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

by leave—I move opposition amendments on sheet 5923.

(1)    Schedule 1, item 3, page 4 (line 23), before “The”, insert “(1)”.

(2)    Schedule 1, item 3, page 4 (after line 31), at the end of section 10B, add:

        (2)    A determination made under subsection (1) does not come into effect until it has been approved by resolution of each House of the Parliament.

I thank Senator Siewert for her comments indicating that the Greens are inclined to support our amendment. In moving the amendments, I re-emphasise that the opposition have also indicated to the government that we are inclined to support this legislation. We have some concerns about the figures, particularly given the backflip on IVF, which we have welcomed, but there will be an opportunity in 12 months time to review whether our concerns were well founded or whether the government, as we believe, got it wrong.

Our support for the legislation, however, has two important provisos. Those provisos are: (1) that this amendment is successful and (2) that the Rudd government in general, and the Minister for Health and Ageing, Nicola Roxon, in particular, find it in their hearts to make one more change to this legislation and that is in relation to the Medicare benefits schedule item No. 42740, which relates to injection of a therapeutic substance into the eye. We understand it is a measure that will save $16 million over the forward estimates. Given the $14 billion budget which is the Medicare benefits schedule, $16 million over four years is a very, very small amount.

This measure will have a significant impact on the treatment of the cause of macular degeneration through injections of the drug Lucentis into the eye. The extended Medicare safety net reimburses patients, not doctors. The government, through this measure, will now shift costs of treatment of macular degeneration to patients. Treatment of macular degeneration with Lucentis is only available in a limited number of public hospitals. It is not available in New South Wales, for example. The patients who cannot afford the increased costs may stop treatment and risk blindness. Savings of $16 million associated with this measure is insignificant when compared to the waste and mismanagement in other areas of government spending, but it would have a considerable impact on patients. Some may go blind unnecessarily as a result. There will also be increased falls, fractures and associated hospitalisations. Macular degeneration is the leading cause of blindness in Australia. It affects one in seven Australians over the age of 50, with the incidence increasing with age, and it is responsible for 48 per cent of severe vision loss in Australia.

As I said, this is one of the last sticking points between the opposition and the government. We had hoped that, through our discussions, we would have been able to convince the government to see the light, dare I say. A few of us were at a dinner on Tuesday night organised by Vision 2020. Senator Faulkner gave a very, very good speech about how important it is to ensure access to quality health care which can help prevent blindness. He gave a very personal account of his own experiences which touched everyone in the room at the time. I would call on Senator Faulkner to prevail on the Minister for Health and Ageing to reconsider this aspect of this measure. I am calling on Senator Faulkner quite deliberately because I was very touched by his very personal account at the Vision 2020 dinner earlier in the week, where he explained and focused on the importance of this sort of treatment to prevent blindness.

I will give some further justification for the importance of this amendment. As I said earlier, we do not want to give the government a blank cheque. They will tell us, ‘Oh well, the regulations are a disallowable instrument,’ but as a regulation that is a disallowable instrument it comes into effect when the government introduces it. We have to make a decision after the event to stop it. Experience, even with this legislation now, shows that unless we had had the ability to force the government to reconsider the impact of the measures that they are pursuing on patients they would have gone ahead with the way the budget measure was originally envisaged and patients needing access to IVF would have been hurt. The only reason we were able to force the government to come back to this chamber and table the determinations and regulations was that this legislation had not been passed yet. In a year’s time, if the government wanted to pass further determinations, they would be able to do so and only if we had a majority in this chamber after the event would we be able to stop it and the MBS item numbers are very difficult to unscramble.

This government have a bad track record when there is too much government power. I have already spoken about the stuff-up in relation to the $105 million budget cut on chemotherapy. We are well aware of the stuff-up in relation to the IVF treatment. Let us just reflect on something that happened during the debate on the increased tax on alcopops. I urge Senators Siewert and Xenophon to listen carefully, because I know that ultimately a particular decision was made. But let us just reflect on what happened. The government used an important administrative process, the tariff proposal process, to introduce a tax increase. Whatever we think about the merits of that, they then played it right to the last minute. They had that tax running for 12 months before they eventually, at the last minute, came to this chamber to seek validation. And guess what? The Senate rejected it. The government did not have the support of the Parliament of Australia to increase the tax. What did the government do? Immediately after the Senate rejected that tariff proposal they turned around and introduced another one. Presumably, if the Senate had not made a decision a month or two later, that would have also been in effect for 12 months—irrespective of the explicit wishes of the parliament. I have previously mentioned that I think that was an abuse of government power and arguably a contempt of the parliament because the government acted against the explicit wishes of the parliament at that time.

From that point of view, given the experiences we have had with the Minister for Health and Ageing in particular across a range of areas, we cannot trust this government with too much power: one, because they stuff up by not doing their homework; two, because at times we have to force them back into this chamber to face scrutiny about the impact of their measures on patients; and, three, because there has been an experience over the last 12 months where they have actually abused the power of the government to make decisions under administrative arrangements in spite of any decision of the parliament to which the government is accountable. With those few remarks I commend the two amendments I have moved.