House debates

Wednesday, 16 August 2017

Matters of Public Importance

Medicare

3:14 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 hurting Australians by undermining Medicare.

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

Going around our communities, we get a lot of feedback about the government. One of the more common questions I hear is: can the Turnbull government get any worse? Obviously, the government has heard this too because this week they've actually taken up the challenge. Just when we thought that they couldn't get any worse, this week, of course, they have. Just when we thought they couldn't be any more chaotic, they are. And, just when we thought this government couldn't get any more dysfunctional and useless, they've rewritten the record.

The behaviour we've seen this week is a new low from a very desperate government—a government lacking integrity and a government that knows that they have an active threat to their legitimacy and a question mark on their majority. But, let's be honest, this chaos isn't anything new. This week has simply added a new chapter—a unique new chapter, I'd have to say—to this government's ongoing record of dysfunction. But the worst part is that, while they are so focused on themselves and their own fortunes, our communities will be paying the price not only today but also for years and years because of policy decisions that have put them and their families last.

This government have only ever cared about themselves, and there is no better example than when it comes to health and to our Medicare system. Every time someone in our community needs to see a GP, every time someone needs to visit a public hospital and every time someone needs to visit a specialist, they are bearing the brunt of this government's continued harsh and unfair health cuts. The government likes to put on a bit of an act and pretend like it's all been fixed, there's nothing to see here anymore and they're committed to Medicare, but there's a very, very simple test—a test that tells the true story about this government's complete neglect of Medicare. Have they dropped all of their unfair cuts that they're making to health that make it less accessible and less affordable for every Australian? Have they dropped every single one of their cuts? The answer, of course, is: no, they have not.

I know that the minister's a bit of a name dropper, and he puts on a bit of an act that he's the superhero in health, but he knows, we know and our constituents know that this is absolute rubbish. The damage done by the government's attacks on Medicare is continuing every day across the country, whether it is in the GP clinics, in the public hospitals or in relation to public dental. People are paying the price for this government's neglect of Medicare, whether it's in waiting times blowing out or the hit to their hip pocket going up every time under this government.

I'd like to particularly focus on dental in this contribution today because it's one of the best examples of why this government can't be trusted when it comes to the health of this nation. If you're looking for more evidence that, when it comes to health, there is nothing that the Prime Minister won't destroy, public dental is an absolute prime example. These are basic dental services that are provided for some of our society's most vulnerable Australians, and they are particularly important because we know that access to dental services is one of the biggest markers of health inequality and, in turn, economic inequality more generally. The most recent statistics from the Bureau of Statistics show that people living in areas of least socioeconomic disadvantage were significantly more likely to see a dental professional than those living in areas of most disadvantage. People living in the areas of most socioeconomic disadvantage were twice as likely to delay seeing or not see a dental professional due to cost compared with those living in areas of least disadvantage.

One study of inequality in oral health in Australia found that the number of middle-aged adults with fewer than 21 teeth was seven times higher in the lowest than in the highest income quartile. That's why the last federal Labor government budgeted $391 million a year for adult public dental services. But the Turnbull government has cut this funding time and time again, with total cuts of around $300 million a year. As a result, every year, more than 300,000 Australians will miss out on critical public dental services. This is a cut that is in addition to the Prime Minister's attempt to abolish the Child Dental Benefits Schedule—a separate program that provides dental care to eligible children. Let me repeat that: that's a program that, in fact, provides basic dental care to children, and this government tried to abolish it. Labor blocked that cut in the parliament, but the adult program is not protected by legislation.

To show you just how damaging this cut is, in an extraordinary step six states and territories recently wrote to this health minister to highlight the disastrous impact of the Turnbull government's latest cuts to dental funding. They were united. This is a major cut to the provision of public dental care across the country. The letter called out the severe funding cut and significant reduction in the level of Commonwealth investment in a national partnership agreement on adult public dental care. This agreement is meant to support the provision of dental care to vulnerable Australians, but the state's letter makes clear that these cuts will lead to fewer people being seen and longer waiting times for dental treatments. And new figures from the department show just how long people are waiting for the dental care that they need. The average wait time across all states and territories is 14 months—and that, of course, is the average; in the Northern Territory it is a staggering 45 months. That's almost four years to get public dental help.

There are more than 409,000 Australians in this situation, on these waiting lists across the country. And how much money did the government allocate in the budget to actually fix the existing waiting lists? Nothing. In fact, they locked in their cuts, which will only make the situation worse. And of course these have come on top of all the cuts across the system that this government has banked in its savings policies. The vulnerable people in this situation are being burnt by the government's cuts. The Medicare freeze will be in place for years to come, with GP items to manage chronic disease, treat pregnant women and undertake mental health assessments frozen until 2020—still banking $2.2 billion of savings cut out of patient rebates. Specialist consultations and procedures continue to be frozen, hitting the 40 per cent of Australians who need to see a GP each year, including some of our sickest and most vulnerable people.

And there has been the abandonment of public hospitals, pushing them to breaking point. We are seeing that across the country—people with higher needs ending up in our emergency departments and unable to access the care they need because of funding cuts by this government. That is the story the government won't admit when it comes to Medicare, our universal health insurance system. It is the story of how they are making it harder for Australians to get the health care they need. This is the story of how health inequality is only getting worse under this government when they continue to put themselves first when it comes to the health care of this nation.

There is another matter I want to raise when it comes to our healthcare system that we've seen today and that I've been incredibly disappointed to see the minister's response on, and that is the issue of vaccination. Whilst we commend the government on the small amount of money it has contributed to running a vaccination campaign, today, again, we have seen One Nation make a statement around antivaccination—Senator Burston, obviously backing in Senator Hanson's previous comments. We have seen again from this government a failure to condemn One Nation for its comments. This is a significant issue. We have a leadership responsibility in this place to ensure that what we say from the platforms of this place is critically important. But in this circumstance we have seen that this government has created a platform for One Nation to continue to spread its misinformation about vaccination. I ask the minister in his contribution to say the words, 'I condemn One Nation's antivaccination comments.' That's what I ask you to say—exactly those words: 'I condemn One Nation for their antivaccination misinformation.' That's what you need to do. I know you've tweeted that you don't agree with antivaxxers; I want you to say that you don't agree with One Nation antivaxxers, because they are the people in this parliament who are using the platform you have given them to actually spruik this misinformation.

It is critically important that we make sure that the message is out loud and clear that we do not support One Nation's comments about vaccination. And I know the minister's embarrassed, because he knows they've done a deal with One Nation on these media reforms in the Senate and they don't want to offend them by saying those words. But I ask him to do that, because it is critically important that we get the message out to parents, even those who voted for One Nation, that on this issue they are wrong.

3:24 pm

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

Labor aren't just environmental frauds; they are 'Medifrauds', because when they were in government they took an axe to Medicare and they took an axe to many different parts of our hospital system. Most significantly, and this is the greatest point of shame, they deliberately ignored the advice of the Pharmaceutical Benefits Advisory Committee and refused to list seven significant drugs, including drugs for lung conditions and schizophrenia. This is an issue that should be a source of absolute and abiding shame for people who claim that they believe in Medicare. When they were in charge, when it was their watch and they were in the role, they failed on every possible front.

Let me run through a series of things. They cut Medicare for GPs by $664 million. We are still feeling the effects of that. They cut pathology Medicare payments by $500 million. They cut the Medicare safety nets by $450 million. They cut a billion dollars—and this is the fascinating thing—from dental care. We just heard a great peroration about the importance of dental care. One of the first things I did was to add $163 million to the dental budget to lift the Child Dental Benefits Schedule from $700 to $1,000. It was one of the very first things that I did—on my watch, in my time, as my responsibility.

What did Labor do? They axed the chronic disease dental care system. And why did they axe the chronic disease dental care system? Because demand was too great—too many people were accessing a form of public dental care. A billion dollars was being rorted! People with broken teeth, with damaged gums, with diseased mouths—these were the people who were rorting it. So they slashed a billion dollars from dental care and dental schemes, and, in particular, from the most vulnerable, the most at risk, and those suffering the most with chronic disease. And Labor say they are smart on dental care? This is the last place I would go if I were the Labor Party—at least out of a sense of decency if not a sense of shame.

But it was worse than that, because they also cut $2½ billion from medicines and delayed seven critical drugs—something that we will not do in our time. Our commitment is to honour and implement the PBAC decisions, which is precisely why we will follow the advice of the independent medical bodies, and why we struck and agreement with Medicines Australia to reinvest every dollar that we were able to secure by having statutory price reductions. That is why we have been able to list drugs such as Opdivo, a drug which was a $1.1 billion investment in reducing lung cancer and renal cancer.

Ms Madeleine King interjecting

These statistics, as you call them, are human lives. Do you think we should, perhaps, not have listed Opdivo? The PBAC is an independent body, and we honour it. You denounced it, you rejected it and you dishonoured it. That is the second point of enormous shame on the ALP's side.

Epclusa is another extraordinary drug. You would not know, generally, that 800 people a year lose their lives to hep C. Those 800 people will now have a real shot at life with the listing of Epclusa. Epclusa helps up to 200,000 people in Australia who suffer from hep C. It covers all the strains of hep C, and, on our watch, we are bringing this in. Most significantly, perhaps of all of the different drugs we have been able to list, this one has an extraordinary outcome: it doesn't just treat; based on all of the medical advice, it is likely to cure 90 per cent of those who suffer from hep C. With 800 deaths a year, we are talking about, potentially, 700-plus lives. That is real medicine, delivering results for 200,000 Australians—and for all of their families and friends. There would barely be an Australian who doesn't know somebody with hepatitis C. In particular, it has an impact in so many different Indigenous communities. This is what medicine is about. This is what managing the health system is about. That is what you should do as a government, not delay seven fundamental medicines that, as advised by the independent medical authorities, should be listed.

Perhaps most significantly, Labor didn't just take an axe to the private health insurance system; they took a chainsaw to it. What did they say before they came into power? I will quote the former member for Gellibrand. She said:

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

In government they took an axe to the private health insurance rebate. They saved $4 billion. They slashed $4 billion from the private health insurance rebate.

Here is what the member for Sydney said after they left government:

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

What does that mean? It means that when they next run for office they'll make noises about the fact that they like private health insurance, they want to do something about private health insurance, they'll protect private health insurance. But do you know what they'll do? They will slash it again. Why does that matter? Because if you slash private health insurance support you undermine the ability of Australians right around Australia to access private health insurance, and if you do that you put the private hospital system at risk. If you do that you put the public hospital system waiting list at risk. Waiting lists blow out. They are the real consequences of an alternative view which doesn't value the Australian healthcare system, with its public hospitals that are some of the best in the world, with its private hospitals that are some of the best in the world, and with a private healthcare system that provides an extraordinary balance.

Those opposite hate private health insurance. Let me repeat that: Labor hate private health insurance. How do we know that? Because when they were last in government that's what they did. That was the reality.

Ms Catherine King interjecting

I am happy to say I love the private healthcare system. I do believe in private insurance, and we have protected it. By contrast, what are we doing? We are seeing Medicare funding increase every year, from $23 billion to $24 million to $26 billion to $28 billion. That's the reality of what's occurring on our watch, in our time. We are seeing hospital funding increase from $19 billion to $20 billion to $21 billion to $22 billion—each year, every year.

But I do want to deal with what our friends on the other side say in relation to hospitals. They talked for a long while about $57 billion, and people could have been forgiven for believing that they would go to the election with a $57 billion increase. But they took to the election only a $2 billion increase—a $55 billion shortfall. Out of $57 billion there was a $55 billion black hole on hospitals. Do you know what is interesting, Mr Deputy Speaker? That is a four per cent success or a 96 per cent failure. Anywhere in the country, four per cent out of 100 per cent is a failure—unless, of course, you happen to be filling in an HSU workplace health and safety survey for a few friends.

Most significantly, by contrast we have put in $7.7 billion of extra funding in the lead-up to and since the election—real funding increases which are seeing real projects being built right around the country. That is what we have done. Those opposite have a $55 billion black hole, which either they are not going to fill, as they didn't last time, or they were fibbing right the way through.

Ms Catherine King interjecting

Here's a question: are you going to add $55 billion next time? The simple answer is: they're not. At the end of the day, what is occurring? We are making sure that Medicare is guaranteed. We have struck agreements with the AMA, the GPs and the Pharmacy Guild, and we have also struck agreements with Medicines Australia and the Generic and Biosimilar Medicines Association, the first time in Australian history that any government has had agreements with all of those bodies at the same time. When it comes right down to it, we have 'medifriends' on this side and 'medifrauds' on that side. If they ever get the chance again they will destroy private health. (Time expired)

Ms Catherine King interjecting

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

The member for Ballarat will not continue interjecting like this for the rest of the MPI.

3:35 pm

Photo of Tony ZappiaTony Zappia (Makin, Australian Labor Party, Shadow Parliamentary Secretary for Manufacturing) Share this | | Hansard source

No matter how hard the minister tries, Australians don't trust the Turnbull government with the future of Medicare. They have good reason not to. The track record of the coalition when it comes to Medicare is appalling. The coalition government has never, ever been committed to Medicare. It began with the coalition government tearing it down at their first opportunity when they came to government after the 1975 election. The only reason this government has not done even more to dismantle Medicare is that they know that the Australian people are watching every move they make. They know that the Australian people voted very clearly in the last election to preserve and safeguard the future of Medicare.

But nothing more undermines Medicare than the government funding cuts to public hospitals, to public dental services and to the MBS rebates. Every time public funding is cut, more of the costs are transferred onto the patient or onto the health professional that is providing the services. And that undermines the universal healthcare system that this country is very proud of. We have a healthcare system that stands amongst the best in the world because it was brought in by Labor and because we have standards that we've been able to meet for decades. When the public health system is under stress, it is the people that are already struggling, the people that are facing hardship, the people that already have chronic illnesses, the people who are already disadvantaged who will suffer the most.

With respect to the Medicare freeze that this government claims it has now lifted, it is the slow thawing of the freeze. We know full well from the government's own documents and from their statements that it's only children and concession card holders that benefit from that thawing of the freeze this year. The GPs and specialists freeze isn't lifted for another 12 months. The specialist procedures and allied health providers freeze comes off in 2019, and only certain diagnostic services will have the freeze lifted in 2020. That means that for some of these providers the freeze has been in place for up to six years and in some cases will continue.

As the shadow minister has pointed out, people who suffer from illnesses like asthma and diabetes, or pregnant woman or those who recently have had a baby, will not be covered by the lifting of the Medicare freeze. Indeed, we have some 300,000 women a year or more who not only have to pay for the direct medical costs but, as we all know, incur additional costs at the time of having a baby that are subject to this freeze. That is because the government is indirectly—in fact, directly—cutting billions of dollars of services as a result of continuing the freeze.

The savings to government that arise from the freeze continuing run into billions of dollars, and those billions of dollars in costs are being transferred to the patients and perhaps, in some cases, to the professionals who are prepared to wear them. The average increase for a service across the country as a result of maintaining the freeze is now over $7 since this government came to office. What it means is people either do not go to see their doctor or they go to the outpatients of the public hospital, in turn putting more pressure on the public hospital services. Not surprisingly, those public hospital services are now being stressed out more than ever before, with elective surgery waiting lists now blowing out to 14 months or more, and so on.

With respect to the $300 million of dental cuts, the reality is that every time a person does not go to the dentist because they can't afford it and have to wait over a year to get public treatment, it affects the rest of their health. So in turn there are other health costs that the nation wears because the government foolishly cuts a service that could have avoided those costs.

The last comment I want to make is about how the government's cuts are affecting people in regional and rural Australia, where people are already at a disadvantage for a whole host of reasons and where most of our poorer people live. If you look at the stats, it's the regional and remote areas where some of the lowest-income people in this country live. For them, the cuts mean even more disadvantage, because the health providers simply cannot continue to provide them, and so their disadvantage is in fact exacerbated.

This is a government that continues to hurt Australians because it continues to undermine the very health services that Australians rely on, and they are the Medicare services that this country has provided for years. (Time expired)

3:40 pm

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

Really, Mr Speaker, they have a hide to talk about us and cuts to Medicare. I think they pulled this out of the bottom drawer. It was a quiet day today. All the other issues of the day don't seem to be cutting the mustard anymore, so they think, 'We'll wheel out Medicare cuts.' You just have to look at the record of the other side, the Labor Party, when they were last in government. There were cuts everywhere. If Medicare and the health system were a patient, they'd still be bleeding in the recovery ward. There were cuts everywhere—death by a thousand cuts.

Look at the dental issue under the former Labor government. They got rid of the chronic dental disease program. That's a billion dollars in itself. In pathology, they cut another $500 million. Medicare payments to GPs were cut by over $600 million. There was the freeze. Who introduced the freeze? It was the Labor Party. If you look at what they cut out of pharmacy, Mr Speaker—it's unbelievable, the chutzpah of the people on the other side who talk about cuts—it was $2.5 billion out of pharmaceutical benefits, let alone blocking Pharmaceutical Benefits Advisory Committee recommendations in cabinet to save money. Then there was the major haemorrhage to private health insurance, which gives so many people access to hospital care because they're on waiting lists for public hospitals; it gives them control over their health.

So, I am certain that, if we put these people back in charge of the health system, they would be back to saying one thing but then delivering another. We in the coalition government have a wonderful record in the Health portfolio. We have supported the four pillars of the health system. With the Medicare benefits schedule, we have started unfreezing the Medicare freeze with a bulk-billing incentive first, then GP rates, then speciality rates and then radiology and diagnostic things down the track. We have put extra money into the pharmaceutical benefits by getting a better, cheaper deal out of the big pharmaceutical providers for the old, cheaper drugs—we got a better deal for them—and we're putting it in the front end so we can get all the wonderful new drugs. You've only got to look at what we have on record: 1,400 new drugs, including all the wonderful drugs for hepatitis C. That is 200,000 people who can now be cured rather than getting cirrhosis and cancers. Look at cancers for kidney, ovary, lung—you name it—renal cancers, the latest announcement of a new drug for chronic lymphatic leukaemia, a common blood malignancy. They all have to be paid for. They're very expensive and we on the coalition side have managed things and got a good deal and have an ongoing funding stream for pharmaceutical benefits and the new drugs that everyone clamours for.

Heart failure—there's another one: hundreds of thousands of people suffer from it, and Entresto is now on the PBS. They talk about cuts to public hospitals. Really, it is just a joke. They say one thing. They're trading off their record from Gough Whitlam's days. They talk up their book, but really what they did in the last government was really disappointing. Public hospitals since 2013 have 64 per cent more funding from the Liberal-Nationals coalition governments. That's another $2.8 billion just in the 2017-18 year, or $7.7 billion since 2016. That's a massive increase: 64½ per cent. And the list goes on.

So we're defrosting the Medicare freeze in a stage fashion. That is how people manage things well. We have the runs on the board. We are delivering in spades for health. It's well managed. We have extra money in childhood cancer treatment. We have extra money for mental health. The huge burden of mental health hasn't been addressed as well as it has with the recent appointment of the member for Flinders as health minister. He realises that the mental health burden in Australia is huge, and we are directing appropriate funds to address that. (Time expired)

3:45 pm

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

What an astonishing week in politics it's been. First off, we have a Deputy Prime Minister whose legitimacy is currently completely under a cloud. This House has had to refer the case of the Deputy Prime Minister to the High Court to see if he legitimately can sit in this House. We've had the foreign minister creating her own diplomatic incident this week—

Ms Price interjecting

I'm coming back to health, don't you worry, Member for Durack. I have health firmly in my sights. But these are desperate times for a desperate government. Remember that look of desperation on Malcolm Turnbull's face on election night when he nearly lost?

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

Member for Newcastle—order!

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

You're quite right, Deputy Speaker. He is the Prime Minister, at least for now. He stood before the Australian people. A very distressed Prime Minister, he was—a man with a 'majority of just one, looking really nervous.' He stood in front of the cameras and said, 'I've learnt my lesson about Medicare. Hands off Medicare. I know what we've done is beyond the pale.' Let's face it: if we examined the record of members opposite on Medicare, we'd reveal a truly scary story. It's a 40-year story of ongoing attacks on and undermining of Medicare since day one. It's in the Liberals' DNA. You can't help yourself. And you wonder why Australian men and women don't trust you when it comes to health. Let's just remember why. When—

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

The member for Newcastle—order! The member for Newcastle will address her remarks through the chair.

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

Quite right. I am pointing out that it is of little surprise that the Australian people do not trust the government when it comes to Medicare or health in general in this country. It's of no surprise. We heard earlier the minister congratulating himself for the release of a whole series of new drugs on the PBS. There's no argument on this side of the House whatsoever. You know what? We actually think it's the job of the Minister for Health to find ways to get new drugs, much-needed medications, onto the PBS list. It's a measure we wholeheartedly support, but we say that that's actually the job of the Minister for Health. So good on you for doing your job.

What we on this side of the House, however, are concerned about is the government's continuing undermining of Australia's universal health system. The member for Macarthur and I have had the extraordinary pleasure of talking with Australian men and women across the country as part of Labor's Medicare task force. Everywhere we go we hear the lived reality of Australian men and women struggling to access quality health care in Australia. We know about the impact of out-of-pocket expenses for Australian men and women. We know, for example, as the speaker before me rightly mentioned, about what I'd call the partial defrost that's going on at the moment—the Medicare slow thaw. Much to the horror of many Australians who were, at first blush, delighted to think that the government had had a change of heart, that they were going to back off having learned their lesson on Medicare, when they tried to actually take advantage of the changes, tried to find and access bulk-billing, they were disappointed. They found, very early in the piece, that if you're a woman—

Mr Littleproud interjecting

Member for Maranoa, you're not a woman, but if you had any experience of trying to get a Pap smear test done in Australia, for example, you would find out, very quickly, that you don't get to bulk-bill your Pap smear test. Now, you might think that 50 per cent of this nation's population don't deserve—

Mr Littleproud interjecting

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

Member for Maranoa, keep quiet.

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

What have you got against women, Member for Maranoa? Really! This is simply one more example. Out-of-pocket expenses, limited access to bulk-billing doctors and GPs in Australia, cuts to the public dental health scheme—all of these things undermine Australia's universal health care. Labor created Medicare. It is Labor that will always protect Medicare. (Time expired)

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

Before I call the member for Berowra, I remind the member for Maranoa that he will be getting his turn shortly. Until then he'll remain silent. I call the member for Berowra.

3:50 pm

Photo of Julian LeeserJulian Leeser (Berowra, Liberal Party) Share this | | Hansard source

Labor is hypocritical on health policy. We all remember Labor's campaign launch last year, where, in a zombie voice, the Leader of the Opposition called on Australians to save Medicare. When the zombie voice comes out, the fake news follows. He scared millions of Australians. He is the best friend 'Mediscare' ever had. Labor's announcement at the last election had all the genuineness of a Milli Vanilli single. It had all the truth of the Ern Malley hoax.

It's one thing to disagree with the government's policy; it's another thing to completely make it up. That's what the Leader of the Opposition did with his fractured fairytale that was Mediscare. The 2017 budget put $94.2 billion into health care, with the Medicare Guarantee Fund being established to secure the ongoing funding of the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme, guaranteeing access to those services. We provided for the Medicare levy, paid into the fund, topped up by personal income tax, to continue the MBS and the PBS. Medicare represents $1 in $3 of the healthcare budget, and it's increasing every single year.

Mr Hill interjecting

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

The member for Bruce is warned.

Photo of Julian LeeserJulian Leeser (Berowra, Liberal Party) Share this | | Hansard source

I'd like to thank the member for Ballarat for introducing this MPI. It is the perfect opportunity to dissect the utter hypocrisy of the opposition on this and many other fronts. In his budget reply speech just a few months ago, the Leader of the Opposition stated:

And a Labor budget will always protect Medicare. This means reversing the unfair Medicare freeze immediately.

I know economics isn't the strong suit of those opposite, but let me give them a bit of a history lesson on this matter. This is the freeze that was implemented by the Labor Party. The Medicare freeze was Labor's freeze. The member for Sydney is the architect of the freeze. The Turnbull government has removed Labor's Medicare freeze. We restored the indexation of the Medicare rebate in the 2017 budget, starting with bulk-billing incentives from 1 July this year, including the retention of incentives for pathology, diagnostic imaging, blood tests, X-rays, scans and pap smears. And from 1 July 2020 we're introducing, for the first time in 15 years, indexation for targeted diagnostic imaging, including mammography, fluoroscopy, CT scans and intervention procedures. Under the current government GP bulk-billing is at record levels. Under Labor it was at 81.9 per cent and under the Turnbull government it's at 85.4 per cent. So all the Mediscare talk is completely wrong. Bulk-billing is going up and up. This means more Australians are able to visit the doctor without having to reach into their pocket. But freezing Medicare was just the tip of the iceberg for Labor's poor record on health care.

When they were last in government, the Labor Party took a scalpel to the health budget, with surgeon-like precision. We had a lecture from the member for Ballarat about dental care. Labor cut $1 billion from Medicare for dental, and means tested it as well. Labor cut half a billion dollars from Medicare for pathology. Labor cut $664 million from Medicare for GPs. Labor cut $450 million from the Medicare safety net protections. Labor cut $2½ billion from pharmacy and medicines.

Ms Catherine King interjecting

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

The member for Ballarat is warned.

Photo of Julian LeeserJulian Leeser (Berowra, Liberal Party) Share this | | Hansard source

Labor blocked access to life-saving medicines. Labor cut $4 billion from the private health insurance rebate for consumers and means tested it. Not only are we ending the Medicare freeze implemented by the opposition but we have increased funding for Medicare. We're investing an additional $2.4 billion in Medicare over the next four years, and spending on Medicare is increasing every year, from $23.7 billion in 2017-18 to $27.9 billion in 2020-21. The government is also reducing the cost of medicines by $1.8 billion over five years to make medicines more affordable for ordinary Australians.

While we're thinking about Medicare, I thought it was also worthwhile mentioning the NDIS. The NDIS is being funded by an increase of 0.5 per cent to the Medicare levy. This is actually properly funding the NDIS where Labor left a big black hole and, potentially, disadvantaged some of the most disadvantaged Australians in our community. That's how they treat disadvantaged people—by leaving a big black hole. We on our side of the House make sure that our programs are properly funded, and that's why we've increased the Medicare levy by 0.5 per cent to guarantee the NDIS into the future. The government is securing the future of Medicare with a strong, stable Medicare with more funding and more bulk-billing, and with the protection of Medicare.

3:55 pm

Photo of Milton DickMilton Dick (Oxley, Australian Labor Party) Share this | | Hansard source

Well, I think I've just about heard everything. We've heard a lot of fake news, we've heard the alt-right and alt-left, and now we've got alt-Medicare. That's what we've dealt with today. We know the government is in chaos and we know there is yet another crisis engulfing this government. But whilst they play the hunger games on that side of the parliament, ripping each other apart, we know that the community has been abandoned by this government when it comes to school funding, abandoned when it comes to standing up for penalty rates, and abandoned when it comes to health and Medicare. What alternative universe, what Orwellian rubbish we've just heard from the member for Berowra. We know, and the people in my electorate of Oxley know, that it was this party, the Labor Party, that built Medicare, and only Labor will protect Medicare.

We got a lecture that we shouldn't go back in time. You need to listen to what former members for Oxley have said, including the great Bill Hayden. It was in the seat of Oxley that the architect of Medicare, Bill Hayden, first developed universal health care for this country, when, during the 1973 second reading speech on the health insurance bill to introduce Medibank—as it was called at the time, before those opposite sold it off—he said it was to provide the 'most equitable and efficient means of providing health insurance coverage for all Australians'. Listen to those words and act: 'for all Australians'—not just for the wealthy, not just for the few, but, as he said, for all Australians.

At every turn, this government has proved they cannot be trusted when it comes to protecting Medicare and the health of Australians. I know this and the whole of Australia knows it. From the secret privatisation task force all the way to extending the Medicare freeze, this government continuously lets down Australians every time it gets the chance. This government is simply not serious when it comes to protecting Medicare. Whilst it might be okay for millionaires living on the North Shore, I ask the Prime Minister and members opposite to spend time in my electorate—

Ms Price interjecting

Here we have the member for Durack rubbishing the people of my electorate yet again. I ask them to speak to the people who are hurting because of this government's abandonment of its commitment to Medicare. Pensioners living in my electorate in Inala are hurting because of this government, families living in Springfield are hurting because of this government, and parents living in the Centenary Suburbs are hurting because of this government. Every time someone in our community needs to see a GP and every time someone needs to visit a public hospital, they are bearing the brunt of this government's continued harsh and unfair health cuts. That's what happens when a government is focused too much on itself and not on the Australian people.

The government fails the Medicare test by delaying to reverse its unfair cuts to Medicare for three years. The Medicare freeze is still in place for years to come. GP items to manage chronic disease, like asthma and diabetes, are frozen until 2020. GP items to treat pregnant women and women who have recently had a baby are frozen until 2020. Rebates for GPs to conduct pap smears are frozen until 2020. And rebates for GPs to undertake mental health assessments are frozen until 2020. We know the impact that the freeze is having on access to GPs, with bulk-billing for GPs dropping since the election and out-of-pocket costs skyrocketing. But it's not just in the GP waiting room; it also impacts Australians who need specialist care. In the past 12 months, 40 per cent of Australians needed to see a specialist. That's around 7.4 million Australians who need to see a specialist each year. Keeping the freeze in place will continue to impact Australia's sickest and most vulnerable patients.

A couple of years ago, on budget night, we saw the government wanting some sort of congratulations for their supposed Medicare guarantee. This reminds me of all those years ago when we saw then Treasurer Hockey dancing on the night of the election to 'Best Day of My Life', cranking the music up, while he brought the axe through the health services in this country.

This is a government that we know is hamstrung by the extreme Right wing, and cuddling up to One Nation. As we heard from the shadow minister, this is a party and minister who will not condemn One Nation's policy on vaccinations, who will not get up and actually denounce those comments. How can the Australian people seriously take this government at their word when they're in partnership and cuddling up to a party like One Nation? It beggars belief. Let the facts speak for themselves. We know Medicare is still under attack. We know it always will be as long as this government clings to power.

4:00 pm

Photo of Tony PasinTony Pasin (Barker, Liberal Party) Share this | | Hansard source

One thing's for sure: 'Mediscare' continues. Those opposite should have been embarrassed about that campaign, but instead they've boldly come in here and claimed the 'Mediscare' all over again. They come back into this place. They like to lecture us about raising the quality of class politics and the debates we need to have across the chamber. Yet secretly they continue a scare—a scare which saw me, during the election campaign, ringing hundreds of pensioners after hours to say: 'Look, I understand you've expressed some concern about the fact that you're being told that Medicare is about to be abolished. Sadly, that's a misrepresentation which is being made by the Labor Party.' And what was so sad about that was that these poor, vulnerable pensioners actually believed it.

Those opposite have a duty to be fair and reasonable, not engage in the spin. If this is a debate about who froze the Medicare rebate: I have young children, girls, and they love that movie Frozen. It's a story about Anna and Kristoff, who bravely push onward in a race to save their kingdom from winter's cold grip. I'd like to think that's what we're doing over here. We thawed the Medicare freeze. The member for Sydney's cast in this movie; she's the snow queen Elsa! She froze the Medicare rebate. But it was us on this side of the chamber who were cast in the role of Anna and Kristoff, bravely mountaineering on to unfreeze the rebate. We thawed it. It's an inconvenient truth for those opposite. So, let's face it: you froze it; we thawed it. We can agree on that. Let's move on.

What else have they done? Their record is one of cutting. Labor cut $1 billion from Medicare for dental care and means tested it. Labor cut $500 million from Medicare for pathology. Labor cut $64 million from Medicare for GPs. Labor cut $450 million from Medicare's safety net protections. Labor cut $2.5 billion from pharmacies and medicines. I wish this speech was allowed to go for 15 minutes; I could talk about all the cuts. But I will keep going. I'll try to speed up my dictation. Labor blocked access to lifesaving medicines. Labor cut $4 billion from private health insurance rebates for consumers and means tested it. Labor refused to back its unfunded $57 billion hospital promise—their biggest cut in weighting. Labor promised 64 GP clinics; they delivered only 33. But, to be honest, for the Labor Party, 50 per cent achievement—pretty good! For the Labor Party, that's kind of an A-grade outcome.

But the real issue here is that Labor promised to end the blame game, but we come into this place, MPI after MPI, and they say, 'Oh, it's all you!' Well, I tell you, we agreed about it before. You froze it; we thawed it. What else have we done? Well, those opposite, who froze it—

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

The member for Shortland, a point of order?

Photo of Pat ConroyPat Conroy (Shortland, Australian Labor Party) Share this | | Hansard source

I ask that remarks be put through the chair, as you have ruled with other speakers.

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

I remind the member for Barker to address his remarks through the chair.

Photo of Tony PasinTony Pasin (Barker, Liberal Party) Share this | | Hansard source

Mr Deputy Speaker, that just gives me an opportunity to reiterate my point: those opposite froze it; we thawed it. You're Elsa; we're Anna!

Photo of Pat ConroyPat Conroy (Shortland, Australian Labor Party) Share this | | Hansard source

Mr Deputy Speaker, on a point of order, he's outside your ruling.

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

I will decide who's following my rulings.

Photo of Tony PasinTony Pasin (Barker, Liberal Party) Share this | | Hansard source

So I have another opportunity. Let's be clear: those opposite froze it and we thawed it. Those opposite are Queen Elsa; we're Anna. Who is the great heroine in this debate? Anna. Queen Elsa was saved by Anna. The telling fact is this: those opposite are the great champions of bulk-billing, but Labor had a bulk-billing rate of 81.9 per cent—that was Elsa's effort—while Anna's effort, those on this side, was 85.4 per cent. It was more, not less. (Time expired)

4:05 pm

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

That was just embarrassing. I'm so sorry that members of the public had to witness that last speech. This government doesn't really care about the retention of Medicare as a universal healthcare insurance scheme. It just doesn't understand it. I know this, and I have seen the various attempts by conservative Australian governments to destroy a universal healthcare system over the last 40 years. From my time as a medical student in 1975, when the Fraser government destroyed Medibank, to the attempts by a variety of conservative Liberal-National Party governments to undermine Medicare in the last 35 years, it has been death by whittling away, by white-anting, by a thousand cuts—whatever you call it, it's the truth. I started my practice in 1984 in Campbelltown when Medicare started. I saw what a dramatic difference it made to health care—and made to health care for the people who were the most disadvantaged. The benefits were real and, unfortunately, we're now returning to the bad old days of the sixties where people—particularly people who are disadvantaged, who are poor, who come from groups that have high levels of disadvantage—can't access proper medical care.

We now have a system that is beset by massive cost shifting, from state to federal, and back again, and around in circles. We now have a system where there are huge increases in out-of-pocket expenses, and I refer you to the article by Stephen Duckett from the Grattan Institute I think only a couple of days ago, demonstrating huge increases in out-of-pocket expenses, particularly to see specialists and subspecialists. We now have a system with extensive waiting lists in public hospital outpatient clinics, sometimes to levels that would be unimaginable for most of us here in this House. For cataract surgery, waiting lists just to see an ophthalmologist in the public system are over 12 months. Waiting lists to see a urologist for some of the most vital surgery, particularly for older Australians, are over 18 months. Waiting lists to see ENT surgeons are at unbelievable levels. In fact, many public hospitals no longer have public outpatient clinics for things like ophthalmology and ENT surgery, which means that the very poorest, the most disadvantaged, just can't access that sort of medical care.

Large sections of the community who have chronic illness can't access the care they really need. I will give you a couple of examples—real examples. During the election campaign, while doorknocking I met a lady at her door who had intractable heart failure. She had heard that there were some new treatments available for heart failure and was referred by her general practitioner to see a cardiologist in his private rooms, but she couldn't afford it. She couldn't afford the over $500 out-of-pocket cost to see the cardiologist, so she just didn't go. This lady could not leave her house she was so breathless. That is disgraceful. It is really affecting people's lives, in case those opposite were wondering. There was another lady who had had spinal surgery and ended up with some spinal damage. She was incontinent of urine and faeces. She could not afford to see a urologist privately, and was told there was a waiting list of over 12 months to get into the public urology clinic at a hospital many kilometres away from my electorate of Macarthur. She was ringing me to see if I could speak to a local urologist to get her fitted in to his private clinic to be bulk-billed, because she couldn't afford the $300 to $400 she was going to have to pay out of her own pocket. She couldn't afford to save that out of her own pension.

These are people's lives. For children who have sleep disorders, I cannot get them into a public sleep clinic with a waiting time under 12 months. So you may as well effectively say they can't access the care. To see an ENT surgeon, in my electorate, they have to see someone privately because my hospital does not have a public ENT clinic. People are faced with costs of $300 or $400, which they cannot afford. This is really affecting people's lives. I want those on the other side to understand that. We also have very poor access to public dental care. (Time expired)

4:10 pm

David Littleproud (Maranoa, National Party) Share this | | Hansard source

I'm amazed that not once through the diatribe and vitriol that we have heard did those opposite talk about that great bastion of Labor electioneering, the privatisation of Medicare. Not once. Do you know why? Because it's been over a year and it hasn't happened. Funny about that—it says to me that those opposite have no credibility whatsoever when it comes to Medicare. Nor do they have credibility about how to run an economy or a nation. Let's talk about Medicare.

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

The member for Macarthur, on a point of order?

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

How dare the member for Maranoa accuse me of having no credibility in a field that I have worked in for over 40 years.

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

There is no point of order. The member for Macarthur will resume his seat.

Dr Aly interjecting

I remind the member for Cowan that she is out of her place and if she speaks again she is disorderly.

David Littleproud (Maranoa, National Party) Share this | | Hansard source

Let's not stop on the health system, because we put this privatisation myth that those opposite perpetrated during the federal election campaign. Let's think about it in real economic and business terms. I have been a small-business owner. Those opposite are normally union hacks, political hacks, never done a day's work in their lives, never had to pay a wage in their lives. Who in their right mind would buy a business that doesn't make a profit? It's not worth anything. No government in their right mind can privatise Medicare. But those opposite have no credibility, not only on the economy but also in terms of health. They're not interested in anything other than playing politics with people's lives. It's an utter disgrace that they come in here and play with the lives of Australians. Since we have been in government we have unfrozen the freeze. Yes, we have! You started it, you started every bit of it!

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

The member for Shortland, on a point of order?

Photo of Pat ConroyPat Conroy (Shortland, Australian Labor Party) Share this | | Hansard source

I request that remarks be put through the chair.

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

The member for Maranoa will address his remarks through the chair.

David Littleproud (Maranoa, National Party) Share this | | Hansard source

I will. Because, again, it was we that took the freeze off. It is those opposite that put it on. Not one of them had the ability to walk into this chamber and admit it, because it's all about politics. It's not about outcomes. This is Labor's way of talking about how they're spending billions of dollars on health. They talk about cuts and, again, we go back to the basics of how to run an economy. There have been no cuts! Another myth, another Labor lie! The reality is that those opposite cannot be trusted. In fact, we have seen an increase in bulk-billing rates since we have been in government. That is an achievement of this government. It is about outcomes, not just throwing money out the window, like Labor does frivolously every time they're given the Treasury benches.

Let me talk about real outcomes. Those opposite talk about cardiovascular appointments. In my electorate only last week we as a federal government gave $1 million to the Heart of Australia fund, to Dr Gomes. He is going to the most disadvantaged places in this nation and allowing them to see a cardiovascular surgeon. That is what we are doing as a real government to get real outcomes, not espousing all these hyperboles about what they can do, but delivering outcomes. That is what a government does.

Let's talk about dental. They wanted to stay away from the freeze, and rightly they should, because they started it. Let's talk about dental. I was in Winton, a small outback town that none of them would know or have ever been to. In Winton in the last couple of months we have had a new RFDS based truck that offers state-of-the-art dental surgery for those in the outback who don't have access to a dentist. That's what we on this side do—not talk about it, not the hyperbole. We deliver real outcomes for people in rural and regional Australia and the disadvantaged that those—

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

Order! The time for this discussion has concluded.