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, including with its six-year freeze on Medicare rebates.

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

This is the last sitting week before the budget—there are only two days of sittings before the budget is brought down. Again, this is a very big test for this latest health minister—will he lift the freeze on the Medicare Benefits Schedule? Will he finally acknowledge that the freeze on the Medicare Benefits Schedule that he and his predecessors introduced, sitting around the cabinet table, is hurting patients across the country?

Mr Hunt interjecting—

The minister says Labor introduced this freeze. The minister does not know the facts. The freeze we are talking about here in this parliament today is a six-year freeze—it is an ice age. The freeze that Labor introduced for eight months to bring Medicare into line with the financial year was lifted in July 2014. This is entirely of your own making, and you have to own this decision—a six-year freeze on the Medicare Benefits Schedule is an ice age when it comes to the fee that is paid in order to make sure that patients can access a GP. Will the minister finally, in this budget, admit that this government got it wrong? Will he back the decisions of every single one of our healthcare workers across the country who say this government has got it wrong when it comes to health and lift the freeze? It is not just Labor. We have been fighting ever since the 2014 budget to make sure that we get money restored back into general practice, back into primary care. The morale of general practitioners and doctors is at an all-time low because of this government's attacks on them, and we have been fighting hard to get this freeze lifted.

Will the government now act, and back the Australian Medical Association, the Royal Australian College of General Practitioners, the Australian Nurses and Midwives Federation, the Consumers Health Forum, the Australian Healthcare and Hospitals Association and the Rural Doctors' Association? They are all telling the government to lift the freeze. In fact I do not think there is a single stakeholder in the health sector that is not telling the government that they got it wrong on health and it is time to lift the freeze.

As I have said, this is a challenge all of the company's own making. It is worth reflecting on where this came from and how we got to this place. First we had the infamous Commission of Audit, which was one of the clearest signs for Australians that the Liberals were not the government that they promised they would be. Interestingly, I see that the Prime Minister has brought Tony Shepherd back into the fold to provide advice—well done, Prime Minister! It was the Commission of Audit that recommended the end of universal Medicare as we know it. Then we had the first health minister, the member for Dickson, and the 2014 budget. In the 2014 budget they introduced a $7 co-payment, in their signature style, to slug every single patient in the country for the health care that they need. It was always clear from the start that this was going to be bad for patients, bad for doctors and bad for the health system.

When they finally dropped that measure—they were forced to drop that measure—they still could not help themselves. They tried to introduce a $20 co-payment GP tax at the end of 2014. That measure did not last very long. It lasted as long as that health minister lasted, frankly—about another three months—and they had to drop that plan again. But then they decided that they would introduce a new freeze onto the Medicare Benefits Schedule because the freeze, of course, had come off in July 2014. Here we were now back in January 2015, and they decided to introduce a new freeze onto the Medicare Benefits Schedule, starting off for a four-year period. Then, of course, in a shock decision in the next budget, they then extended it for a further six years. We then saw the unedifying example of the then health minister—we had another by then; our second in a row—saying during the election campaign, 'Treasury and Finance would not let me get rid of it.' That is what it was—blaming Treasury and Finance. The last time I looked she was actually the minister responsible for the decision.

This six-year freeze has been an absolute ice age when it comes to patients across the country. We have seen out-of-pocket costs higher than they have ever been before. We have already seen GPs across the country increase fees and drop bulkbilling. I know the minister likes to say, 'Here is the increase in trajectory of Medicare spending,' and I think he uses the figures $22 billing, going up to $26 billion.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

Twenty-three, 24 and 25—you've got it! Thank you.

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

I hate to tell you, Minister, inflation and population growth is not a health policy. That is just standing still. In fact, that is just treading water. All that is doing is treading water, Minister. It is actually not a policy. What we have actually seen is bulkbilling in this country decline. The minister will say, 'Oh, no, bulkbilling is going up.' What he does, of course, is compare bulkbilling this quarter to what it was in 2015. He does not look at the trajectory of bulkbilling and what is actually happening to the trajectory of bulkbilling. The trajectory of bulkbilling is going down. There were 383,000 visits to GPs in the last six months that were not bulkbilled that would have been bulkbilled before the election.

Unfortunately, we know it is the most vulnerable in our community being hit. GP clinic after GP clinic have been forced to raise price fees and restrict bulkbilling. We have Latitude 19 Health in the electorate of Herbert, Brighton Doctors Surgery in the electorate of Lyons, Patrick Street Clinic in Ulverstone in the electorate of Braddon, Bowral Street Medical Practice in the electorate of Whitlam—there are examples of practices all the way across the country that have been increasing their fees. You just go and speak to any patient out there in the community about what is happening with Medicare at the moment and what is happening with their access to GPs and the costs people are paying. They will tell you that they are having to pay more and more. Don't forget, this is after the Prime Minister on national television told Australians that they would not pay more to see a GP as a result of this government's freeze on the Medicare Benefits Schedule.

How many chances is this government going to have to actually attack Medicare? We are asking you, in this budget, to finally acknowledge that you got it wrong. Stop whingeing about Labor's tactics during the election campaign. Stop rising constantly and saying, 'Oh, this was terrible. Look at what Labor did to us during the election campaign.' Actually do something about it. You have an opportunity in this budget to lift the freeze. You have an opportunity to admit that you got it wrong when it came to health policy.

What a shame that this is what we are in here debating today. We are not debating about increased investment in innovation in health care. We are not able to debate what new policy initiatives we need to bring forward to make sure that we actually have better and more affordable health care in this nation. What we are debating is trying to get this government to lift the freeze on the Medicare Benefits Schedule that it put in place for six long years—an ice age when it comes to the Medicare system. What we are trying to do is, basically, get them to go back to ground zero—to the starting point—where funding was right at the start of this freeze. That is, basically, what we are asking the government to do.

The minister, I know, loves to quote—he has the very old-fashioned managerial speak, I would have to say—his 'four pillars' of health care. Four pillars, the last time I looked, is a gin that people quite like, apparently! But your four pillars of health care, I hate to tell you, Minister, are crumbling under this government. Medicare, with the freeze, has actually seen an erosion in people's access to general practice. What we need to know is whether this government will actually lift the freeze on the Medicare Benefits Schedule and actually back patients in.

The government has got itself in a world of pain when it comes to this issue. It is not just going to have to lift the freeze for general practitioners and specialists; it will have to lift it for diagnostic imaging, as well. That is what you promised in the election campaign. You signed a deal and put out a press release that you were going to unfreeze diagnostic imaging, as well. You have to deal with the issue that you did, again, during the election campaign—pathology rents. That is the deal that you did where GPs are saying you are going to undercut their entire business model and cost them their practices. So it is really important that the government fixes this because that is what it promised it was going to do. The government still has on the table cuts to bulkbilling incentives for pathology and diagnostic imaging which will be seeing patients pay more when they head to the pathologist and when they need to get those important tests.

So this is a test for this minister. We have two days to go in this last sitting week before the budget. Will you lift the freeze, Minister? Are you actually going to be able to convince your cabinet colleagues to get rid of the freeze on the Medicare Benefits Schedule and finally admit this government got it wrong when it came to healthcare policy and is unable to protect Medicare.

Mr Hill interjecting—

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

The member for Bruce is out of place. If we could have some silence.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

Let me make it absolutely clear for the record, for the public and for the medical profession: Labor introduced the Medicare freeze. They can run, they can hide, they can obfuscate and pretend, but they introduced the Medicare freeze. If there was any doubt, let me go to their own document—the 2013-14 budget. What does that budget say about the impact of their changes on Medicare funding? $664 million, but it is not a one-off hit. This was phased over four years, including this year—right now they would be saving $177 million—they would be cutting $177 million. So in 2013-14, $160 million from their freeze; 2014-15 an additional $153 million; 2015-16 an additional $173 million; and 2016-17 an additional $177 million. This year, this moment, this day the Labor freeze is still in place—this year it is still in place. Hypocrisy, obfuscation, a fantasy and a level of dishonourable dishonesty which belies the very reason people have entered this chamber. They are the authors, the owners and the creators of the Medicare freeze. As their own budget document sets out, it is still in action.

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

You can't read.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

Oh, I can read it and so can the Australian public. That is the critical thing but let me go a little bit further than that. I have to say I have had a tremendous response in my dealings with the RACGP, with the AMA, with the Australian College of Rural and Remote Medicine; the heads have been tremendous to deal with—people such as the RACGP's Dr Bastian Seidel and the head of the AMA Dr Michael Gannon. They are working very constructively with us on the long-term national health plan—on the elements we are working with them on. There is no freeze in their dealings with us. I have got to say that the poor opposition shadow has yet to rise on her feet to address a single question to the current minister in nearly three months—not one question. Why would that be? She has been left in the freeze on her watch, on her time. It is not exactly a grand statement of great achievement.

Ms Claydon interjecting—

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

The member for Newcastle is out of place and out of order.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

The shadow minister quoted the fact that I make the point that Medicare funding goes up each year, every year, from $22 billion to $23 billion to $24 billion to $25 billion. Their argument has been that that we are cutting Medicare; we are not. It is false; it is untrue; it is incorrect. Then they get all upset about the fact that Medicare funding is actually going up. They also get upset about the fact that bulk-billing is actually going up. We were asked about the trajectory—

Mr Champion interjecting—

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

The member for Wakefield.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

What was bulk-billing for GPs under Labor? Under Labor it was 82.2 per cent. What was the last set of bulk-billing figures for us in the last half year?—85.4 per cent. The trajectory for bulk-billing, which is a measure over time of a trend, is up 3.2 per cent. In other words, bulk-billing has increased dramatically under us compared to what it was. So funding is up, and we also see that bulk-billing figures are up. If you put those two together, you have the strongest and most rock-solid support for Medicare that there has ever been. Let me repeat: they introduced the freeze and we are the ones who are dealing with it now in our discussions with the AMA, with the RACGP and the Australian College of Rural and Remote Medicine.

Let me deal now with Labor's record and what we are doing in health. Labor's record is very clear: Labor hates private health insurance. Let me repeat that: Labor hates private health insurance and wants to decimate it. How do we know this? Here is what the former health minister, the then member for Gellibrand, said going into the election: 'Labor made it crystal clear that we are committed to retaining all of the existing private health insurance rebates.' Here is what the member for Sydney—who introduced the freeze, by the way—said after they left government: 'How did I pay for it? I paid for it by targeting private health insurance.' Targeting private health insurance! It is the language of somebody who hates private health insurance and who resents that system.

Opposition members interjecting—

It was not my language—targeting private health insurance. What we have also heard from the member for Ballarat on health funding is: 'The opposition would be kidding itself'—and this was when she was in opposition—'if it did not recognise there were challenges in the budget and that savings need to be found. There is no area that is going to be exempt.'—

Mr Champion interjecting—

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

The member for Wakefield.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

That is what she said just before the election when they were pitching to come into government. What did they do? They cut $4½ billion from private health insurance; they cut $2½ billion from the Pharmaceutical Benefits Scheme; they cut $1 billion from dental care by cutting chronic disease dental care—by axing a scheme for chronic disease dental care. Why? Because it was too successful. What a commitment to dental care! They cut $664 million from the Medicare Benefits Schedule for GPs; they cut $500 million from pathology; they cut $450 million from the Medicare Safety Net. And then we have the grand daddy of all of their deceptions: they used to talk a lot about $57 billion in hospitals. Well, they had their chance. This shadow minister took a policy to the election—they had been talking about $57 billion—and they put in $2 billion. That is a four per cent success rate; 96 per cent fail rate. In anybody's language, that constitutes a fail unless, of course, you are Senator Kitching filling in a Health Services Union workplace safety test for a few friends. So they had a four per cent—

The DEPUTY SPEAKER: The minister will resume his seat.

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

I am very reluctant to call a point of order during an MPI. I understand it is a robust debate but reflection on another member, even if they are in the other place, is simply not appropriate.

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

I asked the minister to withdraw that comment.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

I actually see no basis for that, but, out of courtesy to the Deputy Speaker, I will do that. But the royal commission actually used language referring specifically to filling in for a few friends.

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

The Minister for Health will withdraw unreservedly, please.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

I am happy to withdraw.

Mr Champion interjecting—

Let us compare Labor's $55 billion shortfall—Labor's 96 per cent failure on what it had been talking about, promising, pledging and committing to the Australian people—with what we have done.

Ms Catherine King interjecting—

Since coming in, we have added $125 million to what we are doing for medical research, dealing with things such as providing $39 million for cancer research, $30 million for dementia, $11 million for Indigenous health—

Chris Crewther (Dunkley, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy Speaker, I rise on a point of order. I refer to standing order 65(b). The shadow minister for health and other members opposite have continued to interrupt the minister over a number of minutes, and I ask the Deputy Speaker to draw attention to that.

Mr Champion interjecting—

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

The member for Wakefield is still under a warning from question time. He is on very thin ice. I will explain now: the reason I am doing this is that the minister interjected when the shadow minister was speaking. I will make a statement after the minister finishes.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

We have added $125 million to our work in relation to medical research. On the weekend we announced that the price of 1,100 drugs for Australian families are coming down. Prices for 1,100 drugs are coming down. There are eight new listings, including for areas such as Hodgkin's lymphoma and skin cancer.

Opposition members interjecting—

What we are doing is listing new drugs, reducing the price of drugs and adding to medical research. The opposition slashed Medicare, introduced the freeze and failed on their own hospitals test. That is a recipe for disaster on their side. These people, in the end, are— (Time expired)

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

That did get out of hand. The Minister for Health was interjecting. The shadow minister was interjecting. That was a most unedifying performance for this House. That is the last time in this MPI that I will tolerate that behaviour. The member for Wakefield was warned in question time, and that is still current.

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

I am very pleased to be speaking on the MPI put forward today by the member for Ballarat which refers to the government's constant undermining of Medicare. The people in my electorate rely very heavily on a Medicare system that is robust, available and affordable. In fact, some suburbs, in particular Broadmeadows, constantly show up in statistics as areas of very high need. We are, in fact, one of the neediest areas. With diseases such as chronic heart disease, diabetes and mental health issues being so prevalent in our community, the government's continued attacks on Medicare raises ongoing alarm both for my constituents and our local healthcare providers.

It has always been the case, certainly in the time that I have been the member for Calwell, that one of our greatest challenges has been the affordability of adequate bulk-billing GP services, as well as the availability of specialist services. My local community health centre, the Dianella Community Health care centre, has struggled over the years to attract and maintain GPs and to also maintain GP bulk-billing. In fact, as far back as 2006, following a massive reduction in the after-hours GP services at Dianella, our community launched a petition calling on the then Howard government to provide the much needed funding to continue this very vital service. At the time, Dianella required about $150,000 per annum to restore our after-hours services. I tabled a petition with some 2,224 signatures with an additional 700 letters sent to the then Minister for Health and Ageing, Tony Abbott.

You can see that Medicare has never been safe from a coalition government, nor will it ever be. It has always been, in fact, Labor governments that support Medicare. The election of a Rudd and Gillard Labor government not only saw a return to support for Medicare but also saw the then Labor government invest some $7 million in contribution to the building of a superclinic in partnership with Dianella Community Health. The superclinic is a one-stop medical shop with doctors, physiotherapists, pathologists, podiatrists and occupational therapists all available to my constituents in one place. The superclinic has been running for a few years, and it is doing a great job of meeting my community's health needs. Of course in 2014, under the aggressive budget repair measures, the then Minister for Health, Peter Dutton, derided the value of the former Labor government's superclinic program and, in fact, shut it down. But, for my electorate, the concept of the superclinic was a great model for addressing the shortages and the inadequate availability of health services.

It is not surprising, then, that the governments most likely to undermine Medicare are always the coalition governments. In fact, not only are they most likely to do that but they are most keen and determined to do that. Of course, we have seen the Abbott-Turnbull governments take up this ideological crusade against Medicare since coming to power in 2013. Who can forget the proposed $7 GP tax, the $5 hike in medicines—the biggest price increases for prescription medicine in a decade—the $50 billion cut from public hospitals or the shutting down of the 61 Medicare Locals? The list goes on.

The Abbott government began the aggressive undermining of Medicare, and this Turnbull government has continued the assault unabated. The Turnbull government does not care whether or not people in my electorate can access affordable health care. The six-year freeze on Medicare rebates is making health care less affordable, yet this government's response is to extend it out to 2020, ignoring calls from across the healthcare sector to lift it. My local GPs and health experts constantly tell me how hard the freeze is biting and hurting my local community. We have historically struggled to attract GPs and to keep GP services affordable, and this is becoming increasingly more difficult, especially when demand is increasing and becoming more urgent.

I do want to pay tribute to the many caring GP services in my electorate who are desperately trying to keep bulk-billing and to remain affordable to the underprivileged and underserviced community they serve, but the freeze is really testing them. The cuts to diagnostic imaging affects and further threatens the welfare of people in my electorate, who are statistically more likely to become ill than those from wealthier electorates. Cuts to the bulk-billing incentive given to pathologists and to radiologists will see co-payments rise, and patients will be forced to pay more for tests or scans. Many of my constituents will be forced to possibly skip lifesaving services such as X-rays, CAT scans and ultrasounds as they become more unaffordable, and this is just not acceptable.

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

There are not too many times that this vitally important topic of health can be raised in this parliament. It is appropriate that we discuss it this afternoon, even though both sides of parliament have very different views on this important topic. The previous speaker was listened to politely and without interruption. We should see the same behaviour from both sides of parliament, because this place is better than to be emitting a constant blather with no intention other than trying to put off an opposing speaker. We can be better than that.

I want to start by touching on the performance of Medicare at the moment, casting some other references to the other pillars of health care, which include private health insurance, the function of the PBAC and the PBS, the history, including the other side's superclinics, and then making a reference to the shifting health debate, which is very much moving away from 'How much money can we shovel in?' to an argument about 'What outcomes can we purchase for the investment?' That is a very subtle change in the discussion, but one that is being led by some of the highest-level thinkers, both in the professions, in the health services themselves and even here, encouragingly, as we see more and more people with a health background entering this fine parliament.

I think it would not go beyond the notice of those who are in the gallery today, watching what they should expect would be a highest-possible-echelon debate about the health system, to ask why some of the highly qualified health individuals from the opposition are not in this debate today. Why wouldn't a highly qualified pediatrician with such eminent standing as the member for Macarthur have been approached to be part of the Labor Party's argument about Medicare? Here is an individual, the member of Macarthur from the other side of politics—I would have thought there might have been a hand that reached out and said, 'Sir, would you be part of this debate? Would you devote five minutes of your afternoon to coming to outline precisely how a hospital system works from the inside?'

It is fine for enthusiasts like us to know roughly when the visiting hours are at the local hospital, but that does not make a health expert. What we need is politicians in this place that have some kind of health background, some kind of health training, some kind of economic understanding to be able to discuss health, because it is an incredibly complicated part of social policy. But alas! The member for Macarthur is up there watching on the CCTV, and we have people reading speeches—reading them word for word. That does not serve the community. That will not serve the community at all.

What we have is a history from the other side of politics where they have promised 64 superclinics and delivered 33. What is the point of simply dropping a Taj Mahal right next door to an existing, functional, privately funded general practice and creating a government-sponsored one right next door? That just crushes business. That was the competitive neutrality problem with an investment in superclinics.

Let's remember the drugs that were relentlessly approved by both sides of politics, proud of our PBAC, until this opposition was in power. What did they do when they ran out of money through self-induced overspending? They deferred the PBAC approval process. That is right. Drugs for schizophrenia, drugs for chronic pain—not approved, even though they had cleared the PBAC bar. We had patients told, 'You will have to wait until we have sorted out our finances.' Then the other side of politics has the temerity to come in here and argue over a 60-cent indexation for Medicare. Let me give you the facts. Seventy-eight per cent of Medicare is bulk billed. Eighty-five per cent of all GP visits are bulk billed. If we assume that they are the poorer cohort of Australians, we have over 20 million Australians enjoying bulk-billed GP practices. I suspect that the other four million of us can afford a couple of dollars to see a GP. That is an utterly reasonable proposition.

But instead of discussing activity-based finance, a shift to outcomes, a nationally efficient price, or even the fantastic editorials written by people like Des Gorman and Murray Horn about shifting the health policy debate away from shovelling money to purchasing outcomes—no, no, no; this kind of quality stuff is not picked up by this opposition. All we are going to argue over is a 60-cent GP Medicare indexation, as if the world revolves around the money in a profession where we do it for the love. This is about shifting from purchasing a health agreement on a piece of paper to purchasing a health outcome; to keeping children out of hospital and having them fully immunised; to having outcomes that are funded by a government willing to do it. That discussion can occur with both sides of politics and with general practitioners and other providers. As long as you have your smartest people on the other side of politics sitting in their offices, not invited to be part of this debate, we will continue to have talking points from ministers' offices thrown around here with no greater gain for this community.

Justine Elliot (Richmond, Australian Labor Party) Share this | Link to this | Hansard source

This is a government that cannot be trusted on health care. They cannot be trusted to fund hospitals properly. Australians know it and they just do not trust you. They do not believe you, because time and time again they have seen this government undermining our universal healthcare system. They just do not trust you on these issues. This government has proven time and time again that it simply does not care about the health of Australians.

There is no better example of the fact that they do not care than the six-year freeze on Medicare rebates. Before the election The Prime Minister promised that no Australian would pay more to see a GP under his Medicare freeze. That turned out to be a lie. Australians are paying a lot more to go to the GP now. In fact, the government's freeze has made health care much more expensive for all Australians. This is on top of their cuts to hospitals and other areas of health care, as well.

I think this six-year freeze on the Medicare rebate really highlights the twisted priorities of this government. They can give a $50 billion tax cut to big business and multimillionaires on the one hand, yet on the other they cut funding to health. They are twisted priorities. In contrast, our priorities in health care are based on fairer funding and greater access to services. We made the choice to not give away $50 billion in a corporate tax cut. We choose to properly fund services. That is our priority. Remember, this government previously failed three times to introduce their GP tax. They tried very hard to do that. That did not work, so instead they imposed a GP tax by stealth—freezing the indexation of those rebates. We made it clear at the election that Labor was committed to lifting the government's freeze on the indexation. This was very popular, I can tell you, in my electorate, because people in my electorate just do not trust this Liberal-National government.

There is a lot of speculation leading up to the budget about what the government may or may not do. We will keep on calling on them to make sure they lift this freeze. We have asked them on many occasions to do that. It is going to be a real test for them to see what happens in the budget, because at every opportunity to reverse the freeze they have done nothing. In fact, they have just extended it. In 2014 they introduced the freeze and in 2016 the Prime Minister himself extended it to 2020. The government have been made very aware of these impacts. They have heard it from the community. GPs, specialists and health experts have been sending a clear and strong message: the freeze is hurting and it should be dropped. I hope the government are listening and I hope, when it comes to the budget, they get rid of it. This freeze comes on top of a lot of other harsh cuts by this government that have hurt the community—cutting over $1 billion from the Pharmaceutical Benefits Scheme and increasing the co-payments, cutting diagnostic imaging and pathology, cutting the Medicare safety net—and also their failure to properly fund our public hospitals. This has seen elective surgery waiting times blow out under the Turnbull Liberal-National government to the worst they have ever been.

The combination of all these cuts has been devastating for our country, and particularly devastating for rural and regional areas like mine on the New South Wales North Coast. As I have said many times before, it is choices by the National Party that particularly hurt our regional and rural areas, and they are to be held accountable for these cruel cuts to health and hospital funding. In areas like mine we see the impact of cuts by the federal government such as those ones I have listed, but we also have a state Liberal-National government whose cuts are doubly hurting us. We have right across our region such a lack of funding for health and hospital care. It is so detrimental. In fact, we recently highlighted the fact that our Tweed Hospital is in absolute crisis. I would just like to highlight an article from The Tweed Daily Newson Wednesday, 8 March, with front page 'Out Of Patience' and headline 'Doctors call for help':

Fed-up doctors and nurses are calling on the community to get behind their push to lobby the State Government into action on the stalled redevelopment of the Tweed Hospital … the hospital's Medical Staff Council decided to take the dramatic step of calling out the NSW Government for failing to deliver on its promises to redevelop the facility.

This comes on the back of the lies of the state National Party MP for Tweed at the last election. He said, 'There's $48 million for the Tweed Hospital'—not true; did not happen. We now have doctors speaking out because our hospital is in crisis. This is in absolute crisis, as are other healthcare providers in the region, and this is on top of all of the Turnbull Liberal-National government's cuts to Medicare and cuts to hospital funding. It is leading to a real health crisis in areas like mine, where we have a large proportion of seniors, who have much more complex health needs and are really devastated. That is why at the last election there was a very positive swing to Labor due to the fact that we want to protect Medicare. We created it and will always fight to protect it.

Lucy Wicks (Robertson, Liberal Party) Share this | Link to this | Hansard source

I am very glad to speak to this matter of public importance, because, despite the disgraceful 'Mediscare' scare campaign run by Labor on the Central Coast at the last federal election, health care is a very positive story that the coalition government can tell on the Central Coast. Far from what members opposite would have people believe, the Central Coast is a region where new and world-class health infrastructure is being rolled out to more people than ever before. It is a region with record high bulk-billing rates under a coalition government. It is a region where, after years of neglect by Labor representatives, the coalition is determined to deliver a plan to see more doctors become available for local families where they are needed the most. If members opposite want to know what real action on health care looks like, they should look to the Central Coast and see how this government has been setting a new standard of excellence in health care for our region.

Contrast this with the six years of Labor representation during the Rudd-Gillard-Rudd years, when Belinda Neal and Deborah O'Neill—now Senator O'Neill—were the members for Robertson, and the Central Coast was falling into a state of very poor health indeed. I remind members opposite that Labor's cuts during this time included $1 billion from Medicare for dental and $500 million from Medicare for pathology. I remind them that Labor cut $664 million from Medicare for GPs, $450 million from the Medicare Safety Net protections, $2.5 billion from pharmacy and medicines, and $4 billion from the private health insurance rebate for consumers, and they means-tested it. It is a very long list. And, as the minister stated so clearly—and it hardly needs repeating—it was Labor who introduced, created, owned and authored the Medicare freeze. Now Labor refuses to back its unfunded $57 billion hospitals promise, their biggest cut in waiting.

What is more, Labor, represented on the Central Coast by then members Belinda Neal and Deborah O'Neill, failed the people of the Central Coast by letting the GP shortage on the Peninsula become a crisis. They did this by simply doing nothing, especially on the Peninsula. In contrast, we acted, including in 2015 when the coalition made vital changes to the District of Workforce Shortage calculations so that now the most up-to-date data is used to identify areas where there is a doctor shortage. This change has meant greater availability of doctors in 26 new suburbs in Robertson. Recently we engaged with health experts and health professionals to host a community forum, packed with around 100 people, where we committed to address this problem. The Assistant Minister for Health, Dr David Gillespie, joined me at the forum at Umina Beach, and I look forward to sitting down with him again tomorrow with key medical recruiters here in parliament.

This also comes as bulk-billing rates hit record highs, meaning patients are getting more benefit from Medicare than ever before. Nationally, as we have already heard, GP bulk-billing rates have jumped to 85.4 per cent during the second half of 2016. This is even higher in my electorate, where it is around 87 per cent, and it is almost 91 per cent in the member for Dobell's electorate, but you do not hear these facts coming from Labor. So let this be clear: the coalition government has a rock-solid commitment to Medicare, and funding is increasing by around $1 billion every year. We also have a rock-solid commitment to the Pharmaceutical Benefits Scheme, and from next month the cost of more than 1,100 medicine brands is being reduced, with vital new drugs being added to the PBS for people with conditions including high cholesterol, Parkinson's disease, depression and breast cancer. The coalition government also has a generous and sustainable hospital funding agreement, which delivers an additional $2.9 billion in public hospital funding. That is $7.9 billion more than Labor funded in its last year of government.

Finally, let me underline how the coalition government is clearly demonstrating its commitment to world-class health care on the Central Coast. We have set up a groundbreaking new medical precinct task force for the Central Coast, which includes representatives from government and the University of Newcastle, and health experts from the private and public sectors. We did not hear a word about this when Labor represented the region. Established with the assistance of the Minister for Health, when he served as the Minister for Industry, Innovation and Science, the task force is an Australian-first pilot that will seek to build on our $32.5 million investment in the Central Coast Medical School and Medical Research Institute—again, nothing that occurred under the Labor government.

This is based at Gosford hospital, which is itself undergoing a $348 million expansion thanks to the NSW Liberal government. There are 750 jobs that will flow from the medical research institute and school, with the facility on track to be completed by 2019. I could not be more proud of the work that this government is doing to deliver better standards of health care to people who need it most on the Central Coast and, indeed, around Australia. (Time expired)

Ross Hart (Bass, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to speak on this matter of public importance. The topic talks about the government's undermining of Medicare, in particular with its six-year freeze on the Medicare rebate. At their simplest, the principles underpinning the Medicare system are very basic. In this respect, Medicare is an idea. Medicare is a very powerful idea. It is grounded in the universality of the right to receive health care.

The first version of Medicare, the Medibank system—introduced under the Whitlam government—was opposed by the coalition opposition and a sizeable section of the medical profession. Universal health care is a right. It is a universal right for all citizens to receive health care based upon need rather than the ability to pay. That is why we say that you should be accessing health care with your Medicare card rather than with your credit card.

Despite the simplicity of the idea, and despite the recognition by the medical profession over an extended period of time of the effectiveness of the Medicare system, the coalition—with protestations—is no friend to Medicare. The reason why I can say this with confidence is that every action taken by the Liberals in government reveals their agenda to undermine Medicare through undermining the universal application of Medicare. There is no better example of their lack of commitment to universality and the importance of Medicare as a universal health care system than the six-year freeze on Medicare rebates. When health care becomes unaffordable for more and more Australians, the universality principle is undermined.

In 2014 they introduced the freeze, and in 2016 the Prime Minister extended the freeze to 2020. The medical profession, represented by GPs, specialists and health experts, has been very vocal in warning that the freeze has led to a drop in bulk billing and an increase in gap payments, which have to be met by patients. Whilst the government may wish to fudge the issue through vague references to working on lifting the freeze, its agenda is to undermine Medicare by requiring more and more Australians to meet more and more of the cost of their health care.

GPs and patients have borne the brunt of the unfair freezing of the Medicare rebate. The government, in particular under the previous minister for health, constantly spoke of the necessity to ensure that our public health system was sustainable. All of the cuts to health care, all of the freezes which have been imposed upon our public health system are in the name of sustainability, which is the most Orwellian code for the imposition of inappropriate and unsustainable restraint upon our public health system—the sort of restraint which can lead to system failure.

Medicare is sustainable, providing it is adequately resourced. It is of significant concern to me, as a former member of a public health board—the Tasmanian Health Organisation - North, an operator of acute care—that primary health, that is the people who access general practitioners, are underfunded through the Medicare rebate freeze, and also that there is significant pressure upon our public health system, particularly in my electorate of Bass. The Tasmanian public health system is under significant stress, with the Launceston General Hospital struggling to meet demand and struggling to recruit specialists to a well-regarded general hospital.

Public health should include a focus on preventable health as well as chronic and acute care. A failure to adequately resource Medicare, in the form of a freeze on the GP rebate, means that people will delay consulting a medical practitioner. People will present to the emergency departments of our already under-resourced public hospitals, instead of seeking advice at an early stage from a general practitioner.

This Turnbull government is making health care less affordable for every Australian, with the Medicare freeze already forcing GPs to drop bulk billing and increase out-of-pocket expenses. The record of state and federal Liberal governments is poor in health. Their failure to properly fund our public hospitals has seen elective surgery waiting lists blow out. I have been made aware of shameful delays within the Tasmanian public health system. I have been told of patients who have been diagnosed with serious conditions like bowel cancer, who cannot access life-saving surgery within a reasonable time, due to the mismanagement of the public health system.

The insistence that public health funding is growing year after year but not meeting demand, increase in acuity or increase in healthcare inflation, means that the funding of our public health system is constantly under stress, with public health boards constantly searching for efficiencies and savings. I know that in my electorate of Bass voters rejected the underfunding of health, the freezing of the Medicare rebate and the freezing of the pathology billing incentive. My electorate has significant pockets of disadvantage. My electorate values universal health care. (Time expired)

Julian Leeser (Berowra, Liberal Party) Share this | Link to this | Hansard source

My understanding of mathematics is that there are several branches. There is trigonometry; there is geometry. Today we saw a new branch of mathematics: 'Shortenometry'—that part of mathematics where the figures just do not add up. That is what we saw today from the shadow minister for health. She tried to give us this idea that, somehow, a government that has only been in office for 3½ years was responsible for a freeze that has been in place for six years. The truth is that the Medicare freeze was introduced by the Deputy Leader of the Opposition, the member for Sydney, when she was the Minister for Health in the last government.

But it should not surprise us that those opposite are misleading and deceptive on Medicare, because that is what their record has been like. That was what their record was like during the election campaign, particularly. We saw that big launch where the curtain came down, the Medicare bus was up, and we heard the Leader of the Opposition talk into the microphone with a zombie voice about the importance of saving Medicare. What they did was mislead and deceive the public about Medicare. The 'Mediscare' campaign was the most deceptive campaign ever in Australia. They scared people with robocalls. They scared people by impersonating agencies. They scared people with fake texts.

At one particular point in time in the campaign, the Leader of the Opposition was actually called on this point by Leigh Sales on 7.30 and asked the direct question: can you put your hand on your heart and look Australians in the eye and say that the coalition has a policy to privatise Medicare? What did he do? He could not answer the question. He would not say and he did not say. That is the truth, because, at the end of the day, the 'Mediscare' was one great big deception.

And why wouldn't Labor want to deceive people on Medicare? The nature of Labor Party policy in relation to health has been so bad. They cut over $6 billion, in office, from Medicare and medicines. They introduced the pause in the Medicare indexation. They cut $1.4 billion from diagnostic imaging and pathology. They took a billion dollars from Medicare for dental services and put it into a mean-tested scheme that only helped a third of the children it was supposed to help. They ripped $4 billion out of the private health insurance rebate and premiums went up 30 per cent. They broke a $57 billion hospital funding promise. And, on medical research, they tried to sneak out $400 million.

In my electorate we have seen what happens when Labor administers a health system. I was on the Hornsby Hospital community participation committee before I became a member of this House. For years, Labor in my electorate had neglected that hospital. That hospital was in such bad repair under the state Labor government that when it rained the roofs leaked in the operating theatres, possums ran amok throughout the hospital and many of the buildings and equipment had not been repaired and upgraded since the sixties and seventies. It was only when the coalition came to government at the state level that that hospital was transformed, with a new mental health unit, with a $120 million upgrade for stage 1 and with a $200 million recently upgraded stage 2 of that hospital.

That is a demonstration yet again that Labor like to talk about health but when they are actually in government they fail to deliver again and again. There was their GP super clinics promise. They promised 64 GP super clinics but they only delivered 33. Under Labor, median waiting times for elective surgery went from 34 days to 36 days. They promised to end the blame game on medical funding but they did not. It is broken promise after broken promise.

By contrast, under the coalition, bulk-billing has been stronger than ever. More Australians are visiting doctors without putting their hand in their pocket, with 73½ million GP attendances in the second half of 2016. The bulk-billing rate is at 77.8 per cent. That is a very high rate of bulk-billing. There are more services available through Medicare—$192.7 million of services. That is a real increase in this area. Then we have the Pharmaceutical Benefits Scheme, another part of the health policy of the coalition. From 1 April, the cost of 1,100 medical brands will be reduced. People will have access to cheaper medicines for cholesterol, Parkinson's disease, depression and breast cancer—all areas that are desperately in need of funding relief, and all areas that have been assisted by the coalition's policies in relation to the Pharmaceutical Benefits Scheme and health more broadly.

The Labor Party have no credibility, no integrity and no shame in relation to health policy. They could not deliver a surplus. You cannot trust them on 457s. You cannot trust them on education funding. Why should you trust them on anything? (Time expired)

Michael Danby (Melbourne Ports, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition) Share this | Link to this | Hansard source

This six-year freeze on Medicare rebates is gradually and sneakily undermining Medicare and is set to continue with the Prime Minister's plan to extend it out to 2020. The government's attitude is characterised by relentless attacks on our iconic health system. This government came to power with a plan to undermine Medicare. How could we forget this government's first budget—a budget littered with heartless measures aimed at our nation's most vulnerable people? At the very beginning it became clear that the government wanted to weaken and privatise Medicare. The measures in that budget were astonishing. There was a $7 sick tax—a tax that would have immediately transformed Medicare from a service helping our sick into a tax on our sick; increased cost for medication on the Pharmaceutical Benefits Scheme; and encouragement for states and territories to charge a co-payment for GP equivalent visits to hospital emergency services.

The government introduced this freeze in 2014 and in 2016, as I said, the Prime Minister himself extended it out to 2020. This 'ice age', as the member for Ballarat has described it, has had a massive effect on our health system. Out-of-pocket costs are higher than they have ever been and GPs have already been forced to increase fees and drop bulk-billing. As AMA President Michael Gannon said, 'The freeze is hurting now and it should have been dropped a long time ago.' To quote him verbatim, on 1 July 2016 he said:

We know there are some GPs that are changing their billing practices and that commences today, on July 1. The reality is that there are a lot of GPs who decided they could probably take the hit for a couple of years but they are saying enough's enough.

As the member for Ballarat says, the trajectory of bulk-billing is declining, access is more difficult and costs are increasing.

This time the government are going through the back door as a way of destroying Medicare. They want to make people pay more, not through the measures outlined in the zombie bills that are still in the Senate but by reducing the real earnings of doctors over time. Going all the way back to Fraser, the LNP has, like a Trump administration, opposed what they think is socialised medicine. Their current tactic is no longer to attack it head on but to index payments received by our medical professionals from Medicare. In other words, as inflation pushes prices up, doctors receive no increase in the value of their payments and are forced to charge their patients. The government's unfair health policies, rejected by millions of people at the last election, need to be dropped—the increase in the PBS co-payments, the cuts to diagnostic imaging and pathology and the cuts to the Medicare safety net.

The day before the election, Prime Minister Turnbull promised that no Australian would pay more to see a GP under the Medicare freeze. This was a lie. Australians are already paying more for GPs and out-of-pocket expenses for health are increasing. The current government is making health care less affordable for every Australian, with the Medicare freeze already forcing GPs to drop bulk-billing, as I have explained, and increase out-of-pocket costs. The Prime Minister, Mr Turnbull, the member for Wentworth, is also cutting $1.3 from the Pharmaceutical Benefits Scheme and increasing the co-payment by up to $5—the biggest increase for prescription medicine in a decade.

As the member for Richmond valuably added, cuts to bulk-billing incentives—the payments which give pathologists and radiologists a specific incentive to bulk-bill—will mean that bulk-billing rates will fall, co-payments will rise and patients will be forced to pay more for tests and scans or skip them altogether, which is something that really worries me with Australia's tradition of preventative health care. The government's failure to properly fund our public hospitals has seen elective surgery waiting times blow out under this Prime Minister—the worst we have seen since records started to be kept in 2001. The $1.4 billion cuts to preventative health and health promotion grants are forcing community organisations to close their doors, including organisations which target HIV prevention in young people and LGBTI health in Indigenous communities.

Millions of voters rejected the Prime Minister's health cuts at the last election. Medicare is a universal health system—as the member for Bass pointed out—as imagined by the great Gough Whitlam. It will be preserved only by the election of a Shorten Labor government, with the member for Ballarat as the Minister for Health.

Damian Drum (Murray, National Party) Share this | Link to this | Hansard source

I think this debate on the matter of public importance of Medicare is a great way to define the differences between the two sides of this parliament. What we have on one side is somebody who calls it as they see it and acknowledges that yes, there was a whole range of challenges in relation to funding and continuing to improve on a health service that tends to grow in most western societies and most western countries at around five, six or seven per cent year on year. It puts an incredible strain on the budget of all those First World countries when so many other parts of the economy are potentially stagnant or maybe growing at one or two per cent. This creates a real challenge, but at least the coalition has the decency and the honesty to acknowledge that we have real, serious challenges.

On the other hand, we have a series of mistruths and lies coming out of the Labor Party. And not only do they get found out for these lies but they are incredibly proud of telling these lies to the Australian public. They are incredibly proud of the fact that even though they were caught out with the 'Mediscare' campaign during the election campaign they wear it as some sort of badge of honour that they are so deceitful. They think, 'We can put one over the Australian people', and they wear it with this incredible honour. As the member for Berowra stated earlier, when the opposition leader was caught out on radio in the days and weeks leading up to the election and asked whether he could give us one skerrick of evidence about whether there is any truth behind the 'Mediscare' campaign at all, he was unable to furnish one skerrick of evidence about so-called 'Mediscare'—the fact that we could somehow or other privatise a system that costs us $15 billion. I would like to see who is going to buy that one!

Irrespective of that, the ridiculousness of the 'Mediscare' campaign has been borne out in the months following the election, but there is this incredible attitude of the Labor Party whereby they still tend to revel in the deceit and dishonesty associated with the entire campaign. It is beyond belief. However, the previous speaker, Mr Danby, the member for Melbourne Ports, at least started his contribution by talking about when the freeze on the Medicare rebate was put in place six years ago, and then he went on with the rest of his contribution. At least he acknowledged that it was the Labor Party that started the rebate freeze. It was the Labor Party that put this freeze in place.

If we start from that point of honesty, then maybe we can go along and look at what the rates of Australians who are using the bulk-billing system are now. I do not know what the member for Sydney was talking about when she wanted to talk about the trajectory of bulk-billing, but, quite simply, 75.1 per cent of Australians were bulk-billing in 2012-13. Then in 2013-14 it went to 76 per cent. In 2014-15—a coalition government—it was 76.9 per cent. There were steady increases in the percentage of all visitors to a doctor, the percentage of all Australians accessing bulk-billing, increasing year on year. And in 2015-16 and 2016-17 it has been 77.1 per cent of Australians accessing bulk-billing. So, the statistics and the facts put a further lie to the outrageous claims that are being put forward by the Labor Party. Once again they get caught out.

In relation to bulk-billing rates state by state and then through electorates, for the seat of Murray, for total Medicare, 79 per cent of people who live in Murray are able to access bulk-billing. Yes, it would be great if we lived in a fairyland world where money were no object and we were not spending $100 million a day more than we were making, if we had no budgetary pressures. If the Labor Party had its way, we know where it would go in relation to higher taxes, where it would go in relation to further spending, putting greater pressure on business. Absolutely, as the Prime Minister said today: not one policy that is going to actually be good for the economy, not one policy that is going to create one job, not one policy that is going to actually fix up the deficit that we are going to hand on to our kids. Only the coalition has the courage to balance the budget.

Debate adjourned.