Sussan Ley (Farrer, Liberal Party, Minister for Health) Share this | Hansard source

It is a pleasure to speak on the matter of public importance today and to punch a few holes in the rather ridiculous argument from the member for Ballarat. We get used to hearing this nonsense in here, but it worries me when people listening to the broadcast actually believe what the opposition say the costs of, for example, scans and pathology will be. The member for Ballarat does not know. No member of the Labor Party and no member of the Liberal Party either actually knows what the charging practices of doctors, diagnostic imagers or pathology providers will be from day to day in any location across Australia.

What we did say, and we defend it, is that by trimming a bulk-billing incentive we bring back the spend in pathology and diagnostic imaging to where it should be. But we do not touch the Medicare rebate itself. The Medicare rebate for every single one of these procedures remains the same, but you would not think that from listening to the member for Ballarat. You would think that we had gone into the MBS, changed the numbers and written them down, and made life deliberately difficult for patients. In fact, every day in the Health portfolio, it is patients we think of first; they are front and centre. We think of their needs and we think of the system that we have to build that is sustainable for them.

There has been this massive huffing and puffing, this scare campaign, over Medicare. While the Prime Minister was explaining that we are having a look at the technology around the payment system—the Minister for Human Services also explained that very well—there were screeches coming from the opposition front bench: 'Just rule out that you're privatising Medicare.' I can of course rule that out. This has nothing to do with privatising Medicare. Medicare is the system invested in by taxpayers that remunerates doctors for the procedures that they do on behalf of patients, the procedures I have just been talking about. You go in to diagnostic imaging, you have a scan, Medicare pays your doctor the Medicare rebate and then your doctor decides what they may or may not charge you. Pathology is a good example. The bulk-billing rebates that we have taken away mean it goes from $1 to $3 per service. So how the member for Ballarat can conjure that up into hundreds of extra dollars in costs for patients, I do not understand. What I do know is that it scares people, it upsets people and it is completely ridiculous.

As for looking again at Medicare, which was what the newspaper article the Leader of the Opposition tried to wave around in question time was about—and, yes, our editors get a bit excited about headlines, and maybe that is what happened—why would you not look at a payment system that was designed around the same time Medicare was, in the 1980s, and work out how you can bring it into the 21st century?

Now, maybe Senator Doug Cameron—I actually like Senator Cameron—is not in the digital age. I am sure his children are; I know mine are. They absolutely all get it. Everyone in their twenties gets it. Soon we will not be carrying around bags and wallets and cards. We want to be able to do things on the move. We want mobile platforms. We want a payment system that is quick, that is responsive and that perhaps lets us interact with our own private health data and maybe gives us permission to pass it on to third parties. That is the world we live in: cloud based, computer based, information sharing.

Of course, when it comes to privacy, when it comes to keeping your information safe, the laws are there; those regulations will always remain in place. Senator Cameron said he was very worried that multinationals would get hold of our data. I do not know if he banks with any of our major banks. I do not know if he does business with any multinational corporations. I am sure that our children in their twenties, as I talked about, would remind him that we live in a digitally interconnected world, and it is not really a bad thing to be doing business with people who can make your life easier, who can add value.

There is another point to make about this ridiculous scare campaign about privatising Medicare, and that is: if you are investing in the best possible health system for patients, why would you not work out how to make the back-of-house stuff as efficient as possible? Why would you not want to keep all of your money for the front of house—for the services that are provided by doctors to patients, by nurses to hospital patients and by allied health professionals, GPs and mental health nurses? That is where the money needs to go

It needs to go where it makes the lives of patients, carers and consumers better. It does not make sense for any government not to consider how we might reinvest in a clunky payment system and bring that money to bear where it can do the most good.

The member for Ballarat talks a lot about hospital funding, and sometimes she is joined in that by some state premiers, but at least one Labor state Premier has very positive conversations with me about working together. I know that when it comes to health spending it does not make sense to play politics—that does not make sense when people are not well. When people interact with the health system they want a system that cares. They want someone that understands that that system should be built for them for the long term. So we are working together. I am having really good conversations with state ministers about the next health and hospitals agreement, but I can tell the member for Ballarat this: it will not be like the last health and hospitals agreement. Kevin Rudd as Prime Minister was so desperate to sign up that he added layer upon layer of funding to the states. Did it improve performance in public hospitals? Sometimes here and there—maybe a bit. It was patchy. What it did do was give a very helpful revenue stream to state governments.

What we need to say and what we should say on behalf of the taxpayers whose money we are responsible for is that if we are co-investing on their behalf in the state public hospital system, if we do not have any drivers over the cost of that system we need to make sure that we build into those agreements and arrangements a recognition that prices cannot keep rising at the rate that they are. State health ministers understand this. Actually, previous health ministers understand it as well. The member for Ballarat, like me, works in the health portfolio. Previous Labor ministers have well and truly understood this point. I am a bit surprised that we had pathology rolled out as an example today, because it was Labor that took $550 million out of pathology because it knew that that was where expenses were rising at a rate that was not sustainable for the health system as a whole. Previous health ministers all recognised this. In fact Nicola Roxon said, 'Without reform and a careful and methodical approach the system will cannibalise itself, because in health there is a continuous clamour for more and more funding with no regard to where the money comes from.'

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