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

At the request of Senator Minchin, I move a motion to give precedence to:

• the introduction and consideration of: A bill for an Act to amend the Health Insurance Act 1973 to provide for the revival of certain medical services items should later items be disallowed; and
• Business of the Senate notice of motion no. 3 for today

This is a highly unusual step for us to take. It is a highly unusual process. We grant you that. It is not something that we are doing lightly. However, the government’s actions have forced us into a position where we have no other choice. I want to clarify a few remarks that Minister Ludwig made. He suggested that this is somehow policy on the run and a last-minute consideration. Nothing could be further from the truth. We have been very determined for a long time to make sure that we stop the government from cutting the rebates for cataract surgery because we think that it would hurt patients, force them into an already overburdened public system and make it unaffordable for many of them. People who are not able to get access either through the public system or because they cannot afford it in the private system, at worst, might go blind.

If ever there was an effective preventive health measure it is cataract surgery. Cataract surgery is a life- changing procedure. It helps prevent falls; it helps prevent fractures; it helps prevent mental pressure; it helps prevent social isolation. It is a very important procedure. The government through its very ill-considered and short-sighted budget cuts is trying to save $313 per procedure—to achieve what? To push those patients into the public system where taxpayers will have to pay more than $3,500 to fund exactly the same procedure—that is, for those people who are lucky enough to get in. We understand that there has been advice floating backwards and forwards. The Minister for Health and Ageing has made it very clear that she was not going to take a constructive approach on this. She sought to frighten patients. She sought to frighten doctors and she sought to threaten the Senate, so we took very careful advice.

We very carefully considered our options and we made a decision some time ago to move amendments to the Health Insurance Act to ensure that any disallowance of the Medicare rebate items for cataract surgery would revert to the rebates that are currently in place. We knew that we had to do two things: we had to move an amendment to the Health Insurance Act before we dealt with the disallowance motion in relation to those particular items. There were two different ways we could do it: we could do it the sensible way, our preferred way, which would have been to move two amendments to the Health Insurance Amendment (Compliance) Bill 2009, the bill which the government had given us every indication was a high-priority bill, a bill which they wanted to pass this week, a bill which was time sensitive.

If the rumours around Parliament House are right I understand that Minister Chris Bowen is very unhappy with Minister Roxon because he is now very worried about what is going to happen with his Health Insurance Amendment (Compliance) Bill 2009. Minister Roxon, for her own political purposes, for her to be able to maximise the threat to the Senate, for her to be able to maximise her scare campaign towards patients and doctors, pulled a stunt. At around 5 pm yesterday afternoon, with seconds to go before the Health Insurance Amendment (Compliance) Bill 2009 was due to pass the House of Representatives it was deferred, just before it went to a third reading vote even though consideration of the bill had been completed without amendments. So here you have a bill which was considered noncontroversial in the Main Committee. Consideration of the bill was finalised without amendments. It went into the chamber of the House of Representatives and was about to get passed, and guess what? At the last minute the government pulled it, and the only reason the government pulled it was because the government wanted to prevent the Senate taking a sensible, responsible, carefully considered path in moving amendments to the Health Insurance Act.

We would not be wasting all this time today if the government had not pulled this stunt. So if the government’s legislative program is out of order today it is on their heads, and I suggest that Minister Ludwig goes and has a close, careful conversation with Minister Roxon because she clearly does not seem to understand how the Senate works. She does not understand no for an answer. She does not understand that if she does not have majority support in this chamber she cannot get her way. This is government arrogance at its worst.

We have seen it before that where the government clearly do not have the support of the Senate for a particular course of action, by hook or by crook, they just try to push it through using every procedural trick in the book. On this occasion we made a decision that this is an important issue for patients across Australia who need timely and affordable access to quality cataract surgery. The government wanted to maximise the leverage over the Senate by doing what they did last night, and that is the reason why I, on behalf the opposition, am moving this motion. I will not hold up the Senate too much longer. I think the point is well made: this is a very important discussion for us to have in the Senate and we have the opportunity today to send a very clear message to the government about what the intentions of the Senate are.

These regulations are supposed to take effect on Saturday. The government announced this on 13 May. How many months ago was that? June, July, August, September, October—the government announced this more than five months ago, but they only tabled these regulations two days ago at five minutes to midnight. This was essentially to minimise the Senate’s opportunity to scrutinise what the government is doing and to minimise the time the government could take for appropriate remedial action if the Senate did not support what they are proposing to do.

The minister initially said nothing. Then she said that she got advice that if the opposition votes against this the whole item is going to disappear. We understand that we cannot just move a disallowance motion in isolation. But the government’s own departmental officials do not. I asked the senior official who is responsible for the MBS branch in the Department for Health and Ageing what would happen if the Senate were to disallow these cataract surgery related Medicare rebates. Her answer was, ‘Well, I think it would revert back to the previous rebates.’ If there is confusion at the top levels of the government, what chance have we got?

Contrary to the government’s approach, we always knew what our strategy was: that we needed to move an amendment to the Health Insurance Act as well as to give notice of a motion to disallow and then take a vote on that motion. This is the only way we can make this arrogant government understand that the Senate cannot be taken for granted. Hopefully, the government will learn a lesson from this and in future treat the Senate, and the people we represent, with a bit more respect. Quite frankly, we have got a job to do in this chamber. The government thinks that it can steamroll things through this chamber the same way as it can steamroll things through the House of Representatives. Well, guess what? Every single one of us represents a great state or a great territory across our great country, and we have got a contribution to make in this chamber. At the end of the day, when the whole debate has been had, we will vote. If the majority of senators support something the government wants to do then it gets up and if the majority of senators do not support it then it goes down. That is the way democracy works. It is time the government understood this.

So, with those few remarks, the Senate is well aware what the opposition, together with Senators Fielding and Xenophon, are seeking to achieve: we are seeking to put beyond doubt that if the Senate were of a mind to disallow the reductions in Medicare rebates for cataract surgery then our intention is for the rebates for those items to revert back to the rebates currently in place when it comes up after this legislation has been dealt with. We know that this bill has to go back to the House of Representatives and the government will have to make a decision. They will have to make a decision on whether they will bring on the bill, give it precedence, deal with it and vote in favour of it, or whether they are going to ignore it, vote against it or let the time pass 1 November. If the government do not deal with this before 1 November then it is on their head; the chaos that will be caused out there in the community will be on the government’s head. Clearly, the government have not thought this through. The government should have engaged with us constructively and much earlier. The government should have realised that, without the support of the Senate, they will not be able to press ahead. Arrogantly, and I would argue, incompetently, the Minister for Health and Ageing thought that she could get away with it. This is an important issue. This is about ensuring timely and affordable access to quality health care for all Australians. On this basis, this is a very important process for us to go through today.