Penny Wong (SA, Australian Labor Party, Leader of the Opposition in the Senate) Share this | Link to this | Hansard source

Pursuant to standing order 74(5), I ask Senator Nash, representing the Minister for Health, why question No. 283, which I placed on notice on 16 December 2015, remains unanswered.

Fiona Nash (NSW, National Party, Minister for Rural Health) Share this | Link to this | Hansard source

I can indicate to the chamber that the government is considering its response and will respond in due course.

Penny Wong (SA, Australian Labor Party, Leader of the Opposition in the Senate) Share this | Link to this | Hansard source

I move:

That the Senate take note of the minister's explanation.

Because the Senate's entire time has already been taken up, this will be a more brief contribution than I would like to make on this. But I would make this point: the question I asked was a very simple question which dealt with a MYEFO measure, a Mid-Year Economic and Fiscal Outlook measure. It was not dissimilar in its terms to one of the questions which I referenced yesterday after question time, which also asked for more information on a measure in the Mid-Year Economic and Fiscal Outlook. I think governments should be able to provide detailed information about measures which are published in the budget and budget update.

Yesterday I detailed a measure which had not been answered, and this is in very similar terms. I asked with reference to the 2015-16 MYEFO measure 'more efficient health programs': (1) can the minister provide a list of the 24 health programs which will be cut to achieve $146 million of savings over four years, and (2) can the minister provide a profile of the amount cut from each program over the forward estimates? The minister today has said 'the government is considering its response'. So the government made a decision last year to cut $146 million out of a range of 24 health programs. This, of course, is on top of the $57 billion worth of cuts in the health area, particularly to public hospitals. But, on this one, $146 million of cuts over four years in the Mid-Year Economic and Fiscal Outlook update, they cannot tell us which programs. They are still considering their position.

It is ridiculous. This is already built into the budget, and this information, in the ERC process, would have had to have been part of the way in which Finance costed the measure. It would have had to have been provided to government by Health. The government knows which programs. That is how it can identify in a budget update that there are 24 programs, and now they will not tell us which programs are actually being cut. It is ridiculous.

This government's failure to provide basic information to this Senate on questions on notice really demonstrates its desire to be secretive and not to be transparent when it comes to public moneys, because the question that I am asking and that we are talking about today is not a question where there is an extraordinary amount of work, a question which is obviously not ascertainable without a great deal of detail. It is a question which deals with information which must have been before the government when it made the decision to cut over $140 million from Health. They must know which programs are being cut. That is why the numbers are in the budget. That is why the number of programs—the 24 programs which are being cut—is also in the budget. But they cannot tell the Senate which programs.

I would have liked to have talked longer not only about this government's these cuts but about the $57 billion which the government has cut from public hospitals, but I cannot because of the shortness of time. It has been instructive to see the continued denial by the minister. I understand she has had to leave the chamber for other reasons, but the minister told us yesterday there was no such thing as a cut. Well, it is in her own budget papers. She should have a chat to Joe Hockey, because it is in the budget papers. She should have a chat to the Australian Medical Association, which has documented last week what these cuts mean to people—what they mean for people's waiting times in our emergency departments; what they mean for elective surgery; what they mean to Australians across this country in terms of their medical outcomes and the health care they get.

There should not be a tricky game around saying, 'No, there are no cuts—despite the fact that it was in our budget papers, there are no cuts.' What the minister should be addressing is the real impact on real people across this country. She fails to do that in question time by pretending there are no cuts, even though it is in her own budget papers. She has failed to do that again by not being up front with the Senate about which programs she has cut in the most recent budget update.

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

I have to say to Senator Wong that it is really not all that remarkable, because in estimates I asked an even simpler question about the Minister for Health. That was, since she took over responsibility for aged care, how many aged care facilities had she actually visited? The minister at the table was not able to answer that. Not even the department could. To have them come up with an answer to a question about who has made that decision about the programs and which programs are being cut is probably a bit too difficult for this sneaky, tricky government.

It needs to be put on record yet again that this government's record on health is abysmal. Quite frankly, it is appalling. They will only ever see health as a source of budget cuts. That is quite evident. As far as health is concerned Malcolm Turnbull, the Prime Minister, is even more disastrous than Tony Abbott ever was.

During question time yesterday Senator Nash said that this government is increasing funding to hospitals. What an absolute lie! Go to the budget papers—in the budget papers presented by this government you will see, on page 7, that they have cut $57 billion from public hospitals. That is what Mr Abbott had in his budget when he was Prime Minister. On top of that, we have seen that the Prime Minister, Malcolm Turnbull, has added a further $2.1 billion extra in funding cuts.

No wonder the states are finding it hard to manage their health budgets, when this government, quite clearly, is starving them of funds. We know that that has been part of a strategy by this government to starve the states and territories of funding, which was then going to put pressure on the states to agree to increasing the GST. That is what that was about.

But the essence of this debate is about Australians' health. As I said, Mr Turnbull's cuts to health are actually far worse than those that were brought down by Mr Hockey when he was Treasurer, before he was thrown under the bus by his colleagues here in this chamber and by the Minister for Finance. Mr Turnbull, in fact, has turned out to be worse than Joe Hockey and Tony Abbott when it comes to funding health in this country. Despite promising new leadership and a 21st-century government with a ministry focused on the challenges of the future, Malcolm Turnbull has in fact ripped another $650 million out of Medicare by slashing bulk-billing for diagnostic imaging and pathology. Just think about the consequences and effect that that one act alone will have on the Australian population. It is devastating. There will be women who will not go for their regular mammograms. There will be Australians who will think twice about having their regular tests. We all know in this chamber, because we have spoken about it on numerous occasions, that a lot of Australians have to undertake regular blood tests. We know that some of them will think twice about it, because already their family budgets are stretched. If it is a matter of whether mum goes to have her blood test done this week or not, more likely than not she will choose to put that off, because it might be the case that she needs to provide schoolbooks for her children. That is another further attack by this government, cutting assistance to Australian families.

Cutting the crucial health workforce training program by $595 million is an outrageous attack. Then go back to aged care. My colleagues often say, 'When you speak in this place, everything comes back to aged care.' The reality is that the cuts around health affect older Australians more, proportionately, than they do the younger generations. That is a fact. The reality is that we know what they have done in relation to the aged care sector workforce. They made a lot of plans and commitments but delivered nothing. They said they would have an audit. How long did we wait for that audit? Now it has disappeared. Recently I put out a media release with Shayne Neumann, the shadow spokesperson on ageing, suggesting that perhaps the Minister for Health could get herself a GPS and maybe that would help her find the audit.

Further cuts have had a real impact on the Australian population. They have ripped another $146 million out of health prevention and eHealth programs. These are two extremely important programs that are very important to the Australian population.

We then continue with Mr Abbott's $1.3 billion hike in the price of essential medicines. Let us not forget that. It is all part of health. Then we look at Mr Abbott's $260 million attack on the Medicare safety net. Then we go to another $2 billion cut in a four-year freeze on Medicare rebates for GP visits. We know what they tried to do last year, when they wanted to put a GP tax on the Australian people by wanting you to pay an extra amount to go and see your GP. First up, you have to be able to get in to see a GP—that is the first issue. Once again, it is attacking the essential services of health, access to a GP, access to pathology testing and access to diagnostic imaging. All are fundamentally important when it comes to providing health. It is a fundamental right of all Australians to have access to good health care.

Now we learn that they go even further. They have not even stopped there. I do not know whether they throw in six steak knives with this, but this government has also been working on privatising Medicare payments. We always know that if they cannot dismantle Medicare in one action then they will go for the back door. They will keep trying, because they fundamentally do not believe in universal health care. They do not believe in Medicare—not one little bit.

We know that this government is renowned for saying one thing and doing something completely different. We recall that before the last federal election the mantra of Mr Abbott, his colleagues and those in this chamber was, 'There'll be no cuts to health, there'll be no changes to the pension and there'll be no cuts to education.' And we have seen that for the 2½ years of this government they have done nothing but cut, cut, cut when it comes to health in this country. We also know that, once again, the kids of Australia are being attacked. If it is not about child care, if it is not about cuts to education, now they are trying to kill off Labor's dental scheme for kids in this country.

These things are all very serious, but there is another danger lurking out there when it comes to the health system in this country. That is the deal that has been done behind closed doors with the Greens to change the electoral systems to elect senators to this place. After the next election, if the Australian community judges that they should return this government to government benches and we see the Senate controlled by this government, then there will be no-one who is able to stop the further cuts when it comes to health. There will be no-one, because they will have the numbers in this place and they will control it. I, for one, do not want to go back down that path. I was here under the Howard government when they had control of the Senate, and we saw them railroad through one piece of legislation after another.

Now at least we have a house of review here. When you have Independents, the Greens, the crossbenchers, the Labor Party and the Liberal government, you should be able to negotiate your legislation through this chamber. But what we have seen now is a rubber stamp for a government that is hell-bent on attacking Australians through the health system, through the pension and through education, wanting to put $100,000 degrees on the table for our young people going to university. This is what this government is truly about. But fundamentally, if you are going to make these changes to health and make these cuts, then the minister should be able to come into this chamber and justify and name the programs that the government is making these cuts to. The Australian community and this chamber deserve nothing less. At least be up-front. At least be honest.

If Mr Turnbull does get control of both houses of parliament after the next election, then the GST will increase, and that will mean that there will be a GST on everything. Last year we were able to—with the crossbench—put enough pressure on them, so they have put it in the bottom drawer. But that draw is still open, because if they win the next election they will march in here with control of the Senate and they will increase the GST and put it on everything. Every time you go to the doctor, every time you have a pathology test, every time you have diagnostic imaging, every time you go to the grocers and buy fresh fruit and vegetables, there will be a 15 per cent tax on that. That is what is in store for us.

Senator Seselja interjecting—

Senator McKenzie interjecting—

Those people who want to interject now—I love it when they interject, because they know it is the truth. We know that those on that side who purport to represent rural and regional Australia are city dwellers. They come in here and tell us falsehoods, and now they are trying to justify the cuts to health. All you have to do is look in the budget papers and you will see it in black and white. Mr Turnbull has added a further $2.1 billion worth of cuts to health in this country. That is the truth of the matter. The minister comes in here, as she did yesterday in question time, and totally and utterly misleads this chamber and denies that there have been any cuts, but the reality is that we have budget papers, and we on the side of the chamber have read them. Obviously, not even the Minister for Health and those who are representing the Minister for Health have bothered to read it, because they would see it in black and white, so it is not about whether or not you take my word for it.

I want to turn now to the effect of the budget cuts on the health system of my home state of Tasmania: $57 billion has been cut out of hospitals, started by Mr Abbott, when he was Prime Minister, and carried on by the current Prime Minister, Mr Turnbull. The repercussions of these cuts will be felt in every state and territory. With elective surgery lists growing and hospital beds and wards being closed, unacceptable waiting times for these services will get longer. We have already had the AMA come out with its concerns. The AMA is not a natural ally of ours, on this side of the chamber. Like the GPs who came out and rallied against the GP tax, now we have the AMA being quite up-front about the fact that these cuts are going to hurt ordinary, everyday Australians. That is the AMA.

The figures that were released yesterday also show that the Tasmanian health system will be worse off by $2.7 billion. That is the truth. The state of Tasmania has a Liberal government that has come out and pleaded with this federal government to put more money back into the health budget. The premier and the health minister in Tasmania have been calling on their federal colleagues to return the money. It is not a Labor state government saying that; it is a Liberal state government that have been saying it—and it is all over the media today, if you would care to go and check the Tasmanian papers—because they know that the impact of these cuts will be felt dramatically in Tasmania.

The senators on the other side always listen to me when I am talking about aged care and health—I am sure they do; they probably take notes—so I am sure they all understand that Tasmania has the fastest ageing population in this country. So these health cuts are going to have an enormous impact on my community, and I will not sit in this chamber and allow a minister to mislead and, quite frankly, lie to the Australian community about the cuts that are going to have a detrimental impact on them.

Let us look at an example. I would have thought that those opposite, particularly Senator Bushby, would be interested. I am sure he would have read the newspapers which reported that, in February in the Royal Hobart Hospital, a 95-year-old woman was left lying on the floor waiting for hours and hours to be seen by a doctor. Surely even those hard heads on that side of the chamber would acknowledge that a 95-year-old woman or any Australian should not be left lying on the floor in a hospital waiting to be seen. That is unacceptable for a nation that is as rich as we are. It is a shame on this government and it is a reflection on the state Liberal government of Tasmania, who have not been strong enough in standing up to this government.

But, then again, what would you expect from this Premier of Tasmania? Just yesterday the Premier of Tasmania said in a heated debate that the Leader of the Opposition should go and slit his wrist. That is the level of debate in this country that we see from the Liberals. They say one thing and do something completely different. A week after launching a campaign in relation to the increase in suicides, we had a premier, not a minister—

Zed Seselja (ACT, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy President, I rise on a point of order. I have resisted but the point of order is on relevance. I am not sure where Senator Polley is going now, but I do not think it is relevant to the debate, which was begun by Senator Wong.

Gavin Marshall (Victoria, Deputy-President) Share this | Link to this | Hansard source

Senator Polley, do you wish to speak to the point of order?

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

Yes. Quite frankly, I am very much relevant when it comes to health and the reputation of this government when it comes to funding and the pressure they are putting on a state government.

Gavin Marshall (Victoria, Deputy-President) Share this | Link to this | Hansard source

The motion before the chair is to take note of the response from the minister. It is difficult for me to determine total relevance when I do not actually have in front of me the original question that was asked, but I do understand that Senator Polley and other senators have been arguing to make a case on why the response was unsatisfactory and why the information was needed for these reasons. So I will let you continue on, Senator Polley, but I will remind senators that they do need to remain relevant to the question before the chair.

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

Thank you, Mr Deputy President. The point has been well made here in the chamber. They are interjecting over something that was said by the Premier of Tasmania, which was reported in the newspaper and which is relevant to the issue of health, the funding of health and the pressure that this government is putting on states when it keeps cutting the funding. A cut of $2.7 billion from the Tasmanian health budget over the next four years is an enormous amount of money—and it is unacceptable.

We need to ensure that pressure is kept on this government when it comes to the effect that their cuts are having. These are real effects. The impact of these cuts will affect people's decisions as to whether they choose to have their blood tests and whether they choose to have a CAT scan. Unlike those of us in this place, some people really do not have the money to spend on these extra costs.

David Bushby (Tasmania, Liberal Party) Share this | Link to this | Hansard source

The funding is going up every year.

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

I would have thought that Senator Bushby would have a better understanding of the Tasmanian community and the level of concern that is in that community when it comes to health cuts. If he cannot speak up in his own caucus to support his state colleagues, that is something that he will have to deal with. But, as I said before, I for one am not going to sit by and allow this government, without being challenged, to continue to cut health funding, because those cuts affect everyone in this country.

For a woman who has suspected breast cancer, the cost that she will have to meet upfront is $554. There are a lot of families across Tasmania and the rest of the Australian community who would not have that sort of money—and I am surprised that those on the government side who are in the chamber would not appreciate that. These are the real implications of the savage cuts the government is making when it comes to health in this country.

Government senators interjecting—

We can go on talking about the rest of the cuts. We can talk about your agenda for trying to dismantle Medicare. I am quite happy to talk about that day in, day out. Only last month we had before us motions on ovarian cancer, and a lot of people spoke and supported those motions. Before this year is out, 1,500 Australian women will have been diagnosed with ovarian cancer. There is no screening test and no method of prevention, and it is very hard to detect. So the last thing that we want is for women to not go and seek assistance if they have concerns.

We do not want women, men or children's health to be put at risk because they or their parents do not have a big enough credit card. We know those opposite are all about credit cards when it comes to health and education, but we on this side will never inflict on the Australian community the situation where the provision of health in this country is determined by the size of your credit card. We will not do it. We will not just stand by and let this happen. We will always bring to the public's attention the concerns that we have with the attacks on health. (Time expired)

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I note that we have some young people here with us who are visiting from school. I am not quite sure what school you are from, but you are paying great attention to the debate that is happening here, and I thought I might commence my remarks by explaining what is happening here. I used to be a teacher, and one of the things that teachers do from time to time is set homework. When you go away and you do your homework, you are responsible for returning it to your teacher and, in a way, what we are talking about is some homework that was set for the government. There is a budget and there is also a thing called MYEFO, which is the budget that happens at the end of each year; so we have the budget in May and then we have the MYEFO in December. In the lead-up to that MYEFO in December, the government made some decisions about more things that they were going to cut. We know that they got advice from very important people who advise the government—that is, the Department of Health—and we also know they got advice from the Department of Finance.

Bridget McKenzie (Victoria, National Party) Share this | Link to this | Hansard source

Mr Deputy President, I rise on a point of order. As we are conducting what seems to be a lesson in the Senate today, I would like it to be an accurate one. When we are speaking in this chamber, it is appropriate to actually speak to the chair of the chamber rather than to the gallery.

Gavin Marshall (Victoria, Deputy-President) Share this | Link to this | Hansard source

I am not sure there was actually a point of order. It will be a moot point any moment now, anyway.

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

Mr Deputy President, I rise on a point of order. I want it to be noted on the record that the good senator has chased away these school children, who were listening intently.

Gavin Marshall (Victoria, Deputy-President) Share this | Link to this | Hansard source

Alright. Thank you for your assistance, Senator McKenzie. There is no point of order. Senator O'Neill, you have the call.

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

Perhaps the students, on leaving the chamber, might decide that they want to have a look online where they can read what I say, because I am going to continue the lesson. Let me tell you that the lesson is not just for the students who were sitting in the chamber today; it is also for this shameful government, which is abrogating its responsibilities. Young people would understand about homework. There are only two reasons why you do not hand in your homework: you do not hand it in because you have not done it—and we know that is not the case because they did it. They actually made these cuts in the MYEFO, in the mid-year budget, so we know they did their homework. The reason that it is not on the record and the reason why the minister has not provided the answer is because their homework, for want of a better term—their answer to this question—is so bad that they do not want to put it in the light of public scrutiny. They do not want anybody to see it.

I am thinking back to what was going on in my life on 16 December, which was when this notice was given. I remember that 12 December was a big day in my family—my son turned 19 and, just a few days before, my grand-niece was born. It seems quite a long time ago. An awful lot has happened in the lives of most Australians between 16 December and now—people have paid bills, people have responded to inquiries, people have done their work. But this government are so arrogant that they do not think they should answer the questions that are put on the public record to let the Australian people see what they are doing.

What was the question that was asked? The question that was asked was from Senator Wong to the Minister representing the Minister for Health, as long ago as 16 December, with reference to the Mid-Year Economic Fiscal Outlook. A measure in it was identified—a title, if you want—that says: 'More efficient health programs'. The question was: 'Can the minister provide a list of the 24 health programs which will be cut to achieve $146 million worth of savings over four years?' The second part was: 'Can the minister provide a profile of the amount cut from each program over the forward estimates?'

Those opposite told us in black and white in the figures that they presented that there would be $146 million gone. They know it adds up to $146 million but they are refusing to tell the Australian Senate and, through refusing to tell the Australian Senate, they are refusing to tell the Australian people and we know why. What they have done to the health of this nation since they have got in is absolutely shameful. There has been $57 billion cut from health—$57 billion! This has a massive impact on our hospitals all around the country.

And what did the minister have to say when she did come to the chamber and in response to Senator Wong saying, 'Well, it has been three months. It might be time for an answer.' I think I got her words accurately. She said: 'The government is considering its response and will return an answer in due course.' That is, basically: 'We do not want you to know, and I would rather come down and be embarrassed and say: "I am hiding my homework because it is so bad. I would rather do that as a minister of the Crown than come in and tell you the truth about the savage cuts that they are going to take to these important programs in health".'

What are those programs? What do we know at this stage? The little bit of information that they had to leak out for their budget revelation in December is that they are cutting $40.4 million in 2014-15; $36.9 million in 2015-16; $36.9 in 2016-17 ;and $31.8. And they say they are going to achieve these savings by—and this is a carefully abused word, I think, in this context—'redesigning'. They say they are redesigning 24 health programs. They say they are going to make these programs operate more efficiently, including programs associated with four things; firstly, population health.

Population health is where we have investment in finding out about what is going on—epidemiology, figuring out what is going on in our community—but it is also where we have programs that help to keep people well. What are those opposite cutting? Are they cutting the colon programs? Are they cutting advertising about BreastScreen? What are they doing? What are they cutting in terms of population health? They do not want to answer the question.

If we really believe in keeping ourselves healthy as a nation we should be investing in preventative health and using population health data to make our country more healthy, not less healthy. But that is what they have cut.

They have also cut medical services but we do not know which ones because they will not tell us. They are also cutting e-health, electronic health. We know there is a massive transformation being undertaken around the country to try to get all of our records and details into electronic form, so that if you are travelling you can get your records. I know that many Australians who come to visit us here in the parliament travel around the country. If you become unwell when travelling and if your records are digitised, the person who looks after you when you are away from home has full access to your records. That is e-health. The government are cutting that.

They are also cutting their investment in health workforce. Whether they are directly cutting the health workforce or cutting the preparation and planning for an effective health workforce, we do not know because they will not answer a question, despite the fact that they made the announcements before Christmas. They know what they are cutting. They know right now, today, that they could bring that information forward and put it out publicly, but they are avoiding that scrutiny.

All of these things are vitally important. What we are seeing is a very significant problem and we are seeing it day after day with this government. They are determined to take away the health care of the people of this nation. They call it 'efficiency', but ordinary Australians call it something very different. We call it cuts to health. We call it cuts to access. We call it a deliberate attack by a Liberal-National coalition on Medicare in many, many circumstances. We have seen the cuts of $146 million over four years as the 'more efficient health program'. We have seen them call another program of cuts to the tune of $141 million over four years as 'mental health streamlining'.

I know that people here in the chamber and people who might be listening to this see many, many images of their local members—and they are particularly numerous at the moment as the Liberal-National Party are in government—crying crocodile tears all around the country and bleating about how much they care about mental heath, how much they care about mental health in the bush, how much they care about mental health for men, how much they care about mental health for women. But they have cut $141 million from mental health and they call it 'streamlining'.

Jenny McAllister (NSW, Australian Labor Party) Share this | Link to this | Hansard source

Because there is no money.

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

There is no money because they have actually spent money on absolutely the wrong things. They have ripped money hand over fist out of health. They cannot help themselves. Many people would be well and truly aware of the incredible impact that the changes that this government have been pushing for in diagnostic imaging and pathology services are having on the community. People are scared to death—and perhaps that is not too much of a stretch. They are scared because of the growing cost of getting the basic services that they need to look after their bodies.

We know that people with chronic illness or people who need tests for cancer or breast screening, or tests on a regular basis to manage their diabetes or their mental illness in this new 'streamlined' world that we are hearing about from this government are incredibly anxious. In the last couple of weeks, I have had almost 2,000 emails from people saying, 'Please stop this government from attacking the bulk-billing incentive in pathology labs.'

I want to put on the record the fact there is a very different view between the Liberal-National Party and the Labor Party about people getting access to essential services, particularly essential health services. As a senator for New South Wales with my office in the seat of Robertson, I was very pleased, along with two Labor candidates—Anne Charleton, Labor's candidate for the seat of Robertson, and Emma McBride, our candidate for the seat of Dobell—to welcome Mr Shorten to the Central Coast. When Mr Shorten arrived, we did a tour of the pathology lab in Gosford, which is about an hour and a half north of Sydney.

This pathology lab provides an opportunity for real-time testing of samples so that the hospital next door can get the pathology results and do the operation and respond appropriately in real time. That can only happen because that pathology lab is active and working on the Central Coast right near the hospital. It is a small region with only about 350,000 people. It is a great region, nonetheless it is a regional centre. Over 1,500 pieces of pathology action are taken every single day at that lab for our direct and local community. It employs eight to 10 people on a regular basis with great jobs.

Mr Shorten said, 'What the bulk-billing incentive does is provide just enough money which allows the pathology centres to be able to let people be bulk-billed for vital tests, including diagnosis and treatment of diabetes and other chronic diseases. It is about providing bulk-billing for patients who need cancer treatment for leukaemia.'

When we were in the lab that day, I saw a blood sample of a local young person who has acute lymphatic leukaemia. We looked down the microscope and we saw it. That diagnosis is absolutely essential. When I looked at the sample, I could not tell if that blood came from a rich person, a poor person, a black person or a white person; it was just blood cells—blood cells that needed analysis and blood cells that are being analysed in a fair and equitable way under the current system. But that system is under incredible pressure and is just about to be pulled away.

I was very well informed by Dr Stephen Fairy, a representative from Sonic Healthcare. He explained about the way the government are currently using statistics around diabetes testing, which really misrepresent what is going on. The scale of diabetes in our community is not registering on the Medicare items that are related to diabetes. That is because there is a thing called 'coning' in Medicare that prevents overuse of the system. When our doctors order a full blood count and we go off and have our blood taken, the top three items will be charged but not the following parts of the doctor's order. So many of the items at the bottom, including the diabetes testing, which costs about $10 per item, are actually done for free as part of a job lot, every time somebody gets a full blood count done that has more than three items. So there is no fat in the system. This is what Mr Ferry had to say: 'Pathology is so critical that without pathology medical practice would be almost impossible. Laboratories like the one we have seen today perform thousands of tests every day, providing results to doctors and hospitals that allow them to diagnose and treat patients with a variety of medical conditions, including cancer and chronic diseases like diabetes.'

We are fortunate in Australia because our pathology laboratories are among the best in the world in terms of quality, safety and efficiency. What is more, 98 per cent of all pathology services provided outside of hospitals are currently bulk-billed. If the proposed fee cuts come into effect, that will change. The Medicare fees that allow pathology companies to bulk-bill are absolutely vital. The pathology industry has absorbed fee cuts for many, many years, but now with intense cost pressures that is no longer possible. Many of our laboratories are financially stressed. Mr Ferry said—and I think about what this means for the people I live and work with—that if that laboratory goes from the Central Coast, the people who are in having operations will no longer be able to get real-time analysis. If somebody has an operation where they might have their lung being checked and the doctor is able to get an analysis and do a treatment straightaway for some sort of cancer, there is only one operation involved. But this government knows better. They believe that it is okay to put a barrier between people and the health-seeking behaviours that they have been encouraged to undertake. Labor has built a culture in this country that it is good to prevent ill health, that it is great to seek assistance, that it is a good thing to go and get your blood checked, to manage your diabetes, to manage your mental illness, to keep your medication levels right. Labor believes that, and we made sure that funding was in place to ensure the best possible health outcomes for people.

I am really concerned about with the failure of this government to answer this important question. I have described some of the things that we know this government are doing. What they are hiding is more that they do not want us to see, that they are refusing to give us an answer on. There is this culture of silence. It seems to be endemic in the Liberal-National Party. I said yesterday when I spoke on a matter related to this that, in the great state of New South Wales, under the leadership of Premier Baird, we have two very different views about fighting for fairness for the state between two ministers. We have an education minister, Minister Piccoli, who has actually been able to stand up to this federal government and say, 'Give us the money that you took out of education. Give us your 5 and 6 of the Gonski funding. Don't leave us without the money. Give it to New South Wales.' He is fighting for it. In contrast, the health minister for New South Wales, Minister Skinner, has gone AWOL—absolutely missing in action. We cannot find her on the record, at all, saying anything to the federal government about the cuts that have been inflicted on the state of New South Wales. Let me tell you: it is the worst of the whole country. If we break it down, using the best evidence that we have from the Parliamentary Budget Office, we see that $17.7 billion has been ripped out of New South Wales, with barely a word of complaint from the minister for health in New South Wales. Indeed, on every occasion when she has been invited to come and put the case for New South Wales on the public record, to help us get the information to stand up for the people of New South Wales in this parliament, she has been missing in action. I repeat my invitation for the minister to come and give evidence to Senate Select Committee on Health and put on the record just how much Tony Abbott, Malcolm Turnbull, Joe Hockey and Scott Morrison have decided to take away from the great state of New South Wales and the health budget that we are entitled to.

In Queensland $10.8 billion has gone, in the Australian Capital Territory it is $1.7 billion and in Victoria it is $13.5 billion. In Victoria, where we did have the health ministry come and speak to us, we have had it put on the record and it is in The Age, where it says, 'federal funding cuts to Victoria's health system over the next decade equate to closing down two major institutions.' That is what the Victorians put on the record: a massive cut to their budget. In Tasmania it is $1.2 billion, in South Australia it is $4.2 billion, in the Northern Territory it is $0.8 billion, and in Western Australia it is $6.5 billion. These are the real cuts and they are written into the budget. This government actually put those numbers in the budget, but they continue to deny that they have cut funding from health. And that is why it is of great concern that this minister has chosen not to bring in her homework and not to show the tardy and disgraceful piece of work that she has been complicit in, in taking away more and more health services from the people of Australia.

Question agreed to.