House debates

Wednesday, 25 March 2015

Bills

Private Health Insurance Amendment Bill (No. 2) 2014; Second Reading

12:39 pm

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

It is a pleasure to continue in this debate on the Private Health Insurance Amendment Bill (No. 2) 2014. As I was saying when I was last speaking, it is abundantly clear that a single organisation trying to cover all of the bases with fewer resources cannot be as effective a voice as an organisation solely dedicated to looking after the rights of health insurance fund members, because, quite unlike this government, the Private Health Insurance Ombudsman exists to protect the interests of Australia's private health insurance consumers.

Specifically, the Private Health Insurance Ombudsman assists health fund members to resolve disputes through an independent complaints-handling mechanism; identifies underlying problems in the practices of private health funds, or health care providers, in relation to the administration of private health insurance; provides advice to government and industry about issues affecting consumers in relation to private health insurance; and provides advice and recommendations to government and industry about private health insurance, specifically the performance of the sector and the nature of complaints. It is not as if the services of the Private Health Insurance Ombudsman have not been in demand, or that they have been ineffective or unable to deliver for consumers. With only 12 full-time-equivalent staff, the Private Health Insurance Ombudsman has handled 3,427 complaints in the 2013-14 year. That is around 65 complaints every week and it is growing. This represents a significant 16 per cent increase on the previous year, up from 2,955. Complaints made, no doubt, in part because of the former minister's decision to wave through the biggest average premium increase in a decade. One can only wonder how many more complaints will be generated by his successor, matching that with the near identical decade-high increase last month. I will come back to that shortly.

The increase in overall complaint numbers flowed through into the number of higher level or serious complaints requiring investigation by the Ombudsman. In 2013-14 the Ombudsman received 580 higher-level complaints, which represented a 28 per cent increase on the 450 received in the previous year. The Private Health Insurance Ombudsman also reported a 45 per cent increase on a number of unique visits to privatehealth.gov.au, a resource consumers can use to compare policies and obtain information about private health insurance products. Despite the strong growth in traffic to the web site and strong growth in complaints, the dedicated Private Health Insurance Ombudsman was able to report an increase in the level of consumer satisfaction, with 85 per cent of those surveyed reporting that they were satisfied or very satisfied with the service they received after making a complaint.

It does raise the question, therefore, as to why the government wants to merge the Private Health Insurance Ombudsman with the Commonwealth Ombudsman. It is also worth looking at the type of complaints the Private Health Insurance Ombudsman actually investigates. The annual report reveals that in 2013-14 the issues causing higher numbers of complaints to the Private Health Insurance Ombudsman were oral information, hospital exclusions and restrictions, the pre-existing condition waiting period, cancellation and general service issues.

To look at one of those areas in detail, complaints about hospital exclusions and restrictions came from members who discovered that their treatment was only partially covered, or excluded under their policy. In some cases this was after their health insurer had added new restrictions or exclusions to existing policies. I stress again that we make no criticism of the Commonwealth Ombudsman. But just to highlight this one issue, hospital exclusions and restrictions is a pretty specialised area. It is hard to see how an office that is not dedicated specifically to private health insurance could handle issues like this in such an efficient fashion. Then again, of course, that may well be the whole point of this exercise, because, as we have seen repeatedly since the election, the government is not interested in being scrutinised on these issues. As it has shown again with health cuts across the portfolio and GP tax versions 1, 2, 3 and now 4, this government has repeatedly proven itself to be completely incapable—if not outwardly opposed—to standing up for patients when it comes to health care.

Of course, nowhere has this been more apparent than in this government's handling of the two private health insurance premium rises that have occurred on its watch. We saw this especially with the Minister for Health's announcement late on the afternoon of 27 February that the government would wave through the second-highest increase in private health insurance premiums in a decade. 'Taking out the trash' is how journalists refer to announcements like this, late on a Friday afternoon, as governments try to bury the bad news. Not only was this late on a Friday, it was about the last possible time the minister could make this announcement and still allow health funds the one-month notice they are required to give their members—a month's notice of premium rises. It is fair to say, then, that this was not an announcement that was ever likely to be accompanied by a large number of flags and a television camera.

As I mentioned, this was the second-highest increase in a decade—'second-highest' because that average rise of 6.18 per cent was beaten, by the barest margin, by the 6.2 per cent rise announced by her predecessor just weeks after his election. Whereas the current minister tried to hide her announcement with a Friday afternoon drop, her predecessor tried an entirely different tactic, rushing out his announcement of the biggest rise in a decade months ahead of schedule, just three days before Christmas.

So, 18 months in power and two private health insurance premium rises—both the biggest in a decade, both bigger than any announced under Labor, both around triple the inflation rate and both the biggest since the Minister for Health was the current Prime Minister. So, the current and former ministers can still argue that there was at least one former minister with a worse record when it comes to them and that, of course, is the member for Warringah, the Prime Minister, who routinely approved increases exceeding seven per cent.

When family budgets are under such pressure, when unemployment is rising and when people are watching every single dollar, it is crucial that the government do everything possible to keep private health insurance costs down. That means not just waving through every premium rise that comes across your desk; it means, as happened under Labor, ensuring that every cent of these rises can be justified.

In government, Labor did moderate these increases in the interests of consumers and because we do care about the cost-of-living pressures on Australians—just as we care about the rising out-of-pocket costs that occur in health care. By contrast, both of these rises approved since the coalition returned to power exceeded any of the six annual increases approved under the Australian Labor Party. And this did not occur by accident. In the 2012-13 budget, as a government Labor provided an additional $1.4 million over four years to increase the Private Health Insurance Ombudsman's capacity to manage complaints and to respond to consumer inquiries. In fact, in that budget Labor also provided $2.3 million over four years to the Private Health Insurance Administration Council in order to establish the Private Health Insurance Premiums and Competition Unit. This unit improved the advice provided to government on private health insurance industry pricing, industry cost drivers and insurance premiums. It is a very important mechanism for government to be able to seek advice from and to ensure that it is able to go back to private health insurance companies to say, 'We don't think this rise is justified,' and to ask them to justify that increase on every product.

Unfortunately, we have had the current Prime Minister say that his view in terms of private health insurance premiums is that they should be left entirely up to the market, clearly signalling that the government intends to withdraw from this space entirely. Again, we see this bill and the context of the bill in the context of those comments.

So, frankly, Labor's record, when it comes to standing up for private health insurance consumers every year, is very clear, and it is very different to the government's record from its 18 months in office. The government always likes to talk competition but, unfortunately, it is not delivering in this space. Labor, by contrast, not only backed a competitive private health insurance sector we backed those words with action, and we gave the ombudsman the tools to deliver for consumers. That was proven by the big increase in the number of people using the ombudsman's website to help them get the best information about their health insurance and, where necessary, to get the ombudsman to use its specialist knowledge to act for them when they believed the fund had fallen short of their expectations and their clear understanding.

So, Labor stands for private health insurance members having access to the best information and the best resources to get the best possible outcome from their health insurance at the lowest possible price—just as we stand, always, for patients having access to the best-quality and most efficient health system in the world.

Which is why this government's attack on Australia's health system is as pervasive as it is troubling. Private or public, it makes no difference; the government wants you, as a consumer, to pay more and to get less—high premiums, up-front payments, longer hospitals queues and more expensive medicines. It does not matter what area of health, the government's diagnosis is always the same: you should pay more.

It is also worth looking briefly at the profile of the private health insurance industry. The former Minister for Health, of course, predicted catastrophic consequences when Labor made the decision to means test the private health insurance rebate. And—we have this on record—it still remains the now-government's policy to abolish that private health insurance means test. I look forward to the government bringing that legislation forward. This was, of course, a very prudent budget measure which has resulted in substantial savings to the budget that have been able to be reinvested in health.

The government, or the opposition as they were then—prone to exaggeration and utterly incapable of working in a bipartisan manner—said that means testing the private health insurance rebate would see droves of people abandon their cover. Well, in fact, quite the opposite has been true. Indeed, over recent years we have seen the number of Australians with some private health insurance actually increase. In June 2008 more than 9.5 million people, or 44.9 per cent of the population, had some form of hospital treatment cover. In June 2014 this had risen to more than 11 million people, or 47.2 per cent of the population. And when it comes to general treatment, in June 2008 more than 10.6 million people had private health insurance, representing 50.1 per cent of the population, and in June 2014, 55.3 per cent of the population, or more than 12.9 million Australians, had some form of general treatment cover.

In fact, what we have also seen is an increase in the number of people using the privatehealth.gov website, which has been an important thing for people to do—for people to become much more aware of the type of cover they have and to take the opportunity to ensure they are getting the best cover to meet their needs at their particular time in life and review their cover more regularly. I encourage people to look at the privatehealth.gov website, which provides all of the information for all of the products right the way across the sector, as opposed to some of the more commercial products that only provide information for those products and those funds that provide a fee to participate in that commercial service. It is a very important government service and one that I hope is continued to be supported and expanded where possible, or where it needs to be, by this government.

Labor believes in a competitive private health insurance industry, which is why we opposed the government's decision to sell off Medibank Private; the proceeds of which are not going back into health—a huge missed opportunity—but back into infrastructure, but not infrastructure across the country. It is infrastructure in a particular area in the community—well deserved, I am sure, and well needed. But, given that it is the government's decision to sell Medibank Private, it does seem to have been an opportunity that perhaps the health sector will tell them they have missed.

We know one of the real winners from the sale of Medibank was Australia's spin doctors, with the government having awarded a $2,000 a day contract to sell the sale of Medibank in January 2014. Despite this, the government was not able to explain how the sale of Medibank Private would increase competition in the sector, be in the best interests of health consumers or actually keep downward pressure on premiums. In fact, the opposite has been the case. If this move was going to increase competition, it certainly has not been demonstrated through the second highest private health insurance premiums in the past decade—something waved through by the Minister for Health earlier this month and announced late on a Friday afternoon.

As to some of the substantive elements of the bill, the opposition—as you would indicate from this speech—does have some reservations about the merger between the Private Health Insurance Ombudsman and the Commonwealth Ombudsman. We are worried that it will diminish the capacity of the Commonwealth Ombudsman in terms of where its resourcing is at the moment. Again, I reiterate that it is a very important and excellent organisation, but it is one that is about to take on a very significant and important role in relation to metadata and we are concerned about its capacity to fulfil the work that it has. We are also concerned about the capacity of an organisation to specialise in this area of private health insurance.

Specifically, we are concerned that at present the subject of a complaint may request additional time to report to the Private Health Insurance Ombudsman. This ability is not being transferred ostensibly to provide consistency with the Commonwealth Ombudsman's existing powers, and we are concerned about that. I will be moving some second reading amendments shortly to that affect. We will not be—I will relieve some pressure off the minister's staff members here—opposing the bill in this House outright. We will, however, be moving some second reading amendments that seek to reinstate the powers that the current Private Health Insurance Ombudsman has that are not being transferred to the Commonwealth Ombudsman. We want a very clear explanation, when the minister comes into the House to sum up this bill, as to why they have not been included—and I will detail each one of those. We have also asked that this bill be referred for committee inquiry in the Senate. We will be asking for that to occur, because we think it is really important that there is proper scrutiny of this bill in relation to those powers. We will be reserving our position in the Senate, in relation to the voting on the bill, depending on what that inquiry comes up with.

As to those measures, as I said, one of the measures that is not in there is the capacity for the subject of a complaint to request additional time to report to the insurance ombudsman and that is not being transferred. Similarly, there is a current provision for the minister to intervene where the Private Health Insurance Ombudsman decides not to investigate a complaint. There is the capacity for the minister to intervene and say, 'I actually think this complaint does need to be investigated.' I think that is important. As shadow health minister, I get emails on a weekly basis—as I am sure is the case for many members in this place—from people who have a complaint about their experience of private health insurance. The capacity for a minister to be able to respond to those inquiries from backbenchers to say, 'Actually, I think this probably is worthy of further investigation'—to have that power to be able to say that—has been removed in the transfer from the Private Health Insurance Ombudsman over to the Commonwealth Ombudsman. Again, I think that is an important component to have, and it is unfortunate that has not reached its way into this bill.

Also omitted is the provision for the minister to request the Private Health Insurance Ombudsman to undertake an investigation. Again, that is not being transferred over. I am making an assumption that that has happened because that is not currently within the existing powers under the Commonwealth Ombudsman. But with this specific area, private health insurance, it is a measure that is important.

Likewise, at present, the Private Health Insurance Ombudsman is not able to request information about the complainant's dealings with the subject of a complaint without the complainant's consent. This also applies when undertaking an own-motion investigation. These limits on information-gathering powers are not retained by the move. Whilst the Commonwealth Ombudsman will retain the Private Health Insurance Ombudsman's power to undertake voluntary or compulsory mediation, the penalty for failing to participate in that mediation will be reduced from 30 penalty units to 10 penalty units. Whilst that might be welcomed by some in the sector, the incentive that the penalty units power has is not explained by that change. The penalty for failing or for refusing to provide information to the Private Health Insurance Ombudsman is a maximum of 30 penalty units and is a strict liability offence. The bill proposes to rely on section 36 of the Ombudsman Act, with a maximum penalty of $1,000 and/or three months imprisonment. Section 36 is not an offence of strict liability, although the evidentiary burden will be upon the defendant to prove that they had a reasonable excuse for failing to comply. Again, in terms of the powers currently utilised by the Private Health Insurance Ombudsman, we think there needs to be further investigation of the decision to not move that over.

So, whilst not opposing the Bill outright in this chamber—and again I stress 'in this chamber'—I do want to flag the opposition's concerns about these omissions as well as, more significantly, the opposition's concerns that the capacity of the Private Health Insurance Ombudsman to pursue complaints; provide advice to government and industry about issues affecting consumers in relation to private health insurance; and provide advice and recommendations to government and industry about private health insurance—specifically the performance of the sector and the nature of complaints—will be diminished.

With this in mind I can express the opposition's intention that this bill should be referred outside of this chamber for inquiry so that these issues can be investigated at some depth to inform the debate about this proposal.

We do not think the government has made the case for these changes either in announcing the proposed merger or subsequently, and the opposition therefore is right to hold these concerns. Again this appears as though it has been a line coming out of the Commission of Audit or the budget about something that looks like a good idea without proper and thorough investigation and explanation of why it is actually occurring.

And it is especially, obviously, the case when taking into consideration the context in which this decision is being taken: more than $5.9 billion in cuts already realised in the health portfolio and billions of dollars still to be considered.

The government of course still intends to pursue its freeze on the indexation of Medicare benefits services, effectively cutting the income of general practice by $1.3 billion. The government obviously still has on the table. It is increasing by $1.3 billion the cost of medicines—a measure that includes significant changes to the Pharmaceutical Benefits Scheme safety net too. The government not only intends to merge the Private Health Insurance Ombudsman with the Commonwealth Ombudsman but also wants to cease the Private Health Insurance Administration Council as a separate body, instead planning to merge it into the Australian Competition and Consumer Commission and the merger of health fund prudential regulation functions to the Australian Prudential Regulation Authority.

Private health insurance is a very specialised area. I know from having worked with the people in the department in that space before how specialised that particular area is, and frankly it would be a damning indictment on the government if we were to lose that area of specialty and the level of scrutiny that is on a product that several million Australians rely on.

Again, in our view the government has not made the case for change. It may well be that the opposition can support these changes, but such is the dysfunction of the government in the way it conducts itself that it does not consulted the sector over this. It genuinely has not. The sector has been in to see me about it. It came as a bit of a surprise to them. They are not sure about some of the details of it. It did not consult the crossbench—I have certainly talked to them as well—and it certainly did not consult the opposition. I do acknowledge a briefing was offered, but we had already well and truly formulated our position by then.

So I do think it is important that there be some proper scrutiny on the bill. We will reserve our position in relation to that for the other chamber once that scrutiny has occurred, but I particularly want the government to explain very clearly why it is of the view that those important measures are not in there. I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading the House calls on the government to reinstate the:

(1) provision for the subject of a complaint to ask the Ombudsman for additional time to respond to a complaint;

(2)provision for the Minister for Health to intervene where the Ombudsman decides not to investigate a complaint;

(3) provision enabling the Minister for Health to request the Ombudsman to undertake investigations;

(4)capacity of the Ombudsman to investigate complaints, produce high quality reports, and protect the rights of private health insurance consumers; and

(5) penalty for failing to participate in mediation."

Photo of Alex HawkeAlex Hawke (Mitchell, Liberal Party) Share this | | Hansard source

Is the amendment seconded?

Photo of Michael DanbyMichael Danby (Melbourne Ports, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition) Share this | | Hansard source

I second the amendment and reserve my right to speak.

1:04 pm

Photo of David GillespieDavid Gillespie (Lyne, National Party) Share this | | Hansard source

The Private Health Insurance Amendment Bill (No. 2) 2014 is very much part of our efficiency agenda and measures. It overall reduces the number of additional government bodies in keeping with our red tape reduction program. There are also some housekeeping measures included in this bill. Essentially, it transfers the function of the Private Health Insurance Ombudsman into the Commonwealth Ombudsman's office. The Private Health Insurance Ombudsman assists health fund consumers. It also advises government. It also informs consumers through written, verbal or digital information. This function will continue.

Previous speakers have talked about the abolition of it. It is just rolling the responsibilities into an existing federal government department, and those functions will continue. As we have a very talented Australian Public Service, I am sure they will be able to cope with the responsibilities so given, but it will reduce costs significantly—at minimum at least $600,000 a year and perhaps a whole lot more. Think about a separate body requiring separate premises, a separate secretariat support, all these dollars and cents multiplied across the whole public service. If we can make it more efficient, well and good.

Not only do we have the Intergenerational report on one hand outlining the increasing responsibilities in a fiscal sense that the Commonwealth will have as a result of the ageing demographic; in the electorate of Lyne we have been coping with that demographic for 15 or more years. Not only is all of Australia looking at increased costs because of the ageing phenomenon; we are hoping that lots of people like I have in my electorate will maintain their activity and engagement through voluntary or part-time work But, unfortunately, it is a fact of human nature that there are increasing health costs in the ageing population. So we have had to cope with twice the number of 65-year-olds, which has placed a very large burden on the public hospital system and the private hospital system, as well as on medical practitioners in their private rooms. Somewhere along the line, the Commonwealth has to pay. That is why we need to reduce red tape; because red tape induces cost.

In the electorate of Lyne, we have two major private health institutions that rely on a robust private health insurance industry to deliver their services to the electorate of Lyne. In the town of Taree we have the Mayo Private Hospital, which has been successfully operating since 1922, serving the people of the Manning, from a cottage hospital through to its now state-of-the-art facilities. It is an 81-bed hospital with three theatres and multiple imaging labs—including a cardiac intervention imaging lab. It has new pathology services. It has new radiology services associated with it, including an MRI.

In the first year since the Healthe Care group took over the Mayo Private Hospital in the Manning, over $10 million of capital upgrades have been committed and spent. So there are general medical and surgical services there. There is a large mental health capability and service that the Mayo delivers well outside the Manning, north into the Hastings and south and east into the Forster catchment area. They run a five-chair dialysis unit, which delivers state-of-the-art care for those with renal failure. There are rehabilitation services and a full allied health service. Over 230 staff are employed, with 100 or so credentialed doctors. This is a major asset to the people of the Manning and the surrounding areas.

In Port Macquarie we have a longstanding private hospital, now run by Ramsay Health Care, called Port Macquarie Private Hospital. In the suite of private hospital facilities, they also have the Coolenberg Day Surgery and the Hastings Day Surgery. Within the private hospital, they have 80-plus beds, depending on how many are in the day unit. They have invested heavily in the rehabilitation area, which is very critical in our area because we have larger than average numbers of elderly people, who take a while to rehabilitate after hip surgery or knee surgery or after a cerebrovascular event or a stroke.

We have a state-of-the-art facilities now being provided for people in Port Macquarie. This takes enormous pressure off the public hospital system, where I worked for many years. There is the full range of medical and surgical facilities, short of neurosurgery and cardiothoracic surgery. Services like orthopaedics have been there since inception, and the services for respiratory, cardiology, gastroenterology, oncology, palliative care, urology and vascular are all second to none.

The people in the Lyne electorate are very well served by health facilities now. The Manning Base Hospital has just had a $20 million upgrade announced by my state colleague the member for Myall Lakes, Steve Bromhead. What a fantastic job he has been doing for people in the Manning. I am sure that in this weekend's state election he will be rewarded for the tireless efforts he has undertaken for the people in Taree, Forster and the area of Myall Lakes. It is hard to get care if you do not have hospital facilities—compared to some of the electorates in the rest of the country, we are very blessed—but as I have mentioned, both Manning Base Hospital and Port Macquarie Base Hospital would be overflowing if we did not have these two private hospital institutions in both the major towns of the electorate.

So, getting back to this legislation, the Private Health Insurance Amendment Bill (No. 2) 2014 tidies up, as I mentioned, some housekeeping matters. It removes references to the base premium measures—without any financial impact, it makes it workable. There was a lot of toing and froing about this when it was first mooted and then there was delay in royal assent, so a lot of these measures have been implemented but this is legislatively tidying it all up.

So I commend the red tape reduction program that this government has undertaken. We have reduced red tape that people like the private health industry have to put with, and many other industries. Government regulation and red tape does lead to a dollar cost for many industries. The private health industry was paying for the ombudsman on a cost-recovery basis. If we can reduce the costs, it means lower premiums. We all depend on the private health insurance system in one way or another—whether you are premium payer and a self-insurer or not, everyone relies on the health system sometime or other. If we do not have a viable private health industry, the public health system will fall over.

So I commend this bill to the House and I recommend all its features.

1:13 pm

Photo of Nick ChampionNick Champion (Wakefield, Australian Labor Party) Share this | | Hansard source

It is a great pleasure to speak on the Private Health Insurance Amendment Bill (No. 2) 2014. This bill seeks to do a number of things, but mainly it seeks to transfer the function of the Private Health Insurance Ombudsman to the office of the Commonwealth Ombudsman and to align those two offices as part of the government's commitment—I guess, as the previous speaker would say—to reduce red tape and regulatory oversight.

There are some concerning changes in this bill and ones that the government will have to endeavour to explain to the public. At the present, the subject of a complaint may request additional time to report to the PHI Ombudsman. It would seem to me that that is not an onerous thing. In fact it is of benefit to the subject of the complaint, which would no doubt be a private health insurance fund. This ability to ask for extra time is not transferred in this bill—ostensibly to provide consistency with the Commonwealth Ombudsman's existing powers.

There is currently a provision for the minister to intervene where the PHI Ombudsman decides not to investigate a complaint. This bill has no equivalent provision for the minister to intervene where the Commonwealth Ombudsman decides not to investigate a complaint. Similarly, there is currently a provision for the minister to request the PHI Ombudsman to undertake investigations, but this bill has no equivalent provision for the minister to make such a request of the Commonwealth Ombudsman. There are a number of other issues—for example, the penalty for failing to participate in mediation is being reduced from 30 penalty units to 10 penalty units and there are some limits on the information powers of the ombudsman.

This is one of those bills that will give those opposite the opportunity to decry regulation and they will suggest that there will be some great effect on fees from this relatively minor reform. But the complexity of the modern world is always with us and it is not just government that is responsible for that. The member for Hindmarsh, in an earlier debate, pointed out that much of the red tape that people find frustrating is the result of private sector endeavours. This is one of those areas. We are dealing with private insurers and their regulation.

The shadow minister, the member for Ballarat, pointed out that the ombudsman has been busy, handling 3,427 complaints in 2013-14, or around 65 complaints per week. That is up 16 per cent on the previous year. The ombudsman has not been sitting idle but has, rather, been quite busy. That activity is of course of benefit to consumers. It is consumers who approach the ombudsman with issues relating to private health. One person's regulatory burden is another person's consumer protection. I think the government, and indeed the parliament, needs to be careful when looking at these things. We need to make sure that the necessary protections for consumers are there.

This government's record on health is not great—$50 billion worth of cuts to public health in this country, to public hospitals, to state health budgets. We know that hospital budgets are under increasing pressure—from the march of time, the march of demographics, the march of medical technology and from healthcare inflation. Healthcare costs are rising much more steeply than is ordinary inflation. There is massive pressure on state health budgets, so $50 billion worth of cuts to states is a serious problem. In Deputy Speaker Hawke's own state, Premier Baird has called on the federal government to look again at those cuts. Premiers of all persuasions are grappling with how to deal with those cuts. It is a very serious issue.

This government also shut down some 61 Medicare Locals, even those that were working very well. I know that in South Australia my own Medicare Local and the Medicare Locals in country areas were working very well. You can make always make some sort of argument about the efficiency of such a program across the nation, but I think that members of both parties would agree that the ones in my state were working pretty well. With Medicare Locals the government has thrown the baby out with the bathwater—shutting down 61 of them at enormous cost to the taxpayer, only to reinvent the wheel with primary healthcare networks. People will scratch their heads if they look closely at that. They will wonder what great gain to public health was achieved out of that whole episode.

This government has even considered the privatisation of Australian Hearing. I certainly hope the member for Boothby is weighing in on behalf of an institution that has been around since 1947. It was formed as a result of a decision of the Chifley government to protect war veterans and the victims of a rubella outbreak, but it has become a very important institution. It had the support of the Menzies government and has had the support of all governments since then. It was even expanded quite a bit under Prime Minister Howard. It is an important national institution that both parties should be proud of. It should not be subjected to the vagaries of the private sector. We know that its current service provision—in particular the good research of the National Acoustic Laboratories—would not be replicated under a private model. It is an important public institution that has put Australia at the forefront worldwide of advanced manufacturing in hearing technology. We should be proud of that—and we should certainly not be putting it at risk.

Then of course we have seen the GP tax. I think we are up to mark 4 now. The latest cuts to rebates equate to an $8 GP tax. That is what the effect of them would be—forcing every GP clinic across the nation to be a tax collector. The original $7 GP co-payment was a tax not just on every doctor's visit but on every scan and every blood test. We know that the senior figures in this government who have been trying to put this in place for a very long time will not give up. They will return to it. That first iteration of the GP tax gives you some idea of where, given the slightest opportunity, they will try to go. Mark 2 and mark 3, which occurred around Christmas, I think—it is hard to remember—not only had cuts to rebates but also insane time lines for GP surgeries. I know the member for Boothby was visited by many GPs. I think we are on to our second health minister now, and I know he has been lobbying away very carefully. He knows just the sort of chaos that was inserted into these very hardworking small businesses, particularly around Christmas time. You would not have wanted to be a practice manager around Christmas time. You would not have had much time with your family, because you would have been too busy trying to completely overhaul billing operations in your small practice and trying to work out how you were going to restructure your business. So we know why the government has had to raise the white flag of retreat on these things.

We know they have got a very spotty record on health. In their Our planReal solutions for all Australians there were not many mentions about health and certainly no mention of any of the matters that I have talked about. It was all pretty flossy stuff, but they did say a few things about private health insurance. They have on occasion said that they would bring it back when fiscal circumstances allowed, and the Treasurer, the member for North Sydney, was making promises that they would be in surplus in year one. That would have given people the impression that the means testing of the private health care rebates—something that has saved the budget $20 billion—was something that the government was going to pursue. But we now know that they have absolutely no intention of turning back Labor's very sensible means testing—its very sensible saving of $20 billion to the budget—because they have not included it in the Treasurer's intergenerational review.

We know that they are full of hypocrisy and chicanery on this. That is their MO. We know this from the fact that they have increased private health insurance premiums by an average of 6.18 per cent—and that is from an ABC news report on 3 March this year. What we get is this rather limp urging by the health minister for consumers to shop around, and yet here we have a measure in this bill to help them deal with complaints with private health insurers and they are shifting that into the Commonwealth Ombudsman's portfolio of responsibility. Even though the Private Health Insurance Ombudsman is a very busy ombudsman, they are shifting that to the Commonwealth Ombudsman, who is busy with a range of other matters.

So there are some concerns here. While the government talks a terrific game on private health insurance—saying that they are all for supporting it and that it suits their ideological dispositions towards health—we know that from Fraser onwards they have been constantly trying to reinsert the profit motive and dismantle universality in this regard because it is just part of their DNA. It is just part of the thing that they want to do. We have to be cognisant of this hypocrisy. We have to be as cognisant of their hypocrisy on private health insurance as we should be cognisant of their hostility to universal health insurance.

We know their agenda in government. It is a chaotic moving feast of hypocrisy on the one hand—this commitment to the marketplace on one hand—and, on the other hand, this deep ingrained hostility and commitment to things like co-payments and market signals. You can go back to Fightback and the Fraser years and you can go back to Prime Minister Howard. He wanted to tear Medicare apart. That is what he promised to do. They have this ingrained tendency when in public office, in government, when they are on the treasury bench, to absolutely make a mess out of health and not build on it, as the public would want them to do. Rather, they show chicanery, hypocrisy and hostility toward universal health care, to Medicare—one of the finest healthcare systems in the world; a mixed model of private and public insurance providers; a universal insurer. It is a very important system which has given Australia not only good coverage but also a healthcare system that keeps costs down.

I implore the government and those who are party to it to remember the political consequences of their actions in this place, particularly with regard to health care, and I would urge them to pursue a more moderate course, if only in their own interest but especially in Australia's interest.

1:28 pm

Photo of Andrew SouthcottAndrew Southcott (Boothby, Liberal Party) Share this | | Hansard source

I am pleased to rise on the Private Health Insurance Amendment Bill (No. 2) 2014. This is a fairly minor change. It involves the Private Health Insurance Ombudsman being abolished and its functions being taken over by the Commonwealth Ombudsman. It is estimated that there will be savings of about $600,000 per year, which will be a reduction in the levy that is paid for by private health insurance funds, and it will have a small impact on reducing the cost of premiums.

This is an important issue in my electorate. More than three-quarters of voters in the electorate of Boothby hold private health insurance. Two-thirds of them hold hospital insurance and more than three-quarters hold general treatment insurance. My constituents have always been very concerned about issues related to private health insurance and have been dismayed by the continual attacks that were made by the Labor Party on private health insurance. Before the 2007 election, we saw Kevin Rudd say that there would be no changes to private health insurance, and then, in each subsequent budget, attacks were made on private health insurance and its holders.

I seek leave to continue my remarks at a later stage.

Photo of Bruce ScottBruce Scott (Maranoa, Deputy-Speaker) Share this | | Hansard source

The debate is interrupted in accordance with standing order 43, and the member will have leave to continue his remarks when the debate is resumed.