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

In the grievance debate tonight I want to speak about the parlous state of our healthcare system under the Turnbull government. We saw during the course of the election campaign that people voted against a government that had made cuts to Medicare, with the ongoing freeze of the Medicare Benefits Schedule meaning that GPs across the country had started to charge more out-of-pocket costs for patients. They voted against the rise the Turnbull government wanted in the cost of medicines, they voted against the changes to the Medicare Safety Net and they voted against the privatisation of the Medicare payment system, something that was exposed during the course of the election campaign and that the government has tried to back away from.

On election night we saw Malcolm Turnbull's dummy spit. He said, 'I didn't do so well, and it's all because of Labor's campaigning tactics.' On the eve of the election we heard him say, 'No-one will pay more to go and see the doctor.' Ever since, we have had a government that has not understood the message the electorate gave it about health, not understood why people were worried about their healthcare system; it has spent almost the entire time whingeing about Labor's campaign tactics. What a joke. But the real joke, which is not so much a joke, is what the government is still intending to do. We know that still on the table is the ongoing freeze on the Medicare Benefits Schedule, and we know the impact that is having on general practice across the country.

We also know that every single one of the cuts that the government had before the election campaign are still on the table for 1 January. I will remind people of those. There is the increase to the price of medicines for general patients by $5 per script, or 80c per script for concession card holders. That is a budget measure that the government is still pursuing. The government's intention is to cut, as of 1 January, the bulk-billing incentive for all pathology patients for all pathology services. What that means for patients is that they will start paying a co-payment for pathology services. The government has got itself in an absolute world of pain when it comes to a deal around rents it has done with Pathology Australia, and now GPs who have based their ongoing business model on the amount of rent that they have been getting. The government has still said, as a result of those decisions it is making, that it intends to cut bulk-billing for pathology. The same goes for diagnostic imaging. None of that has changed or is off the table. The government wants to cut the amount of money that people are paid through the Medicare Safety Net. Whilst people might hit the Medicare safety net quicker, they will get less back as a result of the government's decisions. All of those things are still government policy and sit on the table today.

One of the others is the Child Dental Benefits Schedule. What the government has sought, and continues to seek as its policy today, is the abolition of Labor's Child Dental Benefits Schedule. We have a million kids, many of them in some of the poorest communities across the country, accessing for the first time regular dental treatment, getting the preventative dental care that they need, getting the oral health advice that they need and setting themselves up for a lifetime of good oral health. It is a great Labor program. The government wants to get rid of that entirely, but what it also wants to do is get rid of the national partnership agreement for public dental. It has already cut hundreds of millions of dollars out of our public dental scheme and, if anyone has tried to access public dental anywhere across the country, the waiting lists are huge. The government wants to axe that and it wants to take some of the money out of the Child Dental Benefits Schedule because it has made no budgetary provision beyond 1 July next year for public dental. If the government has its way, we will see the Child Dental Benefits Schedule abolished as of 1 January, so no kids' dental. How cruel can you get? They want to cut into kids' teeth and there is no budgetary provision for any Commonwealth funding for public dental beyond July this year. What an absolute disgrace!

All of these problems are of the government's own making, but the people who are paying for this are patients across the country as they go into their GPs every single day trying to access the care that they need and finding out that they now have to pay a fee where they were previously bulk-billed. We already know that patients delay going to see a general practitioner because of cost. We know that that happens today.

The government wants to increase the cost of medicines. That is a provision that is here, and these are the things that this government said during the election were all still part of its policy and remain part of its policy today. It is patients who pay—patients who are already deferring going to see the doctor and patients who are already deferring scripts because of the cost of medicines. If you talk to any pharmacist around the country, they will tell you that on a daily basis they have patients coming in with their scripts saying: 'Which of these can I do without this week? Which medicine can I not take?' It is a critical part of their health care overall because of the co-payments that are in the system already. What does the government think is going to happen when it increases those co-payments to the extent the patients are faced with a choice about whether they access the vital medicines they need or whether they actually go without food?

As I said with bulk-billing with pathology, we know in this community that pathology is increasingly a very important part of the diagnostic journey. We need to make sure that patients are getting the tests that they need, and bulk-billing has been a very critical part of that. We know that those bulk-billing incentives have not only maintained the bulk-billing rate at such a high rate for pathology but in fact increased it, and it is the same with diagnostic imaging. But increasingly under this government we are seeing more and more cuts that directly affect patients.

There are ways to make savings in health. We did that when we were in government without actually affecting patients, but this government does not seem to care about that. What it has been trying to do time and time again is transfer costs onto the states and transfer costs directly under patients. What we have seen since this government has come to office is increasing out-of-pocket costs for people trying to access the health care they need. Who does that hit? It hits the people in rural and regional Australia. It hits the poorest and the sickest of our patients. That is what this government has done time and time again.

We have also seen what they did with public hospital funding. There were significant agreements, years in the making, reached with every state and territory government in order to make sure that we stopped the cost-shifting that was happening in public hospitals. We reached a deal where the Commonwealth would fund 50 per cent of growth in the efficient price of hospital-based activity, ended the cost-shifting and ended the blame game that was happening between the Commonwealth and the states and territories. The government comes into office and, in the 2014 budget, scraps that agreement entirely—a shock to all states and territories—and then puts back on the table a measly amount of money that is not keeping up with demand. If anyone has tried to access an emergency department across the country or if tried to get elective surgery in our public hospital system, they will know that they are not keeping up with demand today. They are under pressure, and what the government has done is basically status quo. It has said, 'We will keep exactly the same amount of growth funding in the system today that we had last year and the year before.'

So this government, at every single opportunity, has absolutely trashed Australia's health-care system. It is not a universal health-care system anymore under the Turnbull government; it is definitely becoming a two-tiered healthcare system where whether you can access the health care you need will depend on what resources and financial means you have. This is not what Medicare is about, it is not what the Australian people have believed in for a long period of time and it is not the system of universal health care that Bob Hawke and the Labor Party so proudly introduced over 30 years ago now.

What we have seen again from this government at every single opportunity is that they have seen health as a source of budgetary cuts. They have not seen it as an investment; they have seen it as a problem to be solved by way of cutting. We have also seen, in the last few days, reports about what the government has said—that they are trying to reset the frame on health with their signature policy, the patient centred medical homes. When you have every doctor group in the country now united in telling the government that they will not work because of the lack of investment, the lack of work in the design phase, and doctor groups are telling their constituencies to not participate in the patient centred medical homes, you have to ask: what more of a bungle can this government possibly make of our healthcare system? At every opportunity they have cut and basically traduced Medicare and, frankly, they should be condemned for it.