House debates

Monday, 14 July 2014

Grievance Debate


4:46 pm

Photo of Amanda RishworthAmanda Rishworth (Kingston, Australian Labor Party, Shadow Parliamentary Secretary for Health) Share this | | Hansard source

I rise out of great concern for constituents in my electorate and indeed Australians right around this country. In recent months Australians have been reeling from one of the most savage, cruel and brutal budgets ever delivered by a federal government. For the first time in a generation, families will face dire financial hardship caused by this government's unfair budget cuts and new taxes. Everyone will pay a heavy price. Families, young people, the unemployed, carers, pensioners and veterans will all have to choose whether to put food on the table or go and see their GP. These are incredibly important issues that will affect the health and wellbeing of our nation.

This government has committed to creating a class system where the rich can access health care while the poor are excluded. The government has committed to implementing a $7 GP tax every time you see a doctor. Many of my constituents thought this was bad enough until they found out that this $7 tax is every time you get a blood test or have an X-ray. Indeed, many families have done the calculation and realise that when they see a doctor and need a number of tests it will add up to a lot more than $7.

You would think that before putting this huge proposal in front of the Australian people the government would have done some research and would have had something convincing to tell the Australian people about why this was so important. They have provided no evidence whatsoever to suggest that this will improve the health of Australians and that this will end up ensuring that people get health care when they need it. Nothing whatsoever has been provided to show how this GP tax will improve the health of Australians. Of course that should be what a government does—looking at improving the health of Australians.

Many people—not just the Labor Party—are speaking out against this. The Australian Medical Association and the Australian Healthcare & Hospitals Association have both recently asked the minister the very simple question: where is the evidence that the implementation of the GP tax will lead to better outcomes? Many people, including many experts in the area, are concerned that this will not only hurt the health of Australians but drive people into an expensive emergency department. This ill-thought-through policy will lead to people who cannot afford to see their GP, a low-cost primary health option, waiting for their condition to get worse or just immediately presenting to emergency, putting extra pressure on our hospitals.

We know where this idea came from. We know that this idea was based on the Commission of Audit, where they recommended a $15 GP tax. The Minister for Health quickly snapped that up, but there has been deafening silence from the Minister for Health about where the evidence is. Where is the evidence? There is no evidence; no modelling—nothing to support this recommendation. Indeed, the AMA president, Associate Professor Brian Owler, has quite rightly attacked this government over the tax. He says

The Government must scrap the current co-payment model and seek expert health advice on a better policy direction.

Why is it that this government is implementing an ill-thought through measure that will create a health divide in this country?

The government has had its rhetoric about the fact that cuts and the GP tax are necessary because the health system is unsustainable. But there is compelling evidence that shows that this is just rhetoric, indeed, it is not factual and it is completely incorrect. Compared with other health systems around the world, Australia has one of the most sustainable. You do not have to look much further than the Commonwealth Fund's recent report Mirror,mirror on the wall: how the performance of the U.S. health care system compares internationally for clear evidence.

The report found that Australia has a sustainable health system, with a lower level of expenditure on health as a percentage of GDP compared to many other countries around the world. But it was worrying that Australia does have concerns when it comes to cost-related problems for accessing health care. And so it is incredibly important that we all work towards ensuring that the health system is sustainable. That is why, when in government, the Labor Party increased bulk-billing rates significantly. It was a significant increase in bulk-billing rates, encouraging our doctors out there to bulk-bill patients. Of course, we know that means that people who may not have the money will access primary health care.

I think it is incredibly important to recognise that we have a very sustainable health system. Of course, we always need to look at it and make sure that it is working efficiently and effectively. But to date we have not heard from the minister how a $7 co-payment will actually ensure that the system works more effectively and efficiently. I call on the government to start providing some evidence about that.

Of course, we also have the concern that the PBS co-payments have also increased significantly in this budget. Rather than increasing by CPI, this has increased 80c per prescription for concession card holders and $5 for other patients. This is well above CPI and is very concerning for some people. The last major study, conducted in 2005—which was the last time there was a major increase in the PBS co-payments—did conclude that a significant increase in patient contributions particularly impacted on concessional patients' ability to afford medicines. I made it very clear in my first speech in this parliament, some years ago now, that it should not matter how much money you have in your pocket as to whether or not you can afford health care. And it certainly should not be the case that we have people in this country who cannot afford the medicines they are prescribed. I think it is very sobering to think that, along with the GP tax hike and that hike for medicines, we will see this impact on the ability for so many people to access the health care they need.

I do want to turn to the $50 billion ripped out of health funding for the states and territories. In South Australia that means an amount of $655 million over the next four years. The South Australian treasurer, the Hon. Tom Koutsantonis, has warned that beds will have to be cut as a result of this budget. It equates to close to 600 hospital beds. That equates to the entire size of the Flinders Medical Centre, which services my constituents.

Unfortunately, as a result of these federal budget cuts we have seen already the $100 million upgrade to the Flinders Medical Centre put on hold—this was to be a major infrastructure investment—as well as the $31.3 million upgrade to the Noarlunga Hospital put on hold. These two hospitals are critically important to my electorate, so it is very, very disappointing. We need to be working with the states and territories. It is no good for the federal government to say, 'The states run hospitals, there is no work for us to do here, we do not have a role in running hospitals.' If you want an integrated high-performing health system, both state and federal governments have to work hand in hand. Indeed, while we were in government that is exactly what we were doing. So I ask the Prime Minister and the government to reconsider these cuts, because health care is a fundamental right that our country should be able to provide.

I also want to touch on the $390 million that has been put on hold in this budget for public dental services. For too long we have had the separation of dental services from our healthcare system. I particularly know that if you do not have good dental health and good dental hygiene it does affect your health. So pulling this money for those that can least afford dental presentations is very short-sighted because it will lead to more and more chronic health conditions. So I really do ask the Prime Minister and the government to stop these cruel cuts to health. These cuts to not improve the wellbeing of our country. They do not improve the wellbeing of our citizens. If we want a country that is prospering and well looked after, we need to invest in health and we need to invest in dental. This government is doing the exact opposite.