Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Mental Health) 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 Opposition senators today relating to health funding.

The questions that were directed to Senator Nash today gave her the opportunity to restate the commitments made during the election campaign by the then opposition leader, now Prime Minister. I asked Senator Nash to restate Prime Minister Abbott's commitment that there would be 'no cuts to health' and that there would be no new taxes. Those are words that the now Prime Minister said over and over during the election campaign.

Australians will be concerned that Minister Nash did not take the opportunity given her to reconfirm those election commitments. She did not say that there will be no cuts to health in tonight's budget. She did not say that there would be no new taxes. That opportunity was given to her and Australians can read that for what it actually is. Repeated requests from our Manager of Opposition Business for her to answer the question were not heeded. She did not say there would be no cuts to health. She did not say that there would be no new taxes. So it is reasonable for people to expect that tonight's budget will see a co-payment to attend the GP and also, potentially, a co-payment to attend the emergency department. That is policy designed because they know that as soon as you charge people on low incomes to go to the GP, with a co-payment, there will be an increased attendance rate at our emergency departments. This will be an absolute broken promise from Mr Abbott, who said there would be no cuts to health.

During the election campaign Mr Abbott also said that there would be no surprises and no excuses from this government. I suggest that in tonight's budget we will see a lot of surprises and a lot of excuses. Mr Abbott also said, 'This government will do what we have said we will do.' Mr Abbott said there would be no cuts to health. Well, we will see. He said there will be no new taxes. The truth is that a co-payment is a new tax. It is a new tax on attending the GP. Any cuts to Medicare Locals in the budget tonight will be a broken promise. Mr Abbott said absolutely clearly that there would be no change, no cuts, to Medicare Locals.

We know, from the research internationally, that if you put a co-payment on attendance at a GP the result will be lower attendances for preventative health scans. The people who should be most encouraged to go to the doctor will not be going to the doctor. We know there will be more attendances at emergency departments. So essentially it is just shifting the cost on to the states and territories. We know that there will be increases in chronic illness, with more cost to the health budget in the long term. Frankly, there will be lesser health outcomes for Australians.

Neither did Senator Nash take the opportunity to back up the bizarre reasoning of Mr Abbott's hand-picked adviser, the Chair of the Commission of Audit, Mr Tony Shepherd, when he said that Australians visit the GP 11 times a year. He also said he did not think we were that crook. I am not surprised, frankly, that Senator Nash did not back that up. Mr Shepherd exposed himself, when he made those comments, as a person who is certainly not a health economist. It also shows that in devising the audit report the group, under his chairpersonship, took no advice from those who do know: the health economists of our nation. It is of great concern that the government in the design of their budget has taken advice from someone who can do a division sum, who can divide the number of GP visits in the year by the population of the community. That is not the way you devise good health policy. That is not the way that you make good health policy for the future of our country.

Mr Abbott was wrong when he said, when he was the health minister, that the government of the day was the best friend that Medicare had. Tonight's budget will show once again Mr Abbott's ideological opposition to universal health care—health care that provides health equally to those who need it, irrespective of the size of their chequebook, so that anyone can attend the doctor when they need to. Tonight's budget will be a test of this government's ability to hold to their election commitments. (Time expired)

Concetta Fierravanti-Wells (NSW, Liberal Party, Parliamentary Secretary to the Minister for Social Services) Share this | Link to this | Hansard source

Following on from what I can only describe as the hypocrisy of those opposite after the mess that Labor left us in health after six years in government, I would like to go to some of the more stark examples of what Labor's health mess was. I would remind those opposite of the words of Kevin Rudd back in August 2007:

When it comes to improving Australia's health and hospital system, as Prime Minister if elected, the buck will stop with me.

He said that the Rudd Labor government would seek to take financial control of Australia's 750 public hospitals if state and territory governments had failed to agree to a national health reform plan. He said that the blame game would end under him. But what did we see in these six years under Labor? We saw this so-called health reform. All that was really about was 'Dr' Rudd and 'Nurse' Roxon madly rushing from hospital to hospital around this countryside, dressed in white gowns, taking photo opportunity after photo opportunity, so it could all be posted on the MyHospitals website. One only has to listen to Ms Roxon's description of some of those visits to know just how stage-managed they all were. That is the legacy of those opposite.

We had the 10 new agencies—the new bodies under Labor, which diverted resources away from the front end, away from benefiting patients—and a whole lot of new bureaucracy so that the health portfolio ballooned by 27 per cent. And of course there were those famous GP superclinics. This is yet another example of Labor's waste and mismanagement, part of the mess they left us in health. Labor pumped $650 million into this ill-conceived program and at the same time pulled money from other areas of health, including subacute beds in public hospitals. Seven years after these so-called superclinics were promised, some are still not opened or even operational. The superclinic idea was all about helping Labor's candidates in marginal seats. It certainly was not about the patients. For many communities, the so-called 'superclinics'—and I put 'super' in inverted commas—remain nothing more than a dream in the distance. So our objective is to clean up Labor's mess. We will methodically assess Labor's programs and failures and make appropriate decisions about them.

Can I for the record correct Senator McLucas's incorrect comments in relation to Medicare Locals. Former Chief Medical Officer Professor John Horvath has carried out a review of Medicare Locals for the government and his report has been presented to the Minister for Health. The findings of that review are currently confidential and any release of that report will be a decision of the government. Of course, like many issues in the health portfolio, the review may be considered in the context of the budget and announcements may be made at an appropriate time. This is Labor's record on health, so it is sheer hypocrisy for Senator McLucas to come into this place and give us a lesson about health given the abysmal and appalling record that they left us in health.

I will make some general comments in relation to the Rudd-Gillard government's six years of chaos, waste and mismanagement, where they delivered higher taxes, record boat arrivals and debt and deficit as far as the eye can see. Labor inherited $20 billion in surplus. They have forgotten how to spell surplus, it has been so long since they last had a surplus. I think 1989 was the last time that Labor delivered a surplus to the Australian public, and they then left a projected $50 billion deficit—$50 billion in the bank projected into debt, well over $200 billion. This is the legacy of the mess that Labor left us. (Time expired)

Anne Urquhart (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I rise on the motion to take note of the answers given by the Assistant Minister for Health, Senator Nash, from questions asked by Senator McLucas in relation to the cuts and increased taxes slated for the health portfolio in tonight's budget. It is clear from the answers from all coalition government ministers today that tonight's budget will be full of broken promises, increased taxes and overblown rhetoric around a budget emergency that is their own creation, and it will be full of cuts to health, education and community services that will hurt the most disadvantaged Australians.

If tonight's budget includes a GP tax, this of course will clearly be a broken promise. A GP tax could cost Tasmanians around $150 million extra a year and a co-payment for PBS medicines could mean an extra $40 million from Tasmanians being spent on medicines. Tasmanians are already some of the lowest bulk-billed patients in the country and we are already paying more for health care. Yet, if you break down these costs on an average per person basis, as those opposite so love to do, it is around $400 per Tasmanian per year. Of course, those on fixed and low incomes, age pensioners, disability pensioners, single parents and veterans may have to visit the doctor more than the average and may rely on prescription medications for pain relief, for blood pressure or for chronic illness. It is these people who have the lowest capacity to pay. It is these people who will be unfairly targeted in tonight's cruel budget.

It will be a budget full of broken promises, as Prime Minister Abbott seeks to find a way to pay for his overblown, unfair Paid Parental Leave scheme—a Paid Parental Leave scheme that will give $50,000 to very well-paid women to have a baby, a Paid Parental Leave scheme that will be paid for by cutting health services, by introducing a GP tax and increasing the co-payments for PBS medicines. This Paid Parental Leave scheme will overwhelmingly benefit very well-paid women while slugging those who happen to be sick with a tax while visiting the doctor and, on the way out, with an increase in the price of their medicine. It is a proposition that will hurt low-income Australians. It is a proposition that is so warped that it will actually discourage low-income Australians, as Senator McLucas said, from visiting the doctor and filling their prescriptions. It is a proposition from a Prime Minister and Treasurer whose priorities are so twisted that they have in fact doubled the deficit in just eight months. In just eight months, Mr Abbott and Mr Hockey have managed to add $68 billion to the budget deficit, create a so-called budget emergency by fiddling with assumptions and provide unnecessary grants to the Reserve Bank. They have not created a better Australia but provided a means to make severe cuts to health services and impose new costs on those least able to pay.

Last week, I met with senior staff from Tasmania Medicare Local to discuss their potential concerns with this budget. Senator Nash would do well to actually come to Tasmania and visit our Medicare Local before resorting to the talking points about duplication and waste. What I saw was an organisation that is extremely efficient at delivering primary health care across the state, keeping people out of hospital and providing e-health, after-hours general practice, population health research, mental health services and specific assistance for Aboriginal Tasmanians. The facts are that Tasmania's population is older than those of all the other states. Our population is ageing at a faster rate than other states. We have higher rates of chronic disease and the most dispersed population in the Commonwealth. Yet this Abbott government will tonight show no regard for Tasmania's health system difficulties. Tonight's budget will hurt Tasmanians in the hip pocket every time they get sick or every time their family gets sick. The budget will be full of the twisted priorities of Prime Minister Abbott and will not be about setting up the country for the future, as government senators said over and over during this question time.

This budget will take the Australian health system back to the pre-war era—that is, pre-war World War II—which was defined solely on your ability to pay, not if you were sick. The Australian community will not forgive this government for its broken promises on health and across the budget. Last week, I was contacted by a doctor in my home town of Ulverstone who said that she has previously worked in the US and seeing patients who had to pay was a dismal failure. She ended up diagnosing many advanced cancers— (Time expired)

Barry O'Sullivan (Queensland, National Party) Share this | Link to this | Hansard source

This is only my second speech in the Senate and I approach it with some trepidation. But I would like to thank the opposition for choosing the topic of broken promises, in particular broken promises in the area of health, because it has made my job just that much easier. Under Labor, we saw the health bureaucracy balloon while public hospitals, private health insurance, dental and other areas were cut. We saw $4 billion cut from private health insurance and $1 billion cut from dental health.

It should have come as no surprise to us, because in the area of promises we had a promise from the Labor government to indicate that they would be fiscal conservatives. They took a cash surplus legacy left to them in 2006-07 and took it to a $192 billion debt. One can only imagine what could have been done in the area of health services had that money being dedicated into that area, which it was not—it competed with reductions. Or, indeed, there are the $1 billion in debt payments that are made here on a monthly basis. That borrowing was an increase of 400 per cent in the first two years, and the borrowing in that area increased by 100 per cent each year. So in less than three years Labor borrowed $147,000 million which could have been put into health and we would not have any challenges to our spending program at the moment. Labor have shown me that they know more about tonight's budget than I do. It will be an interesting discussion tomorrow morning if some of the statements they have made in this place and outside this place do not come to fruition.

One of the things that is necessary for any government to be able to maintain the services they want to in meeting their duty of care to their constituency is to ensure that they have a strong economy. I am happy to have a discussion with the opposition, or anybody, in relation to the economic performance of a conservative government. The previous government under Howard and Costello inherited a debt of $96 billion and were able to dispose of that over the term of their government, leaving us at the time with a cash surplus, if my memory serves me correctly, in the order of $45 billion when Labor took over.

To keep health services well funded, one must be able to operate surpluses. If Labor want to talk about promises, let us talk about the promises of the surplus indicated for 2008-09—where we ended up with a $27 billion deficit. In 2009-10 we were promised that saving decisions would set us up on the path to surplus for 2015-16. Of course, we all know what the deficit is for 2015-16.

They talked about a strategy that would see the budget returned to surplus in three years' time. That statement was made in 2010-11. Well, in the three years' time the deficit was $47 billion. So it is appropriate to have a conversation about promises—promises on any level. The measures that might have to be taken in the budget today will be as the direct result of failed financial management over a long period of time. This was from a government that was headed by someone who I remember from one night when I had to rewind on my television—I heard Kevin Rudd indicate to Australians that he was a 'fiscal conservative'. I watched him with great interest from that period of time.

I think that there is quite a deal of hypocrisy for the opposition to start pre-empting an attack on our government, on the coalition, in terms of the management repairs that they have to do into the future. Might I end by saying that there was a wonderful saying by Walter Kirn in relation to hypocrisy:

Everyone loves a witch hunt as long as it's someone else's witch being hunted.

Ursula Stephens (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to take note of the answers to the questions asked of Senator Nash today and, particularly, the questions that I asked Senator Nash about the future of Medicare Locals.

There has been a bit of argy-bargy across the chamber this afternoon about the issue of broken promises. We are all very conscious of the campaign that the government ran during the election campaign and straight after, where the Prime Minister looked straight down the barrel of the camera and promised that there would be no broken promises, and that his was going to be a government for all Australians.

I suppose that the question that was asked today of Minister Nash really goes to the touchstone issue of health care in Australia. It is the concern that we, as parliamentarians, hear most when we are travelling around our states as senators or in our electorates as m members of parliament. That is, the fear and concern that our constituents have about having access to appropriate and timely health services—particularly if you are regional senator, like all of the members of the National Party sitting here today. They know the challenges there are in combining thin health markets, distance, access to services and particular populations that have particular health needs. I asked Minister Nash today about whether or not she actually supported the Murrumbidgee Medicare Local, which covers a population of almost 200,000 people across south-western New South Wales and across a geographic area of more than 100,000 square kilometres.

She was reluctant actually to commit her confidence to the work of the Medicare Local in Murrumbidgee, and that is a shame because they do an extraordinary job while challenged by some very important and difficult demographics. There is the fact of the density of 4.1 per cent of the Aboriginal and Torres Strait Islander populations of Australia living in that region, as opposed to the national average of about 2½ per cent. So there are really important health challenges that the Murrumbidgee Medicare Local has very strategically and very cleverly made out to address by decreasing the rates of chronic disease and treatable and preventable mortality by expanding the current preventative health and chronic disease services and programs. These are really innovative and locally developed programs to address the specific needs of those communities. They have fantastic prenatal and antenatal services, outreach services that challenge the issues of distance across those regions.

When the government came in, the Australian Medicare Local Alliance issued a release which said the Australian Medicare Local Alliance welcomed the decision by Prime Minister-elect Tony Abbott to appoint Peter Dutton to the position of Minister for Health and welcomed Senator Fiona Nash as Assistant Minister for Health because she understands the issues affecting people in rural and remote communities and will be an asset in the health portfolio. She has an interest in equity of access to health services that taps right into what Medicare Locals are working to deliver across Australia. The Australian Medicare Local Alliance was also pleased that the federal government has continued to recognise the importance of mental health.

Medicare Locals have been systematically, across the country, addressing these issues and are now waiting with bated breath for the announcement of this budget. So trying to actually reassure the patients and participants in Medicare Local programs across the country that Medicare Locals are not for the chop is absolutely okay—they will survive the review and they will survive the budget. We fear greatly for Medicare Locals and we fear that the dislocation and the disruption to quality health care in the regions will suffer immensely from what we know are the Prime Minister's cuts to health.

Question agreed to.