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

I rise to speak to this motion to strengthen Medicare moved by my good friend and colleague the member for Macarthur. Labor has a proud record on health. Forty years ago, the Whitlam Labor government established Medicare, the universal health insurance scheme that continues to serve millions of Australians in need. But Medicare's introduction and, indeed, its survival has been anything but smooth sailing, because coalition governments have had a long history of hostility to Medicare. Today the Albanese Labor government is building on Whitlam's legacy as we strengthen Medicare for all Australians. Indeed, one of the first acts of this government was to restore the much-loved GP access after-hours service in the Newcastle and Hunter region, reinstating in full the operational hours of all clinics and reopening the after-hours service at the Calvary Mater hospital, which closed under the Morrison government's watch. Now thousands more Australians can soon access free urgent care when they need to, through the additional 29 urgent care clinics we announced in the recent budget, bringing the total number across Australia to 87. That's 87 urgent care clinics offering free walk-in care seven days a week over extended hours, completely bulk-billed.

I was pleased to recently host the Minister for Health and Aged Care in Newcastle to announce an urgent care clinic that will be established to service the Newcastle and Lake Macquarie area. This is great news for Novocastrians. It will help take the pressure off the John Hunter Hospital, where around 40 per cent of visitations are what we call categories 4 and 5—that is, patients with non-life-threatening conditions who are turning up to emergency departments when they would be better suited being treated in primary health. I've been fighting for an urgent care clinic in Newcastle and I am pleased to say this government is now delivering. It will go a long way to helping my community access quality, bulk-billed primary health care when they need it. The only card you need at an urgent care clinic is your Medicare card.

After a decade of cuts and neglect from the opposition, Labor's investments in Medicare and our health system are reversing the damage done—and more. The centrepiece of the Albanese Labor government's 2023-24 budget was a historic $6.1 billion investment in strengthening Medicare. This included a $3.5 billion investment to triple the bulk-billing incentives for GPs, benefiting more than 11 million people.

We're also expanding the range of free mental health services through a commitment of $361 million over four years, including a network of 61 walk-in Medicare mental health centres that are fully staffed with professionals to care for people at every stage of mental health distress. We're investing $69.8 million to provide more MRI machines that are Medicare eligible—from 227 machines to 620. We're funding Medicare rebates for nuclear imaging and other common medical tests, enabling more people to access critical and timely diagnostic testing without having to worry about the cost. This will quite literally save lives.

But it doesn't stop there. We're also easing cost-of-living pressures for households through a $4.3 billion investment to deliver cheaper medicines. The maximum cost of PBS medicines has been reduced to $31.60, and 60-day prescriptions have been introduced for 184 common medicines, which is saving millions of Australians time and money, while caring for their health. In my electorate of Newcastle alone, 203,432 cheaper prescriptions have been issued since we've introduced this initiative, resulting in over $2.3 million in savings for Novocastrians.

We still have more to do to undo the previous decade of damage done by the opposition to Medicare and our primary health system, but Labor has a long history of caring for Australians and this Albanese Labor government is no exception. Only Labor can be trusted to invest in and support Medicare, which is, after all, a Labor government's legacy. It is the most pressing issue for people in Newcastle and the Hunter region and I really want to thank the Minister for Health for listening to our concerns. I come from an area where bulk-billing rates plummeted to a record low under the former government's watch. I'm doing absolutely everything I can to stop that downward spiral and turn this around.

Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

Surprise, surprise, I agree with the member for Newcastle when she says that health is the most pressing issue, because it is. Of course it ties in with the cost-of-living crisis too, but if Labor were so good with Medicare and health in general, why have bulk-billing rates slipped and fallen so markedly since they took office in May 2022? Why is a town such as Parkes in Central Western New South Wales in the Riverina electorate not able to have maternity services in the hospital, such that there has not been a baby born there—according to Mayor Neil Wescott—for five years? For a town of that size, it's simply unacceptable. I agree with the member for Newcastle that health is and should always be the No. 1 priority. As Councillor Wescott observed, 'How do we as a town and shire attract doctors when we don't have the services available here to deliver babies?' It's so, so true.

I'm still shattered by the fact that when Labor came to office it changed the distribution priority areas for general practitioners to include some outer suburbs of Sydney and Melbourne, as well as Newcastle, Wollongong, the Gold Coast and other major cities. You cannot tell me and you cannot convince country people that those areas I just mentioned have the same priority as towns like Parkes and others in more remote Australia. Distribution priority areas identify areas where people don't have enough access to doctors based on the needs of the community. There are so many regional centres that fall into that category, yet Labor seems to think that it should include outer suburbs of our two major capital cities. It is simply not good enough, because why would you, having just graduated as a doctor, want to go out to some of those more remote areas of Australia when you can put your shingle up in one of those major capitals centres or, indeed, the Gold Coast? It is difficult enough for rural and regional areas, let alone remote areas, to not only attract but also retain doctors to work in hospitals, as well as to have their own clinics.

Labor's decision has drawn the ire of health authorities. They see the move as a deterrent to doctors going to places where they are most needed, such as Parkes. The Chief Executive Officer of the Rural Doctors Association said:

We're already seeing the withdrawal of applications and a reduced number of overseas trained doctor applicants. … It's having an immediate impact.

She went on to say:

We've seen adverts of corporate practices where they're saying, "If you've got a provider number with restrictions on it, you can now work in Hobart, or Canberra, unrestricted" …

And the president of the RDA, Dr Megan Belot, said: 'No sooner was Labor's change announced than metropolitan medical clinics went after country doctors.' They 'went after country doctors'—so they headhunted them. There has been a longstanding policy to require overseas trained doctors who want to live and work in Australia to spend time caring for rural and remote communities that have had a classification of MMM 3 to MMM 7 before receiving an unrestricted Medicare provider number. Labor, said Dr Belot, has scrapped this requirement by adding all large regional centres, MMM 2, and other outer metropolitan areas, MMM 1, to the distribution priority area classification. It's simply not good enough. And, as she said: 'As quickly as it was announced, city medical practices started targeting doctors in rural areas to move to cities, including Canberra, Hobart, the Sunshine Coast and Wollongong.'

The Murray-Darling Medical Schools Network, I know, is going to make a difference, and I'm so pleased, as it's one of the legacies of my time as Deputy Prime Minister. It will make sure that doctors are able to do their full amount of training in a country setting. Whether that's at Dubbo or Wagga Wagga or Orange or Mildura or even Bendigo, it's going to make such a difference, because they will go to those country areas, if they are not there already. They will stay in those country areas when they get their diploma or their certificate, because they'll fall in love with the area. They'll see there's money to be made in the area. Maybe they might fall in love with somebody in the area, and that will keep them there. But rest assured: it is a good initiative.

I know that, at Wagga Wagga, the UNSW is making great strides in making the young graduates very welcome. They're going to be doing all of their training in that setting, in the new multistorey building, right next door to Wagga Wagga Base Hospital, where they can do their prac. It's a good outcome.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I'd like to thank the honourable member for Macarthur for bringing this motion to the House. I welcome any opportunity to talk about that proud Australian and Labor institution that is Medicare. It's universal caring—something that is actually in my DNA.

Medicare celebrated its 40th birthday on 1 February this year, and doesn't it look good. Thanks to the Hawke Labor government and the vision of Gough Whitlam before that, Australians have had access to high-quality universal health care ever since. There have been a few hiccups, obviously, but Medicare guarantees every Australian access to a wide range of health and hospital services at low or no cost, because all Australians make a contribution. In the last financial year alone, over 26.5 million Medicare customers put in close to 460 million claims.

So we know that Medicare is certainly going strong—and I say this proudly—in spite of the efforts of successive coalition governments to weaken it. We all remember Malcolm Fraser and John Howard having a crack at Medibank and Medicare. That was followed by further attacks during the dismal Abbott-Turnbull-Morrison wandering wilderness years. The now Leader of the Opposition, in his time as the Minister for Health, froze the Medicare rebate, which has meant a substantial decline in the number of GPs that are bulk-billing—something that, as our health minister says, is the beating heart of our health system. I remember that he also tried to establish the GP tax; he tried adding $5 to the cost of every script; and he ripped up the National Partnership Agreement on Improving Public Hospital Services, denying that crucial plank in the health system $200 million. The member for Dickson also cut $50 billion from public hospitals. He even abolished Health Workforce Australia, leaving the nation exposed to medical workforce shortages—something that nearly every previous speaker on this motion has spoken about. I understand the member for Riverina saying that the country is having problems. Even the city is having trouble recruiting doctors at the moment.

In opposition, the member for Dickson led the blocking of legislation for 60-day prescriptions. He just said no. Cheaper prescriptions have saved Australians more than $370 million since January last year. It's good for people organising their lives, and it helps us contain inflation, obviously.

The Albanese Labor government has Medicare's back, and we're committed to strengthening it even further. We're investing nearly $3 billion in this year's budget on a range of crucial measures, such as funding a further 29 urgent care clinics across the nation—bringing the total to 87. I recently had the pleasure of visiting the urgent care clinic service in Brisbane's southside, and I heard firsthand from the staff there how they're taking the pressure off the nearby emergency departments and making it easier for people to see a doctor or nurse—all bulk-billed, of course.

Speaking of bulk-billing, the tripling of the bulk-billing incentive in November 2023 has enabled an additional 950,000 bulk-billed trips to the GP. As the Minister for Health and Aged Care has said, bulk-billing is the beating heart of Medicare, and, at a time of cost-of-living pressures, bulk-billing means that going to the doctor does not impact on the family budget.

Labor understands that mental health supports are vital, which is why we are investing $360 million over four years to expand the free services available. These include a new national early-intervention service, as well as funding Primary Health Networks to employ skilled mental health staff to support patients with complex needs. We're also providing free direct help through psychiatrists and psychologists at 61 Medicare mental health centres.

Labor is also implementing targeted support to women suffering from pelvic pain and endometriosis. From July next year, the Medicare Benefits Schedule will have two new items, to enable extended consults of 45 minutes and increased rebates. This $49 million investment will support approximately 430,000 more services to women across the country.

Strengthening Medicare also directly helps Australians with cost-of-living pressures. Labor has already made medicines cheaper with the 60-day prescriptions, and we have now frozen the maximum cost of a PBS medicine to $31.60—a reduction of 29 per cent. Pensioners and concession card holders will pay a maximum of $7.70. All of this is part of making sure that we've got health professionals who can work with all of the challenges of Australia. You can trust only a Labor government to continue investing in and strengthening Medicare.

Dai Le (Fowler, Independent) Share this | Link to this | Hansard source

Access to affordable medical care is one of the most important qualities that we have as Australians. Our general practitioners are at the forefront of this. They play a critical role, from early detection of diseases and intervention, to guiding patients and their families through difficult medical conversations, through a lifetime of immunisations and check-ups and management of the aging process. In my community in Fowler, the work of GPs is more challenging, with language and cultural needs, as well as cultural beliefs. Over 70,000 people in my community live with a long-term health condition, from stroke to diabetes, arthritis, asthma and cancer—to name just a few.

It is against the increasingly diverse needs in the community that many GPs find themselves working, and it's a particularly challenging job for many, as they are the primary caregiver to their patients and they're the gateway to other specialists, through their referral role. They take on a lot of responsibility for the professional diagnosis and treatment, and they are integral to the administrative processes that ensure continuity and follow-through in patient care.

Like many things in our society post COVID, the healthcare sector has faced, and continues to face, many challenges. The shortage of GPs, especially GPs who offer bulk-billing services, is a critical one. This is not merely an inconvenience. It is a symptom of a deeper malaise in our healthcare system—a shortage in the supply of GPs that is fast becoming a crisis.

I recently met with the CEO of the Minett Group of Companies, who represent numerous smaller GP practices. She informed me that, in the past year and a half, at least 30 GP practices have closed in the south-west Sydney area alone. Of the practices that remain, many are facing an aging profile of practitioners who are nearing retirement. This is not a temporary shortfall; it is a chronic and worsening shortage.

To address this, we must look at increasing the supply of qualified GPs, especially those incentivised to bulk-bill. While we take comfort in the rigorous process that produces highly qualified doctors, we must also acknowledge that there are qualified medical graduates among us, trained overseas, who are waiting for their qualifications to be recognised so that they can contribute and fill the gap that our health system is experiencing. Surely our Australian medical health system can find solutions to bring on these overseas trained and qualified doctors by assessing factors such as the costly exams, the requirement to spend 10 years living in rural regions or the supervision requirements that seem overly bureaucratic and onerous.

In my electorate of Fowler, with its high migrant and refugee population, there are doctors who could be serving our community's need for GPs. While I understand the necessity for English language proficiency and a review of the courses of study passed, surely we can streamline this process. These doctors are much more likely to seek to open practices and stay in communities where they, their families and their friends live.

Another means to increase the supply of GPs would be to review professional qualification process that awards specialism. The decline in medical graduates choosing general practice, from 65 per cent to just 12 per cent, is alarming. The four- to five-year additional training period required to specialise as a GP is the same time commitment as other specialisations that offer much higher remuneration. It is incumbent upon medical associations, with input from government, to reassess this process and align it with the healthcare needs across Australia.

The socioeconomic disadvantage prevalent in south-west Sydney makes the area less attractive for new GPs due to a preference for bulk-billing, exacerbated by the inadequate indexing of patient rebates. This indexing requires urgent review to ensure that areas with the poorest health outcomes can support more bulk-billing practices. South-west Sydney has and will experience great population growth in the coming years. This will require a significant increase not only in GPs but also in nurses, allied health professionals and specialists to support the multidisciplinary teams.

We need changes to incentivise existing GPs to bulk-bill patients. The current cost-of-living crisis, stagnating economy and wallet-emptying inflation overseen by this Labor government mean that many Australians will place food, clothing and fuel costs over their health. This is a false economy as delayed health checks lead to worse health outcomes and higher costs in the long term. I'm committed to engaging with the minister for health on these concerns and working towards a sustainable solution to ensure the health and wellbeing of our nation.

Tania Lawrence (Hasluck, Australian Labor Party) Share this | Link to this | Hansard source

I, together with the member for Moreton, am currently wearing a continuous glucose monitor because he, as chair of the Parliamentary Friends for the Prevention of Diabetes—or 'enemies of diabetes', perhaps, is more accurate—together with Diabetes Australia reckon it's a good idea for politicians to actually understand what people with diabetes have to live with, and they're right. I'm proud that, in July 2022, this government provided all 130,000 Australians with type 1 diabetes access to subsidised continuous glucose monitoring, such as the one I'm wearing on my arm today.

Labor will go to the election next year with good news to tell in the health portfolio, and central to that is the way in which we have begun the long task of strengthening Medicare after years of coalition neglect. The coalition were forever lukewarm at best on Medicare—when they were not actively undermining it, that is. The Australian people remind them from time to time that they better not mess with it. Medicare remains a beloved legacy program based on the premise that your access to primary health care shouldn't depend on the size of your wallet.

Labor introduced Medibank in 1974 and was met with vehement opposition from the conservative parties. Just how much opposition? Well, a double dissolution and joint sitting's worth of opposition. Nevertheless, it got through. Then, after 1975, the scheme was white-anted and then abolished by the Fraser government. In 1984, Medicare was introduced—again with opposition from the conservatives.

Over the years, we have seen coalition leaders like Howard and Abbott talk about getting rid of Medicare, then recanting when they see it's too popular and then pretending to be Medicare's best friend. 'We won't get rid of any Medicare locals,' said Tony Abbott in opposition in 2013. All 61 were scrapped as soon as he came to office. The coalition doesn't oppose universal health care directly anymore, because they understand the electorate won't stand for that. Instead, they just let it run down. Once it has run down enough, they'll try to point to it as a failed system. It's the old coalition privatisation playbook.

The people of Hasluck voted for Medicare at the last election. They voted for a Medicare urgent care clinic in Midland, and now one has been delivered and is operating extended hours at North Street Medical Centre, located close to the town centre of Midland. People needing care for themselves or their children can attend and have the whole of their urgent treatment bulk-billed. The government promised 50 Medicare urgent care clinics at the last election, and we've already delivered 58. In this year's budget, we have committed to creating another 29, with $227 million of funding to bring the total number to 87. Australians are appreciative of this new service, with over 400,000 presentations to urgent care clinics already. More than 25 per cent of those presentations were children under 15 years of age, and more than a third were outside of regular hours. Half of them say that they would otherwise have presented to the emergency department at the hospital.

I am also pushing for a second urgent care clinic to be established in Hasluck. Ellenbrook township is the centre of what is possibly the fastest growing urban corridor in the country, and it remains underserviced in many ways. There is no hospital based there yet, and there is a great need for more and more varied health provision. An urgent care clinic will bridge the gap for many of our local residents.

Last year's budget included a $3.5 billion investment to triple the bulk-billing incentive to benefit more than 11 million Australians. As a result, the GP bulk-billing rate has risen by 2.1 per cent in the first five months of that policy. This translates to an extra 950,000 visits to the doctor. We can add to this—cheaper medicines, by virtue of the caps on scripts and the transition to 60-day scripts for many chronic conditions. The coalition were advised to allow 60-day scripts back in 2018, but they squibbed it, meaning that millions of Australians have paid too much for far too long, waiting for a government that cared enough to see that job done.

These policies underpinning the health of the Medicare system, making medicines cheaper and increasing bulk-billing rates are obviously good for people's hip pockets too. At a time when cost of living is an issue, the government actions in the health portfolio serve to act as a brake on inflation and to help out with the family budget. Labor's investments in Medicare are good for the health of Hasluck and good for the country at large. I thank the member for Macarthur for this motion, recognising his unrelenting advocacy for Medicare and across the gamut of the health portfolio. Anyone wearing this or with any other condition can trust that Labor has their back and their health in mind.

Brian Mitchell (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

If you wanted to know about the state of your car, you'd ask a mechanic. If you wanted to know about the state of education, you'd ask a teacher. And, if you wanted to know about the state of the health system, you'd ask a doctor or a nurse. So thank you to the member for Macarthur, a doctor, for pointing out the incredible work that our government is doing in support of Australia's health system. We are making strides after just two years in government after 10 years of Liberal government neglect. Under the opposition leader as health minister—who, by the way, was voted by doctors as the worst health minister in 40 years—the Liberals cut $50 billion from hospitals, tried to burden Australians with a $7 GP tax and launched an outrageous sneak attack on accessible health care with the Medicare privatisation taskforce. You don't create a Medicare privatisation taskforce unless you're planning to privatise Medicare.

Labor campaigned in 2022 on strengthening Medicare and making medicines cheaper. That's what Australians voted for, and, since our election, that's what we've been delivering. In 2022, the Albanese Labor government delivered the biggest price cut in the entire history of the Pharmaceutical Benefits Scheme. No Australian pays more than $31.60 for their PBS medicine. In just over a single year, that translates to a saving of $370 million across 29 million prescriptions.

In 2023, the Albanese Labor government introduced 60-day prescriptions across 184 medicines. You may have seen some campaigning on that issue. That decision came from listening to expert advice. The coalition heard the same advice over their 10 years in government, but, to nobody's surprise, they ignored it. In fact, they ignored it on six separate occasions when they blocked cheaper medicines for Australians in the Senate. In this year's budget the Albanese Labor government unlocked $4.3 billion to deliver even cheaper medicine. We're adding more medicines to the PBS and we're capping their cost, but we're not stopping there. Our bulk-billing incentives have seen bulk-billing in my electorate alone rise by five per cent.

Of course, the Albanese Labor government introduced Medicare urgent care clinics back in 2022 over the objection of the Liberals. Medicare UCCs are open seven days a week. They accept walk-in patients without an appointment. The care they provide is fully bulk-billed and takes the pressure off emergency hospital departments and working families. More than 58 urgent care clinics have already seen more than 425,000 patients—fully bulk-billed. The health minister and I visited one of the clinics in Hobart last month, whose operators said that around 80 per cent of their patients would otherwise have had to go to the Royal Hobart Hospital's emergency department if the clinic weren't there. The minister and I visited the Launceston clinic in your electorate of Bass, Deputy Speaker Archer, where we were told just three per cent of patients require referral onto hospital or more specialised care, proving that the Medicare urgent care clinics are doing exactly the job that we designed them to do.

I am proud to say the suburb of Bridgewater, in my electorate, will be home to Tasmania's fifth urgent care clinic. It supports not just Bridgewater; it provides necessary care to Brighton, Derwent Valley and Hobart's northern suburbs. The Liberals in Tasmania scoffed at our Medicare urgent care clinics back in 2022 when they were announced. They were called disasters and cruel hoaxes that couldn't be delivered. The social media posts are still up. You should never attribute to malice what can be attributed to idiocy, because two years later the Tasmanian Liberals think the Medicare urgent care clinics are such a disaster and such a cruel hoax that they don't want five in Tasmania—they say they want at least nine. We know the Liberals love saying no, but now it's nine. The Liberal Deputy Premier reckons we're dudding Tasmania by providing just five and not nine Medicare UCCs. You can't make it up.

The Liberals have a long and chequered history on Medicare, which the member for Hasluck has alluded to. Firstly, they wanted to abolish it. When they couldn't do that, they tried to gut it. Then they wanted to privatise it, and for 10 years they starved it. This Labor government lives, bleeds and breathes Medicare. We believe in Medicare. Only Labor will stand up for Medicare.

Bridget Archer (Bass, Liberal Party) Share this | Link to this | Hansard source

There being no further speakers, the debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.