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

I rise today to talk about yet another broken promise from what appears to be an already tired and worn-out government. It is a government that is so bereft of foresight and vision that it has resorted to flailing around in search of any nasties that previous coalition governments had thought fit to hoist on the Australian people. One could be forgiven for feeling as though we have stepped into some sort of sad movie, a mixed-tape of coalition catastrophes of old that have besmirched our nation's history; or, a book of bad ideas, you might say, with a spoiler alert that says it all ends in tears.

We have had the 'hide the boats', the 'stop the boats' and the 'tow the boats' debacle from a government so inept at handling foreign policy that it has severely damaged our relationship with Indonesia—a relationship repaired and strengthened for years under Labor, only to be destroyed in just a few short months of this coalition's misadministration. No amount of censorship, secrecy or hiding behind our nation's fine servicemen in the name of political expedience can hide the shame that Prime Minister Abbott and Minister Morrison have brought on themselves for their ham-fisted attempt at gunboat diplomacy. On the upside, there are more Indonesian patrols on their southern approaches, but I doubt if they are in a very cooperative mood.

We have had the typical attack, which we have sadly come to expect from a Liberal coalition government, on those in our community who are without work, with a slated review to find ways to make already difficult lives a little harder. We have had the trademark coalition assault on our public broadcaster for daring to publish stories critical of the government, swiftly followed by the promise to cut a quarter of a billion dollars in funding and the launch of an efficiency review, which will no on doubt result in even more cuts. We have had billions of dollars cut from education, with the Prime Minister brazenly breaking his erstwhile promise to be on a unity ticket with Labor on schools funding, as well as cuts to vital support to parents with the slashing of the schoolkids bonus.

We are also currently witnessing an unprecedented attack on our public health care, with the coalition launching reviews and commissions of audit to look at how best to gut Medicare. The minister is on record stating that Medicare is 'unsustainable'. He has flagged cuts to Medicare, including front-line services; these are clearly in his sights. Medicare Locals, set up by the Rudd-Gillard government, are in the minister's sights. Labor set up 61 Medicare Locals to strengthen the provision of bulk-billing primary care services in our community and to take pressure off secondary care services and hospitals. Indeed, as the former member for Robertson, I was one of many members of the House of Representatives who wore a path to the minister's office to clearly identify where those Medicare local areas would be geographically and what they would consist of culturally to make sure that we created communities of concern, communities of care, that were practical and responsive to community needs. They are our front-line primary health undergirding and construction device to make sure that we get into the community.

Medicare Locals have enabled the federal government to identify and deliver specific needs for local services, as well as plan for the delivery of services to address inequities through the development of target preventative health initiatives, the deployment of additional medical staff and the provision of out-of-hours GP services. They have been incredibly effective in anyone's book. Medicare Locals have provided the framework for the Commonwealth to directly engage in the provision of local primary care and planning and to improve the overall health of our communities, thereby reducing pressures on our hospital networks, which are a significant part of the state governments' budgets.

In my local community, the Central Coast NSW Medicare Local has been ably led and is very much embedded in the community. It delivers fantastic health initiatives and improved health outcomes for that population. It has been providing this through high quality primary health care services since opening its doors on 1 July 2012. There are many areas on which I could speak about its contribution to the better health of the families of the Central Coast but I would like to highlight, particularly in this week of the Closing the Gap report, the many services it provides to our local Aboriginal community.

Also, on this day, I acknowledge in the gallery two fine aunties from the Central Coast, Aunty Di O'Brien and Aunty Anita, who are elders and well-respected in the community. They come from other lands around the country, down from the Murray; I think the Wiradjuri are there. They have made a wonderful contribution over very many years to the Central Coast. It is an honour to have you here with us today. I am pleased that you are able to be in the chamber to hear the Closing the Gap report, because your lives have witnessed such incredible disadvantage. I know from my conversations with you and the community on the Central Coast how powerful the Medicare Locals initiative has been in engaging and helping the health outcomes in the Indigenous community. There are a few indicators of the changes that have been achieved, including the 74 Aboriginal clients registered on the Central Coast with the CCSS program. I know from my conversations with Di O'Brien that her outreach into the community has been particularly effective and that other communities around the nation have been seeking her guidance on exactly how she has been able to achieve so much in such a short period of time. Not only is Di a hero in our community, she is acknowledged nationally for her great contribution.

The Medicare Local is very much a front-line service, and one of the things that it provides is transport for Aboriginal people with health conditions who were isolating themselves from the community. These people were unable to move, unable to get to health care and unable to be connected to community. These things impact on not just physical health and wellbeing but mental health and wellbeing. That critical provision of transport has made a very, very big difference to the lives of many local people.

The increased awareness in our community of different Aboriginal health programs that are available, like the PIPIHI program and the Closing the Gap initiative, has meant that health awareness is growing and people are taking the opportunity to increase particularly their awareness about chronic disease. Support for people with chronic diseases, and those in danger of developing them, has been targeted with very specific programs and outreach.

It really concerns me when I hear furphies about Medicare Locals being perpetrated in a public place and conversations that say, 'These are only bureaucratic backroom workers.' It is not a backroom worker who puts an ill person into transport and reconnects them with the community and their health care, to which they have a right as a citizen of Australia. It is not a backroom person working on papers who goes out, picks somebody up and takes them to the doctor and gives them access to the support they need to manage their chronic health issue. These are front-line, highly skilled and culturally aware community workers who need to continue to do the work that they do. I have an incredible fear that in slashing and burning these great initiatives, which were described this morning at the Closing the Gap report breakfast as having established the foundations on which we will build to close the gap, we could lose the initiatives that we have so far put in place and lose the hard-won gains that we have achieved.

Medicare Locals also provided a cervical screening nurse at Mingaletta, which is their cultural home for health care on the Woy Woy peninsula. It is important that you go somewhere where you feel comfortable and safe if you are facing challenges and wanting to increase your sense of awareness. Going to have a cervical screening for the first time can be something that is very disconcerting. To go to somewhere where you know that you are going to be supported before and after is a really powerful way of increasing that health outcome.

We have also had great days out at the Gosford Showground with the Aboriginal unit attending many different community events, and, in particular, raising community awareness about health at an annual event. I am very pleased to say that today I am wearing a piece of jewellery that Aunty Colleen made for me, which I got in September—maybe August—at the event last year.

We are also finding that our front-line workers, supported by Medicare Locals, in the Aboriginal health area on the coast are visiting GP practices and providing real-time and in situ education about what it is to make the experience of going to a GP more culturally approachable for Indigenous people. There are visible signs and posters in practices, and staff are increasing their cultural awareness of engaging with Indigenous people. We know that GPs and practice managers have met at Mingaletta, and there are very many stories. I know that we have the Eleanor Duncan and Mingaletta health centres on the north and south of the coast of the local health district, and they are working together. In some cases, and in some areas, it is for the first time. This is one of the critical things that cannot be overlooked about what Medicare Locals are doing. Where there were no connections, they have now been made because of the efforts of those engaged in Medicare Locals ensuring that preventive health access and education is being provided.

For a government that railed in opposition for an increase in front-line services, it stands to reason that this government should be looking to increase funding for a policy like Medicare Locals, which does exactly that. But, sadly, it seems you would be wrong. The Medicare Locals networks employ 3,000 front-line health workers, though according to Mr Dutton these positions are, as I said, bureaucratic. The guiding principle of the coalition, he said, will be 'to take money away from bureaucratic wages'. Despite the Prime Minister promising before the election that they would not shut any Medicare Locals, the government has subsequently launched a review into the network. Asked repeatedly to rule out the closure of Medicare Locals, Minister Dutton has pointedly declined, hinting that cuts are on the cards. He has of course previously advocated for the abolition of all Medicare Locals, before having a poll-driven eleventh-hour conversion before the election. So it is little wonder that the government has chosen to backflip on its promise of convenience.

It is evident that in launching this review the Abbott government is looking to axe Medicare Locals across Australia. Clearly, Minister Dutton is on the record as showing contempt for them and he has recently added statements on the unsustainability of Medicare amid reports of a proposed introduction of a GP tax. The government, sadly, has already axed millions of dollars in funding for medical research and has abolished a number of preventive health bodies. I particularly want to note the abolition of the 50-year-old Alcohol and Other Drug Council. It is quite timely that I make this speech after the senator has just been speaking about issues of concern regarding drugs in our community and the one-punch laws that are now being mooted. If we do not want to get to a situation—as we have—where one-punch laws need to come in and where this becomes an issue of order, we must invest in health and education.

This is a matter of public interest because people all around the country in the last four years have had the benefit of finding that Medicare Locals are oiling the wheels that were so long neglected in terms of integrating all of the health infrastructure and capacity that was out there but was latent and not meeting community needs.

I do believe that you, Mr Acting Deputy President Smith, are on the record as supporting the GP $6 fee. That is of some concern. I hope that I stand corrected because certainly in the areas that I represent as a senator, and particularly on the Central Coast, which I know so well, the challenge of getting to a doctor was pretty big. We resolved much of that during the time Labor was in government. But for the people who have just begun to properly use their local doctors to support them in their personal health care, the impost of $6 for a potential visit would be just too much.

Assistant health minister Fiona Nash's chief of staff, we have found out, is married to the head of a lobbying outfit that works for the junk food industry. The Liberal Party took $107,000 from the tobacco industry in the last financial year alone. When we consider this, it is little wonder that we are sadly seeing this lack of regard for public health. It is the 30th anniversary year of Medicare, and, on this day of all days, when we are articulating our shared commitment to Closing the Gap, I fear for what might happen with this government's continued decimation of Medicare Locals. (Time expired)