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 Government undermining universal healthcare in Australia.

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

In 1983, when Labor established Medicare, we were guided by a simple principle: that every Australian should have access to the best quality health care regardless of where they live and regardless of their capacity to pay. Based on the two budgets now delivered by the Abbott government, we now know, sadly, that this is not a principle supported by the other side. We in fact knew that from their history.

Given the absolute disaster that occurred with last year's health budget, I could not comprehend how this budget could do more damage. Last year's budget was a budget that was so disastrous for health care and healthcare reform that it led to its minister being voted the worst health minister in 40 years, and by year's end he was gone. Last year's budget ripped $57 billion out of public hospital funding. It gutted preventative health and adult dental programs. It hiked the price of essential medicines and, most notoriously of all, attempted to destroy Medicare by forcing all Australians, even pensioners and children, to pay a tax every time they went to see a GP.

Since that time, of course, we have had a $7 GP tax, a $5 GP tax and a $20 GP tax. Now, after being assured that finally the GP tax is dead, that promise is, sadly, about as believable as his original promise that in fact there would be no cuts to health and no new taxes. I can assure you that this budget makes it crystal clear that the GP tax is very much alive and, for many patients, even bigger than the original. Despite more promises that the Prime Minister would make no further changes to Medicare without the support of doctors, the budget makes a very big change that most certainly does not have the support of doctors, patients or anyone who cares about health. That is, of course, the four-year freeze on the indexation of the Medicare benefit schedule.

The free rips $1.3 billion out of general practice over the next four years. As TheMedical Journal of Australia revealed earlier this year, that amounts to additional out-of-pocket payments by non-concessional claimants in excess of $8. It means lower bulk billing, bigger gap payments and a continuing attack on Medicare and universal health care. For people accessing specialists or services that are MBS rebateable in public hospitals, it in fact has a significant impact as well.

We also have—still within the budget—the hikes to the prices of medicine. Unless the minister can come to the dispatch box and say that is now off the table—not just saying, 'That is something I somehow weirdly inherited from the last minister,' as though he was not a minister of the government and neither is she, that it belongs to somebody else—it is very difficult to believe the government on anything it has to say about the prices of medicine.

Of course, these two measures barely scratch the surface of what this government wants to do and has already done to health care in this country. There has literally been no area of health care that is off limits to this budget's razor gang, as was evidenced by the pathetic, small-minded and absurd decision to cut a very modest subsidy going to a very small group of patients who suffer from what is collectively known as inborn errors of metabolism. This cut has saved the budget $3 million. That is right: $3 million a year. And yet for those who receive this payment it means financial and emotional stress for people who already have to carry an enormous burden.

Managing these conditions requires a lifetime commitment to a rigid diet of carefully weighed, synthetic, low-protein formulas and foods that are often very expensive to buy: pasta and rice at $10 a packet and cheese that after shipping costs $68 a block. In recognition of this burden, the parliament in 2001 with then Prime Minister John Howard approved a modest subsidy now worth around $250 a month or $3,000 per year which is currently paid to around 900 families.

Without any warning or consultation, families across Australia were informed not by the minister or any announcement from the government but in a letter from the Department of Health that the grant would be ceasing. Yesterday I met here with three of the people who will suffer as a result of this cut and heard how it will affect them. One of these people was Kymberley. She is pregnant. Imagine having to cope with the burden of pregnancy and often the concern that that raises for you as you are growing this little person inside you and everything it entails in looking after the health of your baby. Imagine going through that knowing every single piece of food you eat and not getting your diet right could potentially lead to that child having a disability. What a huge burden that young woman is having to deal with and has had to deal with every single day she deals with this disorder. It means you have to check every item and weigh every ingredient of every meal.

In the midst of that, with no warning, the government takes away the modest support you receive. Then, when that decision is questioned, the Prime Minister dismisses it by saying you can just use cornflour from the supermarket instead. We now hear that the department is using some different lines to these families: 'Oh, it's an equity issue.' Frankly, again, that is just completely untrue.

As well as that cut within the budget, there were dental cuts. Across the two budgets, the government has ripped over half a billion dollars from programs designed to care for the dental health of some of Australia's most vulnerable patients—adults', children's and veterans' dental health programs that have been the subject of much debate through these parliaments.

This morning the Leader of the Opposition and visited a dental clinic in Canberra to talk about the $125 million cut from the Child Dental Benefits Schedule. Labor introduced the scheme because it was clear that many children were being denied access to essential dental care. The Australian Institute of Health and Welfare found 42 per cent of five-year-olds and 61 per cent of nine-year-olds had decay in their baby teeth. It is a national shame. A staggering 58 per cent of 14-year-olds had decay in their permanent teeth. Something needed to be done, so Labor acted. But the Abbott government has just seen an opportunity for another budget cut.

And the cuts to children's health, of course, do not stop there. This budget also included a cut of $145 million for the Healthy Kids Check. This means that patients will no longer have access to one-hour appointments with GPs for their checks, which we know have been invaluable in the early detection of asthma, hearing and speech issues as well as other developmental issues.

As warned by Sonja Walker, the Director of Kids First Children's Services at Brookvale—in the Prime Minister's own electorate—that decision means families will suffer. Ms Walker told the Manly Daily:

"There is an awful lot of kids who have communication difficulties and the opportunity to identify issues early is vital.

“Children with a language impairment are six times more likely to have a reading problem.”

There is the problem with cutting that program in a nutshell. Fewer health checks mean longer term health problems that deny these kids a decent start in life.

This is a short-sighted and callous move from a government that is demonstrating it has no commitment to universal health care. It is a cut to an important children's health program, which goes to demonstrate that this government does not believe in the universal health insurance scheme that is Medicare. It does not believe in Medicare.

Another cut that was just as short-sighted was the decision to scrap the after-hours GP helpline. The GP after-hours service offered parents with sick kids and elderly patients a vital back-up service when their GP was not available. It was established by Labor as a 365-day-a-year support service. I want to quote from a letter from one of the GPs who worked in this service. He said:

Many times I have helped callers avoid presenting unnecessarily to emergency, and sometimes told the reluctant that they really DID need to go to emergency. I have told people what medications they can use to self treat, or how to get to a medical service. I have helped manage more vomiting adults and crying babies over the phone than I care to remember. Our service was heavily utilised by those without the resources you and I have; the young, poor, refugees, the elderly, the isolated, those with mental health conditions.

That was from a GP who had been dedicating his service on that after-hours line. Well, he is not anymore. It was abolished by the Abbott government in a sneaky budget-night hit on families.

We see the cuts that are coming to the flexible fund that funds vital programs across public health—programs that are run by Alzheimer's Australia, the Consumer Health Forum and the Public Health Association—and advocacy work to ensure that health reform continues in this country. The cuts to those programs were described by the Public Health Association as a bloodbath, and that is no exaggeration when we see what is happening to prevention. This government should be ashamed of its budget on health.

Sussan Ley (Farrer, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

It is great to be speaking on the MPI this afternoon to defend the government's very strong record on health, to describe the initiatives in our recent budget, so poorly misunderstood by the Labor Party, and to reassure those in the gallery, in the House and listening in the public generally that we have as our No. 1 focus the interests of patients in improving their health, in giving them access to more affordable medicine, in preventing disease and in managing Medicare and the PBS in a sustainable way.

I will just go through some of the key points before responding to the member for Ballarat's particular issues. Again, she was demonstrating a very comprehensive misunderstanding of what this government is all about and a misunderstanding of what we in fact did and did not do in our budget. We started with Medicare. We started with the principles of Medicare. It is important that we remind people of what those are: universal in coverage; equitable in distribution of costs; and administratively simple to manage. Those are, indeed, the three principles on which Medicare was built. They are the three principles that will continue to maintain the strong system that we have. It will continue to be universal. It will continue to be equitable. Although we all battle the bureaucracy, we know it will be administratively simple to manage because with administrative complexity comes unnecessary deadweight cost. It is vital that we sustain Medicare.

If we look at the spending into the future in the Intergenerational report we see that it is health spending that is the biggest and fastest rising proportion of public spending. While we absolutely have at our core the value of being responsible with our spend, keeping people healthy and giving people access to lifesaving drugs and lifesaving treatments, we have to consider, 'Why is this cost rising so sharply? What can be done to restrain it? How can we do that in a meaningful way that reduces waste and inefficiency?'

As I embarked on consultations with members across the medical profession, consumers, patients and everyone with an interest in health generally, they all said to me, 'You talk about waste; we can tell you where it is. We can tell you where there are little pockets and big pockets of inefficiency and where your systems at the federal and state government levels can be improved.' That will be at the heart of the future of health care in this country.

Although it is not mentioned very often by the Labor Party, I understand that they could and should be on board with us on this. The reform of the Federation that has been initiated by the Prime Minister gives us a really important opportunity. Reform of the Federation in health is about this: we fund primary care and the states fund the hospital system, but the patient moves seamlessly—we hope—between primary care and hospitals and back out. Sometimes with chronic and complex diseases, they make that journey many times. The artificial nature of the funding in this country has led, we would all agree, to a less than perfect system. That system means that, as you, a patient, get diagnosed by your general practitioner and then admitted to hospital, that two-funding system—

Mr Champion interjecting—

Mr Deputy Speaker, can I ask you to ask the member for Wakefield to shut up?

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

Order! The Minister for Health will be heard in silence by both sides.

Sussan Ley (Farrer, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

The member for Wakefield is not a bad person, but he is a repeat offender in this place when it comes to interruptions.

The important point that I am trying to make is that we have to get this right. We have an opportunity to talk constructively to the state governments about how we can do this better. If we keep more people out of hospital, it costs the state hospital system less money. It costs the federal hospital system less money. It costs the federal primary care system less money. Most importantly, it is in the best interests of the patient. It is a win all around. I look forward to the Labor Party working with me on this.

When it comes to health in the budget I want to make a few key points. Our investment in health and sport will increase to a total of $69.7 billion, which is an increase of $2.3 billion over the last year. So that is $2.3 billion extra spending in health in just 12 months. Total annual hospital funding, often a subject in this place, also increases by 25 per cent or $3.8 billion over the next four years—despite Labor's repeated scare campaigns. We see the MBS growing to over $21 billion in 2015-16, and we will also spend $10 billion on the PBS. These are record levels of spending in health. We are spending more in health than ever before. That is a good thing but it also means that these challenges confront us. In spite of those challenges, I want to reassure the member for Ballarat, the shadow spokesperson, that on some of the issues that she mentioned as being under fire in this budget she is not correct.

I will start with the last thing she mentioned, which was the after-hours primary healthcare arrangements. As many would know, there was in existence a 24-hour phone help service, operated by Healthdirect Australia. This is a triage system, where the nurse answers the phone and decides whether you need to be referred to a doctor. Only 15 per cent of calls to Healthdirect were deemed necessary to be transferred to the GP helpline. So we have made a rephase of the funding. We have not taken the money away. The opportunity to ring the health line will still be there, but instead our primary health networks, which we are setting up on 1 July, will give people a choice, depending on the area in which they operate. Would you prefer to call somebody maybe on the other side of the country—it is always good to have somebody on the end of the phone—or would you prefer to have a local doctor in your own area, available to support you after hours? What we will say to the primary health networks is: you set up the best arrangement for you and we will fund it. No reduced funding in that area.

The member for Ballarat mentioned dental health. I need to place some things on the record. Dental health is very important. It is a really vital preventative health area. We are extending the national partnership with the states for a further 12 months, and we are negotiating the content of that national partnership now. This is about the adult public dental services. It will be valued at $155 million and will go for 12 months. As I said in the lead-up to that work on the reform of the federation—the arrangements we make between the Commonwealth and the states—we will incorporate dental health because we are serious about it. In addition, we are continuing access to the Child Dental Benefits Schedule. This is important, too, because children are frequently treated in the public system. We are allowing the state governments to access the child dental benefit system for children in the public system and also if they go to their private dentist. Dentists are doing the right thing and effectively bulk-billing children, which means that 96½ per cent of all children who go to see their dentist under this arrangement are not paying any out-of-pocket costs. I wanted to respond to the member for Ballarat on that point.

She talked about cheaper medicines. We had some good news about that this week—and I know she was paying close attention. The arrangements that we struck this week—three strategic agreements between the Pharmacy Guild of Australia, Medicines Australia and Generic Medicines Industry Association—mean that we will have five years of certainty and five years of clear understanding between us and the manufacturers of medicine about the supply of those medicines to pharmacists. To the general public, these arrangements are somewhat esoteric and behind the scenes, and I understand that; but the point and the purpose of them is that, when patients go to their pharmacy, they continue to get affordable medicines. The reason we need to do this is the numbers of new medicines that are coming onto the PBS, the Pharmaceutical Benefits Scheme, that are funded by government. This is the responsible approach we take—and I know that it is shared by the opposition—to listing new medicines. It is something which we are very serious about. It is not done as well in many other countries around the world as it is in Australia.

When people are diagnosed with severe life-threatening and life-changing diseases there is the opportunity for them to be able to pay under concession $6.10 per script or, as a general payment for those of us here, $37.70 a script for medicines that may cost $50, $60 or $100,000. In the budget we listed a medicine for third stage late treatment melanoma called Mekinist. The actual value of that medicine is $131,000 a script. I am proud that as a government we can make that available. We need to understand that in order to do that we have to continue to drive down the cost of generic medicines. We have been delighted with the support of the manufacturers of those medicines in understanding that in taking effectively less profits from the system they are enabling the space in the PBS for those listings of medicines. Overall, the many medicines, the commonly used ones, on the PBS are coming down by 50 per cent—a good note on which to end. (Time expired)

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

In September 2013, the electors of Parkes, Page, Lyne and Riverina and, indeed, right throughout regional Queensland voted for National Party members. The fact is that they are still waiting for them to turn up. When they voted for those National Party members, they did it on the basis of the commitments that the National Party members made to their electorate. If ever there has been a land speed record for members of parliament running away from the commitments that they made to the electorate, it has to be granted to the National Party members who were elected to the 44th Parliament.

I have in front of me an excellent document, which is an analysis of the some of the promises that were made by National Party members when they went to the 2013 election. I like this one in particular, on page 45 of the Nationals' plan for regional Australia, which states:

The Nationals will provide increased financial support for doctors who provide health services in regional and remote communities—

wait for it; this is the bit I like—

through increased Medicare rebates and scheduled fees loaded on top of regular Medicare billings …

The truth could not be further from the promise that they went to the election wit Where are the members for Lyne, Parkes, Page and Riverina and those Queensland country members? Why aren't they up here fighting against the proposal to freeze and cut Medicare rebates? The fact is that those Queensland electors voted for a National Party MP, and they are still waiting for a National Party MP to turn up to this parliament.

Like the movie Jaws, the first budget was a shocker and the second is no better—it is still not safe to go back into the water! On top of the $55 billion worth of cuts in the 2014 budget, we have built an additional $2 billion worth of cuts. I have some challenges for those National Party members who purport to represent regional Australia. We have a challenge for them. At a time when it is very difficult to get a dentist at an affordable price in regional Australia, you would expect to see the National Party championing schemes which provide dentists to regional Australia. Instead, in this budget we see cuts to the Dental Relocation and Infrastructure Support Scheme. I expect the National Party to be railing against that with great vigour! At a time when there are shortages in training places in rural and regional Australia, you would expect to see more money going into providing training places for our medical practitioners—not $72.5 million worth of cuts to workforce programs, including the program which is supporting scholarships to people in rural and regional Australia.

They are all very good. But the one that really takes the cake is this one. We saw on the Sunday before budget night, with great fanfare, the Assistant Minister for Health, Senator Nash, launch these fantastic new ads, at a cost, we are told, of $20 million, to educate Australians about the danger of ice and methamphetamine use, particularly in rural and regional Australia. We support appropriate evidence based measures which are going to assist people in rural and regional Australia deal with this terrible blight of methamphetamine use. We thought the government were genuine. But not three days later we saw in the budget paper over $500 million worth of cuts to the very funds which are providing resources for drug treatment, rehabilitation and education to prevent and treat and deal with drug addiction, including ice and methamphetamine addiction, throughout the country. Like the movie Jaws and its sequel, it is still not safe to go back into the water. The people of rural and regional Australia are still waiting for their National Party MPs to turn up in this place and defend the health care in their regions and to stick to their promises.

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

The National Party is always here defending the interests of our regional and rural constituents. Let us start with our commitment to supporting rural and regional GPs. Just the other day we announced payments under the General Practice Rural Incentives Program. If you are in a very remote or modified Monash 7 region, over five years you will get $60,000 extra. That is much more generous for those general practitioners who turn up in regional towns. That is even better than what we proposed.

Opposition Members:

Opposition members interjecting—

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

It is not worse; it is better! Let us turn to the pillars of the universal health care system: the Medicare Benefits Schedule; the pharmaceutical benefits advisory system; and the subsidies on drugs, public hospitals and soon, if we ever salvage it, a personally controlled e-health record. Let us start with the public hospitals. Since the coalition assumed responsibility for the treasury bench, the increases to public hospitals has been six per cent over four years. That is a total of almost 25 per cent more over four years, and $3.8 billion in real terms, for the states for their public hospitals. The member for Maribyrnong made a big song and dance about cuts, but $3.8 billion over four years is not a decrease. In fact all of the arguments about the so-called cuts to the states are based on calling a smaller increase a cut. To me a cut means you get less than you got last year. It is like the guy who gets promised a $100 a week pay rise from his boss and then, two weeks later, the situation changes and the boss comes in and says, 'I can only give you an $80 a week increase.' Members on the other side would call that a $20 cut instead of an $80 increase! They are simple principles.

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

Do you hate workers?

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

We do not hate workers! We support workers all over the place. The Pharmaceutical Benefits Scheme: 652 approvals versus 331. Do you know who did 652? Was it them? No! It was the Minister for Health, who spoke here earlier. The ministry of health has approved 652 new drugs since the coalition was put in charge of administering the health system—$1.3 billion in the last round and $3 billion over 18 months. We have new drugs for melanoma, cystic fibrosis, pancreatic cancer, eye disease, diabetes, multiple sclerosis, various forms of rare kidney disease and kidney cancer and breast cancer. We have done this because we have managed the budget well.

There are over 5½ thousand items on the Medicare Benefits Schedule. We are criticised for damaging that system. But people seem to have very short memories on the other side, including the member for Sydney, the previous health minister. I think most of Australia was not listening and had given up on the Labor Party before the last election. In the last budget that the Labor Party brought down for health—they criticised us for freezing the indexation—the member for Sydney froze it! It was not us. That in itself was $667 billion out of health. The dental scheme has come up for criticism. I just looked at the budget papers before I came in here.

The payments for the national partnership on health with the states amounts to $155 million, and the child dental benefit takes it up to over $200 million. Access to drugs involves the community pharmacy agreement, which the minister and the ministry has just completed with the guild. The pharmaceutical industry continues to negotiate and there will be, hopefully, a complete resolution of the funding arrangements.

Whether you look at one pillar or all of them, the facts are— (Time expired)

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

I appreciate the opportunity to speak on the government's budget, which is just like last year, a triumph of Orwellian bravado. There is no greater proponent of Orwellian bravado in this country than the Prime Minister. We know that every time he gets into trouble he puffs himself up and out he goes for a fight with someone. It does not matter who, it does not matter where, that is his MO.

We know that, as part of that Orwellian bravado, we get his outlandish statements. Today we saw some of it on coding. Of course, we have seen it on Medicare as well. On 3 March he said: 'We are determined that this government will be, as the former Howard government was, the best friend that Medicare ever had.' He was not just happy enough to embark on bravado for his own government, he had to do it for the Howard government as well. We know that bravado has a really poisonous effect in the community.

Let's have a look at the election platform of the Liberal Party for the last election called Real solutions for all Australians. I just love it because it has the subheading: 'The direction, values and policy priorities in the next coalition government'. It is a wonderful thing. If you go to section 16 'Delivering better health services'—

Government Members:

Government members interjecting—

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

This is what is in it. This is your election platform. It has: 'Improving the performance of public hospitals; improving mental health services; funding diabetes research; improving access to medicines; improving private health insurance; and bringing dental into Medicare.' That is what is in it. There is nothing about doctor co-payments, nothing about hacking into children's benefit schedules and nothing about cuts. There is none of that here. This was your election manifesto. This is what you took to the people at the last election.

We know that the Liberal Party has great form, particularly on universal health care, of saying one thing and doing another, because it is what they have been doing for the better part of 40 years. We had the Fraser government tell us that they were going to keep Medibank. In 1976 we had Medibank 2; in 1978 we had Medibank 3; in 1979 we had Medibank 4; and in 1981 they abolished Medibank. So, that tells you about their commitment all those years ago.

What do they say in opposition? What did Howard say? He said: 'Medicare was a miserable cruel fraud, a scandal, a total and complete failure, a quagmire, a total disaster, a financial monster, and a human nightmare.' In 1987 he said that he would pull Medicare apart. In 1987 he said that he would restrict bulk billing to pensioners and those on the welfare safety net.

Mr Taylor interjecting—

Of course, we know what happened in the intervention, and Angus just asked me what happened? Well, Fightback happened. We know that in a burst of honesty—

Mr Stephen Jones interjecting—

'Uncharacteristic honesty' as the member for Throsby says. They said in Fightback that the best way to contain services is to introduce a price signal for health services. Bulk billing will be abolished with the exception of four million pensioners, healthcare card holders and the disabled. In a brief burst of honesty in 1993 they were actually honest and upfront about what they were going to do. What happened? Well, they did not get in. So, they went back to the other plan they have which was to be completely disingenuous about universal health care, completely disingenuous, and to embark, as I said before, on Orwellian bravado.

Where are we today. Well, we have had $60 billion in cuts, we know that, and we have $2 billion extra in this year's budget. The President of the AMA, in talking about Medicare rebates said, 'If rebates don't rise, these costs will have to be passed on in out-of-pocket expenses. We'll see less bulk billing and there'll be the possibility of seeing a co-payment by stealth.' So we know where they are going. They are going to charge consumers more, and send out price signals. If you think this budget is any better than the last budget, then you are a mug. All it is is the Prime Minister's Orwellian bravado and his bull dust.

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

It is nice to wind up the week with a health discussion. Let me just say that all the good people are in here this afternoon; all the people with a heart for the health system. The people at home and in the gallery will be pleased to know that the $120 billion health system has bipartisan passion. You also need a little bit of memory. I think today is probably a good time to do a little shout out to a few Australians—those who were hoping to have their teeth fixed under the CDDS and had it ripped out from under them for the dreadful crime, no less, of having a job. Having a job made them ineligible under the Labor scheme and they ripped out their dental care.

Let's do a little shout out to medical graduates. Remember those medical graduates that could not get an internship under the Labor Party? They were left until the last moment. We had privately funded overseas medical students flying home because they could not get an internship. Let's have a little shout out to them as well. How about the lovely pensioner couples who were told they could not get a cataract operation? Let's have a shout out to them. Remember we cut the rebate in half? Nickel and diming the health system. I remember Nicola Roxon: 'Let's just slash the Medicare rebate for cataract operations in half and see how it goes.' At the same time that cuts in half, there is the payment to the private hospital to do a cataract operation.

All those Australians have very long memories. These guys may well have their talking points from the Labor Party. Every time there is a desperate week with nothing to talk about in the opposition, there is a little frisson of excitement when they find that there might be someone who missed out on a welfare pavement—'We can make a story about that. We can get that one rolling'—and somehow it just does not get reported again.

In health it is pretty complex—multi-jurisdictional economics, private sector, public sector, private operators, highly technological innovations in health. All of it has to be funded, and I will let you know today that Australia is doing very well, thank you very much—not much to do with six years of absent landlord management from the Labor Party. Let's look at that side of the parliament and see how much health experience is over there. I am peering over there. I see a diligent union rep over there. The member for Bendigo is a member of passion for social services. She is here today. I can see the member for Griffith—a massive intellect. I think she would barely know the visiting hours at her local hospital. Do we have anyone else there who even knows their way to an emergency ward or could find their way to ICU? The only thing up there is your argument, Labor Party. Your argument belongs in intensive and critical care.

This is a complex area—let's face it; it is health—but you are guilty by omission today of not being clear about your very own cuts. This is a massively exciting moment in health as we have moved towards health performance. There is the National Health Performance Authority—one of the 11 that you guys created or extended and almost forgot for a minute. There are thousands of public servants who say thank you for our jobs in the agencies—'Thank you for creating thousands of jobs and the double-dipping of PPL that we got along with it. Thank you very much for that.' More jobs created, more water bubblers in the public sector, and more places to sit around in the tea room and talk about the health care you should be delivering on the front line but do not, because you are working in an agency that was not making an ounce of difference to health care in Australia.

Let's get back to the doctors, to the nurses, to the students who are the doctors, nurses and allied health practitioners of tomorrow. They know we need early intervention, and the best that this side could to was a preschool health check for four-year-olds. That is right—that is when health started, wasn't it? A preschool check at the age of four. They are virtually abandoning children between the age of 18 months and four years. There is no plan for early intervention. That was a government that presided over nothing more than extending and expanding agencies and cutting Medicare rebates in half, and now they have the gall to accuse us of something similar. Far more than that, what is happening now is a rational conversation with general practitioners who, far from what you are saying, are not marching in the street. General practitioners know that we are talking about improving the Medicare system through a review, improving chronic disease management and reducing the 635,000 avoidable hospital admissions. We are in constructive dialogue, but you guys never have been, because you burnt off your connections to the health sector within an hour of being elected. You are a Labor Party that is all talk about entitlements and rights to payments and nothing about self-responsibility—looking after one's own health and one's family's health and making sure we can have the best services possible in our communities.

Andrew Giles (Scullin, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to join this important debate on a critical issue: the government's undermining of universal health care in Australia. How very interesting to be able to follow the contribution of the member for Bowman. There are probably two things I should say in respect of his contribution. The first is that I am sure it is a great loss to the medical profession and his former patients that he is with us here. I am very disappointed for them and a little bit disappointed for his constituents as well. Can I also say, with respect to the member for Bowman, that he has changed his tune. Not all that long ago he was standing shoulder to shoulder with government members fighting the GP tax, or at least one of its many iterations—standing up for universal health care, a stance that I commend him for, but I think he declared victory a little too early. Maybe you have been reprogrammed, because those comments you made at the end did not seem to me to be terribly consistent with any support for universal health care. It is quite the reverse. It was almost a plea for the Americanisation of our healthcare system, which is very disappointing.

The Prime Minister did something interesting today—probably a few things of interest. He called for a national conversation on what it means to be Australian. I think this debate is an opportunity to take the Prime Minister up on that offer, because I think a big part of what it means to be Australian is our egalitarian ethos, our concern for fairness and our concern for all of us. At the core of that is our innate sense that access to health care must be based on need and not wealth. Universal health care is at the core of Australia's social compact and it is a stark dividing line between our political parties. Labor stands for universal health care. The conservative parties—while they mouth some weasel words and dissemble from time to time, as we saw at the end of the member for Bowman's contribution and as we saw throughout the minister's contribution—have no regard for universal health care. They have plenty of form in this regard. It goes right back to the 1970s.

Last year I was very pleased in the parliament to celebrate 30 years of Medicare, but, in making that celebration I reflected, as other Labor members did, that it should have been a 40th birthday party. Interestingly, the parallels are quite acute. In 1975, opposition leader Fraser promised to keep Medibank. What did he do after the election? Does anyone remember? He broke his promise and ripped up universal health care. In 2013, we had a very similar approach. We had a Prime Minister who promised no cuts to health and promised to be the best friend of Medicare, but instead, by his actions and the actions of his government under two failed health ministers, proved exactly the opposite—ripping apart bulk-billing through ceaseless attacks on people's capacity to access primary health care without having to pay. There were five attempts at introducing a GP tax through the front door and now, in this budget, we see the back door is the approach—a GP tax by stealth. Members opposite and the government do not resile from their attacks on universal health care and do not resile from their attacks on Medicare, despite weasel words to the contrary. We saw that throughout last year, through the attacks on access to GPs, through attacks on preventative health and through $60 billion in cuts to the health system.

This year's budget is really a continuation. We are seeing more of the same. The cuts to dental care will have a shocking impact on children. Anyone in the parliament who was here for the contribution of the shadow minister, the member for Ballarat, could not but feel our sense of responsibility to do more for young children and their teeth. The life consequences are just so drastic. I think about the cuts to workforce. I think about the $1 billion of cuts going to important preventative health projects.

Across all this there is one key theme. Whatever words government members mouth, they have no commitment to universal health care. Only the Labor Party stands for Medicare. That was true in the 1970s; it was true in the 1980s, when at least John Howard was honest enough to say what he meant; and it is true in 2015. We will send to the Australian people a real values signal, and that is that we will fight for this critical element of the Australian settlement.

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

I think we need a change in title for this MPI here this afternoon. It should be 'never let the truth get in the way of a good story'. What we have heard from those on the other side is just stories. Calling them stories is being kind to them—it is fairytales. What sort of world do you live in? You come in here making up all these facts and figures which are not true. Let's just have a look at some facts. Then I want to go into some details, because those opposite also mentioned what is happening to health in regional and rural Australia. It is something I know a little bit about. I would like to point out some facts on that. Let's just have a look at the real truth.

The Abbott government's investment in health and sport will increase to a total of $69.7 billion in 2015-16, an increase of $2.3 billion over the last year—fact. Spending on Medicare is set to increase again this year to over $21 billion—fact, not fairytale. Dental: this government is providing more than $200 million in the 2015-16 budget for state and territory dental services over the next 12 months to allow for reform work to be undertaken.

It is very interesting, because there was a doorstop this morning and the Leader of the Opposition decided that he should play politics with dental services. He said that, even though $200 million has been given to the states, there is a cut occurring. Then he was asked by a journalist, 'So what is your policy on providing increased dental services to the Australian people?' I waited and waited, and he talked and talked. I thought, 'We have heard about all these new ideas.' I waited and I waited. Nothing—not even a commitment to provide one, nothing.

Josh Frydenberg (Kooyong, Liberal Party, Assistant Treasurer) Share this | Link to this | Hansard source

Any road will get you there!

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

Exactly—any road will get you there, I suppose. Maybe it will. We had the member for Throsby try to talk in fairytales about what is happening in regional and rural Australia—something I know a little bit about. Under the previous Labor government, fact: Labor cut $1.4 million to South West Healthcare in Warrnambool in my electorate. Western District Health Service lost over $400,000. East Grampians Health Services lost $180,000.

Josh Frydenberg (Kooyong, Liberal Party, Assistant Treasurer) Share this | Link to this | Hansard source

Because it's not in one of those Labor electorates.

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

It is not in one of those Labor electorates. So I think the member for Ballarat was maybe focused on directing funding to Labor electorates. The Auditor-General thought so. What happened when we wanted to build an integrated cancer care centre? The state government put in $15 million. The local community put in $5 million. They went to the federal government and said, 'Would you put in $10 million?' Silence—absolute silence. What had to happen? A coalition government had to be elected federally to deliver the $10 million, and that integrated cancer care centre is now being built. It is being constructed. What did we get from the other side when they were asked to provide for that? Nothing, not a brass razoo. They would not know a regional or rural electorate if they fell over one. That is the truth.

So let's put an end to these fairytales, to these stories, and get back to the facts. There will be more funding delivered into our health services this year than has ever been delivered in this nation's history. That is the fact. You might not like it over there, but do not come in here making up stories, making up fairytales, when you know them to be untrue. Come in here with the real data and let's have a proper argument.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

It is a great pleasure to follow the contribution of the member for Wannon. I would like to encourage every person listening to this debate to visit the ABC Fact Check site and have a look at how those facts that the member for Wannon was talking about stand up. If there were a website that looked at fairytales, I think you would find that his contribution would feature very strongly.

The member for Wannon talks about the massive increases in health spending. What I would say to the member for Wannon is: why do the budget papers show there are savings in health? How can there be increased spending yet there are savings? Surely savings equate to cuts. Prior to the last election the Prime Minister said 'no cuts to health'. But what we have seen is cut, cut, cut. The one thing that all Australians know is that you cannot trust the Prime Minister, you cannot trust this government—for that matter, you cannot trust any coalition government when it comes to health, particularly when it comes to ensuring the future of Medicare.

I have been in this place for a little while. I remember when the Prime Minister was the Minister for Health. He used to stand up in this place and he would have a smile on his face. No, it was not a smile; he had a smirk on his face. I think you would have to say that. He would stand up there, look across the House and say, 'I am the best friend that Medicare ever had,' as he continue to attack it, attack it and attack it. He has never supported Medicare and those on the other side of this parliament have never supported Medicare.

They do not believe in it. They do not believe in universal health care. That is what Medicare is: a universal healthcare system, one that is available for all Australians. It is not a safety net. It is not there for only those people who cannot afford to purchase health. Those on the other side of this House want people to pay for their health care with their bank card, not their Medicare card. We do not believe in that. We believe it is the right of every Australian to have decent health care. It should not be dependent on whether or not you can afford it.

Despite the rolled gold guarantees that the Prime Minister gave when he was Minister for Health, we see that Medicare is yet again under attack. I might say that it is only the Prime Minister and this government that can get pensioners out onto the streets to protest about its action and its cuts to Medicare. Pensioners and families all revolted against this government. We have had the $125 million cut to the Child Dental Benefits Schedule. Dental care for children is important. It ensures good dental health for life. It is not just something that is $1,000 for a child that comes for a family who cannot afford dental health; it is about saving money into the future. I heard the member for Bowman talking about the cuts to the child health assessments. The reason that there is a health assessment for four-year-olds is that that is one of those milestones in a child's life. It is a time where the health of that child, as to whether they are developing properly, needs to be assessed.

This government is attacking Medicare. Liberals always attack bulk-billing. Liberals always cut health spending. Liberals promise they will not and coalition members promised that they will not; but the one thing that all Australians know is that no matter what the coalition says and no matter what they write, you should look at the bottom line and look at what they do, not what they say.

Angus Taylor (Hume, Liberal Party) Share this | Link to this | Hansard source

In 20 years of working in the private sector before coming into parliament, one of the things I learned very early on is that an effective service has to be a sustainable one. Those opposite promised the Australian people a lot. But the question we have all got to ask ourselves is, 'Is any of it sustainable?' I have learnt over the last little while that they have got a couple of tricks. Trick No. 1 is to make sure you promise lots out beyond the four-year estimates, because no-one makes you accountable for that. Trick No. 2 is to put in place taxes that do not generate any revenue, because you can promise the future without ever actually delivering it.

I was interested in particular as to how sustainable their healthcare policies were. I went to the Parliamentary Budget Office, who looked back at the Labor years and the rate of growth of spending under the Labor. I discovered that public hospital spending growth was at six per cent a year. Bear in mind that GDP is significantly lower than that. When we go to the MBS, it is nine per cent a year. The PBS—which was their best performer—was at about GDP growth, which is five per cent a year. The total is much faster than GDP. A simple mathematical fact is that when you spend at a rate faster than GDP, then your debt and deficit grows and it is no longer sustainable.

I asked myself, 'What is it about the Labor Party that means that they have this kind of spending growth?' Bear the comparison in mind that our spending growth is about one per cent a year. I thought I would turn to the ANAO, because it is a pretty trusted and independent auditor of government spending. I looked through their reports and I discovered some crackers. The first was on GP super clinics. It turns out that the Labor Party promised 75 GP super clinics over two rounds.

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

How many?

Angus Taylor (Hume, Liberal Party) Share this | Link to this | Hansard source

Seventy-five over two rounds. In classic bureaucratic understatement, the ANAO said that:

The time taken from the execution of funding agreements to the completion of clinics has varied considerably …

It turns out that over a third were subject to non-competitive practices. The ANAO made clear that there were very significant risks in this. Even more interesting, it turns out that 66 per cent of the funding promised in the 2007 election went to marginal electorates and there were only 31 per cent of electorates that were marginal. By complete coincidence, it turns out that these GP super clinics—which never actually happened—went to marginal seats. What a program that was!

I thought I would turn to another one: the ANAO had a look quite recently the Fifth Community Pharmacy Agreement. This was negotiated under the last government. It was a $15.4 billion agreement. Again, in characteristic bureaucratic understatement, the ANAO said that overall the administration of the agreement:

… has been mixed, and there is a limited basis for assessing the extent to which the 5CPA has met its key objectives …

That is because there were none! There were no objectives. When you are Labor, you do not bother with objectives. You might be held to account! In other words, if you do not know where you are going, any road will get you there. According to the ANAO, a number of objectives were only partly realised and there have been shortcomings in key aspects. Labor promised that there would be $1 billion in savings, but the ANAO was disappointed to find that it was closer to $0.4 billion dollars due to shortcomings in estimation methodology.

Then I turned to another one: e-health. How did that go? A billion dollars was spent and there were no results. It turns out that for a billion dollars we got 4,000 records. That is $250,000 a record. I wish that I had been paid for creating records; I would be much richer than I am today.

Even worse, as University of Western Australia software academic David Glance has told us, even if the government had reached its targets, it would have been a meaningless gesture. Those opposite love meaningless gestures. The vast majority of those who signed up, if they ever get to logging in—and I have to say that I never logged in—will be greeted with an empty record. The thing did not work. Given the lack of active participation on the part of GPs, as well as the lack of public hospital systems to integrate with the system, there is little evidence to suggest that anything is going on. There is nothing going on there. In the MBS the ANAO found similar levels of waste under Labor. Contrast this with our wonderful Minister for Health. She is moving forward in containing spending growth and delivering improving health outcomes, because only we understand what it takes to provide sustainable services.

Craig Kelly (Hughes, Liberal Party) Share this | Link to this | Hansard source

The time for the discussion has concluded.