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 impact of the Government’s wrong priorities on nurses.

I call upon those honourable 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

I rise today to talk about the healthcare emergency that has been created by this government's $50 billion worth of cuts to our public hospital system, and the effect that these cuts will have on the hundreds and thousands of nurses and midwives across Australia, some of whom are in the gallery today, and the millions of patients that they care for every day in GP practices, in community health centres, in home based nursing care and in our public hospital system.

When it comes to health care, Australians are being let down by the most uncompassionate government since Federation, and they are being let down by the most ineffective health minister this country has ever seen. These $50 billion cuts are the equivalent of cutting one in five nursing positions across the country—one in five nursing positions across the country! These are front-line services, people who are caring for some of the most sick and vulnerable in our communities, who are keeping older people within their own homes. And it comes at a time when Health Workforce Australia has estimated there is already a shortage of some 20,000 nurses in this country, and more shortages to come. Indeed Health Workforce Australia has said:

… without nationally coordinated reform Australia is likely to experience limitations in the delivery of high quality health services—

as a consequence of a highly significant shortage of more than 109,000 nurses.

So what is the government's response to this nursing workforce crisis? The government's response is to: abolish Health Workforce Australia, and the Senate is considering those bills this week; cut $142 million in funding for health workforce planning; and to get rid of more than 140 jobs in South Australia. This is at a time when public hospitals across the country are struggling to meet their emergency department waiting times and their elective surgery waiting times.

And it is not just the Labor Party that is saying it. Australia's most ineffective health minister has managed to unite the entire health sector against the government with his cruel cuts and lack of any compassion. It takes a pretty special health minister to unite the entire healthcare sector against you and against the government's unfair budget. He likes to be critical of this side of the place, but what he does not seem to understand is that there is every health expert in the country saying your budget is a dud. It is an absolute dud and will damage the healthcare system in this country. It fundamentally undermines the universal principles of Medicare and it actually changes the entire way in which our healthcare system operates. Fifty billion dollars being cut and ripping up the national partnership agreements that saw the relationship between the Commonwealth and the states starting, for the first time, to actually begin to focus on health policy reform—reform that is needed to make the system more efficient. Ripping up those agreements and ripping $50 billion out of public hospitals—it is an absolute disgrace.

The Australian Medical Association President, Associate Professor Brian Owler, last month summed up the health sector's response to this government's backward, inequitable and unfair vision for health care in this country. He said:

The message is clear: the measures add up to bad health policy.

Professor Owler went on to say:

The health measures in the federal budget are almost universally opposed by the people who provide health services in Australia. The [Australian Medical Association] is at the forefront of this opposition.

And we know what the impact will be on nurses and midwives across the country and on the patients that they care for. The Australian Nursing and Midwifery Federation has said these are cuts that will damage the healthcare system. They are cuts that the acting secretary of the ANMF said:

… ripped the heart out of the Australian health system and as a former Health Minister, [the Prime Minister] should be ashamed of that.

And it is not just nurses working in hospitals who will be affected by these changes. Nurses working in general practice across Australia and in private practice will be hit by these cuts. In particular, I want to refer to some correspondence from a GP practice in Ingham and the effect that these new taxes will have on that practice. It said:

We as a practice currently make a loss per dressing we perform. We offer this service as a benefit to the community and to the patients of our practice. We charge no dressing fee to patients due to our belief that this would cause unreasonable hardship for these 'at risk' patients … We perform 20-30 dressings per day.

These are often older patients suffering from things like leg ulcers, wound care that sometimes requires up to three visits a week. Dr Elliott goes on to detail the cuts in this budget to MBS items and then said:

This is clearly not affordable for the practice to absorb these costs. This would result in our practice ceasing to offer this service which would result in patients having to attend Ingham Hospital for these dressings where the costs would be borne completely by the taxpayer at a higher rate. We then would reduce our nurse numbers.

This is not the Labor Party saying it.

Brett Whiteley (Braddon, Liberal Party) Share this | Link to this | Hansard source

That is you saying it!

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

These are GPs delivering frontline services not in my electorate, not in Labor Party electorates, but in Ingham. This is one of the smaller, more remote communities in Queensland.

Mr Nikolic interjecting—

And I note that we continue to have significant interjections from the members who represent seats in Tasmania.

Brett Whiteley (Braddon, Liberal Party) Share this | Link to this | Hansard source

That's right!

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

You represent some of the poorest seats in this country.

Brett Whiteley (Braddon, Liberal Party) Share this | Link to this | Hansard source

Yeah, and do you know why?

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

I have visited those seats many, many times and every single time you have failed to stand up for those people in your community—

Mr Whiteley interjecting—

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

What a shameful thing to say!

Government members interjecting—

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

We will have some decorum, thank you, from both sides!

Ms Butler interjecting—

The member for Griffith is not in her seat and will not speak!

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

who need to access general practice, who need to access health care, and you have failed the members of your communities.

And what will that affect? From the GP in Ingham we know what the effect on nurses will be if the government gets its way and also introduces a tax on hospital visits.

Stephen Duckett from the Grattan Institute—someone who knows something about the health system and how to increase efficiency—has stated:

If just one in four patients chose to go to a hospital emergency department, the Commonwealth will save no money because of the much higher costs of emergency department care; costs that the Commonwealth government now shares.

And this is precisely what this government's GP tax will do.

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

You ruined Tasmania and then you stand there all pious. Good on you!

Government members interjecting—

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

I see those experts over there, those grand experts of health policy, representing some of the poorest electorates in our communities—blah, blah, blah they go; off they go again—failing to represent the people of their communities. I am looking forward to campaigning every single day until the next election on your failure to stand up—

A government member: Bring it on!

to provide healthcare services to your community. I am looking forward to doing that every day.

We know that the support that this government is providing for nurses working in general practice has been poor. Consistent with the lack of transparency, lack of compassion and incompetence that has characterised this government, a fortnight ago this government tried to sneak through changes to the way health assessments are conducted by nurse practitioners in GP practices. Without any warning, the government reinterpreted the role of nurses and determined that practice nurse time does not count in Medicare Benefits Schedule health assessment items. Consistent with the way this government does business, the change was announced without any consultation whatsoever and the president at that time of the Australian Primary Health Care Nurses Association described this as having 'a devastating impact on the ability of general practice to provide high-quality preventive care.' Not long after this announcement was made, the government was shamed into backing down on yet another ill-conceived health policy idea.

The government should now back down on some of its other ill-conceived policies that will result in less places for nurses, less places for doctors, less hospital beds, blowouts in emergency department waiting times and elective surgery, and bed closures. The government should back down from its $50 billion cuts to public hospitals. It should back down from ripping up national partnership agreements that saw increased funding going into public hospitals in every community across this country. It should back down on its $7 GP tax. It should back down on its $1.3 billion hike to the cost of medicines and its unfair changes to the Medicare Benefits Schedule and the PBS safety nets. It should back down on its $367 million cut to the National Partnership Agreements on Preventive Health. If the government wants to try and change the healthcare system, it has to make sure that the healthcare system is focussing on prevention. But what it has actually done is cut all of the money from preventative services. I have been involved in healthcare policy development all of my working life, whether it was working within the Department of Health, whether it was working as a consultant in health consulting or whether it was working in direct care in allied health.

Mr Nikolic interjecting.

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

We will have some silence on my right.

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

I have worked in health policy all of my career and I have never seen a sector so united against a government as it is with this particular budget. The inequitable changes in the budget are the biggest attack on Medicare in 30 years. Indeed, when the changes were first announced the AMA Vice President, Professor Geoffrey Dobb, described them as setting back health care 50 years in Australia. The government's arguments that these cuts are making Medicare sustainable is an absolute mockery because the money is not going back into the system. The government knows it, and it should be honest with the Australian people and keep its hands off Medicare.

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

I acknowledge the nurses' union officials within the gallery today. I hope they have been impressed by the performance of their subjects over there. I hope the effect of the puppets' strings work as well from the gallery as they do for the preselection processes that take place around the country. Of course, some of them have not been preselected from the nurses' union. We have Manser up there who is presumably a product of the CFMEU. Given all the talent and class of the CFMEU that he brings into this place, it needs to be put on the record that he needs to be recognised for the marvellous contribution he makes on a daily basis.

All that you have heard from the Labor Party over the course of the last 10 minutes reflects what we have heard from the Labor Party over the course of the last six years—that is, an attack on those people who are on the front-line services in a desperate cause taken up by Labor at a state and federal level to set up health bureaucracies all around the country to siphon money away from front-line services and to put it into bureaucracies. Why? Not because it is of benefit to patients and to people who are on waiting lists but because it pleases the union bosses.

If you want to know why the Labor Party over the course of the last six years was completely incompetent in government, have a look at the people who fill the benches now compared to those who filled the benches in the Hawke-Keating years. People who had real-life experience served in the Keating and Hawke cabinets, not people like the member for Ballarat, who reported before that she had a lifetime as a bureaucrat within the department and served as a consultant—with all due respect to bureaucrats and consultants. But, just like those behind her, it does not bring professional experience to this place and, frankly, it is reflected when they are in government. They are completely incompetent in the modern age of managing government. That is why they say 'yes' to everybody, they write cheques to everybody who comes through the door, they take money away from front-line services and they rack up record amounts of debt. That is the modern Labor Party. That is what we have seen over the course of the last six years. And that is why, when the election is held in two years' time, the Australian public will make the only decision that they can: that is that the Labor Party has not learnt the lessons of the last six years. People who come from normal nursing backgrounds or normal teaching backgrounds or normal policing backgrounds or backgrounds otherwise cannot get into the modern Labor parliament. They cannot do it because they cannot get past the union secretaries. They cannot get past the union bosses who reward their fellow spirits. It shows in the policy that they put forward and it shows in the way in which they manage. And it has been on display again today. It is not good for democracy in this country.

I ask those on the other side: who has had small business experience? On the other side, put your hand up if you have had small business experience. Just one hand? No, not one hand.

Mr Mitchell interjecting.

Oh, you have worked on the fringes as a union hack marching your way into small business. That does not count. That does not give you the opportunity to say that you put your house on the line. It does not give you the opportunity to say that you employed people and that you understand the hard lessons of business. It does not say that you have life experience—that is demonstrated in these constant interjections and ridiculous contributions.

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

This is most unusual for a point of order. What is the point of order?

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

It is normally, but he should refer to people by their seats.

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

This is a wide-ranging debate. It really is a nonsense to do that sort of thing in this matter of public importance.

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

Why is it that Labor presided over ripping money out of frontline health services and putting it into bureaucracies? Because of the union bosses. What have we done in relation to this most recent budget? I can tell you what we have done in the national context in terms of state-by-state budget funding for public hospitals. New South Wales it increases by 7.2 per cent from 2013-14 to 2014-15. It is 7.3 per cent in Victoria, 12.8 per cent in Queensland, 13.6 per cent in WA and seven per cent in Tasmania. In Tasmania the budget shows, in black and white, that it will go up by 15 per cent. If you listen to the Labor Party you would think that we had cut hospital funding. Next year and the year after in New South Wales it is an increase of 9.8 per cent and 8.7 per cent. If you look at Queensland over the years of this budget, there is an increase of 36.6 per cent over those four years. In New South Wales it is 36.7 per cent; in Tasmania, 30.8 per cent; and in WA, it is a 44 per cent increase in hospital funding over the course of the next four years. So do not listen to this nonsense from the Labor Party. These people are playing up to the union bosses who are visiting the parliament today—nothing more, nothing less.

All I want to do is put the facts on the table. We increase hospital funding in each and every year under this budget. We put it on a sustainable path, because Labor racked up debt. They pretended they could give everything to everybody for free. Well, do you know what? The hangover of the party now needs to be dealt with. People in their household budgets know that you can only spend for so long more than what you earn. People in small or large business now that you can only spend more than what you earn for so long before the banks move in to take over.

My colleagues from Tasmania—who are particularly passionate about health and have seen Labor preside over the worst health mismanagement at a state level over the course of the last six years; exactly the reason Labor was swept from power in Tasmania—passed on a very interesting statistic to me before. And that is that this interest bill that we have been left with from the Labor Party is $1 billion a month. Without any changes it grows to $2.8 billion within 10 years. This is per month. That is money that we are borrowing to pay the interest bill. Imagine if you were running your household like that. If you had to borrow money each month to pay off the mortgage, people would go broke pretty quickly. The country is in exactly the same position if we do not put in place remedial action. What do you get for $1 billion a month? As we heard before from my colleagues from Tasmania, you could employ 10,000 nurses a year. That is 10,000 nurses a year for a single Labor interest bill in a month.

So I say to the nurses in the gallery, 'If you wonder why we are having to take action to repair Labor's damage over the course of the last six years, it is because of the debt that they have racked up.' We have provided extra support for scholarships in relation to nurses and allied health care professionals in this budget. We provide $96 million for bowel cancer screening—early detection is very important in bowel cancer. We provide that support. We provide extra funding in addition to the fact that we can build a $20-billion medical research fund. Why? Because we know that for every dollar that we spend in medical research, $2.17 is returned. Why do we know that? Because of the independent report that Prime Minister Gillard commissioned that came back to the Labor government to say that the health system in its current form is unsustainable and we should be spending more in the areas of prevention, which we do in this budget. We spend more in relation to bowel cancer screening, as I say, but in many other areas as well. We spend more in medical research because, as a country, we punch above our weight. We have world-class medical researchers that other countries are desperate to poach. But we keep them here and we will find better techniques to care for patients as well as the cures for diseases of the brain, for cancers and other issues which will overtake us in decades and centuries to come if we do not do the research today—in a similar vein to the way in which we had to do research around penicillin and other discoveries that came from this country and others over the previous decades.

We are putting money into that space because it will save money long term in the health system. That is the advice that was given to the Labor government. The problem is that Labor mismanaged so poorly. The internal fighting that really engulfed Labor over the course of the last six years is still there. We saw the member for Sydney in the opposition leader's chair today absolutely determined to knock off Bill Shorten in the same way that Julia Gillard was determined to knock off Kevin Rudd. Mark my words, these people, when you scratch beneath the surface, are as bad today as they were six years ago. That is the reason they were never able to manage health properly—because they did not have an eye on patients and nurses and doctors. This government will make sure that we take care of our nurses, that we take care of our doctors, that we take care of our patients and we do that because we increased funding. We take it away from those bureaucratic structures and we put it back into front-line services.

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

If the longest queue in the building is the queue outside of the coffee shop at eight o'clock in the morning, the shortest queue in the building has got to be the queue of government MPs that are willing to line up here in this parliament and defend their own government's policy when it comes to their atrocious attacks on the health care system.

Mr Ewen Jones interjecting—

Mr Nikolic interjecting—

I see Townsville's answer to Benny Hill has got a lot to say, I see 'Sergeant Strop' from Bass over there has got a lot to say, but none of them are willing to put themselves on the speaking list. They had an opportunity today to put themselves on the speaking list and defend their horrid attacks on the PBS system. But all we see is four people who are willing to stand up and defend their government's atrocious attacks on the health system.

Even the minister today had the opportunity—he was given 10 minutes—to say something nice about the nurses who labour day in and day out, caring for the sick in our hospitals. He was given 10 minutes to say something nice about them and he could not find it within himself to praise the men and women who labour day in and day out looking after the sick in our hospitals. Is it any wonder that he had nothing nice to say about them? From the cradle to the grave the nurses are copping it under this government. There is their deregulation of university fees. We heard during question time today that a nurse could expect to pay close to $98,000 to receive a university degree that would qualify them to practise. What did the Deputy Prime Minister have to say about this? He said, 'Don't worry about the $98,000 because we are giving you $500 back in the carbon tax.' With maths like that, is it any wonder he had to give up farming?

Nurses cop it from the beginning to the end under this government. Their penalty rates are in the fire because the minister for industrial relations has promised a comprehensive review—everything is going to be on the table. Under this government those people who work 12-hour shifts across the weekend and over 24 hours a day can look forward to an attack on their penalty rates, because it is in the government's DNA. If it is not enough that the government is coming after their university fees, coming after their penalty rates and making it harder for them to do their job, it is going to ask them to work longer. Only a government made up of people who have never had to work hard shift work in all their lives—nobody has done a hard job where they have had to stand on their feet for 12 or 14 hours a day—would suggest you could do that until the age of 70. That is what the nurses have got to look forward to under this government. It is an absolute and complete breach of faith.

We heard the minister say that there are no cuts to hospitals. We know they do not like to listen to union officials but here is one union official they might like to listen to. During question time today, the AMA said that Australia has 'one of the most efficient and high-performing health systems in the world'. The AMA has said that the health budget is not out of control. That is a complete contradiction of what the government has said. The government is trying to pull the wool over the eyes of the Australian people.

The government say that Medicare spending is out of control. I had a look at Medicare spending. They like to look at the figures over the last 10 years. The government outlay was 4.8 per cent in 2003-04 and 4.6 per cent in 2013-14. The government outlay has actually gone down. The AMA knows it and the nurses of Australia know it. The nurses, the AMA and everybody who has anything to do with the health system know that your rotten GP tax and your rotten plan for the health system just will not wash. (Time expired)

Andrew Laming (Bowman, Liberal Party) Share this | Link to this | Hansard source

It really is a privilege for everyone in this chamber to speak on behalf of Australian nurses. That is what this MPI debate is really about. Without being a little self-indulgent and falling back on lists of talking points, shouldn't this be a moment for us to recognise this incredible profession? Often nurses are bound by paperwork, which I think is partly our fault in this chamber, and are sometimes short on energy and hands, but they are never short on caring. These people do an amazing job. I note also that in regional Australia they probably have the best workforce distribution of any profession. Nurses will go to the ends of the earth and every corner of Australia to deliver their great trade and their wonderful caring. I thank them.

This does raise the question: what provoked the debate today? The Minister for Health exposed the fact that we have some very important people in Canberra today. None of my nursing friends are in Canberra today, no. There are some senior ranking union officials in Canberra. That is why all of a sudden the spotlight is shining on nursing for the first time in years. This is the first time in years they have brought up nursing. There is no doubt about it: the Minister for Health exposed the puppet strings and the fact that they will jump for whoever will get them preselected.

In reality we have a complete disparity between what the union says and what the nurses say. I spent time last week with nurses working in remote Australia and I did not hear them singing from any of the song sheets they have over there. The more I listen to the politics over there the more I realise they do not know much about how a hospital works and when the visiting hours are around the corner. When you dig down and know what life is like working hard at delivering care on the wards, the one thing I think you would ask for—and I do not want to put words in anyone's mouth—is focusing the resources and the attention of the government on front-line health care, making sure that money is spent on patients.

Over the last six years that mob over there had every chance in the world to prove that they could do that but they set up another authority. They slipped it through the parliament. There was a deal with the Greens. What did we get? More high-rise buildings full of bureaucrats and a few more water bubblers, tea trolleys and lumbar supports. None of that was going to help patients, was it? That is the point. That is the raw test of the government's commitment to looking after the ill, the sick and the needy.

This government will never shirk making sure that those on the front line are looked after. That works right through the whole system. We do not employ large numbers of well-meaning people in authorities to tell us the answers we already know to questions. We certainly do not start getting spooked and worried that they are not going to become union members. That is not of any great concern to patients, is it? Patients do not want to know they are being cared for by a union member; they want to know they are being cared for by qualified nurses who are there in appropriate ratios and properly supported by our health system.

Ms Butler interjecting—

I will take that interjection from the member for Griffith. Queensland has shown a stunning turnaround in A&E waits and in waits for surgery that no-one ever thought was possible. What did they do? They did not do it by taking money off the front line, no. They sorted out corporate health and now we are seeing the money directed to where it is really needed.

The second thing is duplication. We want to know that between federal and state services we do not have ridiculous overlaps. We need a health department federally but we do not need one of 5,000 people where none of them treat patients. If you talk to ordinary, everyday Australians, they will say to you, 'I just want to know that when my child is ill I can be seen by a well-supported, qualified workforce in A? and, if I need to get an operation, I know that that will also be available.' Practice nurses are there thanks to coalition initiatives. We have got practice incentive payments there to look after the doctors that do the supervision. We have got the GP numbers increasing from 1,200 to 1,500. They are the real changes that make a difference.

How would we invest in health infrastructure to help those nurses to work? Let's compare and contrast again. How would Labor do it? They would build a superclinic. That is right, a great big Taj Mahal, like the one in Ipswich or the one in Redcliffe, with no doctors—empty, treating no-one. The lights are on but no-one is home. They have even illuminated the cross, but there is nothing going on inside. It reflects a little bit of what is happening on the other side of this House. What are we doing? It is a dollar-for-dollar investment. Practices around the country put up a dollar and we match the dollar with government funds. Then we know the clinicians have put their heart in it and they will use that infrastructure appropriately. You will see more changes and more improvements. Yes, we wave goodbye to authorities. No, we owe nothing to the unions. Yes, on this side, we will do everything we can to serve those on the front line, including nurses around Australia.

Nick Champion (Wakefield, Australian Labor Party) Share this | Link to this | Hansard source

It is great to be here and it is wonderful that the government backbenchers have stuck around to discuss Medicare. I know their great hero John Howard said in 1987 he wanted to 'stab Medicare in the stomach', and that is what this back bench wants to do. They want to gut Medicare. They want to get rid of Medicare. That is what you are doing. There is absolutely no doubt that the essential parts of the Medicare workforce are its nurses, who are an essential front-line part of this system, along with doctors and allied health professionals. They are the sorts of people we should be listening to. But what do you get from the government back bench? You do not get them listening. You get this defence of the government's budget—at least sometimes you do—by interjection. It is not by speeches, not by standing up in the parliament and putting themselves on the record; it is just by interjections and by showing up for these debates.

The AMA, the Australasian College for Emergency Medicine, the Doctors Reform Society, the Public Health Association, the Royal Australian College of General Practitioners, the Consumers Health Forum, the Australian Healthcare and Hospitals Association and countless others are against the government's changes. What are they against? They are against the GP tax, which will cost $7 every time you walk into a waiting room and every time you get a blood test. Think about it: $7 every time is a cascading and compounding tax on Australian families. Those opposite are out there giving their constituents the wrong impression by alleging there is some sort of safety net. We all know that safety net is not defined. We have seen neither hide nor hair of it. All we know is $7 every time you go to a waiting room, every time you get a blood test, every time you go anywhere near a doctor. That is the nature of this policy. That is why it smashes Medicare and it smashes preventative health care.

Dr Bruce Groves from Salisbury North, which is just outside my electorate, wrote to me. I used to go to his surgery. You might want to listen to this. This is not the Labor Party. He says:

To the honourable Nick Champion

Dear Sir

I wish to draw your attention to the massive reduction at my practice of patient numbers since the budget announcement re co-payments in general practice. Our practice of eight doctors, a noncorporate teaching practice, has noted a 30 per cent drop in attendance since this announcement. We are now trying to reassure patients that this measure will only come in if passed by both houses of parliament in July 2015. Patients are confused and upset. We, the doctors, working in a working class suburb with many pensioners and concession card holders are angry and appalled by the proposed co-payment measure, which may well destroy our practice and others in the region, given the response already. The measure is heartless, bereft of social conscience and punishes those who can least afford it.

None of you are listening to your electorates, none of you are listening to the AMA and none of you are listening to general practitioners in your electorates. It is a serious problem because every time someone does not go to the doctor it creates bigger problems down the track. We all know they end up in the emergency departments and they end up in our hospitals, and that will put more pressure on those nurses, more pressure on the front-line services and more pressure on our hospital system. There will be no savings. All of the mythical savings that will go into this wonderful research fund that the minister talks about will not appear because this is simply a cost-shifting situation. If you charge at the GP end, then you will make our hospitals less efficient in the long term.

Government Members:

Government members interjecting—

Nick Champion (Wakefield, Australian Labor Party) Share this | Link to this | Hansard source

We hear a lot of interjections from those opposite. But make no mistake, this GP tax, a cascading $7 every time, combined with the $50 billion worth of cuts, is going to cut some 4,300 hospital beds and one in five nurses. The government back bench might show up and they might interject, but we will not find any of them out in their electorates actually defending this policy come election time. They hope it is defeated in the Senate. They hope that the Labor Party successfully defends Medicare. They hope that this budget is not implemented.

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

When I saw this matter of public importance I thought: 'What is happening here? What are our wrong priorities towards nurses?' I had to scurry back to my office and look through all our documents that we had put through in the campaign and in the budget. To be truthful, I was hard pressed to find anything specifically that was not beneficial for nurses. Then today in question time we hear of visitors here from the Health Services Union and other unions. Then the penny dropped and, like most of you, I realised that this is a bit of a beat up for the people in the unions that are controlling far too many members on the other side of the House.

If you look at things rationally, maybe they are upset about the fact that, when we were in government previously, the coalition introduced practice payments for nurses. But surely they could not be upset about that. Maybe they do not like the idea of 500 scholarships for nurses for up to $30,000 to train, particularly, those in rural and remote areas. They keep going on about this mythical $50 billion worth of cuts, but when you look at it the payments to the states actually go up. What they are complaining about is that the increases are not as prodigious or unrealistic or unsustainable as the previous ALP government made out.

So, there are no cuts. To me, a cut means that what you get next year is less than what you got this year. But things are going up and up—as many speakers here today have pointed up, by nine per cent, nine per cent, six per cent, and then the usual precedent is by CPI and population growth. So, this idea of cuts is absolute rubbish, and these members on the other side should be held to account for scaring the bejesus out of half the people who depend on the health system for their wellbeing. I have worked for 33 years in the health system, and I do not know anyone in the health system who has ever complained about a cut in bureaucracy—and that is what we are doing. The last time I was in A and E and there was blood going everywhere and someone exsanguinating, I did not say, 'Quick, get me a clipboard!' or 'I need a few more paperclips!' or 'I need a new position statement!'

That is what we are doing. We are directing what precious money is in the health portfolio into front-line services. We also have a $331 million Practice Nurse Incentive Payment. Maybe they are complaining about $331 million being dedicated to getting more nurses in private practice, just like they are complaining about nine per cent more, nine per cent more, six per cent more. It is just ridiculous. It strikes me as quite confected anger. They do not have anything else to complain about, so they brew up this major storm about these mythical cuts, when in fact things are going up. There is also $80 million for clinical training programs for nurses. Who could complain about that? So, there is one policy after the other—funding that is going up—yet they are complaining.

In my area, what have we seen from the previous government? We have seen $7 million tied up in my home town for a superclinic that has been in construction for 3½ years and has not seen one patient yet. And you hear the stories all around the country of all these superclinics that are white elephants or are underutilised or not utilised. It is just ridiculous. Practice incentive payments for infrastructure are going to expand the capacity of existing practices rather than superclinics. They also make a big deal about the $7 co-payment. Sure, it is going to change the behaviour in general practices. Hello! That is why it is being introduced—because it was unsustainable. It is sending a price to both the doctor and the patient. And the system, if it is going to be sustained, needs it. (Time expired)

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

The Prime Minister, before the election, made it very clear—he promised—that there would be no cuts to health. Yet in the very first budget this government brought to this parliament we saw $50 billion cut from the health budget—out of our public hospitals, away from all the front-line services. These guys—those opposite—pretend there is no impact on front-line services. You will hear them again today talk about that. It is a complete falsehood, of course. This is just another example of the Prime Minister's wrong priorities that leave shortfalls for the states to pick up that we know they are never going to meet. Those states are never going to pick up that additional cost, and that is just the start.

Across the board the Abbott Liberal government's budget takes the scalpel to health funding and healthcare programs. The introduction of the $7 GP tax hits everyone; we know that. It is going to hit pensioners, parents, the unemployed, low-income earners, people with a disability and even veterans. The tax will cost the people in my electorate of Newcastle more than $5 million a year in extra health costs.

They are hitting the Australian public again with a $1.3 billion increase into the cost of pharmaceuticals. And they are slashing all the preventive healthcare programs, like the Deadly Choices program run by the Awabakal Aboriginal medical service in my electorate of Newcastle.

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

Shameful.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

It is shameful, the attack on the sickest, the poorest, and the most marginalised group in my community of Newcastle. And there has been nothing but silence from those opposite. A preventive healthcare service for Aboriginal people, gone. And this is not something that is coming in the future; these cuts are hitting hard, and they are hitting now. Those opposite are living in some kind of parallel universe if they think there is no impact of these cuts already.

Remember the promise 'We'll shut no Medicare Locals' before the budget? Yeah, we all remember that one. Well, my Medicare Local in the Hunter happens to run this country's most progressive and innovative GP Access After Hours Service. We just celebrated the 10th year of the GP Access After Hours Service, which should be a model for this entire country. It is driven by the dedicated nurses who run the triage work, 24 hours a day, seven days a week—a service that is used by just about every one of the families in my electorate of Newcastle. And it is not just my electorate but the electorates of the member for Shortland, the member for Hunter and the member for Charlton—and the member for Paterson should be in here defending it, actually, because his constituents are also beneficiaries of the nurses who run the GP Access After Hours telephone service, which is gone because of cuts by this government.

Let's not talk about what this will mean in the future, but let's spend the remaining time by focusing on nurses, who are watching this government's attacks on their health industry, their workforce and their sector being cut to the core. It is nurses who are delivering the quality care into hospitals and services in the regions. I might remind the House that for the 20th year in a row nurses have been voted Australia's most ethical and trusted professionals. Do you know that 91 per cent of Australians aged 14 years and over placed nurses at No. 1 in terms of ethics and honesty?

This government is attacking our most trusted. They have no shame. We are facing a shortage of nurses in the near future, and you would think that might be an issue this government might be concerned about, but without a nationally-coordinated reform project that shortage is going to grow to more than 109,000 nurses by 2025. We have got nothing from the government.

You would think they would want to assist women and men to go into nursing higher education, but no: universities like the University of Newcastle are going to be suffering drastically from the cuts in higher education. We know for women it costs more and more to do the degree and repay the costs later. (Time expired)

Ann Sudmalis (Gilmore, Liberal Party) Share this | Link to this | Hansard source

Despite the fact that the federal government does not employ any nurses, I welcome this motion before the House and note that the shadow minister for health has already left the chamber. I also note the member for Throsby's inaccurate assertion that no coalition members are present to debate the issue.

Honourable Members:

Honourable members interjecting—

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

Order!

Ann Sudmalis (Gilmore, Liberal Party) Share this | Link to this | Hansard source

There are eight on the other side and 21 over here. Excuse me while I choke! For seven months now I have been advocating for a practice nurse in a regional area, trying to find out why the previous government changed the rules, disallowing the possibility for a practice nurse to fulfil her obligations for 'recent hours in the practice' while working in order to renew her registration. Please do not snip at our fairy-tale budgetary interpretations measures when it was the previous government that made this change; and regional practice nurses are one of the unintended consequences. Where was Labor and the nurses' union when young nurses were desperate to retrain and get back to work after having a child? How do they assist them to get back to work? The answer is: they do not—no scholarships and no regional application of policies. Shame!

Those opposite speak of health and nurses, but when a previous Labor member announced extra beds in Tasmania, two wards were closed. To those opposite I say: 'don't make me laugh. Labor does not care about nurses or regional health care.' I welcome the chance to speak on this MPI because of the importance of health services in my regional electorate of Gilmore. Only yesterday I met with health minister, Peter Dutton, to talk about health care in my electorate; we spoke about issues like Headspace, bulk-billing, domestic violence services, counselling, MRI issues and more. Gilmore is one of the most healthcare-critical regions in the nation, and that truth is not something to be proud of, but something to advocate for. I am proud to say that on this side of the House we care about nursing and we care about health care.

In fact, the budget papers clearly show that there is no cut. Hospital funding from the government receives an increase of three years—in this budget annual hospital funding increases by over $5 billion. Our commitment to total hospital funding to the states is almost $70 billion over the four years to come. In my own state this goes to $5.9 billion in just three years' time. Those opposite go on about how one of their Kevin Rudd thought bubbles was to increase hospital funding by 10 per cent each year every year. Such an increase would take our current $15 billion health budget to a $40 billion debacle within a decade. Because we are not following this stupid, unaffordable Labor funding thought bubble, those opposite refer to it as cuts. Is it any wonder that we were left with a budget disaster when first-principle economics simply are not understood? It was another Labor thought bubble with no actual thought, no plan, no maturity and no accountability for this proposed expenditure. We are not cutting expenditure; we are just not spending imaginary Rudd dollars.

I find it farcical that those opposite bring this motion before the house today. And yet the Leader of the Opposition is short on how Labor would pay for its pie-in-the-sky health plan. The shadow minister the health never attempts to outline how Labor would find the nearly $15 billion a year extra they claim they can deliver for our hospitals. I guess they prefer the nurses to work in the dark because of the electricity costs.

Gilmore has many district nurses and those opposite even tried to destroy part of their income package by getting rid of the FBT, which is essential for regional nurses. It is not enough that regional areas were starved of funding with no accountability required, but those opposite introduced additional levels of bureaucracy. How on earth does that equate to assistance for frontline nurses? We will be happily investing in healthcare professionals, showing them the respect they deserve, increasing the Practice Nurse Incentives Program, putting in an extra $40 million for medical internships and extra funding for the General Practice Rural Incentives Program, which actually gives nurses an increased chance to work.

We in Gilmore, especially through the Shoalhaven campus of the University of Wollongong, have an outstanding School of Medicine and also one of nursing. This university welcomes the changes to higher education and has confirmed in a competitive environment that it is in the students' interest and that it is unlikely to see fee increases. Unlike those opposite, we know how precious our nurses really are and we will continue to support them by growing the economy so they can actually get a job.

Terri Butler (Griffith, Australian Labor Party) Share this | Link to this | Hansard source

It has been instructive in this debate to hear references to the phrase 'frontline services' on a number of occasions from the speakers from the Liberal and the National Parties. It is not new to me—

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

What would you know?

Terri Butler (Griffith, Australian Labor Party) Share this | Link to this | Hansard source

and I will take the interjection from the member from Bass who suggests that the language is new to me. You might like to know that the phrase 'frontline services' was used by the Liberal-National Party prior to the 2012 state election in my home state of Queensland. 'Frontline services,' they said. 'There will be no cuts to frontline services.' How did that go? What happened? Let us see this: 4,000 full-time equivalent hospital and health services jobs were lost across Queensland, including more than 1600 nurse and midwife positions. So when the Liberals and Nationals use the language of 'front-line services', you know they certainly do not mean front-line jobs. It is code for 'cuts'. It is always code for cuts.

Government members interjecting—

I thank members opposite for so kindly providing me with an eye line and a group of people to address. As the member for Bass and others know, when you hear Liberals talk about front-line services, when you hear Nationals talk about front-line services, you need only think back to the example of Queensland, my home state—1,600 full-time equivalent nursing and midwifery jobs lost across that state, notwithstanding that reference to 'front-line services'.

Who else has spoken about front-line services? Perhaps COAG has spoken about front-line services. What did they say? On 18 May this year, shortly after the federal budget, they said:

The meeting of premiers and chief ministers expresses grave concern that, contrary to the Prime Minister's remarks today, there are immediate impacts on front-line services and the cost of living for Australians. For example, from 1 July 2014, there will be a reduction in funding for 1,200 hospital beds across Australia …

That is what COAG said about front-line services. So when members opposite use the words 'front-line services', we know that is code for cuts.

It is gravely disappointing that, despite the protestations from those opposite that they care about nursing and that they care about health care, they have offered nothing but union bashing in this debate today. It is the old LNP playbook: 'We have nothing to say; let's bash some unions and let's talk about the Labor Party and union connections.' I have some news for you, members opposite. In Queensland, the nurses union is not affiliated with the Labor Party—not to mention that they are a fine representative organisation. Who do you think runs the Queensland Nurses' Union, members opposite? Nurses run the Queensland Nurses' Union. In fact it is enshrined in legislation—democratic control of organisations.

Government members interjecting—

They are not affiliated with the Labor Party. If you were listening instead of interrupting, you might have heard me saying that. Perhaps, members opposite, instead of continuously interrupting, you might want to listen.

Let's talk about nursing. We know that the report Health Workforce 2025

Mr Nikolic interjecting—

Oh! The member for Bass is married to a nurse. In the Labor Party, we run nurses for parliament.

A government member interjecting—

The Queensland Nurses' Union is not affiliated. I have said it several times. But, yes, do you know what? Being a nurse qualifies you to stand for parliament. In fact we have a nurse running for parliament in one of my local state seats, Greenslopes. Our candidate, and hopefully our future member, is Joe Kelly, who is a nurse. He is standing for parliament—and guess what? You can stand for parliament in Queensland if you are a nurse. He will stand up for nurses as we on this side of the House do. I look forward to his getting elected and I certainly hope that he does.

But let's talk about nursing in Australia. Health Workforce 2025reported that there is already a shortage of more than 20,000 nurses in Australia. That is what Health Workforce Australia's report said. It projected that, without nationally coordinated reform, there will be a shortage of more than 109,000 nurses by 2025. Yet the Senate this week is moving to abolish that agency and to cut more than $142 million from workforce planning. It is a terrible shame. This side of the House cares about nursing. I invite that side of the House to join us in doing so.

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

I am very pleased to speak about nurses and to respond to this MPI, which is a very flimsy MPI. I think the Minister for Health really got to the motivation behind this MPI. The nurses union is in town and they say, 'Jump' to the Labor Party—and the Labor Party asks, 'How high?'

As a new candidate I remember being advised by the branch secretary of the Australian Nursing Federation to come and discuss the conditions at Flinders Medical Centre. It was a stunt. As well as me, she invited the local state Liberal members of parliament. What we heard was that this place was the most terrible place you could possibly imagine. I remember at the end saying, 'Look, I actually work there and this does not reflect in any way the conditions at that hospital.' You can imagine my surprise when that branch secretary of the nurses federation emerged some months later as the Labor candidate for Adelaide. Sadly, she did not win Adelaide. At the next federal election, she emerged as the Labor candidate for Makin. Sadly, the voters of Makin did not support her then either. It was realised that Gail Gago—the South Australian branch secretary of the nurses federation—and voters did not really get along, so they tucked her away in the Legislative Council. It is an example, I think, of how poorly health workers have been represented by some of these unions. We saw a really good example of this with the Health Services Union—the actions of those officials.

But, seeing as how we are talking about nurses, I would like to focus on the development of practice nurses. This very proud initiative was pushed forward by Michael Wooldridge, then the Minister for Health and Family Services. You now find that almost every general practice has a practice nurse, someone who is trained as a registered nurse. This provides more capacity in primary care. It means that, in areas like diabetes, chronic disease management, asthma and all sorts of things, the practice nurse can focus on certain things and allow the general practitioner to focus on diagnostics. It has been a great development. We have seen it happen around the world and it happened in Australia under a Liberal government. When Tony Abbott was Minister for Health, we saw this expanded through Medicare, using the practice incentive payment introduced by Minister Wooldridge, as well as using the team care arrangements and an expansion of Medicare in that area.

The Labor Party have talked a lot about nurses, but what they have not mentioned is that they wanted to pull $437 million out of Medicare which was going towards practice nurses. That was something that we, as the then opposition, opposed. In our policy, we made it very clear that we would protect and maintain the $437 million of support for practice nurses that the Rudd-Gillard government planned to strip out of Medicare for these services.

We have heard a lot of rhetoric about nurses but, when it comes to substance, we have the runs on the board. Practice nurses are a great example, but it does not stop there. We have initiatives to provide scholarships for nurses, including $13.4 million for 500 additional scholarships for nursing and allied health. This will be for a maximum value of $30,000 per scholarship. The majority of nurses employed in Australia are employed in acute care settings in hospitals, and we are increasing hospital funding to state and territory governments every year. The increases are six per cent, nine per cent and nine per cent over the forward estimates, and we are providing more than $5 billion in additional hospital funding for the states over the next four years.

When you look at the scholarships that are available for nurses, when you look at the practice nurse incentives and when you look at the funding that is going to hospitals, this MPI just does not stack up. The underlying motivation of the MPI comes down to the industrial arm of the Labor Party muscling the political arm of the labour movement—that is, the Labor Party opposition in this place. We have had a number of nurses represent us, such as Trish Worth and Trish Draper—great members. (Time expired)

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

The discussion is concluded.

Andrew Nikolic (Bass, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy Speaker, I raise a point of order. As a new member, Mr Deputy Speaker, I seek your counsel. If Labor brings on an MPI, are they required to have a minimum number of members in the chamber? I would think that four members for their own matter of public importance—

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

No, they need a certain number at the start of the discussion, when members are called to stand in their place. I might say, too, that it is the responsibility of the government to maintain a quorum. I thank the member for Bass.