Tim Wilson (Goldstein, Liberal Party, Shadow Minister for Small Business) Share this | Hansard source

I rise to support the bill. It's wonderful to be here supporting legislation that's looking specifically at the challenges of the pathology sector, because it's so important for making sure that Australians get access to the health services they need and, of course, for making sure Australians are in a position to get the tests at the time and stages of their lives when they need them. We know a huge number of health services are coming under increasing stress and demand as a consequence of an ageing population. The consequence of that is, of course, that more Australians are living longer. We all agree that this is a wonderful thing. The trade-off from that is that costs continue to escalate in the context of the health sector. In particular, the costs of structures are shifting more towards management of chronic conditions. As a consequence of that, people need more testing to make sure that they're keeping up with their existing medical conditions, managing things like medicine regimes and working more and more with their doctors. That's why primary care is such an important part of facilitating healthcare services where people need support and assistance in community rather than escalating things up to tertiary hospitals and, of course, why it's so important to have access to services within the community, including pathology testing.

We have a massive gap in Australian society right now. We have relatively well serviced electorates in inner urban areas—particularly those that are affluent—but so many communities are less well off, particularly once you get outside of capital cities and into rural and regional areas. Access to health services quickly becomes quite limited and often dire. I want to congratulate the new member for Grey on his first speech last night, where he talked explicitly on the limitations of access to health services once you're outside of capital cities. It's something I'm very mindful of and something that I know the member for Riverina, who is here in the chamber with me, is also very concerned about. When we're talking about limitations on access to health service in rural and regional areas—and, I might clarify, often in lower socioeconomic parts of capital cities—you have inequity in provision of health services, which ultimately extends out to diminishing quality of life, particularly towards the later stage of your life. In addition, there are limits on services, which means you spend more time waiting. There is inequity in accessing and getting the best healthcare outcomes.

This is something we take very seriously, Deputy Speaker Boyce. I know it is very important in your electorate as well. To understand that, you have to understand what happens outside of capital cities. That is often a challenge for the current government, which has taken a casual disinterest in health care outside of capital cities in this country. One of the limitations of services outside of capital cities is pathology centres and pathology services. You want to go into remote Indigenous communities and look at the limitations they have to accessing pathology services. The Royal Flying Doctor Service has to deal with this all the time. They literally have to fly into communities to get blood tests, then fly out, then send back medicine later to be able to help support people managing their conditions. This is a big problem that has other big costs and problems that flow down from it that then mean, because of the inefficiencies of access to these types of services, like pathology, more of the health budget is consumed where it shouldn't be.

Of course, we also know that this is a much bigger story about the limitations of health care under this government and, frankly, under the state Labor governments. Victoria is a classic example. We basically have the complete collapse of our hospital system. If you go to a public hospital, you are increasingly concerned about whether you are going to go in and be at risk of co-morbidities or other conditions and whether you'll get into certain types of services, particularly what is deemed elective surgery. I hear from my South Australian colleagues that, despite all the promises from the Malinauskas Labor government, their health services are a complete bin fire despite the promises that they were going to fight ramping and everything else. Nothing has gone in the right direction. It's like the broader conversation around the economy under this government, but that's getting to another topic.

They you get to the federal government and say, 'Okay, the states are failing—the state Labor governments are failing on access to tertiary services. Let's go to primary care and what needs to be provided by the Albanese Labor government.' They like to crow about certain urgent care clinics et cetera. They hold them up and say, 'This is the perfect answer to everything,' but the reality is it's part of—at best—a bandaid solution to a much bigger problem. The Prime Minister is very fond of it—he likes that Medicare card. He likes to bring it out in question time and show it around. It like a little totem that he thinks gives him some sort of license, or magic powers, like he designed the system. Then, all of a sudden, he can take full ownership of it and he wants to own this conversation. Actually, we have seen a reality under this government. We have seen an 11 per cent reduction in the number of people using bulk-billing under this government. It's not about what I want or what you want or what the opposition wants. It's about the government's own data to reflect on the number of Australians using Medicare, and when they go and say, 'I need to access health services,' often in urgent circumstances—often, frankly, when they're facing other challenges in their lives, like the cost-of-living pressure. They go to the supermarket are already having to make a decision of whether they can afford what's in the trolley. Then they've got kids who are sick. They're going to their local doctor, and the answer from the government is, 'You should be able to get it bulk-billed.' But access to fully bulk-billed doctors is quite limited, and despite the promises of the government, since the Albanese government was elected we have seen a decline in the volume of people who are successful in getting things bulk-billed. There's an 11 per cent decline.

This is the tragic reality. The promise and the reality are completely different things. Now, 45 per cent of Australians are paying more out of their own pocket to see a GP than they were when we were last in government. It doesn't matter how many times the Prime Minister held it up—he can hold it up 45 per cent more times—it's not going to change that. It could hold it up 100 per cent more times in question time if he wanted to; it doesn't change the outcome. The reality is, having a Medicare card and being able to use your Medicare card are slightly different things, and the Prime Minister hasn't quite figured that bit out. That's part of the limitations of this government. They like to talk, they like to scare, they like to campaign and they like the politics, but they don't like the governing bit so much. That's what we're now living with and that's what Australians are living with. Australians have only one of two choices: either deny themselves access to health services, and that has a long, downstream consequence, or turn up and pay with their Medicare card. The promise they were sold does not match the reality that they live. We know more and more GP clinics are not bulk-billing. We've seen a decline in the number of those, so Australians are finding it harder and harder. The irony is the people they claim to want to represent—which are those from lower socio-economic communities—are the ones most badly hit.

We need to be realists. We need to start being honest with the Australian community about where our health system is. Once you start being honest and know where you are, you can at least have a conversation on how we're going to fix it. Unfortunately, the government isn't prepared to have that conversation because they think the answer is a bit of plastic they can wave around in question time. That is not the answer to the problem that Australia's healthcare services face. Without meaningful support or meaningful outcomes, when you go to use it, it's like with bankcards. Some of the members over the other side have those cards—I've seen them in your wallets sometimes. These days you actually get them on your phone as well—you can tap them at the supermarket or any other retail outlet. You tap them. And if you don't actually have the money that sits behind them, they don't work. There's this thing called 'declined'. You've heard of that, member for Riverina?

You have! That's kind of how Australians are engaging with Medicare right now. They go to a doctor and say: 'I would like to redeem this card, the plastic one. The Prime Minister holds it up in question time! I saw him on television! I saw him do it on television, so it must be good, because if the Prime Minister says it's going to work, it's going to work.' But, of course, they go and do the effective equivalent of a tap-and-go at their local GP clinic, and the clinic says, 'Here's the top-up payment—the co-payment.' And they say: 'But the Prime Minister said I wasn't going to have to do that. The Prime Minister said in question time that it was going to work.' In any other profession you'd say that was misleading and deceptive conduct. You'd be off to the ACCC. But it's not so for this government. Tap-and-go on Medicare doesn't work, and he's getting away with it because so many of his new Labor colleagues are actually deeply afraid to challenge this Prime Minister and the Minister for Health and Ageing for their limitations and failings. That is the political reality.

Going through all the first speeches of all the new Labor members, as I have been doing, is always an interesting and fascinating insight. I haven't gotten to all the Labor members who were in the last parliament, but I'll get there—don't worry. They appreciate that—that's right! I know the Labor members opposite appreciate that, because I've said to the Labor members opposite, 'I will send you a copy of mine in return.' But a lot of them talked about health care and Medicare in the process. They talk about how it's so important and how it's part of why they became Labor. I have some sympathy for their commitment to it, but the problem we've got is that what they're delivering is not living up to it. When you can't deliver what you promise, the public starts to lose trust and faith in our institutions.

That's one of the reasons the Prime Minister has been vetting and vetoing all of these new Labor members' first speeches, taking out anything about policy or detail that makes them interesting. The Prime Minister has this obsession with control. He wants to control everything. He wants to control his government. He has all these new Labor members of parliament, and it makes him feel like he's unlimited in his power. But there is a reality that sits behind that which means that he simply has no capacity to go on and deliver. He's not getting the feedback loop, including from some Labor members who are qualified general practitioners themselves, who would knock on the door and say: 'Prime Minister, I know you keep flashing your Medicare card around the House of Representatives in question time. I know you're proud of it, and I get it—we all believe in Medicare and its role in the healthcare system. We've got a problem. People are going to their GP clinic, and it's not being redeemed. People are going there, and the clinics are asking where their credit card is so they can access the services.'

I know it must be very uncomfortable for Labor's new members to have that conversation. It's intimidating; it's a big office, and it's flashy. They've decorated it. They've put lots of nice flags in there and that sort of thing. It's always nice the first time you go in there. I do understand that as well. But part of the challenge of being a member of parliament is that sometimes you have to speak truth to power, and when the Prime Minister is misleading the public, you've got to say, 'PM, it's not right.' The people paying the price on the ground are Australians who can't access health services and are having to make choices between that, their rent, feeding their kids and, of course, making sure they put food on the table.

All I can implore is that, in considering this legislation, the Prime Minister wakes up and the Labor backbench stand up, because we need a health system that will actually meet the challenges of the future of this country, and we're not getting it under the timidity, lack of ambition and, frankly, lack of courage of the Labor members opposite.

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