Tony Smith (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 Medicare.

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

We heard in question time today some of the consequences of this government's decision to change the Senate voting rules. Sitting in the Senate, unable to be passed because of the actions of this opposition, are several health measures that this government has wanted to inflict on the Australian people. Sitting in the Senate, of course, are the increases to Pharmaceutical Benefits Scheme co-payments for general and concessional patients, making medicine more expensive. It is $1.3 billion extra that patients will be paying to access medicines.

Of course, there are also the changes to the safety net which mean that, while some people might reach the safety net earlier, they will get a lot less back when they actually do. Again, it is a cut to the safety net. We are also waiting to see introduced a number of regulations which will see a co-payment introduced for pathology tests; the scrapping entirely of bulk-billing incentive for pathology, leading to a co-payment; and major changes to bulk-billing incentives for diagnostic imagine, which will see, because patients have to pay for both pathology and diagnostic imaging tests up-front if they are being charged a co-payment, in the case of diagnostic imaging hundreds of dollars for people to access tests such as an MRI. This is what the government wants to do with its Senate voting reforms. If it gets them through and calls a double dissolution election, you can bet your bottom dollar that this is what they want to do.

It is worth reminding people just what an appalling record this government has when it comes to the health of our nation. This government at every single opportunity has attempted, through budget, after Mid-Year Economic Financial Statement and in every single policy it has introduced, to undermine our universal health insurance scheme that is Medicare. It is worth remembering that the Abbott-Turnbull government took the decision to cut $57 billion out of our public hospital system, meaning that it will not be able to keep up with demand in our public hospital systems across the nation. Those cuts have already started, but the bulk of them start next year. If you have tried to get into a public hospital recently for elective surgery, if you have tried to get into an emergency department or if you are waiting for an operation and you think it is bad, just you wait to see what this government is about to inflict on this nation when it comes to public hospital funding.

We have seen this government cut millions of dollars out of preventive health programs—programs that are trying to tackle obesity, tobacco and alcohol consumption in this country to keep people well so that they do not end up in our acute system. They are trying to reduce demand over the longer term.

We heard again the government in the 2014 budget cut funding to public dental, but over the weekend, not satisfied with that, the government is now toying—pretty seriously, I understand—with the idea of cutting the kids dental program. That is a program we are very proud of on this side of the House. We knew how important it was to try to address the issue of oral health for young Australians, because the Australian Institute of Health and Welfare had reported most distressingly that the amount of under-five-year-olds who were losing their baby teeth due to tooth decay had increased and was continuing to increase in this nation. It is a scheme that in essence introduces a Medicare benefits scheme. It is now integral to the entire universality of Medicare that we have a kids dental scheme that one million children in this nation have taken up. This is a program that this government has now got in its sight.

You thought that they could not do much more, but we saw in the 2014 budget three separate attempts to introduce a GP tax and make sure that patients trying to access general practitioners were paying a co-payment. They continue to do that by stealth by continuing the freeze on Medicare benefit schedules. This is seeing patients start to have larger co-payments charged and in some cases patients who were never charged co-payments starting to have to pay those as well. All of these measures still sit in the government's budget. Some of them have not passed the Senate, because of Labor's opposition, but you can bet your bottom dollar: you give this government any single chance at the next election and almost immediately you will see those measures put in place.

I want to go back in particular to the cuts to public hospitals. Given just how widespread the cuts to our universal health system, Medicare, and the sustained attack this government has inflicted on Medicare have been, it is hard to concentrate on the detail, because it has been so widespread. But $57 billion of cuts to our public hospital system has very real consequences. When Labor was in office we knew we were facing a very real problem when it came to access to public hospital services, including elective surgery, emergency department and keeping up with demand as people age and we have more and more chronic disease. The acute system is coming under substantial pressure. So we took a year to commission the National Health and Hospitals Reform Commission to look seriously at what you need to do to Australia's healthcare system—prevention, primary care, community based care and our acute system. What do we need to do to make Australia's health system work better and how do we make sure that we have the funding to do so?

What did the government do when it came to office? It basically threw out every single one of Labor's healthcare reforms and it has used health purely as a cash cow for the budget. It has used health to take money constantly out of public hospitals, dental and now our kids dental, prevention and general practice. And what has happened? We are now seeing the results of that across this nation. The $57 billion out of public hospitals saw the Premier of New South Wales—not someone who is overly familiar with our side of politics—say that it was simply unsustainable. What you have at the moment is the government running around and trying to come up with a last-minute deal to get it out of political strife as it heads into an election. It is a deal—if it does the deal that we have heard about—that will see the acute sector on its knees in this country. As I said at the start, if you are a patient trying to get into a public hospital for elective surgery or you have been in an emergency department recently or you are currently in hospital and you are struggling, you can guarantee that this is about to get worse because of the Abbott-Turnbull government.

The government's latest MYEFO budget talks about what it wants to do to pathology and diagnostic imaging. I have spent a bit of time in pathology labs and in radiography clinics over the last few weeks having a chat to patients, pathologists and radiologists about the impact of the government's decisions. The government is trying to say, 'This is no big deal. It's really not going to have much of an impact on patients or, if it does, it is all the fault of radiographers and pathologists in particular.' It is taking $650 million out of pathology and diagnostic imaging for incentives that make sure that patients are bulk billed. Bulk-billing is important to try to keep fees down in the system, but it makes sure that we keep these vital tests affordable for patients. In the case of diagnostic imaging in particular, the cuts are significant. For example, multiple scans are required for a woman diagnosed with breast cancer. That woman, who was previously bulk billed, will face up-front costs of up to $554 for mammograms and ultrasounds with these cuts in place and will be left around $300 out of pocket, even after receiving all of the Medicare rebates. For many of the patients who are now bulk billed, those sorts of costs are simply unaffordable. This is what the government has wanted to do to our health system, and it will do it if it is successful with Senate reforms. The government has simply tried to slash and cut Medicare and has tried to introduce a two-tiered system in this country. This is the Turnbull government proving that, no matter who the leader is, you can only ever trust Labor when it comes to maintaining Medicare, strengthening Medicare and investing in our universal healthcare system.

Ken Wyatt (Hasluck, Liberal Party, Assistant Minister for Health) Share this | Link to this | Hansard source

I find the scaremongering of those opposite regarding Medicare nothing short of embarrassing given the coalition government's record of standing up for a world-class health system with affordable access. I want to remind people of a couple of things. When Dr Neal Blewett introduced the second reading of the bill, he said:

... everyone will contribute towards the nation's health costs according to his or her ability to pay—

with contributions made through the tax system and the Medicare levy of one per cent. He went on to say:

Basic health care should be the right of every Australian.

Further, Making Medicareis a publication that takes up the story of how Labor began developing a proposal for national health insurance against the wishes of many in its party who supported the preventive, community based health system with salaried doctors. It describes the tortuous introduction of Medibank, which finally came into operation and then morphed into the current system.

What is interesting is the pious approach by those on the opposite benches—that they are holier than thou in the way in which they defend Medicare. When we look at the history of the introduction of Medibank and opposition within their ranks, they were not uniform. It seems that the member for Ballarat is so completely at a loss this year when it comes to new ideas that she has fallen back on the age-old Labor policy of extensive and timely fabrication. This is to be expected from a fatigued and boring opposition who wail and fear-monger at alleged health cuts, when their own government sliced $550 million worth of Medicare savings in pathology services and redirected it to what they deemed as 'other government priorities'.

Mr Snowdon interjecting—

Member for Lingiari, it does not matter what you say to intervene. Sometimes it is better to have the truth on the table. You cannot play a holier than thou attitude when you make similar cuts.

Mr Snowdon interjecting—

I will be interested to hear your comments. It was the opposition's dear leader himself, the member for Maribyrnong, who claimed:

... if you withdraw funds from Medicare, you will invariably put up the price of healthcare for all Australians.

Tell me, member for Ballarat, how does your government's policy record stand up against this statement? Alternatively, the coalition government has a clear path forward when it comes to health. In the case of pathology, we are removing a feeble and defective incentive of between $1.40 and $3.40, which is paid directly to pathology providers. Pathology companies have, in some cases, complained about the impact our government's changes will make to shareholders—to shareholders, not patients—which demonstrates what is really motivating these organisations.

With Labor's condemnation of this coalition policy, it seems Labor has finally been exposed as the party of big business, rather than the party for each individual Australian, regardless of circumstance. Under this government, we have sent a strong message that Medicare is not a guaranteed bankable revenue where corporations cash in on taxpayer money. As a government, therefore, we are making it clear that not only should every Australian have access to a first-rate service but that the system of health care we promote is one that is sustainable and relevant to consumers in the future.

Australians deserve the Liberal-National government, which sees health care as a priority, not just as a playground for party tricks and policy flips as the Labor opposition does. Australians deserve better than the six years of anxiety and instability that Labor gave them.

Those opposite on occasion seek to preach on MBS indexation. I am flabbergasted that their memory of their own government should be so incredibly poor. I am glad the coalition government is doing much more work in the area of Alzheimer's, given the difficulties it is posing to some of our Labor colleagues. It was Labor who introduced the freeze on MBS indexation when they were in government—and they seem to have forgotten that. It was Labor that froze the indexation of Medicare rebates. It was apparently okay for Labor to freeze the MBS indexation, but those opposite are suddenly outraged that a coalition government would dare to do the same. Hypocrisy, thy name is Labor!

As a government, we are making it clear that not only should every Australian have access to first-rate services but also the system of health care we promote is one that is sustainable into the future. This means, to quote the Labor spokesperson for health herself: 'The opposition would be kidding itself if it didn't recognise there were challenges in the budget and that savings needed to be found.'

Ms King interjecting—

That is fine; that is not a problem. Let me also go on to give some other quotes, just to jog the memory of the member for Ballarat. 'There is no area that is going to be exempt. We have to look across the board,' said Catherine King on 22 February 2015 on Sky News'sAgenda. Let me share a couple of others with you.

… we did think we needed to make savings in pathology. … Now, they didn’t like it, they weren't chanting in the street saying that was terrific, they didn’t like it.

That was Labor's spokesperson, Catherine King, on 6 January 2016.

In government, Labor worked with the medical profession to improve the quality and safety of Medicare, and where savings were realised, they were reinvested back into the health system.

So said Labor health spokesperson Catherine King on 27 September.

Ms King interjecting—

Can I remind the member for Ballarat: it is great that you have selective memory, because your quotes are clearly there for all to see.

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

You're selectively quoting, Ken.

Ken Wyatt (Hasluck, Liberal Party, Assistant Minister for Health) Share this | Link to this | Hansard source

It is not selective quoting. And let me also say:

Some of those savings did go back into the health Budget, not all of them …

This was Labor's health spokesperson, Catherine King, on 6 January 2016 at the press conference.

Ms Plibersek interjecting—

The member for Sydney might want to interject, but she also went on to say:

We will put a cap on selected Medicare items from 1 November this year where excessive fees are being charged or where Medicare may be being used inappropriately …

…   …   …

The Government will also tighten regulations around diagnostic radiology services so that those taking the images hold minimum qualifications. … it will produce savings of $45.8 million over four years.

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

What happened to bulk-billing, Ken? It went up.

Ken Wyatt (Hasluck, Liberal Party, Assistant Minister for Health) Share this | Link to this | Hansard source

Actually, they did not go up as much as you projected, Member for Ballarat.

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

Yes they did.

Ken Wyatt (Hasluck, Liberal Party, Assistant Minister for Health) Share this | Link to this | Hansard source

No they did not. I think you need to go back and read what is in there.

Ms King interjecting—

Let me keep going. That is why the once-in-a-generation review of the Medicare Benefits Schedule is so imperative for Australia. The review is looking at all of the more than 5,700 Medicare items, ensuring they are relevant and effective. This is a prime example of the sensible policymaking that the opposition were too lazy and distracted to achieve in the six years they had in government. To quote the former Labor health minister Nicola Roxon:

Without reform and a careful and methodical approach, the system will cannibalise itself. Because in health there is a continuous clamour for more and more funding with no regard to where the money comes from.

I am proud to be the assistant minister for health in a government committed to improving our health system in a way that Labor never managed to get around to. I am proud to be part of a government that treats the Australian public's health as a priority.

We are digitising our payments scheme, bringing government processes into line with a modern, innovative Australia. This will ensure a more efficient system that processes more than $42 billion worth of payment transactions every year.

I have every faith that the great work of this government in ensuring that every Australian, regardless of circumstances, receives health care will not be drowned out by a few bitter voices from those opposite. And it is interesting, hearing the continuous interjection from the shadow minister—

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

It is. It has hit a raw nerve.

Ken Wyatt (Hasluck, Liberal Party, Assistant Minister for Health) Share this | Link to this | Hansard source

It has hit a raw nerve. And I will not be lectured on Medicare by those opposite. They do not have a leg to stand on, given the six years of misery they had in government, where they cared little for the circumstances of the people they claimed to represent. I wholeheartedly reject their flip-flopping as they seek to condemn the current government for policies and pathways they so recently supported. It is great that it has hit a raw nerve with you, Member for Ballarat, because, when you think back on the period of when Labor produced its reports and had key areas, they never fully implemented those reports. There was never a full commitment to the funding, nor was there, in the forward estimates, the money that was required.

Ms King interjecting—

Let me say to you, Member for Ballarat: the selective memory, and some of the things that you have raised and challenged, are coming back to haunt you—the same as they will haunt the member for Sydney. So I strongly support the process in which we are engaging with the medical profession and with state and territory governments in achieving outcomes.

Tanya Plibersek (Sydney, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

We all know which is the party of Medicare. We know who it is that established Medibank in the first place and who cut it, when it was Medibank, and who had to reintroduce it as Medicare, because Labor has always been the party of universal health care—health care that depends more on your need for services than on the credit card in your wallet.

We have seen from those opposite: a $57-billion cut to hospitals and a four-year freeze on GP rebates; $650 million cut from pathology and diagnostic imaging; almost $1 billion cut from health programs, including $200 million from the flexible funds that fund the services in your communities that are being closed down right now—drug and alcohol services, Aboriginal health services and others; the GP co-payment; and the increased cost of medicines proposed by those opposite. But perhaps the most distressing for me was the news on the weekend that the kids' dental program is going to be closed down.

Let's just take a little bit of a trip back in history. The Howard government killed the Commonwealth dental program that had been seeing 200,000 people a year. They killed it dead. In the year 1995-96 there was $105 million committed by the Commonwealth to dental programs. In 1998-99 that had dropped from $105 million to $6 million. Instead, when the system turned into a disaster, we had the ridiculous Chronic Disease Dental Scheme that the member for Warringah, as health minister, introduced. It was supposed to cost $90 million a year, and it ended up costing $80 million a month. It had 1,000 complaints made against it. It had patients billed for work that did not happen. It had dentists charging twice. It had one dentist ordered to repay more than $700,000 after admitting to incorrectly billing 293 times.

What did we do? We restored money to Commonwealth dental programs so that people on those ever-expanding waiting lists could be treated, so that more dental chairs could be opened across the country and so that young dentists coming out of university could get the experience they needed. Most importantly, we said that 3.4 million Australian children would go to the dentist every two years as easily as they now go to a GP, getting $1,000 worth of work: check-ups, fluoride and basic cavity treatment—all of the basic treatments that would mean those kids started life with good dental care. We know that, if you start well, your teeth are much more likely to last well through your life. We know that if you have early problems in dental care not only does it mean you are likely to have bad teeth for the rest of your life; it also means you are more likely to have bad general health.

The government have already cut $125 million from this. They cut $400 million or so from public dental programs and so on and $125 million has already been cut from kids' dental health. Now they are going after the rest of it. One million children have had treatment under this program. More than two million children are still eligible. Maybe the government will increase the tobacco excise, but who could tell from the conversation today. We know the health minister and Dr Laming up the back do not support it, but maybe it will be passed. They are not going to focus on multinational tax avoidance. They are not going to make cuts to very-high-income superannuants. They are maybe or maybe not going to increase the tobacco excise. Instead of any of these sensible improvements worth $100 billion to the budget bottom line that Labor have already proposed, they are going to go after the kids' dental program.

We know Australian children are already suffering poor dental health, with many children having to go to hospital under general anaesthetic to have all of their teeth pulled out. Instead of actually supporting the program that would prevent that poor dental health, they are going to go after kids' teeth. It really does beggar belief that, of all the things this mob opposite can think of to do to balance the books, the one thing that they come up with is cutting access to dental care for children.

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

It is always good to engage in a health debate. It almost seems that nothing changes each year when we have them. But, fundamentally, what is this about? Medicare, at the heart of the Australian health system, is growing at an unsustainable rate from around $10 billion to $16 billion and, in 10 years from now, to $34 billion. We have to be able to have some sort of constructive discussion with the other side about real ways to reform and restructure Medicare to make sure it continues to deliver. Of course, Labor have a very short memory. They do not remember that they, themselves, took half a billion dollars out of pathology when they promised those savings would be reinvested into the health system. No, that has been erased away and they just take the cheap shots at the government of the day.

I know that there are a couple of healthcare enthusiasts on the other side. Certainly I congratulate the shadow minister for the fact that she at least turns up to the odd clinic to talk to patients and providers. But actually working in a hospital, as I do every fortnight, I get a fairly privileged look at exactly what is happening in Queensland hospitals. One great observation is that state governments that get serious about provision, reducing waiting lists and shortening time at casualty departments can do it. The one thing I noticed about Campbell Newman's era of running the health system was that the waiting list started to decline and Queenslanders got their operations. I know it is very tempting to dance around on the grave of a former premier, but I can tell you one thing: when you needed an eye operation, you knew you would get it under Campbell Newman's premiership.

Already now, those waiting lists are bloating out again. Why is that? Fundamentally, we have to remember that four-fifths of Australians get completely free Medicare services in this country. If you look at equivalised health earnings, that means that pretty much anyone earning more than double the minimum wage is quite probably paying no out-of-pocket expenses whatsoever under Medicare. That is something to be extraordinarily proud of. If both sides of parliament did not support that, it would not be the case in 2016.

But way more concerning, I think, is Labor's attitude. When given the choice between treating the poor and treating the sick, it is the sick that miss out under Labor. In Tasmania, if you have so much as a minimum wage job, you are denied the services of much of Tasmania's public health system because you are too wealthy to be treated. That is a complete disgrace. It is appalling to see state hospital and dental services turning away patients under Labor because they have a job. It is ridiculous. The member for Bass has told me of young working women who could not get a hole in their teeth fixed under the state dental system because they had a job. How outrageous! They are automatically ineligible. This is Labor's fixation on free health care, whatever the cost.

At the moment the percentage of bulk-billing in diagnostic imaging and in pathology is sitting in the high 80s. The odds that they are out-of-pockets are extremely slender in both pathology and diagnostic radiology. With respect, you have to look at the enabling structures in pathology and diagnostic imaging way more deeply than the shadow minister has done. You cannot just wander the corridors. You have to understand the cost of the equipment and the massively increasing volume of testing and the ability to do that and you have to look at whether the federal government can do this more efficiently. If you are stuck with a fee-for-service system, you almost cannot extract any savings whatsoever.

What are the three big challenges in health? Ageing—I am glad that people are living longer; technology—we have to find better ways to treat more people; and, lastly, the cost of human capital. In diagnostic imaging and pathology it is the workforce bill that is relatively small compared to the large cost of technology. Driving technology is the key. In a fee-for-service system, you have to look twice at paying blanket bonuses to those sectors because we know it may not change behaviour. A lot of those surpluses are simply pocketed by the provider, which is, in many cases, a large corporate entity.

Where two large corporates control the market, with the greatest respect, if one of them decides to change from a bulk-billing practice, they will see patients walk across the road. They will get the doctor to tick the box on the diagnostic imaging or pathology form and they will look around, because the day the policy changes the competitor across the road will put up a sign: bulk-billing is delivered here. That is the market effect that that side does not understand.

If we can improve pathology and diagnostic radiology and if we know that we can do it more efficiently and learn from the private sector that does it far better than the public sector, we have a chance to fund the cancer measures and the hep C cures. These are areas of expanding opportunity for the Australian health system that will keep it one of the best in the world. We should no longer be comparing it to the US. We must now match the achievements of the European health systems—and we can under the coalition.

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

In a few short weeks time the Australian people are going to be sent to an early election. As the government scrambles around for a few policies to put before the Australian people, we know that they are going to be condemned for 2½ years of health policy disaster. They will be rightly condemned for their policies when it comes to primary health care. There was the GP tax mark 1, 2 and 3 and then, through the back door, GP tax mark 4—the tax which the parliament refused to pass—that they are trying to force doctors into introducing by freezing Medicare rebates; and the vicious $57 billion worth of cuts to public hospital systems.

The member for Bowman asked, in a comical sense, just now: why are waiting lists blowing out in the state of Queensland? Why is it that in his friend the member for Bass's state of Tasmania they are having problems meeting the demand for public dental treatment? If he wants to ask why they are having these problems, he need look no more further than the $57 billion worth of cuts that his own government is visiting upon the people and that he put his hand up and voted for. It is those very same cuts which are seeing hospitals in New South Wales without doctors. Could you ever think of such a thing: hospitals having no doctors? We are seeing proposals to increase costs of medicines, which are going to hit pensioners and average wage and salary earners hard, locked in the Senate at the moment—the very same Senate that the government is cynically trying to push legislation through this week so that they can control the Senate in a future parliament. We are also seeing an absolute blow-out in the cost of private health insurance. Year after year we are seeing increases of close to six per cent under this government's watch. If the families of Australia are struggling because of the increased costs, they will know who to blame in a few short weeks time.

On the weekend I had the opportunity to talk to Annabelle Lavender, a constituent of mine from Albion Park in New South Wales. She is a pensioner. She is living with cancer. She came to me deeply concerned about the government's cuts to the bulk-billing rebate for pathology services. She said to me that people in her position will not go and have their blood tests done. She needs to have a blood test done every three months. She sees her haematologist once every six months. She is not alone. She has made the point quite clearly to me that this is her No. 1 issue when it comes to the next election. If this government is re-elected, things are going to get worse.

In Senate question time today we saw the minister who was recently elevated to cabinet and who has responsibility for regional health declare to the Senate, in response to a question from Senator Lines from Western Australia, that there had been no cuts to hospitals throughout the term of this government. The Premier of New South Wales disagrees with his senator. The Premier of Victoria and the Premier of Queensland—in fact, every Chief Minister and Premier of every state and territory in the country—disagree with that statement, because they know that they are being faced with the very real prospect of having to close down hospital beds, increase waiting lists for elective surgery and close services in community health. These are the results of this government's cuts.

It is time that the member for Bowman re-forms his Praetorian Guard. We know it was the member for Bowman who was so active in ensuring that the former Prime Minister be thrown out of office because of the impact that his disastrous Medicare plans were having on their electoral prospects. It is time for the member for Bowman to start organising again, because there is one thing that we can be absolutely sure of: the people of Australia will punish the member for Bass, the member for Bowman and all of those Country Party members who are putting their hands in the air and voting for this government's cuts to Medicare and hospital funding. They will punish them if there is not a change in policy.

What we have at the moment is a different Prime Minister and a different Treasurer peddling the same health policies that they took to their first budget. It spells disaster for public health in this country, and the people of Australia are onto it. They know that this government has no policies. That is why the government is spending so much time talking about the opposition. It does not have not a policy of its own. What it has done in health has been an absolute disaster.

Mark Coulton (Parkes, National Party) Share this | Link to this | Hansard source

It is always a very great privilege to follow the member for Throsby. He certainly puts some effort into his speeches, even if they lack any substance. I have been in this place long enough now that it might be time to reflect on a bit of history around health. Let's go back to 2008 when Kevin Rudd was the Prime Minister and we had wall-to-wall state Labor governments. In my electorate in Dubbo, at the time of the then Premier—I cannot remember if it was Iemma, Carr, Rees, but it was a Labor government; it does not matter who the leader was—the local staff were buying supplies from the local vet to keep the hospital going. Then Kevin Rudd came along. Remember the revolution in health? Remember we had a revolution in a lot of things? We had the revolution in health, which was the policy where the Prime Minister dressed up as a doctor for an entire year and travelled the countryside having photo opportunities, looking very serious in hospital surgical wards and waiting rooms to show his concern for health. Despite the fact that hospitals and health are the primary responsibility of the states, he saw this as a wonderful opportunity to have his health revolution. What did we end up with? Does anyone remember the GP superclinics? There were going to be 150 GP superclinics, I think; we ended up with about seven. Then we had the Divisions of General Practice Network that was working very well; it was under the imprimatur of the doctors, they had ownership of it, and it was providing services in that space. We ended up with the Medicare Local. Despite the fact that we still do not know what a Medicare Local is or what it does, we saw large amounts of federal funds go into these Medicare Locals. The GPs lost confidence in the primary health system. I have to say it has taken a new minister and government to restore some semblance of normality into the primary healthcare system.

We have heard a lot of talk here from the shadow minister and others about our children and the health of our children. But I ask you one thing: will our children be thankful when they get older and those of us in this room, the baby boomers, get to the stage of needing high-level care? It is a fact that we are going to be the generation that will live longer than any generation in the past. Are they going to be thankful for the fact that, when they go to the cupboard to fund aged care and health care when we reach a peak in 2030, the cupboard is completely bare? Will they be grateful that we will be paying every cent to cover the interest from overseas debts that the Labor Party incurred when they were in government? What we owe to the people of this country, especially the younger people, is to be responsible. We need to have a medical system that is sustainable and will cover the needs of this country into the future. Quite frankly, when it comes to caring for the elderly and sick, this is as good as it is going to get. We are facing a huge crisis coming up. It is about time that those opposite stop trying to pretend that we can solve a problem like this by throwing money around and by wearing surgical garb and dressing up as doctors.

I am going to pay a tribute to my state colleagues in New South Wales. A month ago, the Premier came out to Dubbo and opened stages 1 and 2 of the Dubbo Base Hospital. In the last 18 months, 30 new doctors have moved to Dubbo. There are new hospitals at Gulgong, Parkes and Peak Hill in the central west. The people of the west are getting genuine care, and confidence is being put back into the health system.

The Medicare Locals are a failure, and we have moved on. GP superclinics are one of those tales that our grandchildren will tell around the campfire in years to come, saying 'Remember when grandad talked about the greatest health failure in all time— (Time expired)

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Link to this | Hansard source

I want to thank the member for Parkes for reminding us all why the National Party have a problem in the bush in terms of health care and about the stupidity of this government. When Malcolm Turnbull became Prime Minister, there were those of us in this place who thought that we might actually see something different, that we might see some change in public policy and move on from the 2014 budget with its cuts in health. There was a valid expectation that the $57 billion worth of cuts to the hospital system would, in fact, be reversed and that he got the message from the community saying, 'Malcolm, this is not acceptable.' After all, why did the member for Warringah end up being necked? He was necked because of the 2014 budget. The current Prime Minister is sticking to the initiatives of the 2014 budget: $57 billion worth of cuts to the public hospital system.

Let me explain to those opposite what that means for regional communities such as my own. At the Alice Springs public hospital, 80 per cent of its patients are Aboriginal people. If you put together the cuts to the hospitals with the three attempts at the GP tax and co-payments, what they are doing is attacking the most vulnerable people in the community. The government talk about their desire to close the gap. If they actually get these things through the Senate and into law—if there is a change at the next election and they control the Senate—they will penalise the weakest and the sickest in the community. The sickest in the community will be asked to pay more for their services. These are people with massive chronic disease problems who need to regularly see the doctor and to regularly have pathology tests. How the hell do you expect to close the gap if you charge people so much that they will defer their intention to seek assistance from a doctor or to get a pathology test? Pathology tests are, ultimately, very important. We know about the level of chronic disease in the bush and the enormous problems with diabetes. In one community I went to recently, there was a seven-year-old girl with stage 2 diabetes. She was looked after by an Aboriginal Community Controlled Health Service. If you attack GP payments in the way being proposed, it will cost that health service and its ability to deliver health outcomes for those communities.

Let's be very clear about this. This is not just a matter of talking about who is fiscally responsible. This is talking about what is fundamental to most Australians: their health care, the universality of the healthcare system and the importance of that universality to making sure all Australians, regardless of who they are or where they live, can get good access to the same level of medical treatment, whether they live in Alice Springs, Dubbo, Utopia, in the Northern Territory, or Sydney. What we are seeing here is a deliberate attempt by this government to hit the weakest, the poorest and the sickest in the community.

Now we have this stupid proposal, this absolutely asinine and stupid proposal, to cut the kids dental scheme. I am not a doctor, but I do know that there is a relationship between rotten teeth and your general health. If you do not look after the rotten teeth of young kids, you are putting yourself in a position where you are looking at the possibility of these kids getting chronic diseases which will end up costing the community a great deal of money and, most assuredly, will mean a lower life expectancy for those children. That is happening today.

If you cut the Medicare system in the way which is being proposed, if you continue with these stupid cuts to the public hospital system, you are penalising these people. You are making sure that the sickest and poorest in the community suffer as a result of your decisions. These are conscious decisions of the Prime Minister, his cabinet and the backbench, who are supporting him. When he became Prime Minister, I am sure many of them would have thought, 'We won't be living through the 2014 budget again.' Well, you are, because we will make sure that at this forthcoming election every Australian understands what you are doing and trying to do to the healthcare system and what you are doing in terms of undermining universality of health care in this country. Every Australian will be able to make a judgement about you, the 2014 budget, where we are today and the way in which this Prime Minister has deceived the Australian community. (Time expired)

Karen McNamara (Dobell, Liberal Party) Share this | Link to this | Hansard source

Last week I had the pleasure of attending Wyong Hospital. It was fantastic to meet with the nurses, the doctors and the admin staff. They really do an amazing job. Is very important that we support quality health care and our local hospitals. I know that the member for Robertson is a strong advocate for health care in her seat of Robertson and spends a lot of time at Gosford Hospital as well.

Whilst I was at Wyong Hospital, the opposition leader was also on the Central Coast on his national limp lettuce tour. This time he was peddling lies to the media about Medicare and, in particular, pathology. He turned up at a pathologist in North Gosford. The sad thing about this is that to get attention, instead of going out there and launching his reckless negative gearing policy, he has to prey on the most vulnerable members of our community—seniors and chronically ill people. To do that is really, really low. That is how low those opposite have become.

To make it worse, standing right next to the opposition leader and encouraging him with her nodding head was the reluctant Labor candidate for Dobell, who happens to be a senior manager with Central Coast Local Health District. Obviously she was on her lunch break. How typical of the HSU delegates in Dobell—participating in a campaign of lies and deceit. The lies and deceit of the opposition have to stop. At the end of the day it is nothing but lies, when it comes to pathology.

My colleague here, the member for Macarthur, and I were discussing this really top-quality fact sheet that we came across called 'Facts about Medicare—the truth'. The truth is that you can go out there with your scare and deceit campaign, stating that this miniscule budget change to payments to pathology providers—between $1.40 and $3.40—will mean a $30 increase in pathology fees. That is a load of rubbish. This quality fact sheet that we have states the truth: the government has made no changes to Medicare rebates for pathology services, including common blood tests and Pap smears. Changes that were announced in the MYEFO relate to the payment worth between $1.40 and $3.40 that is paid directly to the pathology corporation. It is separate from the Medicare rebate. It has nothing to do with patient's Medicare rebate.

Mr Conroy interjecting—

The member for Charlton thinks it is all a big joke. Maybe you should sign up for the dental program. Anyway, a recent report produced by the Grattan Institute confirms that there is no justifiable ground for large pathology corporations to introduce a $30 co-payment for blood, urine and Pap smear tests, based on the loss of a small payment worth $1.40 to $3.40.

This is not about the patient. This is about the shareholders. The hypocrisy of those opposite! You have no credibility whatsoever on this issue. In government, you cut $550 million from pathology services. It is disheartening that we see the opposition leader, the Labor Party and an HSU advocate and paid staff of the Central Coast Local Health District out there peddling lies, creating a scaremongering campaign, and using panic examples, which we have heard here today during the MPI, of our most vulnerable community members—panic examples none of which are verified.

Labor is always intent on scaring the Australian public. Why does their modus operandi always include making up campaigns that deliberately mislead the Australian public? They are scaremongering, because what else have they got? They talk about their positive plan, but what is the positive plan? All we are hearing is negativity, negativity, negativity. We have not heard a positive thing yet. All we hear about is your campaign of lies and deceit. You are trying to distract the public from the truth about your weak negative gearing policy.

Opposition members interjecting—

You can laugh now, but the Australian public are not going to like it when there is a shortage of rental properties and you cannot allow people to invest in their homes. Property values will go down and you are stopping people from investment. (Time expired)

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

In talking about health, it is interesting to note that the federal minister will not come to the table. The lead speaker could not spend one minute talking about their positive policies, and the last speaker got stuck on negative gearing, because that is apparently to do with health. It just shows that when it comes to health, that side of the House have absolutely nothing. They are a collective of empty shells that do nothing but make cuts to health. Let us talk about what they are doing.

We do not know who would lead a re-elected Turnbull-Abbott government. They do not even know. In the last sitting week, the Prime Minister refused to confirm that he will stay the full term. But what we do know is that a re-elected Turnbull-Abbott government will cut another $60 billion in health, they will sell off Medicare piece by piece and they will bring back their GP tax, which this so-called obstructionist Senate is stopping. Had it not been for Labor, every Australian would be paying, at a minimum, an extra $7 to go to the doctors. The government will continue their perverse cuts to pathology and diagnostic imaging. It surprises me to say this, but Prime Minister Turnbull is actually worse than Tony Abbott. Not many people would believe that, but that is actually how it is going. He has gone places that even Abbott would be too scared to go!

So let us talk about health and let us talk about what happened. I take up the comment of the member for Dobell that $57 billion in health cuts is 'miniscule'. That just shows how arrogant, out of touch and empty that lot over there are. In the three years that we were in government that I was here for, we looked at 22 cancer clinics across this nation—$3.2 billion invested in rural and regional areas. Those opposite want to attack the super clinics. We have two in our area: one in my area, in Wallan, and one in my neighbour the member for Scullin's electorate.

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

How many did you finish?

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

The Bass yabby wants to open his mouth! The government were too chicken to open them. They would not open them because they were a Labor policy. What the clinics have done is cut waiting lists for people to see doctors, and they have also meant better health outcomes for the community.

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

How many did you open? What was the target?

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

So while you sit there, babble on and carry on in your own little world, let us look at what we did. We also spent $4.95 billion on health, and health is a very important thing. In fact, it was so important that the Liberal Party arranged for their own branch members to come and cut the ribbon and do the opening! Those opposite voted against the rural and regional national health and hospital fund. Every rural and regional member in this House that sits on that side should hang their head in shame, because they did not support better outcomes in rural and regional health. We spent $4.95 billion and the only thing that the minister would turn up for was to cut the ribbon. Those opposite would not support it. They would not go there and say, 'We don't think you deserve this,' but that is exactly what their actions did. Their actions said very clearly that rural and regional people do not matter. Those opposite did not want to support the building of these facilities; they did not want to support rural and regional people.

We had the member for Bowman talking about the old dental scheme that was in place. That was the scheme that the so-called economic geniuses of the Liberal Party—

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

You killed off the chronic dental scheme.

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

We did. It was budgeted for $90 million per annum and it spend $90 million a month—12 times what you budgeted for! Seriously, you people should not be in charge of lunch money. You cannot count. We brought in something that has actually helped two million young Australians—making sure kids get good access to dental care. Those opposite want to cut it; they want to remove it. Why do they hate kids and good teeth? Every single medical report supports exactly what happened: our dental scheme means that kids get better teeth and better health outcomes. These are the things that matter to people.

Now those opposite want to off-load Medicare overseas. They want to have your patient records sent overseas and not processed here in Australia. For a government that is supposed to talk about jobs, so far all we have learnt is that they want to send jobs to Spain, they want to send jobs from the Australian Taxation Office to the Philippines, and now they want to offshore Medicare. It is an absolute joke that the government could get worse than the Tony Abbott government, but they have. They have, because every one of those members opposite is an empty vessel that does not support health, does not support universal health care and has never actually backed it. From the day Medibank was brought in to today, they have had this— (Time expired)

Tony Pasin (Barker, Liberal Party) Share this | Link to this | Hansard source

The member for McEwen has just regaled us, and in so doing, he has proved to me one thing: he is the political equivalent of a threatened species. He may well become an endangered species. Who knows? He might not be here to talk about the future of health care.

For those that are listening to this debate, I will make one statement, and it is clear: you would not believe it from what has occurred in this chamber today, but both sides of this House are committed to universal health care. Nothing could be truer than that statement. It is a fundamental truism, and no amount of hyperventilation on the part of those opposite will make that not so.

I was reflecting on the fact that this is a discussion of a matter of public importance, but really, to be honest, it is a matter of rank hypocrisy. Maybe we should change the name of what we do after question time, because Mr Deputy Speaker Broadbent, you know, because you have been in this place much longer than me, that it was Labor that introduced the freeze on the MBS indexation and Labor also cut funding from the extended Medicare safety net and from a range of Medicare item numbers, including GP mental health services. So I will not—and I think those on this side of the chamber ought not—accept lectures from those opposite about MBS indexation arrangements. Quite frankly, despite the amount of hyperbole that I have heard from those opposite in respect of this matter of rank hypocrisy, their record speaks for themselves.

You do not necessarily need to take my view of this; there are others that have indicated that there is a need for reform. In fact, Nicola Roxon, in her capacity as Minister for Health and Ageing in October 2011, said:

Without reform and a careful and methodical approach, the system—

That is Medicare or the MBS—

will cannibalise itself. Because in health there is a continuous clamour for more and more funding with no regard to where the money comes from.

So what are we going about doing? Well, what we are going about doing is what you would expect of an adult government: we are undertaking a review. We are looking at 5,700 Medicare items with a view to ensuring they are clinically contemporary and effective. This is the kind of rational, sensible policymaking that those opposite were too lazy or perhaps too short-sighted to achieve in their six years in government.

Having embarked upon that process of rational review and clinical consideration, why do those opposite shriek about what we do?

They shriek about what we do because they know that it is critical. They know that the cost of Medicare to the Commonwealth has blown out from $8 billion 10 years ago to $20 billion currently, and in 10 years time it will be $34 billion. So there is a need, in the management of the economy, which we are responsible for, to ensure that we are careful about this. Why do we need to be careful about this? We need to be careful about this—I wind all the way back to the beginning—because we are committed to universal health care.

Those opposite say that we are undermining Medicare. Unfortunately for them, 275 million Medicare services were provided to patients in the 2013-14 year. More than four out of five of those services were free to patients—that is 80 per cent. Australians access more than a million MBS services per day. That is the highest level the system has reached since its inception.

Why are we talking about Medicare? We are talking about Medicare because Labor cannot help themselves; they simply revert to type, and their type is to run these not-so-scary scare campaigns—and this is another example of it. I remind those listening that we are dealing with a matter of public importance, which I think should properly be described as a 'matter of rank hypocrisy'. In any event, they revert to type because they know that, if they campaign on their recently announced package regarding negative gearing, they will be punished at the ballot box. I have it on reasonable authority that,8 when the proponents of their negative gearing policy walked into the caucus room and proposed it, most people on the other side thought they were talking about putting the car in reverse. We are here talking about Medicare because they do not want to talk about their policy of negative gearing— (Time expired)

Russell Broadbent (McMillan, Liberal Party) Share this | Link to this | Hansard source

The discussion is concluded. I thank all members who participated.