David Gillespie (Lyne, National Party) Share this | Hansard source

I am very glad that the member for Macarthur put up this motion on health care. It's a really good topic of discussion, and I have mixed feelings about it. Having practised for 33 years before I entered this august institution representing the good people in the Lyne electorate, I was a medical practitioner. So I declare a historical conflict of interest.

Out-of-pocket medical costs are a problem for some people. Fortunately, it is of a scale that is generally very uncomfortable for some people when they visit some medical practitioners—usually in metropolitan centres more than in regional Australia, is my experience. The good news is, for most people, most of the services are bulk billed. The statistics that I have been able to obtain, for the last reporting in 2019-20—I haven't seen the 2020-21 figures yet—of the bulk-billing rate for total general practice non-referred attendances was 89.5 per cent. You can only bulk bill if you don't charge a gap; otherwise, you're not eligible to use the bulk-billing system. So that is not a bad outcome. That is much better than any other country I know that has a government and a private medical system.

The other thing is, the government doesn't tell doctors what they can charge. It doesn't tell electricians what they can charge. It doesn't tell plumbers what they can charge. But I can tell you there are some plumbers and electricians that charge much greater rates to come and do electrical or plumbing work in your house than a general practitioner does for doing a house call. You've got to keep that in perspective. I'm not trying to trivialise things; I'm just trying to point out that the government doesn't control charges that professional people such as lawyers, doctors, dentists—anyone—can charge.

The assistance that we give through Medicare is exemplary. With specialists, though, it is a different matter. There are some specialists who charge way more than the Medicare rate, and there is a significant gap. Whether it's in surgery or anaesthesia, in my practice some people got huge shocks when they went, and there are processes to try to limit that bill shock and the ability for the patient to have some control over who they go and see, but that involves prewarning by the GP who refers you to a specialist. That is meant to be a regular practice now, but there are some people who don't do that. People develop a relationship with a surgeon or a person who runs a referral practice, and I think any practitioner that refers should know the charges of the person they are referring their patients to. But we have put up systems to try to help people navigate that and work out what is a reasonable gap, what's industry standard and what's right out of the ballpark. There is also the extended Medicare safety net.

With the first thing, we as the coalition government set up in 2019 a web site called the Medical Costs Finder. When you're going to see a surgeon or a medical specialist, you can see what the average out-of-pocket costs are in that region. If someone is going to charge you $500 out of pocket but the industry standard in the de-aggregated data is $50 or $100, you can ask your GP, 'Is this really reasonable?' That's what my patients used to hate. You'd refer them and then they'd get a bill from, say, an anaesthetist, and it was bigger than the surgeon, the hospital and me combined. They would fall off their seat. I would be very angry and I tried to control that by counselling my colleagues that I thought their fees were excessive, but not many doctors—

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