Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Hansard source

We will all look forward with great interest to the statement that Senator Farrell was going to make about the fact that we have overdue questions from the supplementary budget estimates 2022-23. These were very serious questions asked of this government in relation to two of the most important portfolios before government—those of health and aged care. It is pretty extraordinary that this government went to the election saying that it wanted to be elected on a platform of transparency, and yet here we are with these really important questions remaining unanswered. These questions are not a couple of days late, Senator Farrell. They're not a couple of days late. They're not a couple of weeks late. They're not a couple of months late. They are really, really late. As we go into the next round of estimates, we could easily see in the very near future that, if you don't provide these answers, we will have three lots of estimates with questions all outstanding at the same time. To call yourselves a transparent government would have to be the greatest contradiction in terms I have ever heard. You are opaque.

This is the kind of track record that we are starting to see from this government in relation to its ability to actually provide the transparency that it promised Australians it would. We've seen it through so many mechanisms by which they've addressed this chamber. I draw attention to an extremely distressing track record and pattern of play that is starting to emerge. It is in relation to the inability to provide any detail whatsoever about legislation and the mechanisms that sit behind legislation when they introduce them into parliament. We see headline after headline after headline, we see legislative instrument and legislation after legislation, all with details completely absent, yet they're expecting us in here to do our job. I would say to those that sit not on the government benches—although sometimes I wonder whether the Greens actually are sitting on the government benches—do your job and make sure you hold this government to account about the transparency and the detail around what they are doing. Stop letting legislation through this place when the details of that legislation are all going to be contained in subordinate legislation where they do not give us any detail.

Today we are debating the Housing Australia Future Fund legislation but we don't have the investment mandate details. I say to those in this chamber, please think very seriously before you let this government push things through completely opaquely, giving no detail because they don't want you to know. Human nature would tell you that when somebody is hiding things from you it's usually because they have something to hide.

Here we are, six months later, and I still don't have answers to questions that we asked in October. The thing that is probably most distressing is the impact the lack of this information is having more broadly on the wider community. I draw the chamber's attention to the crisis we're seeing in aged care at moment. We know that some pretty ill-considered, opaque, detail-less legislation was shoved through this place—and shame on those at the other end of the chamber who supported the government after we gave you a very clear and cogent reason why you shouldn't be letting this legislation be shoved through. We're now seeing aged-care facilities close down as a result of the fact that this legislation was pushed through here with no possible ability for it to ever be delivered. The royal commission into aged care said that 24/7 nurses should be put in place in our aged-care facilities around Australia by 2024. You have to remember that recommendation was made before COVID and before we had the crisis in healthcare workers that we're seeing at the moment. Despite the fact that the royal commission said 2024, and despite the changing landscape in relation to our care workforce, this government, with the support of those down the other end, forced through a piece of legislation which has now seen many nursing homes close across Australia, which means older Australians, particularly those that live in rural and regional Australia, have been forced out of a place they call home and often have to move many miles away from where they were living—away from their families, from their community and from their loved ones—just because you guys didn't do your job and make these guys be more transparent about the promises that they have made.

We heard conversation during question time today in relation to urgent care clinics. They promised that there would be 50 urgent care clinics in place by 30 June this year. We still don't know where most of these urgent care clinics are going to be, other than the few in Tasmania. But, despite knowing where a few of them are going to be, we still don't know: Is there going to be one additional consultation? Is one more person going to be able to get in to see a doctor? Is one more person going to be able to get better, cheaper or easier access in relation to primary care as a result of these clinics? The answer simply has to be no because this government have done nothing at all about the crisis that is before us right now, which is a workforce crisis. We do not have enough workers in our healthcare system at the moment because all the government are doing is running around and making headline promises that don't address the fundamental, underlying problem that is before us.

We are now two weeks away from the 12-month anniversary of the election of this Albanese Labor government. I think it is really quite extraordinary that, despite going to the election promising that they were going to strengthen Medicare, going to the election with the catchcry 'It has never been harder or more expensive to see a doctor', we sit here today on the eve of 12 months with not a lot of hope that in the budget tonight there are going to be any measures that will actually put in place the guarantee that they made to the Australian public about the healthcare system and the aged-care system. They are just simply not delivering.

The minister, Mark Butler, actually labelled the GP workforce crisis as 'terrifying'. It can't be that terrifying because they seem to have a lack of urgency and a lack of transparency about where they are going to find the unmet demand to backfill this sector so that this terrifying situation, in the minister's words, is addressed.

I also want to put on the record how disgusting it is that this government seems to believe that the sacrificing of rural, regional and remote Australia is an acceptable thing to do to mend its budget. Every single action we have seen taken so far has had a perverse additional adverse impact on rural and regional Australia—the irresponsible and reckless changes to the distribution priority areas and the shoving of skilled regional visas to the bottom of the processing pile. We continue to see with the measures that are in this budget that many of them will have a much, much more significant impact in rural, regional and remote Australia than they will in the capital cities. But this government just does not seem to care.

The government come in here and ask us to pass legislation, but they refuse to answer questions and they refuse to give us detail about that legislation. So I would say to the Greens and the rest of the crossbench: do your job and make sure that you demand the information that I think every Australian expects us to know before we make the important decisions that are likely to impact on people's lives, livelihoods and wellbeing.

In relation to aged care, one of the questions on notice that has still not been answered is how many aged-care homes have closed in the last six months, where they were located and whether this has been broken down into Modified Monash areas. Can the department provide a list of the providers that are likely to close? For some reason, we can't be provided that information. So the question must be: does the government not have this information? Is the government not tracking the potential impact of the decision that it has made, one that has such extraordinary impacts on older Australians? Does it not know or does it just not want to tell us how many aged-care homes have closed?

In the case of mental health, one of the questions asked is: has the department been contacted by psychologists or mental health professionals since the decision to revert from 20 Medicare subsidised mental health sessions on 30 December 2022? Has the department been contacted by individuals since that decision to revert from 20 Medicare sessions? Has the minister's office been contacted by psychologists or mental health professionals since the decision was made on health sessions in 2022? Did the department provide advice to the government on the risks associated with the Better Access initiative reverting to 10 sessions? What was that advice? Is the department aware of reports that 70 per cent of general practitioners say that mental health is a top-three priority reason patients attend their practice? Can the department confirm whether they briefed health ministers on the increase in suicide rates? Did the minister consult with Suicide Prevention Australia and Mental Health Australia, the two peak bodies, before the decision was made to slash these really important mental health supports in half?

They haven't answered those questions. We know from peak body research that the thing that is most impactful in Australians' lives and their mental health right now is the cost of living. We know that Lifeline has reported an 80 per cent rise in the number of calls relating to cost-of-living pressures, that headspace's recent national survey identified the cost of living as one of the top three issues facing young Australians and that a recent ReachOut survey found that more than 50 per cent of young people in Australia are stressed out by the cost of living. You would have to be blind not to realise that the cost of living is the No. 1 issue facing our country at the moment, with the rampant, homegrown, Albanese government inflation eating into people's quality of life. At a time when that is happening, there are some serious questions to be asked in relation to decisions by this government to slash in half a program that provided mental health supports. At a time when we know that the cost of living is having a massive impact on people's mental health, this government refuses to answer even the most basic of questions about the basis that sat behind their decision, when it happened, to slash these particular programs.

Other questions that are before us at the moment that we still have not had answered are: What is the current unmet need for GPs? How many vacant places are there and where are those vacant places in relation to the Modified Monash categories? Can the department provide a Modified Monash Model map highlighting areas where GP shortages are most significant? What new measures has the government put in place to increase the supply and distribution of GPs across the country? How many international medical graduates have moved from MM 5-7 areas to MM 5 areas and below since the decision was made to change the distribution priority areas?

As I said, the minister has been out there saying that this is the most terrifying crisis that is before the nation. He made a promise to the Australian public that he was going to fix this upon coming into government, yet a really fundamental set of questions that go to the very nature of the impact of these measures on rural, regional and remote Australia remain unanswered as we stand here today, months and months after they were asked. There is clearly a track record and pattern of behaviour that are starting to emerge here that suggest that this government has no intention whatsoever of caring about the real delivery of those headline promises it made to Australians when it was up for election. They're quite happy to make the headlines—and headlines often sound good. Who wouldn't think strengthening Medicare was a good idea? Who wouldn't think that putting the care back into aged care was a good idea? But they're just headlines unless you put in place the initiatives that are actually going to make a difference, and they're really not worth the paper they're written on if you are not prepared to provide the details around how you're going to go about it so that Australians can actually see how these things are happening.

We're already starting to see the wheels fall off, as we've seen with the aged-care promises. The wheels are falling off because older Australians are being pushed out of their aged-care homes—places where they've lived, often for many years—simply because this government was so pig-headed on insisting that the 24/7 nurse requirement was in place, almost without exception or exemption. We're now starting to see the consequences of that announcement, which was something that we all would've aspired to see—that older Australians get the care that they deserve and they warrant in their old age—but shoving them out of their homes simply because you've put in place a requirement for an action that was never deliverable is, I think, one of the most despicable things that a government could do. You were more interested in the headline delivery of a promise that you made at the election than watching the circumstances as they unfolded on the ground and realising that your actions were actually going to have terrible, detrimental impacts on older Australians. Instead of helping older Australians, you've made their lives worse.