Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Medicare Compliance and Other Measures) Bill 2022. This bill amends the Health Insurance Act 1973, the National Health Act 1953 and the Dental Benefits Act 2008. In broad terms, the bill aims to protect the viability and ongoing integrity of Medicare, including the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme.

I want to place on record that Australia has a world-class health system. If you travel anywhere in the world, you can see how good our health system is. It is first class. Can it be better? Of course, it can always be better. Can it be improved? Yes, indeed. But we should be very proud of the fact that our health system is what it is. Certainly under the coalition government we did everything we could to ensure our health system was enhanced in taking over from the previous Labor government. I acknowledge all of the efforts—new bills and new drugs that any government, current or past, put onto the PBS—because they save lives. They, indeed, save lives. Our provision of health care for all Australians is the envy of most nations.

But this is something we should never take for granted. We should make sure that we do everything we can to enhance it. When we were in government, we demonstrated our steadfast commitment to affordable health care for all Australians. We certainly did that in our nine years of government. I can remember the former health minister, the member for Flinders, being passionate about that. It was not just about health services and health care in Australia. During COVID-19 and the darkest days of the global pandemic—and we are still not out of it, by the way—there was the attention that he drew and the efforts that he made to ensure that Pacific island nations were looked after as far as vaccines, as far as health professionals and as far as making sure that we saved as many lives as we could.

I am staggered by the fact that some of those opposite often ask, 'What did we get for the debt we are now in?' I know that the media has changed its tune in some sectors about where we are now and where we were just two short years ago. Some people have convenient memory loss as far as the situation that we were faced with. I was in those meetings when Professor Brendan Murphy said that we could lose tens of thousands of Australians in a matter of weeks if we did not act. We did act, and we made sure we did everything we could to get the vaccines rolled out, to get Australian lives put first and foremost, because that is the first priority of government. So I know the minister opposite is keen to ensure that this government also does what it should, builds upon the record we had and ensures Australians are looked after when it comes to their health system.

I also know that with Medicare and certainly bulk-billing we need to make sure, particularly in regional Australia and particularly in remote Australia, that Australians are looked after. Obviously we'll do everything we can, and I know the members with me here, Braddon and Barker, being regional members, know too how important it is to keep our health system front and centre, because regional Australians often don't get the health services and indeed the health professionals that they enjoy in capital cities. So anything that can be done by a Labor government or by the provision of bills and by the passing of bills to improve the lives and lots of those who live beyond the bright lights of our capital cities we should and we will indeed support, because our opposition leader, the member for Dickson, said—as did the Nationals leader, the member for Maranoa—that if there's good policy and there is good legislation put forward, we'll not only consider it but help the government pass it. Indeed we committed through our budgets $133 billion over four years to Medicare, including $31.4 billion in 2022-23, an increase of $7.3 billion compared to the 2021-22 budget, and we had those commitments going forward. Medicare and the PBS form the cornerstone of Australia's universal health system—a health system, as I said before, we should be very proud of. We saw record investment as a government in Medicare, and that was important for healthcare services no matter where people lived.

This bill is drafted in almost identical terms to a bill introduced by the previous government in the 46th Parliament. It was not debated, and it lapsed upon dissolution of that parliament, prior to the 21 May election. This bill proposes to make a number of changes to the Commonwealth's health provider compliance program to strengthen the ability to recover debts owed by health providers who have engaged in inappropriate practice. We cannot have people engaging in inappropriate practice. I see the good member Dr Freelander up there, and I know he's going to speak next. I know how his constituents regarded his level of service when he was practising in his local area, and I commend him for the role that he played in that.

The most significant amendments include new sanctions and increased maximum penalties for body corporates and nonpractitioners. Overall the proposed amendments appear to be uncontroversial and unopposed by stakeholders, although stakeholders have continued to raise broader concerns about the intricate nature of the Medicare system for healthcare providers and the challenges of complying with Medicare obligations in some instances. Importantly, this bill is comprised of one schedule, which is divided into four parts, and I'll just go through those for benefit of the House.

Part 1 amends the HIA to provide for a number of amendments to the operation of the Professional Services Review scheme, including allowing the director of the PSR to enter into agreements with body corporates. Part 2 amends the HIA, NHA and DBA to clarify that a person or body corporate owing a debt to the Commonwealth may make only one application to the Administrative Appeals Tribunal with respect to a reconsidered decision or notice of assessment of shared debt determination, even when multiple garnishing notices have been issued in relation to that debt. Part 3 makes a number of amendments to the HIA, NHA and DBE to clarify the Commonwealth's debt recovery arrangements following the passage of the Health Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill 2018. Finally, part 4 amends the NHA and DBA respectively to replace references in those acts to making a false or misleading statement with references to the giving of false or misleading information.

These are all important. I note that the HIA, NHA and DBA set out a legislative framework for the provision of claiming of services and benefits with respect to the three major public health funding schemes: the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme and the Child Dental Benefits Schedule. That is good, and that is appropriate. I again place much importance on child dental appointments that parents should make. Before I became a parent, and certainly when I did become a parent, my mother always said to me that, if you look after your child's feet and if you look after their oral health, then the rest of it just about takes care of itself. That is important: put your kids in good school shoes, take them to the dentist every year and you can't go too far wrong. My mother, as always, was correct.

The Medicare GP bulk-billing rate in the 12 months to June 2021, interestingly, was 88.8 per cent, up from 82.2 per cent in Labor's last year, that being 2012-13. I appreciate times change and practices alter, but it should be noted that that is a 6.6 per cent increase on what the Labor government achieved. And that is to be commended. That is a feather in our cap, when we were government. More than 152.2 million bulk-billed GP services were delivered in 2020-21. That was 46.4 million more than Labor's last year, in 2012-13. Sometimes those on this side get a bad rap when it comes to these things, but those figures do not lie; they tell a story. They tell a story about our commitment to a world-class health system. They tell a story about our commitment to Medicare GP bulk-billing and to making sure that GPs can offer that service and are doing well enough to survive and keep their doors open, particularly in rural and regional Australia.

Just last Friday I turned the first sod on the rural medical school in Wagga Wagga. That follows on from successful rural medical schools in other parts of regional New South Wales and Victoria, and that is going to make such a difference for the young people—and some not so young—who want to become GPs and want to do their training in a regional setting. If you train people from end to end, from start to finish, in a regional setting, chances are you'll keep them in that regional setting. Charles Sturt University, which is partnering with Western Sydney University in the rural medical school at Orange for their courses, generally claims that between 70 to 75 per cent of those students right across the spectrum of the course offerings they provide—given they are doing the tertiary education in a rural setting, whether it's Albury-Wodonga, whether it's Wagga Wagga or elsewhere—do actually stay in that regional setting. And they have an equally wonderful veterinarian course across the university's broad spectrum of offerings.

When I was Deputy Prime Minister, that was the first act I did—to make sure that rural medical school network was established. It's going to make such a difference. Already more than 20 students are at that UNSW course in Wagga Wagga. When they get the new three-storey building with the research and the educational components, it's going to make the world of difference. It's almost one of those cases of build it and they will come. If you build not only the right infrastructure but also the right services, put in place the right provisions in regional Australia, you'll get young people doing their medical training there and then staying there. It is so important.

That facility will open next year. It's not only going to be important for Wagga Wagga; it's going to be important for those smaller regional communities outside of even the Riverina electorate—places such as Deniliquin, Finley and Hillston and other areas that I do not represent. That's not what this is about. As a member of parliament, certainly a regional member of parliament, I should always be fighting for those services to be given to regional areas, because, my goodness, they do need them.

In the coalition March budget this year, we provided $66 million towards deregulating and expanding access to Medicare funded magnetic residence imaging, MRI, services in regional and—particularly importantly—remote Australia. We strengthened Medicare by making telehealth consultations permanent. That is a good thing. I don't ever want to see telehealth taking over wholly and solely from face-to-face appointments, because often general practitioners and other medical specialists need to see patients right in front of them to give them the correct diagnosis. But, certainly, during COVID lockdowns and the situation with remoteness, telehealth became very, very important.

In the Riverina and Central West region, there have been more than 400,000 telehealth consultations funded through Medicare since the start of the pandemic. I thank people for their patience and for taking up this wonderful technological advancement. But I also thank the telehealth medical specialists, whether they're in a regional centre or a capital city, for being on hand to provide those services. In the year leading up to the March 2022 budget, the coalition government funded 2,414,195 free or subsidised medicines in the Riverina through the PBS. I know what a difference this made for long-term, long-time sufferers of debilitating illnesses. It makes such a difference when they can get that drug freely or when it is cheaply available to them. It changes their lives, and it changes their family's life.

During the coalition's time in government, we made nearly 2,900 new or amended medicines listings through the PBS, and we should be congratulated for that. This is important proposed legislation, and I'm glad it's been brought to the House by the minister.

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