Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Hansard source

I rise to speak on Health Insurance Amendment (Extended Medicare Safety Net) Bill 2012. The Extended Medicare Safety Net, established by the previous coalition government, assists thousands of Australians with high out-of-hospital medical expenses. For those who have eligible expenses above the relevant thresholds—and I can remind the Senate that that is $598 for concession card holders or $1,198 for all non-concession card holders—the safety net provides 80 per cent of any additional out-of-pocket costs for the remainder of the calendar year.

In the lead-up to the 2007 election those opposite, the Australian Labor Party, claimed that it would honour the safety net and the support it provided to families. The then opposition leader, Kevin Rudd, and the shadow health spokesperson, Nicola Roxon, stated on 22 September 2007:

With about one million people each year receiving some cost relief from the safety net federal Labor will not put more pressure on family budgets by taking that assistance away.

I think we all know what is coming. In the 2009 budget Labor proposed cuts of $610 million from the Extended Medicare Safety Net by capping item numbers for a range of services, including obstetrics, assisted reproductive technology, treatment of varicose veins, the injection of a therapeutic substance into the eye and cataract surgery. The changes, of course, as is typical with the Labor government both under Mr Rudd and Ms Gillard, were proposed without consultation. When have we seen that happen: the social workers, the occupational therapists, the mental health nurses recently—the incentive program? We have seen it with a whole range of things. It is so typical of those opposite. We have seen it in quite a number of programs in mental health. We have recently seen it with aged care. They go out, they do not consult, they make the decisions.

Then there is a kerfuffle and we work out that patients are at risk and then all of a sudden we see quarter backflips, some other backflips and no backflips and an absolute debacle with patients most especially left in the lurch.

Taking you back to 2009 and the proposed cuts of $610 million, the changes were proposed, as I said, without consultation and were a clear breach of the promise given at the previous election—surprise, surprise! Why should this not surprise Australians? Because this is a government whose hallmark of its time in government has been broken promise after broken promise, whether it is the carbon tax and 'there shall be no carbon tax under a government I lead' or something like this in the health or mental health or ageing or any other portfolio.

At that time the coalition secured some important concessions. The government was forced into negotiations with key patient groups and the profession. The coalition's actions resulted in increases in Medicare rebates, increases in the proposed caps and the addition of new items, particularly in relation to IVF. The coalition was also successful in preventing the capping of the item numbers for injections into an eye, which would have been detrimental for patients requiring treatments for macular degeneration.

Given Labor had already broken its promise on the Extended Medicare Safety Net, the coalition also successfully moved an amendment to provide greater scrutiny of any future changes to the caps. It requires that any ministerial determination to change the caps must be approved by a resolution of both houses of parliament. Ultimately, the review of the capping arrangements did show that out-of-pocket expenses had increased for patients for those items that had been capped.

This bill makes further amendments as a result of the caps that the government has put in place. It seems clear that this is an issue which should have been addressed when the caps were enacted. This bill will allow caps on benefits under the Extended Medicare Safety Net to apply where more than one Medicare service is performed on the same patient on the same occasion and it is deemed to constitute one professional service. The bill limits the Medicare benefit payable under the Extended Medicare Safety Net for a deemed professional service to what would apply to the constituent items of service; that is, the Extended Medicare Safety Net cap that will apply in such circumstances will not exceed some of the Extended Medicare Safety Net caps that would apply to the individual Medicare items. The bill appears to address an anomaly rather than making policy changes. It also removes the requirements that families confirm in writing the composition of their family for the purposes of the Extended Medicare Safety Net.

I will now take the Senate to some comments that were made by the health minister on 16 August during the debate of this bill the other place. They are so typical of those opposite, most especially Minister Roxon, the previous health minister. And now Tanya Plibersek, the current health minister, has taken up the usual rhetoric that they normally throw into every health debate, which is this absolute fabrication—the assertion that when the Leader of the Opposition was health minister apparently a sum of money was taken out.