Chris Bowen (Prospect, Australian Labor Party, Minister for Financial Services, Superannuation and Corporate Law) Share this | Hansard source

I move:

That the House insists on disagreeing to amendments Nos 1 and 10 insisted on by the Senate.

It is important that I outline to the House why this Health Insurance Amendment (Compliance) Bill 2009 is so important. This bill aims to protect the integrity of Medicare, which had an expenditure of $14 billion in the year 2008-09, and also enhances Medicare Australia’s compliance program. The bill will enable Medicare Australia to give notice requiring the production of documents to a practitioner or another person who has control of the documents to substantiate an amount of Medicare benefit paid in respect of a professional service. Practitioners may be liable for a financial penalty where the amount paid in respect of the service cannot be substantiated and is above a specified threshold.

Last year the government agreed to those amendments moved by the Senate which relate to this bill. The government did not agree with amendments (1) and (10) and our position has not changed. Amendments (1) and (10) are not related to the compliance bill. The amendments have no substantial relationship with the bill and are clearly a stunt. The government have engaged with the opposition in good faith on the amendments that are related to the bill and have been happy to support the amendments that have risen from these negotiations. I recognise the good faith in which the opposition entered into those negotiations and I think, in fairness, the opposition would recognise the good faith in which the government responded. However, the government will not be supporting a political stunt from the opposition pretending to the Australian public that they are in a position to cover up their reckless acts in the Senate. We have a responsibility to manage the budget in a sustainable way that provides for the best outcome for the taxpayer. This amendment could hinder the government’s exercise of that duty.

By way of background, everyone knows improvements in technology have made cataract procedures quicker and less expensive. In the 2009 budget, the government sought to adjust cataract expenditure because, as a government, we wanted to ensure that the benefits of technological investments were passed on to the taxpayer. Ophthalmologists disagreed with the extent of the change and after extensive negotiations we have agreed to a 12 per cent cut on cataract MBS items, effective from 1 February 2010, a freeze on indexation of cataract items until November 2011 and a review of the items on the MBS under the new MBS quality framework process. This compromise maintains $47 million of the proposed $98 million saved at a time when health spending represents a going pressure on government budget. A review of all the relevant items will enable a more detailed assessment of the appropriate fees to apply in the future.

I am pleased to hear that the opposition have supported the new rebate levels. These amendments are intended to take effect retrospectively from 26 October 2009. They are clearly intended to have the effect of increasing the Medicare Benefit Schedule fee for items disallowed by the Senate on 28 October 2009. The amendments would increase spending from a standing appropriation for Medicare payments and would have the effect of appropriating money. The government have legal advice that these amendments fail to comply with sections 53 and 56 of the Constitution and are therefore unconstitutional. According to the longstanding practice of governments, the Minister for Health and Ageing does not intend to release the government’s legal advice. We do intend to reject this amendment.

As I say, we—my office and the office of the former shadow minister for Human Services—have sat down with the opposition. I know that the current shadow minister for Human Services is aware of the issues and these have been worked through in a mature and sensible way. Amendments which relate to this bill have been agreed to by the government and the opposition and have passed the Senate and will pass the House. But amendments which the opposition move which do not relate to this bill are completely unacceptable to the government. We did not accept them in the Senate; we will not accept them in the House. They are unconstitutional. Therefore, having supported the government’s compromise on cataracts, I would appeal to the opposition to, just as we have negotiated in good faith on the issues that are related to this bill, now drop their insistence that these amendments which relate to cataracts but do not relate to this bill in any way, shape or form be pressed upon this House. They should be rejected in this House and the opposition should get behind this very important legislation—and not block it—which not only protects the integrity of Medicare and taxpayers but also protects those doctors doing the right thing. It also enables Medicare to take appropriate action against doctors doing the wrong thing to protect—(Time expired)

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