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

I rise today to speak on the Treasury Laws Amendment (2023 Measures No. 2) Bill 2023. Whilst I acknowledge that a number of the measures that are contained in this bill are particularly important, I also acknowledge that it implements a number of measures that the previous coalition government had put forward.

The subject I'm particularly interested in talking to in my contribution today is schedule 1 of the act that amends the Medicare Levy Act 1986 and the A New Tax System (Medicare Levy Surcharge—Fringe Benefits) Act 1999 to index low-income and family Medicare thresholds in line with the CPI to increase the number of people under the threshold who would otherwise be captured due to inflation. Can I say at the outset that the coalition, the opposition, supports the regular indexation of Medicare as contained in this legislation. It's very welcome, but it does also draw attention to the fact that a number of other measures and actions have been taken by this government that have weakened our health system and our Medicare system.

Today I want to put on the record that we are particularly disappointed in a number of these measures. Firstly, this government came into power promising that they were going to strengthen Medicare. The reality is that since this government's been in office all we've seen is Medicare being weakened. A Strengthening Medicare Taskforce report was released by the government earlier this year which was really articulate in articulating the problems were facing our healthcare system in Australia, although it really didn't provide very much in the way of solutions. But the most disappointing thing about that report was that I don't think anybody in Australia does not realise that the health workforce crisis that is before us is the most urgent thing that we need to be dealing with. The report did not address workforce in any way, shape or form. And whilst the report was very strong on aspiration and very strong on rhetoric and talked a big game about big picture things, it had no specific actions contained in it. There was no funding in it, there were no time lines in it and there was no urgency—no urgency about the most important issue facing Australia's healthcare sector, and that is workforce.

We've been hearing from the health minister and from the Prime Minister for months and months and months about the issues around workforce shortages. We've also been hearing from the aged-care minister about the fact that there are workforce shortages. Yet, despite that, we have seen nothing about addressing the workforce crisis—in fact, the counter. We've seen the aged-care minister bring forward the recommendations of the royal commission into aged care by a whole year, requiring 24/7 nurses in aged-care facilities—something that the coalition has always supported, but only supported in the context of the royal commission's recommendations—in the middle of a workforce crisis. So, not only have they failed to recognise the severity of the workforce crisis; they've actually put measures in place that make it worse. In addition, in relation to our doctors, one of the most critical places that we have seen that workforce crisis play out has been around primary care, and the burden on our healthcare system because our primary care system is under such pressure is immense. We see this with ramping at hospitals. We see it with people not being able to get in to see their doctor. We see it through a lack of accessibility to hospital systems. Despite that, we have seen nothing at all about addressing the issue around general practice. Right now we have a great challenge before us, and we have a government that is not doing anything to address these issues.

Another area we heard a big game about in the portfolio was urgent care clinics. Of course, addressing the issue that is primary practice is tremendously important. We as an opposition have always said that if there were measures that this government was prepared to put forward that were sensible and were actually going to address the issues—that were going to focus on patients, the consumers in Australia—then of course we would be prepared to support them, But what we've seen, once again, in the announcements around urgent care clinics is a really big game when it comes to the announcement—50 urgent care clinics in Australia within the first year of this government, and right now we don't actually have any new urgent care clinics. All we've got is eight clinics in Victoria that have been rebadged. The Victorian government—Premier Andrews—got up and heralded these new clinics that were established, took full credit for the establishment of a number of care clinics in Victoria, and then a few weeks later the Albanese Labor government stood up and took credit for the exact same things. So, we are in a situation here where, despite all the rhetoric around supporting our healthcare system, supporting our Medicare system, we actually haven't seen very much, apart from a heap of headlines with no substance behind them.

In addition, one of the most important things facing Australians at the moment is mental health. We know from speaking to many stakeholders in the sector that we are seeing a huge increase in the number of people reporting being under stress, having anxiety, particularly as a result of the cost-of-living pressures on them. We know that right now we are in a cost-of-living crisis. I think every Australian wakes up every morning and realises that they're worse off than they were this time last year. Australians are seeing escalation in mortgages, escalation in energy bills, escalation every time you go through the supermarket in how much they are paying for everything that is happening to them. It was estimated as part of the budget process that the average Australian family with children is up to $25,000 a year worse off than they were 12 months ago, and this is having a devastating effect on people's mental health.

We are seeing an escalation in demand for mental health services, and what does this government do? It cuts the number of sessions that are Medicare subsidised to people who need them, from 20 sessions to 10. Those Medicare subsidised sessions were actually in place for those people who had moderate to severe mental health challenges. So, the most mentally vulnerable in our community have had their access to the support that they previously had cut in half.

But I think the worst thing about the decision by this current government to cut those sessions from 20 to 10 is that, despite recommendation 12 of their review—which came out and said that the sessions should remain in place, particularly for those people who needed them the most—the government removed the sessions and then, sometime later, after the backlash from the community and from people who were depending on them, decided they'd hold a round table with stakeholders, which they did earlier this year. They got together a number of stakeholders across the whole mental health sector. And guess what's happened since then? Absolutely nothing. We have seen nothing in response to that round table. We have seen nothing in response to the huge number of concerns, including petitions that were signed to say to the government that these Medicare funded sessions were so important. And despite the minister saying he didn't think this was the best way to provide mental health support—he thought maybe we should come up with a different way of providing additional support to Australians—we have not seen any additional support. The government, once again, is big on the announcement but pretty light on the delivery.

So, when we responded to the budget this year, the Leader of the Opposition made the commitment that a coalition government would reinstate those 20 sessions because we understand the cost-of-living pressures that Australians are currently under, with an increase in the number of people who are reporting that they are under stress and have anxiety as a result of cost-of-living pressures. We believe that the onus is on government to make sure people get the support that they need, because the mental health of Australians plays into the wellbeing of Australians, and that should always be an absolute priority of any government.

We've also seen measures put through the budget that disproportionately impact rural and regional Australia. The very first thing that this Labor government did in the health sector—its very first policy announcement—was to change the distribution priority area classifications. Instead of what we had previously had, an advantage for rural, regional and remote Australia in getting access to overseas trained doctors and graduates, to have priority, we saw a change that meant that they were actually able to go into other areas which were urban and metropolitan, therefore incentivising doctors who otherwise would have gone to rural and regional areas, who thought, 'It's probably easier; we'll just go to metropolitan areas instead.' The first thing that happened in those areas that were already struggling to get a general practice workforce—the further you get away from the metropolitan area, the further you get away from the GPO, the more likely it is that there is workforce stress—was that doctors were given the incentive to move back to the city.

In supporting this bill today, I would say that schedule 1, which relates to the Medicare indexation, which of course we support, just highlights the fact that, despite that particular measure, there are so many other measures in the healthcare sector that have made Australia's healthcare system and Medicare—instead of coming in here and actually delivering on the promise to strengthen Medicare, all this government has done is weaken Medicare.