Deborah O'Neill (NSW, Australian Labor Party) Share this | Hansard source

I too rise to address the Second interim report of the Senate Select Committee on Health. I thank Senator McLucas very much, not only for her wisdom and experience as a member of the committee—particularly with that powerful interest that she has in mental health—but also I thank her for being ready to step in for me here in the Senate today, as I have been attending the funeral of a fine Irish Australian, Bernie Lowe, which was held on the Central Coast at The Entrance today at 11 am. I am very pleased to be able to return and speak to matters that I know would have inspired him to act for his local community. I want to convey my condolences formally on the record to his wife, Isobel Lowe.

Health is such a critical part of the way people interact with their governments. Sadly, we have been recording, over the course of the last six months, the fallout of the government's policymaking on the run. I want to put on the record the words of the President of the Royal Australian College of General Practitioners, Dr Jones, who gave this very salutary warning to the government:

Australian general practice patient services have been unfairly targeted by the government to find savings within the health budget. GPs and practices are now faced with an ethical dilemma of providing ongoing quality care balanced against practice business imperatives. Please remember—

'please remember', he says, pleading with the government—

that most general practices in Australia operate as small businesses.

But the attack that we have seen on the businesses which are our general practices across this country has been absolutely unprecedented. Far from the drama that those opposite attempted to create when they were claiming that Australia's Medicare system was in crisis and threatened to become unsustainable, the Bettering the Evaluation and Care of Health in Australia (BEACH) program report from 2013-14, entitled General practice activity in Australia 2013-14, states:

Australian general practice can reasonably claim to represent world best practice in terms of both cost and patient outcomes. There is ample evidence that preventive and primary care services that are patient-focussed rather than disease-focussed provide the most cost effective health outcomes for those individuals and communities.

That is the evidence base—GPs telling the government that the government are making decisions on the run that are causing chaos and threatening the provision of primary health care across the nation, and the BEACH report, an independent study, saying that Australians get good value per dollar.

But this government cannot help themselves—they opposed Medicare at every turn, and here we are, in 2015, with their best efforts to destroy that very effective system of health access. They have had a few goes as it. And I absolutely concur with the comments of my colleague Senator McLucas who went through the litany of disastrous policy-making on the run that has characterised the health ministers of this government so far.

Can I say: it is a very different approach from the approach that Labor would take. But I do want to go, in particular, to the impact of the decision making of this government to continue a freeze on indexation. The $7 co-payment was so badly received, by a sector that was completely ignored at any point of consultation, that it was overturned by political will, frankly. The second phase of the $5 GP co-payment and the level A and B fiasco were similarly overturned by political will because of the terrible damage that they would do to the system and to those businesses run by our GPs across this country and, through that, to the access of Australian people.

But this government continues to say—and that is why this report is so important—that they want to put a price signal, a gap, between people seeking health and the person who can provide it for them. They want to put a gap between sick and vulnerable people—elderly people, the chronically ill, ordinary Aussies walking around healthy today but sick tomorrow, and children—and the health care they need. They want to send a price signal. It was bad when they wanted to do it themselves up-front, but the way they want to do it now is even sneakier. They want to do it by indexation.

So what does it mean, this indexation? I will use the words of Stephen Parnis, the vice president of the AMA, who indicated that the indexation freeze proposed by this government was a 'co-payment by stealth'. He said:

… irrespective of the model of business that you adopt, when the government component of contribution is fixed at zero per cent while all of the other overheads continue to rise, that means the margin there will diminish. If one is a practice that exclusively bulk bills, it will not take long before that impacts. Inevitably doctors will have to make decisions to change the way in which they bill—effectively, asking patients to make a contribution where the government is not. We believe that bulk billing rates will diminish.

That is what the government's policy is set to achieve—to place that price gap between ordinary Australians and the health care that they need. A freeze on indexation means that those who are providing the service will not have any increase in the provision of that service into the foreseeable future over the forward estimates. And of course as businesses—and, as I said at the very beginning, these GPs are businesses—they will not be able to continue to deliver that service. We have seen and recorded the struggle that GPs are already talking about. How do they discern who can pay and who cannot? How do GPs in poor communities discern who is the rich one that they are going to overcharge so that they can afford to give a basic service to somebody who has no capacity to pay?

We are not just talking about people here who might be on a concession card with carve-outs—because this is the other myth that we have been able to explore in the course of our inquiry. The reality is that there are many chronically ill people who manage their health very well, by attending their GP on a frequent basis and getting the good preventive care that they need, and who are working and paying taxes. There is no proposal from this government to look after the chronically ill—none whatsoever. They are so determined to push ahead with this disastrous proposal.

I want to speak, briefly, in the time that remains, of the threat that this is, and not just to people in the city; I want to record the concerns that were raised with us in the regions. Regions are particularly vulnerable because we know that, in many cases, there might be only one place in which that service is provided. The concerns that are being raised with us are being raised in the states of Queensland, New South Wales and Victoria. They were raised most recently when we were in Broken Hill, in the health minister's own seat of Farrer. And the shameful thing that went on there—and, again, it reveals why this report is so important—is that the CEO of the local health district, albeit a state government employee, sent out an email, which we have recorded, telling his chief executives that, if they were contacted by the Senate Select Committee on Health, they were not to cooperate; they were not to respond. That is trying to hide what is going on—trying to hide every day the shameless attack that this government has been perpetrating, from the day that they came in, against health workers, health providers and health seekers across this nation.