, at one desperate family conference, ‘Son, someone’s got to go to Canberra to see if we can fix all this.’ I am quite pleased and proud to say that things are a jolly sight better. I think the shadow minister made reference to somebody in the Speaker’s electorate, which is immediately south of Mallee, the region I represent, so it is geographically the same. I have the largest number of aged-care places in my electorate of any member in this place. I think the number is 47. I also have the largest number of acute hospitals of any member in this place. The number is 23. That reflects the sparse, spread-out nature and the population centres of the north-west of Victoria. Given what used to be in 1993, I have to say that since 1996, when the coalition came to government, we have been progressively addressing all of the issues.

The particular issues which the shadow minister raised are no longer on my radar—I am more focused these days on planning for the future on infrastructure investment and the very serious need of water—except for the need for dental care. It is a little frustrating—not part of the blame game but a historical reality—that the Commonwealth will have to play a greater role in the provision of dental care. That has been recognised in this year’s budget with access to a first consultation with a dentist funded by Medicare. If there are urgent medical reasons related to diet et cetera, there is support available for up to $2,000. This amount will not cover the cost of technicians for dentures, and that is a delicate issue.

I often say to my constituents, ‘You can get access to a dentist immediately, provided you are privately insured.’ As a privately insured person, I have had no trouble getting access to a dentist. There is a prospering economy in my constituency. The argument that there is no access to dentists—access can be provided if a person is privately insured—has to be put in context of the debate, especially given the incentives that the government put in place for people to privately insure.

On the broader subject of people’s health across the nation, I have a 20-page document of successive initiatives by the government since 1996 to address those needs which are consistent with the budget process. It is worth reflecting that the Minister for Health and Ageing often refers to the fact that, since 1996, this government has been the best friend that Medicare has ever had. In the electorate of Mallee, the bulk-billing participation rate is one of the highest and is in excess of 80 per cent. With additional incentives in the budget for rural GPs to bulk-bill, their incomes have increased substantially. The GP income from Medicare has increased, on average, across the nation from $195,000 in 2002 to well over $300,000.

There is also an improvement in the Pharmaceutical Benefits Scheme. We had not been in government all that long, but I remember the days when there was a long list of people waiting for medications through the PBS. The list is shorter now. There are newer medications these days. The outcome of research and development of pharmaceuticals is that the latest medication is available, whether it is the latest treatment for prostate cancer or treatment for any of the huge variety of cancers. In earlier days, these medications should have been on the PBS. The PBS budget has increased over the past 11 years by 600 to 700 per cent. It is a very significant budget item and is funding important medications for people.

I turn now to aged care. In my rural constituency, standards in aged-care facilities, even in small facilities, are improving in the number and quality of beds available. Of the 47 aged-care places I mentioned, many have only 10 aged-care beds, but they are associated with a rural hospital; therefore access for professional support services is nearby and available. Occasionally there is someone waiting for a placement in their home town and there is a bed available within a 20- to 30-minute ride to the next town. I occasionally get representations about that, but ultimately I find that it is not long before they are placed in their home town where their friends and family are located and they are provided with that important support.

There are also a plethora of services provided by the government for allied health and support. I am delighted to see that in-home support being provided. It is a fact that elderly people would prefer to be in their own home, surrounded by their life memorabilia and memories. They are in a much better spiritual and emotional state when they are in their own home. There has been a staggering increase of 700 per cent in the number of community care packages in my constituency and there is an enormous benefit in that.

I recognise that there is always somebody who is not entirely happy because their loved one has been placed in a nearby town and they want them placed in their own town. If there is a bed available and the aged care assessment team has decided that institutional care is needed as the person concerned is no longer able to stay at home, then at least they are getting the care needed. They will then wait for a geographical place that supports them better and is better for family, friends and loved ones.

I refute the intention of this matter of public importance today. I recognise that there is more to do in the area of dental health. I am pleased the government has picked up responsibility for it. We have got over the issue of expecting the states to do it, because quite clearly they do not want to. (Time expired)

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

The Howard government’s approach to health care is to blame someone else, anyone else, for any problem in the health system. The only rule the Howard government adheres to is to take no responsibility for any problem whatsoever in the health system. It is just blame, blame, blame. Whether the problem is doctor shortage or health workforce shortage, insufficient aged-care beds or Australians, usually elderly or children, waiting up to 10 years to have dental work completed, it is somebody else’s fault. It is no surprise that the Howard government’s favourite victim to blame is the state government, any state government, as long as it diverts the blame from John Howard and his merry men and women. The bad news for the Howard government is that the Australian people know that before it was elected there was a Commonwealth Dental Health Program that operated in Australia and a nearly non-existent waiting list for dental treatment.

At the time the Commonwealth Dental Health Program existed I was a state member of parliament and I know that people were able to see a dentist when they needed to see a dentist. I also know that when the Howard government was elected and that scheme was axed by this government immediately I had constituents coming to my office complaining that they could not see a dentist. These were elderly people that could not get dentures, could not have their rotting teeth removed from their mouths or filled. These were people who were suffering as a direct result of the Howard government.

When the Howard government was elected there was an 800-aged-care-bed surplus. Now let us compare the dental and aged-care bed situation. Firstly, the nearly non-existent waiting list has blown out to 650,000 Australians languishing on a dental waiting list. I will share with the parliament the experiences of two of my constituents. One gentleman, Eddy, had his teeth removed after waiting some considerable time. He then had to wait over 12 months to get dentures and for that time he lived on soup and other liquids. This does not appear to worry members on the other side of this House, the government. Another constituent, a gentleman who lives in Toukley, had only a top set of dentures and had been waiting for two years for his dentures. He was forced to live on soups and soft food. At the time I had to say that this was not good enough in a country like Australia.

Then we look at the aged-care bed situation. We now have an aged-care bed shortage in excess of 4,000. The Shortland electorate is a very old electorate, one that has got the 10th oldest population and the highest number of residents over the age of 65. In that electorate, covered by both the Hunter and the Central Coast, there is a shortage of beds in the Hunter area of 390 and, on the Central Coast, 596. Actually, in the two areas there is a greater shortage than the surplus that existed in the whole of Australia at the time the Howard government was elected.

Who is to blame? If you listened to the Howard government you would say that it was the state government. If you listened to the Howard government you would say it was anyone else other than them. The member for Mallee talked about the fact that people can take out private dental health insurance and can then see a dentist. The member for Mallee did not take into account the cost of private dental health insurance and also the fact that there is an enormous gap.

There has also been mention of elderly people being referred to as ‘bed blockers’ by the Minister for Ageing. I know that at any one time there are a large number of elderly people in our hospitals waiting for places in nursing homes. They are not bed blockers; they are elderly Australians that need to be placed in an aged-care home, people that should not be in beds in acute care hospitals. This government is responsible for that and it is time that it acted and ended the blame game. (Time expired)

Patrick Secker (Barker, Liberal Party) Share this | Link to this | Hansard source

After being in this parliament for 8½ years, I have to say this is the weakest, most pathetic, ill-conceived matter of public importance I have seen. The Labor Party has certainly got the trifecta today: the worst three features I have ever seen in an MPI in this parliament. It is absolutely pathetic. The Labor Party could not even get a question up in question time about an MPI—normal procedure. The member for Gellibrand in her opening statement said that the health system was not all that bad. What is she going on about? This is a most ill-conceived, pathetic and inaccurate MPI. So many things about it were just shocking and I think that the Labor Party have really got to look at their health spokesman. It has been an absolute joke today.

Our constituents have told the government that health care is important to them, and we have responded with literally billions of dollars in funding support—incentives, programs and services. We have seen some major achievements in health in recent years with this government’s activities primarily focused on the development and implementation of ongoing health system reforms aimed at supporting universal and affordable access to high-quality medical, pharmaceutical and hospital services and improving health outcomes through promotional and disease prevention activities, maintaining sustainability and providing access to quality aged-care services.

When I was first elected to this parliament in 1998 you could wait up to two weeks to get to see a GP. Labor’s answer to the health system in rural areas was: I hope you get better before you get a chance to see a doctor. That was the answer. When I was elected in my electorate there were 149 doctors. There are now 189 doctors in my electorate—40 more doctors than we had when we were elected in 1996. That is our answer: we provided more health services and we provided more doctors, more nurses, and this despite a very badly run health system from state governments throughout Australia.

Let us talk about my electorate of Barker. Let us talk about rural and regional health care, and the leaps and bounds it has taken in recent years because of the opportunities that have been afforded and paid for by this government. You will notice a common theme in what I am about to share—that is, consistency. The government has a very consistent scorecard when it comes to steady improvement in health care. Further to that, total Medicare benefits scheme funding has more than doubled in the past 10 years, to where it now stands at $66.1 million in my electorate alone. Bulk-billing rates of non-referred GPs have seen a similar improvement—a 20 per cent increase. And the good news is that it is likely to get even better from here. It is in the nature of rural health programs that they often service very large areas and cannot always be accurately allocated to an electorate.

Ian Causley (Page, Deputy-Speaker) Share this | Link to this | Hansard source

Order! The time allotted for this discussion has concluded.