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 attacking Australia’s universal healthcare system.

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

What an unedifying display it was in question time today to see the Prime Minister of this country who has introduced the most regressive policies when it comes to health actually not understand or know the detail of his policies, of the imposition of the GP tax when it comes to diagnostic imaging. In fact, the statements that the Prime Minister said in relation to diagnostic imaging are simply untrue. It is absolutely extraordinary when it comes to one of the government's own budget measures, when it comes to health policy, that the Prime Minister through those budget measures will be making it harder for people who need to get a cancer diagnosis, adding hundreds and thousands of dollars of up-front costs for people having to access diagnostic imaging for their cancer diagnosis—hundreds of dollars out of pocket.

We were not making figures up or plucking them from the air; these were figures that have come from the Australian Diagnostic Imaging Association. The impact of the government's budget when it comes to diagnostic imaging is more than $7. The government has not been telling the truth to the Australian public about its $7 GP tax when it comes to diagnostic imaging. That is because it is not just a $7 GP tax that represents a $5 rebate reduction per item, not per time, that you have to represent for diagnostic imaging. It may be a number of MBS items are actually charged during that time. So it is a $5 rebate reduction per item according to the advice of the Department of Health to the Australian Diagnostic Imaging Association. It is also the abolition of the 10 per cent cut in rebates for general patients who were previously bulk-billed due to the abolition of the bulk-billing incentive.

The Prime Minister sought in question time to say, 'Oh, there's a low gap incentive that will cover that.' That is simply not true. The low gap incentive does not apply to anybody who is a general patient. So if you are general patient, not a concession card holder, and you currently go to diagnostic imaging and you do not have a lot of money, and the radiographer decides that you should be bulk-billed for that cancer diagnosis, something that is very expensive to undertake, then what happens is that you will have to pay up-front for a start and you will have to pay the additional cost that now will be borne by the radiographer because the government has got rid of the 10 per cent bulk-billing incentive.

The other thing that they have done is that they have abolished the general permissible gap which moderates the cost of high cost items from 1 January 2016. The figures are, frankly, pretty disturbing. For those high-end scans when you are talking about PET scans in particular, that can potentially be $1,000. That is $1,000 that you will have to pay up-front in order to get your PET scan. This is how absolutely appalling these measures are that this government has introduced. It is not telling the Australian public the truth about the impact of its decision to apply—I call it a GP tax because it is about raising revenue off the back of sick people; that is exactly what it is—what its co-payment, as it calls it, actually means for diagnostic imaging. It is a very serious issue. We already know that people often leave their scans, their access to be able to get their cancers diagnosed, too late in some circumstances. We know that many people—we want to be optimistic about our health—put off finding out what is wrong with them and that often means that they leave their scans too late for a cancer diagnosis. We do not want that to happen in this country. We do not want barriers to be put in place for people accessing the diagnostic imaging that they need in order to have a diagnosis of cancer; we want people to do that early because they know they have a higher chance of survival. So what this government is doing with its measure, frankly, is making it less likely that people will be able to access diagnostic imaging, make it even more expensive up-front for people to get that diagnosis and will leave them potentially hundreds of dollars out of pocket.

I comes, of course, in the overall attack that this government has had on our universal health insurance scheme. We celebrated yesterday the life of Gough Whitlam and we on this side of the House that 40 years ago, when Medibank was introduced in a historic joint sitting of parliament to get it through, that this mob on the other side fought it tooth and nail—not only fought it tooth and nail but at the first opportunity they had they got rid of it. It took to get in the Hawke and Keating governments to introduce our universal health insurance scheme that is Medicare, the scheme that has served this country well, with some of the best health outcomes in the developed world. It is a scheme that we all support.

What we saw at the time was the Liberal-National Party saying that they would work with every breath in their body to try and kill off Medicare. We know that has been their agenda. What we have seen with this first Abbott government budget is an appalling attack on our universal health care system; a $7 GP tax for every time you go to see a GP, putting a barrier in the way of that critical primary-care part of our system where we want people to go to stay well, to access prevention—making it harder for people to access in fact what is the most efficient and cheapest part of our health care system that is at the centre of Medicare.

But it is not only a tax when you go to the GP; it is an X-ray tax, a pathology tax, an MRI tax, a tax on PET scans, a tax on CAT scans—a tax every time you need to access a diagnosis for cancer. Or if your kid falls off the monkey bars, in a circumstance I am very familiar with, and breaks their arm. It is a tax on all of those services. It is also more than $50 billion worth of cuts to the public hospital system, which has serious implications for health and hospital reform over the next decade. There were historic agreements that were reached with states and territories to reform our public hospital system and make it better: make it more efficient to get access to emergency departments and to elective surgery—to actually get the states and territories to agree on an efficient price for funding activity in hospitals, driving really important health reform.

The new Abbott government has decided that it does not want to be in the business of public hospitals. It actually thinks that the states should do it. It wants to withdraw and go back behind the barriers to say, 'We don't want to participate in actually reforming our public hospital system.' I know many people in the community want the Commonwealth to be in the business of reforming our hospital system and should be in the business of making sure people have access to decent emergency department waiting times and elective surgery waiting times.

We have also seen the $1.3 billion cut to pharmaceuticals, a bill that is sitting before the Senate at the moment. It is $1.3 billion, changing in a very sneaky measure the safety net, making it harder and harder for concession card patients to actually meet that safety net, and making the cost of medicines unaffordable in this country. There is also the $368 billion for the national partnership agreements on prevention, funding states that were relying on this from this financial year to tackle obesity, smoking rates and alcohol abuse—activities happening in communities right the way across the country: in our workplaces, in our schools and throughout our community organisations.

But there has also been more than $600 million cut from our public dental programs, including $200 million this financial year alone—walking away from the national partnership agreements for adult public dental services. There has been a cut of $197 million from what we call the health flexible funds, which have been going largely to not-for-profit organisations—things like the Heart Foundation, the Cancer Council and AIDS councils—to run their activities. This is really important work to improve our health system in communities across this country.

This is what the Abbott government's first budget means for health, and it is an unprecedented attack on our universal health insurance scheme. We know that if it was not for Gough Whitlam introducing Medibank 40 years ago we would not have Medicare today. We know that if the Liberal-National parties had their way, then Medicare would never have existed and they want to kill it off today. From the measures they have introduced into this budget, it is obvious that they are attempting to destroy Medicare by stealth and we absolutely on this side of the House stand and condemn them. Medicare is not your plaything. Keep your hands off Medicare; keep our public health insurance scheme! Learn the lessons of your own history. The Australian public will not stand for it!

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

I welcome the opportunity to contribute to this debate and I thank colleagues who are very interested in an important debate. I want to correct a lot of what the shadow minister had to say, and I want to inject some facts, strangely enough, into this debate. Much of what we heard from the previous speaker, the member for Ballarat, is Labor rhetoric and part of a scare campaign, and we saw the opposition misleading the public again in question time today.

It is worth having a sober look at the actual statistics and what the figures provide for in this budget, in black and white. The total expenditure goes up each and every year in this budget. The money we are spending on health and in hospitals goes up each year. The reality for this budget, quite opposite to that which was proposed by the member for Ballarat, is that we put more money into Medicare again this year. In fact, we will put about $19½ billion into Medicare this year. That has gone up by 42 per cent over the past five years. But if we do not take some action over the next 10 years, Medicare will go up by an amount that will mean we will spend $34 billion a year—so $20 billion this year, growing to $34 billion in 10 years' time. If Labor believe that is sustainable, then they should put that on the record. Certainly state Labor health ministers do not believe it is sustainable. Certainly it is the case that the two independent reports commissioned by both the Rudd and Gillard governments advised Labor that spending on health at its current rate each year was unsustainable.

And so what have we done in this budget? What we have said in relation to hospitals is that we will increase funding to hospitals by nine per cent this year, by nine per cent next year, by nine per cent the year after that and by 6½ per cent in year 4. Labor want to betray the 2½ per cent reduction from nine down to 6½ per cent growth as a cut, which is quite tricky, and politically the member for Ballarat may well get away with that. No doubt people listening to this debate today will think, 'On the member for Ballarat's contribution, the government's cutting funding to hospitals.' But we are increasing it by nine per cent each year over the next three years, and we have put it at 6½ per cent in year 4—6½ per cent when our economy is growing at five per cent, which I think is quite reasonable. It is a lot more than what is happening in some other developed nations around the world, including in New Zealand for example, and I believe that that is putting it on a sustainable path.

That is at the same time as the government is trying to pay down Labor's debt. We are borrowing money each and every month to pay down just the interest bill, let alone the capital of the debt that Labor ran up. Bear in mind that they were only in government for six years, but ran up debt approaching $667 billion. And anybody in the gallery today, listening to this broadcast at home, those who do their own household budgets know you can only spend more money than you earn each year for so long. You cannot continue to spend more than you earn; you can until you run out of savings, until the bank takes the house, but then the whole operation closes down. So, yes, we are trying to pay down Labor's debt and yet still increase spending each year, but by a more sustainable path. I think that is perfectly sustainable; I think that is perfectly reasonable.

The honourable member opposite, the member for Ballarat, talked about the introduction of Medibank and Medicare. It is quite interesting to reflect on some of the comments that were made by Labor when Labor was a strong party. The Bill Shorten of today is no Gough Whitlam of yesterday. That is the reality. The Leader of the Opposition is not a patch on former Labor leaders, including Gough Whitlam and Bob Hawke. I will tell you what Gough Whitlam had to say in relation to Medibank. I think it is very instructive. It was one of the guiding principles of Labor during the fifties, sixties and seventies. Gough Whitlam had this to say:

The government is determined … to give all Australians access to high quality health care at reasonable cost.

'At reasonable cost'. He never claimed that you could give everything to everybody for free, which is what this Labor opposition is pretending. Four out of five presentations to doctors today are for free; 80 per cent of those presentations are free. Now the taxpayer works hard and pays taxes so that we can provide those services for free to four out of five people.

Ms Anna Burke (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

What is the Medicare levy then?

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

The Medicare levy? 'The Medicare levy' comes from the former Speaker in this place. It was not even good enough to be put up by her good friend Julia Gillard, the former Prime Minister. Let me correct that: the former Speaker, the member for Chisholm, says that somehow the Medicare levy should cover what we spend on Medicare. Let me give her a basic lesson in economics: we raise with the Medicare levy about half of that we spend on Medicare each year. The problem is—the basic economic facts escape Labor—that the growth rate of Medicare is much greater than that which we collect on the Medicare levy, so over time Medicare becomes even more unsustainable. The basics need to be understood by the Labor Party opposite before they can make a proper contribution to this debate. Gough Whitlam got it right when he said that health care needed to be 'at reasonable cost'. He did not propose that 80 per cent of services, when you go to the doctor, should be for free.

So what have we said in relation to this budget?

Much the same as what Bob Hawke said: 'It's very difficult to suggest a co-payment … is going to create great hardship.' What did Bob Hawke suggest? Bob Hawke suggested and implemented a co-payment of $3.50 which incidentally, had it been indexed—

Ms Butler interjecting—

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

The member for Griffith is not in her seat and not entitled to interject.

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

over the course of the last years, would be about $6.40 today. What is the government proposing today? A co-payment of $7. But, importantly, we are retaining bulk-billing not for four out of five services but for those people who cannot afford a co-payment themselves. That retains the principle of universality, which is what this matter of public importance is supposed to be about; it was mentioned only once during the course of the shadow minister's contribution. But universality means that you can provide support to those to those who cannot afford health-care costs themselves. We do that. It is central to the principle of the plan we have on the table. We say people who have the ability to pay $7 should pay it so that we can keep Medicare sustainable. If you want to adopt Labor's proposal that everything is free for everyone, and we continue to rack up debt on the credit card, it will fall over.

Australians are not stupid. They saw through the Rudd and Gillard governments and they see through Bill Shorten and his opposition as well. At the next election we will look the Australian public in the eye and say that yes, we have had to take tough decisions during the course of the first 12 months of this government, and no doubt over the course of the next two years, to rectify some of the waste and deficit that Labor racked up; but at the same time we have sustained a Medicare system which will serve us for decades to come. I do not have any problem at all saying that to the Australian public. But at the next election the Leader of the Opposition and the Labor Party will have to say to the Australian public that they are not prepared to make changes which will make Medicare sustainable. If we want to have that debate I am more than happy to have it.

If we had abolished bulk-billing altogether I would think the member for Ballarat might have a leg to stand on. If the member for Ballarat could stand up here and say, 'You have wiped out the ability to provide for those who are in most need', then she would have a fair debating point. But that is not what is on the table. The government has said we will take care of those who are most needy.

Where Labor's greatest hypocrisy lies in this particular debate is around pharmaceuticals. Labor says it is completely unreasonable to ask people who can pay a simple a co-payment to pay it. But at the same time it was Labor that introduced a co-payment in the pharmaceutical system for those on concession cards. You would not know it from the contributions of those opposite. When the sickest, poorest Australian needs to fill a prescription at the pharmacist does Labor say that they can bulk-bill and have that prescription for free? No, they do not. They say to that person, 'You will pay $6.10 for the first script and every subsequent script, and the safety net does not cut in until you reach about 60 scripts.' So an equivalent co-payment in the medicine system is $360. Labor presided over that system all the way through the Hawke years, the Keating years and the Gillard years—or the Rudd-Gillard-Rudd trifecta disaster for this country. They sat on that policy and they charged the sickest and poorest; yet they come in here and suggest that a $7 co-payment to keep Medicare sustainable, while still protecting those who cannot afford the $7, is somehow unreasonable. They are completely wrong on this topic.

Do you know what else they do in the states? If you go around state-by-state, the Labor party charges co-payments in relation to dental and other emergency services. We will highlight that as the weeks and months go along. The Labor Party will have to explain at the next election why it stands for a Medicare which is unsustainable.

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

The honourable minister said he wanted to inject a few facts into the debate. Here are a few facts the minister got wrong.

The first is that Medicare is not free. We pay for it. We pay for it through our Medicare levy. That includes those people who are concession card holders. I know the minister tries to deny the fact that concession card holders are also paying, but one of the facts he might like to go and find out for himself is how many of those concession card holders are also taking up private health insurance. They are being whacked twice by this GP tax, a fact the minister does not like to admit.

He also gets his facts wrong on the Pharmaceutical Benefits Scheme. He tries to convince people that it was the Labor government that introduced a co-payment for the PBS. I have news for the minister: there was this bloke called Menzies. The minister may not know our history very well but you would expect a Liberal Party minister to understand their own history a bit better than he does. It was Menzies who first introduced the co-payment into the PBS system. It was 1960 and it was a charge of five shillings.

Yesterday the House, and indeed the nation, mourned the passing of a great Australian. Today we on this side of the House recommit ourselves to his vision for a better Australia—a better Australia that includes universal access to health care. As Gough Whitlam stood on the steps of Parliament House some 39 years ago, he issued a solemn injunction to all fair-thinking Australians. He said to us, 'Maintain your rage.' Maintain your rage against all of those who seek to make Australia a place that is smaller than it is today—a place that is less equitable than it is today. There is much that we remain angry about. That sacred duty to maintain the rage now falls to each and every Labor member of parliament, because just as Labor was the party that introduced Medibank and Medicare, we are the last line of defence for those who would seek to destroy them.

Amidst the confusion, the chaos, the ineptitude, the false communication and the rotten handling of this terrible budget, we can define a consistent line of thought that joins this Prime Minister, this health minister and the policies of this rotten government to those Liberal elitists who sought to destroy Medibank 40 years ago—who sought to stop Medibank ever being introduced and then over the next four years pulled it apart, brick by brick. It was Billy Snedden who said in the debates during the historic joint sitting of parliament to introduce the Medibank legislation:

We will fight and we will continue to fight. We will destroy it.

Of all the promises that this government seeks to keep and all the faith that they tried to keep between 1974 and today, it is the promise to destroy Medicare brick by brick—and that is exactly what they are attempting to do. They are trying to destroy Medicare, just as they tried to stop it happening in 1974 and again in 1984.

I want to talk about the regions. When we contemplate the impact that these atrocious policies are going to have on regional Australia we are left wondering what it is that binds the MPs on the other side of the House to these mad policies. Let's contemplate the facts—as the member for Ballarat has done today—of the cost of diagnostic imaging for people living in regional Australia. It is $90 up front for an X-ray, $380 for a CAT scan and $160 for a mammogram. A PET scan could cost over $1,000 for people who are living in some of the poorest communities in the country. You have got to ask yourself why the people who pretend to represent those communities in regional Australia are binding themselves to these mad policies. If they were such good members as they pretend to be, they would be standing here today arguing against those policies and they would be crossing the floor when the legislation comes before the House because that is the right thing to do. (Time expired)

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

Those on the other side have an affliction with free stuff. I know that 30 years ago there was a leader of this country who wanted free health care. But do you know what? Not just Australia but the entire world has moved on. It was interesting for me in 1997 when I got my chance to meet the great man himself, Gough Whitlam. And, no, it was not out in Western Sydney, it was not in a public hospital. It was in Australia's finest private hospital, and he certainly had no problem with the fine system we have of public and private hospital provision. Let's be honest, we have a system where there is choice. I have no problem with both sides of this chamber exercising choice. But do not for one minute be so misguided as to think that the Medicare levy pays for Medicare. We have had two Labor spokespeople now say that the $10 million that we collect from the 1.5 per cent actually pays for Medicare. I suspect that I am now going to hear that a Labor government would be prepared to rule out, or otherwise, an increase to the Medicare levy to pay for Medicare—that's right, double it!

The Medicare levy costs us all around $500 a year, if you are earning about one hundred grand a year, and an extra $500 for every $10,000 that you earn on top of that. That can add up over time—$50 for every $10,000 above that. That is what those higher income earners pay into the system. But that only pays for half of the cost of Medicare, which has gone from $9 billion to $18 billion over the last 10 years and will go up to $34 billion over the next 10 years. It is a challenge to bend the cost curve. Every economy in the world is working on bending that cost curve. But the poor unfortunate Labor Party is riveted, welded and stapled to this notion of free health care because their great leader said so in 1975. They are stuck with that notion. They are unable to review it and unable to reconstruct their thinking because it is all about the free stuff. Let's keep in mind that throughout the known world, and particularly here in a developed system like Australia's, people without financial means are bulk-billed and will continue to be. It will never be compulsory to charge a co-payment. That co-payment is still less than a Macca's meal deal—a quarter pounder mid-sized meal deal. The smartest, most talented and hardworking professionals in this community are worth $7 to spend some time with to look after your health. They are worthy of that payment. Do not take it from the doctors or the health planners on this side; talk to the doctors on your side.

Opposition Members:

Opposition members interjecting—

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

What? There are no doctors on the opposite side? Where are the doctors on that side? They are not including you over there, Dr Gillespie. Give me Dr Leigh over there, one of the finest minds who under any other system of merit would be opposition Treasurer by now—but not in the Labor Party. That fine Dr Leigh said that we need a moderate co-payment:

… not enough to put a dent in your weekly budget, but enough to make you think twice before you call the doc.

Perfectly said, Dr Leigh. Come and join the doctors over here and let's have a world-class health system.

Now let's be honest, bulk-billing is still absolutely endemic—

Dr Leigh interjecting—

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

The member for Fraser is interjecting outside of his place in this chamber. It is very disorderly to interject outside of your place in this chamber.

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

in diagnostic radiology and pathology. As long as those requests are on the same form in pathology, there is only the one co-payment charged. Two-thirds of all items under Medicare when you see a doctor are exempted from the co-payment. Any of the chronic disease items are co-payment exempt.

But let's go back to that Labor world. That was where they used to promise you the free stuff in the form of a super clinic—except they only built 33 of the 66 of them planned. And what were those buildings doing? Long before they could even find a GP to steal from the neighbouring general practice—because that is what they did—they turned all the lights on. That's right, in the member for Petrie's area there was no working super clinic; they just turned the lights on with a big cross outside! They delivered a super clinic, but what was undelivered was staff in it actually doing some work! Of course, we have the PBS co-payment. Right now, Australians pay around $6 to fill a script. But this lot will not pay the same amount to go and see the highest trade professionals in the health system. Who were the architects of the pharmaceutical co-payment? Labor. Who tried to dull the pharmaceutical co-payment without success? Labor. How much does it add up to over time over time? Sixty scripts at $6 adds up over a while, doesn't it? But oh no, we cannot have a $70 maximum capped out co-payment to see a doctor. The argument is so thin. The argument is riven with holes, like Swiss cheese.

Let's move to private health insurance. That's right, you are quite prepared to nickel and dime average Australians by making health insurance more expensive. Out go the ancillaries and home come the allied health professionals from the regional areas because there is no work anymore. How much does it cost a patient to insure the continuity of their health care? This is a Labor government welded to the past, welded to the ideas of Whitlam and not keeping up with the future of a sustainable Medicare.

Terri Butler (Griffith, Australian Labor Party) Share this | Link to this | Hansard source

The government are attacking the universality of health care in this country and they are doing it because it is in their DNA to attack the universality of health care in this country. Under Gough Whitlam, who passed away yesterday, Labor introduced universal health care after many years of policy development and broad consultation with people. I will tell you what Gough Whitlam said because there have been some unfortunates on the other side verballing him today. I will explain it in Gough's own words. He said in 1969:

We propose a universal health scheme, based on the needs and means of families.

That is what he said in 1969. In 1973 he said:

It is only our insurance program—because it is based on the payment of a percentage of taxable income—which can overcome this problem—

that is, the expensiveness of health care in Australia. He continued:

It is only our insurance program which will ensure that a low income earner will pay less than a middle income earner and that a middle income earner will pay less than a wealthy man. Australia will not have a just and equitable health insurance system until that principle is enshrined in its laws.

For all those people over there claiming that somehow health care is currently free and that people should pay for their health care, as previous speakers have said, people already make a payment for their health care. I can tell you that you do not need a price signal to value GPs. You do not need a price signal to value the medical assistance and advice that you get from a GP. You absolutely do not. It is an absolute fallacy.

At the end of the submission to the Commission of Audit that advocated for the co-payment—and we all remember the Commission of Audit—the author said, 'By the way, we should actually find out whether there is a problem of people going to the doctor when they do not need to.' Oh, do you think? Do you think you should find that out before you start putting in disincentives for sick people to get primary health care that might keep them out of hospital, keep them safe, keep them well and give them the opportunity for early treatment, because we all know that early treatment is the key?

Everyone on this side of the House understands those principles of universality. The minister claimed that universality was about low-income earners being able to get health care. Universality is about having a great health system for everyone, no matter how rich or how poor they are. It is not about a two-tiered health system where there is some safety net for poor people and rich people get great health treatment somewhere else. It is about universal access to health care so it is whether you are sick that determines the health care you get not the size of your wallet and income. That is what universality means.

What is this government doing? This is in the great tradition of Liberals and Nationals past, who opposed the introduction of Medibank in the 1970s, who opposed the introduction of Medicare in the 1980s and who, under John Howard, attacked bulk-billing. I remember fighting a 'Save Medicare' campaign back then too. They cannot help themselves—they always want to lay into Medicare because they do not support it. They are just getting sneakier. John Howard learnt that you cannot openly attack Medicare in this country. He learnt that the hard way, so they have to get sneakier. Let us not let them get away with it. Let us talk about what the Prime Minister's budget is actually doing to health care in this country.

Tony Abbott, the Prime Minister, came to power promising that there would be no new taxes and no cuts to health. I remember in my by-election the Prime Minister coming to Brisbane and telling the voters in Griffith that there were no plans for a GP tax when his own Commission of Audit already had a submission, when his own candidate in Griffith had already welcomed the idea and when he knew full well—or he ought to have—that there was a very real prospect of a GP tax in the budget. And what did we get? We got a GP tax in the budget. We got a GP tax that will slug you every time you go to the doctor or get an x-ray or a blood test.

According to the Australian Diagnostic Imaging Association, we have also got the situation where general patients will have to pay upfront a minimum of $90 for an x-ray, $380 for a CAT scan, $160 for a mammogram—and what do the Liberals and Nationals have against mammograms?—and $190 for an ultrasound. For a PET scan the upfront costs could hit $1,000. For a typical patient with thyroid cancer the upfront charges for the scans and tests would come to around $1,000. A woman with a lump in her breast would need to spend at least $280 upfront to have her cancer diagnosed. A person with lung cancer will have a minimum upfront payment of $320. Shame. (Time expired)

Angus Taylor (Hume, Liberal Party) Share this | Link to this | Hansard source

As we pay our respects to Gough the legend, we look mournfully at those opposite. If only there were something—anything—of 'legend' about the current Labor offering and if only there were a glimmer of hope, we might be content. But, no. The former Labor government had absolutely no comprehension of how to manage money or how to provide services on a sustainable basis. Indeed, I do not think many of them on that side can even add up, excluding the member for Fraser, who has done some excellent work on the health system. They rack up debt every time they get into government and then it is our job to come in and clean up the mess.

This government will not stand by and watch Medicare collapse under its own weight. So let us look at some facts. Unfortunately in the speeches from the last couple of speakers from that side we did not see many of these facts. Let us look at the sustainability of the healthcare system under Labor. When we came into government, as they have already pointed out, the Commission of Audit pointed out the areas where we are spending most of our money. They turn out to be welfare and health. The two biggest numbers, which constitute about 40 per cent of our budget, are for welfare and health.

Here is where it gets hard. They are growing at a much faster rate than the economy. They are growing at about eight or nine per cent a year—almost 10 per cent per year—but the economy is growing at 4.5 per cent or five per cent in a good year. So if you keep going and wait long enough, the whole economy will be health and welfare. It is simple mathematics. There will be nothing else left. That happens surprisingly quickly. Indeed, on these growth rates, out of control health spending will reach almost a quarter of the economy within 20 years. The member for Fraser is looking over here saying: 'Yes, I have done those numbers. They are right.' That means that almost one out of every four dollars would be spent on health. Who is going to pay for that?

The biggest numbers for the government are in Medicare. So let us put this in perspective. The total cost of the health system, federal and state, is about $140 billion. The Medicare levy we pay in our taxes is about $10 billion out of that $140 billion. Very little is paid for by the Medicare levy. We know that and we heard that from previous speakers. People know that over the last five or six years the Medicare expense in this country has gone up by 42 per cent.

The biggest increases are coming from chronic disease funding. If you take the MBS item numbers that cover chronic disease, they are rising at 25 per cent a year. In 2007, the beginning of the Labor government, those costs were $200 million. In 2014, those costs will be just over $1 billion—five times greater in only seven years. It does not matter how you look at it; that is not sustainable. It will not be a universal health system for the next generation if we do not deal with this now.

Of course, those opposite mistake 'universal' for 'free'. 'Universal' does not equal 'free'. So let's look at how free the healthcare system was under the previous Labor government. It turns out that during the time that Labor was in power, health care required large direct payments from individuals throughout the system. And I will give you some numbers here. Under the PBS, 17 per cent of the costs were paid for by individuals; other health practitioners, 55 per cent. These numbers are from the Australian Institute of Health and Welfare. Dental was 67 per cent; aids and other appliances, 74 per cent; and non-PBS medications, 97 per cent. So in total almost 40 per cent of the costs across all of those various items were paid for by the individual. The health system is not free, and those opposite know it, they just want to pretend otherwise.

We know that the co-payment is reasonable. We are asking for a $7 contribution. We know that in New Zealand it is $17.50. And New Zealand has a much lauded health system—in fact, those opposite have often praised the New Zealand health system. We are not saying that it should be $16, as it is in some parts of Europe. We are saying that $7 is a reasonable payment for Australians to make.

Our country is paying $1 billion a year in interest. We are on our way to $3 billion. One group in this place says: 'If we've got a spending problem, just up the taxes.' We say: we want a sustainable health system, and the way to do that is to ensure that those who can pay do so.

Ms Anna Burke (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

I really do feel like it is groundhog day. One of the things I campaigned on in my first election campaign before I came into this place was to save Medicare. If you look at my Facebook page, you will see me with Gough Whitlam, and a balloon that reads 'Save Medicare'—to save our universal health system.

Unlike those opposite, we do not equate 'universal' with 'free'. We understand that universality is about access for all. If you want to go and look at numbers, maybe you should read what has just been announced in Senate estimates today; senior Treasury officials say the $7 co-payment will not help the healthcare system, as those opposite have been crying out. Here we are again—16 years later—and yet another Liberal government is doing everything it can to destroy universal healthcare in this country.

Gough Whitlam and the Labor Party established universal healthcare in 1974. In the face of Liberal Party intransigence, it took a double-dissolution election and a joint sitting to establish—and thank goodness it did—what has become one of the greatest assets this country has ever had: universal access, Medicare. Yet, ever since the establishment of Medicare, the Liberal Party has done nothing but try to destroy it. Whenever there is a Liberal government, universal healthcare is at risk, and never more so than under this despicable Liberal government.

It is notable that, when responding to the passing of Gough Whitlam, the Abbott government's loudest cheerleader, the ever mean-spirited, Alan Jones, said:

The Abbott government is even today dealing with the costly consequences and culture of entitlement bequeathed by Whitlam's decisions to give free universal medical care and university education.

The central policy unit of the LNP, the Institute of Public Affairs, yesterday described the establishment of universal healthcare simply as 'regrettable'. That is the thing those opposite do not want to say: this is about the beginning of the end—the destruction of Medicare, the destruction of universality—despite the fact that maintaining universal access to affordable healthcare has been a linchpin in our society's ability to remain healthy and prosperous.

You do not need to just take our word for it; study after study after study demonstrates that Australia's healthcare system is one of the best, one of the most affordable, because of our access to primary healthcare. Prevention is better than cure. Prevention upfront, ensuring people get to the doctor in time; have a mammogram in time; do not leave it until it is too late. Then it is genuinely too costly not just to the individual but to our whole society. As sickening as these comments from these unelected representatives of the Liberal party are, they represent the ugly truth of the Abbott government's attitude towards the very notion of universal health care. Their policies prove their intent to try and kill it, once and for all.

We have not even managed to bury Gough and he is turning in his grave—he has not even got there yet—because of what this government is trying to do: a $7 tax on visiting the doctor, a $5 hike in the price of medicine; more than $50 billion cut from hospitals; and more than $4 million cut from dental programs. These measures spell the death of universal health care; just what the Abbott government is planning and hoping for.

The GP tax of course will apply to far more than just visiting the doctor. And the Abbott government's 10 to 15 per cent cut in the rebate paid to radiologists will dramatically increase the out-of-pocket cost for people needing scans. In fact, as we heard in question time today, the Australian Diagnostic Imaging Association has said that we will have to pay a minimum of $90 upfront for an X-ray.

My son managed to destroy his thumb before grand final day, ending up in hospital—missing out on seeing his Swans beaten, which was probably a saving grace. We would have been up for $90; we would have been up for more for the plastic surgeon we had to see that day.

In my electorate there is a great organisation called Knitted Knockers, who are out there knitting prostheses to give away to women who have suffered breast cancer and had mastectomies. They are appalled that there will not be help upfront. Women will be prevented from going to a doctor. This government stands condemned.

Natasha Griggs (Solomon, Country Liberal Party) Share this | Link to this | Hansard source

It gives me great pleasure today to speak against the member for Ballarat's outrageous matter of public importance. The member for Ballarat's statement could not be further from the truth. In fact, it is the Abbott government who are actually protecting Australia's healthcare system by ensuring that it will still be functioning when the next generation want to use it. I want to make sure that our healthcare system is still around when my granddaughter Evie is an adult and might need it. That is what we are doing over on this side of the House.

The coalition's budget measures for health are all about building a strong health system. We are laying the foundations for a stable system that can absorb the pressures caused by an ageing population, by chronic disease and by higher costs. Medicare, the PBS and public hospitals have really been feeling intense pressure from these factors, and the coalition government is supporting these agencies by working with them to create strong plans for a sustainable future in health care. Expenditure on these has grown faster than the economy. We are focused on delivering a stronger, more stable health system for the future, and only the coalition government can deliver this system.

In my electorate of Solomon, I was able to secure—along with the health minister—$110 million to build a brand-new hospital to cater for the growth of health service needs in Palmerston and Darwin. My good friend, the Northern Territory health minister, Robyn Lambley, and her team are doing a fantastic job, delivering on this project. They are taking the time to make sure that we get it right and to spend the money wisely, because we all know that health money is very precious. We want to make sure that we have a hospital that is being built to cater for the needs of the Darwin and Palmerston residents of the next 50 years.

This is how the people of Darwin and Palmerston know that the coalition is taking health care seriously. People in my electorate know that the adults are now in charge of something as precious as our public healthcare system.

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

It's the juveniles!

Natasha Griggs (Solomon, Country Liberal Party) Share this | Link to this | Hansard source

The member for Moreton just needs to button his lips!

Labor's blatant waste of taxpayer dollars in our healthcare system is absolutely outrageous. Let's put the facts on the table. They spent $463,000 to do a study on a fat tax—on junk food—when they had already ruled it out. They spent $236,000 on an informative Facebook page that actually gained a whopping 244 likes. I cannot do the figures but I think that is a very excessive amount of money for 244 likes. They also spent $650 million on the infamous GP superclinics, and we heard earlier that of the 66 promised clinics only 33 were delivered.

The previous Labor government were more interested in putting bureaucrats in front of paper than in putting the nurses and doctors in front of the patients. Instead of delivering on healthcare promises they stood around and talked about it. The Labor government, as we know, is big on promises and very bad on delivering them. This government, however, is it committed to ensuring that our precious health dollars are spent in the most efficient way possible, ensuring that every dollar is directed towards improving patient outcomes. We are ending the wasteful and inefficient spending in the health portfolio that occurred under Labor.

Mostly we hear of the opposition's objections to our plans for health care. We very rarely hear of any plans that they come up with to improve health care. We heard from the member for Lingiari; he was whingeing and moaning about the co-payment but, in actual fact, he voted for one. So Labor has left the coffers dry. We want to make sure that the money that is there can be spent—

Ms Burke interjecting—

Mr Stephen Jones interjecting—

Mr Deputy Speaker, they should be told to stop interjecting!

But anyway: Labor does not have a plan. All it does is want to spend, spend, spend and whinge, whinge, whinge. We all know that Labor cannot be trusted with money, we know they cannot be trusted with credit cards and we know they cannot be trusted with getting this country on track. That is why we are here. We have to clean up their mess time after time. We are doing it again and this rubbish about Medicare is just, as I said—rubbish. Medicare is not under threat—only from those opposite!

Maria Vamvakinou (Calwell, Australian Labor Party) Share this | Link to this | Hansard source

It may have been a good idea for the member for Solomon to have made some references to the needs of the Indigenous community that she represents in this place.

I would like to start by saying that one of the iconic reforms of the Whitlam government was the establishment of Medibank, a universal healthcare system that provides access to best-quality health care and medical services to all Australians, regardless of their socioeconomic status. Universal healthcare cover has since become the Australian way of life, a system of health care that is highly valued by our community because no-one in this country has ever had to worry about forgoing medical attention. Nor have they had to worry about becoming ill or dying because they cannot afford to go to the doctor. In fact, Australians, and in particular my constituents, have never had to be concerned about the size of their cheque books or wallets when it comes to health care.

That is why this MPI is very important, because it puts this government on notice that the opposition, together with the Australian people, will fight hard and will fight long to protect our universal healthcare system because we all believe that access to health care for all is a right and not a privilege.

Perhaps this government has not learnt from the Howard government's attempts to tamper with Medicare and bulk-billing in the past. Or perhaps they have learnt, as the member for Griffin said earlier on, that if you want to attack Australia's universal healthcare system you do not let the public know in advance. That is why they deceived the public in the lead-up to the last election by promising no cuts and no new taxes. My constituents are livid at the broken promises and are prepared to fight this government's attempts to change the universality of our healthcare system.

In the time that I have been the member for Calwell, the availability of bulk-billing and after-hours GP services, which are a lifeline for the health and wellbeing of my community, have always been a priority. The proposed $7 GP tax, the $5 hike in medicines, the $50-billion cut from the public hospitals, the $400-million cut from the dental programs and the shutting down of 61 Medicare Locals is going to have far reaching ramifications in my electorate. I am concerned about this because I have a very large multicultural community, an ageing community and the general socio-economic status of my electorate is such that any additional cost will be a financial burden to the point where my constituents will be forced to make choices about going to the doctor—choices they have never had to make before.

So when the Australian Diagnostic Imaging Association reports that the effects of scrapping the bulk-billing incentives on diagnostics will mean that patients will have to pay a minimum of $90 for an X-ray or $380 for a CAT scan or $190 for an ultrasound or a person with lung cancer will have a minimum upfront payment of $320, my community and I become very alarmed. I have an electorate where, statistically, people are more likely to become ill than those in wealthier electorates. We cannot afford a situation where people cannot afford to go to the doctor.

I am particularly concerned about the impact of the GP tax on mammograms. Women in my electorate face paying a minimum of $160 for a mammogram, and especially alarming is the prospect that a woman with a lump in her breast will have to spend at least $280 upfront to have her cancer diagnosed. I spend a lot of time advancing awareness about breast cancer in this place and I know how important preventative measures are because early detection is critical to survival rates. I not only know how important it is for a woman to have a mammogram but I also know how difficult it is for many women, especially those from non-English speaking backgrounds, to make that decision. We work hard to encourage those women, but I can tell you that the burden of cost will be a deterrent. One in nine women get breast cancer. When a woman gets breast cancer, a family and a community is affected. Increasing the costs of visits to GPs will be a deterrent and that is just not acceptable.

For those of us on this side of the chamber and for the Australian public at large, Australia's universal health care system is to be treasured and maintained; it is not to be undermined.

David Gillespie (Lyne, National Party) Share this | Link to this | Hansard source

How often do we see hypocrisy, hype and scaremongering in this House? Who was it that actually developed and delivered the Chronic Disease Dental Scheme? It was the coalition. It was the first vehicle for providing widespread dental care to a million people. Who got rid of it? The ALP. Who tried to make Medicare more sustainable by encouraging private insurance? The coalition did. Who attacked it? Labor did. All this hypocrisy is too much to bear. Who introduced the co-payment for the Pharmaceutical Benefits Scheme? It was Labor. Yet when we try to make something sustainable that is going to last for decades to come, they criticise it. They have no credibility at all. Just look at the money they wasted on super clinics—trophy buildings that pinch doctors from other medical centres. They have not really delivered much at all when you analyse what they are criticising.

As that famous woman who ran Britain for more than a decade said: pennies do not fall from heaven; they have to be earned here on earth. The same applies to the health budget. Governments do not create money. They are given it by taxpayers and they hold it in trust to be used wisely and efficiently. Primary industries, secondary industries, service industries and people that create wealth then pay a portion of it to the government. But we have this school of magic-pudding economics where the government pays for everything that just rears its ugly pudding head again and again.

Labor have a PhD in economics in the member for Fraser, a doctor. I think he needs to tend to the sick health economics being applied. The health budget is in terminal decline and maybe not even the good doctor could cure the health economic ills. The opposition does not seem to realise that it is not the universality that is being threatened; it is the long-term sustainability. Bulk-billing occurred 237 million times last year. Four out of every five visits to GPs were bulk-billed. That is $12.8 billion, a huge increase. There has been a 45 per cent increase in five years or 122 per cent in 10 years. Do they really think that is a sustainable course? It is simple home economics. People who have had to make their own way in life and do their own books the realise that sort of increase is not sustainable. For those that do have a healthcare card or for children, the co-payment occurs only 10 times or to a maximum of $70 in a year. Do we really think the four out of five people in Australia cannot afford $70? My electorate has more pensioners than any other electorate except for Hinkler. The reality is that most people are able to afford $7. After 10 visits or $70, it reverts back to bulk-billing.

The other mistruth that gets peddled around here is that we have already paid for our Medicare services. The Medicare payment only covers half, let alone accounts for the increase. Is the opposition going to propose putting up the Medicare levy by 122 per cent? Or are they going to put up general taxation revenue by 122 per cent to make it pay? No, they are not; they are just going to go to the magic pudding and borrow more money and take it away from general revenue, which will mean there will be no money for schools or bridges or roads.

The opposition want to have it all but they do not want to pay for it. We just need a giant reality check by the opposition to make them realise that what we are doing is what a sensible economic manager would do, which is what they did with the Pharmaceutical Benefits Scheme, and introduce a co-payment. It sends a message both to the orderers of the tests as well as to the consumers—so it is not just for patients. There is a whole cohort of my colleagues that have not had to be responsible for the costs they incur for their patients. (Time expired)

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

Order! The time for the discussion has concluded.