Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) acknowledges that:

(a) the GP Access After Hours service:

(i) has provided over a million urgent after-hours consultations to families in Newcastle and the Hunter region for more than twenty years;

(ii) delivers 50,000 face-to-face appointments and handles 70,000 calls through the nurse led triage call centre each year; and

(iii) saves our health system up to $21.7 million in unnecessary emergency department presentations each year;

(b) due to the Government's continuous cuts to bulk-billing incentives and its failure to adequately index Medicare rebates, Hunter Primary Care has been forced to make cuts to the GP Access After Hours service;

(c) from Christmas Eve, the Calvary Mater Clinic will close completely, and operating hours for clinics at the Belmont Hospital, John Hunter Hospital, Maitland Hospital and Westlakes Community Health Centre will be reduced; and

(d) over 10,000 people from the Hunter region have signed a petition calling on the Government to restore funding to the GP Access After Hours service;

(2) recognises that:

(a) the GP Access After Hours service has been an essential service for tens of thousands of Newcastle and Hunter families who rely upon bulk-billing GP services to access the healthcare they need, when they need it;

(b) with so few bulk-billing doctors in Newcastle and the Hunter region, any further loss of services will have a huge impact on families already faced with high out-of-pocket healthcare costs;

(c) any cuts to this service will dramatically increase pressure on our already overstretched and under-resourced emergency departments; and

(d) not only is the Government's lack of support for primary healthcare unacceptable, it is also grossly irresponsible in the middle of a global pandemic; and

(3) calls on the Government to:

(a) restore the funding to our GP Access After Hours service to stop the closure of the Calvary Mater Clinic and retain existing hours of operation at all remaining clinics;

(b) reverse cuts to bulk-billing incentive payments in the Lower Hunter that have seen GP practices close and vulnerable people left without access to a bulk-billing GP;

(c) abandon any efforts to further reduce funding to our GP Access After Hours service;

(d) provide additional support for GP Access After Hours to expand their services to areas of need throughout the Hunter; and

(e) utilise the success of the GP Access After Hours service as a model of best practice after hours primary healthcare across Australia.

I'm very pleased to move this motion in the Australian parliament today. This is an issue that concerns all of my Labor colleagues in the region because of the brutal reality of the Morrison government's decision to cut our GP Access After Hours service in the Hunter. From Christmas Eve, the after-hours GP service at the Calvary Mater hospital in my electorate will be closing permanently, and operating hours at the four remaining clinics—at the John Hunter Hospital, the Belmont Hospital, the Maitland Hospital and the Toronto Polyclinic—will be significantly reduced.

The Liberal government has a long history of undermining our universal healthcare system. We've had eight long years of savage cuts to Medicare under Liberal governments, including Medicare rebate freezes; the reclassification of most of the Hunter region from being a district of workforce shortage to being a so-called metropolitan area with no GP shortages at all; brutal cuts to our bulk-billing incentive payments which have cost our region some $7 million in lost revenue and the forced closure of many GP clinics; and, earlier this year, almost 1,000 changes to the Medicare Benefits Schedule, resulting in even higher out-of-pocket costs for patients. And now the Calvary Mater hospital after-hours clinic is next on the Morrison government's chopping block.

The Morrison government have made it abundantly clear that they have zero intention of restoring the funding to our GP Access After Hours service, leaving local families just hanging out to dry. But this isn't the only thing they have in store, because the Minister for Health and Aged Care has a review sitting on his desk which, if implemented, would totally gut our GP Access After Hours service, wiping out any hope of retaining an after-hours service as we know it in the Hunter. Abandoning this much-loved service would have a profoundly negative impact for our community and place enormous pressure on our public hospital emergency departments.

Keeping this service fully operational makes good sense from a social and public health policy perspective, but it also makes good economic sense. Sadly, the Morrison government would rather continue the blame game with the New South Wales Liberal government about who should fund primary health services than stop the closure of this essential frontline service. Make no mistake, this is nothing more than a silly finger-pointing exercise. It's buck-passing. It is a classic Morrison government move. Every problem is someone else's fault. Every crisis is someone else's responsibility. It's clear that the Morrison government have absolutely no clue what it's like for sick Novacastrians to try and access affordable health care and it's clear they have no plan for the 15,000 people who will be impacted by these cuts.

Over 11,200 people have already signed my petition, and that number grows every day. Hundreds of people from the community have reached out to me to share their stories of what the service means to them and their families. They've expressed their dismay and disbelief, their frustration and anger, over these cuts. These reckless cuts make no sense to my community. As Sue from my electorate noted in a message to me: 'Last Saturday afternoon, my husband had an accident and badly injured his hand. GP Access After Hours was able to offer him an appointment at the Mater within 30 minutes of calling, and treatment was completed in one hour. Compare that to what would have happened on a Saturday night in emergency, waiting for six hours or more.' Rachel from my electorate said: 'I've used the GP Access After Hours service a few times, and so has my family. It's an excellent service. I have to pay to see a doctor and at times don't always have the cash to pay. With GP Access, there are no wait periods.' Michelle Harvison from Toronto was so outraged when she heard news of government cuts to our GP Access After Hours service. She told me how this service had saved her daughter's life. Her three-year-old daughter's health deteriorated. She went to GP Access first. Without a prescription for the antibiotics and an X-ray from the GPs at the Toronto Polyclinic her daughter's pneumonia would never have been attended to in time.

This government has demonstrated nothing but contempt for the tens of thousands of families like Michelle who will feel the full force of this reckless decision. This government should be listening to the firsthand experiences of local families, GPs and health professionals on the ground who will wear the full brunt of these callous cuts. We cannot allow the public good to be sacrificed for some petty bureaucratic turf war. It is madness to cut a service that is saving the government millions of dollars every year. This government's stubborn refusal to restore funding for our GP Access is pathetic. The GP Access funding shortfall is a drop in the ocean for the Commonwealth's budget, but it has a very large ripple effect. This money must be restored immediately.

Prime Minister, it is time you stepped up and took responsibility to restore this funding for a vital primary healthcare service immediately, because at the end of the day it's the families in the Hunter region who will pay the price for your inaction.

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

Is the motion seconded?

Pat Conroy (Shortland, Australian Labor Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

I proudly second this motion and reserve my right to speak.

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

[by video link] It's a brave member who stands up to New England MPs in a rage, but there is probably a need for some sobering information about exactly how after-hour services work and the fact that there's a broad platform of services that all residents in the Hunter and New England are able to access.

The first speaker was absolutely correct that large amounts of money, from both sides of politics, have gone into supporting after-hours GP services. It was an absolute brainchild of the Howard government, which put together this scheme. It led to significant after-hours access to GPs, and it' really important. That funding has never been cut. But, by being activity based, as Medicare is, the more the service is used, the more likely a service is to be viable. Likewise, if hours are reduced by providers then, by definition, their income will be lower. I think that's at the heart of this problem, not some malevolent hatred from a political party towards after-hours access. The rules are the same nationwide. If an individual service is noting a decline in funding then it's most likely due to a decline in activity. That's a very important point.

As a government, we don't directly fund Hunter Primary Care. Funding can and has been reduced, for instance, by the state government, which is likely to have a significant impact on the decision to close Calvary Mater hospital on, I think, 24 December. That's a state not a federal issue. I know that residents there can access one of the four other GP Access After Hours programs in the Hunter region. There's a John Hunter just a 10-minute drive away. You've got the explosion of online consultations, as well, through Medicare. We do understand the irritation and frustration, but hopefully not political opportunism, from the first speaker. She's a good MP, but I don't think she fully understands the economics behind changes in funding that are predominantly activity based.

The government spends nearly three-quarters of a billion dollars on after-hours care, and $71 million of that for the PHN After Hours Program. It's basically driven by demand, isn't it? You need to be finding your GPs. I'd say to the member: go out and promote the after-hours service and get more GPs into your area who are prepared to bulk-bill. If you're losing that battle to electorates like mine, which have lots of GPs prepared to bulk-bill, then you have a PR issue and you need to work on your marketing and on your recruitment of GPs to your area. Do better. A C-plus for the member on those grounds.

We know that after-hours investment ranges from all of the basic MBS to the Practice Incentives Program and the Healthdirect services. There are lots and lots of sources of funding. There's been a recent program evaluation of the Hunter, New England and Central Coast PHN. The PHN After Hours Program, in particular, had an independent assessment that looked at whether the program was filling critical roles, meeting after-hours needs, and they found significant areas that needed to be worked on and improved. You need to expect the government to be able to have that latitude and headroom to be able to improve services where required and to work with PHNs to redesign a service, particularly when they're not consistently prioritising the delivery of primary care services in the after-hours period. There are instances where the PHN was commissioning services that just duplicated other Commonwealth and state services. To follow the line of logic from the previous speaker, do we do nothing about that?

Of course not. You've got to do something. You've got to hold workshops. You've got to improve the focus. You've got to make sure patients are able, through this raft of providers, to get an after-hours service. Whether or not it's from that service member is not as important as ensuring that they can get the service.

We're not here to save every provider. I can see some whimsical, quizzical faces in the opposition. Well, I've been doing this for a couple of decades. I know that some services don't meet the needs of the population that others do, and we need to be making sure that there is a financial signal, and it's mostly through demand. If there are reduced operating hours at a place like Calvary Mater clinic, then that contract has to be renegotiated. It's quite simple. There are plenty of other providers out there for GPs to work for—to be redeployed. It just reflects the national trend, doesn't it? If providers are doing a good job, they attract GPs. The decision to bulk bill is one for them to make, and them alone.

I know this is a very good member moving the motion, but I've got to be honest. I've been doing this for a long time; I know exactly how after-hours services work. Some do it better than others. Some meet community needs; some don't. Some deliver after hours in a genuine sense, and others are sometimes duplicating services and sometimes not getting the activity and the customer base that they should be from patients, and funding must reflect that. I think having these workshops at PHN level is an important step in that direction. I hope these service providers get through it, but there's no malevolence from the government. These are local issues, and these GPs need the support from their local MPs.

Pat Conroy (Shortland, Australian Labor Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

I proudly second the motion by my colleague and friend the member for Newcastle, defending the Hunter GP After Hours Access service and calling on the government to urgently reverse its draconian cuts, because the truth is that the GP After Hours Access service is a Hunter institution that has touched the lives of every single Hunter family. I'm yet to meet someone who hasn't had a family member or a friend call on this great service to get them through a tough time. My own family, with two young kids, has been to the GP clinic many times—many times—and we've got phenomenal service, and, importantly, we've avoided a trip to the emergency department, saving taxpayers lots of money.

The facts are these. This service receives 70,000 phone calls a year; 25,000 are immediately triaged and told that they can see their normal GP on a weekday or take some paracetamol or some other treatment. That's straightaway 25,000 visits to the emergency department avoided. Then the remaining 45,000 callers are given appointments at the GP clinic, again avoiding a huge weight on the emergency department, which is much more expensive to run than a GP clinic. The truth is that this service, which costs $4½ million a year to run, saves nearly $20 million a year in taxpayers' funds that would have gone to emergency departments. The truth is that, when the Belmont clinic had to close temporarily because a nurse got sick, the waiting time at the Belmont Hospital Emergency Department blew out from two hours to six hours—a great anecdotal example of how this service saves taxpayers money. It means that patients in my community don't have to wait for hours and hours and hours in an emergency department for conditions that can be treated by a visit to the GP.

That's why the current Liberals' cut of $560,000 so tragic. This cut of $560,000 will close the equivalent of two clinics. It will mean that the hours that my local clinic at Belmont Hospital will be halved on the weekend, when people need it most. It means that, of the 70,000 funded consultations, 15,000 hours are cut straightaway.

The letter from Minister Hunt that Labor MPs received was a disgrace. Minister Hunt defended the cut. He defended the cut to this great GP service. And the previous speaker, the member for Bowman, in Brisbane, defended the cut, quite bizarrely. He didn't have a single fact right about what this service does, how it's funded, its meaning for our community, but he defended the cuts, just like Minister Hunt.

This is an interesting debate because I'm yet to see a single coalition MP come to the chamber to defend the cuts; they've all gone missing. The member for New England, the Deputy Prime Minister—the great hero of the Hunter, if you've ever seen him on Sky 'news after dark'—is nowhere to be seen. He's in hiding, like the coward that he is, not defending the cuts—I withdraw. He has gone missing, he is hiding from these cuts, because he is ashamed of what his own government is doing.

The truth is there is a review on Minister Hunt's desk, and if he accepts it—and we've got no reason to believe that he won't accept it—it will slash the remaining $4 million of funding to $1 million. He'll slash it from $4 million to $1 million. If that happens, the service is gone. It's kaput. It will disappear. The remaining four clinics will have to be closed, and this great service will be gone from our community. Families will have to wait longer at the emergency department to get treatment or they won't be able to see a doctor, and that would be a great tragedy. Minister Hunt has refused to rule that out. In fact, from the tone of his letter, there is a very good likelihood he will accept that review's recommendations and kill the GP Access After Hours service.

This is the fourth attack on Hunter Health outcomes that we have seen from this government recently. We've seen the cut to the bulk-billing incentive that's forcing constituents of mine in Shortland to pay more to see a doctor. We've seen the reclassification of our area from an area of GP shortage to a bizarre metropolitan classification, which means that it is incredibly hard to find a doctor—and if you do get into one you have to wait an extraordinarily long time to actually see them. And we have the cuts to the Medicare Benefits Schedule that make it much more expensive to get treatment.

The truth is that the coalition government do not give a fig about good health outcomes for the people of the Hunter and Central Coast. They do not care about it. You only have to look at their actions to know that. That's why all the Labor MPs are calling on the government to reverse the cuts that hurt every single constituent of mine in the seat of Shortland.

Terry Young (Longman, Liberal National Party) Share this | Link to this | Hansard source

I rise to speak on this motion about the GP Access After Hours service with pleasure. I wholeheartedly disagree with the member for Newcastle's suggestion that the government's not supporting primary health care for Australians. I stand here proud to be part of the Morrison government that is committed to improving the lives of all Australian through health care and GP services when and where they need them. We have made access to safe, quality and accessible health care a priority for all Australians—especially through this COVID-19 pandemic—but we won't stop there. We will continue to work with our GP specialists and consumers across the country to improve the delivery of care.

Bribie Island, in my electorate of Longman, is well-known for having the oldest average population in Queensland and for being a great place for our senior Australians to retire. In early September last year, I announced that Bribie Islanders will have access to the medical care they need thanks to a new trial of after-hours primary care, with the Australian government investing $500,000 in the Brisbane North Primary Health Network to co-design and develop this service. This was a huge win for our Bribie Island residents, who have for years been calling for better access to medical services because their community doesn't have an established after-hours healthcare service available through their GPs or medical deputising arrangements.

I also discovered that mobile GP services like 13SICK National Home Doctor deem it not economically viable to make house calls on Bribie Island, due to the geographic location of Bribie Island and simply no mobile GPs living close by to Bribie. Go figure. Why wouldn't you want to live on Bribie Island? In fact, when I was first elected the lack of after-hours GP services on Bribie Island was one of the main issues that came up. Not having an after-hours GP in the community that is known for its older population simply isn't good enough for our senior residents who call Bribie Island home, and as their federal member I have been fighting to bring this project to fruition.

A single bridge connects Bribie Island to the mainland and sees many people coming and going every day. Currently the Bribie Island community, including its older residents, is forced to drive over the bridge in order to access urgent after-hours medical treatment or care 20 kilometres away in Caboolture. This means that if there's an accident on the only bridge leading in and out of Bribie Island, our senior residents are stuck and unable to get the medical attention they need. Although I had secured funding for this service last year, its rollout has been delayed. But there is good news on the horizon, and we are making progress. It has been a long and arduous process to find a service provider, but I'm pleased to announce today that primary health network Brisbane has advised me that a provider will be announced early in the New Year. I know this will be a relief for the Bribie Island community as well as the surrounding suburbs.

It's incorrect to suggest that the Commonwealth government, which since the 2018-19 budget has invested over $3 billion in new primary healthcare initiatives, doesn't care about the primary health of Australians. Each year the government spends more than $728 million on access to after-hours GP services through higher MBS rebates, incentives for GP practices to stay open longer and funding to the primary health networks. In the 2021-22 budget the Australian government provided funding of $71 million to extend the PHN After Hours Program for one year, increasing the government's total investment in the program to more than $452 million since 2015. Does this sound like a government that doesn't care? I don't think so.

Providing Australians with affordable access to universal health care is a key pillar of the Australian government's long-term national health plan. We're investing a record $125 billion in Medicare, an increase of $6 billion over the forward estimates, to ensure that all Australians continue to access high-quality, affordable health care, including primary care services. This investment includes an additional $204 million to extend COVID-19 MBS telehealth measures, providing unprecedented access to healthcare services including GPs, specialists, nursing, midwifery, allied health and mental health services. The increased investment in Medicare announced in the 2021-22 budget includes more than $65 million from 1 January 2022 to boost bulk-billing rebates and to provide more affordable health care for patients in regional, rural and remote areas.

Meanwhile, I'm pleased to say that, thanks to the Commonwealth government, Bribie Island will have immediate access to a GP for after-hours care. As we head into an election there will no doubt be misinformation and unsubstantiated claims made by others; this, sadly, is a fact in the political world we live in. But I know that the Australian people are not fools, and that they will see through any falsehoods that may be circulating.

Meryl Swanson (Paterson, Australian Labor Party, Shadow Assistant Minister for Defence) Share this | Link to this | Hansard source

I rise in support of this motion by my colleague the member for Newcastle, and I acknowledge the hard work that she has done within our community. We value GP after-hours-access services for the people of the Hunter region and we condemn the Morrison government for cutting funding that will cause the closure of the Calvary Mater clinic and reduce operating hours at Belmont, John Hunter and Maitland hospitals, and at the Westlakes Community Health Centre.

Cuts to this valuable and pioneering 20-year-old health service will be devastating for the people of the Hunter, who have come to rely on it so very much. These cuts will put more pressure on our overstretched and underfunded emergency departments, and will cost the taxpayer much more in the long run. It just makes no sense. But, most importantly, these cuts mean that an important safety net will be taken away from Hunter families—families who can't get into a GP because, quite frankly, there just aren't enough of them and families who cannot afford to see a GP who bulk bills because there aren't enough of those either. And all of this because the Morrison government is determined to undermine Medicare. This is the length and breadth of it: they hate Medicare and they don't want universal health funding. They can't stand this because it's a Labor idea that has worked so brilliantly well over the decades. They just hate Medicare and it's death by a thousand cuts for Medicare.

Why on earth would a government want to cut an after-hours GP clinic that saves it money? We really have to wonder about the Morrison government, led by this Prime Minister. Of course, they've tried to pass the buck to the state, to the New South Wales government, but no-one's buying that. The Minister for Health in the Morrison government can reinstate GP access funding right now, today. In fact, the Prime Minister could himself reinstate GP after-hours funding when he comes to town—which he seems to enjoy doing these days. In fact, he flies in like Santa Claus and sprinkles a little bit of magic dust around, but then, on Christmas Eve, he takes away GP access.

For every parent who has sat in an emergency waiting room for hour after hour with a sick child—I myself have done it—whether they sat at the John Hunter or Maitland hospitals, thinking, 'Please, God, let them be seen soon,' GP access has provided the answer. You can actually make an appointment, be seen within a short time and not sit all night in an emergency department. And it takes the pressure off these overstretched emergency departments. The people in them are doing such a great job.

GP access is a godsend, and this government wants to cut it. It's death by a thousand cuts. The government freeze Medicare rebates and then they make it harder for doctors to bulk bill. Then they make it harder for regional practices to actually recruit doctors and then they make it nigh impossible for people to get into a doctor, or into a doctor who they can afford. And now they're cutting the safety net: the after-hours GP access. We have seen through COVID that health has never been more important to the people of this country. Why would the government cut such a valuable service? It just does not seem really important to this government.

What about our frontline workers? Where's the recognition of what they've done for us over the last couple of years and, quite frankly, what they've done for us every day? The past two years during the pandemic have been inordinately stressful for healthcare professionals. Nurses, doctors—they're on the front line and particularly those who work in after-hours clinics such as GP Access. They've borne the brunt of this. They're part of our community and they understand how valuable the service is.

Access to GPs and GP Access in the Hunter is an institution. It was started in the Hunter; it should most definitely stay in its full capacity in the Hunter. It saves families time and distress. It saves families money. It saves the government money, for goodness sake! Where is the downside to this? I have been proud to join with my Hunter colleagues to speak up in support of this incredibly important service. Over 11,000 people have signed our petition to stop these cuts and restore GP Access to its full operation. This is the thin end of the wedge. We cannot allow the Prime Minister to cut the health care of good hardworking Australian families.

Emma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | Link to this | Hansard source

I rise to speak in support of the motion moved by my friend and colleague, the member for Newcastle, and to join my colleagues across the Hunter and the Central Coast in opposing these outrageous cuts to health care in regional Australia.

People in regional communities across Australia are fed up with this government's cuts to health care. They've spent years slashing funding to our hospitals and GP services; they've cut Medicare rebates for hundreds of orthopaedic, cardiac and general surgeries; and they've sat on their hands when it comes to the GP shortage, which is in crisis across regional Australia.

Because of this we're seeing another major GP service being forced to close. The GP Access After Hours service at the Mater, just north of my community on the Central Coast of New South Wales, will close its doors on Christmas Eve—all because of cuts to bulk-billing and Medicare rebates under this government.

The GP Access After Hours service is one-of-a-kind service in regional communities. It triages patients to the right place at the right time for the care they need. They take the pressure off emergency departments and they always take care of the health of locals. This is a service that deserves the government's support, not cuts. But, instead of backing the service with more funding, this government is standing by while the doors are being closed at the Mater and the other services are having to cut their hours at Belmont, John Hunter, Maitland and the polyclinic at Toronto.

Even the New South Wales health minister, Brad Hazzard, has written to the federal minister asking for more funding for this service to be kept open. He said, 'You would be aware of these additional pressures that the state and territory health systems are under as a result of the pandemic. I seek your immediate assessment of the circumstances and commitment to ongoing funding to enable the service to continue operating under its current arrangements.' This is from the New South Wales health minister, Minister Hazzard, pleading to Minister Hunt. But instead of acting, what does the government do? It ignores responsibility and shifts the blame.

The community I represent on the Central Coast of New South Wales is under the same pressure. We've been facing a critical shortage of GPs for years. Locals have to wait weeks for routine appointments, practices have been forced to close their books and GPs are exhausted through the pandemic, because this government refuses to recognise my community as a distribution priority area and refuses to take responsibility for the health care of people living outside of big cities. That's why, with the help of my Labor colleagues, we successively called for a Senate inquiry into GP shortages. Our communities need answers and they want solutions, not more blame-shifting.

I made my own submission to this inquiry and so did countless locals—people like Dr Brad Cranney. Dr Cranney is a senior GP who runs four general practices in the community that I represent on the north end of the coast. Ten years ago, he had 32 GPs on the books. Now he only has 25, and he's lost two more who'll be moving soon to Queensland. In his submission to the inquiry, he said that patients in the community are waiting weeks to get an appointment with their GP and they are turning away 60 patients a day. And that was before COVID-19. Dr Cranney says the pandemic has only made things worse.

Then there's Dr Shamila Beattie, who runs her own clinic in Blue Haven in the northern end of the Central Coast. This clinic serves around 6,000 patients in our community, but they're struggling to keep up with the demand because we're not considered a priority area. In her submission to the inquiry, Dr Beattie said:

Due to changes in the government policy, we are no longer eligible to sponsor overseas trained doctors or deemed to be in a Distribution Priority Area (DPA). This change to policy has had a catastrophic effect to our local community as we are no longer able to provide the service they want or deserve. We have to turn away new patients every day as all of our GPs have closed their books.

Dr Beattie, who runs a brilliant service on the northern end of the Central Coast, has described the situation as 'catastrophic'. There is an urgent need for action now, while locals are waiting weeks for routine appointments, while emergency departments are stretched beyond capacity.

I worked at Wyong Hospital in my electorate on the Central Coast of New South Wales. The staff who work there are capable, dedicated and trained, but they are under enormous strain. The cuts and the slashing to healthcare funding by this government is only making it worse. This is not good enough. We have dozens of practices in our community crying out for help. We have hundreds of patients who can't access quality care close to home when they need it. Emergency departments are under strain, stretched to capacity, treating people who could have been seen by a GP—but they can't be. That is why I will keep pushing for a public hearing of the Senate inquiry to be held on the Central Coast in the community I represent. Communities like mine are struggling to get the quality care they deserve close to home when they need it. I want the Senate inquiry to hear from people on the north end of the coast because this has gone on for far too long.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

I seek leave to make a further contribution to this debate.

Leave granted.

I wanted to rise to respond to some of the comments that have been made. I note that we have had two government members speak on this bill, the member for Longman and the member for Bowman, both good Queenslanders. Sadly, there has been a distinct absence from our regional members, like the Deputy Prime Minister, who has a seat in one of my neighbouring areas and who has a lot at stake when it comes to the potential loss of the GP Access After Hours Service in the Hunter region. Sadly, he can't be in the chamber to speak on this motion today. Likewise, I note the absence of the minister assisting—well, no, he's actually the Minister for Regional Health, a man who should have a primary interest and responsibility in the loss of GP Access After Hours Services in rural and regional communities like mine and the lower Hunter. Sadly, he is not present in the chamber today. Maybe they have matters at hand; let's give them the benefit of the doubt.

I also want to bring the House's attention to a response that I received to a letter I wrote to the Minister for Health, Mr Greg Hunt. Sadly, the minister himself couldn't be bothered responding to me personally but got his chief of staff to write a letter back to me, which really just said, to all of the tens of thousands of families in our region: 'Well, you know what? This clinic is going to close. The Martyr Hospital Clinic will be closing on Christmas Eve. We have zero intention of restoring funding to that service. That will be closing. So merry Christmas, Lower Hunter.' The biggest Christmas Grinch of all, this Minister for Health, is giving us the worst possible Christmas present, the closure of a GP Access After Hours Clinic at the Martyr Hospital. He says: 'That clinic is going to close. And you know what? You can just tell all the families in your electorate, Sharon, to get in the car and drive to another clinic.'

This is a minister that clearly doesn't live in our region. He doesn't understand the importance of this service for vulnerable families and he doesn't understand the lack of public transport that might make connections between these respective clinics difficult. It is an outrageous proposition and an absolute insult to my community, to the communities in the Shortland, Patterson and Hunter electorates. Indeed, as the member for Dobell made clear, this issue stretches to the Central Coast as well. What an insult. For members opposite to suggest that there is no undermining of Medicare taking place by this government, I remind this House that this threat to our GP Access After Hours Clinic comes off the back of ongoing cuts to Medicare and our universal health system. There have been cuts to the bulk-billing incentive payments, which have seen GP surgeries close their doors in my electorate; cuts to the MBS program, which have seen increased out-of-pocket costs for patients; and the redefining of our region from an area of need to a metropolitan area where, suddenly, we apparently don't have any GP shortages. I'll tell you what: that's news to my GPs and it's news to all of my constituents. This government seems to forget all the years and years and years of Medicare rebate freezes. Do not come to this chamber and say that you are somehow investing in primary health care in our region. This is not true. I heard the member for Longman say that he was looking forward to a renewed service on Bribie Island. You know what? Good luck to those people. I suspect there has been a great helping hand from the Labor Palaszczuk government up there to ensure that there are good health services in Queensland.

I don't want to see a situation where a region like the lower Hunter misses out on having a quality primary health service. It is a unique service in the Hunter. Don't try and push us into some cookie-cutter national model that you've got in mind, because we predate all of that. Our service is owned by our community. It is owned by our GPs. More than 240 GPs volunteer their time to be rostered on to this service. It is a unique service in our region. It is a local response to what has been an issue of access to affordable, quality healthcare services in our region. So step up and take responsibility, Mr Morrison.

Julie Owens (Parramatta, Australian Labor Party) Share this | Link to this | Hansard source

I remember when, in Parramatta, the Labor government funded the expansion of the clinic in Harris Park to allow for after-hours services. We actually funded the renovation of a building so that that service could be open essentially 24 hours a day. They had a whole range of specialists in that building, as well, so people were able to walk down the street, in this high-density area, to an after-hours clinic that profoundly made a difference. Rather than getting in the car and spending several hours at emergency—if they had a car; many don't in that suburb—they were able to get the help they needed.

It reminded me of something that I've had discussions about with health professionals for years, which is that it is almost always true that what is best for the patient turns out to be cheapest for the taxpayer—early intervention and better primary health care, helping people not progress towards diabetes or liver failure by actually getting in early with calcium tablets, vaccinations, cancer scans, colon cancer checks and all those things. What is best for the patient is nearly always cheapest for the taxpayer.

There can be no doubt that the issue that the member for Hunter has raised, which is after-hours GP clinics, is actually both best for the patient and—coincidentally!—cheapest for the taxpayer. It is better for everyone that people can take their families to an after-hours GP clinic and get in quickly rather than go to the emergency department where the costs are enormous because the safety checks and the protocols are horrendous—quite rightly in an emergency department. It is much more expensive, by thousands of dollars, to go to an emergency department and not as effective or as useful. In fact, there are many people that will not be able to take their three children under the age of five to be at the emergency department all night because one of them has a tummy ache. They will wait. It's not good for the patient and, in the long run, not better for the taxpayer either.

Why on earth would the government do something which is worse for the patient and more expensive for the taxpayer? The answer, I suspect, is in the system where one part of the cost is paid by the federal government and the other part of the cost is covered by the state government. If the federal government cuts its GP after-hours services, it's cheaper for the federal government but more expensive for the state government, because the state government pays for the emergency services. They have to do that within their budget. So you take the money out of the federal government cost and whack it over to the state. That's what's happening here. It's worse for the patient, cheaper for the federal government, and more expensive for the state government And there are many, many examples of that. If primary health care isn't sufficient, people end up in hospital, moving the cost from the federal government to the state government. If people can't get the treatment they need in an aged-care facility, they end up staying in hospital for long periods of time because they can't get the treatment or the bandages they need at home or they don't live in an aged-care facility that will take care of them. That means the cost doesn't go to the federal government but goes to the state government. It's not blame shifting, it's cost shifting. It's profound cost shifting, and it's not good for anybody, because ultimately the taxpayer pays for it. Taxpayers either pay for it through federal funding to the states or they pay for it at the federal level. But the taxpayer pays for it, so it is worse for the patient and worse for the taxpayer in the end. But one section of government gets to look good and the other one tends to look bad.

What we've got here is a really dumb decision. It's a decision born of the system that we have that allows for cost transfer between state and federal governments. It's a symptom of not having a holistic approach to health which actually considers the overall cost to the government and the overall benefit to the patient, and that's what we see happening here. This is a nonsense decision. If the government were closing down my after-hours clinic, they would be putting thousands of people's health at risk. The other interesting thing we're hearing about today is the loss of one in the Hunter, but, according to the member for Longman, gaining one in the Longman electorate, which means we're losing one from a Labor electorate and gaining one in a Liberal electorate. What is that about? How many times have we seen that pattern with this government? They look after the ones that vote for them and think, 'Stuff the others.' What we've got here is a transfer of costs from federal government to state government and, essentially, moving the cost from a Labor electorate to a Liberal electorate. It's just wrong, and we should all be outraged.

Sharon Bird (Cunningham, Australian Labor Party) Share this | Link to this | Hansard source

The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made in order of the day for the next sitting.