Jerome Laxale (Bennelong, Australian Labor Party) Share this | Hansard source

When Australians talk about what they want from their government, fair and equitable access to health care is always near the top of the list. Medicare is one of Australia's greatest institutions and one of the proudest achievements of the Labor Party. Introduced in its current form in 1983, it remains as important today as it was on the day it was made law by the Hawke government.

Let's not forget that, if it weren't for successive Labor governments in the 1980s, those opposite would have dismantled Medicare. During successive elections in the 1970s and 1980s, Medicare was opposed by the Liberals and the Nationals. They knocked off Medibank after the Whitlam government, and, had they beaten Bob Hawke, they would have knocked it off again after promising to bring down Medicare after it was reinstated by a Labor government in 1983. But it was Labor that locked it in. That tells you why people trust Labor to protect and strengthen Medicare in the face of opposition to and ongoing attacks of it by the Liberals and the Nationals. Medicare represents the simple but profound Australian value that access to health care should be affordable and accessible—where Australians can rely on their Medicare card, not their credit card, to see a doctor. Medicare is about fairness, universality and dignity. It's about knowing that, no matter your circumstances, you can get the care you need when you need it.

When we came to government in 2022, Australians were facing the toughest conditions in Medicare's 40-year history. Bulk-billing was collapsing after a decade of neglect. Families were struggling to find a GP who would see them without huge and rising out-of-pocket costs. Medicines were becoming more and more expensive. Hospitals were under enormous strain. It had never been harder or more expensive to see a doctor. That was the reality that we inherited. That's why strengthening Medicare was at the front and centre of our election platform. We took a plan to the people, and we've been delivering on it ever since.

In just our first term, we've made multiple massive investments in Medicare. In the latest record investment, which we took to the last election, we're putting an extra $8½ billion into delivering more bulk-billed GP visits every year, training more doctors and nurses and making health care more affordable for families. We're expanding bulk-billing incentives. They work so well for concession card holders that we're going to expand that to every Medicare card holder, ensuring that, by 2030, nine out of 10 GP visits will be bulk-billed—just as it should be. We've delivered the two largest increases of Medicare rebates in three decades, reversing years of Liberal freezes and cuts. Already, bulk-billing rates are climbing in every state and territory, with six million additional free visits to GPs delivered in just over a year.

Importantly, we've also taken decisive action on medicines. Australians have already saved more than $1 billion through our reforms. We've slashed the costs of hundreds of common prescriptions. We've introduced 60-day dispensing for nearly 300 medicines. We've lowered the PBS safety net. Just last week, this parliament passed legislation to cut the maximum price of a script to just $25. That is the price it was in 2004. On top of that, we've delivered urgent care for families. We only promised 50 Medicare urgent care clinics; we've delivered 90 across the country. Already, more than 1.8 million Australians have walked through the doors of these clinics, getting free urgent care without waiting hours in a hospital emergency department. These clinics, just like the one in Bennelong, at Top Ryde, are open extended hours, seven days a week. All you need is your Medicare card to get urgent care.

On top of that, we're delivering new Medicare mental health centres, creating walk-in support, so Australians can access mental healthcare when they need it most. We've invested half a billion dollars in women's health, funding more contraceptives, and new endometriosis and pelvic pain clinics—just like the one in Hunters Hill—for treatment for menopause and perimenopause. This is what strengthening Medicare looks like in practice: cheaper medicines, more bulk-billing, more urgent care, better mental health services and historic investment in women's health.

This is what it means in Bennelong. Families in Bennelong have already saved more than $8.6 million on cheaper medicines since 2022. We've opened that Medicare urgent care clinic in Top Ryde, which has seen more than 10,000 presentations. I'm proud to tell the House that another one is coming soon to Chatswood, which will relieve pressure on Royal North Shore Hospital. Tenders are out right now, and I look forward to delivering that in this term of government. In Ryde, we'll also deliver a Medicare mental health centre, which means that locals can get walk-in mental health support when they're in crisis. These are real changes, improving the lives of families in Bennelong and across the nation.

Strengthening Medicare is not only about expanding services or cutting costs but also about ensuring the system is sustainable and trusted, because when a program is as essential to Australian life as Medicare is, we have the responsibility to protect it, to protect taxpayer funds that underpin it and to protect patients from harm. The overwhelming majority of doctors, pharmacists, dentists and allied health professionals are honest and hardworking. They do the right thing, often under enormous pressure. But, in a system that processes more than a billion claims every year, there will always be some who don't. Sometimes, that noncompliance is unintentional, sometimes it is deliberate and fraudulent. Either way, it costs taxpayers money, it undermines confidence, and, in the worst cases, it puts patients at risk.

That's why, in November 2022, our health minister commissioned respected economist Dr Philip to conduct an independent review of the Medicare integrity and compliance measures. His review made it clear that integrity measures across Medicare, the Pharmaceutical Benefits Scheme and the Child Dental Benefits Schedule needed to be strengthened. He found that our systems had not kept pace with modern challenges and recommended reforms to better identify and deter noncompliance, to safeguard patient safety and to ensure that every dollar goes where it should—that's right into patient care.

In response, the government established the Medicare Integrity Taskforce in the 2023-24 budget, and we provided further funding in the 2024-25 budget to continue this work. This bill is the next step on that much-needed and important reform. The Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 implements a key recommendation of the Philip review. It amends the National Health Act, the Health Insurance Act, the human services act and the Dental Benefits Act.

The changes are targeted but significant. They will strengthen compliance and enforcement powers, allowing for the proper investigation and deterrence of fraud and misconduct. They will modernise investigative powers that are currently inconsistent and fragmented, ensuring that serious offences—particularly in relation to pharmaceutical benefits—can be prosecuted effectively. The bill also shortens the timeframe for Medicare claims on bulk-billed services from two years to one. This will reduce the risk of delayed or duplicate claims whilst preserving the minister's discretion to allow late claims in truly genuine cases. The bill will also improve the efficiency of the process for approving pharmacists by combining two stages into one, reducing repeat applications and extending the term of appointment for members of the Australian Community Pharmacy Authority. These changes will cut red tape, reduce administrative burden and deliver timely access to medicines in communities.

The bill also makes important adjustments to the Therapeutic Goods Act and the Public Health (Tobacco and Other Products) Act to support broader reforms. It strengthens the government's ability to manage therapeutic goods shortages, supports compliance with vaping reforms and ensures tobacco regulations are clear and enforceable. Together these measures safeguard Medicare for the future by protecting taxpayer funds, by strengthening patient safety and by ensuring sustainability.

Integrity in Medicare and our systems is not only about protecting taxpayer dollars; it's about protecting patients. When fraudulent claims are made, when prescriptions are misused and when loopholes are exploited, patients are often the ones who suffer. The Philip review emphasised that patient safety must be at the centre of these integrity measures, and this bill delivers on that recommendation. By strengthening the powers, by harmonising enforcement across our health schemes and by closing loopholes, this bill will ensure we can respond quickly and proportionately to misconduct. Only a small percentage of practitioners and businesses will ever be affected by these measures. Those who deliberately and repeatedly do the wrong thing will have to be held accountable. But, for the overwhelming majority, this bill will provide confidence that their hard work is protected, their reputation is upheld and the system that they serve and participate in remains strong.

Our government is strengthening Medicare in every sense of the word. We are investing in more doctors, more nurses, more urgent care, more mental health support, cheaper medicines and better women's health services. Through this bill, we're also protecting the system itself, ensuring integrity, sustainability and trust. Labor created Medicare; only Labor will protect and strengthen it. We're delivering on these investments, reforms and integrity measures to ensure that Medicare remains strong and sustainable for generations to come. This bill builds on historic investments we've already made in Medicare, it strengthens compliance and enforcement, it supports timely access to medicines, and it cuts red tape for pharmacists. These are all really important improvements. Most importantly, it ensures that Medicare, the program that has cared for Australians for over 40 years, will remain strong and sustainable.

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