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

Pursuant to standing order 74(5), I seek an explanation from the Minister representing the Minister for Health and Aged Care, Senator Gallagher, as to why the following questions on notice remain unanswered: SQ23-001600, SQ23-001607 and SQ23-001606.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I'm able to update Senator Ruston on those matters. I understand that those three questions are still with the department and have not been received by the minister's office at this stage. They are being chased. On all the other matters, answers that I think were outlined to my office earlier have been tabled and emailed to Senator Ruston's office. Senator Ruston didn't refer to those, but a number have come through today.

Our government have received 2,573 parliamentary questions on notice in the Senate and has answered 97.5 per cent of them. We've also received 19,000 estimates questions on notice and have answered 93 per cent of them, with all answers submitted from October 2022 and all but one from February. Parliamentary questions on notice have increased from an average of less than 1,000 per year from 2016 to 2020 to 2,200 in the first year of the Albanese government. Senate estimates questions on notice have increased from 11,700 in 2017 to 2019 to more than 18,000 in the first year of the Albanese government. The Morrison government had nearly 1,000 unanswered questions on notice when it left government, some dating back to October 2019, and many Morrison government ministers returned answers from the previous round of estimates while the next round was underway.

In short, we are doing everything we can to answer the questions that senators have asked, but departments essentially have been inundated with questions and are working through them. I think those statistics, particularly the fact that we've answered 97.5 per cent of parliamentary questions and 93 per cent of all estimates questions—19,000 of them—shows how seriously we take the issue of transparency and accountability to the parliament.

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

I move:

That the Senate take note of the explanation provided by Senator Gallagher.

Once again, we have a government who continue to keep throwing back to times past about things that have happened in the past instead of actually facing up to the fact that it is they who are in government now. It is they—the Albanese Labor government—who have not been providing the answers to the questions. Interestingly, too, whenever you look at the questions that remain unanswered, they always seem to have a particular focus on areas that the government clearly doesn't want any transparency or accountability around.

Before I go into some of those issues around transparency and accountability for the areas that I think are tremendously important and that they're failing to provide information on, I would point out that, over the last few days—and I mean a few days—we have seen hundreds of answers to questions on health and aged care for which we have been asking for a long period of time. Lo and behold, when we start making threats about coming into this place and demanding an explanation about why questions haven't been answered, these questions arrive en masse. More than the three questions that I actually cited in my request for an explanation from the minister were actually outstanding before question time started. Just in the last hour, the government has answered questions in relation to a very, very important insulin drug called Fiasp. They've answered questions in relation to 60-day dispensing. They've answered questions in relation to Medicare and general practitioners. Interestingly, it is only when we, as an opposition, seek to have some accountability and transparency from those opposite that they actually come through and provide the answers to questions. But they still haven't provided answers to questions that, really importantly, focus on mental health and the mental health policies of this government, which have been an absolute retrograde step in terms of the support that Australians are receiving for their mental health.

It's quite interesting. A government that was elected on the platform of transparency is quite happily hiding behind the fact that it's not going to answer questions and then comes in here and starts complaining about the numbers of questions being asked by the opposition. Well, do you know what? We probably wouldn't have to ask so many questions if you just answered the questions that were put to you in the first place. We still have hundreds of questions that remain unanswered. As I've said, today we've seen an increase in the number of those questions answered in the Health and Aged Care portfolio area, but they still have failed to answer questions on the very important issue of mental health. It also flies in the face of the transparency role that this parliament and this chamber particularly have to perform in making sure that we have scrutiny. If you don't answer the questions, it's really very hard for anything to be scrutinised.

As I said, there are still three really important questions on notice in relation to mental health that remain unanswered. During the COVID pandemic, we saw a significant increase in the number of challenges that Australians were facing around their mental health. That was why we put in place the additional sessions, increasing them from 10 to 20 Medicare subsidised sessions for people suffering from mild to severe mental health conditions. The first act of the new Minister for Health and Aged Care was to slash those sessions in half. That's despite the fact that just about every agency that looks after the mental health of Australians had been saying for months and months beforehand that, now that we'd gotten through the worst of COVID, the biggest challenge affecting Australians' mental health was cost-of-living pressures. They were seeing an ever-increasing number of people presenting with mental health challenges and, at the very same time, this government chose to cut mental health sessions.

The three questions that remain unanswered relate to things like the minister having called a mental health forum in January 2023 to engage stakeholders about the ways in which the government could develop new policy to support Australians who were struggling with the mental health challenges that were confronting them at the time. We asked questions around what was discussed at that round table, who was invited, what the outcomes were and the process by which those outcomes were going to be delivered.

To the best of my knowledge, and in discussion with stakeholders, which is something that we do in opposition—we actually engage stakeholders; we don't just hide behind the department and refuse to speak to people—to date, some nine months later, not one outcome has been delivered as a result of that round table. There has not been one change when it comes to supporting people with mental health issues, despite this really cruel cut in the number of sessions people are able to access. And we have not seen the promises that this minister made at the time about coming forward with a new mental health policy that he believed was going to be better than the better-access policy that was put in place by the previous coalition government—one that was providing Australians with the extra supports they needed to make sure they were dealing with the mental health challenges that were being forced upon them by the extraordinary cost-of-living pressures we currently see.

I can assure you that the cost-of-living pressures Australians are facing are only getting worse. Every day we see greater stress on mortgages, greater stress on energy bills, greater stress when people go to the supermarket to buy your groceries and greater stress when it comes to just getting access to general health care. We're seeing a reduced number of people being able to access bulk billing. We know it continues to plummet under this government. The combined effect of this stress is that people are seeking help for their mental health way more than they have been previously.

So, once again we are talking today about the fact that this government doesn't want to come into this place and provide answers in relation to really serious issues. The questions have been asked, and all they're happy to say is, 'Well, the previous government asked a whole heap of questions, and we've answered a certain percentage of them.' Well, you may have answered a certain percentage of them in the last few days or in the last hour, but you haven't answered the questions that I think are tremendously important to Australians.

Another one of the questions that remains unanswered is around the details around consultation. The one thing that I think you could say epitomises this government is their absolute lack of preparedness to consult on issues. You cannot possibly get a good outcome in relation to policy development if you don't speak to the people who are going to be impacted by those decisions. Another one of the questions that remains unanswered in terms of mental health is: who is the minister consulting with in relation to making sure the decisions that are made, the policies that are developed, are actually the right policies? Well, I suppose you don't have to consult if you're not actually going to make any changes.

We also sought to find out from the government what they were putting in place for support outside of the clinical response. Where is the funding to support the clinical response? But also, what is the support funding that's going in place to support Australians outside of that clinical response? Often the clinical response is the thing that is dealt with best out of all of the things people go through when they're being challenged in terms of their health—making sure there are things in place to support them through their journey of recovery, because mental health can often be quite seriously impacted as a result of the challenges—the questions around funding for headspace, an amazing program that's helped so many young Australians deal with mental health.

The minister can come in here and make all the comments she likes about percentages and the like, but what about the answers to the Australians who are currently suffering from mental health challenges who have had their supports slashed by this government? They had promises of a new policy to be put in place and, as we stand here today, on 11 September, some nine months after the minister promised a result, we have seen absolutely nothing. As I said, just in the last hour we've seen answers to questions in relation to some pretty serious issues. But the reality is that even in those answers we haven't really received any answers.

I'll refer to something really important. Six months ago the government made an announcement—once again without any consultation with anybody—about speaking to the 15,000 Australians who live with type 1 diabetes and who rely on a drug called Fiasp, that they were going to, in effect, remove that drug from the market. They didn't speak to them, so, once again, there was no consultation. They made a decision that in a matter of days they were going to cut this life-changing, life-saving drug away from people who had been relying on it. Thanks to the huge advocacy for Diabetes Australia and Juvenile Diabetes Australia from so many people who came out and said to the government it was completely outrageous to rip the support mechanism out from underneath those 15,000 people. Combined with the coalition's advocacy and demands, we managed to get the government to agree to a six-month extension for those people who were on Fiasp to be able to maintain their prescriptions until 1 October 2023. It's 11 September today, so Fiasp will no longer be available for Australians in 20 days' time, unless the government changes that decision and allows Fiasp to remain on the PBS.

We know that this minister is very good at leaving everything to the last minute. But what I would say is please, please, please make the decision to continue to make it available to those 15,000 people who rely on it because you are taking away a life-changing, life-saving choice for Australians who live with type 1 diabetes. It's a completely unacceptable level of uncertainty. If the minister was going to make a decision, you would have thought he would have made one by now. In fact, he has to make a decision. He has to either make a decision that it will continue to be made available or he has to make a decision that is not going to continue to be made available. The minister has within his power the ministerial discretion to continue to list this particular drug on the PBS. Don't let anybody kid you, there's absolutely a pathway to enable 15,000 Australians who rely on this drug to continue to get it. Yet here we are 20 days before it's due to expire and the minister has not provided any certainty whatsoever to those people, which I think is absolutely disgraceful.

The minister has also refused to answer questions in relation to 60-day dispensing. As I've said 100 times, the coalition supports cheaper access to medicines for Australians and we support 60-day dispensing. But what we don't support is this absolutely bungled and botched way that this government have sought to implement this policy, claiming that they are delivering cost-of-living relief for Australians, when really all they're doing is making pharmacies, your community pharmacy, pay for that cost-of-living measure and, in the process of doing so, are probably forcing the most vulnerable in our communities into a situation where they will actually be worse off—not better off but worse off. We know that for those people who are vulnerable, those with chronic conditions, those in aged-care facilities, those who are older and have many medications, those who are poorer, those more likely to be relying on medications, this 60-day dispensing policy will most likely make them worse off, not better off.

We asked a whole heap of questions so we could provide information to Australians, to make sure that they had the information that they needed to understand what the implications of this policy were likely to be on them. But, no, the government aren't going to worry about providing that information. Apparently Australians don't need to know about what the policy is going to deliver.

The other thing we asked about was the modelling. This government came forward with a policy that was, once again, not consulted; they didn't consider the consequences. There was no consultation but there was also no modelling. The government admitted they put a policy out into the marketplace and had done no modelling on the flow-on consequences of this decision. We have sought for that information to be made available. We know that the government has subsequently, behind closed doors, gone and issued a tender for that information to be made available. Why on earth wasn't that done before the decision was made to put this policy in place? So once again those opposite just don't want to provide the details, because this government are all about headline. They have no regard and no concern for the transparency around the consequences of their actions, the details of their actions, because it is always the devil that's in the detail. Invariably, in that search for a great big headline, the search to try and deliver on a election commitment that had not been considered, we see that everyday Australians pay the price for this government's lack of transparency, lack of consideration of the consequences, lack of consultation and lack of modelling. Once again, here is a government that went to the election and said it was going to be transparent. But the day they were elected they shut the blinds down! No more transparency: 'We're not going to answer questions, we're not going to tell you what the consequences are. We're just going to go out there and shove something in your face. We're not going to speak to the people who are impacted by the decisions, we're just going to tell you what we want.' This is a government that's all about headline and has no regard for delivery.

Ross Cadell (NSW, National Party) Share this | Link to this | Hansard source

On this point, it's exactly what my good friend Senator Anne Ruston said: if you went into an election promising to be more accountable, more open and more careful about what you do, this is not what you do—stand up and deliver answers at the very last minute only on compulsion. You don't have to be forced to do the right thing in this world.

If we want to talk about transparency and accountability: when I was growing up my parents always said, 'Don't use words you don't know the meaning of,' and it is clear that this government do not know the meaning of this word. If they were being transparent with the public, with the people of Australia, in the lead-up to the election, they would have said: 'Our policy is don't consult, don't explain, don't think about what people are doing out there and don't care about the results. That's what we're doing.'

We've heard about 60-day pharmacy and what's happening out in regional and remote Australia—to people in my part of the world, the people in rural and remote New South Wales, which I represent. What is happening is that someone sat down in a Labor Party think tank and said, 'We need to make pharmacy cheaper.' What a great idea! We've seen the problem, and everyone admits it—Senator Ruston said we all want to make pharmacy cheaper. They asked, 'How long do we want to spend on this?' The first idea that came up was to double prescription rates: 'A great idea, let's model it. No, let's not model it, we haven't got time.' This is what's happening. We're trying to get the answer to these questions about the process, but that's what it looks like from the outside.

What is the consequence? In the other place and in here, pharmacists whose businesses will close and whose pharmacies will become unviable. We're not talking about affordability of medicines, we're talking about access to them. We're talking about entire communities that don't have a doctor but who might have had a pharmacy, and that's going to go. We want to understand why, so we asked the question. That's so we can sit down and so Senator Ruston and the opposition can come here and say, 'Here's another idea.' But do you know what weak-minded people do? They have an idea and they don't vary it: 'I have the solution, I know everything and I know the way to go.' This is what's happening here We are not entitled to the answers and the Australian public are not entitled to the answers.

There may be a better way to do it. There may be a way to give cheaper medicine to the people of Australia and not shut down the pharmacies across rural and remote Australia. But they can't give the information and they didn't even have the modelling. They didn't even think about seeing what the consequences were, 'Because we are right.' That's what was thought across the road there; that's what was thought in government. They have probably moved on to the next thing: 'Let's have a referendum and we won't tell people what we really want; we'll just tell them it will be a lovely question and a lovely gesture. We'll come into the chamber and change superannuation—it will just be a modest change.'

Government is a serious business and affects everyone here. If you can't get your governance right, and the way you handle information and the way you deal with decisions and maintain accountability right, then you can't get government right. I've sat in here and I've stood and spoken about getting our governance right—for both sides. There is no political party without sin when it comes to governance in this joint. But it is an opportunity for us to get it better, to respect the Senate and respect the processes. You don't have to hide information if you're not scared by what is behind it. And something is crook in Tobruk; something is wrong here if they're not prepared to answer simple questions about process. And if they aren't in question time, I'm sure people will go into that—to talk about what time they met someone, if they met someone or if they had a conversation about these things.

This is a government that came in with a lot of ideas and no idea of how to execute them. It's like someone jumping into the driver's seat for the first time and thinking they're going down the road but hitting every second thing and saying, 'Oh, you might have done that,' or, 'That's a problem because there wasn't enough fuel in the car and the tyres weren't inflated when I took over'—all of these things. If you want to be in the driver's seat, you've got to take responsibility.

So when these questions are asked, when we're talking about the people on diabetes medication who are managing their health and their plans—life and death—do they deserve more than 20 days notice? Do they deserve more than 20 days of information to make plans? I and most on this side would think that, yes, you do deserve more than 20 days to make plans about your lifestyle. But here we go: 'We're in the last four days of this sitting period before we have a five-week break from sitting, so let's drop it out now. Don't give any real scrutiny.' I'm surprised, I've got to say, Senator Ruston, that they gave us four days. This was going to be a Thursday thing, in my book: 'Let's put it out on a Thursday. That's always a good day. It's the last day we'll be here.'

So we get 97 per cent of questions answered. That's fine, but those answers are coming at the very last minute, when there's little work that can be done on the information and there are real consequences to what we can do. We're seeing it right across this on so many points. But what we really want to do is come back to that governance question: if you have nothing to hide, give the answers. If the health minister is proud of this situation and confident that he went through the right processes, if they are feeling this is the right thing to do, don't hold back till the last minute. Don't be fearful that Senator Ruston is going to stand up and give you a good grilling here. As mean as she can be, she wants to put the Australian people first. She wants information that allows better decisions. She wants some clarity going forward so that people aren't sitting 20 days out, wondering what drug they're going to get next month and what effects it will have on their life.

There are questions about mental health still outstanding. Is there anything more important to people now, in respect of health, when we have such economic uncertainty? We have real wages getting lower, the cost of mortgages going up and the cost of energy going up—all of these things. We're not getting answers to questions around the mental health provisions being put in place for these people, and there are stresses. Everyone suffers with mental health, but so many people in my area, the Hunter region, particularly the men—the blokes—don't want to talk about it or address it, because they're tough. Too many times, that ends in horrible circumstances. There have been incidents of self-harm, family breakdown and DV because of this. There's more than one victim. We're asking a few questions on mental health, and I think Senator Ruston said that the answers are still outstanding.

As we move forward and look at a governance procedure to improve government, can we just ask that when these questions are asked that they're answered at a time where we can do things to make a better Australia? I can't think of anyone here, individually, that doesn't want a better Australia but, collectively, we suck at it. We get behind our little banners and wave our little flags, and we don't make decisions in the best interests of the country. We sit over there and talk about our team and your team and who said this or that. Put the information out there. If the information is in the public interest, we will always make better decisions. Let's get the rest of these questions—93 per cent, 97 per cent or 90 per cent, I don't care what. Let's get to 100 per cent. Let's get them on time. Let's enable a proper conversation so we can see why things were done. Let's start a conversation across the chamber and out there in the world. Let's talk to stakeholders more—all of these things—so that we can say that we do consult and we do care about the results, because that's what we need to make this country better.

Question agreed to.