House debates

Tuesday, 18 October 2016

Bills

Appropriation Bill (No. 1) 2016-2017; Consideration in Detail

12:36 pm

Photo of Julie CollinsJulie Collins (Franklin, Australian Labor Party, Shadow Minister for Regional Development and Local Government) Share this | Hansard source

Let's be frank about this: there are a lot of very bad measures in this appropriation bill when it comes to health, particularly extending the Medicare freeze for six years. That might just be the very worst in the whole appropriation bill. It is worth reflecting on the history of this freeze, though, because we hear from the other side a lot about the history of this freeze. Let's be truthful about it. The Abbott government tried and failed to impose the GP tax three times. When they failed, they introduced this freeze on the Medicare rebate—a co-payment or GP tax by stealth. The current Prime Minister sat in the Abbott ministry, as did the minister. So the GP tax or co-payment by stealth is as much the minister's and the Prime Minister's as it is the member for Warringah's.

I want to give credit where credit is due. GP rates were indexed in July 2014, as the last Labor government had budgeted for. When the current minister says that Labor initiated this freeze on the Medicare rebate, she is talking rubbish and she clearly knows it. She is not being truthful. Even though the member for Warringah and the member for Dickson indexed GP rates, it is something that this minister and the current Prime Minister may never do. In his very first budget the current Prime Minister not only kept the freeze on the Medicare rebate but extended it for six years. He did that in spite of the assurances the minister had given to doctors. We understand the minister went around and consulted with doctors and whispered to them or whatever, keeping them in the tent and telling them that this freeze would be lifted. So you can imagine the surprise of doctors when the freeze was actually extended. Instead of four years, which was bad enough, the freeze will now run for what the Rural Doctors Association are calling an ice age—a very long time, indeed.

Everybody in this place knows that that freeze will drive down bulk-billing and drive up out-of-pocket costs for patients. We know that GPs simply cannot afford to keep bulk-billing if Medicare does not keep pace with the rising costs. It is pretty much economics 101. If costs go up and you do not get more costs coming in, it works out like that. Now we have heard the current minister cherrypicking the statistics and arguing against this inevitability. She is trying to use different statistics and be a bit clever about it, but the minister should come clean with the Australian public and answer some basic questions about what percentage of patients, not services, are currently bulk-billed and what percentage of GP services for those patients—not all services but GP services—are currently bulk-billed. We know that this is changing, and that, as this freeze goes on longer, it will change more. We know that the minister is unlikely to answer those questions because she knows what the answers are going to be. But, try as she might, she cannot really hide the impact of that freeze from Australians, because of course, every time they go to a GP or they are referred to a specialist, the freeze will hit them where it hurts. Out-of-pocket costs are a really serious issue out there in the community.

Australians who are not bulk-billed already pay an average of $35 to see a GP. That is up 20 per cent in just three years under this government. Around Australia we are seeing practices abandoning bulk-billing. In my home town of Hobart, the Grosvenor and Collins Street General Practices have been forced to charge pensioners and Health Care Card holders for the first time. Their sign actually says it is due to the freeze on the rebate. This is at a time when we already know that one in 20 Australians does not see their GP because of the cost. So we already know that people are making a decision not to go to the GP because of the cost. The government knows the impact that this is going to have.

What has the minister said? Interestingly, during the campaign she did say something. She said:

I've said to doctors I want that freeze lifted as soon as possible but I appreciate that Treasury and Finance aren't allowing me to do it just yet.

Then of course she went into hiding because it was a bit of a gaffe. They did not say very much about GP tax—and she certainly did not come out and say very much at all—until just before the election day, when the Prime Minister went on Sunrise and guaranteed that no Australians would pay more to see a doctor as a result of this government's freeze. So the health minister must have known the Prime Minister was wrong when he made this undertaking.

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