Rachel Siewert (WA, Australian Greens) Share this | Hansard source

They will have to think about it, but they probably will not support it; and yet again patients are getting caught in the middle. This is not an acceptable way to deal with what are potentially very serious health outcomes for the people in our community who can least afford it. Let us face it: we are not talking about the people who can afford these procedures—the middle or higher income people. They will of course go and pay for it. The people who are being impacted are those who can least afford it.

The Greens were extremely concerned, as I indicated during the debate, about the extended Medicare rebate and the issues around the cap, but we are not convinced that this is not going to result in adverse outcomes for those who can least afford these operations and who will be most harmed by not gaining access to cataract surgery. The government has agreed to a review as a result of an amendment that the government agreed to under the extended Medicare rebate bill process that we already debated in this chamber, but we do not believe that leaving this process to a review down the track or people going onto the public list and ophthalmologists that are not engaged in private work getting work in public hospitals is a way to resolve this. We think that we need a more definite way to resolve it. We urge the government and the ophthalmologists—as I said, I think there are problems on both sides—to sit down and resolve this. This is a very clumsy way of resolving a highly complex issue. The bottom line here is that patients are getting caught in the middle. I do not think it is appropriate, which is why we were of a mind to support the disallowance, to cut the rebate in half. It is not an adequate way of dealing with these very complex issues. The government did show goodwill with medical professionals in the other sectors that we have dealt with, such as the RAT issue and the obstetricians. I know the obstetricians were not fully happy with the outcome of the negotiations, but I understand there was considerable support for some of those changes.

Those changes are not the issue here. The specific issue here is around cataracts. I do not think the government has got it right. I think the ophthalmologists have engaged in a scare campaign that is not appropriate, because it has scared people, particularly older people, into thinking that they are not going to be able to get access to cataract operations. We think there is concern on both sides. We need to sit down and we need to resolve this. This is not the appropriate way, but at this stage this is the only way that the Senate has of raising its concerns and forcing people to start negotiating this in good faith. We need to come up with an outcome that does not leave growing waiting lists, with those on low incomes and older people who cannot afford operations languishing on public hospital waiting lists hoping that ophthalmologists who are not engaged in providing private services will then switch over to the public system. Unfortunately, that is the very real scenario we could be facing. We do not think that is appropriate. It is not easy. If it were easy they would have sat down already and resolved this, but they need to try again to sit down and talk about it. We need both sides to come to those negotiations in good faith. It is not beyond the wit of the people engaged in this issue to come up with a solution that does not require this blunt instrument we are being forced into using.