House debates

Wednesday, 1 March 2017

Matters of Public Importance

Turnbull Government: Health Care

3:22 pm

Photo of Tony SmithTony Smith (Speaker) Share this | | Hansard source

I have received a letter from the honourable member for Ballarat proposing that a definite matter of public importance be submitted to the House for discussion, namely:

'The Government’s failure to deliver on its health promises'.

I call upon those members who approve of the proposed discussion to rise in their places.

More than the number of members required by the standing orders having risen in their places—

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

This week we have seen the government's division, their infighting and their chaos splashed across our parliament. But the government's chaos is not just impacting on the fortunes of the Prime Minister; it is having a very real impact on the lives of Australians around the country.

There is no better example of the failures of the Turnbull government than their approach to health. This week, we have seen two extremely serious—and I can only use this word—stuff-ups when it comes to health. They have had a ripple effect on Australians right throughout the country. These two stuff-ups are: the absolute debacle that is the government's outsourcing of the National Cancer Screening Register, and, as we have learnt today, its failure to deliver a single life-saving continuous glucose monitoring device for the thousands of children with type 1 diabetes.

I will be honest: it is hard to point to a single policy area where the government is effectively delivering any of its policy decisions. But the implications when it comes to health are particularly serious and are clear proof that, while the government and its ministers are so busy focusing on themselves, they have absolutely dropped the ball when it comes to health.

It is tough competition for the worst stuff up in the health portfolio, but I think the bungling of the rollout of the program to detect cancer earlier would have to be the top contender. So the most egregious recent stuff-up from the Turnbull government is the National Cancer Screening Register. The government said they would roll out the Cancer Screening Register on 1 May, which would include a new cervical cancer screening test to detect cervical cancer earlier. This is the establishment of a new register that combines the national cervical cancer screening register—currently undertaken by state and territory governments, and, in Victoria and South Australia, the Victorian Cytology Service—and the National Bowel Cancer Screening Register, currently operated by the Department of Human Services.

The government handed the register to Telstra, against the advice of Labor—and against the advice of the experts, including the AMA and the college of general practice. This was despite Telstra never having operated a register such as this. The government signed a $220 million contract with Telstra, only days before the election was called and before the enabling legislation had passed this place, effectively privatising the register. It was a highly controversial decision—and, in the words of Yes, Minister, a highly 'courageous' decision.

Labor and the Senate were assured—and it is on the public record—during the process of the passage of the legislation through this parliament, that, if the legislation was passed on 30 October, the register would be up and running by 1 May. The legislation passed the parliament on 13 October. We have now learnt that the register will not be ready until 1 December. We have not learnt that from the government coming in and actually telling people—telling Australian women—what is actually happening with the cervical cancer screening register. We learnt about it because of the media. And the Chief Medical Officer released a statement after it was in the media.

The implications of this are incredibly serious. They have now completely stuffed up the implementation of the register and, in turn, delayed the new cervical screening test and, potentially, put women's lives at risk. That is what you have done.

With the revelation that the government has bungled the rollout of the new test, experts have warned that: women could delay cervical screening, having already put off their Pap smears in the hope that they would have the five-year HPV screening test instead; the cytology workforce is in crisis since, as only one in every six cytologists will be needed for the new program, people have already taken voluntary redundancies or accepted new positions; and there are already delays in Pap smear results, and these will only get worse, we are told, potentially blowing out to six to eight weeks.

The government has had to patch together an emergency bailout because of its stuff-up, and that will cost millions of dollars. That is what you have done with the stuff-up of the National Cancer Screening Register.

It is a very serious failure of policy implementation. The government has completely failed to explain to Australian women what has occurred or to advise them of what they should do, and the minister, frankly, has been missing in action on this issue—he has not been out there explaining to Australian women what has happened and what they should do. And, only days before it was revealed that the government had completely stuffed this up, there was the minister, embarrassingly, out there spruiking how great the new scheme was. And it will be a great scheme, when it is place, in December—not May; December. So the fact that he has been missing in action on this stuff-up—when he should be explaining it and accepting responsibility—and has not had the decency to front up and tell women what has been happening, has been a complete disgrace.

If that were not enough, we have also learnt today that the government is yet to deliver a single one of the life-saving continuous glucose monitoring devices promised to children with diabetes at the election. The government committed to delivering 4,000 continuous glucose monitoring devices to Australians under 21, from 1 January. That was when the rollout was supposed to have started. But not a single device has been distributed, and the government cannot give a clear date for when the devices will actually be delivered. In fact, as we have seen in Senate estimates this morning, the government's own department seemed completely unaware of the government's promised start date. It did not even know about it.

Continuous glucose monitoring devices can literally save lives, by continually monitoring blood glucose levels through sensors placed under the skin, and linking to hand-held devices such as mobile phones or to insulin pumps. CGM technology reduces the risks associated with type 1 diabetes and improves quality of life.

There was a bipartisan commitment to the delivery of these devices, with Labor making a broader commitment, and there should be no excuse for this government's failure to deliver. It is eight months after the election, and the government still does not have its act together on its key promises. It cannot go around telling one thing to desperate families—many of whom have approached me—only to leave them in unacceptable limbo. You have not explained why there is a delay with your election promise. Australians were expecting it on 1 January and people were coming up to me and asking, 'Where is it?' Where have you explained that there is a delay? You have not done so. Own your own mistakes.

Of course, this all comes in the context of the government's continued attacks on health. Remember the day before the election when the Prime Minister promised that no Australian would pay more to see a GP under his Medicare freeze. That was simply not true. Australians are already paying more for GPs, out-of-pocket costs for health are increasing and, despite the heroic attempts by the minister to try to claim otherwise, bulk-billing rates for GP consultations continue to fall, with the most recent data showing that bulk-billing rates for non-referred GP attendances continuing to drop across the country. In almost every state and territory, bulk-billing for GPs is lower than it was at the time of the election. The reason, of course, is that this government is making health care less affordable for every Australian, with the Medicare freeze already forcing GPs to drop bulk-billing and to increase out-of-pocket costs.

We have had the Prime Minister also cutting $1.3 billion from the Pharmaceutical Benefits Scheme and increasing the co-payment by up to $5—the biggest price increase for prescription medicine in a decade. The government's Medicare safety net cuts will see Australians paying more and more before extra support kicks in, and then they will receive a reduced amount. Cuts to bulk-billing incentives, the payments which give pathologists and radiologists a specific incentive to bulk-bill, will mean bulk-billing rates for those important tests will fall, co-payments will rise and patients will be forced to pay more for tests and scans, or skip them altogether. The failure to properly fund our public hospitals has seen elective surgery waiting times blow out under the Turnbull government.

This is the legacy of this government when it comes to health. Everything they touch turns into a complete and utter stuff-up. Millions of voters rejected every single one of the Turnbull government's health cuts at the last election. Nothing has changed, and nothing will change unless the government drops their savage health cuts and unless we get rid of this appalling government.

3:32 pm

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Minister for Health) Share this | | Hansard source

I am delighted to address this topic. Let me begin with Labor's abysmal health record. Labor left the health system in poor health. I will also deal with the irresponsible claims that those opposite make, in defiance of the best medical advice provided to the government not only by the experts within government but also by those outside. I will also inform the House about what we have delivered not just since the election but even in recent weeks, including progress on medicinal cannabis, which Labor never delivered; progress on Kalydeco, which Labor—

Ms Catherine King interjecting

No, you never did it on your watch, in your time. You failed. You were absent, and we delivered it. There is also what we have done with the NHMRC. We also have the highest half-year rates for bulk-billing on record—higher than any year under Labor—and the lowest private health insurance changes in a decade.

But let me run through Labor's record, just to put all of this in context. Labor hate private health insurance. They ripped $4 billion out of private health insurance. They ripped $4 billion out of private health insurance and they did it on the back of a grand deception. Here is what the member for Gellibrand said before they went into government:

... Labor has made it crystal clear that we are committed to retaining all of the existing Private Health Insurance rebates …

And what happened during their period in government? It was summed up very neatly by the member for Sydney after their period in government. She said:

How did I pay for it? I paid for it by targeting private health insurance.

A complete fraud.

They cut $2½ million from the Pharmaceutical Benefits Scheme and medicines and pharmacy, and they put seven major drugs approved by the PBAC on delay. They put those drugs on delay. That included drugs for schizophrenia and drugs for pulmonary condition. That is a disgrace and something that we will not be doing on our watch. The PBAC passed drugs that were fundamental and lifesaving and Labor put those on delay. They did it; we will not.

Honourable members interjecting

Photo of Mark CoultonMark Coulton (Parkes, Deputy-Speaker) Share this | | Hansard source

Order! The House is under a general warning. If this does not cease, I will be starting to evict people under 94(a).

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Minister for Health) Share this | | Hansard source

But it goes beyond that. They slashed a billion dollars from dental by cutting chronic disease dental care. They cut $664 million from Medicare for GPs—and, by the way, they introduced the freeze on GP rates. They then cut $500 million from Medicare for pathology and $450 million from Medicare for safety net protection. They are not Medi-friends; they are Medi-frauds—rolled-gold Medi-frauds. That is what we have on the other side. Add to that, there is the small matter of the not-so-super clinics that never actually appeared.

Those opposite have a disgraceful record. But let me add one more thing. As all members of this House would know, in the lead-up to the last election, they made much of the notion that they were going to reintroduce $57 billion of hospitals funding. But, when the Treasurer called them out and they were forced to account for what they would do, they produced $2 billion—a $55 billion shortfall; a four per cent achievement. In anybody's language, four per cent is a failure—unless you are Senator Kitching filling out a few HSU forms on behalf of other people. It was a four per cent achievement and a $55 billion shortfall. That is why they have dropped their hospitals campaign, because they were caught out red-handed misleading the Australian people, something that was a disgrace, something for which they were caught and something which now shows they were never Medi-friends; they were always Medi-frauds—rolled gold, through and through, caught in the act. That is what Labor did, and remember this always: Labor hate private health insurance.

More than that, you then come to the claims they make today. They have made two claims. The first is in relation to women's health and the test for cervical cancer. The Royal Australian College of General Practitioners have had no hesitation over the years, where they have had disagreements with this government, in making those disagreements well and truly known. Here is what the president of the college, Bastian Seidel, said only last week:

… I commend the government for its sensible decision to delay implementation until all necessary systems are fully in place.

The college's media release stated:

… the decision this week to delay implementation of the program was a positive indication of the Federal Government's commitment to safe, high quality health care for Australian patients.

Do you know what? On coming into office, I checked through a number of programs and this is one which I discussed with the CEO of the company in question. My judgement was that this was not ready to proceed. It was not going to be able to proceed safely, so at my request the Chief Medical Officer made this known immediately and within three days we had an agreement with the pathology sector to ensure safe and continuous protection of women and testing of women. Our commitment is to women, to achieve these protections and to introduce the new test when it can be safely done, on 1 December. That was the advice of the Chief Medical Officer. If the opposition disagree with the Chief Medical Officer, they should say so. If they disagree with the royal Australian college of GPs, they should say so.

The other one that they have tried to have a go at today is the implementation of continuous glucose monitoring. Here is what Diabetes Australia said today:

… Diabetes Australia fully supports the current timing and approach being taken for the safe, reliable and effective delivery of the new CGM program to maximise the benefits to children and young people with type 1 diabetes.

I have only been in the job a few short weeks and we are in a position, as the opposition spokesperson knows, to make an announcement in the very near future about an imminent commencement. That is why those opposite are trying to get this in today—because they know we are going to do what they never did in government. How much did they allocate when they were in government? Zero dollars. How much have we allocated? Fifty-four million dollars. We have allocated $54 million; in government they allocated zero dollars. We are doing what they never did, and we have the support of Diabetes Australia and the support of the DANII Foundation.

Let me go to broader issues. What have we achieved in just the last five weeks? We have achieved medicinal cannabis import rules, which at my request have been expedited and will see Australians given real access to medicinal cannabis on prescription for the first time where it is fully available. That is something that no-one in Australian history has done previously. We have announced the listing of Kalydeco for cystic fibrosis sufferers between two and six years of age. This is fundamental and vital and should be welcomed, and I believe it is welcomed by members on all sides. We have announced subsidised access to olaparib, a drug for women with gynaecological cancers that will save them up to $100,000 per year—again a tremendous result. The NHMRC will receive funding of $125 million, with over $30 million going to cancer research in Australia. Beyond that, we have announced the highest half-year bulk-billing figures for GPs in Australian history, up over 3½ per cent compared with when Labor was in office—over 3½ per cent higher than Labor's figures.

Do you know what? Our four pillars of our long-term national health plan are based on a rock-solid commitment to Medicare first and foremost. Our funding goes up from $22 billion to $23 billion to $24 billion to $25 billion. It is based on a rock-solid commitment to our hospitals, where funding goes from $17 billion to $18 billion to $20 billion to $21 billion. It is based on a deep personal and national commitment to mental health and preventive health. We have already taken real strides on that front and we want to work with the opposition on that—I would hope there is no back-chatter on that one. Finally, on medical research, we have created a Medical Research Future Fund, which the ALP never did. We are committed on all four fronts and we are delivering where they failed.

3:42 pm

Photo of Sharon ClaydonSharon Claydon (Newcastle, Australian Labor Party) Share this | | Hansard source

It is with great pleasure that I rise to support the shadow minister for health's matter of public importance, because goodness knows there is a long history of failure to deliver on health from the members opposite. At the risk of incurring the wrath of the Minister for Health while he is still in the chamber and being accused of backchatting here, I would like to suggest that we welcome the long list of additional PBS medicines that the minister has made available in the last few weeks, which will make important inroads for those with cystic fibrosis and cancer. You will get no argument from members on this side of the House, Minister. Nor will you get argument around the release of research grants money and NHMRC money. But, Minister, that is your job. You are the Minister for Health. It is the core business of your portfolio to release moneys for medical research. It is your core business to make sure that there are affordable medicines available for Australians everywhere.

I noted your comments earlier around private health insurance. It is extraordinary that you should point to private health insurance as some emblematic moment for the Liberal Party and as a sign of achievement, because, if you were to talk to Australians anywhere in this country, they would have a lot to tell you about their experience of value for money when it comes to private health insurance. Indeed, Minister, private health insurance premiums increased by $200 in the last year alone. That is hitting family budgets massively, not just in my electorate of Newcastle but across Australia. An increase of $200 means that families are now paying around $900 extra in annual premiums every year under the Abbott-Turnbull government watch. When you talk to men and women, particularly those who might be facing a cut to their penalty rates now, they are struggling to figure out how they will pay these bills, how they will make ends meet in their family budget. When you jack up private health insurance premiums by those massive amounts, when you sit by and allow that to happen in this country, then you should not be surprised to see private health membership plummeting.

Indeed, what you should be focusing on is how you might support public health in this country, how you might support Medicare. I do not know what it is about the Liberal Party, but you cannot keep your hands off Medicare. There is some ideological opposition that is embedded in your DNA that makes you unable to stand up for Medicare. Forty-odd years ago, you fought us tooth and nail in this parliament—in Old Parliament House down the road—around trying to introduce what was known in those days as Medibank. I am sorry you are leaving, Minister Hunt, because I do enjoy this banter with you! I am sure the Australian people listening to this debate will understand that sometimes this kind of truth hurts, it cuts to the core.

I think the way that these cuts impact on everyday men, women and kids in this country concerns all of us on this side of the House. The member for Macarthur and I are speaking to people all around the country at the moment about the lived experiences of cuts to Medicare under this government. I see the member for Dobell is sitting in the House with us. Indeed we very much appreciated the opportunity to visit her electorate and the neighbouring electorate of Robertson, where we learned that some 30,000 men and women have chosen to delay or defer going to see a GP because they cannot afford it.

It is not just the fact that you have failed dismally to remove a single one of Tony Abbott's cuts from the table—all those zombie cuts are still there on the table—it is that men and women are already paying increased prices. This is something that is already happening. To delay seeking quality medical advice in this country is a matter that concerns Labor members of this House greatly. We believe in a strong public health system. We believe that every Australian deserves the right to access affordable, quality health care wherever they live, regardless of the size of their wallet or their bank account. We will always defend Medicare. Labor created Medicare, and we will always fight to protect it. (Time expired)

3:48 pm

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

I love it when the Labor Party come up with these MPIs on health! They always assume that, because they had Gough Whitlam and invented Medicare, they are the saviours of the whole health system. But when you look at the pillars of the health system—whether it is the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme, the private health insurance system, grants to the state governments for their hospital systems or workforce measures—the coalition government has certainly got the runs on the board.

Let us start with bulk-billing rates for GPs. I have health department figures. The bulk-billing rate in 2012 was down to 81.9 per cent; now it is up to 85.4 per cent. There were 105 million bulk-billed GP services in 2012; now there are 125 million. There was $10.85 billion in Medicare billing in 2015—a $300 million increase. That is $1¼ billion more than in 2013. There is a lot of criticism about the freeze, but who brought the freeze in? They did.

Let us look at the health workforce. There was a problem with the health workforce. There were not enough medical practitioners, so we had to rely on overseas trained doctors. We are rejigging the workforce paradigm so that we get homegrown doctors working, training and living in regional Australia. We have a number of incentives. We announced $94 million for the Integrated Rural Training Pipeline and regional training hubs to expand the postgraduate training footprint. We have expanded the Rural Health Multidisciplinary Training Program. We have three new university departments of rural health lined up for Western Australia, Queensland and New South Wales. We have given an extra $20 million to the Flying Doctor Service. The General Practice Rural Incentives Program is focused on areas where it is needed—not the major regional cities like Cairns and Townsville but places that are really rural and understaffed. There is a $3 difference in the bulk-billing incentive for rural general practice. We have $40 million being spent on more intern training opportunities in rural and private situations.

You also have to look at this lie about our so-called and mythical cuts to hospitals. In this four-year period, $2.9 billion more is going to state hospitals. By 2020, that will be $21.24 billion. That is $4 million more. This year, there is $7.9 billion more funding than in the last year of the Labor government—$7.9 billion more. We have retained Activity Based Funding, but like any sensible manager of massive amounts of money, we have capped it at 6½ per cent growth. Previously it was uncapped and unfunded. The incentive programs that the previous government rolled out after 2010 did not even have KPIs. As the Minister for Health mentioned, we have facilitated medicinal cannabis. We have allowed importation of CBD plants, we have liaised with the states and we have changed it from a schedule 9 to a schedule 8 drug. The setting up of authorised prescribers and a Special Access Scheme is underway. On smoking and obesity—the biggest things facing the country in terms of preventive health—we have got many runs on the board.

We have our quit smoking program and our Don't Make Smokes Your Story program. We have put $160 million into the Sporting Schools program. That is not for elite sports but for schoolchildren. Six thousand schools are taking part in Sporting Schools. We have the Healthy Food Partnership with the industry, public health and consumer groups. We are driving reformulation, portion control and better choices in the packaged food system with the health star rating. We have increased the child dental benefit back up to $1,000. We have not cut programs like the very effective Chronic Dental Disease Scheme that the minister was referring to.

In the PBS, over 1,000 new drugs have been listed, including ovarian cancer drugs such as olaparib, lung cancer drugs, hepatitis C treatments, cystic fibrosis drugs and the list goes on. (Time expired)

3:53 pm

Photo of Susan LambSusan Lamb (Longman, Australian Labor Party) Share this | | Hansard source

It was only one month ago to the day that we as Australians were celebrating the 33rd birthday of the Hawke government's revolutionary Medicare reforms. I could spend the rest of my five minutes discussing how great Medicare really is—how many lives it has saved, how many good people it has enabled to live normal and also extraordinary lives and how much good it has done for the Australian people—but I will not because we all know this, right? Even the opposition who have fought so hard over these past three decades to tear down our country's globally renowned universal healthcare system could not argue against this, because they know it too. They have used it and so have their constituents.

Despite their knowing that Medicare bettered the lives of 21 million Australians last year alone though quality and affordable GP visits, vital tests, scans and hospital treatments, they continue to pursue their remorseless attacks against it. They continue the trend of breaking pre-election commitments that has become commonplace in Liberal-National administrations. Right now, I think I need Medicare myself because this government's sheer neglect for the Australian people makes me sick. I am sure it makes the 170,000 constituents who make up my electorate sick too.

In mid-December last year, I had the pleasure of meeting with Dr Steve Osman-Toddhall. He practices as a GP at the Hub Medical Centre in Burpengary. It was just over three months ago that I spoke with him. Not six months prior to that, Prime Minister Malcolm Turnbull promised that, under his government, nobody would pay more to see the doctor as a result of the coalition's extended freeze on the Medicare rebate. I can tell you that this government has forced Dr Osman-Toddhall to cease bulk-billing new patients between 18 and 65 years of age and, in many cases, to drive up costs by more than $20. Sure, this might not mean much for the opposition. It might not mean much for the minister or the assistant minister. But for the people of Longman this can mean the difference between sickness and health.

Do you know what the median total personal income in Longman is? It is $27,000 a year. Think about that for a moment. That is just over $500 per week. The ordinary, hardworking members of Longman struggle to put food on the table as it is. How are they expected to respond to the unforeseen medical costs that undoubtedly surprise us all from time to time? I was speaking with a local woman, Christine, the other day. She is a resident in my electorate. She reached out to me. She was appalled and disgusted by this government's decision to force her elderly mother to pay an extra $83 every couple of months to have a special heart blood test. She needs this test; it is vital for her health. She used to receive it under Labor's Medicare. The Liberal government have turned their backs on this poor woman. They would much rather line the corporate pockets of their friends with some questionable tax cuts. It is not just this elderly person in my community who needs Medicare either. It is everyone.

Let me quickly return to that income that I talked about earlier—that $500 a week. $500 a week is the median personal income for people in my electorate. That figure is going to drop very soon, too, if this government gets its way, because that $500 a week includes income secured through penalty rates for some people who live in my electorate. Up to 700,000 Australians are going to be affected by this government's unfair, unacceptable and undeserved cuts to penalty rates. Just imagine if you were counting on that extra income to pay the exorbitant medical fees that are being inflicted by the Prime Minister. Imagine that you are on $500 a week and part of that money comes from penalty rates and they are going to be cut.

I know the opposition across the floor feel threatened by Medicare. It is the pride of our nation and the envy of countries all over this world. It signifies one of Labor's greatest achievements. We, the Labor party, the architects and protectors of Medicare, will not sit by and watch this government put people's health at risk.

3:57 pm

Photo of Nicolle FlintNicolle Flint (Boothby, Liberal Party) Share this | | Hansard source

I have to say that I am getting a little bit tired of getting up here to talk on yet another misguided matter of public importance from those opposite claiming we have failed and that we are doing the wrong thing when Labor and especially state and federal Labor in my home state of South Australia are the only failures in the health space that I am aware of. I am just going to run through a few of the successes achieved by the coalition government. There are so many that I do not think I am going to have time to go through them all. I know that people in my electorate and other Australians already know full well that they are benefiting from our record investment in health in this nation. Australians know this because their medicines are cheaper than ever. GP bulk-billing rates are higher than ever at 85 per cent. The number of services subsidised by Medicare has increased under us yet again. This is because we are rock-solid when it comes to the health of Australians and we are rock-solid on Medicare, the funding for which is increasing consistently by about $1 billion every year.

On top of this, we are tackling harder issues such as obesity and ice addiction. We have rolled out our $160 million Sporting Schools program to keep kids active. I am particularly interested in the Girls Make Your Move campaign which looks to encourage more young women to get involved in sport. We have invested $398 million to underpin the National Ice Action Strategy and have geared up our Primary Health Networks to help with this terrible scourge as well.

We have also started to fix the health issues of tomorrow with a substantial investment in health and medical research to the tune of $125 million. I just want to quickly mention the work that Flinders University, which is in my electorate of Boothby, and the Medical Device Research Institute are doing in a smart ageing area. We know that ageing and looking after our ageing population is one of the big challenges that we face. They are doing some remarkable work in this space. I look forward to seeing the results of that research during my term.

Those opposite always want to talk down our contribution to health. They like scaring the elderly. And they did that throughout my campaign in Boothby. I do not know on what basis they can do this because their track record is undeniably poor. They cut $1 billion from dental care and means tested it. They cut $500 million from Medicare for pathology. They cut $664 million from Medicare for GPs. And they cut $450 million from Medicare safety net protections. For me, as a South Australia, Labor's track record in this place is of no surprise, given that we are seeing the result of their appallingly bad policies in South Australia. They have decimated our health system, they are lurching from crisis to crisis and, of course, they cannot even keep the power on. I would like to know what my South Australian counterparts opposite are actually doing about this. I do not see them doing much at all.

Let us look at the biggest failure in South Australia health at the moment—the failure to open the brand-new $2 billion new Royal Adelaide Hospital. We have one of the world's most expensive buildings sitting there without its doors open and without a single patient being treated. It is an absolute failure. I hope that the state Labor government can pull this together and provide health care to the South Australian people for this huge investment.

Labor are closing a number of hospitals and changing services. They are calling this the Transforming Health program. Personally, I see it as the 'Trashing Health' program. One of the most disgraceful decisions under this program in South Australia has been the closure of the repat hospital, the war veterans' hospital, in my electorate of Boothby. I was at the bombing of Darwin ceremony last weekend in my electorate in the heritage-listed chapel on the repat hospital site. I heard firsthand the distress that our veterans feel about the closure of this wonderful hospital that has served them for some 70 years. It is also a really important community facility, particularly for elderly people in my electorate. It is just another example of Labor's appalling record on health.

Labor has brought chaos to South Australia's health system. Given another chance to govern, those opposite would undoubtedly do the same to not just South Australia but the entire nation.

4:02 pm

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I would like to thank the member for Ballarat for bringing this matter of public importance to this House. It relates very strongly to the reason that I am here today.

The clue to what sort of government this would be came early—it came late on election night on 3 July. What we have seen since has been a cranky, insular, sullen, confused and intellectually lazy government. We already knew before the night of the 2016 election that this was a government whose solution to housing affordability was for voters to go out and get some rich parents. Its solution to the most important public need of all, health care, now appears to be: let the public system slide away—Medicare—and hope that private medicine will take up the slack, at least for those the government thinks matter.

Increasingly, we are faced with evidence of the government's failure to deliver on health policy and health commitments. Yes, there are pockets of good news—the funding of some new medications, as already mentioned, for cancer therapy. Genetic disorders, such as cystic fibrosis, is one area. And I congratulate the minister on the approval of the use of medical marijuana in severe neurological disorders. I congratulate him. It was a good decision. It was one, I agree, overdue. I am just sorry the minister is not here to hear my congratulations on this matter. However, the most serious problem within this government that I see is a lack of an overall policy framework for health care for all Australians that is equitable and accessible. The government not only has no overall philosophy of health care but has no commitment to transparency in health care. Whilst it publicly states that it does not want to privatise or Americanise our healthcare system, it has privatised our national cancer register with very little debate. It is now looking to privatise our national hearing service. This information is only leaked very slowly. There is no transparency. Certainly, there is very little debate.

The coalition went to the election with very little clear health policies apart from freezing Medicare rebates for years, a move which all agree would gradually reduce bulk-billing to make health care less accessible to many vulnerable people. The Prime Minister came to my electorate to announce funding for insulin pumps for people with type 1 diabetes under the age of 21. He made a great fanfare about it. The parents of my patients with type 1 diabetes were very grateful but anxious that access to these tremendously life-changing treatments be available as soon as possible. The commitment was given to have them available on 1 January. However, now, eight months after the election, this policy has still not been implemented. Also, promises about mental health services have not been translated into action, and $1.4 billion has been cut from preventative health and health promotion grants.

Many of the Closing the Gap targets in Indigenous health have not been met, and the government just seems confused about what to do next. In my state of New South Wales, hospital waiting lists are longer now than they have been for decades. More and more people are struggling to access specialist care. Dental care is out of reach for many, particularly the elderly. Waiting times in my electorate for cataract surgery are over a year. Many people cannot afford to see an ENT surgeon, affecting many children with hearing loss. More and more people are struggling to access specialist neurologists and cardiologists where gap fees can now be over $300. The Liberal- National parties do not seem to understand the importance that access to health care has for some of the most disadvantaged and the importance of adequate funding of Indigenous health services, in particular, in making overall community wellbeing much improved.

I am in this place because in my practice I was increasingly concerned with the difficulty my patients were in having access to care. I was a medical student in 1975, when the Whitlam government introduced Medibank. That was destroyed by the Fraser Liberal government. I started my private practice in 1984 with the advent of Medicare, which was introduced by the Hawke Labor government. I saw the dramatic improvements that occurred. Demonstrably, only the Labor Party has a clear commitment to universal, affordable health care. This government's health policy is polarising and inequitable. They appear to have no real idea about complex health issues or the importance of equality in health care. Sir Michael Marmot, the former President of the World Medical Association, has spoken of the importance of the social determinants of health. In paediatrics, good health care can be a passport out of poverty and into education and social mobility. On this side we understand that. (Time expired)

4:07 pm

Photo of Trevor EvansTrevor Evans (Brisbane, Liberal Party) Share this | | Hansard source

I am very pleased to rise and speak in defence of the government's record on health, especially in light of some of the consistent comments that we are hearing from those opposite. The opposition gets fewer than 100 opportunities a year to raise matters of public importance, and it speaks to the paucity of their policy development and their readiness for government that they waste one of the opportunities here today trying to give the appearance that their shadow minister is keeping up with the government's work and our imminent announcements.

Those who care about the quality and standard of debate in this country, those who have ever wished that politicians might be restricted from saying blatantly untrue things and those who have an interest in sound policy should be listening very carefully to the words that the opposition are using here today with respect to health funding. They ought to be alarmed. Listening to Labor's lies you might conclude that the government is delivering less in health than Labor did in office. It is a fact that this government is delivering record levels of money—

Photo of Ed HusicEd Husic (Chifley, Australian Labor Party, Shadow Parliamentary Secretary to the Shadow Treasurer) Share this | | Hansard source

On a point of order, Mr Deputy Speaker, I ask that that unparliamentary language be withdrawn.

Photo of Mark CoultonMark Coulton (Parkes, Deputy-Speaker) Share this | | Hansard source

I ask the member for Brisbane to withdraw that word.

Photo of Trevor EvansTrevor Evans (Brisbane, Liberal Party) Share this | | Hansard source

I withdraw. It is a fact that this government is delivering record levels of government money towards health. We are delivering more this year than last year, more than in any year before, and certainly more than in any year under Labor. Anyone who is inclined to believe these Labor lines should just ask a Labor politician to show them an actual graph of the funding delivered over recent years. They will see very clearly what I am about to say. The budget papers show very clearly how the federal government's health funding is growing every single year. The federal government's contribution to health is $71.4 billion this financial year. It rises to $73.4 billion next year and $76 billion the year after that. Then it rises to $79 billion in 2020. Anyone who cares about health funding can confirm what I have just said for themselves. These numbers are in the budget papers. People can go straight to the source and check this out themselves. The budget papers are online—budget paper No. 1, statement five, page 5-49. It shows the government spending there and our commitments under area under health. It is all there in black and white. They can see straight away that the numbers are going up, not down. They are going up by an amount that is higher than the rate of inflation and the rate of population growth combined. It is increasing per person, per year in real terms. You can clearly see there that about half the federal government's health budget goes to Medicare. I will come back to Medicare in a moment. About a quarter of it goes to the states to help them run the states' hospital systems. The federal government, of course, does not manage hospitals. The remainder is split between the PBS, other health services and specific Indigenous health services.

There is one area in the budget where those numbers are not going consistently up and are not at record levels. That is administration expenses. It is probably a topic for another day to talk about the difference between the coalition and Labor governments when it comes to managing administration expenses.

Those opposite have said quite a bit about Medicare in their speeches here today, so I will focus on that for a moment. The budget papers show that this government is delivering record funding to Medicare. It is there in black and white. Our funding of Medicare is going up each year, not down, and it is going up by an amount higher than population growth and inflation combined.

Labor's next line that needs to be called out is that they are trying to say that they would have spent more had they had the opportunity. They want us to believe that if they promised to spend more, then somehow that equates to cuts on our side, even though our actual funding continues to go up. This is a case of promises, promises from Labor. Labor promised extra funding at exactly the same time as they promised this country three surpluses. That never eventuated either. The ABC fact checker called this out repeatedly. I quote from the ABC fact checker:

It is far from certain that the Gillard promises would ever have been fulfilled. They were looking far into the future and their increases were never budgeted for. History shows budgets change dramatically from year to year, and something cannot be taken away if it was never given in the first place.

4:13 pm

Photo of Brian MitchellBrian Mitchell (Lyons, Australian Labor Party) Share this | | Hansard source

It gives me great pleasure to rise today to speak on the shadow minister's MPI on this government's atrocious failures in health care. As the member for a regional electorate, nowhere has it been more appalling than in regional health. The day before the election the Prime Minister promised that no Australian would pay more to see a GP under his Medicare freeze. This was a line. Australians are already paying more for GPs and out-of-pocket costs of health care are increasing. Indeed, in October last year the AMA recommended that fees rise to $78, which will leave patients $41 out of pocket. Perhaps members opposite can explain to us how we have an election, yet the AMA is recommending that fees go up. It does not align too well with what Prime Minister said. This year's increase to private health insurance premiums sees a $200 increase. Since 2013 they are up $900 a year. That is 23 per cent in five years. These are massive out-of-pocket costs that ordinary Australians simply cannot afford.

Australians pay more out of pocket for health care than people in many countries. The out-of-pocket cost increases are 4.5 times higher than government funding over the last year. According to the Productivity Commission they have gone up six per cent, compared to 1.3 per cent in government funding. On every measure this government is failing the health needs of Australians.

The Turnbull government is making health care less affordable for every Australian, with the Medicare freeze already forcing GPs to drop bulk-billing—an increased out-of-pocket cost. Indeed, bulk-billing in December dropped from 84.6 per cent nationally to 83.9 per cent. They are rabbiting on about the increases in bulk-billing, but the figures show they have dropped over the last quarter from 84.6 to 83.9. In Tasmania, it is even worse: from a low bulk-billing rate of 76.4 per cent, they have dropped to 74.5 per cent. In one quarter they have gone down 1.9 per cent. The only place in Australia that bulk-bills less than Tasmania is the ACT. It has the highest income in the country; Tasmania has the lowest. Tasmania should have the highest bulk-billing rate in the country given its comparatively low incomes, but it is 13 per cent lower than New South Wales, which is comparatively much richer.

Tasmanian Dr Graeme Alexander was reported in November saying patients avoid seeing a GP because of the cost. He said:

This problem is just going to get dramatically worse and very quickly.

The Royal Australian College of General Practitioners president, Bastian Seidel—a Tasmanian—says that the drop is concerning. He said:

You are going to end up in a public emergency department or you will be calling an ambulance out.

These are the real consequences of when you fail to properly fund Medicare, when you fail to properly fund the health system and when you fail to properly look after primary health. It shoves people over to the hospital system, which is already under stress. Bastian Seidel continued:

That is even worse because we know an ambulance call-out costs the taxpayer at least $800 and a presentation to a public hospital emergency department costs the taxpayer at least $200.

So for small savings in one area, you end up with a massive blowout in another area. It just points to failures all round by this government.

Their failure to properly fund our public hospitals has seen elective surgery waiting times blowout to the worst they have ever been. And Tasmania's dedicated elective surgery hospital, the Mersey, just to the north of my electorate, is currently on a one-year funding deal. It expires in July this year, and yet we have no indication from this government about the future of that funding deal. Patients are left in the lurch; they do not know what is going on. The Tasmanian Liberal government is tearing its hair out. It is trying to get a deal out of this government and it needs some answers about what is happening with the Mersey. Is it getting a one-year deal, a three-year deal, a five-year deal or a 10 year deal? Nobody knows, and yet the members opposite think that is just fine.

As for hospitals more generally, the Royal Hobart Hospital is 'exceeding capacity' says the state Tasmanian health minister, Michael Ferguson—and he is a Liberal. Ramping is endemic. Patients are being interviewed in corridors. (Time expired)

4:18 pm

Photo of Andrew WallaceAndrew Wallace (Fisher, Liberal Party) Share this | | Hansard source

I rise to oppose this quite wrong suggestion made in the matter of public importance before the House today. At the heart of this matter is delivery. Delivering is exactly what the government is doing in the area of health care for all Australians, as it is in so many other policy areas. I am pleased to be able to speak in this debate today to correct the members' opposite misguided view, and shed some light on the reality of the government's extensive delivery on its health promises.

As I have previously spoken about in this place, I am passionate about tackling the issue of mental health not only in my electorate but also across the country. The House knows the horrific figure that one in five Australians will suffer from a mental illness in any given year—20 per cent. The need for a favourable change in these figures is more pressing than ever before and this government is delivering in this area. The government is investing $192 million to support mental health care, to fund suicide prevention regional trial sites and provide for additional headspace centres. This is hardly a failure. Indeed, it is a sign of the government's decisive action on mental health.

The government's commitment and record in delivering on its health promises is by no means limited to mental health. Indeed, as we have heard, the coalition government expenditure on health continues to grow each and every year. In 2015-16 the government committed $69 billion to spending on health. This commitment has increased to almost $73 billion this budget year and is projected to exceed $79 billion in 2019-20. If we consider the total spending on health, aged care and sport in 2016-17 it amounts to $90 billion.

Funding is not everything in health, but we recognised that we needed to invest more. We promised to do so, and we have delivered in every state and territory. As the member for Fisher, I represent many constituents who understand the health related challenges of living in regional Australia. This government promised to improve access to health care in regional and rural areas of Australia, including on the Sunshine Coast. The government made this promise, and it is delivering on that promise.

We recognise the unfortunate reality that access to health services is often an issue for those Australians living outside major cities in regional and rural settings. That is why we are delivering new initiatives to help. The government is delivering $93.8 million over four years for a new integrated rural training pipeline to coordinate the different stages of medical training within regions. The government is delivering $131.2 million over four years to build upon the Rural Health Multidisciplinary Training program and to support clinical placements in non-traditional settings. The government is delivering a $20 million funding boost to the Royal Flying Doctor Service. The government is delivering an incentive of $9.25 per service for GPs that bulk-bill eligible patients in rural, regional or remote areas. The list goes on.

I am just sorry that I only have five minutes to talk about this matter, because I could stand here all day and talk about the wonderful things that we are doing in space. But unlike those opposite, we on this side of the House prefer to let our record and actions speak louder than our words. These actions are delivering tangible results today and will undoubtedly further improve the standard of health care available to people across the country in the future.

Let me just give you a few examples. Despite the unjustified and desperate actions of those opposite during the election, Australian patients are receiving more benefit from Medicare under a coalition government than ever before. This government has a rock-solid commitment to Medicare, and funding continues to increase year on year. In the second half of 2016, Australians received more than $10.85 billion in Medicare benefits. This was $1.23 billion more than the same period in 2012 under Labor.

The Turnbull government clearly understands the health needs of the Australian community and continues to deliver in all areas of the health portfolio. Today's debate is simply another example of the Labor Party's dishonest and inaccurate characterisation of the coalition's healthcare record. (Time expired)

Photo of Mark CoultonMark Coulton (Parkes, Deputy-Speaker) Share this | | Hansard source

The time for the debate has concluded.