Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

At the request of Senator Minchin, I seek leave to move a motion to give precedence to:

• the introduction and consideration of: a bill for an Act to amend the Health Insurance Act 1973 to provide for the revival of certain medical services items should later items be disallowed; and
• Business of the Senate notice of motion no. 3 for today.

Leave not granted.

Pursuant to contingent notice, and at the request of the Leader of the Opposition in the Senate, Senator Minchin, I move:

That so much of the standing orders be suspended as would prevent Senator Minchin moving a motion to provide for the consideration of a matter, namely a motion to give precedence to:

• a motion for the introduction of A bill for an Act to amend the Health Insurance Act 1973 to provide for the revival of certain medical services items should later items be disallowed; and
• consideration of that bill and Business of the Senate notice of motion no. 3.

More than seven weeks ago, the coalition, together with Senators Fielding and Xenophon, gave notice of our intention to disallow the government’s moves to reduce Medicare rebates for cataract surgery. We made it very clear that our intention was to prevent the government from cutting those rebates and certainly from deleting those items from the regulations altogether. The reason we want to prevent the government from cutting those rebates is that we take the view that it will hurt patients, it will make this life-changing surgery unaffordable for many Australians, it will push people into the public health system—where the particular procedure is actually more expensive for taxpayers—and it will hurt Australians, in particular those in rural and regional Australia.

The Minister for Health and Ageing, Minister Roxon, has had plenty of notice. Has she done anything? She has not done anything at all. True to form, she sat on her hands at first. Then out came the scare campaign and then, two days ago, in her usual reckless fashion, she pressed ahead, regardless of the fact that she well knew that a majority of senators in this chamber did not support the cuts the government was trying to push through the parliament.

We were keen to handle this issue in a very sensible and reasonable fashion. It is a very unusual for us to use this process and we do not do this lightly. Our intention had been, and we made our intention very clear, to stop the government from cutting those rebates for surgery by 50 per cent. We wanted to do it in a very responsible and reasonable fashion, so we gave notice yesterday of a disallowance motion and we also gave notice that we would seek to amend the Health Insurance Act. In good faith we informed senators in the chamber that we intended to move two amendments to the Health Insurance Amendment (Compliance) Bill 2009. That would have been a very easy, non-disruptive way for the Senate to deal with this.

What did the government do? Rather than grasping the opportunity of cleanly and smoothly handling this challenge faced by the Senate, the government—even though for the whole week it had been telling us that this was a very important and urgent bill, and it was listed on the Senate red on Monday and Tuesday—at the last minute, seconds before the Health Insurance Amendment (Compliance) Bill was due to pass the House of Representatives and just before the third reading vote was to take place, it deferred further consideration of the bill. That was a reckless and irresponsible move, and by doing it the government did not leave us with any option other than to take the steps that we have are undertaking here today.

This is a very serious issue. The coalition, together with Senators Fielding and Xenophon, have made it very clear that we do not support this savage cut to Medicare rebates for cataract surgery. We think it will hurt patients, we think it will push patients into the public system—into the lengthy and overburdened public hospital queues—and we think it will hurt patients, in particular in regional Australia. We will do what it takes, and if this is what it takes then this is what we will do. The government was well aware, but they were trying to push through a budget cut for which they did not have majority support in the Senate. It was due to come into effect on 1 November. It was announced on budget night in May, but two days ago the government finally tabled those regulations—with four days to go. Nicola Roxon, the health minister, has been out there frightening patients and frightening doctors. She has been threatening the Senate knowing that there are only four days to go. She has said, ‘If you pass this disallowance motion, there will be no rebate at all.’ It is an absolute disgrace.

The process that we are engaging in today will give the government an opportunity to deal with this matter responsibly. Our intention is to ensure that, if the Senate disallows those cuts to Medicare rebates for cataract surgery, we will revert to the Medicare rebates that are currently in place. That is the intention behind the process that we are engaging in today.

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

What the opposition are now engaged in is nothing short of a stunt. They let my office know about this a couple of minutes before 9.30 am, when the bells were ringing. If that is the way they want to manage the relationship on how we deal with the program, it is clear that what they said yesterday about the program should be just thrown out the window. The opposition have now clearly indicated that they want to manage the program, and that they want to speak to the program and to use it to suit their own political ends, rather than allow the usual procedures in this place to continue in an appropriate way. So all that has happened now—

Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

Senator Cormann interjecting—

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

I listened to you in silence, Senator Cormann; you should offer me the same courtesy. What you cannot do, Senator Cormann, is provide a cogent argument as to why you are pulling this stunt. It is a stunt and you know it. There are ways to deal with these matters in debate, but you cannot help yourself. What you found out, first of all, was that to attempt to disallow the regulation was silly. Now you are trying to fix that as well. The opposition are simply making policy on the run. It is unwise, can I suggest to you, to make policy on the run in this way. What you need to do is sit down and deal with this in a sensible way rather than continue to make short-term decisions using this chamber in this way. It is inappropriate. It should not be supported. I urge senators not to support this silly stunt that is being performed by Senator Cormann.

Of course, the nub of the issue goes to Senator Cormann’s inability to grasp the need for reform in this area. What underpins this is that Senator Cormann must be in the pocket of specialists who are ophthalmologists. There is no other explanation than that to drive the position that he is putting. The opposition’s actions are not about putting patients first. This is about putting the interests of a group of specialists—a group who earn over half a million dollars a year from Medicare alone—first. That is what the actions of the opposition are about in this respect, and it is a sad day to see it. Ophthalmologists will simply continue to charge their high fees for the procedures while the opposition’s actions will prevent the government from paying any rebate to the patient. That is what the opposition faced. They then decided to use the Senate for the purpose of trying to retrospectively fix their problem, before it was even there. So they are not even in order, quite frankly. It is a stunt.

The opposition have come into this chamber and simply tried to hijack the Senate to ensure that they can underpin their false argument. It is an extraordinary abuse of this Senate’s procedures. It is an extraordinary abuse for the opposition to use the Senate in this way, yet they try to put a rational argument that they are acting in good faith. Well, it is not acting in good faith for them to make policy on the run, to come in here and to use Senate procedure for a stunt to try to underpin their own argument and to try to bolster their own position—let alone to come in here and abuse the Senate processes. That is the difficulty that the opposition face. There is no merit in the argument that is being put by Senator Cormann. In fact, the opposition may wish to respond to the CEO of the Consumers Health Forum of Australia, who was today quoted as saying:

I would like to know why the Opposition is seeking to support medical specialists who are seeking to retain high incomes at the expense of consumers.

The government want to pay an appropriate rebate for this procedure and hope that the opposition will reconsider their position and support these changes. That is the position they should be adopting. They should be in a position to negotiate in good faith with the minister and to come up with an outcome—rather than to come into this Senate, abuse the processes of the Senate and pull stunts such as this without any notice. It is a very shoddy way of acting, and quite frankly it quite surprises me that the Manager of Opposition Business in the Senate has allowed it to go on.

Nick Xenophon (SA, Independent) Share this | Link to this | Hansard source

I indicate that I support the motion. I know a little bit about stunts, and this is not a stunt. The position is this: yesterday, when I discussed this matter with Senator Cormann—

Kerry O'Brien (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

So it was contemplated yesterday, and we got no notice.

Nick Xenophon (SA, Independent) Share this | Link to this | Hansard source

It is not my motion, but my understanding is that the government’s bill, which the opposition and others intended to amend, did not go to the third reading stage. That was quite extraordinary and changed things dramatically. That is why this extraordinary measure has been used. There is an issue here about whether or not this amendment is necessary, but the government has its own view, and to remove any ambiguity this needs to be sorted out. I would have thought that the fair thing to do, from the point of view of statutory interpretation, if regulations are disallowed would be to revert back to the earlier regulations. But this legislation is about ensuring that this issue is brought to a head, and the government needs to determine what its position is. It is not reasonable that if there is no Medicare rebate paid. It is not reasonable for patients, and that is my primary concern.

If the Minister for Health and Ageing—and I think the minister did make a number of reasonable points on the whole of fees being charged—is concerned about overcharging, there are other mechanisms to deal with that which are not so blunt an instrument as the government has used in relation to cataract surgery. That is for another debate, if this motion succeeds, but I support this motion on the basis that the government’s own actions yesterday in the lower house in not allowing the bill to go to a third reading vote—which was quite extraordinary—forced the hand of those who are concerned about these measures and about the impact they will have on senior citizens in Australia.

Stephen Parry (Tasmania, Liberal Party) Share this | Link to this | Hansard source

I have some matters of rebuttal for the Manager of Government Business in the Senate. I support the comments of my colleague Senator Cormann, and Senator Xenophon summed up what has happened. This is not an ambush. This morning we woke up and found that listed on today’s order of business was no bill, because it was stopped in the House of Representatives yesterday. The only politics being played in this are that the government are aware that we want to amend this bill and they have deliberately held it up in the House of Representatives so we cannot amend it. The only course for us to take is to fix it now with our own legislation, with the support of other concerned senators not necessarily from the Liberal or National parties but equally aggrieved and upset that this matter would not otherwise have been resolved.

The implementation will commence on 1 November—this weekend. Once we finalised this morning what we were going to do about this, we advised the government of the day. The stunt is that the government have not bothered to consult with us about holding this bill back in the House of Representatives. The only political argument that they have is absolutely false, because they are the ones playing games. We are responding to the government’s fear. The government is scared of introducing this bill, because we will amend it. We would have amended this bill successfully, and they were not prepared to run that test through the Senate chamber so they held it back. We have rectified that. The people of Australia will thank us for this because we will solve this problem. This weekend everyone will be sure about what is happening with the cataract rebate.

Question put:

That the motion (Senator Cormann’s) be agreed to.

Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

At the request of Senator Minchin, I move a motion to give precedence to:

• the introduction and consideration of: A bill for an Act to amend the Health Insurance Act 1973 to provide for the revival of certain medical services items should later items be disallowed; and
• Business of the Senate notice of motion no. 3 for today

This is a highly unusual step for us to take. It is a highly unusual process. We grant you that. It is not something that we are doing lightly. However, the government’s actions have forced us into a position where we have no other choice. I want to clarify a few remarks that Minister Ludwig made. He suggested that this is somehow policy on the run and a last-minute consideration. Nothing could be further from the truth. We have been very determined for a long time to make sure that we stop the government from cutting the rebates for cataract surgery because we think that it would hurt patients, force them into an already overburdened public system and make it unaffordable for many of them. People who are not able to get access either through the public system or because they cannot afford it in the private system, at worst, might go blind.

If ever there was an effective preventive health measure it is cataract surgery. Cataract surgery is a life- changing procedure. It helps prevent falls; it helps prevent fractures; it helps prevent mental pressure; it helps prevent social isolation. It is a very important procedure. The government through its very ill-considered and short-sighted budget cuts is trying to save $313 per procedure—to achieve what? To push those patients into the public system where taxpayers will have to pay more than $3,500 to fund exactly the same procedure—that is, for those people who are lucky enough to get in. We understand that there has been advice floating backwards and forwards. The Minister for Health and Ageing has made it very clear that she was not going to take a constructive approach on this. She sought to frighten patients. She sought to frighten doctors and she sought to threaten the Senate, so we took very careful advice.

We very carefully considered our options and we made a decision some time ago to move amendments to the Health Insurance Act to ensure that any disallowance of the Medicare rebate items for cataract surgery would revert to the rebates that are currently in place. We knew that we had to do two things: we had to move an amendment to the Health Insurance Act before we dealt with the disallowance motion in relation to those particular items. There were two different ways we could do it: we could do it the sensible way, our preferred way, which would have been to move two amendments to the Health Insurance Amendment (Compliance) Bill 2009, the bill which the government had given us every indication was a high-priority bill, a bill which they wanted to pass this week, a bill which was time sensitive.

If the rumours around Parliament House are right I understand that Minister Chris Bowen is very unhappy with Minister Roxon because he is now very worried about what is going to happen with his Health Insurance Amendment (Compliance) Bill 2009. Minister Roxon, for her own political purposes, for her to be able to maximise the threat to the Senate, for her to be able to maximise her scare campaign towards patients and doctors, pulled a stunt. At around 5 pm yesterday afternoon, with seconds to go before the Health Insurance Amendment (Compliance) Bill 2009 was due to pass the House of Representatives it was deferred, just before it went to a third reading vote even though consideration of the bill had been completed without amendments. So here you have a bill which was considered noncontroversial in the Main Committee. Consideration of the bill was finalised without amendments. It went into the chamber of the House of Representatives and was about to get passed, and guess what? At the last minute the government pulled it, and the only reason the government pulled it was because the government wanted to prevent the Senate taking a sensible, responsible, carefully considered path in moving amendments to the Health Insurance Act.

We would not be wasting all this time today if the government had not pulled this stunt. So if the government’s legislative program is out of order today it is on their heads, and I suggest that Minister Ludwig goes and has a close, careful conversation with Minister Roxon because she clearly does not seem to understand how the Senate works. She does not understand no for an answer. She does not understand that if she does not have majority support in this chamber she cannot get her way. This is government arrogance at its worst.

We have seen it before that where the government clearly do not have the support of the Senate for a particular course of action, by hook or by crook, they just try to push it through using every procedural trick in the book. On this occasion we made a decision that this is an important issue for patients across Australia who need timely and affordable access to quality cataract surgery. The government wanted to maximise the leverage over the Senate by doing what they did last night, and that is the reason why I, on behalf the opposition, am moving this motion. I will not hold up the Senate too much longer. I think the point is well made: this is a very important discussion for us to have in the Senate and we have the opportunity today to send a very clear message to the government about what the intentions of the Senate are.

These regulations are supposed to take effect on Saturday. The government announced this on 13 May. How many months ago was that? June, July, August, September, October—the government announced this more than five months ago, but they only tabled these regulations two days ago at five minutes to midnight. This was essentially to minimise the Senate’s opportunity to scrutinise what the government is doing and to minimise the time the government could take for appropriate remedial action if the Senate did not support what they are proposing to do.

The minister initially said nothing. Then she said that she got advice that if the opposition votes against this the whole item is going to disappear. We understand that we cannot just move a disallowance motion in isolation. But the government’s own departmental officials do not. I asked the senior official who is responsible for the MBS branch in the Department for Health and Ageing what would happen if the Senate were to disallow these cataract surgery related Medicare rebates. Her answer was, ‘Well, I think it would revert back to the previous rebates.’ If there is confusion at the top levels of the government, what chance have we got?

Contrary to the government’s approach, we always knew what our strategy was: that we needed to move an amendment to the Health Insurance Act as well as to give notice of a motion to disallow and then take a vote on that motion. This is the only way we can make this arrogant government understand that the Senate cannot be taken for granted. Hopefully, the government will learn a lesson from this and in future treat the Senate, and the people we represent, with a bit more respect. Quite frankly, we have got a job to do in this chamber. The government thinks that it can steamroll things through this chamber the same way as it can steamroll things through the House of Representatives. Well, guess what? Every single one of us represents a great state or a great territory across our great country, and we have got a contribution to make in this chamber. At the end of the day, when the whole debate has been had, we will vote. If the majority of senators support something the government wants to do then it gets up and if the majority of senators do not support it then it goes down. That is the way democracy works. It is time the government understood this.

So, with those few remarks, the Senate is well aware what the opposition, together with Senators Fielding and Xenophon, are seeking to achieve: we are seeking to put beyond doubt that if the Senate were of a mind to disallow the reductions in Medicare rebates for cataract surgery then our intention is for the rebates for those items to revert back to the rebates currently in place when it comes up after this legislation has been dealt with. We know that this bill has to go back to the House of Representatives and the government will have to make a decision. They will have to make a decision on whether they will bring on the bill, give it precedence, deal with it and vote in favour of it, or whether they are going to ignore it, vote against it or let the time pass 1 November. If the government do not deal with this before 1 November then it is on their head; the chaos that will be caused out there in the community will be on the government’s head. Clearly, the government have not thought this through. The government should have engaged with us constructively and much earlier. The government should have realised that, without the support of the Senate, they will not be able to press ahead. Arrogantly, and I would argue, incompetently, the Minister for Health and Ageing thought that she could get away with it. This is an important issue. This is about ensuring timely and affordable access to quality health care for all Australians. On this basis, this is a very important process for us to go through today.

Nick Xenophon (SA, Independent) Share this | Link to this | Hansard source

I think the Minister for Health and Ageing, Nicola Roxon, does a lot of good things. Her focus on preventive health is laudable, but that is for another debate, perhaps later today. The focus on getting to the cause of illness and to the cause of people getting sick in the first place is a fundamentally good thing. I also think that the minister’s reforms to the dental program—which, with some relatively minor amendments, I support—need to be done, and it is regrettable that after a year that has not been dealt with.

I do have an issue in relation to the changes to cataract surgery. I think a mistake has been made. I think the government’s concern about some ophthalmologists not doing the right thing has been dealt with with a very blunt instrument. This instrument has been to have an across-the-board change to the cataract rebate. This bill is the same as the Health Insurance Amendment (Compliance) Bill 2009 but with one important difference: it ensures that if any regulation to change in a time in an item to a table of medical services is disallowed them the situation will revert back to the previous regulations.

Currently if such regulation is disallowed then the result is as if no regulation existed. This is vital because items in a table of medical services provide rebates for important procedures such as cataract surgery. The government has cut the rebates for items Nos 42699, 42701 and 42702 by 50 per cent. These items are for medical services associated with cataract surgery, and the information provided by the Medicare benefits branch in estimates last week indicated that in the 2007-08 financial year there were 187,912 cataract procedures provided. Of these, 131,675, or roughly 70 per cent, were provided in the private system, which would have had the rebate level halved under the government’s changes. Meanwhile, the remaining public sector patients would have continued to get their treatments for free, but I think it is important to have that balance between the public and private systems and that you do not overload an already stretched public system.

My office has been inundated with correspondence from constituents and individuals opposing these changes by the government. It has not been just about lobbying by medical practitioners or private health groups; bodies such as COTA—the peak advocacy body for senior citizens in this country—have publicly criticised this move by the government and so have those who have practised in the area for many years. I will quote from an email from one ophthalmologist:

The proposed change will reduce surgeons’ income—but not in the way the Government might think. Almost none of my colleagues will reduce their fees. There will be some reduction in demand for surgery with patients putting off their surgery or electing to go public—more on that in a minute. Most ophthalmologists (myself included) use safety for driving and safety from falls causing fractured hips as the primary indication for determining readiness for surgery. You can see that deferral of surgery is potentially dangerous. It is also true that the demographic that suffers from cataract surgery is very price sensitive. The capricious way that this extreme measure has caused a lot of anger within the ophthalmology community. The ophthalmology community is not politically divided and is strongly united in response.

The general public has been contacting me about this as well. I have been getting many faxes, emails and letters—many handwritten—from constituents who are concerned about this. It has been put to my office that the department were looking for cost cuts, they saw these large items and they made the cut without looking at the consequences. I think it really is a case where the government has used a very blunt instrument to deal with a perceived problem.

While it is true that there have been significant improvements in technology with this surgery in Australia since 1984, this needs to be put in perspective. Prior to 1984, a cataract operation was an intracapsular lens extraction which took about an hour to perform, depending on the proficiency of the surgeon, and had a relatively mediocre result. At that time, one waited until patients were virtually blind before performing surgery. In 1984, in South Australia, extracapsular lens extraction was introduced and this improved results dramatically and reduced the time for the operation considerably. As a consequence, the fees were reduced in 1987 by a federal Labor government. I have been reliably informed that there have been no significant advances in the last 10 to 15 years.

I think that the government is using the new technology as an excuse when in fact that was previously dealt with back in 1987. That is why I cannot support the government on this issue—because of the impact on patients. I think if the government wants to deal with issues of overcharging and informed financial consent, these are separate issues and this is not the way to do it, because of the impact it will have on patients.

Yesterday an amendment to the Health Insurance Amendment (Compliance) Bill 2009 was circulated in the names of Senator Cormann, Senator Fielding and myself. That amendment would have achieved the same purpose as this bill. It was an amendment drafted in support of a disallowance motion for changes to cataract surgery rebates. Essentially what the government was seeking to do was to make easy cost cuts at the cost of those with cataracts. The disallowance motion would have prevented this. To protect cataract patients we also sought to amend the Health Insurance Amendment (Compliance) Bill to ensure that if any change to an item in a table of medical services were disallowed, then the situation would revert back to the previous regulations. However, the government recognised that it would still end up providing the previous rebates for cataract surgery, so I think it is a fair assumption to make that the bill has been stalled. That is why I have reluctantly agreed to this course of action. I do not think there is any other course in order to protect those who require cataract surgery in terms of their not being out of pocket.

I think it is also relevant to point out that in estimates last week—and Senator Cormann is well aware of this, because I think he is the person who asked the question—the advice from a senior official in the department was that the item would revert back to the previous rebate level if the new lower rebate were disallowed. Because there is ambiguity in relation to that, I think it is important that we remove any ambiguity with this particular bill, and I think that is the most sensible approach. If this bill does not get up—if the government maintains its position that there will be no rebate—I think that we will find ourselves with an urgent legal challenge being made by a representative group or by an individual taking on a test case, presumably in the Federal Court. That is something that we need to avoid, given the uncertainty and the fact that there will many Australians who will defer their cataract surgery pending this.

I think there is a way forward in this. I know that the opposition does not say this, but I think that the Minister for Health and Ageing, Nicola Roxon, has done a lot of good things in her portfolio. I have supported many of those things, but this particular measure is not one that I support, because I think it is too blunt an instrument to achieve a good policy outcome and I am concerned about patients being significantly disadvantaged. Therefore, I support this bill and I am still hopeful that there can be a reasonable compromise that will not disadvantage patients who require cataract surgery.

Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

Mr Acting Deputy President, on a point of order: I just wanted to make sure that Senator Xenophon was aware that, at this stage, we are still talking about the motion to give precedence rather than the bill itself.

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

I am not sure that is a point of order, Senator Cormann. Senator Xenophon is of course entitled to include in his remarks anything that he chooses.

Nick Xenophon (SA, Independent) Share this | Link to this | Hansard source

I thought it was important to set out the basis of why I support this particular motion, and that is that I believe the bill has merit. In a sense, it will save me doubling up on my comments in relation to support of the bill. I am grateful for Senator Cormann’s point of order—even though you have ruled, Mr Acting Deputy President, that it was not a point of order. The point is: I think it is important that I make clear why I support the motion. I support the motion for the reasons set out in terms of the policy rationale behind this bill. That is why I think it is important that we support the suspension of standing orders, and I have set out in my remarks why I support this particular move. I think it is important to set out the background for that.

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

It seems that we are on the precedent motion, and I think it is clear that this bill is one that you would not give precedent to, quite frankly. We are now in a very odd position, where the opposition feel minded to hijack the Senate procedures to fix what would otherwise be a silly position they have got themselves into. I will take the Senate through this madness that the opposition are now putting forward. I will go back to the position where, at budget, the opposition agreed to pass our budget measures, except the private health insurance issue, which they would have a debate about. I think that is clear. Those were the words that Mr Hockey used at the time—I do not have them before me but I recall them in that way, and if I have not recalled them correctly I am happy to correct the record.

In short, the government made clear what its position was in relation to its budget. It is a budget that means that issues such as this would need to be passed so that things like Avastin as an emerging treatment for bowel cancer, new paternity leave reforms, incentives to get doctors to the bush and matters relating to regional cancer centres and the like can be proceeded with. It is about providing realistic savings out of the budget to allow these matters to be dealt with—and when technology and techniques improve. The government put forward this position to ensure that where technology did improve you could change your schedules. That is the next piece of this puzzle: where the government, quite rightly, moves to change or introduce a regulation to deal with the schedule. The opposition always has the opportunity to say, ‘We object to that position,’ and have a debate about that at the appropriate time. That is the position we would ordinarily come across. But, in dealing with it in seriatim, as we are—and as Senator Cormann has quite correctly said—we would oppose that position and we would not agree to the schedule. Notwithstanding the rationale or the arguments that might have been put forward, that is a debate you would have during the disallowance motion.

However, Senator Cormann, in making policy on the run, seems to have turned little attention to how this place works. It works by the government ensuring that its legislative program is dealt with in terms of what is before it in the Senate. The government determines the order of bills that are dealt with in the Senate, and that is the long-established precedent in this place. The opposition, to support a mad position that Senator Cormann has now adopted, have agreed to allow him to move a suspension notice to allow a private senator’s bill to be introduced into this place. So we are now in a position where the opposition, Senator Xenophon and Senator Fielding have agreed to hijack the legislative program—notwithstanding that we have a lot of urgent bills to be dealt with during this sitting period and notwithstanding the pressures we have on the program for the next fortnight—to allow this pantomime by Senator Cormann to play out.

Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

Senator Cormann interjecting—

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

The shrieks from Senator Cormann highlight the difficulty that he has put himself in. It has exposed the madness that he is now pursuing in the Senate. He is using the Senate—and the opposition have agreed to this with Senator Fielding and Senator Xenophon—and the procedures in this place for his own political pantomime. It is the only way you could describe it. We will get to the substance of the bill shortly. We are dealing with the precedent motion. I will deal with this madness that the opposition are now pursuing. To underpin the position, they were looking to the House of Representatives for a bill which was dealing with Medicare compliance—not a bill dealing with the Health Insurance Act at large, but with Medicare compliance.

Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

Senator Cormann interjecting—

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

Mr Acting Deputy President, I allowed Senator Cormann to speak in silence. Interjections are disorderly. It seems that he does not like me explaining his madness. Quite frankly, I can understand that. I might have interjected too if I had started this madness. I do have the right to be heard in quiet, and he should defer to that, rather than highlighting the fact that his position is untenable and exposed.

So he looked at a bill about Medicare compliance, all the way over in the House of Representatives, and thought: ‘Ah-ha! I have a way of stopping myself looking so stupid in this instance. If I oppose the disallowance motion, the position I will find myself in is that the Medicare schedule that has been introduced will drop away.’ But, of course, the bill is not in the Senate. It is a matter for the government when it comes to the Senate. That is the legislative program. He guesses a whole range of ideas as to why it has not moved from the House to the Senate, but those are assumptions he has made in relation to how these things work. But, notwithstanding that—

Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Link to this | Hansard source

Senator Cormann interjecting—

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

Mr Acting Deputy President, Senator Cormann had an opportunity to make his contribution in silence, and I should have the same courtesy extended to me.

Russell Trood (Queensland, Liberal Party) Share this | Link to this | Hansard source

Thank you.

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

The position now, of course, is that Senator Cormann has to stretch to say, ‘Look, I don’t have a particular bill before me to deal with to try to support the insane position I am now trying to adopt,’ so he introduces a private senator’s bill to give himself cover for the pantomime that is being played out here. He intended to wait for a bill to come across from the House to the Senate and amend that, but it is an unrelated bill. It is not dealing with the substance of the matter; it is an unrelated bill, and he was seeking to tack. So not only do we have an unprecedented position now emerging here, where Senator Cormann is using the Senate in this peculiar and unprecedented way, but this is a second way of providing himself a cover for the pantomime that he is trying to act out. That is, quite frankly, unprecedented in that it is normal practice in this place not to tack other amendments onto bills, and usually both the opposition and the government take the principled position and reject tacking bills. Why? Because the amendments are not about the substance. They have not been through a Senate committee. They have not been dealt with in an appropriate way. They have not been looked at, scrutinised—and, of course, that is the usual position we adopt this place.

Instead, the opposition have now breached two significant principles. One is—in the first instance, to provide Senator Cormann cover for his pantomime—to say that it is okay to tack bills. That is a significant breach of what I would call the usual procedures in this place and the policies that oppositions for a long time have adopted. Why? Because it is a sensible, principled position to adopt. Why? Because all governments can suffer from tacking bills, which are then used as stunts in the Senate and which eat up time. Why? Because we have a bicameral system, so it has to also pass to the House to be considered, and the reality of that should be driven home to the opposition.

The opposition have to understand—and maybe they have been in opposition for too short a time to follow this—that, first of all, the principles in this place are that the government determines the legislative program and the government determines the order of bills to be dealt with, and the principle usually adopted in this place is that you do not tack bills, especially when you do not even have them in the Senate to begin with and you try to second-guess when a bill is going to be introduced into the Senate. If it is not introduced, you then second-guess again—so it is an assumption based upon an assumption—and say, ‘Seeing that it’s not here, I’m going to introduce a private senator’s bill to hijack the legislative program.’ That is the third breach by the opposition in a program, because if you agree to all of these—there are three so far, and I am counting—what is to prevent Senator Xenophon, Senator Fielding or the Greens, although I suspect they are more reasonable than this position, from adopting mad tactics in this place to turn it upside down so we do not deal with our legislative program? We are then in a position where we are always at risk of having this place turned upside down at any time. They are the principles that have long been established in this place to allow proper scrutiny of the legislation, to allow the Senate to do its work. The opposition are now saying that they will throw all that in the bin and deal with whatever mad stunt a particular senator might come up with to give himself notoriety—

Kerry O'Brien (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

Cover.

Joe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | Link to this | Hansard source

and cover. The next major issue is that it is unprecedented not only to then agree to a suspension to deal with the private senator’s bill, as I outlined, but also to do the second tack, which is to say, ‘We’ll also include the disallowance motion in that procedure so that we’ll deal with that as well.’ That is the fourth breach of what I would call longstanding principles in this place. Why? Because once you start making rules on the run, once you start breaching long-established processes and principles in this place, you end up making not only policy on the run but also practice on the run. The difficulty will be where you end up once you throw all of that in the bin and you then want to argue from a principled position, should something else occur that you might want to argue against. The precedents in this place are well established. What the opposition are now doing is throwing all those precedents in the bin and saying: ‘We’re going to run it like a rodeo. We’ll let the bull out and see what happens.’ It is complete madness to travel down this path, and you should recognise that.

I do not expect Senator Cormann to recognise that, quite frankly. I do not. I accept that he has a policy position. He is blinded by how to resolve the position he has put himself in by mistake, accident or even design. He is looking for cover. He will search around, stretch out and grab anything to hold on to to see if he can bring himself a bit of respectability. But I cannot accept that the opposition, from their leadership, are going to accept that position. I cannot accept that, but it seems that they have been either sucked in or hoodwinked into this process. I can argue, but it seems that they are hell bent on proceeding down this path.

I can only give you some free advice—and cautionary advice, at that—that this is not a path that should be travelled because you have not provided any notice of your overturning of procedure. This course of action is unprecedented. You will get yourself into Odgers on it, I suspect. I am not sure if this Clerk will write it up; maybe the next Clerk will have to deal with that. The position you are allowing is that the opposition will be able agree to any freewheeling process and procedure to find a result to give them some cover, some fig leaf of respectability, in relation to a policy position that is completely unsustainable.

I will not deal with the substance of the matter in this debate. It does not look like I am going to have the numbers in this place, so I will not take up all of the time. I will end on this point: this is a silly position to adopt to try to give yourself an air of respectability in relation to a policy position that is completely unsustainable.

Stephen Parry (Tasmania, Liberal Party) Share this | Link to this | Hansard source

Senator Ludwig has outlined the inadequacies of the government by attacking the man. He has attacked Senator Cormann rather than the substance of the motion. He is trying to thwart the motion by indicating that it is a pantomime and things of this nature. I want to take us back to the real issue. The reason for us seeking precedence is that there will be thousands of Australians who will not have the benefit of cataract surgery if the government’s course of action were to be continued. That is the crux of the matter. That is what we are fighting for. We have come from that policy position very early on. We wanted to disallow the regulations, and that has been flagged for seven weeks.

It should be no surprise to the government that we wanted to move down this path, and we tried to do this through all the procedural avenues recognised as Senate convention, until yesterday. Yesterday, the government removed the bill and removed the opportunity for it to be debated in this chamber—and to be amended in the fashion that Senator Ludwig indicated. That amendment, on very good advice from the Clerk’s office, would have facilitated the particular course of action we wanted, and that was to make sure that the rebate for cataract surgery remained in place so thousands of Australians would not be disadvantaged.

On Monday and Tuesday this week the bill was listed on our Order of Business, subject to its introduction from the House of Representatives. Yesterday it was listed, and then miraculously removed. This is not an ambush, as Senator Ludwig indicates, because we have been very open and frank about our wish to amend the bill to achieve our outcome. That has been known for some time. We were then forced to take urgent action, and the urgent action was finalised this morning. A bill was presented to our Senate tactics group and we agreed to that bill. We have taken a sensible course of action. It is an unusual step, as Senator Ludwig indicates, but we were forced into this by the urgent circumstances. This legislation was going to be ready this weekend and the legislation was not going to arrive in this chamber for us to deal with in a timely manner.

On top of that, Senator Ludwig said, ‘It was all Senator Cormann.’ Apart from the Liberal and National parties, who are as one on this, we have two other senators. We cannot adjust or rearrange government business without the support of the majority. This is a democracy, as my colleague Senator Cormann mentioned, and we are doing this in the best interests of thousands of people who will now, if the government supports this in the lower house, continue to receive the rebate they are entitled to for cataract surgery. That is the basis of what we are doing and we have been forced into this urgent set of circumstances because of the government’s tactics in the House of Representatives yesterday.

Kerry O'Brien (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I did not intend to enter this debate but, given what has just been said by the Manager of Opposition Business and Opposition Whip, I have to say this: is the good senator suggesting that we should have kept the bill on the red even though it was not available to us? The nonsense in his argument is that we were supposed to keep the bill on the red because it had been there before, when in fact we could not keep it on today’s red because it had not passed the House of Representatives. He knows that. The fact of the matter is that what he is trying to say is: ‘We have this strategy. We were going to deal with the disallowance today.’ We have been dealing with all sorts of adjournments and disallowance motions this week and there has been no indication that this was the path they considered essential, that the disallowance might have to be put back or that some other action had to be considered.

Senator Xenophon belled the cat in his contribution earlier that this action this morning was discussed and arranged last night. The suggestion by Senator Parry and Senator Cormann that this matter was not decided until this morning is a fiction. It was cooked up last night, and Senator Xenophon has belled the cat. There was no consultation with us about this. We did not know until the bells were ringing this morning. There was no opportunity to discuss it. It was clearly an ambush. I reject the suggestion that this is not purely and simply a move by Senator Cormann and the coalition to give themselves political cover because they want to disallow something—and there is a consequence to that. That is their position. They are trying to give themselves political cover. That is what this is about and the Australian people will see through it.

Question put:

That the motion (Senator Cormann’s) be agreed to.