Amanda Rishworth (Kingston, Australian Labor Party, Shadow Parliamentary Secretary for Health) Share this | Hansard source

The National Health Amendment (Pharmaceutical Benefits) Bill 2014 is just one of many bills before the House attacking our universal healthcare system. What we have seen in this budget of broken promises is a cost-shift from government to ordinary people—aimed at pricing them out of the healthcare system. The proposed GP tax would spell the end of universal health care. I have spoken many times in this place about the extra expense that the GP tax will impose on people. In my community, many people are very confused. When I tell them—they did not realise this; they thought the $7 GP tax was bad enough—that they will have to pay the tax on X-rays, on blood tests and on similar services, they are quite clearly shocked. Then, on top of that, I have to tell them about the government's proposal to significantly increase the cost of medicines as well. If you are thinking of visiting the doctor, getting a blood test, going back to the doctor to get a prescription and then getting that prescription filled, you will have to pay the government's new taxes at each step. So these budget measures will end up taking many dollars out of your pocket. I think that is very concerning.

Labor will oppose this $1.3 billion tax increase on medicines—because it will hurt every Australian. There are many people who delay filling, or who do not fill, their prescriptions because of the cost. It is important to recognise that deterring people from getting essential medicines is a significant issue. When the Liberal government increased the tax on medicines in 2005, sales of some essential medicines fell by as much as 11 per cent. That means that people were not going in and getting their prescriptions filled—even though these medicines were essential medicines—because they just could not afford it.

The Minister for Health and many of those on the other side think that this is just a small amount of money for people. They do not realise that forking out extra money every time you go to the doctor—$7 plus $7 plus $5 dollars and so on—adds up. If you have a couple of children, it adds up even more, and the cost does eventually deter people from getting the health care they need. I find it quite strange that, when we are looking at ensuring that people have the medicines they need—and, indeed, at ensuring that they get the primary health care they need—the government seems to be pulling money away. What will be the consequence if we do not ensure that people are taking the essential medicines they need? What will be the consequence if they are not going and getting a check from their GP? They will end up in hospital—and we know that hospital care imposes higher costs on the taxpayer. So when the health minister comes in here and talks about sustainability of the healthcare sector, what he is really doing is lazy policy development. He is shoving a whole lot of costs onto consumers without doing any analysis of what will happen to the most expensive part of the healthcare sector—hospitals.

We hear day by day the rhetoric from the minister that our healthcare system is not sustainable. It is just not true. Our universal healthcare system is the envy of the world, and the costs are kept in check. The PBS has ensured that many people can get the medicines that they need. That is not to say that we do not need to look continually at our system and make sure that it continues to be efficient, but shoving costs onto patients in the community will not somehow make the system more effective. It might cost the government a little bit less in the short run—because people will not go to the doctor when they are sick and they will not get the medicines that they need—but those costs will come out somewhere else, and that will be in our emergency departments.

These changes are part of an ideological campaign to get rid of our universal healthcare system and create a two-tiered user-pays system. There has been criticism right across the world of two-tiered systems that do not ensure that people can get help when they need it. So it is strange that this government seems to be clamouring to ensure that we have a two-tiered user-pays system where if you can afford your healthcare costs then you can get the health care you need, but if you cannot afford them then you will not. Some of Australia's most senior doctors have already warned that changes in this budget will put Australia's healthcare system back 50 years.

The price increase comes off the back of the $80 billion in cuts to our public hospitals and schools. While moving costs onto ordinary Australians for their health care and ensuring they bear the brunt of these costs, the government is also cutting funding to our hospitals. In South Australia the cuts equate to about $655 million—equivalent to the cost of running Flinders Medical Centre. Flinders Medical Centre is one of the important hospitals in South Australia; it takes on many patients from my electorate. Without the amount of money being cut by the Commonwealth, that centre could not exist. Of course, the state government is ensuring that they continue to support Flinders hospital, but that is the size of the cuts that we are talking about.

We hear regularly the Minister for Health say that the PBS and MBS are the same. Of course, they are not the same. We pay a Medicare levy and high-income earners pay a Medicare levy surcharge. There are no such funding arrangements for the PBS. I think it is really important to note that this increase will have a significant impact on our most vulnerable. The government's argument that its intention is for the PBS to grow in a sustainable way is complete nonsense. If that was the case, they would be investing the money they save back into health. Of course, they are not doing this.

Labor did a lot of hard work when in government, especially when it came to the PBS. Accelerated price disclosure has slowed the real rate of the PBS growth and put the PBS on a sustainable footing. I remember distinctly that when Labor was making these difficult decisions those in the coalition were crying blue murder. They spoke out very much against price disclosure, saying, 'This is terrible. How dare you accelerate price disclosure?' While Labor was doing the hard yards in policy reform to make the PBS sustainable, the coalition were saying: 'Don't do it. That's not fair for pharmacists around the country. It shouldn’t happen.' What we are seeing now is the Liberal Party not only adopting those measures but also saying, 'That's not enough; we are going to move those costs onto patients.' That is very concerning.

When it comes to price disclosure, the package announced in 2007, running to 2017-18, will have savings of close to $20 billion. That is significant reform, and those are significant savings to ensure the PBS is sustainable. It would be nice to see this government do the hard policy yards, rather than just say to Australians: 'We can't be bothered looking at reform. We are just going to put the cost onto you. Here is $5 extra for your prescription, another $7 for the GP and then $7 for an X-ray.' It just keeps going on. As I have said many times, this will have a perverse impact on our health system. It will not result in savings. It might look better in that one budget item because fewer people are going to the GP, but of course the costs will come out in other areas.

It is important to note that this bill before the House is part of a pretty nasty budget that will hit people in the community. I held a seniors forum in my electorate last Friday. People are really concerned about this. The government seems so out of touch. The government seems to stop listening to people about their concerns. Even at our seniors forum, people were raising concerns about the changes to Newstart and about the issue of young people being cut off for six months. One gentleman said, 'That's all right; these young people can rob the doctor's surgery, because there will be plenty of money there.' That is the cynicism out there in the community about what these changes will mean and about how little this government cares about the cost of living for so many people. I think it is really important.

The bill proposes to increase the PBS safety net by 10 per cent plus CPI indexation on 1 January each year from 2015 to 2018. The government states that from 1 January 2019 only the CPI index will apply, but it is fair to be sceptical of the government's promise on that when it has broken every single promise when it comes to health care. I think that is an important point to make. The bill before us today is not something that reflects how the Australian people thought things would be before the election. If you had said to the Australian people before the election, 'Will the government slap a big new tax on your medicines?' people would have said: 'No. They have not said that in their blue book'—their blue book of 'real solutions'. 'Will they slap extra money on you when you go to see the GP?' Of course people would have said: 'No. It's not in their little blue book. They said they'll keep their promises.' When it comes to health funding and hospital funding, do you think that if you had asked the Australian people, 'Are they going to cut $50 billion out of hospitals?' they would have said: 'No. They said they wouldn't make any cuts to health.' That would be the response of the Australian a people. Of course, we now know that it is not true. Indeed, all the promises made to the Australian people were about not cutting funding and no new taxes. This bill is part of the many broken promises that were made to the Australian people before the election, so it is particularly concerning.

This bill proposes to increase the concessional PBS safety net by two prescriptions each year from 1 January 2015-18. This means that not only will medicines become more expensive for those who are at their most vulnerable—because that is what the safety net is there for; it is to protect Australians who are in very vulnerable situations—but the safety net will also be further and further away. This is another concern. It is another tricky item that the government has put into this bill.

This bill represents one of the many, many items in the budget that are unfair and tricky—things that the Australian people did not expect. They did not expect another broken promise. I think it is the case for many people—certainly for those I meet when I am out in my electorate—that they have just run out of fingers and toes on which to count the broken promises of this government. They add them up, and there are the cuts to education, the cuts to health, the cuts to family payments and the cuts to pensions—the list goes on and on and on. I would ask the government to reconsider this bill. I think it is a somewhat lazy and also unfair way of shifting the cost to ordinary Australians. This bill, along with so many other costs, such as the increase in the GP tax, will be a huge burden.

I have mentioned emergency departments on numerous occasions, and I have to say that it is disappointing that it is the federal who is advocating for a co-payment at emergency departments as well. This is their answer to stopping people from going there. If people cannot afford to go to a doctor or cannot afford to get their medicines and they turn up at emergency, it is a case of: let's charge them there as well. I am really proud that the South Australian government has ruled out charging co-payments at emergency departments. I would be very concerned if, as a result of that, this government made any more cuts. We know that today Joe Hockey has said that he would like to see more cuts on top of the ones that we have already got. I think we need to stand up—and this side of the parliament will stand up—for the Australian people when it comes to health in order to ensure that we have an affordable, accessible, universal healthcare system that does not mean that you get health care if you can afford it but, more importantly, that you get health care when you need it.

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