Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Before the House considers the Senate message insisting on its amendments to the Health Insurance Amendment (Compliance) Bill 2009 disagreed to by the House on 24 November 2009, I remind the House that it was then informed of constitutional questions raised by these amendments. In short, the view has been taken that the amendments, if enacted, would result in an increase in an appropriation and there is doubt that the Senate may proceed in these circumstances by way of amendment because of section 53 of the Constitution. Copies of the Deputy Speaker’s statement of 24 November 2009 are on the table.

Chris Bowen (Prospect, Australian Labor Party, Minister for Financial Services, Superannuation and Corporate Law) Share this | Link to this | Hansard source

by leave—I move:

That so much of the standing and sessional orders be suspended as would prevent the Minister for Human Services moving an amendment to the Health Insurance Amendment (Compliance) Bill 2009 during the consideration of the Senate’s message insisting upon its amendments to the bill.

Question agreed to.

I indicate to the House that the government proposes that the House insist on disagreeing to amendments Nos 1 and 10 disagreed to by the House and insisted on by the Senate and that an unrelated amendment be made to the bill. A motion to suspend so much of the standing and sessional orders as would prevent the unrelated amendment being moved has just been agreed to by the House. I suggest, therefore, that it may suit the convenience of the House to first consider Senate amendments Nos 1 and 10 and then the unrelated amendment which I will move.

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

Member for Dickson, is there an agreement that the minister proceed with the motion as proposed?

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

Yes, Mr Deputy Speaker.

Chris Bowen (Prospect, Australian Labor Party, Minister for Financial Services, Superannuation and Corporate Law) Share this | Link to this | Hansard source

I move:

That the House insists on disagreeing to amendments Nos 1 and 10 insisted on by the Senate.

It is important that I outline to the House why this Health Insurance Amendment (Compliance) Bill 2009 is so important. This bill aims to protect the integrity of Medicare, which had an expenditure of $14 billion in the year 2008-09, and also enhances Medicare Australia’s compliance program. The bill will enable Medicare Australia to give notice requiring the production of documents to a practitioner or another person who has control of the documents to substantiate an amount of Medicare benefit paid in respect of a professional service. Practitioners may be liable for a financial penalty where the amount paid in respect of the service cannot be substantiated and is above a specified threshold.

Last year the government agreed to those amendments moved by the Senate which relate to this bill. The government did not agree with amendments (1) and (10) and our position has not changed. Amendments (1) and (10) are not related to the compliance bill. The amendments have no substantial relationship with the bill and are clearly a stunt. The government have engaged with the opposition in good faith on the amendments that are related to the bill and have been happy to support the amendments that have risen from these negotiations. I recognise the good faith in which the opposition entered into those negotiations and I think, in fairness, the opposition would recognise the good faith in which the government responded. However, the government will not be supporting a political stunt from the opposition pretending to the Australian public that they are in a position to cover up their reckless acts in the Senate. We have a responsibility to manage the budget in a sustainable way that provides for the best outcome for the taxpayer. This amendment could hinder the government’s exercise of that duty.

By way of background, everyone knows improvements in technology have made cataract procedures quicker and less expensive. In the 2009 budget, the government sought to adjust cataract expenditure because, as a government, we wanted to ensure that the benefits of technological investments were passed on to the taxpayer. Ophthalmologists disagreed with the extent of the change and after extensive negotiations we have agreed to a 12 per cent cut on cataract MBS items, effective from 1 February 2010, a freeze on indexation of cataract items until November 2011 and a review of the items on the MBS under the new MBS quality framework process. This compromise maintains $47 million of the proposed $98 million saved at a time when health spending represents a going pressure on government budget. A review of all the relevant items will enable a more detailed assessment of the appropriate fees to apply in the future.

I am pleased to hear that the opposition have supported the new rebate levels. These amendments are intended to take effect retrospectively from 26 October 2009. They are clearly intended to have the effect of increasing the Medicare Benefit Schedule fee for items disallowed by the Senate on 28 October 2009. The amendments would increase spending from a standing appropriation for Medicare payments and would have the effect of appropriating money. The government have legal advice that these amendments fail to comply with sections 53 and 56 of the Constitution and are therefore unconstitutional. According to the longstanding practice of governments, the Minister for Health and Ageing does not intend to release the government’s legal advice. We do intend to reject this amendment.

As I say, we—my office and the office of the former shadow minister for Human Services—have sat down with the opposition. I know that the current shadow minister for Human Services is aware of the issues and these have been worked through in a mature and sensible way. Amendments which relate to this bill have been agreed to by the government and the opposition and have passed the Senate and will pass the House. But amendments which the opposition move which do not relate to this bill are completely unacceptable to the government. We did not accept them in the Senate; we will not accept them in the House. They are unconstitutional. Therefore, having supported the government’s compromise on cataracts, I would appeal to the opposition to, just as we have negotiated in good faith on the issues that are related to this bill, now drop their insistence that these amendments which relate to cataracts but do not relate to this bill in any way, shape or form be pressed upon this House. They should be rejected in this House and the opposition should get behind this very important legislation—and not block it—which not only protects the integrity of Medicare and taxpayers but also protects those doctors doing the right thing. It also enables Medicare to take appropriate action against doctors doing the wrong thing to protect—(Time expired)

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

I thank the minister for his contribution. It is the case that there has been consultation between the shadow minister’s office and the Minister for Health and Ageing’s office on these issues over a period of time. The coalition support proper measures being put in place to investigate and to enforce the law as it pertains to doctors. That is not in dispute. As I understand the minister’s contribution and the way in which the amendment is put, the coalition, on that understanding, have no issue with that. But we certainly do have an issue with the government’s recalcitrance in relation to the amendments which have been moved by the coalition on behalf of those Australians who need cataract surgery and whom this government robbed of hundreds of dollars for their own political purposes. That is why we opposed this government’s harsh cut to the rebate and we facilitated on behalf of those patients discussions between the government and the ophthalmologists so that we could arrive at a better outcome.

It was regrettable that the government forced the coalition into a position where we needed to put amendments to this Health Insurance Amendment (Compliance) Bill 2009, and our stance has not changed in relation to these amendments. We do believe, like the Senate, that the government should be supporting the coalition. Of course, that will not be the case, because this is an ideological attack that is present not just in this debate but in so many that the government is conducting at the moment. We will continue to deal with this matter both in this House and in the other place. We will be insisting on a certain course in the other place. We do not seek to frustrate the intent of what this bill is trying to deliver, but it is important that the minister’s actions not be repeated.

There is no guarantee that the minister could not again move unilaterally, post this change, in relation to the item number and in relation to the rebate that was the subject of debate on the issue of cataract surgery. That has been the consistent position of the coalition and it will remain so. We believed, like the crossbench senators, that it was completely unjustifiable for the government to announce a 50 per cent cut to the Medicare rebate in relation to cataract surgery. It was the case through the course of a number of months that the government were unable to substantiate any reason as to why they had invoked that cut, and in the end they negotiated an outcome with the ophthalmologists which was a cut of just over 10 per cent.

The real issue now for patients, particularly for older Australians, who have had cataract surgery is that those people have paid out-of-pocket expenses that they should not have had to. The minister has had the opportunity to put in place a regime which would compensate those patients, many of whom are on lower incomes, most of whom are of an older age and need that support but have been denied it by this government. That is why the coalition will continue to stand up for older Australians who require cataract surgery. It is why we were able to arrive at a better outcome. It is why we had to attach these amendments to this bill, and it is why we will continue to insist on the course that we have in relation to this debate in the past months.

Chris Bowen (Prospect, Australian Labor Party, Minister for Financial Services, Superannuation and Corporate Law) Share this | Link to this | Hansard source

I welcome the shadow minister’s assurance that he does not seek to frustrate the passage of this Health Insurance Amendment (Compliance) Bill 2009. However, I am concerned that the rest of his contribution indicates that the opposition do seek to frustrate the passage of this bill. In fairness, I would say that there has been very good engagement between the government and the opposition on this bill. There has been very good engagement with the former shadow minister for human services, Senator Scullion, and I know that the current shadow minister for human services has continued in that vein, because I think the government and the opposition agree that this bill is important.

The government and the opposition agree that it is important that the integrity of Medicare Australia’s operations be protected. The government and the opposition agree that those doctors doing the right thing should be protected and those doctors doing the wrong thing should not be protected, and that this bill is important in enabling the government to deal appropriately with that very, very small number of doctors who seek to do the wrong thing through their interaction with Medicare. But what the shadow minister for health has done and what the opposition have done is to apply to this bill amendments which (a) are unconstitutional, (b) are totally unrelated to this bill and (c) undermine the negotiations between the government and the opposition on the cataract measure, which is completely separate to this bill.

If the shadow minister for health really, seriously, wants to be taken at his word that he does not seek to frustrate the passage of this bill then he should drop the opposition’s insistence on these amendments in this place and in the other place—and he should let this bill pass. If he wants to continue to quarrel about cataracts, that is his right, but he should do so in relation to legislation which is relevant. He should do in forums of the House which are relevant and not seek to frustrate the passage of what is an important bill, a bill which otherwise enjoys the support of the government and the opposition. He should drop the political stunt and get out of the way of the government seeking to implement a very important measure.

Robert Oakeshott (Lyne, Independent) Share this | Link to this | Hansard source

Having only just been informed of this move by the coalition and the Senate, I cannot help but agree with the minister in the chamber. I am a local member with a large number of constituents who need cataract surgery, and it is a life-changing event for many of them. This dispute, which has been going since post the budget last year, has been an incredibly fractious one and a difficult one in the lives of many people. It has been frustrating for many of the ophthalmologists involved, frustrating for many of the patients involved and frustrating for the parliamentary processes involved because of the continued disagreement that we see over this issue.

I am of a view to support the coalition in regard to the issue of cataract surgery. The cost of the surgery should not make individuals decide not to undertake it. It is, as I say, a life-changing moment for many people. However, this is not the time and this is not the moment. Quite clearly, in the legal advice that has come through, this amendment has no substantial relationship to the health insurance bill. There are other forms of the House for that. I am happy to talk with the shadow minister for health about those forms of the House—private members bills or notices of motion. I am happy to co-sponsor or do whatever it takes to continue to raise awareness of this issue.

It is an issue on which I was, up until about 10 minutes ago, under the impression that a negotiated agreement had been reached, even though it was not satisfactory. I thought it was broadly accepted by all parties. Obviously it is not. Therefore, if the issue is going to continue to be raised by other members of this House, I am all ears and all eyes in regard to how we can even further improve access to surgery for patients in areas such as mine. My electorate is of a lower socioeconomic status, and therefore surgery being too expensive can quite often simply mean not having it at all, and that is not a result anyone wants.

However, in regard to the point the minister is making, I think I share his view. Yes, we all have a right to bang on about any issue we want, and I will continue to bang on about cataract surgery in my area, as I am sure others will continue, quite rightly, to bang on about this issue in their electorates—but at the right time and at the right moment. The legal advice is quite clear. There is no substantial relationship. Therefore, I would hope we can get on with the job of passing the Health Insurance Amendment (Compliance) Bill 2009 and continue to argue the toss on cataract surgery at another time, in another format and hopefully get the government to listen at the right moment, either in this House or out of it.

Question put:

That the motion (Mr Bowen’s) be agreed to.

Chris Bowen (Prospect, Australian Labor Party, Minister for Financial Services, Superannuation and Corporate Law) Share this | Link to this | Hansard source

I move:

(1)    Clause 2, page 1 (lines 7 and 8), omit the clause, substitute:

2  Commencement

                 This Act commences on the day after this Act receives the Royal Assent.

This is a very straightforward amendment. The passage of this bill has been delayed in the Senate. The original bill had a commencement date of 1 January 2010. Clearly, that is not now possible unless the legislation were to be retrospective, which the government does not believe is appropriate. Accordingly, this amendment changes the commencement date to the day after it receives royal consent.

Also, I have tabled some very minor and technical amendments to the explanatory memorandum which correct small errors. Subsection 129AEB(5) deals with the application of a 50 per cent increase to the penalty in certain circumstances, including when the total amount of the previous debts is more than $30,000. The EM incorrectly states that the threshold is $2,500, which is corrected in the amendment I have handed forward.

As I said in my earlier remarks, there has been very good engagement between the government and the opposition on this bill, both with the former shadow minister for human services, Senator Scullion, and the current shadow minister for human services, the member for Menzies. I acknowledge that and I acknowledge the good faith in which these matters have been discussed between the government and the opposition.

Kevin Andrews (Menzies, Liberal Party, Shadow Minister for Families, Housing and Human Services) Share this | Link to this | Hansard source

I indicate to the government that the opposition will not be opposing this amendment, contrary to information provided to the minister. I am informed that Senator Scullion had not been informed about it and neither had I. The minister at the table informed me about it just briefly before the previous division came on. I have looked at the matters and, as I said, we will not be opposing the amendment.

Question agreed to.