House debates

Thursday, 27 February 2020


Appropriation Bill (No. 3) 2019-2020, Appropriation Bill (No. 4) 2019-2020; Second Reading

12:38 pm

Photo of Pat ConroyPat Conroy (Shortland, Australian Labor Party, Shadow Minister for International Development and the Pacific) Share this | Hansard source

I'm pleased to make a contribution on Appropriation Bill (No. 3) 2019-2020 and Appropriation Bill (No. 4) 2019-2020. First, I'd like to talk about Medicare, and the centrality of Medicare and bulk-billing to Australia. The health of all Australians must be our No. 1 priority, and the health of my community in Shortland is being threatened by changes to Medicare that came into effect last month. On 1 January this year, the Morrison government cut bulk-billing incentives to doctors in the Hunter region and 13 other regions throughout Australia, making it harder for doctors to bulk-bill, even for those who need it the most. Notices have gone up in many surgeries saying they will no longer be able to bulk-bill, while other surgeries have put up their fees. I've been inundated with calls from people telling me how worried they are, and with good reason. I don't blame the doctors for this. This cut is simply the latest in a long list of cuts to Medicare by Liberal governments.

The electorate of Shortland already has low bulk-billing rates. Fewer than 60 per cent of people are routinely bulk-billed, meaning two in five people in Shortland have to pay every time they see the doctor. Let me repeat that: two in five people in Shortland already have to pay to see the doctor. And, when they do pay, they are $37 on average out of pocket for every visit—an increase of 38 per cent since 2013. That's well in excess of inflation. And for specialist visits it's even worse: fewer than one in five people are routinely bulk-billed to see specialists in Shortland, meaning four out of five people are out of pocket to the tune of, on average, $80 every visit.

This cut to Medicare bulk-billing incentives will only make matters worse. Unfortunately, the lower Hunter combines some of the lowest bulk-billing rates with some of the highest rates of disadvantage in the nation. Windale and Mount Hutton are amongst the most disadvantaged communities in Australia with particularly high levels of children living in poverty. People living in these communities cannot afford to pay to see the doctor. Others who already pay to see the doctor cannot afford to pay more. When people can't afford to go to the doctor, they do one of two things: they either stay at home and put up with whatever is ailing them, making things worse in the long run; or they go to hospital—and we all know how busy and overstretched emergency rooms are. This does not even make economic sense as it costs far more for our health services to treat a very sick person in emergency than to treat a sick person in a doctor's surgery.

We saw evidence to a Senate committee during the GP tax debate which found that, if only one in 50 people who were deterred from seeing a doctor because of the GP tax then presented to the emergency department, the entire savings from the GP tax would be wiped out. I've no doubt that this is what will occur again. People will not go to a doctor, because of the cost increases brought on by this government. They will get sicker and they will have no choice but to present to the ED ward at Belmont Hospital or John Hunter. That will cost the taxpayers of Australia much, much more and it imperils the health of those individuals.

People are raising their concerns with me daily. For example, David from Caves Beach rang my office furious that his GP at Blacksmiths will no longer be bulk-billing him and his wife. The practice will now only bulk-bill people over 70. David is a self-funded retiree who has a health care card. Previously, he and his wife were bulk-billed. It is now going to cost them $65 to visit the doctor, and they go at least three times a month. It will have a huge impact on their budget. It's something those opposite haven't considered, despite all their professed love for self-funded retirees. Gordon rang to say the skin cancer clinic he attends at Belmont will no longer bulk-bill for surgical procedures. He is about to have a procedure for which he was bulk-billed last year, but this year he'll be out of pocket a staggering $250. It's not a major procedure, he says, but it is necessary and it is a lot of money. These are just two of the many examples of hardship.

I've been running a petition for my constituents to sign, and they've been able to provide insightful feedback which clearly identifies the importance of bulk-billing and how much Australians care about universal health care. Peter from Jewells wrote:

If you have an ongoing health problem it becomes a huge problem if you have to go to your doctor and he no longer bulk bills. If you cannot afford to go to your own doctor and you decide to go to the hospital you are told that you should have gone to your own doctor because the hospital is already overloaded.

Joan has a very clear call to the government:

It is bad policy to undermine the public health system in favour of demonstrably far less efficient privatisation of health services. With the current government's policy settings we are heading down the path of the US which has the most inefficient and expensive healthcare system in the world.

Cutting back Medicare for doctors after a decade-long freeze will sound the death knell of public health in this country. Please don't do it.

These are just a few of the hundreds of comments I've received from my constituents who are outraged at the recent changes. I've written three times to the health minister, and I'm asking him again today: please restore the bulk-billing incentives to doctors in the Hunter. The health of our community depends upon it.

This is also a good opportunity to provide an update on community groups I've been catching up with in Shortland. Supporting community groups in my electorate is one of the greatest and most pleasurable parts of my job, and I've been very pleased to have been able to grant more than $423,000 to 31 organisations in Shortland in three recent rounds.

Under round 5 of the Shortland Stronger Communities Program, 14 organisations have shared in $150,000—grants that they will match with their own financial or in-kind contributions. Under the Shortland Communities Environment Program, five groups have shared in $73,000 to continue their environmental work, and I look forward to the program being refined to make it a lot more accessible if the government chooses to continue it. Under the Shortland Local Schools Community Fund, 12 schools have shared in $200,000 to improve the education and wellbeing of their students. The projects are interesting and varied and spread throughout the electorate, from Cardiff in the north to Buff Point in the south.

Stronger Communities funding will allow Macquarie Care to enhance their amenities for homeless people living in their cars at Cardiff. Novacare Community Services will create a wellness centre for older people in Swansea. Northlakes rugby union club will set up a permanent canteen at their home ground, Slade Park, in Budgewoi. San Remo's Men's Shed will install a dust extractor for the safer use of woodworking machines. Novocastrian Swim Club will install an all-weather area for dryland training, socialisation and presentations. Redhead Surf Lifesaving Club will fence off a secure area to store and maintain board and ski trailers. And I thank and congratulate Redhead Surf Lifesaving Club for their recent part in a rescue of a couple of surfers who got into trouble in some rough conditions. Marine Rescue Lake Macquarie will purchase grounds-keeping equipment to maintain their pelican base. Swansea Community Cottage will install clear weatherproof blinds at their ARTea Gallery & Garden so that it can be used in inclement weather. Biddabah and Gwandalan public schools will upgrade their playgrounds. Warners Bay Scout Group will refurbish amenities in their hall. Buff Point Girl Guides will replace flooring in their hall. Charlestown Lions Club will upgrade their catering trailer.

Environmental grants went to three Central Coast Landcare groups for weed eradication: Budgewoi Beach Dune Care, Budgewoi Island Landcare and Gwandalan Landcare. Fern Creek Gully Landcare received funding to enhance the habitat for the threatened squirrel glider at Dudley. Belmont Wetlands State Park will continue its successful dune stabilisation and regeneration on Nine Mile Beach.

Local School Community Fund grants went to Belmont High, which will establish a student wellbeing centre. St Pius X Primary in Windale will create a reconciliation cultural centre, which is incredibly important, given the fact that half the students at that school are Indigenous and it has one of the lowest SES scores in the entire nation. Northlakes High in San Remo will install fitness equipment. Cardiff High and Blacksmiths primary will upgrade technology to their school halls. Windale, Caves Beach and Charlestown East public schools will improve their playgrounds. Dudley and Nords Wharf public schools will install new bubblers and water bottle refilling stations. St Brendan's Catholic Primary School, Lake Munmorah, will develop a play area and sensory garden for students with disabilities. St Francis Xavier Primary, Belmont, will invest in Lego educational robots for computer programming classes. I had a great visit to SFX last week, and I look forward to coming back so the kids can teach me all about these Lego educational robots. Great things are happening in schools and community organisations throughout Shortland, and I'm pleased to be able to support so many local organisations.

In the time remaining, I want to talk about a couple of portfolio issues. As the shadow minister for international development and the Pacific, it's an intense privilege to develop policies to support people throughout this world—because, ultimately, to state the blindingly obvious, we are all humans and we all have an obligation to advance human welfare wherever we find it. That's why it saddens me so deeply to remind the parliament of the $11.8 billion of cuts this government has imposed on our official development assistance budget. This cut not only undermines the soft power of Australia, not only undermines our ability to influence other nations; it costs human lives. I don't say that lightly. These budget cuts kill people. They literally kill people.

We're seeing three things. We're seeing the budget cuts. We're seeing diversion of resources to the Pacific step-up. And the Pacific step-up is a worthy initiative, which we support. We've got some views on how to improve it. We support the Pacific step-up, but it should not result in a step down everywhere else in the world. We're also seeing extreme cuts to health and education assistance, which is, as I said, costing lives. The impact of these cuts from the government—Senate figures came out highlighting this—is a cut in our official development assistance to South-East Asia of 30 per cent; cuts to assistance to South Asia of 42 per cent; cuts to assistance to Africa of 49 per cent; cuts to assistance to Latin America of 85 per cent; and cuts to multilateral organisations of 25 per cent.

This is having an extreme impact. This is hurting people. This is costing lives. And it is actually impacting on national security. For example, by the end of this year we will not provide a cent of bilateral assistance to Pakistan, the centre of Islamic extremism in the world. This is a very short-sighted approach. The cuts are hurting nearer to home. For example, we had a visit by the President of Indonesia a couple of weeks ago. It would have been useful to highlight during his visit that Australia has cut its overseas development assistance to Indonesia in half. The cuts to health assistance for Indonesia were a massive 86 per cent, and there were cuts to education of 57 per cent. These are very, very significant. We've cut assistance to Vietnam in half. This government has cut assistance to the Philippines, Laos and Cambodia by a third. Tragically, we've cut assistance to the poorest country in the entire world, Timor-Leste day, by 10 per cent in the period to 2018.


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