Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

When the story of this government comes to be written, and when we look back on how it unravelled so quickly and in such spectacular fashion, the budget whose appropriation bills we are debating today will feature very heavily. Because the budget represented such a fundamental betrayal of this government's commitments to voters, it immediately poisoned any goodwill it might have expected from the electorate and set the course for the debacle that we now witness on the government benches.

'No cuts to education, no cuts to health, no changes to pensions, no changes to the GST and no cuts to the ABC or SBS'—we all heard the Prime Minister pledge the night before the election that that is what he would deliver. But, instead of a policy platform, we soon learnt that this in fact was the Prime Minister's platform of platitudes; a shopping list of all the promises he planned to break. Nowhere has that deceit been greater than in the one area that matters most to Australians: our healthcare system. 'No cuts to health and no new taxes'—it barely survived the first 100 days before the cuts to hospitals commenced in the mid-year review and the government started softening us up for its GP tax.

It is worth documenting again in this debate just how widespread the government's cuts in health policy have been, across every single element of health policy. Fifty seven billion dollars has been cut from public hospitals. They tried to cut $3.5 billion out of primary care and we are in the middle of a fierce debate about that today. They shut all 61 Medicare Locals, to transition to Primary Health Networks, at a cost of some $200 million already. There is their $5 hike in the price of every prescription, and they have made it harder to reach the PBS safety net—$1.3 billion cut out of the pockets of people trying to access medicines. That measure is still blocked by Labor in the Senate. They are cutting $368 million out of preventative health programs, which states were relying on to tackle obesity and reduce smoking and alcohol use. They have cut more than $650 million out of dental funding, including $229 million out of dental clinics and $391 million from adult public dental programs, which will see public dental waiting lists blow out—$200 million has been cut this financial year, a decision that will restrict access and blow out dental waiting times. They have cut $3 million from the National Tobacco Campaign, $54 million from the Partners in Recovery Campaign and abolished Health Workforce Australia, which included a cut of $142 million in funding which sees the Commonwealth with little or no role in planning and resourcing Australia's future health workforce. And, of course, they have cut $264 million of priority health initiatives, things like Westmead Hospital; Millennium institute at Westmead, Children's Medical Research Institute, Nepean Hospital, St George Hospital, the MRI at Mt Druitt, Queensland Cancer Package, Biala health service, Flinders neonatal unit, the WA cancer team and stroke coordinators across the country—that is how extensive this government's cuts to health have been.

It was not until the budget, which we are now debating here again today, that the full extent of that deceit became apparent. It was a budget that destroyed the electorate's trust of the government, a budget the government had no mandate for and a budget which all the evidence shows will be bad for health, bad for patients, bad for doctors and bad for the budget. None of this, understanding what it was going to do to the healthcare system, has caused the Prime Minister to abandon his GP tax. The health experts have all been telling him what a disaster this policy actually is. We think we will know today, we think, what they are planning to do with the GP tax when the Minister for Health makes her press statement at 1.30.

It has not been the patients and doctors deluging the government with petitions and warnings about what a disaster this plan is. We have had 10 months of a government with no health policy at all, at war with doctors and at war with patients. Patients are already starting to be charged different fees within doctor's surgeries. It has not been the state governments telling him how this plan would deluge our emergency departments with patients and destroy the public hospital system. It has only been when his own party has moved against him that the Prime Minister has had to throw everything overboard to keep his own leadership afloat. And finally—we think, finally, today—he claims to be junking his GP tax. Well, let us see. There are $2 billion of cuts to primary care, to general practice, are still sitting on the table.

If he dumps the $5 GP co-payment—the GP tax—today that is one element. There are still $1.3 billion of cuts on the table to primary care that will be passed on to every single patient trying to see a general practitioner. Let us see how meaningful their actual changes are. He is not doing it for the health of patients; he is doing it for the health of his numbers in the party room, to try to stave off another challenge. It is also important to note, maybe when that challenge comes, that this was not about the Prime Minister's health budget, because as the finance minister has assured us just last month, not a single member of cabinet ever raised any concerns about how deeply unfair this budget is—not the Prime Minister, not the Treasurer and certainly not the communications minister or the foreign minister.

We know on this occasion, at least, he is telling us the truth, because in June last year the member for Wentworth was asked by Ben Fordham, 'Do you support the $7 GP co-payment aimed at reducing doctor visits and improving the bottom line?' The member for Wentworth's answer was unequivocal: 'I certainly do support it. I support all of the budget.' Of course such candour has not always been a feature of this government's health policies. When news broke during the Griffith by-election, for example, in January last year when asked about whether the government was in fact considering a GP tax at all, the foreign minister said that there was no plan for co-payments and the GP tax was just Labor's scaremongering. She said any suggestion was nonsense that Labor had mischievously and dishonestly attributed to the government.

So, here we are, some 10 months later, with several iterations—I think we are up to our third GP tax. The Prime Minister asked us to support a $7 GP tax, then a GP tax that would have seen $20 extra added to patient visits to doctors. We then had the $5 GP tax and the four-year freeze on indexation, which potentially will see patients being forced to pay for some consultations up to $100 up-front before they even get in the door of the doctor's surgery. We have had that many iterations of this GP tax—and this was the GP tax that the foreign minister, at the time of the Griffith by-election, said was Labor's scaremongering.

So while Liberal MPs squabble over who should be their next leader, the sad truth for Australia is that regardless of whoever eventually comes out on top nothing will change. It does not matter. They all support the destruction of Medicare. They have all got their hands dirty with trying to see our universal health insurance scheme destroyed in this country, because the truth is they have never believed in fairness, just like they have never believed in Medicare. They have all endorsed this budget, and at the heart of this budget is a proposal to destroy something Australians hold very dear and that has provided Australia with some of the best health outcomes in the OECD. It is a proposal to end universal access to health care and to make the treatment you receive dependent not on the basis of need but on the basis of your ability to pay. It is a proposal to end bulk-billing and to make bulk-billing only available to concessional patients and nobody else. This fails to recognise that there are many patients who are not eligible for concession cards, such as self-funded retirees on a fixed income, a very small fixed income, whose healthcare needs are increasing and who will have to pay more to go and see the doctor; and people who have chronic conditions, who are struggling—the working poor—to continue to be able to work but who need access primary care to do that.

This government will see a collapse in bulk-billing rates. When we left office they were at 82.3 per cent. We know that the last time they were really low was when this Prime Minister was health minister, when they sat at around 60 per cent. Because we ran a very successful campaign to try to get bulk-billing rates lifted, they had to come in and do something, and we are reaping the rewards of that today. Bulk-billing also is good for the health budget because it keeps GP fees low and it makes sure that general practice continues to be accessible. We already have a problem with bulk-billing not being accessible across the country.

In different parts of the country, it is very difficult to access a bulk-billing doctor at all. Often it is those areas where people are the most vulnerable and are on the lowest incomes, or they are in areas where there are massive GP shortages. Out in some of the mining communities, people already have to pay substantial amounts of money to access general practice. Instead of dealing with these issues, trying to look at how to deal with the spread of general practice, how to make sure people are accessing primary care in a better way, how to make sure people get a good experience and a quality experience out of general practice and how to support doctors, this government has been at war with them for the past 18 months, and health policy has suffered as a result. That is what is at the heart of this government's budget when it comes to health—the end of universal access to health care and making the treatment you receive dependent not on the basis of your health care need but on the basis of your ability to pay. That is a proposal which all of the evidence shows is based on an entirely false premise—that somehow Medicare, the MBS, are unsustainable and must be denied to as many people as possible.

Just last month, again this dishonesty was shown by the government's own Department of Health. In a damning admission to the Senate Select Committee on Health, senior officials from the department admitted they were 'unaware of any substantive work in Australia specifically about the impact of something like the Medicare co-payment and reduction in rebate'. We know that the reason they did not do any 'substantive research' was that it would have told them that the GP tax was built on a lie.

As the Productivity Commission confirmed, Commonwealth spending on health is at the lowest level since the commission began compiling its statistics. The report found that, in 2012-13, the Commonwealth's share of total health expenditure actually fell, and spending on the target of the GP tax—primary health care—has been effectively unchanged for a decade. But, at the same time, the report reveals 4.9 per cent of Australians are deferring visits to a GP and 7.6 per cent are missing prescriptions because of out-of-pocket costs, figures that will only worsen as a result of this deeply unfair budget. So the GP tax, and indeed the entire health budget, is built on a lie, a lie the entire cabinet has been complicit in. As the finance minister assures us, not one single member of cabinet has ever argued this deeply regressive attack on the sick is unfair, and, as the member for Wentworth has assured us, it is policy that has his full support.

The health minister might have changed, and the Prime Minister may soon change, but one thing we can be absolutely certain will not change is this government's deep antipathy toward Medicare. Two health ministers have now publicly committed to the GP tax. Let's see what they do in just under an hour's time. What sort of health minister decides, in the face of all the evidence from the experts and professionals alike, that a price signal is the most important thing to pursue in health policy? What sort of health minister thinks that a price signal is good health policy? Where are you talking about the importance of quality general practice? It is a Liberal minister that thinks that that is the best thing you can do. Now, and only now, when the Prime Minister's job is on life support, does this commitment to the GP tax change. The names on the door may change, but nothing, it seems, changes the Liberal Party's determination to end bulk-billing and to destroy Medicare.

Labor do not regard health as set in cement, where nothing can ever change. We of course made significant savings when we were in government. Private health insurance rebate means-testing was a very difficult thing to do—something this government says it is going to reverse. I am interested in where they are going to find the $600-plus million that is required to do that. There were the Pharmaceutical Benefits Scheme changes. Again, a very fierce campaign was run by community pharmacy against those changes to the agreement with Medicines Australia, but those changes have meant that we have realised savings in the PBS which will allow the listing of new and improved medicines—a very important change. Again, that is something that this government, in opposition, used as a campaigning opportunity.

I am going to listen very carefully to what the minister has to say shortly. But be in no doubt that, with these bills, what they have done in the totality of health has been a fundamental attack on our Medicare system and a fundamental attack on patients and doctors in this country, and they should be ashamed of themselves for it.

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