House debates

Wednesday, 21 October 2009

Health Insurance (Extended Medicare Safety Net) Determination 2009

4:47 pm

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

I move:

That, in accordance with section 10B of the Health Insurance Act 1973, the House approves the Health Insurance (Extended Medicare Safety Net) Determination 2009 made on 9 October 2009, and presented to the House on 19 October 2009.

Photo of Peter DuttonPeter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | | Hansard source

We welcome this small win for common sense. This has certainly been a case of great bungling by the minister and by the government. The motion today is a result of the work of the coalition and crossbench senators who successfully fought to amend the extended Medicare safety net legislation so that the Rudd government must seek parliamentary approval to make any changes into the future. This is an important safeguard for patients across the country who rely on the protection of the safety net to ensure affordable access to quality health care. Indeed, in a joint statement by Mr Rudd and Nicola Roxon on 22 September 2007, it was stated:

With about one million people each year receiving some cost relief from the safety net, Federal Labor will not put more pressure on family budgets by taking that assistance away.

This was just another promise that the Prime Minister and the health minister had no intention of honouring. Following coalition questioning of the figures used by the minister, the government was forced into negotiations with patient groups and doctors regarding the changes. Minister Roxon was eventually forced into a backflip on the caps on IVF treatment. Increases in Medicare rebates, increases in the safety net caps and the addition of new Medicare items now mean that those seeking IVF treatment will not be forced to pay thousands of dollars more in out-of-pocket expenses.

Despite increasing the caps and the Medicare rebate for a number of items, the minister still claims that the government will generate exactly the same savings, casting more doubt over the assertions and calculations. I quote media release of 8 September this year by the Minister for Health and Ageing:

The restructured items and caps achieve the same savings announced in the 2009-10 Budget ($451.6 million over 4 years).

The coalition welcome the removal of item No. 42740—‘Injection of therapeutic substance into the eye’—which was only removed after significant pressure was applied by the coalition and the crossbench in the Senate. This measure would have had a significant impact on the treatment of macular degeneration, through the injection of the drug Lucentis into the eye. The safety net reimburses patients, not doctors, and the Rudd government tried to shift the cost for the treatment of macular degeneration to patients. Treatment of MD with Lucentis is only available at a limited number of public hospitals. It is not available in New South Wales. The patients who could not afford the increased cost may have stopped treatment and risked blindness. The $16 million in savings associated with this measure is insignificant when compared to the waste and mismanagement in other areas of the Rudd government’s spending. It would have had a considerable impact on patients, with some unnecessarily going blind as a result. It would have meant an increase in falls, fractures and associated hospitalisations for older Australians in particular, and that is why this government should be exposed for the frauds that they are in relation to health. This government promised a lot at the last election. They promised to fix hospitals and they promised to fix the health system. They have not done anything in that direction. This humiliating backflip by Minister Roxon today is further evidence that this government are not serious about health. We welcome the government’s backflip. We are sorry that it took so long but, in the end, I am happy that the coalition, with the assistance of the crossbench senators were able to force the government’s hand.

4:51 pm

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

It is good to see that the shadow minister for health is ‘back in the saddle’, his fate having been decided. The one thing you cannot criticise the shadow minister for is a lack of front. He has had the most humiliating couple of weeks, yet he accuses us of a backflip. It is convenient that the retiring member is here at the table while we have this discussion. The government does not accept for one minute that this is a backflip but, even if you do call it a backflip, it would be ‘junior grade’ compared to the Olympic standard backflip executed by the shadow minister opposite.

Photo of Patrick SeckerPatrick Secker (Barker, Liberal Party) Share this | | Hansard source

The minister should keep to the debate.

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

This piece of legislation and the determination that goes with it are very important. The shadow minister did not mention it, but I understand that he has agreed to make sure that this has speedy approval through the processes of the parliament. It is a very unusual arrangement that the safety net determinations, as requested by the opposition, must be approved by resolution of both houses of parliament before the instrument can take effect. Obviously, this unique process is now required for giving the legislative instrument the legal effect that it needs.

We are comfortable with the change that was made, as mentioned by the shadow minister, of removing item 42740 for the injection of therapeutic substances into the eye. We were persuaded by the arguments that were put by community members and the opposition that a save of under $20 million in a package worth nearly half a billion dollars, given the impacts that were highlighted to us, could be contemplated. We have made those changes accordingly. The only other change that appeared, in comparison to those that were tabled and released as draft determinations, was the indexation of the safety net benefit caps by the consumer price index. Of course, this is of benefit to patients as it means they will receive a higher benefit.

The last matter that I would like to address is the lack of understanding that is still being displayed by the opposition about the budget measure—the fact that this will still deliver the budget figures as estimated and released on budget night, with the adjustment, of course, of the under $20 million for the injection of therapeutic substance into the eye. It was announced and contemplated in the budget papers that the reworking of, for example, the IVF schedule and the obstetrics schedule was part of the calculations that were made for this budget measure. It suited the opposition to pretend that that was not part of the announcement and it suited them to campaign on it while those negotiations were underway, but the truth is that a reasonable arrangement has been met with broad support from the industry. It was not comprehensive support—I acknowledge that. I am pleased that the opposition has decided that this is a measure that they will support. I welcome that support and commend the determination to the House.

Question agreed to.