Claire Moore (Queensland, Australian Labor Party, Shadow Minister for Women) Share this | Link to this | Hansard source

I move:

That the Senate take note of the answers given by the Assistant Minister for Health (Senator Nash) to questions without notice asked by Senators Sterle and Lines today relating to charges for medical services.

It was interesting to hear Minister Nash who, in her responses today—or in the partial responses that we were able to get—was unable to talk specifically about government but could clearly talk about the Commission of Audit. In fact, I think for the first time in answers from Senator Nash in her area, we heard that the Commission of Audit has been set up to look specifically at a range of issues. Our questions were to the much publicised issues around the co-payment for GP visits and also around the general issue of bulk-billing.

There has been no shortage of political and public statements made about these issues. There has been almost a running debate for several months in the major media about what the impact of such changes would be; about comments that have been made—although never hearing any specific comment from the minister; and about a range of issues, such as the cost to the overall health system and the impact of the growing demand for health care. But none of this was backed up by specific data, because there are issues around the actual cost of our medical system. We all share a commitment to having an effective, responsive and sustainable medical system in our country. A number of surveys on a number of issues have been run across the media in our country asking how people feel about these two particular issues and about the core of the Medicare system in our country, which is the access of all Australians to free, as-needed medical services—access they have had for many years.

The answers that we heard today from Minister Nash gave no direct response to the questions which were asked, even though—as we found out during Senate estimates, when we asked questions both of the minister and of her department—the department has been doing work on issues of co-payments. Departmental officials were open about that, and they put on the record that, over a period of time, they were looking at what kinds of things were happening to our process in relation to the question of co-payments. In terms of how it happened, we know the department is working on it.

We know also, having sat through many Senate estimates hearings, that consistently questions have been: 'If there is work being done on these issues, will you share it with us? Share with us the costs and the issues that impact on how the policy could be introduced. Share with us the background and the impact—in particular, the impact on the most vulnerable people in our community, who have concerns about where they operate within a health system for which we in this place all know there has been a clear direction over many years to look at effective preventative health motivations in our community, encouraging people to take control of their own health and their own body, to check out concerns and to take early action to look at what can impact on them and their future health.' This has been a standard message over a number of years. On both sides of the chamber, we have been encouraging Australians to have a positive relationship in looking after their own health.

Naturally this process means that people want to know what services are available in their community, they want to be able to access them and they want to know exactly what any of that would cost. The saddest thing about how this debate has gone is that there has been a sense of judgement put out into our community which blames people for accessing the health system. There have been pontifications about the impact of people overusing the health system, not accepting that the health system is there to support people's health. It is not a bad thing for people to access their health system. The kind of rhetoric that we have heard over the last two months has tended to make that into an accusation—that people are overusing the health system because it is a free system. That is offensive to so many people. It actually causes a guilt response in people who are just trying to make sure that their own health and the health of their families is looked after.

The one answer we did get, though, is that there is a Commission of Audit— (Time expired)

Anne Ruston (SA, Liberal Party) Share this | Link to this | Hansard source

Before I take note of specific questions that were directed to the Minister representing the Minister for Health, Senator Nash, I would like to make a comment about the number of common threads that appeared in questions in this place today. Firstly, there seemed to be a lack of a real policy position or line of questioning. Those opposite failed to recognise in any way, shape or form the financial and economic legacy that was left to this government by them. Also, many of the questions were entirely based on speculation without any substance. Some of them were even based on false media reports.

Having said that, I will now come back to the motion at hand, particularly the answer to the first question asked by Senator Sterle of Senator Nash in relation to co-payments for Medicare services. The first thing I would say is that in Australia everybody wants to have a situation where many of the social services that we take for granted are easily accessible. But the fundamental bottom line is that we do not want to end up with a situation where our health system, education system and community welfare system are not affordable. First and foremost, we need to make sure that we can afford them.

When we got into government on 7 September last year, we inherited a situation where there was not much money left in the barrel. In fact, my understanding from all of the reports is that there was minus money in the barrel because we owed so much and were paying so much money in interest on the debt that had been accrued in the short space of six years. There was a lot of damage done in those six years. We, the government, decided to take a sensible, methodical and considered approach to looking at all issues of the budget over a period of time. As has been mentioned many, many times in this place during question time, we commissioned an audit of all activity. In the process of commissioning that audit of activity, we will look at all aspects to make sure that we can have a long-term, sustainable government for all Australians that all Australians can get the maximum amount of benefit from.

I would also draw the attention of this place to the fact that the reason we are having so much trouble balancing the budget is the many taxes that have been put on Australians. I refer, once again, to the two taxes we have been debating in this place. Since 7 September last year, we have done very little work in this place apart from debate the repeal of the carbon tax, a tax the people of Australia voted in this coalition government to repeal. Now we in this place are wasting hour after hour of Senate time debating the repeal of the mining tax, which, once again, the Australian public voted us in to repeal.

Senator Sterle interjecting—

I would draw the attention of senators from Western Australia to the fact that this is a tax that is hurting their state. We need to be able to get rid of these burdensome taxes that are preventing Australia from moving forward, that are stopping economic activity and economic benefit, and that are a threat to employment across the whole sector.

Those opposite have come in here today to speculate about what might or might not be considered in an audit report, to speculate about what might or might not be in a newspaper and to question the validity of what might or might not be in a newspaper. As we heard from the response today, the information that was contained in a particular news article was factually incorrect. Rather than coming in here to waste our question time, I would really love to hear from those opposite some questions about policy.

In conclusion, in relation to taking note of the answers by Senator Nash, I would suggest that maybe it might be sensible for those opposite to wait until the response from the audit commission has been considered and decisions have been made about which components of that particular audit report are going to be adopted by government and which ones the government is not going to adopt, for whatever reason. Instead of coming in here and speculating about it, let's take a sensible and methodical approach to it and allow the government to consult where it needs to to make sure that these decisions are not made over a weekend, as was the pink batts policy, or on the back of an envelope, as we have heard that the development of the NBN proposal was. Let's make sure that we deliver good, solid, well-researched and well-thought-out policy for all Australians.

Glenn Sterle (WA, Australian Labor Party) Share this | Link to this | Hansard source

I would like to make my contribution to taking note of answers to questions put to Minister Nash today. I think it is amazing that, all of a sudden, everyone in this chamber is so interested in Western Australia. I think we should be interested in Western Australia every day, not just because there is a Senate election coming. I find it very hypocritical when I hear the nonsense coming from the Leader of the Government in the Senate, ably backed up by the chirping of non-Western Australian senators, about this 'job-destroying' tax. What a load of nonsense!

I made a contribution this morning which referred to just how well the mining tax is going, but I ask the question all the time: 'If it is that bad and job destroying, what mines have shut down?' The silence is deafening; nothing has shut down. I want to share something that is very important to help people get a handle on what the Abbott government really thinks of Western Australia. On Sunday, 17 February 2013 at a Western Australian Liberal Party campaign rally, the then Leader of the Opposition, Mr Abbott, was invited to speak. He said to the madding crowd that he hoped to model his government on Premier Colin Barnett's. For those who do not know, Premier Colin Barnett is the Liberal Premier of Western Australia. He went on further to say to the madding crowd—

Honourable Senators:

Honourable senators interjecting—

Glenn Sterle (WA, Australian Labor Party) Share this | Link to this | Hansard source

I do not know; Senator Smith could have been there throwing rose petals at his beloved leader. I have no idea, but I would not be surprised. I do not think he would like to throw petals; he would probably like to throw something else at the moment. That is only what I am assuming.

Mr Abbott went on to say that he has learned a lot from Mr Barnett, describing his government as a model he hopes to repeat in Canberra. Well, well, well—here we go. If he wants to model himself on Premier Barnett's government, why don't we look at the $183 million cut from the Western Australian education budget and cut from Western Australian schools?

I have some really interesting figures that I wish to share with the Senate chamber. It just so happens that I grabbed some material on the size of the cuts to schools in the federal electorate of Hasluck, which is represented in the other place by the Liberal member, Mr Ken Wyatt. Darling Range Sports College, the old Forrestfield Senior High School—I know this college very well because I am the patron. I also take kids on World War I Western Front tours and raise a lot of money. It is a darn great school in a very low socioeconomic area not overly endowed with heaps of ratepayers or with the same support from the business community enjoyed by private schools. Everyone must know, however, that, while Mr Abbott is modelling himself on Premier Barnett, that school has had cuts to this year's budget of $379,268. While I am at it, I will go to another high school in the same federal electorate—the Southern River College in Gosnells. They are losing $258,488—I am referring to everyone's interest in Western Australia, Mr Deputy President.

Alan Ferguson (SA, Deputy-President) Share this | Link to this | Hansard source

Senator Sterle, you have just raised a point, and I trust you are going to come back to the matter at hand today.

Glenn Sterle (WA, Australian Labor Party) Share this | Link to this | Hansard source

I definitely am, but it would be remiss—even criminal—of me if I did not take this opportunity to finish quoting some of these figures, because everyone is so considerate of Western Australia at the moment. Everyone should be considerate of Western Australia, because everyone out there in radio land, or wherever they may be, should know that your Prime Minister is modelling himself, whether it be in health, education, telecommunications or jobs—and I will talk about the 5,000 Qantas jobs later once I have finished addressing this point—on Premier Barnett. It is very important that Western Australians understand that my old high school in Thornlie—Thornlie Senior High School—in the Hasluck electorate has had its funding slashed this year by $435,083.

They are just the cuts to education. No wonder we are worried about health. No wonder we just do not trust what is coming out of that side of the chamber. I think we are right to be demanding the government tell us what is in the Commission of Audit report. As much as that side want to defend their Prime Minister, they cannot defend the Prime Minister. If you are all that concerned with Western Australia, it is imperative that the government lets the people of Western Australia know what is actually on the chopping block in health, education, jobs or whatever it may be.

Dean Smith (WA, Liberal Party) Share this | Link to this | Hansard source

It would be ungracious of me if I did not start by acknowledging the great local work that Senator Sterle does in his local community around the area of Forrestfield, so congratulations, Senator Sterle. Just on the weekend, we had the Leader of the Labor Party and the Leader of the Opposition, Mr Bill Shorten, travel to Western Australia. For those of you in the gallery who do not know, we have a Senate election rerun in Western Australia coming up on 5 April. I will not bore you with the details; that is a speech for another time. Mr Shorten said, 'It's a new season, not a replay of last year's grand final.' What has happened in last 24 hours? Mr Shorten's ruckman, Paul Howes, has left the team. That is not an endorsement of the team's captain.

Let me move onto Senator Moore's contribution. No-one doubts there is a debate in our country about whether or not people should be able to access medical services or, more specifically, access their GP. There is a debate in our country about whether some people are accessing a GP more than they need to and whether doctors are overservicing some patients. That is a debate we need to have. Why do we need to have that debate? Because health spending in our country is increasing by 4.8 per cent and our GDP is only increasing by three per cent. There is a health funding issue in our country. We know that real government spending has increased by 3.5 per cent over the last five years and will grow to 3.7 per cent over the medium term. Shock! Horror! The new government might be considering how we can do things better, how we can get better health outcomes for Australians. You should not be 'Shock! Horror!' that the government might or might not be considering a range of alternatives. There will be a lot of fury over possible improvements to our Medicare and health system, but it will be embarrassing for Labor when they embrace the political reality that looms large over them, because what is the history?

Indeed the idea of Medicare co-payments was one that was embraced, one that was discussed, one that found itself in the budget papers of former Prime Minister Bob Hawke. It is an idea that you have embraced. I will read from this article in the Fin Review—and indeed, it was one that was agreed and endorsed in 1991 by the Hawke government:

The co- payment Mark I of $2.50 (which in today's money is just over $4) was used as a bargaining chip by then leadership challenger Paul Keating, in his importuning of recalcitrant Labor backbenchers.

Perhaps it was sweet revenge that after Bob Hawke humiliated Keating in 1985 by nixing his consumption tax, Keating was able to return the favour by scrapping Hawke's co-payment.

When it comes to the Labor Party, politics trumps economic reality every single time.

I have a few moments available to me. I would like to give you a running account of the consideration the former Labor government gave under Bob Hawke and Paul Keating to changes to our Medicare system—changes that were not just discussed, changes that were not just thought about; changes that found their way into the budget papers of 1991 under Bob Hawke's leadership. It is totally correct. It is totally prudent for a new government to look at what it can be doing differently when it comes to government expenditure.

Let's just go back to the clear commitments the government has actually made. It has said that in the context of the National Commission of Audit it is sticking to its election commitments. It has said, 'We are not going to cut the overall level of spending in health, in education, in defence and medical research.' It has said quite rightly—and this will be in the interests of all Australians—that the National Commission of Audit is about promoting efficiency, effectiveness and identifying areas of duplication with the states and territories.

There is much work to be done, because some people in our parliament—some people in this Senate chamber—do not think that there is a problem. They think that we can continue to go the way that we have been going for the last six years. There are others on this side of the Senate chamber who believe we cannot do that—not because it is not good for us but it is not good for future generations of Australians. You want to put your head in the sand. You are prosecuting many myths around this National Commission of Audit. You will be exposed, the budget will be improved and you will continue to stay in political never-never.

Sue Lines (WA, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to take note of answers given by Senator Nash in relation to health. Before I do that, I am absolutely astounded by the responses we have heard from government today. We are not seeing any commitment to Australians doing it tough. We are not seeing any commitment to ordinary everyday families. All we are hearing about is this myth that everything has to be slashed and burned, and the only group in our society that is going to get any benefit is the big end of town, the business end of town.

Again, Senator Nash today in answer to questions around GP co-payments, bulk-billing by GPs and so on, just went on with the government's key theme of secrecy. It is all a secret. We all have to wait until sometime in the future when the government gets around to telling Australians, particularly Western Australian voters, just what it has in store for them.

Things are tough in Western Australia. They are tough for ordinary Australians, and all we have seen from Senator Nash, and indeed the Abbott government is: 'We're going to make it tougher for you.' So there was this refusal today by Senator Nash to give a response to a simple question:: is the government considering a co-payment? First of all, she misunderstands a very clear question and then we just get weasel words. We get a waffly response and, again, she tells us nothing.

Not only that: one of the things this government is really good at doing is not taking responsibility. It likes to blame anyone. It blames unions. It blames workers. It blames the former Labor government and then it cannot make its own decisions. It puts things out to a Commission of Audit, which has been sitting with the government for four weeks, remaining totally secret.

But things are leaking out. Peter Dutton, the Minister for Health, said on the 7.30 Reportin February that he wanted to have a frank and fearless discussion about the future of our health system. Where is that frank and fearless discussion taking place? In some secret three-person cloakroom, because it sure is not out there.

Mark Furner (Queensland, Australian Labor Party) Share this | Link to this | Hansard source

In a telephone box.

Sue Lines (WA, Australian Labor Party) Share this | Link to this | Hansard source

So, yes, perhaps it is taking place in a telephone box. But, apparently, it does not include Senator Nash, because she tells us nothing is on the table—yet we have had the health minister himself telling us there is going to be this frank and fearless discussion. Time is running out, because the budget is due in May, under 12 weeks away. We are told there is a plan. We are told there is frank and fearless discussion. When is that going to happen? When will voters in my state of Western Australia get to hear about what is in store for them? What is in store for Western Australian families when they go to a doctor? How much more is the Abbott government going to force them to pay?

Again, we see this emerging theme: don't let facts, science or academic research get in the way of ideology. The AMA, usually the friend of the Abbott government, is totally opposed to any kind of GP co-payment and, indeed, questions what is actually going to be put in place. It goes further and says there is no proof of overservicing—something we even heard Senator Smith go on about today—no proof that a co-payment is going to do anything at all. Further, the AMA says it will push people back to hospitals, and yet the government will not confirm what will happen in our hospitals. Indeed, people have talked about a co-payment, if you front up to an emergency department. So it is time now for this government to come clean about its plan. We were told today—it is the only thing we heard today from Senator Nash who said 'some plan'. It must be a secret plan. It is time to put the plan out there.

The Abbott government, prior to September, was very clear about its agenda. Ever since then we have seen a secret agenda and it is a big secret in Western Australia. Western Australians have a right to ask and a right to know if they are going to be having to stump up a co-payment that will add to the cost of families already suffering massively high electricity bills under the mismanagement of Colin Barnett. Indeed, as Senator Sterle says, the Prime Minister wants to model himself on Premier Barnett. The only thing they have got in common at the moment is they both seem to have lost their treasurers. But it is time, clearly, for the government to come clean, to tell the people of Western Australia what is in store for them before the Senate election.

Question agreed to.