Lisa Chesters (Bendigo, Australian Labor Party) Share this | Hansard source

The change in the conversations that we have in this place is remarkable. Less than 24 hours ago we had the government continuing their pretence about 'Mediscare' and about Labor being wrong about the push to privatise Medicare. Well, this debate and the way in which the government have tried to push this issue through the parliament—where they have not been honest with the Australian people—is another example of why we are arguing that the government's real agenda is to privatise Medicare.

Let me say from the beginning, as previous speakers on this side of the House have said, Labor strongly supports the establishment of a National Cancer Screening Register. However, it has to be done in the proper and correct fashion. What we heard during the election, after the election and as recently as this morning is that prior to the election the government signed a contract with Telstra to establish the National Cancer Screening Register. Like other speakers, I will outline the weaknesses in the government's push to do that. If you are saying on the one hand, to the average Australian out there, that, 'We have no plans to privatise,' yet you sign a contract with Telstra to privatise part of what people would see as a government service, then they put two and two together and say: 'What is the government on about? I thought they said Medicare was safe from privatisation.' It is clearly not, and this push by the government is another example of their real agenda for Medicare.

So keen were they to rush this legislation through that we are here today with amendments. These amendments are necessary to ensure that the data that the register will hold—the most sensitive of health data—is not going to be misused or leaked and that it is safe. The register will hold Australians' most sensitive data, like the results of cervical and bowel cancer screenings. We need to make sure that we get any establishment of this register right. We have concerns about the government's shambolic approach to this important legislation. There are serious concerns about how they have managed this. It demonstrates, again, how chaotic the government are.

On the eve of the last election, this government signed a $220 million contract to outsource the register to Telstra, before this parliament even saw the legislation. When you talk to people in the community, Deputy Speaker Mitchell—and I know you would have lots of these conversations with them—and when you explain that the government signed a contract with Telstra for the new National Cancer Screening Register most people roll their eyes. They struggle to get Telstra on the phone to fix basic phone services! They struggle to get Telstra out to look at faulty connections! There are problems and issues within Telstra. They have a lot of work to do to rebuild their brand. They have a lot of work to do to rebuild respect and their relationship with people in regional Australia in particular. So to hand them a $220 million contract right before the election means people in the community are rolling their eyes and saying: 'What will happen? What does this mean?'

In an embarrassing rebuke to the government, their own Information Commissioner has made six recommendations to the Senate inquiry to help fix the legislation. Some of the loopholes identified by their own commissioner were alarming. So, while the government claim that we are being hysterical, we were actually proved right again. This seems to be a bit of a pattern with the government—for example, the government's bills draft may allow the register to operate to collect all Medicare claims and information for people who are on the register. All Medicare claims! It is clearly a loophole that the government did not foresee.

Last week Labor proposed nine amendments to improve the government's legislation. The government has now accepted many of these and we understand that it may have more to be presented. We too have our own to make sure that we close all of the loopholes in the legislation. There are still gaps that are being identified by their own people, by health services.

I recently held in my electorate a number of hearings and forums about Medicare. I want to spend a few moments on that because it is an issue that people in the community are scared about. They are scared about the increasing out-of-pocket expenses in relation to Medicare. They are scared about the cost of going to the doctor. Several people have said to us that since the government froze the Medicare rebate and started to talk about a co-payment or a GP tax their doctor has started charging a gap fee. So, whilst bulk-billing rates are high in areas like Bendigo, more and more doctors are charging a gap on top of that. Doctors have also told us that they, unfortunately, have to do that because of the cost of running their clinic. It is alarming that we have GPs now saying that their practices are becoming unviable because the government has continued the freeze on the rebate. The price they are getting from the government means that their practices are struggling to break even.

In the city and places like North Melbourne it is not such a big issue because their bulk-billing to fee-paying ratio may be 75 to 25—75 per cent have the disposable income to pay upfront and 25 per cent may be bulk-billed on a concession card only. In parts of the region it is the complete reverse. In parts of Bendigo, like Kangaroo Flat and Eaglehawk, households are struggling on the smallest of incomes, so their ratio is the complete reverse. Some 75 to 80 per cent are bulk-billed concession card holders and only about 20 per cent can afford to pay upfront. If you do the maths, you work out very quickly that it is hard for these GP bulk-billing services to continue.

What happens when GPs start to increase their fees is that people stop engaging with primary health care. They stop going to the doctor when they need to. They might turn up in our emergency departments. They stop doing preventative health care. We want people to be proactive. Let me turn to how this relates to this register. It is a very similar story when it comes to people being proactive about getting regular testing. Take a Pap smear, for example, and it talks here about the cervical cancer register. I had one person tell me that it cost her $70 to go to the doctor to get her Pap smear test. She had to pay a bit of a fee to get the test done and she had to pay to go to the doctor. She will get some of that back through Medicare, but she said: 'I didn't know until I turned up and I had to have $70 in my bank account to do it. I will now think in two years time whether I will actually go. I will have to plan ahead to have the money in my account.'

That is the wrong message we want to be sending women. It is the wrong message we want to send to people over 55 around bowel cancer or prostate cancer. We want to encourage people to go to their GP and have these tests because we know that when it comes to all of these cancers early intervention and early diagnosis are critical. We have been able to drastically reduce the rate of women dying of cervical cancer because we have early testing, and we have had a strong community based campaign to encourage that.

My concern about some of the reforms that have been put forward is that, if it is not guaranteed that people's data and results are kept secret—that they have the privacy that they currently have within our government departments—people will not go. Until it is guaranteed and people are sure that Telstra can get this right, that the government can get this right, people may be deterred from getting these vital tests that can help improve their health outcomes. If there is a sad case where they are diagnosed, they can seek the help they need.

Another alarming thing that has come up as well through the discussions we have had is the cost involved with cancer treatment. It is an area we do need to look at. A decade ago a woman in Bendigo was diagnosed with breast cancer. She said her out-of-pocket expenses were about $300. Today a woman in Bendigo, who decided to pay for some of it upfront because she wanted the best quality care she could get, paid $30,000. It is extraordinary that in one town, a decade apart, two women diagnosed with breast cancer had such different experiences when engaging with our health system—$300 versus $30,000.

I do not believe that the government really understand what is going on on the ground, particularly in regional areas, when it comes to health care and healthcare delivery. That is why I do not believe they fully understand what they have put forward. They have rushed legislation in relation to the National Cancer Screening Register. They still have not closed a number of the gaps and loopholes. There are a number of amendments that we will still put forward. We want to see the government adopt them because only through adopting these amendments can we ensure that the new register does have the confidence of the community, does have the confidence of the health profession and does have the confidence of this place that it will actually do what it is to do.

The amendments will still allow the register to be operated by one government agency or a not-for-profit organisation that has successfully managed existing registers. This is critical. This is what people want from their federal government when it comes to health care and healthcare delivery. Labor's amendments will also provide that the new National Cancer Screening Register be operated only by the government or a not-for-profit agency. This is critical. It goes to the heart of one of Labor's arguments about this government's hidden agenda to privatise Medicare. We believe that a register of this nature—the National Cancer Screening Register—should be operated by the government or a not-for-profit agency.

It should not be operated by a for-profit agency.

How can members of the government stand up and say the government has no privatisation agenda for our health system? How can they do that in one breath knowing full well that they signed this contract to a private company in the midst of an election hoping that people would not notice? I know some of the people in the Nats still see Telstra as a great government business. You guys sold it off years ago. It is now a profit-making independent business. It is not part of the Australian government; it is not owned by taxpayers in any way. So to try and link the two is just messy and a demonstration of how chaotic this government has become.

I hope the government will realise the importance of these amendments. Again, it is an example of how, in opposition, we have cleaned up the government's mess. This legislation is another example of how the government are not really interested and are not putting in the time and the detail we need to ensure that we have good quality health care. They have managed to turn the good idea of establishing a National Cancer Screening Register into another shambolic attempt and another mess that they have created. It demonstrates that they do not really understand what is going on in our regions with regard to health care and Medicare.

See this speech in context