Mrs Bronwyn Bishop (Speaker) Share this | Link to this | Hansard source

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

The Government undermining universal healthcare in Australia by cutting billions of dollars from healthcare and the pain this will inflict on 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—

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

Thank you, Madam Speaker. We saw it well and truly on display today from the Prime Minister in question time. Having said before the election that there would be no cuts to health or education or pensions and no new taxes, when questioned about the $80 billion worth of cuts to health and education that are in his own budget papers, he could not answer any of the questions about the impact of those cuts. It is not surprising, given what we know from Senate estimates that no modelling has been done and that no-one has looked at the impact of the GP tax on communities across the country. When the Prime Minister was directly asked the question about the impacts, he said: 'Where's the problem? I don't see any problem. There's no big deal here.' I will tell you where the problem is. When you cut $80 billion out of hospitals and education and when you cut some $55 billion out of hospitals it does mean fewer beds; it does mean longer waiting times for elective surgery; it does mean longer wait times in emergency departments; and it does mean that Australians will find it difficult to access the health care that they need. Perhaps that is exactly what the government is trying to do: to shift the responsibility for health out of the Commonwealth and onto the states and territories and onto individual taxpayers.

We know that if these cuts go through, and the government is determined to cut $80 billion from hospitals, we will not have the hospital beds that people need. We will not have the jobs for the doctors of the future, many of whom I have recently met in medical schools. We will have fewer nurses in our public health system; and we will have problems with our emergency departments. I want to take people through some of the detail, because the government and the Prime Minister have again been caught out on this. The Prime Minister is claiming, 'Oh, the cuts they are not for three years' time; they're funded on the never never and so they somehow don't exist.' The first thing is the $80 billion worth of cuts are in their own budget papers, and the savings from these—read cuts—are going into this Medical Research Future Fund which was established, we hear, some six weeks before the budget. If anyone has seen the Hollow Men episode on the endowment fund—I can highly recommend that you download it and there is a piece in the newspapers today by Dan Harrison—it absolutely bells the cat on the government's Medical Research Future Fund.

I am going to rely on a paper from the Parliamentary Library; it is a practice members opposite used to do on a regular basis, but this is on their own budget. It says:

A number of related health funding agreements with the states and territories are slated for termination, deferred or redrawn.

These are historic agreements that Labor signed with states and territories to end the blame game in health. Over the course of the last few years that blame game—the cost shifting between Commonwealth and the states—and the arguments over health have largely disappeared. This government has ended that by ripping up those historic agreements. It is not just ripping them up from 2017, as the Prime Minister said; it is in fact not honouring those agreements from 1 July this year. The Commonwealth had pledged to meet 45 per cent in the growth in efficient price and rising to 50 per cent after 2017.

The government's own pre-election policy paper says that is exactly what they would do too. It is another broken promise. So ashamed are they that their health policy seems now, unfortunately, to have been removed from a webpage, but it stated that 'a coalition government will honour 50 per funding of the efficient price.' That is what their document said, and they have absolutely broken that promise. From July 2017 the Commonwealth's contribution will no longer use the funding model. The Commonwealth's contribution will be linked to movements of the consumer price index and population growth—essentially the funding model is being replaced. 'If CPI movements track below the growth in the cost of medical services, the state and territories will face a shortfall in funding under this new formula.' That is the Parliamentary Library's budget paper.

We have seen in Queensland in the last hour, as they handed down their budget, $16 billion of cuts to health and education and that is a direct response to the Abbott government's cuts to health and education. We have seen states and territories frantically redraft their budgets. The ACT is another case in point—they have frantically redrafted their budget—and Victoria's budget papers, which were handed down before the Commonwealth budget, clearly state that there are a whole lot of assumptions which they had to build in but which have been smashed. According to the Parliamentary Library paper:

From 2014–15, the Commonwealth will also cease the funding guarantees agreed to under the NHRA. Under the funding guarantee, the Commonwealth promised that no state would be financially worse off as a result of transitioning to the NRHA activity based funding arrangements which apply from 2014–15. The Commonwealth guaranteed that its contribution would be at least $16.4 billion greater than the amount the states and territories would have received under the superseded funding model. The cessation of the funding guarantee means payments of up to $574 million which were due to commence from July 2014, will not proceed.

That is money that was there in the budget and in the forward estimates. Any sort of spin that the minister wants to put on it that this money did not exist is not real. It was real money, all right—and it was real hospital beds and real nurses and real doctors—and you have cut them.

The other thing that the government has done is this:

Under the NPAIPHS, the states and territories receive funding for improving access to elective surgery, emergency care and subacute care. Funding involves both facilitation and reward payments for meeting agreed targets. The budget announced that the reward payments for emergency care and elective surgery would cease from July 2015. Around $30.7 million in these payments were made to states and territories in 2013–14. Savings of $201.1 million over three years are forecast.

It is not surprising, and again I will quote from the Parliamentary Library budget paper—

Paul Fletcher (Bradfield, Liberal Party, Parliamentary Secretary to the Minister for Communications) Share this | Link to this | Hansard source

Madam Speaker, I would like to ask the shadow minister a question under standing order 66(a).

Mrs Bronwyn Bishop (Speaker) Share this | Link to this | Hansard source

I think that standing order applies only to speeches and not MPIs.

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

I will repeat: obviously, they are a little bit sensitive on this point. Having lied to the Australian people, you are now being caught out when it comes to public hospital funding. You are absolutely being caught out. Your own budget papers say that there is an $80 billion cut to public hospitals and to education and your own health policy document says that you will honour those agreements 50 per cent. That is what they say. The Parliamentary Library paper says:

Unsurprisingly, the response from state and territory governments to the loss of Commonwealth hospital funding has been negative.

The response from the states and territories has been negative because many of the Liberal state governments across the country—Victoria and Queensland are cases in point—have been cutting funding to public hospitals and they know they are about to face a massive shortfall when it comes to funding hospital beds, nurses and doctors. According to the paper:

The Australian Health Care and Hospitals Association … expressed its concern that the change to hospital funding commitments will have an immediate effect on hospital waiting times and standards. Others hold concerns that the potential efficiencies from applying an activity based funding model with an efficient price, will be lost with a return to a population/CPI model which provides no incentive for such efficiencies.

Shame on this government! This government has tried to claim that, somehow or other, it hasn't not told the truth about what is happening with health and education funding, that really it is all not happening until 2017 and that no-one should worry about it. As of 1 July we will see hospital bed closures, elective surgery waiting times begin to climb again and times for people access emergency departments climb and climb again. Every single time that happens it will be on the head of this government, because of their $80 billion worth of cuts to hospitals.

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

This is a very important issue. People who are listening to this broadcast would be thinking: 'Why is the government saying that funding for public hospitals is increasing by nine per cent each year over the course of the next three years and six per cent in year 4, yet we have just heard the shadow minister claim that money is being cut from public hospitals?' I will explain it in this way: imagine a person going to work on an income of $1,000 a week. His boss says, 'I'm going to give you pay rise. Your pay will go from $1,000 to $1,200 a week.' The bloke goes home that night and says to his family: 'You wouldn't believe it. I was expecting $1,300 a week and my pay has been cut by $100 a week.' It just does not hold any water. The fact is that we are increasing hospital funding by nine per cent year-on-year over the course of the next three years and by six per cent in year 4. Yes, the states and territories would want more than nine per cent, no question. That is understandable. But the reality is that this government was left with enormous debt by the previous Labor government. People realise that in their own budgets—in their own household budgets and their own small business budgets—you cannot afford to borrow money to pay the interest bill. You cannot afford to do that in your own household finances and you certainly cannot afford to do it at the Commonwealth level.

We have seen in New South Wales, where the health system was a disaster, that more money did not mean better outcomes. The O'Farrell government—now the Baird government—was elected to clean up Labor's mess in health. In New South Wales Labor put more money into health bureaucracies. Why? Because that is what the unions demand. Unions demand that more people go from the wards into academic positions, into positions that are non-frontline, and that new health bureaucracies be created. It is exactly the same picture that took place in Queensland, where we saw the Dr Patel disaster and the payroll debacle. We saw people spending years and years on waiting lists. It was not because Labor at a state level had cut money out of the public hospital system; indeed, they put more money in. They got worse outcomes because they had taken the money that used to be used for frontline services and put it into bureaucratic positions. It would be no surprise to anybody in this country that, over the course of the last six years, under the Rudd-Gillard-Rudd period of dysfunctional government Labor applied exactly the same formula. There were the Australian National Preventive Health Agency and Health Workforce Australia. Believe it or not, in addition to my department, the Department of Health, there were 23 outside agencies.

If you are taking money from the frontline services, from the doctors and nurses and hospital wards and from GP services around the country, and putting it into that ever-growing bureaucracy, no wonder you would have worse health outcomes. This has been Labor's formula, tried and failed at the state level and applied at the federal level over the course of the last six years. We were elected, as were the O'Farrell and the Newman governments, to clean-up Labor's mess; and clean it up we will.

In this budget we say that some states have overstated, for argument's sake, the amount of activity that has been taking place in their hospitals. We say to the states, 'Under the crazy Julia Gillard agreement that you signed, you were guaranteed funding in your hospitals even if you didn't perform the surgery.' We will continue to honour the agreement and fund the additional surgery that takes place within hospitals, but, you would not believe it, we are insisting that the surgery actually takes place. I do not think that is a foreign concept to anybody in this place, let alone to the Australian taxpayer, who funds all of these services. We are saying that we will provide the additional funding if you do the surgery. If you see the people in emergency departments, if you perform the surgery for not just hearts and hips but knees and all the rest of the elective surgery that takes place, we will provide that additional funding. I think that is a completely reasonable arrangement.

One of the lies that Labor push is that, somehow, money has been cut from this budget, because we did not continue the so-called national partnership agreements. Let me give members one example. Then-Prime Minister Gillard entered into a subacute national partnership agreement with the states and territories, which commenced on 1 July 2011. There was a defined amount of money that went to the states and territories to help them build some beds in public hospitals. Nobody argued against that. The funding was due to finish on 30 June this year, and it will finish. In the run-up to the election the Labor Party issued their policy document and, through their discredited economic spokesperson, they put out their numbers, which did not have one extra dollar from 1 July this year under that time limited partnership agreement.

When we put out our policy, we also said, 'We accept that that partnership agreement expires on 30 June this year, and we won't provide funding beyond that.' Labor and the Liberals went into the election with exactly the same policy. Somehow the Labor Party now says, 'The Liberal Party are cutting this NPA. They are not providing funding going forward.' It is a complete fallacy, and it is at complete odds with the truth of the Labor Party's position.

That is not where it stops, unfortunately. The former government had lots of problems. They spent money, racked up debt and wasted money. The shadow minister before referred to a series called The Hollowmen. Many people in this place and listening to this broadcast would have seen The Hollowmen series. You know what? It was based on the Rudd government years. It was based on the failed Rudd period of government. Kevin Rudd said—as Bob Hawke said in 1991—that Medicare is unsustainable without a co-payment. The Labor Party supported a co-payment in relation to the Pharmaceutical Benefits Scheme in the 1960s, the 1970s, the 1980s, the 1990s and right up until 24 hours ago when the Labor Party all of a sudden referred to a PBS co-payment as a PBS tax. Why did they do that? Having said for 50-odd years that we needed a co-payment to keep our medicine scheme sustainable, why are they calling it a tax now? It is simply politics.

What we are endeavouring to do today is put the facts on the table in a rational way for people to make a decision for themselves. The Labor Party claims that there is somehow a cut in hospital funding, and yet the budget papers demonstrate that we will increase hospital funding nine per cent this year, next year and the year after and by six per cent in year four. We do not want to tear Medicare down; we want to build it up. We are saying in relation to Medicare that in a country of 23 million people with an ageing population we cannot pretend that 263 million services for free each year is sustainable. It is not. Bob Hawke said in 1991, 'We need a co-payment for the PBS because we want to make our drug system sustainable.' He said, 'We need a co-payment for the Medicare system because we want to keep the health system sustainable.' Andrew Leigh, the shadow Assistant Treasurer, has written at length about this very issue and has said that Medicare is unsustainable without a co-payment. We know the member for Jagajaga, a senior frontbencher within the Labor Party, as the policy head of the health section within the Labor Party at the time advised that Brian Howe should introduce a co-payment. And Brian Howe did introduce a co-payment. He introduced a co-payment as Bob Hawke's health minister and as Deputy Prime Minister because he recognised then as we do now—and as Kevin Rudd did in 2007—that if we do not make Medicare sustainable it will collapse.

We are saying that, for people who can afford to pay a $7 co-payment, $5 of that will go towards a $20 billion medical research fund to address the fact that 7,500 Australians a week by 2050 will be diagnosed with dementia. I want to make sure that we can put more money into research to address the issues of an ageing population—such as diseases of the brain, cardiac disease and rare forms of cancer. I want to make sure that we can provide additional support to our medical researchers, and so $5 is going into that fund. The other $2 of the $7 will go to supplementing the money that doctors receive now under Medicare. That means that we can continue to bulk-bill those people who cannot afford the $7 and ensure the universality of Medicare.

The Labor Party at the moment believe you can rack up debt after debt on the country's credit card and that somehow that is sustainable. Nobody else believes that. This government was elected to clean up Labor's mess. As I said before, we will clean it up, and not just the boats, the economy and the budget. We will also make our health system sustainable. Australians know in their hearts and minds it is only the Liberal Party that can do that.

Stephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | Link to this | Hansard source

The truth is that this policy is an orphan. The minister has done a valiant job of standing here and trying to defend something that none of his backbenchers will be out there in their electorates defending when they get back home. None of them will be out there defending it when they get back home. It is easy to understand why. When we got up and read out the MPI today, you could see people rushing for the doors. In fact, the National Party MPs just about knocked the doors of their hinges—they are still swinging—because they did not want to be in the chamber to stand up and defend what is clearly an indefensible policy.

There is little wonder. National Party members would have been entitled to think that, as they have a National Party minister with the title of 'minister for regional and rural health', she would have had some input into this policy. Yet we discovered something last night in Senate estimates when she was asked a very clear question about the impact of the GP tax on rural and regional Australia. She was asked by Senator McLucas:

Did you go through a consultation process with rural and regional health stakeholders to canvass the notion of a GP tax with them?

The answer from the minister for rural and regional health was:

I was not privy to any discussion around the creation of the GP co-payment.

She was not keen to claim it as one of her own. She said:

There was speculation leading up to the announcement. I did not have any specific discussions on that matter.

You could not have it any clearer than that. The minister who is responsible for rural and regional health had absolutely no input into the policy—and doesn't it show? The impact of this cruel GP tax and these cruel cuts to health and hospital funding are going to have a big impact on rural and regional Australia—and don't National Party MPs know it? That is why they will not be standing in this place defending them.

There is a word for people who do not tell the truth. We are not allowed to use it in this place because it is unparliamentary. But before the budget he said that there would be no cuts to education and no cuts to health. Then he lured people to vote for him. Then, at his very first opportunity, he wacks them with his very first budget. 'No cuts to education and no cuts to health'? The people of Australia are not going to forget it.

When they go back to their electorates—I can hear the noisy member for Bass over here, I can see the member for Page over there, and I can see a lot of other members from regional Australia—they will not be going out there defending this policy. They will be at pains to speak about just about anything else, because they know that this is going to go down like a bucket of sick in regional Australia. It is absolutely on the nose.

It is not only members on this side of the House that are bagging these horrible cuts to the health budget. What did the newest Premier of New South Wales have to say about this? He said this:

In terms of the funding in health what we are seeing is hundreds and hundreds of hospital beds impacted.

He also said:

We cannot absorb these cuts.

So all those members from regional New South Wales, when they go back to their electorates, should be repeating the words of the Premier of New South Wales. It wasn't just the Premier of New South Wales who confessed that these cuts are going to amount to 2,380 beds in New South Wales that will have to close; it is the Premier of Queensland. He said he was 'deeply concerned about what this budget means for health and education services' in his state. Today he stood up in his parliament and said it amounts to $16 billion worth of cuts to health and education services in Queensland. These were not the cuts the people of Queensland voted for. In fact, they were promised the very opposite.

In the nine months they have been in office they haven't got a health policy; they have a wrecking ball! They have thrown away the National Health Reform Agreement; they have cut millions and millions of dollars from programs that are helping ordinary Australians. There is no policy. It is a cut to the fair go. These cruel cuts are closing beds in regional Australia, they are hurting everyday Australians, and you guys should vote against them.

Darren Chester (Gippsland, National Party, Parliamentary Secretary to the Minister for Defence) Share this | Link to this | Hansard source

It is a pleasure to join the debate because it provides an opportunity to remind Australians about the mess this government has inherited and to highlight our efforts to keep our world-class health care system in place and sustainable in the future. It is a pleasure to support the minister, who quite rightly acknowledged that the Australian people gave us a big job to do in September last year and we are determined to do it.

But listening to those opposite you could be forgiven for thinking that perhaps the last six years didn't happen—it was a mirage, an apparition, a hoax. But it did happen and the damage is real. I do not blame those opposite for being in denial about this. They do not want to acknowledge the mess they have left behind for the Australian people to clean up and the coalition government to clean up. That is all okay—I know it is hard to admit your mistakes. But those opposite are now acting like the tenants from hell. You have had them in the rental property. They have wrecked the rental property: they have broken windows, they have stained the carpet, they have pulled down the curtains—

Luke Hartsuyker (Cowper, National Party, Assistant Minister for Employment) Share this | Link to this | Hansard source

They owe rent.

Darren Chester (Gippsland, National Party, Parliamentary Secretary to the Minister for Defence) Share this | Link to this | Hansard source

They owe rent and now they want to stop us from coming in and cleaning up the mess. They want to stay in there and keep doing the damage.

Ten years ago the cost of Medicare to Australian public was in the order of $8 billion per year. Today we are spending about $20 billion per annum on Medicare. Any responsible government would acknowledge that there is a challenge there to make sure that Medicare is sustainable into the future. This government has had to make some tough decisions. They are tough decisions but they have been fair decisions. In proposing this modest contribution that we have put forward in the budget, with a strong safety net for concession card holders and children under 16 years, we are taking steps now to try to make sure that our world-class health system is sustainable in the future.

The members opposite in today's MPI like to talk about the Australian people feeling the pain. The Australian people know all about Labor's pain. We have had six years of absolute budgetary dysfunction from Labor. The record of Labor is something that we need to be reminded about. Labor converted the record surpluses of the Howard government into record deficits. Labor delivered nearly $200 billion worth of deficits and there is $123 billion of deficits over the next four years to come. That is 10 years of deficits. That is an extraordinary effort by Labor!

Get this! Labor promised a surplus in 2012-13 on over 500 occasions. We are still waiting for the member for Lilley's first budget surplus. Australia's debt is already costing us billions of dollars in interest payments. This year we are paying $12 billion in interest costs alone.

Mr Mitchell interjecting—

Those opposite are going silent, apart from my good friend the member for McEwen—he's always up for a blue. The member for McEwen is the only one prepared to defend this. We are paying a billion dollars a month in interest payments. Imagine what that $1 billion per month could do in terms of new health care facilities, new hospitals, new roads.

It is fascinating to sit here and listen to Labor deny the mess they left behind. In the six chaotic years of Labor we had to Labor prime ministers, three deputy prime ministers, five ministers for regional development and six ministers for small business. In total they made 11 changes to ministerial arrangements. There were 20 different parliamentary secretaries and 48 ministers, with over 100 different ministerial titles. It was a mess. The Australian people, quite rightly, hired us to do a job in September last year—and that was to clean up Labor's mess.

This matter of public importance debate is important, but the premise of the statement is untrue. This government is not undermining health care in Australia; it is making responsible, long-term decisions to make sure that our health system is sustainable in the long term. The Abbott government is delivering record funding for hospitals and schools.

Mr Perrett interjecting—

They don't like it, but it's true. The Abbott coalition government is delivering record funding for hospitals and schools. I am surprised that my good friend the member for Moreton is even here. He normally leaves by this time of day. The Abbott government is actually honouring its commitments and increasing hospital funding by over $5 billion or around 40 per cent over four years. Those opposite don't like it but it is true. Labor loves to make big promises but they never delivered. This government is in fact increasing funding for hospitals each year and every year. The annual assistance to the states for public hospitals increases by more than nine per cent every year for the next three years and will increase by more than six per cent in the fourth year.

I said at the outset that the Australian people elected us to do a job, and that job was to clean up the mess left behind by the Australian Labor Party. I urge those opposite just to admit their past mistakes. I know you didn't mean it—I know you didn't mean to make a complete mess of it—but admit your mistakes and get out of the way and let the clean-up begin.

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

I would like to take this opportunity to explain exactly how these cruel and heartless cuts are going to severely affect my electorate of McEwen and highlight, yet again, the many promises that Tony Abbott has broken. Universal health care is absolutely vital for Australia and is one of the main concerns for our communities in McEwen. By introducing the GP tax, Tony Abbott is going to be charging our electorate almost $8 million a year just for being sick or injured. In regional areas such as Kilmore, Broadford and Seymour, where we have larger elderly populations, it is especially going to hurt. Our pensioners and people on fixed incomes are already struggling to make ends meet on modest incomes and now—

Mr Nikolic interjecting—

The Bass yabby—he goes on, doesn't he. They will struggle to afford to go the doctor. Let's say they can scramble together $7 to go the doctor. They may need to get a blood test done. That is another $7. Then there may be a follow-up appointment to check on their health progress. That is another $7. For those opposite, that is $21 for one ailment. What about the young families we have in areas in like Laurimar, Mernda, Craigieburn and Sunbury. A family with a couple of sick kids is being pinged $14 if they take two kids to the doctor. This heartless GP tax is hurting our most vulnerable Australians, those least able to afford it. And to add insult to injury, millionaire Joe Hockey fires off comments suggesting, 'It's no big deal, if you compare it to a pack of smokes.' He said:

One packet of cigarettes costs $22. That gives you three visits to the doctor. You can spend just over $3 on a middy of beer, so that's two middies of beer to go to the doctor.

This is why the budget is in such a mess. If the Treasurer is not competent enough to know three plus three equals six not seven, no wonder this country is in the state it is in. This budget is not worth even using as a boat anchor. How arrogant and out of touch is the Treasurer of this country to honestly believe that those who are struggling to keep their heads above water can compare their health needs to a middy. This shows just how out of touch the Abbott government really is.

By now, we know Abbott's famous quote from the night before the election, but it bears repeating: 'No cuts to education. No cuts to health. No changes to pensions. No changes to the GST.' So four out of five promises have been broken. He has cut billions of dollars from public hospitals, dental services, preventative health initiatives, bulk-billing services, planning and training programs, and of course the Medicare safety net. If he thinks these are not funding cuts, I would hate to see a budget with funding cuts from the Prime Minister.

In February this year, in a doorstop with Bill Glasson, the Prime Minister was asked: 'Can you guarantee there won't be a Medicare co-payment?' Tony Abbott replied: 'Nothing is being considered. Nothing is being proposed. Nothing is planned.' The parliamentary Pinocchio also stated: 'Don't forget, we are going to be a no surprises and no excuses government.' There you have it: he reckons this is a 'no surprises, no excuses government'. I can tell him there are millions of vulnerable and struggling people across Australia who have been absolutely shocked by the cruel budget of broken promises, especially the people in McEwen. Even the Premier of Victoria, Dr Denis Napthine, a fellow Liberal Party member, has outed more of Tony Abbott's health-care cuts and lies. Mr Napthine states:

The Prime Minister is telling Australians that the cuts will only take place post-2017. But our figures clearly show, as of the first of July... there'll be a significant reduction in funding in health and concessions in Victoria.

In his 2009 book Battlelineson page 133,Tony Abbott writes:

Commonwealth spending on health and education now approaches $90 billion a year ... Still, any withdrawal of Commonwealth involvement or spending in these areas would rightly be seen as a cop out.

So what does the PM do? His budget has an $80 billion cut to health and education. Or for the intellectually bereft up the back on the other side, 'savings' is the term they use in the budget. 'We are not spending it; we are saving it.' That is a cut by any stretch of the imagination.

I reiterate: these savage cuts to health care and the cruel taxes on GPs and medications are going to drastically hurt the livelihoods of the people of McEwen. Needless to say, we are going to fight these. In this House in September 2010, it was said of the then government:

This government is built on a lie. This is a thoroughly dishonourable and deceitful government and it deserves to be exposed as such.

Well, Mr Abbott, when it comes to your perfidious government, I could not have said it better myself.

Bruce Scott (Maranoa, Deputy-Speaker) Share this | Link to this | Hansard source

Order! Member for McEwen!

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

That was a quote from the now Prime Minister. While those opposite sit there whingeing and complaining— (Time expired)

Andrew Southcott (Boothby, Liberal Party) Share this | Link to this | Hansard source

Medicare celebrated 30 years this year. It is a system which has stood the test of time and part of the reason it is so popular in the community is that it built on the existing system. It was a fee-for-service system. It allowed discretion for medical practitioners to continue as they had before. But it has bipartisan support. It is supported by the Labor Party and it is supported by the Liberal Party and the National Party. You only need to look at what we did when we were last in government. We had some great innovations for Medicare. The practice incentive payment was a great innovation. It allowed GPs to focus on chronic disease management. There were things that a fee-for-service system did not always lend itself to. It was a way of getting general practice computerised. That was a great success of the Howard government. We introduced the GP management plans and the team care arrangements. That expanded Medicare to allied health services, to podiatrists and more. We had the Chronic Disease Dental Scheme, an innovation of the current Prime Minister when he was health minister. He understood that it was not the checks that people needed but the access to restorative treatment. We had a great expansion, again, under the Prime Minister when he was health minister, in the area of mental health, greatly expanding Medicare there.

The issue now is the sustainability of Medicare. Whereas 10 years ago it was costing $8 billion, now it is costing $18 billion. For that reason, a modest co-payment is a good idea. This idea that it affects the universality of Medicare is simply rubbish. Medicare remains a universal social health insurance scheme. That has not changed.

Australia has a good health system. For nine per cent of GDP, we have a population which, by international standards, is healthy. We have one of the highest life expectancies anywhere in the world. We are in the top five countries in terms of survival from a cardiovascular event. We can do much better. There are areas that we can focus on doing better in, such as chronic disease management, and we must look at hospital readmissions and preventable hospital admissions. There is a lot more that can be done. But there is all of this confected outrage, over what is a very modest scheme which will allow Medicare to become sustainable.

The Labor Party understood this when they were in government in the early nineties. They understood that having a co-payment was a way of making Medicare sustainable. The principle of having a co-payment has been well established in the Pharmaceutical Benefits Scheme since the 1960s. We have a differential scheme: one for concession-card holders and one for everyone else. We have had it since the 1960s. And this is very similar.

When you look at how we stand internationally, about 17 per cent of health spending is an out-of-pocket spend by the patient. We are about average by international standards. And this measure is not a large measure. It is $7. There are protections there for people who cannot pay. There are protections there for people who are card-holders. They will have to pay on only 10 occasions. It is an important innovation to make sure that Medicare is sustainable. And it does preserve the universality of this health insurance scheme.

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

This government's budget rips $80 billion out of health and education. It is setting Australia's health system back 50 years. I have always believed that the Prime Minister looks to the past for inspiration, and we are seeing that in what he has done in this budget.

This government is waging war on the health of Australian families by attacking the universality of Medicare. It is a war that the Prime Minister, Tony Abbott, began to wage when he was minister for health. I remember the days when he stood up in this chamber and gave rolled-gold guarantees that he would not touch Medicare. I remember the days when he stood up in here with a smile on his face, smirking from ear to ear, and said, 'I am the best friend that Medicare ever had.' We know that the more he says something like that the less you can believe it, because the Prime Minister has made an art of saying one thing and doing another thing—of presenting a case that he believes one thing when in actual fact he believes something else.

In the days when the Prime Minister was health minister, bulk-billing rates in Shortland electorate went under 60 per cent. When we came to government, when Labor was in power, bulk-billing rates rose to over 82 per cent. That says to me that Labor, the opposition, is committed to ensuring that those people who need health care can get health care when they need it, because, when the doctor bulk-bills, a person does not have to make a decision about whether they buy food to put on the table or go to the doctor when they are sick.

I know the Prime Minister has always believed in a US-style system. Millions of residents in the United States have absolutely no health insurance, and they cannot afford to go to the doctor when they are sick. Earlier I heard the minister talking about credit cards. Well, this government wants to make the Medicare card useless and force Australian patients to use their credit card when they get sick. That is really bad health policy. Good health policy encourages people to be involved in preventive health care, not just to react when they get so sick that they have got absolutely no option. If you have got to pay to go to the doctor, then people will put off going.

My electorate is a very old electorate and there are a number of people there who suffer from chronic diseases. They have been able to put in place good healthcare management plans, and they are a lot healthier because of the Labor government and the health policies that we had in place. Under this government and the cuts in this budget, the incentive will be for people not to go to the doctor when they are sick, but only to go when they are in a critical condition. This co-payment will have an enormous impact on the health of this nation, and those on the other side of this parliament just do not get it.

When Tony Abbott was in power, as health minister, he committed the then health committee to inquire into the funding of health. They brought down a report, The blame game. Now we are moving back to the blame game; back to a situation where the Commonwealth is passing the costs for providing health to the states. You have people like the Liberal premier of my state, Mike Baird, saying that these impacts start on 1 July and they cannot absorb them. They will have an immediate impact and that immediate impact is really going to hurt the people of Australia.

This government stands condemned for its health policy. (Time expired)

Karen Andrews (McPherson, Liberal Party) Share this | Link to this | Hansard source

I rise to oppose this matter of public importance put forward by the opposition.

When we talk about public importance there is nothing that is more important than ensuring the future viability of universal health care. And that is exactly what this government is doing. Medicare is a great system, which we all support. The health reforms in the budget are all about making sure that Australians continue to have access to affordable health care and ensuring that the system is viable in the long term.

Like other speakers in this debate, I want to debunk the whole premise of this MPI, that funding is being removed from the health budget. Budget Paper No. 1, page 6-25, clearly shows that Commonwealth health funding will grow from $64.5 billion in 2013-14 through to $78.8 billion in 2017-18. This is an increase of $14.3 billion over the next four years. We have kept in place all vital safety nets to ensure that the most vulnerable are protected, especially the concession card holders, of whom there are currently about 8.9 million in this country.

But we are implementing reforms that will ensure that problems like overservicing and duplication of services are addressed. We are making some important decisions, including the introduction of a co-payment that will act as a price signal and help ensure the future viability of the scheme.

Labor has been claiming hysterically that this is the end of Medicare; nothing could be further from the truth. This is exactly the medicine that Medicare needs to stay strong. I ask members opposite to stop with the scaremongering and to be honest. Be honest, and recognise the fact that the co-payment is very low by world standards. Other countries with universal health care have much higher co-payments. For our neighbours in New Zealand it is $17; for those in Sweden it is between $20 and $30; and in Finland it is $20. Co-payments help to make universal health care viable.

Labor used to recognise this important fact. It was Labor themselves who introduced the co-payment on pharmaceuticals. The Hawke and Keating governments may not have been perfect but 'Old' Labor certainly looks like responsible managers compared to 'New' Labor, who learned all they know under the spin and mismanagement of the Rudd-Gillard-Rudd governments.

'New' Labor appear to live in some magical fairyland, where everything is free and you do not have to worry about how to pay for things. You can make promises that you will spend billions of dollars in 10 years' time without having to find the money, and then act outraged when someone asks you how you intend to pay for it. You can promise to cut waiting lists and never deliver. In fact, hospital waiting times for elective surgery grew from 34 days to 36 days under Labor. You can promise 64 GP Super Clinics but only deliver 33. You can promise not to touch private health-insurance but then introduce $4 billion in cuts. You can do nothing about cost blow-outs. What are a few billion dollars more on the debt?

This is the world the 'New' Labor in habit. It must be a very cosy place, where you can be all-caring and promise the world. It is where you can self-righteously oppose the tough decisions that are necessary to fix the mess that you created. This is 'New' Labor: all care and no responsibility.

They do not even pretend to offer an alternative. The Leader of the Opposition stood up in his budget reply speech and offered the Australian people absolutely nothing. It was quite unprecedented in the history of this place. He offered nothing but confected outrage, scaremongering and some sympathy—much like the Labor speakers in this debate.

That is not what responsible leaders do. That is not what good government is about. Good government is about ensuring that the things we value, like universal health care under Medicare, are managed properly and are viable long term. Good government is about planning for the future and having a practical vision, like building the world's biggest medical research fund that will help deliver better health care.

If those opposite had a modicum of decency, they would stop their scaremongering on health, they would step out of their 'New Labor Fairyland' and recognise that this government is taking the responsible decisions necessary to strengthen universal health care and make sure it is available for all Australians well into the future.

Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

As Australians, we have enjoyed the envy of others around the world in relation to our healthcare system. Labor has had the courage to tackle the threats to our nation's health by listening to health professionals and formulating sound health policy. It was Labor that delivered the universal health system, Medicare. But with the announced budget cuts our system is under threat.

The Abbott government's budget includes more the $80 billion dollars of cuts to health and education. Not only that but there will be a new tax if Prime Minister Abbott gets his way. After promising before the election, 'No new taxes,' here it is: a new tax—the GP tax! A tax that is claimed will raise $3.5 billion dollars. A tax that will be imposed if you dare to get sick and have to visit your GP. A tax that will be imposed if you want to get your child immunised and stop the spread of infectious disease. A tax that will cruelly hit Australian families and will damage Australia's health system.

What do the medical profession have to say about this GP tax? They are against it. The AMA, the Australian College of Emergency Medicine, the Public Health Association of Australia, the Royal Australian College of General Practitioners, the Australian Healthcare & Hospitals Association, the Doctors' Reform Society of Australia, the Consumer Health Forum of Australia and many more health academics and economists have all advised against the GP tax, but their expert advice has fallen on the deaf ears opposite.

Why? Because the Prime Minister of Australia is so out of touch with the population that he thinks it is fair to tax people for going to see a doctor. His policy, if implemented, will see the Australian healthcare system evolve into a two-tiered, American-style health system in which you will only be able to access quality health care if you can afford it.

On this side of the chamber, we advocate and believe that all Australians—it does not matter about your bank balance—should get the health care that they need, not just the health care that they can afford. I know that in my electorate, like in many around the country, people do not want to see Australia's healthcare system begin to mirror America's health system.

It is people in my community that will be affected by this tax. Current bulk-billing rates in Wyndham are at 92 per cent. The projected impact of the GP co-payment on the bottom line for our community is $11 million per annum. That is a lot of money out of our local economy. Why is there such a high bulk-billing rate? Because the doctors locally know the value of early access to health care as an efficient way to manage health costs. They know the pensioners and young families will stay away if the co-payment is the difference between keeping food on the table or visiting the doctor.

So what are the health issues in my electorate? They are cancer, diabetes and heart disease in adults, and asthma in children. The leading new cancers for Wyndham are bowel, prostate and breast cancer; 4.8 per cent of Wyndham's population has diabetes. The National Heart Foundation data suggests high rates of heart attack, unstable angina and heart failure in the Medicare Local catchment; and the leading cause of hospitalisations for children up to eight years is asthma. Mental health disorders are the most significant broad cause of years lost to disability in the western metropolitan sub-region affecting 30.7 per cent of women and 29.3 per cent of men. Three-quarters of men in Wyndham have reported low levels of psychological distress. Seventy-five per cent is well above the Victorian average of 68.9 per cent. I want those men to see their GP and not wait.

So when these people in my community require the treatment of their GP, they will need to pay a tax under this government. When they are at their most vulnerable and require what is a most basic need of medical attention, they will have to pay a tax. And what if they cannot afford it? It is quite clear they will simply not go to their doctor. We must ensure that Australians have access to good health care. We all pay through our Medicare levy at tax time. It is a system that has served us well for 30 years. I will not sit to the side and watch this happen and I know the Australian public will not either.

Nickolas Varvaris (Barton, Liberal Party) Share this | Link to this | Hansard source

This budget has revealed that we have a government which is committed to record levels of funding for health. What this budget clearly states is that we are committed to safeguarding the sustainability of universal health care for generations to come. This is an MPI which flies in the face of that truth.

The truth about health funding is that hospital funding is increasing by over $5 billion over the next four years—$5 billion in real money, in costed and affordable increases that we will actually be able to deliver for Australians. That is not a cut to health. Budget papers clearly demonstrate there is no cut. This misleading of the truth by the opposition is affecting the public adversely. Budget facts include funding to states for hospitals to increase over nine per cent each year over the next three years and a further six per cent in year 4.

Now in my electorate of Barton, the St George Hospital services a large amount of constituents and is one of the biggest hospitals in the area. The sad truth is that until a Liberal government came into power, it had not seen any funding. This was a terrible shame for the individuals who needed the services the most. And the truth about health funding is that this government is not only funding health at record levels but is investing in a world-class Medical Research Future Fund, which will reach $20 billion of funding by 2019-20.

The Medical Research Future Fund will complement existing establishments like the St George and Sutherland Medical Research Foundation in Barton that will truly aid preventative health. These institutions are at the forefront of preventative health, something the opposition purports to safeguard but contradicts itself by objecting to these initiatives. It is very short-sighted. The truth about health funding is that you cannot claim the moral high ground on health funding when you make uncosted promises for which you know you will not be in government for when it unravels. That is real pain inflicted on unsuspecting hard-working Australians.

With regards to a modest GP co-payment, I would like to refer to the words of another honourable member by quoting the wise words of the Shadow Assistant Treasurer, the honourable Andrew Leigh, in 2003:

As economists have shown, the ideal model involves a small co-payment—not enough to put a dent in your weekly budget, but enough to make you think twice before you call the doc. And the idea is hardly radical.

Well, this government agrees with Dr Leigh: the idea of a small co-payment is hardly radical. It hardly robs a nation of universal healthcare. It would take a lot more than $7 to fulfil the radical and dishonest premise on which this MPI is founded. It would take a lot more than a small co-payment, which is a feature of equitable healthcare services all around the world in great social-democratic countries such as Austria, Belgium, France, and our neighbour New Zealand, to undermine universal healthcare.

The government further agrees with and applauds the sensible notion first put forward by the Hawke government in 1991 when a small co-payment of $3.50 was proposed with the cooperation of the National Health Strategy director, now the Member for Jagajaga. I look forward to seeing the customary respect shown by the opposition to their Labor forebears of 1991, who had the reason and the insight to look at a small co-payment as a way of safeguarding and sustaining universal health care for all Australians in this great and equitable nation. That was not an attack on Medicare then, and it is not an attack on Medicare now, but a bid to sustain our healthcare system for generations of Australians to come.

The World Health Organisation itself, a body for which Labor would have the utmost respect, I imagine, has ruled that a co-payment is not incompatible with principles of universal healthcare or the right of humanity to essential medical treatments. Those opposite know very well that not all elements of health care are free to the user. The Pharmaceutical Benefits Scheme, a concessional scheme, requires a small fee, but Labor has never claimed that the PBS is an affront to universal health care. The truth is that receiving treatments free of charge is not the substance of universal healthcare; that substance is accessibility.

Sadly, Labor is not concerned with the sustainability of Medicare or with mapping the road to surplus and security for our finances, which include our government funded services. Labor is only concerned with finding the most fear-inspiring and sensational way to frame reasonable, sensible government proposals and flinging them towards a nervous public. I reject the premise of the MPI and reiterate that health care which is accessible to all Australians is a true measure of universal health care.

Bruce Scott (Maranoa, Deputy-Speaker) Share this | Link to this | Hansard source

The discussion has concluded.