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

I move:

That the amendments be agreed to.

I am very pleased that the opposition, after all of their blustering on this measure, have decided to support what is a sensible and important budget measure. The bill will allow the government to put the extended Medicare safety net onto a sustainable footing into the future. With expenditure increasing 30 per cent in the last year alone, it is obviously an important measure to keep some of those costs under control.

The Rudd government’s health budget this year was all about reforming our health system, delivering better services to the community, funding new drugs and expanding successful programs and making them fairer and more sustainable in the long term. Unfortunately, the opposition do not seem to have yet made the connection between funding new programs, demanding existing ones are fair, delivering to patients and providing best value for taxpayers’ dollars.

We know that every taxpayer dollar in health is precious, and the limited funding we have must be targeted to ensure we get not just the biggest bang for our buck but the best bang for our buck. This measure returns almost half a billion dollars—which has been buying Rolls-Royces and all sorts of other extravagances for some very well-paid specialists—so that we can invest in health measures that will have benefits to patients.

For example, in this year’s budget we provided funding for a new cancer drug, Avastin, at the cost of $314 million. We have continued the Herceptin breast cancer drugs for women, at $168 million. We have instigated a new maternity package, providing more choices for women, at $120 million, and a rural health package with incentives for doctors who work in more remote parts of the country, at $134 million. So it is important that these savings measures can be delivered to allow for this expenditure in health.

We are happy to support the amendments; however, I would note that the determination that implements the caps is already a disallowable instrument in parliament, so there is already parliamentary scrutiny. The amendments to this bill will create an additional burden for the parliament, with every annual indexation of the cap having to go through both houses.

I am pleased that the opposition has indicated that it will now facilitate the smooth passage of this determination when it is presented to the House, and this will happen after the bill has received royal assent.

The government has agreed that a cap on the benefits for the injection of a therapeutic substance into the eye will not be implemented. In recent years there have been significant advances in therapies to treat macular degeneration which can hold dramatic results for patients, including saving sight. I would like to acknowledge the important role that the Macular Degeneration Foundation has played in securing these changes, and I support the amendments before the House.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

This has been a long and drawn-out process, unnecessarily so. It shows the fact that there is no direction on health policy under the Rudd government. This is a government that promised so much at the last election, but at their every move they have turned health debate in this country into an absolute farce. There has been backflip after backflip by this minister. Promises have been broken—key election promises—in relation to hospitals and private health in particular.

We have been calling on the government for a period of time—in fact, since the budget—to make a series of changes. We took the minister at face value when she mentioned some figures in relation to a number of measures, but it became quickly apparent after speaking to stakeholders that those figures were incorrect and misleading. It was inappropriate for the minister to put a position which the industry clearly had not agreed to. There was, from the industry and from patient groups, a complete denial that the case the minister was putting forward was legitimate. We forced the government into negotiating with a number of parties. This ultimately resulted in outcomes and amendments that this government has been forced to backflip on and ultimately agree with.

It was a shameful process. This government introduced changes which had had no consultation. This was a government which said at one stage that they were open and transparent, that this was a new age of government and that they were going to consult more widely. Well, in relation to this bill, that clearly has not happened. Of course, when you do not consult properly as a government—as the Rudd government refuses to and as this health minister refuses to—the obvious consequences come. In relation to IVF, there were some significant changes made by this government. It was a magic pudding exercise in the end, but, nonetheless, we accept the government’s advice that the patients can be better off and the doctors can be better off—the government can be no worse off.

Language like that is unbecoming to a member of the executive in this chamber, surely, and I would ask the minister to withdraw it.

Harry Jenkins (Speaker) Share this | Link to this | Hansard source

I am not sure—

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

I will repeat the word if you like, Mr Speaker, but she knows what she said. It was said in hushed tones.

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

Ms Roxon interjecting

Harry Jenkins (Speaker) Share this | Link to this | Hansard source

I did not hear anything. Obviously, in the eyes of the member for Dickson something occurred. I am usually reluctant to ask for the expression to be repeated but I am in no position to make a call on this because I thought things were being relatively quiet.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

Mr Speaker, if it will help the House, I have three minutes to go and I will accept that you did not hear it. I understand that. The minister has really embarrassed herself in the parliament today but I will leave that to her. What we faced was a situation where this government had arrived at a ‘magic pudding’ arrangement. They cannot explain the figures—they have refused to explain the figures. The true figures will be borne out in estimates and over the coming months. We will see what happens in relation to that.

There were other measures in relation to the bill. The minister had tried to extend the power she had, which was completely inappropriate given the fact that this minister had proven herself not to be responsible with the use of figures. We had negotiations with the government which forced them into backflipping to agree to a position they put to the Senate. In relation to the injection into the eye—the Lucentis issue—the government has quite falsely claimed that they had any interest in this measure before being forced into it by the opposition. We accepted the advice of the patient group who came to us and said that they had been ignored by the government. We forced the government into a change in relation to that measure.

The government can dress it up however they like but in the end this has been yet another backflip by an incompetent health minister and we will fight to make sure that we improve the health outcomes in this country. We will not tolerate this minister misleading the debate. We will continue as an opposition to get good legislation and this has been an improvement. (Time expired)

Harry Jenkins (Speaker) Share this | Link to this | Hansard source

The question is that the amendments be agreed to. Before giving the call to the member for New England, I thank him for dealing with his recalcitrant mobile and I understand that he is aware of the need to not have it ring in the chamber.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

I do apologise. I was watching the shadow minister in my office and could see the time, so I rushed down and inadvertently still had my phone on. I would like to speak briefly on this. I had intended to ask the minister a question on this issue in question time yesterday, but as questions were truncated earlier I was unable to do so. I am led to believe that, on the issue of macular degeneration, the Lucentis injection treatment has been accepted by the government. I am told that the opposition and other senators represented that view and the government has apparently accepted that. But I think there may still be some concerns in terms of the regulations that still have to be treated by both houses of parliament. I would just like clarification of that, if at all possible, because I think that issue highlights a very significant cause of blindness in our community.

If you look at the demographics of what the legislation was attempting to do for the great body of people accessing Medicare and other arrangements, the elderly in particular were a very small portion of that graph. There is no doubt in my mind that, for those people suffering with macular degeneration, the treatment could in fact assist. They may well have found that the additional money they would have to find would have caused them to make a decision not to seek the treatment. The outcome of that, in most cases, would be blindness. So I am pleased to hear what I think I am hearing but, if the minister is able to give some clarification to that, I think many elderly people with that disease—and those people working for them—would be very pleased to hear it.

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

Yes, I am happy to address that issue. You are right that we have made a change. We have supported suggestions that were put to us by you, the Macular Degeneration Foundation, Vision 2020 and the opposition and have agreed, both in the House and in the Senate, that the determinations will not include any cap on that measure relating to the injection of a substance into an eye which affects Lucentis.

What we have done, given requests made by the opposition previously, is table our draft determinations. We are not permitted by the rules of this place to have final determinations until the bill receives royal assent, so that item will no longer be in the final determination; otherwise, the exposure draft that has been provided is exactly as has been provided to and debated in the House. There were concerns and requests by the opposition and others that they be able to look closely at the contents of that determination for the IVF measures and the obstetric measures et cetera. We gave an undertaking that there would not be any changes to that determination other than this one, which is agreed. We accept that there were concerns that it might have unintended consequences.

I have to take issue—as will probably not surprise anyone listening to this debate—with some of the quite inaccurate comments being made by the shadow minister. On budget night, when these measures were announced, it was quite expressively identified that as part of this measure consultations would be undertaken, particularly with the sector, to restructure the IVF items. They are a complex range of items. We made quite clear that as part of that budget measure there would need to be a restructuring. The shadow minister opposite can pretend as much as he wants that that is a changed position. He can say ‘backflip’ as many times as he likes. In fact, that was exactly what was always intended. That process delivered an outcome that was ultimately accepted by the industry and by consumer groups and I am pleased was finally also accepted by the opposition.

The only thing that has been changed since budget night is our agreement to exempt Lucentis. It is not listed as Lucentis; it is listed as an injection of a therapeutic substance into the eye but, around here, of course, particularly among nonprofessionals, we have been calling it the ‘Lucentis exemption’ and we are happy to agree with that change. But I think it is a bit rich of people, particularly the opposition—and we see this also in a range of other measures so I might as well put it on the record in the House right now—to demand consultation and then to pretend that, because consultation takes time and because through consultation processes we come up with options that work for people, somehow the government is not doing its job properly.

I just conducted yesterday with the Prime Minister the 25th consultation on our health reform agenda. Anyone who thinks that we are not consulting on extensive health reforms has just been living in another country for the last six months. On our budget measures you simply cannot have it both ways. For example, with the introduction of nurse practitioner changes where questions have been asked about why the descriptors are not yet available, the descriptors are not yet available because the consultation meetings with doctors, nurses and others who have asked to be involved in drafting those provisions are drafting them. The shadow minister can come in here as many times as he likes, but it will not divert us from pursuing significant reform that was neglected by the previous government. It might be new initiatives like MBS and PBS access for midwives and nurse practitioners or it might be making measures like the Medicare safety net sustainable so that it can continue into the future and so that some of that money that perhaps was being misused—going into the pockets of specialists instead of to patients—can be redirected to better causes.

I think this outcome is good. I am happy that this change has delivered some relief to people who were concerned about the impact for macular degeneration, and I welcome the opposition’s belated support for this measure.

Question agreed to.