Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Hansard source

Thank you, Madam Acting Deputy President. Firstly, the opposition welcomes the backflip by the government in relation to what was yet another ill-considered, ill-thought out budget measure in the health portfolio. What we had from the minister yesterday afternoon was a final draft of the regulations to this legislation which enshrine increases in a key Medicare rebate relating to IVF. It introduces new Medicare rebate items for IVF. It increases caps under the extended Medicare safety net arrangements for IVF. Yet the minister was also saying in her press release yesterday that the changes would not have any fiscal impact. She said:

The restructured items and caps achieve the same savings announced in the 2009-10 Budget ($451.6 million over 4 years).

Patients are better off and doctors are better off, but the government is telling us that there is no fiscal impact whatsoever.

The opposition is not prepared to take the government on trust on these revised measures. The minister entered into an agreement with stakeholders on Thursday last week and it took them until yesterday afternoon to table the final draft of the regulations in the House of Representatives, and they tabled them in the Senate this morning. After the regulations were tabled in the House of Representatives yesterday afternoon the opposition sought a briefing last night, essentially to seek some reassurance as to whether the figures actually add up. Is it possible that doctors and patients can be better off to the tune, we believe, of about $1,000 per IVF procedure yet there will be no impact on the budget bottom line?

This morning we received that briefing and we asked very specific questions. The department told us that they would be increasing the Medicare rebate for the first IVF cycle by $1,100, for the second and subsequent cycles by $900. We asked the very specific question: what is going to be the impact of that in terms of additional expenditure by the Commonwealth? The departmental officials said: ‘We haven’t got that information. We were asked to come here at the last minute. We were asked last night to provide you with a briefing this morning.’ The reason we were only able to ask the department to provide a briefing for us last night is that the minister waited until yesterday afternoon to table the final draft of the regulations. Very sensibly, Senator Fielding, Senator Xenophon and the coalition moved the second reading amendment when this legislation was being debated during the last sitting fortnight. In part it said:

... and further consideration of the bill be an order of the day for three sitting days after a draft of the final regulations and determinations relating to this bill are laid on the table.

That has happened in the Senate today and it happened in the House of Representatives yesterday. But we do not think that the figures add up. We welcome the government’s backflip. We welcome the fact that families seeking access to IVF treatment will be better off. But we want to get some more detail from the government and we think that it is quite reasonable for the Senate to be able to spend those three days properly scrutinising the impact of what the government announced as late as yesterday afternoon.

Industry stakeholders are quite happy with the deal that they were able to reach with the government on Thursday. They were not happy with what came out of the budget last year, so if they are now happy there must have been some improvement. How is it, if there is some improvement, that there is supposed to be no impact on the bottom line? Industry stakeholders tell us that there are about 20,000 couples who would access 2½ cycles each on average and all of them are going to be $1,000 per procedure better off. Quick maths on the back of an envelope indicate that if 20,000 women are able to access IVF and are $1,000 better off per procedure and will access on average 2½ procedures each, that is about $50 million in additional expenditure per annum.

The government tells us, ‘Well, we can offset some savings in another Medicare item number.’ We asked the questions: ‘How much are those savings? How many procedures do you expect to be accessed on the item number where there is a saving?’ ‘We have not got that information’ was the answer we were given. To cut a long story short, the minister initially introduced a budget measure that was going to hurt families requiring access to IVF. She was forced to go back to the drawing board by the actions of the Senate. She has left it until the last minute to put forward the final draft of the regulations which we demanded during the last sitting fortnight. We are now given a couple of minutes to deal with it. (Time expired)