Emma McBride (Dobell, Australian Labor Party, Assistant Minister for Mental Health and Suicide Prevention) Share this | Hansard source

I welcome the opposition's support for this important legislation, the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023. In my role as Assistant Minister for Rural and Regional Health I visit towns and suburbs around Australia and have the great privilege of meeting with healthcare workers and the communities they care for. In the last few months I've been to Mildura, in north-west Victoria; Burnie, in Tasmania; Gordonvale, in Far North Queensland; and Coffs Harbour and Lismore, in New South Wales. Everywhere I go I hear the same thing. People cannot get the health care they need when they need it. Medicare is in the worst state it has been in in its 40-year history. That doesn't just happen; it's a result of a decade of cuts and neglect. But we're turning that around. We're doing what should have been done a decade ago: strengthening our healthcare system and Medicare. At the centre of Medicare is bulk-billing. As the health minister, Minister Butler, has said, bulk-billing is the beating heart of Medicare, but, after nine years of neglect, that beating heart needs more than a pacemaker. It needs a defibrillator.

Thankfully, our $6 billion investment in Medicare is just what the doctor ordered. We are strengthening Medicare so that Australians will have better access to care and a stronger healthcare workforce. In the budget, we announced that we are tripling the bulk-billing incentive. This is the largest increase in the incentive in the history of Medicare. We are also indexing the Medicare rebate. It is the largest increase of the Medicare rebate in 30 years—three decades. This will transform our healthcare system. In our major cities, it means a 30 per cent increase in investment, and, in rural and regional centres, it's a 50 per cent increase. And we're not stopping at bulk-billing. We announced a comprehensive package of measures to rebuild Medicare. This includes supporting health professionals to work at the top of their scope of practice, using all of their skills and training; expanding our essential nursing workforce, right around Australia; improving access to crucial after-hours care; providing flexible funding for team based care—the right kind of care; and investing in digital health, including initiatives to support the sharing of pathology and medical imaging across the entire health sector, so that vital information is at the fingertips of healthcare professionals when they need it most.

As I visited the outer suburbs and regional towns after the budget, I met with healthcare practitioners. This is what they has to say. In the Illawarra, I met with Dr Katherine Michelmore, a GP and the medical director of South Eastern NSW Primary Healthcare Network. She told me: 'It's perhaps the first time in a long time that we've had cause for optimism.' When I was in Lismore, I met Ken from the Lismore GP SuperClinic, who told me: 'What the government announced in the Medicare increase is exceptional. It is going to bring back bulk-billing. It is going to encourage those who have recently changed maybe to private billing to go back to bulk-billing, and I really think it's a step in the right direction.' When I was in the Hunter, I met with Dr Yasas, a fellow of the Royal Australian College of General Practitioners. He said: 'It has been a lifeline thrown at us with the budget because we've been struggling to continue bulk-billing patients, especially the vulnerable parts of our community, especially children and elderly and those people living with disabilities.' These measures are going to work.

The Australian Labor Party have a proud history with Medicare. After all, it was the Whitlam Labor government that founded Medibank in 1975, before it was axed by the Liberal coalition under Fraser. Thankfully for all of us, it was reinstated as Medicare in 1984 by the Hawke Labor government. It seems that it's the role of Labor governments to throw the lifeline to our universal healthcare system time and time again when it has been left to the perils of the Liberals. For those on this side of the House, health care isn't just what we do; it's who we are. The member for Higgins is an infectious disease specialist and general physician. The member for Newcastle is a former disability support worker. My good friend the member for Macarthur is a paediatrician. The member for Cooper trained as a nurse on the floor of the Mercy Hospital in Melbourne all those years ago. The member for Robertson is an emergency doctor in my community on the Central Coast of New South Wales. The member for Kingston is a psychologist. The member for Ballarat started her working life as a social worker in Victoria. The strength of our health care system is that it's universal—that no matter who you are or whatever your background, you can get the care you need when you need it.

This amendment, in practice, will remove the veto power of the Australian Medical Association in the appointment process of the Director of the Professional Services Review, also known as the PSR. As an independent statutory agency, the PSR is responsible for protecting the integrity of Medicare—our universal system of care—by investigating inappropriate practice. The PSR is critical to ensuring that patients are protected, as we all must be, in our clinical care and that dodgy conduct, when it occurs, is stamped out.

Integrity must underpin our universal system of care. The changes will remove potential conflicts of interest to enhance public perceptions of the PSR scheme and ensure the PSR process can operate with impartiality and independence. These measures are essential to maintaining public confidence and strengthening the integrity of Medicare. The amendment will make sure that our healthcare system remains public, by Australians for all Australians.

I am proud to be part of Labor's healthcare team. It demonstrates Labor's investment and the priority of health care that we have five ministers and assistant ministers working in health care. I'm very proud to support the member for Cooper, who introduced this bill. As the member for Cooper said, Australians are rightly proud of Medicare and of the committed group of doctors and other health professionals who deliver Medicare services right around Australia. The member for Cooper has also said that bulk-billing is at the heart of Medicare. It is the beating heart of Medicare. We know, and I know from my visits to suburbs and towns around Australia, that it has never been harder or more expensive to see a GP. We as a government are investing in making Medicare stronger for all Australians, wherever they live and whatever their circumstances, and in delivering critical funding and investing in reform for the healthcare system of tomorrow.

The budget handed down in May delivered more than $6 billion in new investments to strengthen Medicare, as well as the indexation boost to Medicare rebates that I mentioned. The value of that is more than $1.5 billion, the biggest increase in 30 years. It is absolutely critical that all Australians, wherever they live and whatever their age, have access to care when and where they need it. That's why strengthening Medicare was the centrepiece of our budget.

This package is worth $3.5 billion. As I mentioned, it triples the bulk-billing incentives for GP visits, the largest ever investment in bulk billing incentives. In our major cities, it means a 30 per cent increase in the payments to a bulk-billing GP, and, in the many rural and regional parts of Australia where I have had the chance to visit and hear from healthcare professionals, it will mean an increase in bulk-billing of around 50 per cent. That will transform health care right around Australia, particularly in the most regional and remote parts of Australia. It will mean five million children and their families, and seven million pensioners and concession card holders, will all benefit from the increase in the bulk-billing incentive. This historic investment means three out of five visits to a GP will be bulk-billed. That is why this legislation today is absolutely critical, because every Australian must have confidence in our Medicare system, our universal system of care, and the legislation that we're discussing today is important in protecting the integrity of Medicare.

This bill makes several priority amendments in response to the recommendations from the review. As I mentioned, the measures in this bill will strengthen the operation of the Professional Services Review, known as the PSR, as well as improving the effectiveness of the current process for auditing payments relating to Medicare services. It means in essence that the bill removes the veto power of the Australian Medical Association, known as the AMA, in the appointment process for the director of the PSR; amends consultation requirements for appointments of other statutory office holders of the PSR, including deputy directors, panel members and members of the determining authority, to enable consultation with relevant peak bodies directly; enables the appointment of associate directors of the PSR; and removes the need for engagement with stakeholder groups as a prerequisite for issuing a notice to produce documents during an audit.

The PSR is an independent statutory agency responsible for protecting the integrity of the Medicare program by investigating whether a person has engaged in inappropriate practice. In doing so, the PSR protects patients and keeps us safe, and the community in general, safe from the risks associated with inappropriate practice, if and when it occurs. As a healthcare professional myself, I understand the importance of these measures—as, I'm sure, millions of people around Australia do as well. The PSR addresses the behaviour of a person who may have engaged in inappropriate practice through a review by the director or by committees made up of clinical professional peers.

Currently, the director of the PSR cannot be appointed without the agreement of the AMA. The government considers that this veto power isn't consistent. It's not aligned with public expectations and could undermine confidence in the independence of the PSR as a regulator. The veto power, it's important to note, has never been exercised, raising further questions of the need for this requirement. Given the potential conflict between the PSR's objective to safeguard Medicare and the AMA's role in representing the interests of medical professionals may be subject to the PSR review, it's appropriate for the veto power to be removed.

I am very pleased to support the member for Cooper and the legislation that we're putting through the House. As I mentioned earlier, it is absolutely critical that all Australians have confidence in Medicare, in our universal system of care. That's so they know they're receiving the right kind of care and that all health practitioners will conduct themselves professionally and behave in a way in accordance with the professional standards of their discipline and the community expectations of healthcare workers. So I'm very pleased today to be able to support this legislation.

In conclusion, these changes I have mentioned will remove potential conflicts of interest, enhance public perception of the PSR scheme and ensure that the PSR process can operate with impartiality and independence so that Australians can have confidence in the impartiality and independence of the PSR. These measures are essential to maintaining public confidence, so that every Australian, wherever they live and wherever they're accessing care, will know that their healthcare professional is conducting themselves appropriately, meeting professional standards and meeting the community's expectations of them. The amendment will make sure that our healthcare system remains public, by Australians for Australians. Thank you.

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