Anne McEwen (SA, Australian Labor Party) Share this | Hansard source

Tonight, dreams have come true for the coalition in the budget that has been delivered. Wealthy Australians will be left largely untouched by this budget, but disadvantaged Australians will be even more disadvantaged because of it. Australians who are already doing it tough will be punished and will do it tougher. If you are old, if you are a student, if you are disabled, if you are unemployed or if you are sick, you have been targeted in this budget by a callous government that promised one thing before the election and did the opposite after the election. Despite the promises made by the Prime Minister before the election, we have seen attacks on health and education and we have seen the introduction of new taxes. There is a new tax, the so-called debt levy tax, despite the clear promise of the Prime Minister himself that there would be no new taxes as part of the 2014 budget. There will also be a freeze or a reduction on family tax benefits, directly targeted at poorer Australians.

The clearest indication yet that this government hates Medicare and the universal healthcare system, of which Australia should be so proud, has appeared in this budget. It has always been clear to Labor that the coalition would like to bring about the demise of Medicare, the demise of universal affordable health care for all Australians. Tonight we have seen the introduction of the $7 co-contribution payment. That is $7 that Australians will have to pay if they want to visit a GP and seek some other services. All of the evidence is that having to pay an up-front payment for medical care dissuades people from seeking that care. All of the evidence is that preventative health care and early intervention prevents escalation of illness and, of course, prevents escalation of the costs associated with treating illnesses at more advanced stages. Seven dollars per visit to a GP is not much on the salaries of those who work in this place, but for a family or a person on a low income it is a great barrier to better health outcomes.

Introducing a co-payment for GP visits will not see any significant cost savings. It will see the beginning of the end of Medicare. Medicare was introduced by the Labor government, and we understand that is the primary reason the coalition government wants to get rid of it: it was a good Labor initiative that benefits all Australians. The groups of people who most benefit from universal health care like Medicare are the most disadvantaged groups in our communities, including and in particular Indigenous people, low-income earners, those with severe mental health problems and the aged. All of those people will be hurt by the government's announced $7 co-payment.

There has been discussion as part of this budget that Australia's healthcare system is careering out of control. That is not true; it is not factual. Australia spends 9.1 per cent of its gross domestic product on health care, and that is comparable to other countries such as Sweden, Britain, Spain, New Zealand, Canada and France. They all spend more than we do in Australia. The United States spends much more, at 17 per cent of its GDP.

The biggest growth in Medicare Benefits Schedule expenditure has been growth in visits to specialists, not to GPs. To prevent visits to specialists you need to ensure that people have access to preventative health care and primary health care that ensures that they do not get to the stage of an illness where they do need to visit a specialist and incur the significant costs to the health system.

I was particularly disappointed tonight to get confirmation at last that Medicare Locals are to be shut down by this government. That is despite clear, articulated promises from the health minister and the Prime Minister himself that Medicare Locals would not be attacked in this budget, but they have been. Tonight we heard that 61 Medicare Locals are to go. I would like to point out to the Senate some of the great benefits of Medicare Locals and, in particular, a Medicare Local with which I am familiar in South Australia. The Country South SA Medicare Local is based in Murray Bridge, in the federal electorate of Barker. I visited that organisation last year and saw the value of what it does in coordinating primary healthcare services and preventative healthcare services for a rural and regional community. Barker is a seat that extends from the Barossa Valley, through the Murray and down to the south-east of South Australia—all areas which struggle to provide healthcare services by virtue of distance and the difficulty in attracting healthcare providers to those regions.

The Country South SA Medicare Local works cooperatively with GPs, aged-care services, ancillary care services, nurses and primary healthcare deliverers to ensure that the region's needs are met and that the services that the community needs in the electorate of Barker are delivered in the most efficient way. In the short time that the Country South SA Medicare Local has been in operation it has initiated a number of great programs. I would like to outline a couple of those to the Senate, because they are the programs that are now at risk because of this government's attack on health services. The Medicare Local strongly supports Aboriginal healthcare programs and empowerment of the local Aboriginal community. It works in partnership with Indigenous organisations to ensure that healthcare services are targeted at that Indigenous community and make the best use of the services that are available.

The Country South SA Medicare Local has also funded a number of mental health programs throughout the region—as I said, from the Riverland to the south-east—and provides services throughout Mt Gambier. Those services are across the disorder spectrum, from high prevalence low-level disorders such as anxiety and depression through to low-prevalence complex disorders requiring clinical intervention. If it were not for the Medicare Local coordinating the provision of those services, many regional South Australians would miss out on services, particularly to assist them with mental illness. The Medicare Local has also provided funding to general practices in the area for enhanced after-hours services and it has assisted providers to set up and run services where they are needed and at times when people can access them.

Another great innovative trial conducted by Country South SA Medicare Local was to work with a nurse practitioner model of care so that patients can receive access to GP services utilising a nurse practitioner. That has greatly increased the services available in regional areas—where, as we all know, it can be hard to attract a GP workforce. Another initiative of Country South SA Medicare Local is the work that is done on providing health care services by telehealth and e-health. I have seen those programs in action and understand what a great innovation it is, particularly for rural and regional South Australians in areas like the seat of Barker, who otherwise would not have access to those very important primary health care services.

Those are some of the things that Country South SA Medicare Local has provided and they are some of the programs that are now at risk because of this government's budget that we have witnessed tonight. The people of Barker have been dudded by this government, by the Prime Minister, by the health minister and by their federal member of parliament, Mr Tony Pasin. The Prime Minister promised before the election that there would be no cuts to health or education, and no new taxes. He said, 'We will do what we have said we will do,' and then did exactly the opposite. He has introduced new taxes and he has made cuts to health services. He has targeted Medicare Locals, which are a great Labor innovation.

I am sure that further examination of the budget by other senators will reveal more broken promises by this government and Prime Minister. I can assure the people of Barker that Labor will continue to hold this government to account. We will detect all of the broken promises made by this Prime Minister, by his ministers and by members of parliament who purport to serve the people of Barker but tonight have left the people of Barker disadvantaged and worse off.