Matt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Parliamentary Secretary for Foreign Affairs) Share this | Hansard source

A couple of days before the last election the Prime Minister said that there would be no cuts to education, no cuts to health care, no changes to pensions and no cuts to the ABC or SBS. Well, in the wake of the budget we all know that that is now a complete farce. It was a complete misrepresentation of the truth by the Prime Minister and it was not disclosed to the Australian public prior to the election. Before the election that statement was made. After the election those promises and commitments to the Australian people were clearly broken.

The National Health Amendment (Pharmaceutical Benefits) Bill 2014 is part of that process of breaking a commitment to the Australian people. It is effectively a tax increase on the cost of medicines that unfairly impacts on the most vulnerable in our community. That is the gripe and the opposition that Labor has to this budget: it unfairly targets the most vulnerable in our community by increasing taxes, payments and levies that were not disclosed prior to the election, and, at the same time, it reduces the taxation burden on some of the most profitable sectors of our economy, most notably the mining sector, which will get a tax break if the mining tax is removed. Also, the most wealthy Australians can earn profits of over $100,000 a year as an income based on their superannuation of over $2 million and pay no tax on that. That is the unfair nature of this budget. It targets the most vulnerable—those who can least afford to pay and to bear additional costs—but it lets off those who are most able to shoulder some of the burden when it comes to the sustainability of the fiscal position.

Labor opposes this $1.3 billion tax increase on medicines, which will hit the most vulnerable in our community. The tax increase is in the form of a $5 increase to the general patient co-payment and an 80c increase to the concessional patient co-payment, for concession card holders. This bill also increases the general patient safety net threshold by 10 per cent per year for four years and increases the concessional safety net by two prescriptions per year for four years. This is about chipping away at the universality of our healthcare system, chipping away at the hallmark of a healthcare system that Australians are so proud of, in Medicare. The changes proposed in this bill are part of this government's campaign to undermine the universality of our healthcare system and to create a much more user-pays based system in Australia.

The government will not admit this fact. They say they are about ensuring that the health system is more sustainable in the future. This is not true. If it were, the revenue raised through these measures would be going back into the PBS; the revenue raised from the Medicare co-payment would be going back into the sustainability of Medicare. But it is not—instead, the government is putting this money into the Medical Research Future Fund.

Labor has no opposition to investing in medical research—that is a role that government should properly play within our economy and our community. The problem with this fund is that it will reduce the government's commitment to funding medical research through the National Health and Medical Research Council, the very body that has been established and has bipartisan support to deal with adequate levels of investment in medical research in our community in the future. That is the great shame of what is essentially a political game that is being played through this bill and through the proposed Medicare co-payment.

I wish to make a couple of points about the sustainability of our healthcare system. The government would have us believe that the healthcare system is out of control—that spending is out of control and the system is unsustainable—and that that justifies their making these changes to prescriptions and to introduce a Medicare co-payment. But the facts speak otherwise. The facts are that Australia's public health costs are well within the average bounds of OECD expenditure. Australia spends about 11.5 per cent of its GDP each year on public health; the OECD average of expenditure for governments on public health is 11.3 per cent. Australia is spot on in terms of the average cost of funding public health in our country.

Not only that, recent studies have demonstrated that the Australian system is a very efficient one when it comes to delivering proper health care for our community. A very well researched study was recently published in The Lamp, the journal of the New South Wales nurses' federation. The study was undertaken by The Commonwealth Fund, the very well respected health research body based in Washington in the United States. It looked at and ranked the overall effectiveness, efficiency and health of various healthcare systems throughout the world. It looked at the top 11 healthcare systems in developed countries and included nations such as Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK, the US and of course Australia. Australia ranked very well—4th out of the 11 nations—on a series of important indicators, including the effectiveness of care, the safety of care provided to patients and the level of coordination amongst healthcare providers at various levels throughout the healthcare system. Issues related to the cost of access, timeliness of care and efficiency of care were a big part of this study, as were equity and the extent to which the healthcare system promoted healthy living, or preventive health, within a community. Australia ranked in the top five on nearly all of those indicators and overall, as I said earlier, we were ranked No. 4 out of those 11 healthcare systems.

Interestingly, the healthcare system that came last, that was the worst out of the 11, was none other than that of the United States, which we all know is a privatised system—a two-tiered system, if you like. The US system, which this government is no doubt interested in looking at for Australia, ranked worst overall on all the indicators in the study. The No. 1 system, on the indicators in this study, was the United Kingdom's system—the National Health Service—which the citizens of the United Kingdom are rightfully very proud of. They are so proud of it, in fact, that they included it in the opening ceremony of the Olympic Games when they hosted it in 2012. It is a healthcare system that both Conservative and Labour governments have respected and valued and recognised as a great strength of the United Kingdom's democracy. The argument that the Australian healthcare system is becoming unsustainable does not hold water at all. That is why the changes in the bill we are discussing today are unjustified.

The costs of the Pharmaceutical Benefits Scheme are increasing, but they are being managed well and are increasing in a sustainable way. In fact, it has been shown that the PBS is growing at a much slower rate than expected in recent budget updates. At the moment the government spends around $9 billion per year on the Pharmaceutical Benefits Scheme to ensure that Australians have access to subsidised medicines and that the most vulnerable in our community get the necessary care they need. While in government Labor proposed and introduced the accelerated price disclosure scheme, which has slowed the real rate of PBS growth and put the PBS on a sustainable footing. I must point out that, prior to the last election, the Pharmacy Guild of Australia campaigned against accelerated price disclosure and simplified price disclosure. It had petitions in all of the pharmacies throughout Australia saying that this was a great shame for our healthcare system, that it would put pharmacies out of business and that it would ensure that Australians would not get the necessary care and access to the medicines that they needed. It was none other than the opposition of the day, the Abbott government, that were as the greatest cheerleaders for opposition to simplified price disclosure. And what do we find now that they are in government? Suddenly they have had an awakening. Suddenly they now support Labor's program of simplified price disclosure—much to the disappointment, I might add, of the Pharmacy Guild of Australia, which reported in a press release on 28 May this year:

The Pharmacy Guild has expressed disappointment over a response from Health Minister Peter Dutton to its petition on Simplified Price Disclosure (SPD).

I must say to the Pharmacy Guild of Australia: you are not alone. You are not alone in feeling your disappointment in this government in terms of the commitments that were made prior to the election regarding this government's proposals when it came to health care and the provision of adequate pharmaceuticals for Australians throughout this country. As we all know and as I mentioned earlier, prior to the election the Prime Minister gave a commitment that there would be no cuts to health, and once they were elected that commitment was thrown out the door in the first budget.

In Labor's last budget there were changes that were expected to deliver more than $1.8 billion in additional savings to this program through reforms that Labor was introducing. That would have taken the package announced at the 2007 budget through to 2017-18. The savings would have been close to $20 billion. These are savings that this government could have been using to ensure that new drugs or future lifesaving drugs could be listed as quickly as possible once they have been recommended by the Pharmaceutical Benefits Advisory Committee. It is something this government could have done if it were interested in ensuring greater access to more drugs as they come on line and are developed and commercialised—but no. Once again they are interested in slugging Australians through tax increases under the guise of sustainability.

One of the most worrying aspects of this government's increase in taxes on medicine is the fact that it will hit the most vulnerable. In the wake of the government's budget the University of Sydney conducted a study looking at the combined impact of higher co-payments, which it found will hit those 65 and over the hardest. The report's co-author, Clare Bayram, is quoted in The Sydney Morning Herald on 7 July:

The introduction of co-payments won't be shared equally.

…   …   …

It will particularly affect people who need to use more medical and related services, such as older people and those with chronic health conditions.

And these are the people this government has chosen to slog with its higher taxes through the introduction of this bill through the Medicare co-payment.

They do not have the support of the Australian Medical Association, who are also damning of this tax increase. Brian Owler has said the University of Sydney study supports concerns that doctors across Australia have with the measure. He agrees that the study shows that the impacts will be on the most vulnerable within our society. That is why Labor is opposed to this bill. That is why Labor will defend Medicare, the universality of our healthcare system, the efficiency of our healthcare system and the effectiveness of our healthcare system. That is why this bill should be rejected.

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