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

I thank the member for Wannon for his enthusiasm at the opportunity to listen to a speech characteristically to legislation before the House from the member for Goldstein—of course, certainly better than the predecessor member for Goldstein, I'm sure, on the subject matter of which he is humbly agreeing with as well.

The point of this legislation, of course, as was mentioned by the previous speaker, is straightforward, but we need to acknowledge it sits in a much broader context about the health care of this nation. We all have a natural interest in having a sustainable health system for our country. Doing so is one that supports the workers to be able to go on and deliver the primary care they need in community, and that's of critical importance. One of the things that COVID demonstrated or revealed to all of us is the health inequity that exists across our country around access to services between not just rural and regional areas but also affluent and less affluent parts of capital cities. In a moment of crisis, when people need care, it's explicitly revealed to the whole of the nation. The question is how you seek to address that and make sure that the system is sustainable and gives people the support that they need.

What we've heard from this government to date around health care has been principally, as they hold up their Medicare cards, that everybody can go to the doctor for allegedly free. I now see the television propaganda that has been pushed out by this government to try and reinforce their political messaging. The problem is anybody who has actually gone and visited a doctor. And let's start with the ACT, which is not my constituency, and I can assure you it probably never will be. But, as people who live in the ACT said to me only the other day, there are no bulk-billed doctors in the ACT, the heart of this nation politically. Surely, if the government is going to achieve its objective anywhere, it is here. Yet there are no bulk-billed doctors in this capital city for people. So, if you're low income, you're not getting support. You're a pensioner who doesn't have the financial means and resources to be able to pay. So, despite the bluster and the rhetoric and the holding up of the Medicare card and waving it around and all of the other rubbish that the Prime Minister goes on about, it is not being lived by Australians. A Medicare card comes with a credit card if you want to be able to access a doctor in large parts of this country. No matter what they say and no matter what they do, they are not delivering on the words they promise.

You think about the distrust that breeds within the community, where they see the so-called political leader of this nation waving their card around and saying, 'We're the answer and we're giving that pathway,' and then they go and live a very different reality of a co-payment. Let's be honest about health care. Let's be honest about how people are living and what happens with health care. You can ration health care by one of two ways: price or lists. And the answer of this current government is to do both of those things, which is a completely irrational conclusion. You have to wait longer for higher and more expensive health care, principally so that they can feed the interests of the select few they seek to represent through the trade union movement rather than what we should actually be doing in health care, which—call me radical!—is focusing on patient outcomes. That's my radical proposition. I think we should run a healthcare system focused on patient outcomes that actually empowers Australians to be able to get the health and support and community through primary care to minimise long-term dependency on tertiary care and, more importantly, to make sure that people can live their best, full lives as healthy, engaged participants in the community and the workforce so that they can be happy, not a system designed to keep people ill to feed the benefits of the unions and the people that they are paid to represent and to maintain the political control by the Australian Labor Party.

So that's the situation we currently face in health care, but that doesn't mean that occasionally we get pieces of legislation that come along that at least can do some good to try and change that, because even the Labor Party know the gig is up and they're not going to be able to sustain the health system that they rhetorically promote through their words and their propaganda on television because Australians know the gig is up because they're living the opposite reality. So, when you empower registered nurses to be able to prescribe things off the PBS in certain circumstances and when they're authorised to do so, you help empower nurses, reduce costs and hopefully get better care pathways through to achieve what I believe the central objective of the health system should be, which is to improve patient outcomes. That is a worthwhile objective, and, frankly, I'm very open to many measures that seek to achieve this in many realms, particularly in the healthcare system, to make it more sustainable, to reduce costs and to improve best outcomes for Australians and best healthcare outcomes for Australians.

Having served on the Nursing and Midwifery Board of Ahpra from 2010 until about 2013, I've seen what happens within the sector. You see the enormous pride that nurses rightly take in their profession. But, as is often the case with disciplinary and registration boards, you also, tragically, see the consequences of when trust is abused. We see that in this place with certain committees as well, where trust is abused. But when there are improper and rigid guidelines around access to certain healthcare services and certain medicines there are a select few who, unfortunately, abuse that trust for their own gain and their own benefit. Getting the balance in law is right because it's such an important part of it.

What we have here is legislation that addresses a pathway for registered nurses who are qualified, have capacity and have the regulatory framework to be able to do their jobs better, to allow better outcomes for patient care. On that basis, I'm very supportive of the principle of the legislation as passing it will improve patient outcomes, will improve healthcare services and will actually free up capital and time for nurses, doctors and specialists to be able to support patients where it's needed. That's going to continue to be a big challenge for our country into the future.

We know what happens if we don't do that. We're going to have higher costs and unsustainability in the system that will come through via lower quality care in communities, particularly in lower socioeconomic communities and rural and regional areas. We know that it will make it harder to be able to build a robust and resilient health system that this nation needs.

You only need to look at what is happening in the British and Canadian systems. Because of their rigidity with a system geared towards the interests of union members, not patients, the consequences that then flow from that mean people increasingly have to wait, they are denied care and, because they can't buy things on the basis of price, they are forced to ration on the basis of lists. The lists are getting longer and longer and longer and longer and longer. This feeds distrust and resentment within the Australian community, because those who need services are not able to access them, and we're not getting the health outcomes that Australians desperately need.

In the context of putting forward a practical, modest measure, I implore the government that finally they might start to work towards a healthcare system that works for the Australian people based on honesty, based on patient outcomes and based on improving the health and wellbeing of this nation.

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