Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I am pleased to speak in support of the Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008, especially in front of you, Mr Deputy Speaker Bevis. I know that you have a longstanding connection to the health industry, as does the member opposite, the member for Bowman. Both of you are committed to good health services. One of the first things that occurred for me as a new member was to appear on the front page of the TUH journal with you.

This bill amends the Health Insurance Act 1973 to allow medical specialists and consultant physicians access to the 90 Day Pay Doctor Cheque Scheme. GPs have had access to this scheme since 2001, so I am sure the member for Bowman will be surprised that this is one of the first times that the medical hierarchy has been reversed. This bill brings justice and equity for our poor, neglected medical specialists and consultant physicians.

One way in which patients can pay their doctor is via a claimant cheque. Medicare Australia sends the cheque made out to the doctor to the patient, who then forwards the cheque, along with any outstanding payment, to the medical practitioner. Only around five per cent of Medicare services, or 13 million claims, are paid in this manner. Of these, the overwhelming majority of patients forward the cheque and payment to the doctor within 90 days. However, in some circumstances, for whatever reason, patients fail to forward the cheque within 90 days. The 90 Day Pay Doctor Cheque Scheme allows for the cheque to be cancelled and then Medicare pays the GP directly.

However, the problem is not limited only to GPs. Other medical practitioners also experience non-payment of patient accounts, and that is why this bill extends the scheme to cover specialists and consultant physicians where the original Medicare claim is submitted electronically. This bill effectively closes a loophole whereby some specialists and consultants would not get paid for medical services that they had provided. Obviously, we have more than enough medical workforce shortages in Australia at the moment. A long history of that issue can be traced back to health ministers in the previous government. But this proposal from the Rudd government will go some small way towards alleviating one concern of practitioners.

The benefits of this bill are far reaching. Firstly, it will help to ensure that specialists and consultants receive some payment for the services that they have delivered to patients. It will also help patients meet the costs of health care by ensuring that they can use the Medicare rebate up-front towards payment of their bill. This will help take pressure off families and seniors if they are not required to pay their medical bills up-front. It will also encourage more specialists and physicians to use electronic claiming of Medicare benefits, therefore creating administrative savings and time savings for these health professionals. As I said, the specialists and consultants can only access the 90 Day Pay Doctor Scheme if their original claim is submitted electronically. This is a smart way to encourage more doctors to use electronic claiming, which is obviously a far more efficient process. The Rudd government is always looking for smarter ways to do things which produce savings for the broader community. Online claiming allows patients to lodge claims immediately after the consultation, without attending a Medicare office or submitting a claim via email.

I have a three-year-old son, so I have probably gone to the doctor more times in the last three years than I have in the last 40 years. Because I have gone to the doctor lots of times, I have had the joy of lining up in a lot of Medicare offices. Anyone who has spent any part of their life lined up in Medicare offices knows that not only will that time be a part of their life they will never get back but anything that can be done to alleviate that time would be a good thing. I note in passing that there are no Medicare offices in Moreton, even though it is an inner seat of Brisbane. It is shameful. It is over 100 square kilometres in size but there are no Medicare offices at all. That is another area of neglect that the former member failed to address.

The online lodging of claims is also of particular benefit to rural and remote patients, as they will not be required to travel long distances in order to present to a Medicare office to receive their rebate or pay with a pay doctor cheque. Having come from the bush, it is a bit strange for me to be complaining on behalf of the people of Moreton about the problems they have lining up when I think of what the experience would be like in places like St George, where I come from and where the closest Medicare office is about 380 kilometres away. Whilst it might be tough in Moreton without any Medicare offices, it is even tougher in the bush.

This is a great initiative that will benefit people all over rural Australia. It is good to see that the Rudd Labor government is looking after the people in the bush, because the National Party have obviously deserted the field in so many ways. I notice that in Queensland they are joining up with the Liberal Party just to confirm that desertion. New South Wales will have the joy as well! As a further incentive, a support package currently only available to GPs—as I said, this program has been utilised by GPs for six or seven years—will be extended to specialists and consultants. The package will help these doctors take up the new system, which requires additional software and EFTPOS facilities.

In a previous life I had the joy of being a policy adviser to the Queensland health minister. That year of my life was quite an interesting experience. The health system in Queensland is not quite the health system in New South Wales but it has certainly had some challenges over the last few years. What amazed me time and time again while travelling all around Queensland, which is the most decentralised state, was the failure of software to support the delivery of health services basically because GPs, doctors and state health systems did not talk to each other. All these people had developed software packages and programs over the years but they did not know how to talk to each other. This initiative from the Rudd government goes some way to addressing one of those concerns. As I said, there is a package to help doctors take up this new system.

The change to the 90 Day Pay Doctor Cheque Scheme is expected to cost $4.5 million over four years. However, I understand that most of these costs are associated with helping medical practitioners take up electronic claiming. There are probably some professional development opportunities there for consultants and physicians. This will obviously deliver savings for all of Australia in the long run. For now, other health practitioners like allied health professionals—and it is good to see one of those in the room here: the member for Kingston, who is beside me—and dentists will continue to be excluded from the scheme. But this is an important first step in the right direction. Not only does this scheme help mums, dads and seniors pay their doctors’ bills but it ensures that our doctors will not be left out of pocket.

We all know that there are many pressures on mums, dads and seniors at the moment. We see it every day. We hear about fuel prices, the rising cost of medicine and the problems tracking down health professionals and getting in to see doctors and GPs, but the bill before the House goes some way towards addressing some of those pressures. Prior to me making this speech, my office and I had many meetings with the Brisbane Southside Central Division of General Practice, which is the grouping of GPs on the south side of my electorate. They were very supportive of this initiative. Obviously, as GPs, they have been using it for a while. They saw the benefits. I commend the bill to the House.

Belinda Neal (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008, a simply titled bill that just rolls off the tongue! It contains amendments to the Health Insurance Act 1973 which are designed to expand access to the 90 Day Pay Doctor Cheque Scheme. As has already been stated, the scheme was formerly only available to general practitioners, but the amendments before the House today will make the scheme available to all specialists and consultant physicians in cases where the original claim for the Medicare benefit was submitted electronically to Medicare Australia.

The 90 Day Pay Doctor Cheque Scheme was introduced in 2001 to guarantee GPs the payment of the Medicare schedule fee, more commonly known as the Medicare rebate. The original intent of the scheme was to rectify problems that arose when a patient submitted an unpaid claim to Medicare. In these cases, Medicare issued a pay doctor cheque to the account of the GP for the amount of the Medicare rebate. The cheque was given to the patient to forward to the GP who provided the original service along with any copayment required to satisfy the full amount of the account. In effect, this arrangement allowed the patient to use the Medicare rebate towards the payment of their medical bill rather than paying the medical bill in full at the time they were claiming the service.

So, in its original formulation, the 90 Day Pay Doctor Cheque Scheme carried advantage for both parties: it allowed the patient a more flexible payment option and provided a payment mechanism to the doctor of the Medicare schedule fee. But in cases where this cheque was not returned to or presented to the doctor or where there were lengthy delays in its presentation, the doctor sometimes incurred an unmet debt for services that had been provided in good faith. To overcome this problem, the 90 Day Pay Doctor Cheque Scheme provided that, if the doctor had not received and banked the cheque within 90 days of it being issued to the patient, Medicare Australia could cancel the cheque and forward the applicable Medicare rebate direct to the doctor via electronic funds transfer.

Under the legislation as it stands now, this scheme is only available to general practitioners, as I have said and as has been previously stated in the debate. It was noted at the time that the scheme was first proposed in 2001 that such instances of nonpayment of patient accounts were not limited to GPs but were experienced by other medical practitioners as well. However, proposals to make this scheme more widely available to practitioners other than GPs were not taken up by the previous government. The amendments before members today extend this scheme to a wide range of medical practitioners, specifically to specialist and consultant physicians, including pathologists, but only where the original Medicare claim for the service provided was submitted electronically. Other practitioners such as dentists and allied health providers will not be included in the amended scheme and the current arrangements for GPs will remain the same. It will provide an incentive for more practitioners to take up the use of electronic claiming of Medicare benefits.

The bill will also provide benefits to the patients and the families using the amended scheme. This is especially true in rural and remote areas and in regional areas such as my own. When a claim is submitted to Medicare electronically, the patient is not required to visit a Medicare office in person to receive their rebate or pay doctor cheque. This will have great advantage for those in rural and regional areas, where getting to a Medicare office sometimes requires travelling long distances or where public transport systems offer limited access to facilities operating in other towns. So I welcome any measure that eases the burden of people being forced to travel to access such facilities.

In addition, the elderly, the frail and many people with a disability will be able to have their claims automatically generated and lodged immediately after their consultation. They will not have to travel to a Medicare office to receive their rebate or a pay doctor cheque. An increased uptake of electronic lodgement mechanisms for Medicare claims makes for a more streamlined, efficient and flexible system. It brings advantages to patients and medical practitioners, but there will be a beneficial impact on the families.

I have mentioned that the scheme has the potential to reduce the number of families that are required to pay their medical bills up-front at the time of the service. Paying medical bills up-front, often with little warning in an emergency and little time to plan for the event, can have an adverse consequence on a family’s cash flow—in other words, they often cannot afford it. Being able to use their Medicare rebate towards the payment of such bills will materially assist many families right across Australia.

My own electorate of Robertson, centred on Gosford on the Central Coast of New South Wales, is far from being the most remote or rural of regions but it has many areas where access to medical facilities and Medicare offices is still difficult. People living in areas such as Mangrove Mountain and in rural areas further west towards Spencer and Wisemans Ferry, in the lower Hawkesbury Valley, are relatively isolated from Medicare offices. There is a medical clinic in Mangrove Mountain but without regular public transport for many people in the area connections to the Medicare office at Erina Fair and in Gosford are difficult when trying to claim medical expenses. They in particular will take great comfort from a more accessible method to claim Medicare benefits. Even some of the residents of Kariong, a relatively new and affluent suburb adjacent to the F3 freeway, have been vocal in their demands for better access to medical facilities.

The Central Coast is a region in which 19 per cent of the population is aged over 65 years—a proportion that is well above the national average of approximately 13 per cent. Just like the rest of Australia, the ageing of the nation’s population is a challenge that must be met. The amendments to the 90 Day Pay Doctor Cheque Scheme contained in this bill before members is part of the Rudd Labor government’s efforts to meet this challenge.

These amendments will be especially important for the nearly one in five Central Coast residents who are seniors. They are more reliant than the rest of the population on public transport and they face greater obstacles when travelling to complete what is at present a trying and sometimes time-consuming task. This is a task that will be made much easier by the passage of this bill. The Rudd Labor government is investing in many other ways to build a stronger public health system but I will leave the discussion of those to a later time.

Amanda Rishworth (Kingston, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008. This bill provides for specialist and consultant physicians to make use of the 90 Day Pay Doctor Cheque Scheme. This ensures that medical specialists who have not received the patient’s Medicare cheque can make an electronic lodgement and be paid directly by Medicare. This measure is designed to encourage access to specialist or physician services without up-front payment.

Every person has intrinsic dignity even if, for one reason or another, they are not blessed with either the ability or resources to earn a high income. Our healthcare system should be built around our recognition of this and the recognition of that dignity. Our duty is to create and pursue this end. As I note for my first contribution in this chamber, I am deeply committed to preventive health programs as evidence shows clearly that they are pivotal to achieving good long-term health outcomes. This initiative is one of many new Rudd health reforms.

The Rudd government’s approach to health is in stark contrast to that of the previous government. Over its term in office the Howard government shirked its duty to build an Australian public health system that respected patients’ intrinsic dignity. The Howard government did little to tackle the challenge of the growing GP shortage which has left parts of my electorate with only one doctor for more than 5,000 people. Almost every time I have a street corner meeting or go doorknocking, I meet another person who knows that there is something wrong with them medically but cannot find a doctor with whom to make an appointment. Instead of having their often medically simple problem treated quickly, they live lives in quiet pain and suffering.

While millions of dollars could always be found for advertising the previous government, the Commonwealth’s share of public hospital funding fell to just 41 per cent of total expenditure. Figures from the Australian Institute of Health and Welfare say that the states invested an extra $3.1 billion in public hospitals, whereas the Commonwealth invested just $1.4 billion more, even while the Australian population was ageing. According to the previous government, even while they refused to invest in more public health, growing elective surgery waiting lists were the states’ fault and the states’ problem. Outdated equipment and dilapidated hospital facilities were not the result of a falling Commonwealth share of public hospital funding. It was always someone else’s fault. It is no wonder that many Australian families felt the need to invest in private health insurance, particularly given that individuals on just $50,000 per annum were slugged with a Medicare levy surcharge, even if they did not want or could not afford to take out private health insurance.

I am pleased that in the Rudd government’s first budget we are adjusting the threshold for the Medicare surcharge to apply to those who actually can afford to take out private health insurance. I am proud to be part of a government that is committed to building a healthcare system for all Australians, not just for the wealthy. This government is tackling the elective surgery waiting lists as an immediate priority and has invested $150 million in an elective surgery blitz to slash the number of people waiting longer than clinically recommended for elective surgery. Nationally, 25,000 people are going to benefit from this initiative, which directly combats an era of the Howard government’s lethargy and neglect. In the Rudd government’s first budget, we have made health a priority. We have begun establishing 31 GP superclinics to support health professionals in communities where they are needed most. I am pleased that one of these clinics is going to be in my electorate of Kingston.

In this budget we have also committed to funding 50,000 additional health vocational training places, the implementation of a $249 million National Cancer Plan to improve diagnosis and treatment of cancer, a plan to improve child and maternal health services for Indigenous communities and reinvestment into the Commonwealth dental care scheme. These are just a few of the many health initiatives of this new government.

The bill before us today ends the distinction between specialists and GPs for the purposes of the 90 Day Pay Doctor Cheque Scheme. I know from my experience as a practising psychologist that modern health care is delivered not just by the family GP but by a team of medical professionals working together, particularly in the case of chronic illness. Increasing the number of health professionals who have access to the 90-day cheque scheme will cut down on bad debts and help keep practices afloat, particularly for specialists in the areas where many patients come from low socioeconomic backgrounds. This bill will encourage specialists and consultant physicians to allow patients to be treated without up-front payment by guaranteeing that wayward Medicare cheques will be cancelled and medical professionals will be paid electronically. This makes it easier to offer a deferred payment.

We all know the convenience of seeking a non-bulk-billing doctor and not having to pay up-front, rather than forwarding the Medicare cheque, when it arrives, along with the gap payment. Unfortunately, it is sometimes easy to forget to get around to posting the cheque, since treatment has already been delivered. There is also the problem of mailboxes being pilfered and some people stealing any business letters they think could be of value, even though a Medicare cheque is not transferable. This bill will make it more likely for specialists and consultant physicians to provide services to patients without up-front payment. This is a positive measure that helps working families get the health care that they need. I commend the bill to the House.

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008. I do so not as a person with experience as a health professional but as a mother, a parent and a person who understands the cost-of-living pressures facing many families in my electorate of Petrie. I understand that parents find it difficult at times to find the money for themselves or their children to see a general practitioner—and finding the money to see a specialist or a consultant physician is sometimes even more difficult. The government understands that working families need access to high-quality health care and is investing in a strong health system for the future. That means investing in the public health system, after 11 long years of neglect by the Howard government, whilst continuing to support a strong private system. This bill is an important part of that commitment.

The effect of this bill is to extend to specialists and consultant physicians the 90 Day Pay Doctor Cheque Scheme, which already applies to general practitioners. A ‘pay doctor via claimant cheque’, also known as a ‘pay doctor cheque’, is a cheque for the amount of the Medicare rebate that is made out to a medical practitioner who provides a service. It is used in situations where the patient is not bulk-billed and either cannot or need not pay the account in full at the time of the health service. This has significant benefit in areas of low-income households, including those of pensioners, increasing the choice that people can make in accessing the health care they need. In some cases people will be able to get access to private specialists or consultant physicians within a much shorter period than they may otherwise have through the public health system.

This bill not only benefits families and older Australians but also protects specialists and consultant physicians when there is a lengthy delay in a patient presenting a cheque to the practitioner or when a cheque is not presented to the practitioner at all, resulting in a bad debt for a medical service provided in good faith. The 90 Day Pay Doctor Cheque Scheme ensures that, if the doctor has not received and banked the cheque within 90 days of it being issued to the patient, Medicare Australia will cancel the cheque and forward the applicable Medicare rebate directly to the doctor via electronic funds transfer. Allowing specialists and consultant physicians access to this scheme will provide these practitioners with an assurance that they will receive some payment for services provided in good faith. By extending access to this scheme we are supporting improved up-front affordability for health services for Australian families.

My electorate has paid significantly for the Howard government’s neglect in the area of health. Our bulk-billing rates, which were six per cent above the national average in 1996, declined by 21 per cent over just 10 years to 65 per cent, or 11.6 per cent below the national average, by 2007. Health is an issue that people across my electorate are concerned about—from young adults to older Australians. Making access to specialists and consultant physicians more affordable through the 90 Day Pay Doctor Cheque Scheme is welcomed by my community.

This amendment is part of an incentives package to support the use of electronic Medicare claiming and is designed to encourage electronic claiming in support of the government’s move towards more claiming via electronic means. This will benefit patients, as they will not be required to visit a Medicare office to claim their rebate. Of course, it will be of particular benefit to rural and regional Australians. This amendment is part of the Rudd Labor government’s commitment in the budget to improving hospitals and health services.

I can tell the House that the people in my electorate support the injection of funds into the public hospital system and allied health. In particular, the people of Redcliffe Peninsula are supportive of the Rudd Labor government’s commitment to a GP superclinic. This clinic will complement the additional investment from the Queensland government into our local hospital through the new emergency department at Redcliffe Hospital. Labor’s $220 billion investment in GP superclinics will provide greater convenience for Australians by co-locating teams of health professionals, GPs and allied health services such as physiotherapists, psychologists and dietitians together under one roof. Labor’s GP superclinics will be an investment in taking pressure off public hospitals, providing infrastructure to attract doctors to areas that need them most—like Redcliffe, in the electorate of Petrie.

Andrew Laming (Bowman, Liberal Party) Share this | Link to this | Hansard source

Mr Laming interjecting

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

As the member for Bowman would appreciate, it will also assist the neighbouring suburb of Strathpine, which sits in the electorate of Dickson. You would hope and expect that the member for Dickson would support such an initiative for his electorate, but unfortunately he opposes this initiative and the commitment to bringing improved health services to the people in his community. I applaud the efforts of Fiona McNamara, who was the federal Labor candidate for Dickson in the 2007 election, and Bonny Barry, the state member for Aspley, for their lobbying for a GP superclinic for Strathpine. The good news for the people of Dickson is that the Labor government is committed to delivering a GP superclinic for Strathpine.

The government’s investment in GP superclinics will also help improve healthcare outcomes by better prevention and management of chronic disease and will improve affordability. Health professionals working in GP superclinics will be encouraged to bulk-bill. At the end of 2005, the Petrie electorate had only 94 general practitioners. These GPs are not necessarily situated evenly across the electorate, with some areas experiencing a larger shortage of GPs than others.

The GP superclinics can include specialists and consultant physicians, along with GPs. We need to do more to train and attract GPs, specialists and consultant physicians to my local area. The health sector is seeking governments at all levels to work to improve the health services of Australia. The government’s commitment and my commitment are to delivering improved public health and allied services. A GP superclinic at Redcliffe is an important part of that commitment. This government, through the budget, has shown that it is not just about policy; it is about substance. It is about delivering what is promised. It is about looking after those most in need in our society. This bill is another important part of this government’s commitment to enhanced investment in health services. I commend this bill.

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

I start my contribution by acknowledging the interjection made by the member for Bowman during the previous speech when he indicated that the Regional Partnerships program was flawed. That is something that we on this side of the parliament are very aware of. I also note at the commencement of my contribution to this debate that there have been no speakers from the opposition side on this legislation. When they were in government they had total disrespect for people in the area of health. They did not have a clue when it came to health and they let the bulk-billing rate decline to an extent that was unforgivable. None of them have any idea or any commitment and none of them are prepared to stand up for people in their electorates on a piece of legislation such as this. The Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008 is good news for everyone in their electorates because it allows medical specialists and consultant physicians access to the 90 Day Pay Doctor Cheque Scheme, provided the original claim for the Medicare benefit is submitted electronically to Medicare Australia.

The 90 Day Pay Doctor Cheque Scheme has worked very well for GPs. If a patient does not submit the cheque within a 90-day period then that cheque is cancelled and the doctor is paid electronically. This legislation will encourage more specialists to use the 90 Day Pay Doctor Cheque Scheme. It will encourage more specialists and physicians to use electronic processing of payments for their patients, and I think this is very important.

The Shortland electorate has a very elderly population—in fact, it is the tenth ‘oldest’ electorate in Australia. We do have a doctor shortage. We do have GPs that tend not to bulk-bill. The people of the Shortland electorate will benefit from a GP superclinic, to be built in the northern part of the Wyong shire, as they will be able to access doctors, and hopefully those doctors will bulk-bill. The people of the Shortland electorate will be able to access a Medicare office at Belmont when it becomes operational. This will enable more people to have their consultation fees processed electronically, which will put less of a financial burden on them—a financial burden that escalated when the previous government was in power.

I will use the remaining time available to me to go through some of the so-called achievements of the Howard government when it came to health. We had a Prime Minister that was totally opposed to Medicare, and I think that he used every opportunity to undermine Medicare. He went to the electorate and said there was a rolled gold commitment to ensure that Medicare and bulk-billing continued, yet we saw an incredible decline in bulk-billing and we saw a government that tended to invest in private health rather than invest in Medicare, the universal healthcare system that all Australians can access.

I did mention that we in the Shortland electorate have been left with rather a problem as a result of the Howard government. We have had a massive decline in the number of GPs working in the electorate. There is a concentration at one end of the electorate that actually makes the figures coming in look not too bad: there is about one GP to about 1,700 or 1,800 residents, which could be a lot worse. I see the member for Parkes sitting opposite. I know that in his electorate there would be a shortage of GPs, and his electorate’s patient-to-doctor ratio may be even worse than that which exists within Shortland. I think that it is very important that the Committee remember how those members on the other side sat on their hands and allowed the previous government to totally undermine our health system. What that did was put people at real risk.

One area of my electorate actually lost a GP. It is an area with a lot of very elderly people in it, and they were without a doctor—totally without a doctor. But I know that the current health minister, the Minister for Health and Ageing, has put her mind to resolving the issues to do with the shortage of GPs. Extending the pay doctor scheme to specialists and physicians will greatly benefit those elderly people that live within the electorate of Shortland. I praise the initiative that the minister and the Rudd government have shown in extending this scheme, along with the initiative of the GP superclinics and all the other wonderful health initiatives that have been introduced even as early into the term as we are at the moment—so I congratulate the minister and the government. I think this gives financial security to both physicians and specialists and I say that extending the 90 Day Pay Doctor Cheque Scheme to the specialists and physicians is an outstanding initiative, one that should be endorsed.

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

in reply—In summing up the debate on the Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008, I would like to thank the members of the government who have seen fit to speak on this important bill: the member for Moreton, the member for Robertson, the member for Kingston, the member for Petrie and, of course, the member for Shortland. I am surprised, frankly, that nobody from the opposition has spoken on this bill at all. It is a measure that will provide important relief to a large number of people, particularly elderly people. We know that pensioners in particular rely on these sorts of measures. So it is somewhat surprising that the opposition members have not taken the opportunity to support it. I presume and hope that they will be voting for the bill, but perhaps in future we will see more engagement from the opposition on what is a measure that I would expect all people in this Committee to be able to support.

We know, as speakers have already mentioned and as I mentioned in the introductory speech, that the 90 Day Pay Doctor Cheque Scheme is currently available only to general practitioners. When a patient submits an unpaid claim to Medicare Australia, the patient is presented with a pay-doctor cheque. This cheque is for the amount of the Medicare rebate and is made out to the medical practitioner who provided the service. The patient is then responsible for forwarding the cheque on to the medical practitioner, along with any required copayment, enabling patients to use their Medicare rebate towards the payment of their medical bill. While the majority of patients do present the cheques to their doctor, some cheques are presented very late or not at all, leading to lengthy delays or some bad debts. This bill allows Medicare Australia to cancel a cheque that is not banked within 90 days and to make electronic payment to the specialist or consultant physician. So, whilst providing important relief and choice to patients who might not be able to find the money to pay all of this up-front, there is still a mechanism in place to ensure that specialists and physicians are protected from any bad debts.

We do know that many people across Australia face out-of-pocket costs when they visit private specialists, and we hope that extending access to the scheme will encourage more specialists and consultant physicians to use the pay-doctor cheque scheme, as it provides assurance that they will receive some payment for the services that they have provided. As I have said, this will provide much needed relief to many patients by enabling them to avoid having to pay the full up-front costs of a medical bill when they visit a private specialist or consultant physician. Access to the scheme will be dependent on the original claim being submitted electronically to Medicare Australia. This will also provide a direct benefit to patients, who will not be required to visit a Medicare office to claim their rebate—a particular benefit for those who through illness, disability or distance do not have easy access to a Medicare office.

I commend this bill to the House. I thank the members of the government who have spoken on this bill, particularly in respect of many elderly patients in their electorates whom they are seeking to represent. I hope that the bill will be supported by the opposition.

Question agreed to.

Bill read a second time.

Ordered that the bill be reported to the House without amendment.