Andrew Wilkie (Clark, Independent) Share this | Hansard source

I thank the member for Fowler for bringing this important matter before the House, because access to quality, affordable health care is a fundamental right, and it shouldn't be dependent on your postcode. But, sadly, it's the case that it is. The postcode lottery is the daily reality for too many people in this country, particularly in my home state of Tasmania. I do acknowledge that this situation is, in part, due to health policy and funding being a complicated responsibility shared between the federal and state governments. But that doesn't mean the difficulties being experienced by the community can't be solved nor that we should accept the situation when specific challenges seem to be intractable. And, boy oh boy, aren't there some challenges to confront right now!

As I speak with families and healthcare workers in my community and, indeed, right across Tasmania, I hear the same concerns repeated again and again—that GP clinics are overbooked, that bulk-billing is still difficult to find, that facilities are outdated, that emergency departments are cramped or overflowing, that diagnostics are limited and that, way too often, essential care is delayed. At the start of this year, GP bulk-billing across Tasmania was up more than 5 per cent—to 80 per cent—compared with 12 months ago due to the government's boost to incentives. And that's great. But, to be honest with the community, that improvement is off a low base, and Tasmania remains the second-lowest bulk-billing state in the country, well behind New South Wales and Victoria. Moreover, the figure is distorted by improved rates in rural areas, leaving the actual bulk-billing rate in Hobart somewhere between 60 and 70 per cent, and all that is despite Tasmania having one of the oldest, poorest and sickest populations in the country.

As the Grattan Institute notes, boosting the bulk-billing incentive has the perverse side effect of 'entrenching a dysfunctional funding model' which incentivises practices to see more patients for shorter visits, regardless of patients' needs. This leaves GPs feeling overstretched and unable to meet patient needs and leaves patients without the time and support to properly address increasingly complex and chronic conditions.

It's not just primary health care that's shackbaggerly in my home state, because acute care lags the rest of the country too. For instance, in Tasmania hospital emergency department waiting times are markedly worse than the national average, with the latest data showing that the state recorded the worst results in the nation for emergency department performance. In fact, only 46 per cent of patients were seen on time in 2024-25 compared with the national average of 67 per cent—the goal, of course, should be 100 per cent—and that's if you actually manage to get to the ED, because Hobart has the longest ambulance response times of any state capital in the country. Across Tasmania last year more than 4½ thousand emergency incidents had to wait more than 35 minutes for an ambulance to arrive. That's just shameful.

Meanwhile, the public mental and dental care system remains in dire straits in Tassie too. In fact, if you're on the waitlist for the public dentist, you're likely facing a wait of about four years. This is, of course, not because our healthcare workforce aren't doing their best. No, they are highly professional and do an excellent job under a huge amount of pressure. But they do need to be properly supported by a funding model and a healthcare system which works no matter where you live. That's something we should be able to provide in this country. I've said many times before that Australia is one of the wealthiest countries in the world, and if we decide something is a priority then we can afford it. Indeed, according to the latest UBS Global wealth report, Australia ranked second in median wealth behind only Luxembourg. In the last budget, the government had over three-quarters of a trillion dollars on hand to spend. In other words, it's all about priorities and teamwork.

Instead of each jurisdiction wandering around like Brown's cows on healthcare policy and funding, they should be working together with the Commonwealth to ensure that, no matter what your postcode is or where you are in the country, you can be assured of access to quality and affordable healthcare when you need it.

See this speech in context