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:

This Government's five-year record of failure on Medicare.

I call upon all those honourable 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 and Medicare) Share this | Link to this | Hansard source

I'm faced today with a pretty monumental task, trying to condense five years of government failures on Medicare into a single 10-minute speech. I could very easily spend 10 minutes just on their disastrous six-year Medicare freeze, which has ripped billions of dollars out of Medicare and forced up the cost of health care for all Australians, a freeze that continues in part today. I could spend 10 minutes on the infamous 2014 budget, where they sought to run a wrecking ball through our universal health insurance scheme by making everyone pay more to see the doctor, or on their attempts to dismantle bulk-billing incentives or to privatise the Medicare payments system. And that's not even to mention their overblown claims about daily PBS listings or their savage ongoing cuts to hospitals, including their new retrospective cuts of hundreds of millions of dollars for public hospitals. I could definitely spend 10 minutes just talking about their five years of failure when it comes to Medicare-licensed MRI machines. Yes, they've finally acted on that now, after pretty much copying Labor's policy. Imitation is the sincerest form of flattery, Minister, so thank you very much.

Alas, I don't actually have an hour; I have just 10 minutes, so I'll do my best. Labor, as everyone knows, is the party of Medicare. We invented it, and we will always protect it. It is the heart and soul of our healthcare system, and it is the envy of countries around the world. More than 20 million Australians access Medicare services every year. It is without doubt one of the most important programs that the Commonwealth government delivers. It's fundamental not just to our health system but to our economy and the very fabric of our modern society. It took two Labor governments more than two decades to shape and embed the Medicare that we know today.

Many Australians take Medicare for granted, and I wish they could take it for granted, because, in the Labor Party, we believe Australians should be able to rely on Medicare wherever they need it, without worry, without a second thought. But the Australian people cannot take Medicare for granted, because, every single time the conservatives get into power, they start to look at creative ways to dismantle it. Remember the $7 co-payment from just a few years ago? That was an unprecedented attack on the universality and accessibility of Medicare, effectively ending bulk-billing. It was a policy that would have forced up the cost of seeing a GP and the cost of hospital pathology and X-rays.

The minister likes to pretend that all things just started with him. You've got history in the party on the government benches in what you've done to Medicare, so you need, in your address, to actually address what you've done since 2014: cut after cut after cut. The co-payment that was in that budget wasn't just targeted at the wealthy or well off; it was everyone, including children and pensioners, the chronically ill and the poorest, most disadvantaged people in our nation. The Liberals wanted to use this co-payment as a price signal to deter going to the doctor. That is what they said was exactly what they wanted to do. Can you believe it? Their health policy at the time revolved around deterring people from actually seeking health care.

Of course, we know that the people who don't go to the doctor typically get sicker and sicker and end up costing the health system more. So the conservative prescription was to make people sicker and end up spending more on the health system in the long run—absolute genius. It was Labor, it was the parliament and it was the Australian people who ultimately stopped this government going down that road. As is so often the case, we helped save the government from themselves, but the plan revealed what was actually in their hearts. And when they couldn't get that plan through, they resorted to extending the freeze on Medicare rebates. Again, under intense pressure from Labor, doctors and the public, the minister announced a gradual thaw in the six-year freeze in May 2017, but he still hasn't actually lifted it all today. Many elements will still remain up until 2020. That is six years of slugging doctors and ultimately patients, simply because they won't want to access our health care.

I recently visited the Gold Coast and met with Professor John Corbett. After providing bulk-billed specialist EEG services for over 20 years, John Corbett has recently been forced to cease providing these services because of the government's ongoing freeze. That means higher costs for patients, and this sort of thing is happening all over the country. The rebate freeze has ripped $3 billion out of Medicare, and the Liberals are still banking savings from those cuts today. That's $3 billion ripped out of the pockets of patients.

A couple of months ago, the Australian Institute of Health and Welfare finally laid bare the full extent of the health affordability crisis in Australia—a crisis inflicted by this government. The report showed that Australians are spending nearly $30 billion on out-of-pocket health expenses a year. That includes $3 billion a year on nonhospital Medicare-subsidised services. Half of all patients have incurred out-of-pocket costs to see a GP or a specialist or have blood tests, X-rays or other scans. Seventy per cent of patients seeing specialists made some out-of-pocket payment, and more than a million people spent $600 or more on medical gap fees. As a result of these costs, 1.3 million people are either delaying or skipping seeing a doctor or getting a test when they need it, putting their wellbeing and their lives at risk.

The AIHW report also exposed this minister's claims about bulk-billing. The data shows that only 66 per cent of patients are bulk-billed by their GP, a far cry from the 86 per cent figure the minister trots out on a daily basis. The Australian Healthcare and Hospitals Association confirmed that the figures cited by the minister are in fact misleading. That's a nice way of saying they're a complete con job and totally meaningless. You cannot trust this minister. Malcolm Turnbull couldn't trust this minister. This minister lined up in this place to profess support for the former Prime Minister, all the way working with the member for Dickson to tear him down. And how well did that work out for the minister? Remind me—is the member for Dickson the Prime Minister? And how many votes did the minister actually get for the deputy job? I think it was 16. His colleagues can't trust him and neither can the Australian people.

It's the same when it comes to the Pharmaceutical Benefits Scheme. Every other day the minister tries to trumpet this government's record when it comes to listing new medicines. It's basically all that he talks about nowadays, probably because their achievements elsewhere in the health portfolio are so evidently lacking. But, when he does, he so conveniently forgets to mention that it was his government, in fact, that tried to increase the co-payment, which would have forced up the cost of PBS medicines by up to $5, including for vulnerable pensioners.

Despite all the government's cuts and failures, they still make the remarkable claim that Medicare has never been stronger and that their commitment is rock solid. But you can't judge them on what they say. You have to, of course, judge them on what they do, and their record is an appalling one. In Senate estimates earlier this year, officials said that the government's 2018 budget—and this is the government officials—was trying to bend the cost curve of Medicare. That's the government's fancy new way of saying 'a cut'. The government also wants to bend the Medicare cost curve until it actually breaks.

The government has also now broken an election promise—another one. In the election campaign they gave an unequivocal commitment that every element of Medicare services would continue to be delivered by the government. That is the commitment the then Prime Minister gave. They gave that commitment after they got the scare of their lives as we were fighting so hard against their privatisation agenda—the agenda to privatise the Medicare payments system, which is what you were doing. You are now trying to do it by stealth. We understand, as exposed by the member for Chifley, that 12 contract staff are set to administer Medicare payments for the first time in Hobart. It is the start, again, of the privatisation of Medicare—the privatisation of the Medicare payments system, bringing in contractors for the first time.

You bet we're going to absolutely highlight your hypocrisy. You're trying to do it absolutely again. This is a government that has fought and hated Medicare every single step of the way. They dream of an Americanised health care system where every man, woman and child should care for themselves, where people die or suffer for years because they cannot afford a doctor and cannot afford to go to a hospital. This is their vision for Medicare, a two tiered system—opposed all the way, every day, by Labor.

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

I am delighted to speak today because I've got a simple message: you cannot trust Labor to list medicines because you can't trust Labor to run the economy. How do we know this? Last time they were in government they blew the budget and the economy, and they stopped listing medicines. Seven medicines were deferred by the then assistant Treasurer, the now Leader of the Opposition—and the would-be next Labor Prime Minister—on the basis that, due to fiscal circumstances, the government would 'defer medicines until fiscal circumstances permit'.

Let me translate that budget paper to what it means for ordinary Australians. It meant that Australians were unable to get a medicine approved by the PBAC, approved by the medical experts, because of a decision by government to stop listing medicines for conditions such as asthma, chronic obstructive pulmonary disease, endometriosis, schizophrenia and for women engaged with IVF. These were conditions for which the previous government, with the same people in charge as now—a Leader of the Opposition who was the assistant Treasurer, a Deputy Leader of the Opposition who was a health minister under that government and a member for Ballarat who had a certain history with regional issues and now wants to administer a $100 billion health budget—wanted to stop listing medicines. That is the reality.

You can't trust Labor to list your medicines because you can't trust them with the economy. Their track record proves this. They deliberately and consciously overrode the advice of the medical experts and hoped that it would never be realised that they were denying Australians vital medicines—after they had reached agreement on price with the companies in question. That is extraordinary and something which should never be repeated in Australia.

Let me turn to Medicare. I'm really proud of what we've done in our time, on our watch, in relation to new items being listed on the Medicare schedule. More than 200,000 Australian women a year will have access to 3D mammogram screening, there will be new MRI tests for prostate cancer and there will be better access for renal dialysis in remote and rural Australia, with a particular focus on Indigenous communities. What does that translate to? Over the current four-year period we go from $25 billion to $26 billion to $27 billion to $29 billion of investment in Medicare per year. Each year, it will travel by more than a billion dollars—a $4.8 billion increase at the last budget alone.

Listening to Labor you would think, 'Gosh, they must have had a higher figure.' No. When I looked at the figures for Labor in 2012-13, their last full year, it was a budget of $19.5 billion for Medicare. By the time this forward estimates period is over it will be $29 billion, almost a $10 billion increase in outlays on Medicare. Each year, every year, there is record investment and record increases. What we're seeing is each year, every year, a record investment in and record figures for Medicare.

What is very interesting is they did mention the Australian Institute of Health and Welfare. I do actually happen to have a report from the Australian Institute of Health and Welfare. It's their 2016-17 review of health expenditure. There was something I hadn't quite realised, and I apologise for not having picked this up earlier. But I'm enjoying my research, as the member of Ballarat encouraged me to do, looking to the past. I was looking at some of Labor's figures. I have been encouraged by the member for Ballarat to look back at the recent history. What did the Australian Institute of Health and Welfare say in relation to table 3.3 on total health expenditure in 2012-13? It was $64 billion. That's a reasonable figure. The growth in that year, for Labor's last full-year budget, was minus 2.6 per cent. So they cut health in their final budget dramatically. In their last full year, it was minus 2.6 per cent—a $1.7 billion cut. That was their watch, their time and their responsibility. Of all of the topics they could have picked to talk about, to have a 2.6 per cent cut to the overall health budget in their last full year in government, is a classic Labor con. They talk about a belief in Medicare and, yet, the health budget in their last full year was down by $1.7 billion. It was down by 2.6 per cent. That's not our figures. It's from the Institute of Health and Welfare to which they referred themselves.

That brings me perfectly to the question of bulk-billing. The bulk-billing rates are up. Not only are they up; they are up significantly and dramatically. Where are they now? They were at 82.2 per cent under Labor. They're at 86.1 per cent now. What does that mean? It means, for every 100 visits to the general practitioner, 86 per cent of them are completely free to the patient. They pay no outgoings whatsoever. Every 100 visits, 86.1 per cent are free. For some reason the member for Ballarat seems to dispute these figures. I also did a little bit of history. I looked at the last time there was Labor commentary from a Labor minister using exactly the same methodology and exactly the same processes. That was on 13 May 2013. The then Minister for Health, the current member for Sydney, the Deputy Leader of the Opposition, crowed about bulk-billing rates for GP services reaching a new record high of 82 per cent in the March quarter—the highest rate in Australia's history, at the time. And, yet, this is using exactly the same figures and exactly the same comparator. I haven't heard the member for Ballarat say that it was all a fraud when Labor was in government. It's the same figures and same methodology, unchanged through Medicare and unchanged through the assessments. So what we see is that we've gone from 82 per cent under Labor to 86 per cent under the coalition. That's the reality. Bulk-billing rates are up almost four per cent under this government.

What that means is that fewer patients are having to pay to go to the doctor. Fewer patients are having to pay. But, even for those who are, right now we're embarking on a reform that's never occurred in Australia. The Chief Medical Officer is bringing together the Royal Australasian College of Surgeons, physicians, the AMA, GPs and others to ensure that we have a transparency model for out-of-pockets, which has never occurred in this country on this scale. That's something that we initiated. It's something that I requested the Chief Medical Officer to commence and it's something which will have, I believe, an important and critical impact and will be a historic step forward in transparency.

Then we go to the Pharmaceutical Benefits Scheme. I couldn't be more delighted to discuss this topic. Bizarrely, Labor has started to question whether or not listings have actually occurred. I just want to take you to one of the more embarrassing interchanges last night, when Senator Watt tried to deal with this in estimates and Senator Dean Smith asked the departmental people exactly how many listings there were. He said, 'Did I hear, Ms Shakespeare,' the deputy secretary of the department, 'in your evidence, that there have been 1,900 new or amended listings that have taken place since 2013?' Ms Shakespeare said, 'I'll just check that number for you.' And I do apologise to the House; I haven't been completely correct—I had been saying 1,900. The evidence from Deputy Secretary Shakespeare was, '1,920 new and amended listings.' Dean Smith said, '1,920 new or amended listings have taken place since 2013; that's correct?' 'Yes, October 2013.' Dean Smith said: 'That's very specific—October 2013. So that could translate—and maths was never my strength—but that could translate to one per day?' Deputy Secretary Shakespeare from the department said, 'That's new and amended listings, averaging 31 per month, approximately one per day.' Even when they are trying to make it up, they can't get it right. So what we see is that, yesterday, we had new medicines which will help 4½ thousand patients with macular degeneration and with issues such as blood clots in the eyes. This is about giving 4½ thousand patients access to medicines that will transform their lives. In the end, we're transforming lives, we're investing in Medicare and we're giving Australians security for their health future.

Tony Zappia (Makin, Australian Labor Party, Shadow Assistant Minister for Medicare) Share this | Link to this | Hansard source

Once again we heard the Minister for Health spending much of his time speaking about the listing of new medicines. The listing of new medicines is nothing new. It has been going on as part of government policy regardless of who is in government for decades. But the minister of course didn't talk about the delays of the listing of the new medicines that he refers to. More importantly, the minister spent his time speaking about the listing of new medicines in order to deflect from his government's failures and his personal failures in managing the health system of Australia—the failure to adequately fund our hospitals, with a $2.8 billion cut between 2019 and 2025; a $715 million cut over this three-year cycle; a failure to adequately fund our health professionals, and that refers directly to the six-year Medicare freeze, which is still going; and a failure to adequately fund medical professionals, such as doctors who do after-hours visits and, in particular, how that affects the residential aged-care facilities of this country. Indeed, the out-of-pocket costs to Australians wanting to see their doctor are increasing. Medicine scripts are not being filled or are being delayed, as are GP visits and doctors visits more broadly. For dentists—and I haven't got time to go into the details—the out-of-pocket costs reached $240 per person last year. In Australia's most disadvantaged communities, over one-quarter of people delay seeing or do not see their dentist. Today we heard of the government wanting to use labour hire staff in Medicare offices—again, a step towards privatising Medicare.

Cuts to public health are intended to do two things: (1) to push people into private health insurance and (2) to push the responsibility onto the public health system of the state governments by sending people to the hospitals. But what we've seen happen with respect to both of those matters is that, with private health insurance, costs have increased to over a thousand dollars more per year per person. We're seeing people dropping their policies because of that. We've also seen the government now delay by one year the introduction of its gold, silver, bronze new private health insurance system because the government knows that proposal will increase the costs and reduce the services that people get from that cover, and it didn't want to introduce that policy just before the next federal election. It wouldn't have been a good look for them to do that.

What we've also seen is elective surgery waiting lists blowing out. In particular in my state—and I understand it's happening in other states as well—we're seeing ambulance ramping. It's happening because people are avoiding going to their doctor and using the state system as an alternative, and it's happening because doctors will not go to residential aged-care facilities, and they've made that clear. Residents of those facilities are then being transferred to the hospitals. I have heard that from people that work directly in the system.

Nowhere are these cuts hurting more than in country Australia, where country people have fewer GPs, less choice, fewer doctors who bulk-bill and higher co-payment rates—not to mention the travel costs they incur. There are seven million people who live in country Australia. We know the chronic disease burden is much greater there and we know that, for them, getting the healthcare they need is much more difficult. Martin Laverty, the CEO of the Royal Flying Doctor Service, talks about the mental health crisis in country Australia—and, again, time does not allow me to talk about that in detail.

Only last night, the member for Macarthur and I, at a function held by the Lung Cancer Foundation, spoke with a person from Mackay, who, over the years, has had multiple surgeries. Her family has had to spend a million dollars for her healthcare needs. When she goes to her GP, each visit costs her about $100 because there is no bulk-billing provided—not to mention the travel costs this person incurs to go to Brisbane every time she needs to get the serious treatment she needs. That is typical of the hardship being faced by country people when it comes to the health services provided by this nation. The facts speak for themselves. Out-of-pocket costs for remote Australians went up to $60.20 in 2017 and, for very remote Australians, to $64.25. That's the government own report figures. For specialists, the out-of-pocket cost for remote Australians is now $81. The figures don't lie. This comes from the government's own Medicare report.

The fact is that a healthy nation is a productive nation. Health care comes at the top of what matters to people most, and the Morrison government, and this minister in particular, have failed to adequately manage Australia's healthcare system.

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

I love it when the opposition bring up these MPIs on health and make these outrageous claims. There are black-and-white budgetary figures that show that most of what has been said in the last two speeches from the other side is absolute rubbish. First of all, Medicare funding has gone up exponentially. There's another $4.8 billion going into Medicare over the next four years. Bulk-billing rates have gone from 82 per cent up to 86 per cent. That is not a reduction in Medicare billing. There is $10 billion more annually since 2013 going into Medicare billing than there was in the last final year of the ALP being in charge of health. It is unbelievable that they have the temerity to say that we've cut things in Medicare. We've established the Medicare guarantee legislation, which means that the first funds out of the budget go into Medicare funding and Pharmaceutical Benefits Scheme funding, and it's topped up by income tax. So there is a legislated guaranteed allocation of funds and appropriation for health first up.

On hospital funding, my goodness, there has been so much more money go into state and territory hospital funding than you could realistically expect. In fact, one would say we have taken over more responsibility than any other government since Federation. Hospital funding to all the states has increased by 70 per cent since 2013. And the new hospital agreement that has just been signed up to go from 2020-21 out to the 2024-25 budgetary year will increase funding by another $30.2 billion. The states must be so pleased that they have got all these extra funds. Just so you know that I can count: $13.3 billion from the federal government in 2013 and this year it's $22.7 billion. That is a massive increase.

I will go to some of the other pillars of our health system—for example, health insurance. We have reformed health insurance and we've changed what can be claimed on health insurance for people in regional and rural Australia. We've given a discount to young people in order to get more young people to take up private health insurance early. You will be able to claim a travel allowance under the new scheme if you are using your private health insurance.

Regarding one of the other pillars, the Pharmaceutical Benefits Scheme, we've just heard the most up-to-date figures. There are 1,900 new or amended listings. There is $10 billion a year going into the Pharmaceutical Benefits Scheme, of which $2.4 billion has been for new listings. Whether it is for asthma, cystic fibrosis or cancers like leukaemia, lymphoma, ovarian cancer or melanoma—you name it—there are new drugs there that will give hope to people who have been afflicted by serious cancers. Whether you have heart failure or hepatitis C, there are new, amazing drugs that are now on the Pharmaceutical Benefits Scheme that weren't there before. They have been listed because we have had the economic management in place to secure the funds for these vital services. We have grown the pie. We are cutting taxes. We have done so much to secure the essential services that everyone in Australia relies on.

We have given another 30 MRI licences. That's another bonus to the state hospitals, because some of these MRI licences will be in public hospitals. Medicare is subsidising cutting-edge radiology in state and territory public hospitals. There's another 20 MRI licences that can be tendered for. That's a 17 per cent increase. As for what we've done in mental health, there have been extra funds for mental health in the bush. Mr Laverty, the CEO of Royal Flying Doctor Service, came to us when I was in the health portfolio and said, 'We need more money for mental health.' And what did we get in the last budget? We got extra millions and millions of dollars for the Royal Flying Doctor Service. We've expanded end-to-end medical school training in regional Australia. The Medical Research Future Fund has kicked the funding into biomedical translation funds and for blue sky development of new research ideas. (Time expired)

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

This government has a five-year record of failures on Medicare. I just don't have enough time to describe this government's failures on health. There was the My Health Record, the hugely increased gap payments for Medicare visits, the failure in imaging, the failure in pathology and the failure in providing services to rural and regional areas. It is an absolute tragedy. I'll just remind the minister that it was the Labor Party who introduced the bipartisan PBS in 1948, and it has been bipartisan since then. His false claims of new listings—particularly including generics, which we all know are not really new drugs—is just absurd.

Those opposite have been in power now for five whole years. I can't emphasise this point enough. In the Federation Chamber yesterday, I highlighted this lazy government's modus operandi, whereby whenever they are criticised for one of their failures they do their utmost to blame the issues of today on a long past Labor government. I suspect we'll see and hear more of this today in the MPI. We've known for some time that those opposite have given up on governing. This is made even more obvious whenever the current Prime Minister speaks. He is obsessed with us and our fight for fairness. Rather than positively contributing to policy debate, he and his entire team merely try to smear us when things don't go their own way. After the 2016 election, those opposite—despite emerging victorious—could be heard day in and day out, crying and whining like toddlers, about a campaign about health they couldn't understand.

During my allotted time, I think it will become quite apparent to all those who listen that the opposition is right to publicly fight for and defend the integrity of our beloved Medicare system, which was introduced by the Labor Party. It's apposite that we mention the name of Professor John Deeble, who died recently. He was one of the fathers of Medicare, with Dr Dick Scotton. All present here know that it was under the Abbott-Turnbull-Morrison government that the Medicare freeze has been extended for over five years. It was their horrid 2014 budget which saw this freeze continue and, indeed, it continues on today. This has resulted in $3 billion being ripped out of Medicare. They also wanted a Medicare co-payment which would damage and prevent health care for the most disadvantaged.

I'm a doctor. I still do a volunteer clinic at my local hospital, and I have many friends who presently practise in their respective medical fields. So I would suggest that those opposite listen closely to what I'm saying. They might learn a thing or two.

Those opposite have sat on the treasury bench, and whilst they've done that we've seen gap costs for specialists absolutely skyrocket. For example, seeing a cardiologist now can cost patients almost $500 out of pocket. There's been a collapse of the public hospital outpatient system. And the policies of those opposite have resulted in Australian patients having to front higher and higher out-of-pocket expenses, including things like pregnancy ultrasounds, which I've seen patients avoid because they couldn't afford the gap payment. People are having to pay more for GP visits, blood tests, X-rays and other consultations. Australians are forgoing undertaking the medical treatment they require, because they cannot afford it.

This is Australia. It's not the United States. However, we are very rapidly developing a two-tiered system. I might mention IVF therapies. IVF therapies are now out of the range of most lower income Australians. This is a two-tiered system. Imaging is another field which sees patients paying higher and higher gap costs. There exists a massive divide between those in metropolitan areas and those who reside in rural and regional areas. Those who live in country towns and in the bush have had their access to high-quality health care restricted by costs, and medical treatment is simply becoming unobtainable for some people. Those opposite do not seem to grasp the importance of this.

In almost every aspect of health care you can look at, the Liberal and National government are failing. They come in here and they self-promote about listing medications, without really understanding the fact that we are now developing a two-tiered medical system in Australia. It is an evolving tragedy. If they do not understand it, they need to take a few lessons.

Yet another example of this government's failure is the blowout we've seen in waiting lists, in particular in the public hospital system. I hold the Prime Minister responsible for a cut of well over $3 million to my hospital in my electorate of Macarthur. Prime Minister, I'd like that funding back because it is desperately needed.

Tim Wilson (Goldstein, Liberal Party) Share this | Link to this | Hansard source

Deary me, it's Thursday afternoon, and we know what it's like. It's the end of a sitting period—two weeks. The call goes out from the whip's office or the Leader of the Opposition, saying, 'Can somebody come up with a subject that this opposition can talk about that's a matter of public interest?' They scratch around, looking under every surface, speaking to every shadow minister, who is visionless with any possible policy. They turn around to the shadow minister who has to deal with housing and say, 'Could we do a matter of public importance on housing?' Then someone says, 'Actually, we can't do that, because we're actually proposing a policy that would lead to 42,000 fewer homes being built and housing becoming a shortfall.' Then they scratch around and they say, 'What about if we take concern for senior Australians?' Then they go: 'No, actually we've got another problem. We're going around and raiding people's full tax refunds.' So they can't do that.

Eventually they get to the member for Ballarat, our favourite shadow minister, the shadow minister for health. She says: 'I know. I've got a brilliant idea. Let's do a matter of public importance on this government's five-year record on Medicare.' And they think it's genius, because they start by saying we should be afraid of the campaign they ran at the last election. We all know that at the last election the opposition lied. They lied big time. The opposition lied. And what we have—

Kevin Hogan (Page, National Party) Share this | Link to this | Hansard source

The member for Wakefield on a point of order.

Nick Champion (Wakefield, Australian Labor Party, Shadow Assistant Minister for Manufacturing and Science) Share this | Link to this | Hansard source

Deputy Speaker, the member for Goldstein used an unparliamentary term, and I'd ask him to withdraw it.

Kevin Hogan (Page, National Party) Share this | Link to this | Hansard source

Yes, I concur. I ask the member for Goldstein to withdraw.

Trent Zimmerman (North Sydney, Liberal Party) Share this | Link to this | Hansard source

On the point of order, Mr Deputy Speaker: the member for Goldstein was not referring to any individual member of parliament. He was referring to an organisation, and I don't think it's unparliamentary to use that language unless it's specifically directed against one of our parliamentary colleagues.

Kevin Hogan (Page, National Party) Share this | Link to this | Hansard source

I take the member for North Sydney's point, but I ask the member for Goldstein to withdraw.

Tim Wilson (Goldstein, Liberal Party) Share this | Link to this | Hansard source

I shall withdraw and say that the opposition perpetuated mistruths, misinformation, to mislead the Australian people—if that would be a satisfactory answer. That is at the heart of everything they're doing in this matter of public importance and everywhere else.

We know the record over the past five years of this government. The record is quite clear. We have record rates of Medicare bulk-billing. More Australians than ever before are accessing bulk-billing. If that's a record of failure to those opposite, I'd hate to see what a record of success is.

What this opposition has done is misled the Australian people at every point. We know there is more federal funding for public hospitals under this government—up from $13.3 billion to $22.7 billion nationwide. We know that the GP bulk-billing rate has gone up to 86.1 per cent, from 82.2 per cent in Labor's last year in government. Apparently, that was a success that they were prepared to own. But, when you increase it and deliver more for the Australian people, they declare it a failure somehow. They have the most appalling metrics.

But as the previous speaker, the member for Macarthur, mentioned—and I know within his heart he means well. Unfortunately, he has to sit on the other side of this parliament and parrot the lines that were given to him by the member for Ballarat. He has to repeat the narrative, even if it is baseless. I know he wrestles with the fact that, under this government, there have been 1,900 medicines listed on the PBS, which equates to one new medicine every day, because I know in his heart he actually does care.

But it isn't just about the past; it's also about the future, while we watch the comedy that rolls out in front of us. We have 30 new MRI licences to support more than—

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

Mr Speaker, a point of order: I was not given any lines. The lines were all my own work. So the point of order is on truth.

Kevin Hogan (Page, National Party) Share this | Link to this | Hansard source

That's not a point of order. The member will resume his seat.

Tim Wilson (Goldstein, Liberal Party) Share this | Link to this | Hansard source

What this government is also doing is issuing new MRI licences so that people in communities can get the support and assistance that they need. They will benefit more than 400,000 patients. I'd particularly like to acknowledge the new licence at Monash Children's Hospital in Clayton in Victoria, in very close proximity to— (Time expired)

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I rise today in support of the matter of public importance before this House, and I do so because Labor, on this side, believes in investing in health care so that all Australians can access services of the best possible quality. In this matter of public importance, it is important to highlight the failures of the government. All we have to do is look back at the 2013 federal election, when the then leader, the member for Warringah, said publicly, on TV, a few nights before the election, 'There will be no cuts to health,' and he pledged to continue Labor's fifty-fifty hospital funding arrangement. But in his government's first budget—the very first budget—they tore up Labor's agreement, ripped it to shreds, not honouring the promise that he had made a few months earlier, and reverted to the previous, failed funding system—the failed formula that resulted in a $57 billion cut to hospitals across Australia. You cannot take $57 billion out and expect the hospital and healthcare system to operate in a way that provides good, proper health care to Australians.

As we've heard from colleagues, Labor believe in a universal health system. We were the ones that invented it. We were the ones that brought it to parliament on two occasions. On the first occasion, it was ripped down by the Fraser government. When Hawke came back as Prime Minister, a Labor government reintroduced it—and again the now government opposed it. They voted against it that time as well. We know it's in the government's DNA. It's in their DNA to rip down Medicare if they can. We certainly know this.

In the last federal election, if we hadn't spoken out, if we hadn't challenged them, they would have privatised Medicare. The only reason they haven't done it so far is that we on this side have defended it year after year after year. It's been defended by us because we believe in it. You don't believe in it. That's the difference. The reality is that, after the 2013 election, you tried to water it down by bringing in the co-payment for GPs. It didn't work, so you went through the back door. The back door was to put a freeze on doctor's payments. So you had already sown the seeds in 2014 for people not to trust you when it came to Medicare, for the Australian public not to trust this Liberal government. And nor should they, when they look at your track record.

We heard the member for Ballarat talk about the PBS. Those opposite wanted to bring in a co-payment where pensioners would be expected to pay $5 more for their medicines. Not only that; today we saw a report in the paper that said they actually are privatising parts of Medicare by bringing in contract workers to work in Medicare offices. It might not be a direct privatisation but it is creeping in, and they would love to creep it in all the way and privatise it. Their agenda has been to privatise Medicare from back in the Whitlam days, when they abolished it, and the Hawke days, when they opposed it. Every change that we bring in to better it, they oppose it.

There's much more I could go on with. For example, we know that the government ripped down the 50-50 hospital funding agreement—they tore up Labor's agreement—and made a further $10.4 billion in cuts to Medicare and other health programs, including the dental care program that Labor brought in. They ripped that up and threw it away immediately. They tried to bring in a $7 GP co-payment. It is in this government's DNA to water Medicare down, to bring it down, to do everything they can not to have a good, universal system.

We on this side of the chamber believe in a universal system. We believe that everyone should have access to good health care. We also believe that everyone can visit their GP if they're not feeling well and want tests. Those on that side of the chamber want us to present our credit card, not our Medicare card. It's quite obvious.

The reforms that this side of politics, the Labor Party, fought for throughout the seventies and eighties to ensure we have a system in place that looks after everyone—they are what we on this side are defending. That's what we defended in the 2016 election campaign, and we'll continue to do so in this place, because Australians deserve a good healthcare system.

Keith Pitt (Hinkler, National Party) Share this | Link to this | Hansard source

Before I commence my contribution to the discussion on this matter of public importance, can I acknowledge the contributions of the member for Lyne and the member for Macarthur in their private lives. I think it is important to recognise the dedication they have had to the health system, as specialists, and to all those people out there who are less fortunate, who are ill and need assistance. To the member for Macarthur, in particular: as a parent who's spent plenty of time with sick children in the rooms of a local paediatrician, I acknowledge that it's a very difficult role and I congratulate you on the work that you have done over your lifetime.

But we are here for a political debate, obviously, and unfortunately those opposite are looking to make mileage out of things that are untrue. We know that in the 2016 campaign, the 'Mediscare' campaign, they quite simply made it up. They thought they could go into an election campaign and take an opportunity to scare people who were vulnerable—seniors or others concerned about their health—on something that was completely untrue. In fact, my wife got a text message on her mobile, on the day of the election, saying that we were making massive changes to Medicare.

What's happened? Has that happened? It has not. In fact, we've legislated the Medicare Guarantee Act, so those opposite know there has been a piece of legislation put through this House which will guarantee Medicare—guarantee it! Yet still they sit on that side and say that there are cuts. They must be Edward Scissorhands over there—everything I hear is 'cut, cut, cut'. The reality is that that is just not the case. We have increased federal funding for public hospitals from $13.3 billion in 2013-14 to $22.7 billion in 2020-21. That's a 70 per cent increase.

Government Member:

A government member interjecting—

Keith Pitt (Hinkler, National Party) Share this | Link to this | Hansard source

I'll take that interjection—it's a reverse cut. I'm fairly confident that 70 per cent is bigger than 10 per cent, bigger than 20 per cent, bigger than 50 per cent. It's even bigger than 60 per cent. I know there are some over there who have education outside of being union organisers and all those types of things. They know that a 70 per cent increase is an increase. It's not a cut, it's not a decrease; it is an increase in funding. So we have guaranteed Medicare through the Medicare Guarantee Act and we have increased federal funding to the health system for public hospital services. But there are some challenges out there. Mr Deputy Speaker, you know that I'm a passionate Queenslander and, unfortunately, Annastacia Palaszczuk, the Labor Premier of Queensland, is refusing to sign up to the national partnership agreement. Not only that but, in my electorate, in the area of Wide Bay—I have Hinkler and my next door neighbour is Wide Bay, but the area is generically known as Wide Bay—state Labor cut nearly $4 million in the last year alone, 2016-17 to 2017-18, and, at the time, our contribution increased by $25 million.

So we have a state government in Queensland that are cutting funding to health services. We are trying to increase funding to health services. Across the board, it is a 70 per cent increase, and yet we have a state Labor government that will not sign up to the national partnership agreement; they just will not. There are billions of dollars that can help our people, the people we represent, just like those opposite. I say to those opposite from state Labor in Queensland: get in there, convince Palaszczuk to sign the national partnership agreement. It is in all of our interests. We are ready to provide that funding. It is much better for us; it is much better for our constituents.

We hear all the noise around Medicare. I've got to say, in my electorate of Hinkler in 2012-13 our local GP bulk-billing data showed there were 768,076 individual services bulk-billed. In 2017-18, that is now 944,174. That is a substantial increase in the number of services provided to the people in my electorate. In fact, it is up by 167,098. So I say to those opposite: stop trying to make political mileage out of things that don't exist; stop making up numbers; stop suggesting to those vulnerable people who are concerned about health services that there are cuts when they are not. We know that the Labor state Premier in Queensland is not signing the agreement. We know that they've taken money out of my electorate and others across the state. On this side, we will continue to deliver. Those on the opposite side will not.

Emma McBride (Dobell, Australian Labor Party) Share this | Link to this | Hansard source

In my community on the Central Coast of New South Wales, health care really matters. One in five of us is aged under 15 and one in five of us is aged over 65. The youngest and the oldest in our community have the biggest need for affordable health care, and this government has let them down. Vulnerable people in our community—the old and the young—have been let down by this government. This month, Mental Health Awareness Month, I stand here as a pharmacist who worked in the mental health in-patient units at my local hospital in Wyong for almost 10 years. The strain on patients, the strain on carers and the strain on families because of the lack of mental health services in regional and remote communities is growing. It's at crisis point.

On headspace Day, I heard from young people at the Gravity Youth Centre in Gorokan who spoke of their personal struggles to access care for themselves and for others due to the lack of local services. For young people in crisis in regional and remote Australia, help can't wait. One young person told me:

Why would I want to go and get help when too often the system fails?

This was from a young person in my community on headspace Day.

As a pharmacist, I would like to turn to the health minister's claims about PBS listings. The PBS was established by Labor. The principles that underpin the PBS are about universal access to medicines. Medicines matter. Access should be affordable and access should be fair. The minister should stop politicalising the PBS. The government tried to increase the cost of prescription medicines—

Mr Tim Wilson interjecting—

for all Australians, including children and pensioners. It was blocked by Labor.

Mr Tim Wilson interjecting—

The government's five-year record of failure on health care, particularly Medicare, began with the 2014 budget. The Liberals were elected in 2013 after promising—

Mr Tim Wilson interjecting—

Kevin Hogan (Page, National Party) Share this | Link to this | Hansard source

The member for Goldstein is warned!

Emma McBride (Dobell, Australian Labor Party) Share this | Link to this | Hansard source

no cuts to health and pledging to continue with Labor's 50-50 hospital funding agreement. Do you know what the Liberal state government tried to do in New South Wales? They tried to privatise five public hospitals, including mine, at Wyong, on the New South Wales Central Coast—an area of need. Luckily, the community stood up and fought, so those public hospitals are still in the community's hands. In their first budget, they tore up Labor's agreement and reverted to the previous failed funding formula, resulting in a $57 billion cut to hospitals—$57 billion!

I worked in public hospitals in New South Wales for almost 10 years. I have so much regard for the dedicated, trained, expert staff who work there, who are working under enormous strain because of these cuts at a state and federal level. It has to be changed. Health can't wait in regional and remote communities.

In their first budget, the government tore up that agreement. They then made a further $10.4 billion in cuts to Medicare and other health programs, including to preventive health care.

What else did they try? The infamous $7 GP co-payment. On the one hand, the minister is spruiking listing things on the PBS; on the other hand, the government tried to increase the co-payment for medicines. You can't have it both ways. The PBS is about affordable medicines. The PBS is about universal access to medicines. It's outrageous!

In 2014, the budget also included the Medicare rebate freeze—which was later expanded, and persists to this day—ripping $3 billion out of Medicare. It also began the process of inviting the private sector to take control of the Medicare payment system, a plan Labor campaigned strongly against in 2016. In the wake of the public backlash against the 2014 budget, the Liberals abandoned some, but not all, of these measures.

Since then, Australians have had to endure endless cuts to health and hospitals. They particularly affect vulnerable people, particularly the young and the old in our community, those living with mental health problems and those in crisis. This government's shameless cuts to health and hospitals, at the same time as spruiking the PBS listing of medicines, is outrageous. It has to stop.

The only answer is a change of government. We need a change in attitude to health care in Australia, and the only answer is a change in government at both state and federal level. I'm standing here today as a health worker and as someone who is a former mental health worker. For the people of my community, we need a change and we need it now.

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

From this debate, we can identify a commonality on the importance of mental health. But, at this point, when you reach the end of a sitting week and you have yet another health and hospital debate driven by the Labor Party, absolutely determined to pillory private health provision—recognising about half of the entire Australian health system—it's really, really disappointing that there can't be bipartisan agreement on private and public delivery.

Secondly, of course, the best way to identify whether a party that is in opposition would do an even better job than the government is to have a look at how the Labor Party is performing in states where they do control the hospital system. And it's not a pretty picture in Queensland. I'd like to devote a little bit of time to what is happening in the great state of Queensland, where we'd be hoping that ramping wouldn't be happening and that people with mental health issues would be getting the care they need, where it's actually in the hands of the Labor Party to fix it.

There's no news more recent than the news right today on page 4 of the Courier Mail that recognises some of the areas in Queensland with appalling waits, appalling ramping, loss of hospitals beds and an inability to even meet national benchmarks for hospital performance. I think that the remaining people in the gallery would concur; they would probably say that the performance of their local hospital system, wherever they live around this great nation, doesn't change much between Liberal and Labor. They don't notice any particular difference between one party that trumpets that they invented the PBS in 1948 and a party that trumpets that they invented Medicare in the mid-seventies. We're not disputing health history. We're not disputing the actions of Menzies and those who came before him. It's about whether the people in the chamber can get the help they need.

In Queensland, of course, we've got a health minister with a PhD—and that's promising! The PhD is in 'union renewal'. And if you look up the Wikipedia page for the state health minister of Queensland, there is just one simple sentence, and I think I could distil it onto a postage stamp. It says, 'Steven Miles ran campaigns to improve rights at work' as his grounds for being a health minister. And his entire pre-political career is a single line in Wikipedia saying that he used to run campaigns to save penalty rates—a job he did so well they gave it to the Fair Work Commission to do after he left! That is the sum total of the experience of the person running Queensland's health system. So it's no wonder that, when we look at the kids' hospital in Queensland, we see the Queensland state Labor government ripping funding out of the kids' hospital.

What do they do with the funding? You'd like to know how they'd run the health system. They tear down the name 'Lady Cilento' from the children's hospital, spending half a million dollars on rebranding, taking off this great woman's name from the hospital on the pretext having a female's name on the hospital might make you think it's private, and that causes confusion to ambulances. Only a kilometre away you've got the Princess Alexandra Hospital. How on earth is that causing confusion that the hospital may not be a public hospital? They spent half a million dollars on this ultimate insult to Lady Cilento. Nodding over there on the other side is the member for Macarthur, extension 2311, and the member for Dobell—I respect a pharmacist in this place; a doctor never wants to get a pharmacist offside, does he? The problem is they don't listen to either of you. They ignore you in making policy on the Labor side. If they listened, we'd be in a far better place.

So we've got a Queenslander unable to run a hospital, unable to resist ripping a name off the kid's hospital, out of a political vendetta against a woman who fought for family planning, who recognised the role of vitamin D, but, no—she is not good enough for her name to stay on the hospital. It is a complete insult to rip her name off a hospital after she's been bipartisanly recognised as a great contributor. She is from Adelaide. She studied and trained in South Australia, but she is not good enough to have her name on the hospital.

This is a consistent pattern. In MRI, they are happy to dribble out the MRI licences for political need. When Redcliffe hospital needs an MRI licence, all they have to do is fill out an application form. Is Labor going to do it? No way. Why? They would rather take the Labor commitment of an MRI than actually apply for it through the normal channels. You've got the Redcliffe state hospital held to ransom, saying, 'Vote Labor, or you'll get no MRI, because we as the state government aren't going to apply for it.' This is the annoying—no, disappointing—conduct of a state government that can't even run the system.

I'm not going to talk to you about funding, because those on the other side do not even understand numbers. They don't understand that $23 billion is bigger than $13 billion. There's no point reading numbers to that side of parliament. What's true is that you can't run a great health system without a great economy that funds the needs of a growing ageing population and a more technologically based health system. You will always get, on this side, an absolute guarantee to increase health funding and to list drugs when they are approved and not when you feel like that. That's why people trust us in health care.

Kevin Hogan (Page, National Party) Share this | Link to this | Hansard source

The discussion has concluded.