Mrs Bronwyn Bishop (Speaker) Share this | Link to this | Hansard source

I have received a letter from the honourable member for Ballarat proposing that a definite matter of public importance be submitted to the House for discussion, namely:

The pain that Australians and their families will feel from the Prime Minister’s broken promises.

I call upon those members who approve of the proposed discussion to rise in their places.

More than the number of members required by the standing orders having risen in their places—

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

We know that before the last election the Prime Minister had a fair bit to say. But some of the words that have come back to haunt him are that he made a very strong promise that there would be 'no cuts to health, no cuts to pensions, no cuts to education and no new taxes'. We know with this budget that he has not only broken those promises, he has absolutely smashed them.

We know, revealed in the budget, that there is $80 billion being taken out of health and education. That is $80 billion, $50 billion of which is being taken out of public hospitals in this country, ripping up the historic agreement that Labor reached with states and territories to improve our emergency departments, to put more beds into hospitals—both acute and subacute—to fix elective surgery waiting lists, to provide more staff in hospitals, to provide better infrastructure for hospitals and to make sure we were fixing a lot of the mess that had been left to us by a Liberal government that saw a declining Commonwealth share of public hospital funding.

Now, we have had a bit of mean and tricky stuff from the Minister for Health, where he has tried to argue—and he has been running this false argument around the sustainability of the health budget—that, in fact, part of the problem has been a blow-out in hospital spending. In fact, it was a deliberate decision of a Labor government to make sure that there were investments from the Commonwealth in public hospitals, to do our share of the heavy lifting to make sure that people continued to have access to a universal healthcare system, Medicare, that provides access to public hospitals. That was a deliberate decision that Labor made.

In this budget, this government has smashed that. It has ripped up those historic agreements with states and territories. I asked a question of the Prime Minister in question time, whether he would guarantee that no hospital beds would close, that no nurses or doctors would be sacked from our public hospitals, that no further beds would close and that we would not see a blow-out in our emergency department waiting times or in our elective surgery waiting times as a result of this direct cut to hospitals in every state and every territory, and in every community across this country. He has refused to give that commitment. But I say to the Prime Minister: every bed that closes, every emergency department waiting time that blows out and every patient that is denied access to a public hospital as a result of these cuts will be on your head. And we will make sure every day from now until the next election that the Australian public in communities right the way across the country understands that.

The other thing that we know—finally, after the months and months of speculation—is what the cuts to health more broadly are going to be. We saw in the budget the introduction of the $7 GP tax. Let me take you to some of the detail of what this is actually going to mean to people. This is about the substantive policy detail; this is what we will see. The government is trying to claim, 'Oh, no—it won't affect bulk-billing. It will be fine. We're going to let doctors continue to bulk-bill, if they want to. It's okay.' They have been mean and tricky about that. The way in which they have administered this measure and the way in which they have reduced the schedule item actually means that there is a disincentive for doctors to bulk-bill. Doctors will have reduced wages, reduced income, if they actually bulk-bill. So there is no incentive for doctors to bulk-bill. Currently there is an MBS item to provide incentives for doctors to bulk-bill. It is greater in the country than it is in the cities, where it is still a bit unclear about what is happening to that MBS item. But what is actually built into this budget is a disincentive to bulk-bill. Doctors will be punished if they bulk-bill.

So here we have, across the country, some of the highest rates of bulk-billing than we have ever had before. They were achieved under Labor—82 per cent of MBS GP visits were bulk-billed under Labor. We will be watching every single day to see what happens to bulk-billing rates in this country because we know the measure that has been introduced by this government is deliberately designed to get rid of bulk-billing in this country.

And why is that so important to this government? I fail absolutely to understand why they want to smash bulk-billing. But you have to go back to some of the history of this. This party that is now in government has never believed in universal access. It has never believed in Medicare, which is a system of insurance where everybody pays through the Medicare levy. Through the Medicare levy, we pay for our universal access system. Through the Medicare levy surcharge some people pay even higher for the universal system. That is in fact the system that ensures that people have access to general practice and that they have access to the public hospital system. That is what we voted for back some 30 years ago. We celebrated the anniversary—this year it would have been 40 years had it not been for the Fraser government. What the Prime Minister and what this Minister for Health are trying to achieve in this budget is what Howard could never achieve: the end of Medicare. Be in no doubt: that is absolutely what they intend to do.

There are a whole lot of other budget hits within the budget that are hidden. They claim that they are reforming the Medicare safety net, but somehow making a $270 million saving from doing so. It is mean and tricky! What that actually means is that while some people may hit the extended Medicare safety threshold a little bit earlier, they in fact will actually have to pay more in out-of-pocket costs. That is really what this is, so look at the devil in the detail.

We know this budget is full of pain for ordinary Australians. Every time an Australian tries to access a general practitioner, whether it is because they feel unwell or because they are trying to manage a chronic disease like asthma or diabetes or because they have heart disease or cancer in their family and they are worried about how they keep well, about what the markers are or the things that they need to do to ensure that they can stay well in the course of their lifetime—every time someone tries to access a general practitioner because of that—they will be slugged $7.

The way in which this government has implemented this policy is an absolute nonsense. Nobody in the health sector has said this is a good idea. The only people who are advocating this are all of those on the opposite side of the chamber and the Commission of Audit. The Australian Medical Association—you would think they would know. The Royal Australian College of General Practitioners—you would think they might know something about health. The Consumer Health Forum, representing some of the most vulnerable people in the health system in this country—no, they do not think it is a good idea. The Australian Council of Social Service also represent some of the most vulnerable people in this community. From right the way across the health spectrum, there is nobody saying that this is a good policy or a good idea except for the Abbott government, because they know that the design of this policy is to end bulk-billing. It is to impose substantial costs on patients so that they avoid going to the doctor. That is what it does. It is designed to make people avoid going to the doctor.

Somehow or other, the Abbott government thinks it is in a better place to decide when people should go to the doctor or not. This is putting a substantial barrier in the way of people accessing general practitioners. What a stupid policy. What a stupid thing to do. Apart from the enormous pain it will inflict on families and on families' budgets, it is also stupid health policy. It is putting a barrier in the way of general practice, the part of the system which is in fact, as the minister will know, the cheapest part of the system. It is putting a barrier in the way of accessing primary care, where you want people to go to stay well, to manage their chronic conditions and to keep out of the more expensive part of the system—hospitals and specialists. Putting a barrier in the way of that system is just plain stupid health reform. It is not health reform; it is ideology.

What we have seen from this government is an absolute hit on the budget of every family as they go to the doctor. How on earth are people on fixed incomes, people who are on marginal incomes in this country, supposed to budget for when their family gets sick? How on earth are they supposed to do that? But somehow that is exactly what this government believes they should do. Factor into your family budget just how many times you are going to need to go to the doctor a year and how many times your kids are going to get sick—how many of you are going to get sick at what time. You need to factor that into your budget.

Shame on this government, frankly. It is an appalling measure and certainly not something that Labor will support under any circumstances. I know the Prime Minister started to talk about horse-trading. You do not horse-trade when people are sick. Only the Prime Minister would make such a statement. The government now is obviously facing a substantial backlash from all of the states and territories. I do not know any state or territory telling you that this GP co-payment is a good idea. I do not know any state or territory saying that your slashing of $50 billion out of public hospitals is a good idea. And there are not many states and territories which think taxing people to go to emergency departments is a good idea. This is a stupid policy that will inflict pain on Australian families and pain on their budgets.

Peter Dutton (Dickson, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

It is obvious that Labor still remain within some sort of parallel universe, denying the fact that they thrust our country into an enormous amount of debt. They are denying the fact that they are putting this country on a path to an unsustainable health system.

As usual, as history shows, Liberal governments are elected to clean up Labor messes, and clean them up we will. We will tidy up the economy because we cannot continue to borrow $1 billion a month just to pay the interest bill. We cannot continue to provide 263 million free services a year under Medicare for a population of 23 million people. It is absolutely essential that we provide support to those people who cannot provide for themselves, and in this budget we do that. It is absolutely essential that we address Labor's waste and inefficiency.

I saw former Minister Plibersek in the chamber before. She presided over the greatest wasteful spending in the health portfolio since Federation, spending money on programs like the GP Super Clinics, half of which remain as vacant paddocks, many of which just have not been able to deliver even the most basic of health services. If people knew anything about the Rudd and Gillard years, they knew that they were big on ideas but completely and utterly hopeless at management and implementing reforms and changes that were needed.

This is what we face when it comes to the health portfolio in this country. In the Medicare levy, we raise less than $10 billion a year, yet the Commonwealth spends $65 billion a year. We project over every year of the forward estimates and into the out years that health spending will grow. It will grow in public hospitals. It will grow in Medicare. It will grow in the overall expenditure within this portfolio. But it will grow at a sustainable rate.

Public hospital funding was not sustainable. If people just cast their minds back—and they are having a bit of a glimpse back to the Rudd days at the moment—to the period in which Julia Gillard was elected as Prime Minister by the Labor caucus, former Prime Minister Gillard came into office saying that she would fix up the boats disaster that Rudd had presided over, that she would fix up the climate change problem that Labor had created and that she would fix up the healthcare agreement that Kevin Rudd had spoken about since 2007 but was never able to put to bed. What happened was that, in an act of desperation that we saw quite regularly in the Gillard years, there was a heap of money put on the table—and I mean a heap of money.

The previous Labor government knew how to waste money. They put a heap of money on the table, and they signed the state premiers and health ministers up. Of course, why wouldn't the health ministers sign up? If they were being thrown money, not for additional services within hospitals and not for additional services across the health system, why wouldn't they take the money? Of course they would. But the problem was that the growth rate was 9½ per cent a year, and it was unsustainable. When the economy is growing at three per cent, who can say with hand on heart that spending increases of 10 per cent a year, year on year, are sustainable?

Nobody can, except the Labor Party, because the Labor Party have a history, since Federation, at a federal and state level, of thrusting this country into debt. People knew in New South Wales what the Labor Party did to the health system. They knew in Queensland, through Patel and the payroll debacle, what they did to the Queensland health system. And they knew over six years what federal Labor did to the health system in its best attempts to destroy it over that period.

This government will set up a world-leading medical research future fund. We will do that to protect the $20 billion capital amount. Why? Because we are worried that future Labor governments would seek to spend all of that money. Why would they do that? There are a couple of reasons. One is that they have not seen a dollar that they do not want to spend. The second is that people will remember back to 2011 and the fact that the member for Lilley, the former Treasurer, sought to rip out $400 million from medical research—but in the end was overturned by his caucus—so we know already that Labor has a track record for trying to rip money out of medical research.

Why is it important to put money into medical research? Again, for a couple of reasons. Firstly, we need to be able to find the discoveries about, and the cures for, the diseases that will confront an ageing population. We need to address the fact that we have diseases of the brain—Alzheimer's, dementia. We need to make sure that we address those, particularly with an ageing population but as they present in younger patients as well. We need to make sure that, for the rare diseases, for the cancers, for the coronary diseases, we provide additional support to our medical researchers—world-class, world-leading medical researchers in the best institutes in the world. We will support those people, not just through the $900 million a year that we provide now to medical research but through the $1 billion that will be earnt from the $20 billion medical research fund to supplement that money and to make sure that we can provide those discoveries and cures over the coming decades. That is how, in part, we will make our health system sustainable. That is how we will strengthen Medicare. That is what this government is determined to do.

The second point in relation to this area is that we need to spend money efficiently. We will do that. We will do it in part by saying to the Australian public that, for services previously bulk-billed in general practice, in pathology and in diagnostics, we will ask for a co-payment of $7, $5 of which will go into the medical research fund and $2 of which will flow to the doctor. That will mean, for doctors in this country, an additional $468 million that will provide support to rebuilding general practice. Remember that Labor, over the course of the last six years, tried to rip down general practice through their failed GP Super Clinics Program and their attacks on doctors otherwise. We will restore confidence into the health system.

Make no mistake about this: the only threat to the universality of the Medicare system in this country is the Labor Party. You cannot have a universal system by providing everything for free. You must have a balanced system. Labor will waste money. They will propose programs but never deliver them. This coalition government was elected to clean up Labor's mess. Clean it up we will, and at the same time we will create the world's biggest medical research fund. But we will strengthen and modernise Medicare so that it can provide not just for today, not just for next year, but for decades to come. People will see this as the strongest contribution to Medicare in generations.

We cannot sustain a system of 263 million free services a year for a population of only 23 million. We retain bulk-billing for those people who cannot afford to contribute to their own health needs. We will provide increased funding every single year for our public hospitals around the country. We will provide more money for our Pharmaceutical Benefits Scheme, where the Labor Party support a co-payment already. This is an important point for the public to recognise. The Labor Party claim to be the friends of those who are most ill and most in need, but they support—in opposition and in government—a co-payment in the Pharmaceutical Benefits Scheme from day one. From the first script, the Labor Party ask sick people to pay over $6 for every single prescription up until the safety net that we put in place to support those patients. Why is that not a tax? Why do the Labor Party say that the co-payment going to the PBS to make the PBS sustainable is not a tax? Why do they describe that as a co-payment and yet, when you go to see the doctor, somehow—for political purposes, not because they are interested in the health of Australians—they, for their own political reasons, term that a tax?

The Australian public got it dead right at the last election. They knew the Labor Party would waste money. They did. They knew that the Labor Party would not be able to implement health reform, and they did not. They knew that the Labor Party would put this country on an unsustainable path in an economic sense but also in relation to the health system, and they did. The Australian public tossed out that dreadful government of Rudd and Gillard because they wanted us to fix up Labor's mess, and that is what we are doing in this budget. We are strengthening and modernising Medicare, a 40-year-old system, and we are protecting universality as an important principle. The Labor Party seek to destroy it through their waste and mismanagement. The Australian public know in their hearts and in their minds that it is only a Liberal government, only a coalition government, that will strengthen Medicare for all generations to come.

Jenny Macklin (Jagajaga, Australian Labor Party, Shadow Minister for Families and Payments) Share this | Link to this | Hansard source

One thing is for sure: the Australian people know that this Liberal government is all about destroying Medicare, just like all the Liberal governments we have seen since it began 40 years ago. In the days leading up to the budget, we heard the Prime Minister saying that this budget would be about pain with a purpose. We are very clear now what that purpose was. The purpose was plainly to make it harder for Australian families to make ends meet. The purpose was plainly to destroy the fair go that Australian pensioners have seen for generations. The purpose was plainly to end the Australian way of life as we know it.

This Prime Minister is inflicting the pain of this budget following so many broken promises. We saw him come into question time again today and deny broken promise after broken promise. Many Australian families are going to be up to $5,000 a year worse off. Each and every one of those members opposite are going to have to go back to their electorates and defend to their constituents that they are taking $5,000 out of the pockets of those families. That is what this Liberal government is doing.

They will also have to face up to each and every pensioner who was told before the last election there would be no change to pensions, that there would be no cuts to pensions. Of course, now pensioners know that, as a result of this budget, they will have their pensions cut. And, of course, young Australians know that, as a result of this budget, they have been deserted. They have been deserted by this government that will leave many vulnerable young Australians with absolutely nothing to live on for six months. That is exactly what this government is doing. It is a cruel government and it is a cruel budget.

So many of the promises were made before the last election. The member for Ballarat has outlined so clearly that each and every person who goes to the GP will have to pay $7. Seven dollars for a GP visit—how is that going to impact on the families of this country when they have two or three kids who all get sick at the same time? Seven dollars adds up, and add on the cost of the medicines that parents are going to have to pay for. Families on family tax benefit part B are going to lose family tax benefit part B when their youngest child turns six. It was called out by former Prime Minister Howard today, making it clear that those families are going to pay that as an increased tax. So many people are going to be affected by so many of the changes that have been made and that will affect the standard of living of Australians.

I hear people saying that pensioners are not going to face a cut. Let us once again look at what Mr Howard had to say. The former Prime Minister understood the need for the pension to actually keep up with the standard of living of other Australians. It was not only the former Prime Minister; it was also the current Minister for Social Services. He understood how important it was to have a wages benchmark so that the pension kept up with the standard of living of other Australians. But that is not going to happen with this budget. Every single pensioner is going to face a cut because of this budget.

But the worst thing in this budget is what this government is doing to young people. People under 30 who cannot find a job and who want to be on Newstart or youth allowance are going to face six months without anything to live on. That is what each of you are going to have to front up to in each and every one of your electorates as these young people face months of nothing. (Time expired)

Alan Tudge (Aston, Liberal Party, Parliamentary Secretary to the Prime Minister) Share this | Link to this | Hansard source

This opposition party is living in a parallel universe. Not only have they not realised that they created an absolute financial mess that we are trying to get control of; they also come in here and have been lecturing us all day about our election commitments and our supposed breaches of them when they are the party that made an art form of breaking promises. I would like to take this opportunity to remind this parliament and, through it, the Australian people of some of the broken promises which they made, because it was those broken promises that got us into so many financial troubles that we are now in and that we have the responsibility to fix up.

I only have four minutes remaining, so I cannot get through the entire list of broken promises, but let me at least give you some of the highlights. First of all there was the tax cut for small business. Do you remember that one? The former member for Deakin even wrote to his entire electorate, promising that tax cut and saying it had been delivered. Of course, it had not. There was a promise to spend only $4.7 billion on the NBN. It has ended up being about $50 billion. There was a promise to build 2,650 trade training centres. How many of those were actually built? There was $2.1 billion for the Epping-Parramatta railway—that was an Albo special. I know the member for Bennelong is still waiting for that one. He will be waiting for a long time if Labor is back in power.

I love this one: the promise for one regulation out for every regulation in. How did they go on that one? They introduced 20,000 new regulations. How many did they take out? Two hundred. Missed by that much! What about their promises in relation to the private health insurance rebate? They said they would not touch it. What did they do? Ripped $4 billion out of it. What about the promise to take a meat axe to the Public Service? Twenty thousand more public servants. They promised no changes to union right of entry to businesses. We know the outcome there. They promised strong management of our borders, and Mr Rudd even promised to turn the boats around before the election. What a job they did on that one, $10 billion later with hundreds of people drowned at sea and 50,000 people arrived on our shores illegally.

They promised a 150-person-strong citizens assembly before introducing anything in relation to climate change. That was visionary! What about Fuel Watch and Grocery Watch? They were great promises. They actually did introduce those but only for a very short time and then scrapped them because they were so useless. They promised spending caps of only two per cent growth—a great promise that one too!

Perhaps I should focus on the two grandaddies of them all. The one which has been repeated time and time again in this parliament is: 'There shall be no carbon tax under a government I lead.' That was their solemn promise that got them through the 2010 election and into government. Had they not made that promise I doubt very much whether they would have scraped across the line.

The last promise mentioned 600 times by the Prime Minister, by the Treasurer at the time and by other members of the frontbench was: the Labor government will deliver a surplus. They mentioned 600 times that they were going to deliver a surplus. They promised the Australian people that 600 times. What did they actually deliver? The four biggest deficits in Australian political history and set up this government now, had we not taken further action, for the next five years of deficits constituting $123 billion of deficit and $660 billion of debt. Tonight the opposition leader will be giving his budget-in-reply response. He has the opportunity to say once and for all how he actually might deliver a surplus in the future and he has the opportunity to say, 'I will get rid of the carbon tax.' (Time expired)

Stephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | Link to this | Hansard source

This year is the 33rd anniversary of the Fraser government's dismantling of Medibank. Next week we are going to witness another anniversary and that is the anniversary of the Fraser government tearing up the health and hospital agreement, the agreement they negotiated with the states to provide more funding for Australian hospitals. They are at it again this mob. The truth is: whatever they say, they just do not believe in Medicare. The Prime Minister nailed it himself in his book. He said the Liberal Party is made up of two camps. The first is the camp that accepts that Medicare is a part of the framework of this country, a part of the landscape. The second camp—

Alan Tudge (Aston, Liberal Party, Parliamentary Secretary to the Prime Minister) Share this | Link to this | Hansard source

Where is Dr Leigh when you need him?

Stephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | Link to this | Hansard source

I suspect the member for Aston is a member of this camp. They see Medibank and Medicare as nothing more than medical socialism. Those are the Prime Minister's own words.

There have been a few interjections. I heard the member for Dawson had a bit to say by way of interjection and a few National Party members had a bit to say by way of interjection, but none of them are on the speaking list because none of them have the guts to stand up here and defend their own government's policy. They are absolutely wetting themselves about going back to their electorates and telling them what their minister and their Prime Minister have proposed. There is a very good reason for it. The true evil in this proposal to introduce a GP tax is this—health and welfare in rural Australia drags the chain and falls behind the health outcomes when it comes to the rest of the country. Those members representing regional and rural seats know it and that is why they are so afraid to go back to their electorates and defend these proposals. They know there are fewer doctors. They know there is a higher incidence of chronic disease. They know there are lower incomes in regional Australia and that this GP tax is going to hit them hard.

I see that the member for Gilmore is in the chamber. She would have read in this morning's Illawarra Mercury a doctor from Milton sticking the boot into the government's proposal. He said:

We say to people here, 'oh you need to drive to Wollongong from Milton for a specialist appointment' and they say 'I can't afford the petrol. I can't go this week because I don't have petrol'.

We don't realise there are people living on the edge. They've said people who are under 30 and unemployed aren't going to get the dole for six months. If they're not eligible for the dole, how are they supposed to make a co-payment?

Dr Thomson also took issue with the co-payment being designed to limit people making too many visits to the doctor. He said:

I don't necessarily accept that premise, that limiting people coming to the doctor's is a good thing.

The member for Gilmore should be listening to her constituents and she should be listening to the GPs in her electorate. If she were listening and knew what was going on, she would know that the GP bulk-billing rate in her electorate was 84.9 per cent last year. If the $7 GP tax is applied to each and every one of those visits, it will be a $6.2 million hit to the hip pockets of patients in her electorate.

It is very good to stand in this place and say you stand for things, but actions speak louder than words. When the vote comes up on this proposal I expect the member for Gilmore, the member for Eden-Monaro, the member for Dawson and every single National Party member to be sitting on this side of the chamber because actions speak louder than words. There is a very clear message for Australians in this budget. The message from the coalition to Australia in this budget is: do not grow old, do not get the sack and do not get crook because if you do, you better have a credit card because your Medicare card is not going to get you in the door.

Nola Marino (Forrest, Liberal Party) Share this | Link to this | Hansard source

I can assure the member for Throsby that I am very confident in going back to my electorate and talking about affordable and sustainable health services, which is exactly what Labor did not provide. We saw costs in health explode under Labor by 46 per cent since 2007. The pressure on the budget from Medicare, the PBS and public hospitals has been unrelenting, driven by many reasons: chronic disease, continuous higher costs, an ageing population and the rising cost of medicine as it becomes more advanced and complex. We can perform procedures today that a few short years ago would have looked like science fiction. We have a raft of new drugs that treat disease better and faster, but each costs a small fortune to develop and get onto the market. Chronic disease conditions that we once just lived with we now treat with surgical correction—for example, knee and hip replacement surgery has grown exponentially. Of course, we should develop new techniques and new medicines because this improves the quality and quantity of life for Australians. In many cases, our work benefits the entire world.

However, all of this improvement comes at a cost—and a cost that never goes down. Once we start fixing one disease state, another one takes prominence. Cardiothoracic treatment and surgery has made major inroads into the outcomes of heart attacks, as have preventative campaigns. But massive growth will still occur in new areas of growth, such as dementia, diabetes, degenerative diseases and mental health, which will take ever-increasing funding to address—something that is ignored by the other side.

This is why the government's $20 billion medical research future fund is so critical. It is a never-ending issue of cost that must be managed. There is no choice: we have to manage this. But it is Labor's failed management of expenditure growth that has left us where we are today. The coalition is spending more money on health but is doing so in a responsible manner by addressing the ever-growing costs. Developing a plan to manage spiralling health costs is a long-term job that requires tough decisions. Labor's plan was simply to spend and ask future generations to foot the bill. They were putting the health budget growth on the national credit card. This is extremely unfair because it asks our children and our grandchildren to pay for health outcomes after the fact—and, of course, that is true even of today's generation. When the former Treasurer, the member for Lilley, was asked about the debt limit, he responded by saying, 'Well, it will be someone else's problem.' An affordable and affordable health system is someone else's problem—it is certainly not Labor's. He would have passed on the current generation's health bill to the next generation.

However, the government recognises that the increasing demand that causes increasing costs is in part the responsibility of the recipient of those services as well as government, and should not simply be dumped on the never-never—on future generations. We need affordable and sustainable health services that Australians can access now and in the future. It is not just about today; it is about the future. It is what we, as a government, take responsibility for providing. Of course, all Australians have to invest in their health outcomes at every level that they can afford. That is our responsibility. It will take a responsible and disciplined government to make this happen. They are the two things that we never saw with the previous government—taking responsibility and discipline.

To not act as the Abbott government has outlined is simply to make future generations pay and pay and pay. The other side of this is: what happens in the instance where there are insufficient health services because it is not affordable and because it is not sustainable? What would we be doing to future generations? To top this, the investment fund to help drive outcomes that can help maintain some of these costs, maintain sustainability and maintain affordability is what we should be all aspiring to. But we could well see Labor actually vote against that—vote against better health outcomes for current and future generations. This would be the most dreadful outcome. What a legacy to leave for this nation. I am pleased to be part of a government that will take responsibility for current and future generations. That is what we are here for and that is what Labor could never do.

Pat Conroy (Charlton, Australian Labor Party) Share this | Link to this | Hansard source

I am proud to be part of a party that will be voting against any attacks on Medicare and any measures that deter sick people from going to the doctor's. The truth is that this is a budget built on a lie. It is built on a confected budget emergency, and that has given those on the other side an excuse for a raft of broken promises. Remember the promises before the election: no changes to the pension, no increased taxes, no cuts to health. All lies; all untruths. They were all said to gain government. Now, in government they have found a confected budget emergency, and it is families that are feeling the pain. The GP tax is one of the greatest betrayals of all. People in the Hunter will pay an extra $25 million per year because of the GP tax. It will deter people from going to the doctor's. International studies have shown that it will deter people from going to the doctor's. What is even worse is they are reducing the incentive for doctors to bulk-bill and increasing the cost of medicine. This is all an attack on Medicare, as the member for Throsby mentioned before.

Fraser, when in government, killed Medibank; Howard lost an election in '87 trying to kill Medicare; Hewson in '93 lost an election trying to kill Medicare. I will give the current government some credit. They were a bit smarter this time. They knew that they had to slowly strangle it. So they are doing it inch by inch, cut by cut, and this is the start of the process. They are going to be deterring sick people from going to the doctor's, and that will place further pressure on emergency departments and hospitals around the country.

I have the honour of having the biggest hospital between Sydney and Brisbane in my electorate. With the only trauma centre in the area, it has the busiest emergency department in the entire state—and that is the John Hunter Hospital. It will suffer increased pressure because of this. Sick people on low incomes will have no choice but to go to the emergency ward instead of seeing their GP. What makes this worse is that this budget also contains $1.2 billion in cuts to New South Wales hospitals—another broken promise by a government of broken promises. Further down the track we are seeing $80 billion in cuts to hospital and education funding by this government. No wonder Mike Baird said that this is a kick in the guts.

But I was wondering what the Prime Minister thought about this area in the past—and, luckily, I heard a journalist talk about this earlier. I do not trust anything the Prime Minister says because, clearly, we cannot trust it. He has always said that you have to get it in writing. So I went to his bible, Battlelinesdo not worry, I did not pay for it. I went to the library. I am not going to help the Prime Minister go to another wedding. On page 133 of this book, which he spent a year writing, or which someone else wrote for him, he said:

Commonwealth spending on health and education now approaches $90 billion a year, or about a quarter of its total spending.

And it goes on to say:

… any withdrawal of Commonwealth involvement or spending in these areas would rightly be seen as a cop out.

So this is the man of action—action man Abbott—in his own words copping out, hurting our public hospitals and condemning the sick and vulnerable to suffer second-rate health.

We should not expect anything better from this government because this government is all about pain for families and blaming everyone but themselves for their broken promises. We have also seen it in the pension—they are attacking almost 100,000 pensioners in the Hunter. Changing indexation is a cut by another name. Increasing the retirement age to the highest retirement age in the world is also an attack on pensions. I have got many workers in my electorate who have no confidence that they will ever get to 70 years of age in the workforce. They are the ones who are going to suffer because of these cuts. We have seen cuts to family benefits. This is a party that claimed to be the party dedicated to reducing the cost of living. How can you reduce the cost of living when you are slugging families with a $5,000 cut to their family tax benefit, with a petrol tax hike and with the abolition of the schoolkids bonus? How is that helping families with the cost of living?

This is a government that has betrayed the people. In my electorate of Charlton, my office has been inundated with phone calls opposed to these changes. This is a mean and sneaky budget that will hurt sick people, hurt pensioners and hurt families, and there is tremendous anger in the community. The government have been pretty quiet in question time over the last few days because they know that attacking Medicare is a political no-no. We will have wait to see the defence. As the member for Throsby mentioned earlier, let them go back to the electorate and defend these attacks on Medicare. They are the party that killed Medicare; they are the party that hates helping poor people go to public hospitals. It is incredible. They are the party that have breached the trust placed in them by the electorate. They are the party that said that they were the adults in government. How adult is it to lie to the people or to deter sick people from going to a doctor? I for one will not stand for it and will happily fight against it. (Time expired)

David Gillespie (Lyne, National Party) Share this | Link to this | Hansard source

The Treasury told us and told the nation that if the record deficits were not addressed and the debt was not brought under control, the outlook for the gross national debt was $667 billion, over half a trillion dollars, in 10 years time. We, in government, were left with this legacy after six years of Labor government. To fix that, things will have to change. People on the other side of this House are still living in denial. For things to change hard decisions have to be made, and we have made those hard decisions through this budget. The Prime Minister made many promises—stop the boats, cut the waste, build the roads of the 21st century and bring the budget back under control. Those opposite would all be familiar with those as they have time and time again complained about his making them.

The Medicare levy plays a small part in getting the budget back under control. People think the Medicare levy pays for Medicare. It does not—it pays for less than 20 per cent of Medicare. People have to face the reality that if they want everything paid for by the government the Medicare levy should be five times what it is. People do not want to pay this. I worked in England years ago where the NHS pays for everything but I had to pay almost 11 per cent on top of my tax as a NHS loading. At least they are honest with people over there and tell them how much their government-paid-for health system actually costs. We are living under a giant delusion that the Medicare levy pays for it all, but it is only paying for part of it. So we have to do things differently. It takes a wise and sound government to make the hard decisions.

The people on the other side have criticised us for breaking promises. I will run through a few of their achievements. Earlier, we heard claims of a long list of broken promises. Since they decided to take on the issue of health, we might have to remind them of what they did to medical research. What about changing the accounting for the NHMRC—talk about doing mean and tricky things! In the last Labor budget, instead of accounting for funding on a quarterly basis in advance they changed it to monthly in arrears, effectively avoiding the payment of a quarter of a year of funding and striking $120 million out of the NHMRC. What about the medical bureaucracy that grew like mushrooms under the previous government? Look at the cost of that. The Rudd and Gillard Labor government established 10 new federal bureaucracies. Look at the human cost of those bureaucracies. When people walk into an accident and emergency department with their kids they do not want to be met by a bureaucrat with a clipboard, they want to see a doctor or a nurse or someone else who can help them. Bureaucracy abounded, and that could not continue in a system under such financial strain.

The Australian National Preventive Health Agency provides further examples of waste through bureaucracy. They spent the princely sum of $463,000 doing a study on the potential of a fat tax. The economists involved in the study discovered that a fat tax would prove to be a cumbersome chore, with undesirable side effects. It would mean higher prices for lean meat as well as for fatty burgers. Another bureaucratic financial waste was the use of $236,000 to build an advertisement for a fake music festival and place it on Facebook to get their messages out. After wasting their money on fat, they then spent their money supporting fat tyre burnouts at the Summernats—$130,000 was spent on grants to the Summernats so the participants could do fat tyre burnouts. (Time expired)

Laurie Ferguson (Werriwa, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the matter of public importance. It is no accident that on the front page of today's Sydney Morning Herald is a photograph of one of my constituents—one of the people that might once have been described as 'Howard's battlers', people that are socially conservative but have doubts that they are getting anything out of the Australian system. She was visiting a medical centre and the article was focusing on the question of this $7 impost. It is not surprising, because in Reid 96.2 per cent of doctor visits are bulk-billed. As earlier speakers have indicated, this change is created through a confected propaganda campaign about a crisis. It is worth noting that the total health expenditure in the United States—which those opposite want to emulate and where they think that there is something to learn—is 17.7 per cent of GDP and in Australia it is 9.5 per cent. So, while Clinton and Teddy Roosevelt and a whole lot of other people have been fighting for a system like Australia's for virtually a hundred years, those opposite want to destroy ours despite the fact that the health spending to GDP ratio is nearly two times higher over there.

If we just look at government expenditure on health we notice that, as a percentage of GDP, we are the 10th lowest of the 33 OECD countries and we are the lowest amongst the wealthy countries. I was here when Costello used to carry on, making comparisons between Australia and the Central African Republic and Botswana. I agree with him: the people we should be comparing ourselves to are the First World. We see from those kinds of figures that in actual fact the GDP expenditure by this country on health is very low, yet those opposite are using this contrived crisis to try and destroy this system.

In terms of general government expenditure, I am indebted to the member for Fairfax for photocopying documents showing that in 2013 Australia's government net debt as a percentage of GDP was 13.5 per cent compared to 73.5 per cent in the advanced economies. So those opposite are manufacturing this so-called crisis to justify the destruction of Medicare. We have heard earlier that the issue is not just the $7; it is the fact that there are now financial disincentives for doctors to bulk-bill. This is also, of course, accompanied by an $80 billion attack on health and education in general—abandoning agreements that were made with the states. Is it any wonder that state conservative governments are now denouncing those opposite for what has occurred, because their systems are going to be under very real pressure?

Another indication of the way in which those opposite have manufactured statistics to justify this comes from our old friend in the Commission of Audit Mr Shepherd, who alleged that there were 11 doctor visits per Australian per year. When that was actually looked at, a variety of statistics indicated otherwise. The figures from Medicare show that there were 128 million visits to GPs last year, giving a population average of 5.6 visits. The National Health Performance Authority, an independent agency, put average doctor visits at between 2.4 and 7.4. So in actual fact the statistics are wrong in regard to the level of visits. The allegations of abuse of the system and of people using doctors for social visits are not a reality.

I do not think we should necessarily restrict ourselves to the views of the opposition on these matters. I want to quote a few perhaps more independent and respected authorities on the impact of this policy. The Royal Australian College of General Practitioners said, 'The government has failed to meet its promised commitment to those in the community with the greatest health needs.' They further commented: 'The government is seriously compromising every point of access to the Australian healthcare system.'

Another eminent organisation known to the member in the chair, the Rural Doctors Association of Australia, has alleged that the real danger is that many of the poorest rural patients will choose not to see a doctor for preventative health care. That will be the outcome: people who have children with health problems are going to decide not to visit; people who have conditions that are not at the moment chronic will have those conditions become chronic as they are untreated. That is the intention of these people: to basically make sure that people do not use the system and to undermine it on all fronts.

Finally, I want to comment on the attacks on young people. I note two things that are going to be affected in my electorate: the massive cut when those opposite force young people to live without payments while at the same time attacking the rail system, which is so vital in my part of Sydney, because people buy houses cheaply there and sacrifice travel time. Those opposite are basically going to massively strip back rail expenditure in the country while at the same time making it harder for those that possess a car to get to work through increased petrol charges—basically impoverishing them as much as possible.

Andrew Southcott (Boothby, Liberal Party) Share this | Link to this | Hansard source

In speaking on this matter of public importance I want to talk about one of the centrepieces of this year's budget—that is, the medical research future fund.

When we look at Australia's history in this area, we see a proud tradition in medical research: Howard Florey, Gus Nossal, Fiona Stanley and also, more recently, Peter Fraser. Australia has an excellent system of clinical trials. One of the areas where Australia has previously fallen down has been the commercialisation of medical research. As part of that, the Howard government commissioned Peter Wills to do a strategic review of our health and medical research. Going back 15 years, what that led to was a substantial increase in the budget for health and medical research in the 1999 budget. I pay tribute to previous health ministers Wooldridge and Abbott, who were strong champions of the need for medical research, and I pay tribute to the current Minister for Health, the member for Dickson, who has continued in that vein.

We all remember the attempts that were made by the previous government to savagely cut the health and medical research budget. This future fund will have a transforming impact. It is visionary. What you will see is that the impact of this will be to make Australia a destination of choice for young medical research scientists and medical research scientists at the top of their careers from around the world. By 2020, it will lead to a $20 billion fund and will see the income from this fund reaching $1 billion per year.

Around Australia we have a number of excellent medical research institutes: the Walter and Eliza Hall Institute; the Garvan Institute; the Baker IDI; the George Institute; the QIMR; and, a newcomer, the SAHMRI in my home state of South Australia.

This is really consistent with what we said before the election in terms of our themes. One of those themes was to back our strengths. Medical research is a strength for Australia but it can become even greater in the future. Previous speakers quoted a number of people's comments on the budget. I wanted to quote one from the Association of Australian Medical Research Institutes, which said that the 'Medical Research Future Fund is a visionary investment in Australia's future.' I quote from Professor Brendan Crabb, the President of the AAMRI:

Creation of this $20 billion fund into perpetuity is amongst the most significant initiatives in the history of medical research in Australia.

Like many members of this House, I have extensive ties in the medical research community, having close family members in it. I have seen this debate over the last 15 and 20 years, and I think we are now poised at a very exciting point. In the future, people will look back to the creation of this fund. It is very important that we make sure that it has a lock that cannot be picked by the Labor Party, because we saw what they have done with previous capital funds in higher education and in health and hospitals—they took the capital and spent it as income. This is a very exciting development for the future of Australia. It means that the next Australian Howard Florey—who made his career in Oxford in the UK, but was a product of Australia—will be able to make their career, do their research, and commercialise their innovations here in Australia.

Bruce Scott (Maranoa, Deputy-Speaker) Share this | Link to this | Hansard source

Order! The discussion has concluded.