Luke Gosling (Solomon, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes that 2024 marks 40 years since the introduction of Medicare;

(2) acknowledges this was one of the most transformative moments in Australian history and meant access to health care became a right that all Australians could share, regardless of their income or background;

(3) further notes that to mark this historic occasion and anniversary, the Government has launched the Stronger Medicare Awards in recognition of primary healthcare professionals from all corners of the country who have gone above and beyond to improve the lives of all Australians;

(4) congratulates the finalists and winners of the Stronger Medicare Awards;

(5) extends its gratitude to every general practitioner (GP), nurse, midwife, pharmacist and allied health professional working in primary care, for the work they do to keep our communities healthy;

(6) recommits to the fundamental belief that it is your Medicare card, not your credit card, which should guarantee access to quality health care; and

(7) further acknowledges that:

(a) as the Minister for Health, the current Leader of the Opposition:

(i) tried to introduce a tax on visits to GPs;

(ii) froze Medicare rebates;

(iii) cut $50 billion from our hospitals;

(iv) said there were 'too many free Medicare services'; and

(v) was voted by Australia's doctors as the worst health minister in the history of Medicare; and

(b) only the Government can be trusted to keep Medicare strong as we build Australia's future.

There is no higher priority for the Albanese Labor government than health, by strengthening Medicare and rebuilding general practice. Our government's 2024-25 budget provides $2.8 billion to continue to strengthen Medicare. This is in addition to the historic $6.1 billion investment in Medicare in the 2023-24 budget. We are taking the key steps needed to address the pressing challenges in our healthcare system.

The Albanese Labor government has delivered more than double the amount of indexation to Medicare than those opposite did in almost a decade. In 2023 we delivered the biggest indexation boost for Medicare in 30 years, and this year we have delivered the second-largest increase, with almost $900 million in additional funding for Medicare. We are delivering for Australians and we are delivering for my electorate of Solomon—for Darwin and Palmerston.

It doesn't stop there. Bulk billing was falling off a cliff because of the six-year freeze on Medicare rebates by those opposite, which is why we tripled—that's three times—the bulk-billing incentive from 1 November last year, in the largest investment in bulk billing in history. Since we tripled the investment, we've seen a turnaround in bulk billing, with a national increase of 1.7 percentage points in the first year, and 5.4 million additional estimated visits. My electorate saw an increase of 6.1 per cent in the bulk-billing rate. Obviously, this is incredibly helpful for families. We saw 61,000 additional estimated visits to health professionals in the Northern Territory.

Cheaper medicines is another area. Our government went to the election promising Australians that we would make medicines cheaper, and we are delivering on that promise. We have delivered the largest price reduction in the 75-year history of the Pharmaceutical Benefits Scheme. People now pay no more than $31.60 for medicines on the PBS. We've introduced 60-day prescriptions for around 300 common medicines, meaning that millions of Australians are not only saving time but saving significant amounts of money as well. Australians have saved $1 billion on cheaper prescriptions so far. That is real cost-of-living help.

Urgent care clinics are making a real difference for patients and for busy hospital emergency departments. We have opened 77 urgent care clinics across Australia, including one in my electorate in Palmerston. There have been almost 860,000 visits to Medicare urgent care clinics across Australia, and all of those visits have been completely bulk billed, which helps with the cost of living, of course, and making sure Territorians and all Australians get the care that they need. We know that the opposition have never supported Medicare urgent care clinics, because they have never supported Medicare. The shadow Treasurer has made it clear that our additional investments in Medicare urgent care clinics are on the chopping block, and that is a choice that Australians will have next year. These urgent care clinics are benefiting our community, but, if those opposite were to be on this side of the parliament, that would all be in jeopardy, as they would close. I know this would be of a great detriment to our community in Darwin and Palmerston and across the country.

Finally, but most importantly, the workforce who run our system—like you, Deputy Speaker Freelander—are the backbone of our system, and I was delighted to see the Territory's midwifery group practice be recognised as Medicare Champions in the recent Stronger Medicare Awards, recognising them as outstanding health professionals. Since the Albanese Labor government's record investment in Medicare, our general practitioner workforce is growing. The health system added one new doctor every hour on average last year, with more doctors joining in the last two years than at any time in the past decade, and I'm really proud that, next year, Charles Darwin University will start having its own medical program. In the last two financial years, an additional 17,846 new medical practitioners have been registered to practice, which is really significant.

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

Is the motion seconded?

Kate Thwaites (Jagajaga, Australian Labor Party, Assistant Minister for Women) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Kylea Tink (North Sydney, Independent) Share this | Link to this | Hansard source

As a child of the seventies, I have no recollection of a time before Medicare, yet, as the member for Solomon's motion notes, today, that time actually did exist just as little as 40 years ago. Today, our public health system is the envy of the world and stands in stark contrast to the toxic, discriminatory and inefficient systems that dominate some other Western economies, including the United States of America. But, as the House notes the 40th anniversary of the introduction of Medicare, I would argue that, rather than simply applauding the government for the work it's done in this 47th parliament, it's important we all reflect on the environment within which Medicare was originally created, as opposed to our current circumstance, and ask ourselves whether Medicare is still fit for purpose in 2024.

At its establishment, Medicare promised universal access to health care, based on the premise that all Australians should be able to see a doctor regardless of their socioeconomic status. It was believed this would lead to better health outcomes and relieve pressure on public hospitals. From the outset, general practitioners have played a pivotal role in stewardship of not only the Medicare system but patients more broadly, and, for many years, they have done an excellent job. Yet, today, many would argue the system no longer provides enough support for general practitioners, and, as a result, it is unravelling.

As health appointments have become increasingly complicated and supportive health services like counselling, diagnostic testing, health screening and specialist referrals have become more demanding, GPs have found themselves being called on to bridge increasingly large gaps with minimal additional compensation. As a result, access to affordable primary care has been diminishing at an alarming rate. From 2013 to 2022, the former government froze Medicare rebates, leading to dramatic increases in out-of-pocket payments for patients and reduced bulk-billing by medical practitioners. As a result, today, about 1.2 million Australians annually defer or miss out on seeing a GP due to cost. This government then claims its recent investment in Medicare urgent care clinics, along with targeted bulk-billing incentives and the promised reintroduction of bulk-billing indexation for selected pathology services, have stemmed that tide. But this is not the experience of my community in North Sydney, where bulk-billing rates have fallen to a record low of nearly 15 per cent this past year. Of 54 primary care clinics in North Sydney, just under 15 per cent offer bulk-billing, and, while many Labor held seats have an urgent care clinic, as we've just heard, that is not the case in North Sydney.

Ultimately, the conversations I have with people in my community suggest there are real problems that need fixing for Australians to continue to have access to the health care we expect. The sorts of issues people have raised with me vary, from frustrations at the difficulty in finding a bulk-billing clinic through to the impact of managing increasing out-of-pocket expenses for patients. At the same time, people routinely urge me to advocate for vital pathology and essential preventative health measures, like basic dentistry, to also be funded under Medicare. While all these issues are valid, the truth is GPs simply can't afford to bulk-bill, because the rebate has not kept pace with business costs, like rent. The out-of-pocket costs for a standard GP consultation in North Sydney are now around $48, yet GPs, as both small-business owners and individuals, continue to struggle. In fact, analysis by the Australian Medical Association in 2022 showed that Medicare has generally failed to keep up with the real-life costs of operating a medical practice. Ultimately, despite what the government may like to say, the system is breaking and, if we are committed to ensuring it continues to meet our contemporary healthcare needs, our government must do more than just applaud itself.

I note the motion moved by the member for Solomon expresses gratitude to allied health professionals, and this is a truly thoughtful gesture, except I would offer the fact that many allied health professionals that I speak to would rather have that gratitude shown by having their services listed on the Medicare benefits scheme. At the end of the day, health care is consistently one of the top issues for Australians, and Medicare was a transformative piece of policy when it was first introduced. But, as the Strengthening Medicare Taskforce noted, reform is needed to ensure all Australians continue to enjoy access to world-class primary health care regardless of the politics of the electorate that they live in or their socioeconomic status.

Meryl Swanson (Paterson, Australian Labor Party) Share this | Link to this | Hansard source

I want to thank my friend and Labor colleague the member for Solomon for raising this matter of public importance and private member's business about Medicare and our health workers. While he takes care of up north, I've got the beautiful New South Wales area of the Hunter and the seat of Paterson. I couldn't be prouder to call Paterson my home and know that, under our government, we are working to protect this incredible institution that is called Medicare. We've got a long history of protecting Medicare because it was our idea in the first place. Like a lot of good ideas, they do need to be nurtured and cared for, and that's what this Albanese government is doing. This year, in 2024, Medicare celebrates 40 years. That's 40 years of a universal healthcare system, where it doesn't matter how much you earn or where you live; primary health care is yours, and that's such an important and fundamental principle. We know that it can be transformative in people's lives. But we also know that in 2024 it can be difficult to get in to see your doctor. I know in my seat it can take up to three weeks. That's why we're working on encouraging more people to become general practitioners. We are working with amazing institutions, like the University of Newcastle, to encourage more people to become general practitioners.

This month, I had the pleasure of attending the Stronger Medicare Awards here in Canberra, where we acknowledged and honoured our Medicare Champions—those medical practitioners who work incredibly hard to provide accessible, high-quality and innovative health care to people, to their patients. I want to congratulate Dr Chris Boyle from Raymond Terrace Family Practice. Dr Chris Boyle is a Medicare Champion, and he was one of the eight finalists to be acknowledged by those awards. Dr Boyle has become a vital member of our community, but it hasn't happened overnight; it has taken him 40 years to do that, and he has been doing it for about the same time as Medicare has been around. After those 40 years, he talks to me about the fact that now about 10 per cent of graduating students go into general practice. When he graduated in the early seventies it was 50 per cent—so we have seen a decline. We know we need to turn that around. We have said it is a priority for a Labor government to do that. We want to continue to build and rebuild general practice services in all our communities.

The government's 2024 budget provides $2.8 billion to continue to strengthen Medicare. This is in addition to the historic $6.1 billion investment in Medicare from the 2023-24 budget. These actions respond to recommendations of the Strengthening Medicare Taskforce and take key steps needed to address the many pressing challenges in our healthcare system.

In 2023 we delivered the biggest indexation boost for Medicare in 30 years. We're not freezing the indexation like those before us did; we are boosting it, and that is a critical thing. This year we delivered the second-largest increase, with almost $900 million in additional funding for Medicare. This government is delivering. We have delivered more than double the amount of indexation to Medicare than the previous government did in almost a decade. I repeat that: under our government, in just under three years, we've doubled the indexation. The previous government froze it—and hear me when I say they may freeze it again; it is a real worry. They don't love Medicare like we do, and they spend their time trying to condense it, cut it and generally wind it back—and that's not good enough.

We know that we have to take a serious position and action on delivering bulk-billing as well, and that's why we tripled the incentive for bulk-billing. Since November 2023 we've seen the largest investment in bulk-billing. In my electorate of Paterson, that's a 3.1 per cent increase—so since November last year there's been a 3.1 per cent increase in bulk-billing. That equals 75,737 visits that have been bulk-billed in my electorate alone. That's important. Labor cares about Medicare and will continue to.

Jenny Ware (Hughes, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on this motion in relation to Medicare. I thank the member for Solomon for giving me the opportunity to speak on this very important motion.

As 2024 marks 40 years since the introduction of Medicare, this is an appropriate time for us as Australians to acknowledge that Medicare has been transformative in the area of public health. But it is also an opportunity for us to look at how much better we can do in this space. I particularly want to talk about my electorate of Hughes, which is down in the Sutherland shire in southern Sydney and also now into south-west Sydney.

I have sat here for 2½ years now and heard this government talk about the fact that they now have more GPs. I heard the member for Paterson mention that as well. That may be the experience in her electorate but it is certainly not the experience in my electorate, and it is certainly not the experience in my electorate that there is more bulk-billing occurring. There has been a 20 to 30 per cent drop in bulk-billing in 2½ years in the Sutherland shire and in south-west Sydney under this Labor government, under Minister Butler. I've done the research on this, and I'd be very happy to again send Minister Butler the names of every single GP practice within my electorate that no longer bulk-bills.

We return to the motion and also to the position of those in government that say they have increased the number of GPs. Wattle Grove Family Medical Practice, which is in my electorate and serves the local area, has over 3,000 patients on its books, and Dr John Stanford and I have been advocating to the health minister on this issue to no avail. He refuses to meet with me on this and refuses to assist my patients and my electorate. Many of those patients are veterans' families because the medical centre is located in Holsworthy. It simply requires a change of designation from inner metropolitan to outer metropolitan; that would be enough to restore a GP, a registrar, to that practice. While I have all the respect in the world for the honourable member for Solomon, it would be helpful perhaps if he could have a talk to the Minister for Health and Aged Care to find out why it is that the health minister does not care about my electorate there, around Holsworthy and Wattle Grove.

While we are talking about this government not caring, I want to talk about vision health in south-west Sydney, particularly in and around Campbelltown Hospital. I have written similarly to the state health minister and the federal health minister on this. Formerly optometrists in south-west Sydney could refer patients with glaucoma and cataracts for surgery at the Sydney and Sydney Eye Hospital. That option has been cut under this government. Further, this government has said that not only can optometrists not refer patients to the Sydney and Sydney Eye Hospital but patients have to go to Liverpool Hospital and the referral can only be through a GP or an ophthalmologist. There are people in my electorate around south-western Sydney who cannot afford to go and see an ophthalmologist or have to wait months and months, sometimes years, to see one. People in my electorate are losing their vision because this government has changed its position on vision health in south-western Sydney. I particularly want to thank Clinton Maynard on 2GB. I was speaking to him the other morning at about 4.30. He's an insomniac, similarly to me.

Lastly, I want to talk about pelvic pain clinics. I acknowledge that this government has established some pelvic pain clinics for women. I've been advocating for a pain clinic for women where endometriosis, menstrual pain, menopause, PCOS and all of the many other issues that are unique to women could be dealt with in the one place. I have been told that women in my electorate can go to Mittagong—Mittagong is 90 kilometres from the centre of my electorate—or they can go to Leichhardt. It's more than 40 kilometres from Macquarie Fields to Leichhardt. This government must do better on Medicare.

Karen Andrews (McPherson, Liberal 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 an order of the day for a later hour.