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

It is with pleasure that I rise to contribute to the debate on the Social Security Amendment (Diabetes Support) Bill 2016. Issues around diabetes are very dear to my heart. It is an issue that I have worked on extensively in this chamber, particularly as diabetes relates to Aboriginal and Torres Strait Islander peoples, because we know that they are disproportionately affected by some of the end-stage kidney diseases that are related to diabetes. I am also very passionate about issues for young people with juvenile diabetes. It is an issue that we all need to be paying attention to. The fact that this bill is being debated will highlight the issue extensively and I do congratulate Senator Muir taking up this issue. This debate helps to bring this very important issue to national attention and to the attention of the government so that they know there is a lot of public pressure and commitment from many of us in this chamber to addressing this issue. We know diabetes is recognised as a national health priority due to its significant contribution to the burden of chronic illness in this country. It is a very significant chronic illness and it is a significant contributor.

Australia has, unfortunately, one of the highest rates in the world of type 1 diabetes, with over 130,000 Australians living with its effects. It is the fastest growing chronic disease in Australian children. There is much that can be done in the management of type 1 diabetes that would prevent serious consequences from progression of the illness and there are new techniques that can help to avoid hospitalisation and debilitating or even life-threatening events. Those developments are there in part because of the ongoing advocacy on this issue. Many of these management approaches and technologies would relieve the considerable stress on people with diabetes and their families and save money in the acute aspects of the budget. As with most things in health, prevention, early intervention and good management is better all round for patients, for their families and for the health system.

Senator Muir's bill would provide an automatically issued health care card to those who suffer from diabetes mellitus—I usually just refer to it as diabetes type 1, its common name—who meet a means test of up to $176,000 for a member of a couple or $88,000 from an individual. This bill cannot appropriate funds, as we know the issues around that in the Senate—to actually make a payment an appropriation is needed. The bill would introduce an anomaly into concession card arrangements providing concessions for those with a specific health condition. While we congratulate Senator Muir for picking up this issue, we think there are some issues around this particular mechanism. I know that we do need a mechanism, but it is a different approach to the way that we make arrangements for concession card arrangements. The card would also be anomalous, in that it would entitle holders only to concessions relating to diabetes treatment, management and for those who only qualify through HHS under the proposed conditions. It is unclear how this would apply in the case of the Medicare safety net concession thresholds—for example: would the concession thresholds apply only to diabetes related services? I understand very clearly—and I am sure many of us do—the predicament of advocates for people with type 1 diabetes, who are keen to see more support from government, and we share that very strongly. They, obviously, would see the bill as a way of doing this. I know of the work of the Danii Foundation, which was set-up in the name of Danii Meads Barlow, who tragically lost her life to type 1 diabetes at the very young age of 17. Having done a lot of work in this area, I also know of other young people who have lost their lives at a very early age to type I diabetes. I am aware of the Danii Foundation's submission seeking a program to subsidise 4,000 continuous glucose monitor sensors for high-risk children and adolescents with type 1 diabetes who have impaired awareness of the warning symptoms of severe hypoglycaemia, yet can be protected from seizure, coma and potential death through these CGM sensors—hence their importance.

I also believe they would be happy with other strategies such as funding through the National Diabetes Services Scheme—known as the NDSS. I understand that Minister Ley's office is looking at whether they can add new devices to the NDSS, but, as usual, they are under financial pressure. Of course, we believe that we need to be putting more effort into making sure that people have access to this vital equipment.

Much like the rest of the world, Australia's health system is facing rising costs and uneven quality. The system is also facing rising public expectations for new treatments and technologies to be made available as they come to our attention. The health system adopts these technologies, but the bureaucracy of the health system has been slow to figure out ways in which they can respond to these new technologies and to funding for these new technologies advancements. There is a relentless public debate about the state of the government's finances. The debate shifts from fiscal crisis to a crisis in growth or productivity at the government's political convenience. So we have this conundrum of rising health costs, a pipeline of innovation, rising expectations, growing inequality and a paralysis on revenue generation. The Greens believe that health spending is a reflection of our values. It is a choice. It should not be seen as a drag on our economy. Better health outcomes are good for labour force participation, for productivity, for families and, of course, for our wellbeing. We know from the now extensive literature on the social determinants of health that poor health outcomes do have a significant impact and we know that inequality has an impact on our health.

The Greens have the courage and the vision to see that we need to spend more on our health rather than spending less. We have a suite of tax reform measures that will generate additional revenue, that do this in a fair way and that direct investment towards more productive areas of the economy and, in doing so, enable us to make better choices about how to use our collective wealth. Just this morning we released costings from the Parliamentary Budget Office that show we can raise an additional $4.1 billion over the forward estimates from making the deficit levy permanent and introducing a new marginal tax rate for the people who earn over a million dollars a year. That kind of money can help to pay for vital health care, education and infrastructure. These are choices that the government could be making.

I am not saying that there is no need for improvements in our health funding. We can always be more efficient, and we should target our spending better. We are a wealthy country and we can afford to deliver better quality health care for all. But we are concerned that this bill, which would amend the Social Security Act, is rather clunky. It creates a precedent for a single health issue but does not actually appropriate funds to cover costs, and for this reason we have some serious concerns about the bill. I also work in a number of other areas that address issues round health. This bill deals with a single health issue. Do we start addressing this issue by making the same sort of concession for each particular health issue and chronic condition? I have just articulated some other ways that we could be addressing this issue, because we are very committed to making sure that we are helping those with type 1 diabetes. There is some concern about this amendment to the Social Security Act. Being the spokesperson on social services for the Greens, I am very aware of the overall clunkiness of this legislation and the extreme complexity of the act.

People have raised with me their concerns about the cuts to health which will result in people having to pay for certain pathology tests and other procedures. I have, quite frankly, lost count of the number of emails that I received. They number into the thousands, and I am sure all my colleagues are getting the same sorts of emails. People are deeply concerned. In fact, when I was out in the community during the weekend, the one issue that people raised with me on an ongoing basis was the additional cost for pathology that people will have to pay and the fact that, because of this additional cost, people with chronic conditions who require access to things like pathology tests on a very regular basis will delay some of their test requirements, endangering their health even further. On that, I share the concerns expressed by Senator Gallagher and others in this place who are concerned about those particular proposals by the government.

We add the voice of the Australian Greens to call on the government for action to ensure vital healthcare and health technologies with proven benefits and safety make it to Australians in a timely and affordable manner. This bill has enabled us to have this debate and, hopefully, to provoke the government into taking this issue seriously. I seek leave to continue my remarks.

Leave granted; debate adjourned.