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

In just two days time this parliament will rise for the final time before the 2015 budget. The next time we sit, the Treasurer will hand down his second budget and yet in health, as in so many areas, we are still dealing with the smoking wreckage of the Treasurer's first effort way back in May last year.

I have been an MP for some 14 years now and I cannot recall a time when a budget had been so disastrous, so rejected, that it continues to cast a shadow over the budget for the following year. The Prime Minister is now assuring everyone that this will be a very boring budget with none of the broken promises or shocking attacks on patients, pensioners and students that were the hallmark if this government's first budget.

The facts are that, as far as health is concerned, nothing has changed: the broken promises, the tax hikes, the attempted destruction of Medicare, public hospitals, Medicare locals, the cuts to drug and alcohol services that are about to be announced—if the government is to hold true to the 30 June deadline for all of these services across the country—and mental health, we have heard today, is in absolute crises. All of this will be in the so-called boring budget, because the sad thing is that, when it comes to health, this government does not seem to have learnt a thing from its debacle. So in this final week of the parliamentary sittings before the 2015 budget, it is worth going through the long and sorry tale of the damage it will continue to inflict as a result of the 2014 budget.

No issue has done more damage to the standing of the Abbott government and in destroying its legitimacy than its lack of a coherent health policy and then its attempts to severely undermine the architecture of healthcare reform and universal health care—measures it kept hidden from voters in the 2013 election campaign but then unveiled in the May budget. The public outrage and political fight over that budget has of course been dominated by the GP tax, and frankly I am astonished that the Abbott government is still determined to pursue this measure. We have had a $7 GP tax, a $20 GP tax, a $5 GP tax and now a GP tax via stealth through a long-term freeze on rebates. It has been called a co-payment, a price signal, a value signal and, for one day, a modest contribution.

The government is set, it appears, to pursue what is called direct billing, which in essence is bulk billing but will enable bulk billing and GP co-payments to co-exist, opening the door for patients to now pay for the government's $1.3 billion cut to GP services. Regardless of the name, regardless of the method, the one thing that has not changed is the government's aim, which is to fundamentally undermine universal health care, to reduce bulk billing, deter people from seeing a GP—in fact, its measures are predicated on a drop in GP visits—and make patients pay more. It is bad for patients, it is bad for doctors, it is bad for health care and it is ultimately bad for the budget. It is a self-defeating policy which tries to make a short-term addition to the budget at the cost of greater long-term health costs. It will simply turn people away from seeing a GP, sending many of them into emergency departments or in some cases causing some people not to seek early intervention, leading to even worse conditions and enforced hospitalisation. There is virtually no health expert in the country who thinks putting a barrier between patients and their GP is good health policy, and yet this is what the Abbott government has done and has held up as its principal goal when it comes to health care for almost a year now.

In hospitals the focus on the GP tax has taken some scrutiny away from other changes made to health in that budget which are every bit as damaging. Principal among these were the decisions to abandon Labor's agreements with the states to fund 50 per cent of growth in the efficient price of hospital based activity over the next decade—not just inflation or population growth—a move which has cut $57 billion out of the budget over the next decade. If you read the Liberal Party's policy document, that is something they committed to too. 'Fifty per cent of growth in the efficient price of hospital based activity' is there in blue and yellow, which I think were the colours of the policy document at the time. It is there, and that promise has been broken.

In March's Intergenerational report this was the single biggest contribution to the savings claimed by the Abbott government, and yet it is a complete fraud. The growth in hospital costs will not magically be lowered by declaring that from 2017 the federal government's share of hospital spending will grow each year in line with inflation and not by the six per cent or more that is the actual cost of running hospitals. This cut did not save the claimed $57 billion over the next 10 years; it just transferred that cost onto the states and territories.

At the same time, the government has also torn up the series of agreements years in the making and agreed by governments both state and federal, Labor and Liberal, to use that funding to improve patient care and make hospitals much more efficient. After decades of hospital agreements simply being an excuse for cost shifting, this one rewarded activity and at the most efficient price. It really was an agreement to try to stop the blame game that happens in health funding.

The Grattan Institute, for example, has found the difference in cost of a common gall bladder treatment varies by around $4,000 across hospitals and hip replacements by more than $16,000. Taxpayers could save potentially more than $1 billion a year if all hospitals just met the average costs of treating patients. That work has in essence, by the ripping up of the agreement that requires the growth from the Commonwealth to be based on that price, been tossed aside. State governments with their diminishing sources of income are now somehow supposed to pick up the tab for the gap between inflation and hospital costs.

On the issue of Medicare Locals, one of the more distressing and frankly ridiculous decisions of the government has been to get rid of the 61 Medicare Locals despite the Prime Minister promising none of them will close. They are all meant to close on 30 June. All of them are providing substantial mental health services. All of them are providing Indigenous health services. All of them are providing other important training and other mechanisms throughout the primary healthcare system in communities. Over 3,000 staff who do not know if they have a job past 30 January are waiting while the government makes a decision on its primary health networks—some 30 of those primary health networks—without having any clue about how much money is to be committed to them or any of the programs that are currently funded. What is going to happen to Headspace, which is overseen by Medicare Locals, and what is going to happen to staff? They are cutting it very fine indeed.

Cuts to dental health have also had significant implications for dental waiting lists right across the country. Another issue is: what is happening with the flexible funds? Some $197 million was cut out of the flexible funds in the budget. It applies to 11 of them. These flexible funds fund our drug and alcohol services. That funding runs out on 30 June. There are hundreds of drug and alcohol services across the country today which do not know if they have funding beyond 30 June to provide drug and alcohol services—in country towns, in regional cities, in major capital centres.

Important information services that provide help to people when we are trying to prevent suicide, trying to provide online counselling services to people who have cancer, online counselling services to people who are trying to break drug addiction—all of those services are potentially going to have to give notice to their staff on 1 April. This government has failed to provide any certainty to any of those services.

We saw today's debacle. I think it is unprecedented. Some 75 different mental health organisations across the country, after having raised this problem with the government back in February, now, at the 11th hour, still do not know if they will have any funding beyond 30 June. We have seen it happening everywhere. In preventative health, we saw the abolition overnight of funding for the national preventative health partnership agreements, which were funding programs to try and tackle obesity, to reduce smoking rates and to try to mitigate the impact of excessive alcohol consumption. Programs for healthy communities, healthy kids, healthy workplaces and funding for local governments, for schools and for a whole raft of community organisations right across the country—all were aimed at prevention and their funding was axed overnight.

If you go right through every element of the health sector, including the architecture for health reform that was put in place by the previous government, it is a litany of disaster. It has been a disaster for health policy across the country and for service delivery across the country. None of this will change in the 2015 budget that is shortly to be handed down. The government should be condemned for its health policies.