House debates

Thursday, 28 June 2018

Matters of Public Importance

Health Care

3:21 pm

Photo of Tony SmithTony Smith (Speaker) Share 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’s failure to properly fund healthcare for Australians.

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—

Photo of Ms Catherine KingMs Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health and Medicare) Share this | | Hansard source

The Liberals have cut $2.9 million from Caboolture Hospital. That is a fact. The Prime Minister and the Minister for Health somehow have the gall and temerity to stand up in this place and in the media and accuse Labor of lying about health funding. I'm sure they'll continue to do it every single day between now and the 28 July by-election. They are so desperate to avoid being exposed for who they really are—neoliberal crusaders hell-bent on cutting and privatising the services that Australians rely on and care about. They do all they can so that they can give the top end of town a tax cut.

Labor won't rest until every single voter in Longman knows the truth. This government has cut $2.9 million from their hospital. Here are the facts. The Liberals promised to fund 50 per cent of the efficient price growth in our nation's hospitals. They did that in their own policy document. They lied. They broke that promise the first chance they got—literally within their first budget. The member for Warringah slashed $57 billion from public hospitals all across the nation just a few short months after promising that he would make no cuts whatsoever to health. He slashed and burned health funding. The Prime Minister reversed some of those cuts, but not all of them. He agreed to fund 45 per cent of the efficient price growth—it was better than Abbott but still well short of their promise.

In Caboolture the difference between 50 per cent and 45 per cent over the 2017-20 agreement is $2.9 million. It's a simple formula. There's nothing tricky about it. The Liberals are delivering $2.9 million less than they promised the Australian people they would, and that's $2.9 million less than would have been delivered under Labor's National Health Reform Agreement—a landmark agreement that the Liberals just could not wait to tear up. So, yes, we're telling the people of Longman about this cut. They have a right to know what this government is up to and how this government is hurting them, even if it does frustrate and anger this arrogant and out-of-touch Prime Minister to be exposed.

The $2.9 million cut to Caboolture Hospital is the equivalent of 4,300 emergency department visits, more than 800 cataract extractions or 480 births. These are real cuts that will have an impact on the capacity of the hospital to meet future demands in the region. And that $2.9 million cut over the three years of the government's current agreement, which runs from 2017 to 2020, is $715 million nationwide.

Now, they've been trying to lock in an even bigger cut from 2020 to 2025 by refusing to change their inadequate funding formula. This would result in a $2.8 billion cut nationwide, including $650 million from Queensland alone. No wonder the Queensland government are refusing to sign up to their agreement. They know this deal is woefully inadequate. We congratulate the Queensland government for holding out and demanding a better deal for Queenslanders and the people of Longman, even though it is denying some budget certainty for the Queensland government.

The Liberals claim there is no cut, because the government funding is increasing year on year. Of course it is. Funding for hospitals always increases with population and health inflation and, because it's an activity based funding system, when services and activities are carried out. If we take population alone, there will be five million more people living in Australia in 2025 than there were in 2015, the year the government uses as the benchmark for its counting. But even on that basis the government is falling short, with funding actually declining on a per capita basis. It doesn't change the fact that it's delivering less than it promised, less than Labor's agreement would have delivered and less than a Shorten Labor government actually will deliver.

Under Labor's Better Hospitals Fund, Caboolture Hospital will benefit from much better funding. That means more beds and shorter emergency department and elective surgery waiting times. The government is peddling other lies and furphies in Longman and misleading claims across the country. When the government says its funding is increasing much faster than the Queensland government funding, there is a simple reason for that. The government is calculating it off the low base of the Abbott government's rock-bottom offering. That's where it is calculating it from.

Again, here are the facts. The National Health Funding Pool report on the Metro North Hospital and Health Service for 2016-17 shows that the Queensland government provided $356 million more to Metro North hospitals than the Commonwealth last financial year—more funding from the Queensland government than the Commonwealth. And the same data from July 2017 to January 2018 shows that the Queensland government provided $310 million more to Metro North hospitals in the first half of this year alone—more funding from the Queensland government than the Commonwealth funding.

This week the government also sought to claim that Labor was lying about a lack of chemotherapy services for Caboolture Hospital. There are no chemotherapy services at Caboolture Hospital. The hospital's own website, in fact, actually confirms that—websites are something the minister likes to check, I heard, from Wikipedia. But, anyway, there you go. People have to travel to Redcliffe Hospital or to another hospital in Brisbane to get access to those services.

We think that is unacceptable for the people of Longman. That's why we have promised to invest $10 million to establish a chemotherapy treatment service at Caboolture Hospital. This investment will see 360 patients receiving around 3,700 treatments every single year. At the moment, people have to travel significant distances to access critical chemotherapy treatment and bypass the Caboolture Hospital because the service isn't available. For a cancer patient living on Bribie Island who needs chemotherapy, this will cut their travel time by half.

We believe it's important that we make these investments now because this is a fast-growing region, and there is going to be a lot of pressure on local health services into the years ahead. It is a region the government have woefully neglected. For example, this is an area that desperately needs a new MRI licence so people can get affordable access to life-saving medical scans without having to travel long distances, but the government have ignored their pleas. While Labor delivered 238 Medicare-subsidised MRI licences when we were last in office, the Liberals have just delivered—I know you'd think, 'We did 238; maybe they might have done half of that.' How many have they delivered? Just five in five years. The latest, of course, is in Kalgoorlie, as part of a dodgy deal with One Nation to win Senate votes for their inadequate income tax cuts. If only Queensland had a One Nation senator who could extract a similar deal with Caboolture! Oh, wait—apparently Senator Hanson isn't capable of making the same deal as her WA colleague for the people of Longman.

The Liberals have also ignored the people of Bribie Island, who desperately need better access to emergency care. At the moment, the people of Bribie Island have to travel to Caboolture's overstretched emergency department. Almost 10 per cent of the 52,000 people who presented at the Caboolture ED last year were from Bribie Island, but the Liberals have done absolutely nothing for them.

The Liberals also have a very shocking record when it comes to north-west Tasmania. They've cut funding and services relentlessly, leaving the people of Devonport and Burnie and the rest of the region worse off. Over 6,000 Tasmanians are waiting for critical elective surgery under the Liberals' surgery backlog, with one in 10 waiting almost a year. These are patients waiting for vital procedures such as knee and hip replacements, cataract surgeries and hysterectomies. One in four Tasmanians currently wait outside the clinically recommended time. This is the worst in the country. That is why Labor has committed to a $30 billion investment to slash Tasmania's elective surgery backlog. This will enable 3,000 extra elective surgery procedures—equivalent to half the waiting list.

Then there are the government's cuts to TAZREACH, a vital service that gives Tasmanians access to better services. It provides access to services that otherwise are not available in that community. I'm proud that Labor has restored that funding, $4.5 million, that the Liberals have failed to match.

When it comes to health, all this government can do is cut. It's cut hospitals, it's cut prevention, it's cut dental care and it continues to slash Medicare every single day. That is what the Liberals do. The choice at the next election, and the choice at the by-elections, particularly in Longman and Braddon—these critical elections—could not be clearer: more savage cuts under the Liberals, or a record investment under Labor and a record investment in Longman and Braddon

3:31 pm

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Minister for Health) Share this | | Hansard source

It's interesting to note that there was no mention of mental health, no mention of the PBS and no mention of medical research. I want to talk today about what this government is doing and what the previous government and the current Labor opposition can never do: guarantee the funding of essential services. We can guarantee that funding because we are able to secure a strong economy based on a deep plan.

Let me begin with a very simple quote. This quote isn't from us; it's from Labor's health portfolio budget statement in May 2011. What did that statement say? That statement from the health portfolio budget said:

… given the current fiscal environment, the listing of some medicines would be deferred until fiscal circumstances permit.

There were seven medicines. Do you know what happened? It's very interesting. A Senate inquiry followed that, which saw people from all the different sides of the political divide and the medical profession condemn and chastise the ALP and force them to realise that what they had done was utterly unacceptable. As somebody said to me, 'They could fund pink batts, but they couldn't fund the PBS.' It was over $2 billion that they put towards pink batts, but the were unable to fund fundamental medicines—for schizophrenia, for IVF, for endometriosis for chronic obstructive pulmonary disease—because 'fiscal circumstances' did not permit. Those are their words, not ours. There could barely be a more damning indictment of the inability of one side of this parliament to manage government and to manage the economy—and, therefore, their inability to manage health—than the deliberate deferral of medicines because 'fiscal circumstances did not permit', while at the same time they were funding pink batts.

Under us, fiscal circumstances will always permit, because we not only manage the economy but manage the federal budget. We manage it as custodians for the people. Delivering new medicines is one of the most significant things that any government can do. Guaranteeing that you can manage the economy to deliver those new medicines is one of the fundamental tests of both honesty and competence upon which the Australian people should base their decision at the next election and upon which we ask the people of Longman, Braddon and Mayo to base their decisions in the coming weeks.

Let me go forward. The result of this management of the economy is record funding for health overall, from $99 billion to $102 billion to $104 billion to $109 billion over the forward estimates of the budget. In Medicare, the first pillar of our long-term national health plan, we will go from $25 billion to $26 billion to $27 billion to $29 billion. That's record funding each year and every year, with new items such as 3D mammography scans coming in for over an anticipated 200,000 women a year, with new MRI tests for prostate coming in this weekend for thousands of males, with new renal dialysis provisions coming in under Medicare and with new treatments for ophthalmology coming in under Medicare. All of these things are critical and fundamental.

But we see more than just that. There are new listings of medicines, as I mentioned earlier today, such as Kisqali, a $700 million investment, one of the largest on record by the Commonwealth, for breast cancer, something that I believe has the support of every member in this parliament. That means 3,250 women a year will have access to a medicine that would otherwise have cost $70,000 and been beyond the reach of virtually every woman and family in Australia. Only a very small number would have been be able to access it. However, what we see as well on so many different fronts is what we're doing with support in relation to HIV and the listing of PrEP, what we've done in relation to Crohn's disease and the listing of Stelara, and what we've done in relation to Keytruda and Opdivo and the extension to new forms of cancer treatment. These are fundamental. Along with mental health, these are probably the two things that are raised with me most often by the public. What do they ask about? They ask about mental health treatment, acknowledging the importance of this fundamental issue, and they ask about and are delighted at the access to new medicines and the guarantee that this government gives.

When it comes to hospital funding what we also see is record funding each year, every year. We're going now from $21 billion to $22 billion to $23 billion to $24 billion a year under this government. What we see is a more than doubling of hospital funding from Labor's last year in office to the end of the new hospital agreement and a $30 billion increase, including an additional $7.5 billion in Queensland alone. There was some discussion about the metro north region, where the Caboolture Hospital is based. It is very, very interesting that Labor has walked away from its campaign. What was front and centre is now an embarrassment. When it was revealed that this government in the last full year alone increased funding to the metro north region in which Caboolture Hospital is based by $120 million at the same time as Queensland Labor reduced funding for that region by $20 million there were looks of horror on the faces of the opposition. They were embarrassed, shamed and caught in a classic Labor lie. But this time we're right onto it, right from the outset, as we were in Bennelong. We have learned not to dismiss Labor lies; we have learnt to deal with them head-on.

What we saw in the papers today is that the people of Longman don't believe them on health either. That must have been a devastating blow for Labor. That must be one of the reasons why they have walked away from their great Caboolture Hospital lie. They were caught out. Patsy said it on radio, and Patsy's indictment of the Leader of the Opposition was simply devastating. She spoke for the people of Longman, the people of Queensland, the people of this parliament and the people of Australia when she made it absolutely clear that you cannot trust the Leader of the Opposition on health and you cannot trust the Labor Party. The reason why is very simple: if you can't manage the economy, you can't manage health.

We're able to manage the economy. We're able to make investment in the third of our pillars—mental health. There is $338 million being added to mental health in this year's budget. There is $70 million and more for suicide prevention in wonderful programs through Lifeline and beyondblue; over $100 million to support our seniors, many of whom suffer from desperate loneliness, isolation and depression; and $125 million through the million minds mental health mission under the Medical Research Future Fund for the single largest medical research program into mental health in Australian history. We've also been able to support preventative and recovery actions for those who have drug addiction, including, in Caboolture, $11 million for the Lives Lived Well program: $3½ million for detox and recovery and rehabilitation facilities and $7½ million for a residential facility for those needing longer form recovery treatment.

That finally brings me to medical research. What we've done in medal research has been one of the great achievements of this government. By laying down a $20 billion Medical Research Future Fund, we are able to do things such as fund $250 million for clinical trials for rare diseases and rare cancers, to assist with $80 million for clinical fellowships, to assist with translation of new drugs and devices and to assist with a $100 million and more Australian Brain Cancer Mission and a $500 million national genomics mission. At the end of the day, you can only fund health if fiscal circumstances permit. Under this government, fiscal circumstances will always permit and always allow.

3:42 pm

Photo of Steve GeorganasSteve Georganas (Hindmarsh, Australian Labor Party) Share this | | Hansard source

There is only one group of people you cannot trust when it comes to health—only one group—and that is this current government. I say so because, in 2013, we heard the promises of the then Prime Minister, the member for Warringah, say: there will be no cuts to health; there will be no changes to our system; and the hospital care will be the same. And what happened? They were elected in 2013, and not long after in 2014 they cut billions of dollars from our health system—billions of dollars! The only people you cannot trust when it comes to health is this government and their backbenchers and all involved.

If it weren't for Labor's campaign on Medicare at the last federal election, these people here would have already privatised it. The only reason they haven't done it is that we campaigned against it—and you know it.

Government Members:

Government members interjecting

Photo of Steve GeorganasSteve Georganas (Hindmarsh, Australian Labor Party) Share this | | Hansard source

You want to privatise it. You might not be saying that to the public, but, deep down in your hearts, you want to privatise Medicare. There is no doubt about it. The Australian public has one choice at these upcoming by-elections, especially in Braddon and Longman. The difference between Labor and the government couldn't be clearer: there would be more savage cuts under this government and record healthcare investment under a Labor government.

After four years of Abbott-Turnbull cuts and neglect, Australia's public hospitals are in crisis. Let's just look at my own state, South Australia. The state health minister recently signed an agreement with this federal government, which they were touting as additional money for health, expecting the public to applaud them. But this was after the Turnbull-Abbott government cut a billion dollars out of that state's health system in 2014. What a joke! This government wants applause for signing some agreement with the state government in South Australia, which is no different from stealing $50 out of their pocket and putting $20 in the other pocket and saying, 'Please, give me praise for that $20 I've just given back to you.' That's exactly what they've done. What a joke! This government and the Marshall government in South Australia are in cahoots, talking up funding increases, after this government slashed billions out of our hospital system. It's an absolute shame. This is smoke and mirrors, like most of their other policies. The Labor health spokesman in South Australia is all over this. He's exposed them for this. If you look at their last parliamentary session, you will see it. He recognised straightaway that the state Marshall government was caving in to his Liberal bosses here in Canberra in the federal government. By contrast, Labor has a proud record on public hospitals and public hospital funding. We were the architects of Medicare. They were the ones that brought it down and we brought it back in. And they'll do the same again.

The Rudd-Gillard government signed a historic national health reform agreement with the states and territories in 2011. This committed the Commonwealth to fund an equal share of efficient growth in hospitals and it was designed to end the blame game. It was designed to give the public hospitals long-term budget certainty, and it worked. Ahead of the 2013 election, again, the Liberals promised no cuts to hospitals, but we all remember the horror 2014 budget. How can you forget it? The government broke this promise. They tore up this historic agreement and cut billions from hospitals. We shouldn't be surprised because this what is they do. This government can't help themselves. They're pathologically compelled to cut from the health portfolio, whether it's public hospitals, dismantling Medicare or other health services. All they see is a pot of money they can raid, get into and then throw at the top end of town, as we've seen in the billions of dollars of tax cuts.

You can't trust a word they say on health care. They don't take it seriously. So the choice at these by-elections and at the next federal election is very clear. The choice couldn't be clearer—more savage cuts under this government, under the Liberals' record of healthcare investment, or big investment under Labor ensuring that the services that people require in my electorate and in all electorates around the country will be funded properly so people get the adequate health care that they require and the services they require. They know that, if they need to go to a hospital, if they need emergency services or if they need to see a GP, they'll be able to do so. Under this government, we will see more cuts, we will see the dismantling of Medicare, we will see a disgrace— (Time expired)

3:47 pm

Photo of Keith PittKeith Pitt (Hinkler, National Party) Share this | | Hansard source

I rise to make a contribution on today's MPI. I've got to say that I think about this often. I sit back and I wonder how it is that the Labor Party approaches their policy and how they reach a decision, and some of things that they say. I'm sure it's something you consider too, Deputy Speaker, but I've come to the conclusion that they announce a policy, they determine what that is, they go out and say what it is that the government has cut from their policy, even though they're not in government and they can't deliver it. In fact, I'm fairly confident they go and have a bit of a giggle out the back, and say, 'We've gone out and done it again.' But I have to agree with the contribution from the shadow minister, and I did note one line in the shadow minister's contribution, and that is that we have increased spending in the budget for health. She said, 'It's gone up, that's right.' And that is—

Opposition Members:

Opposition members interjecting

Photo of Keith PittKeith Pitt (Hinkler, National Party) Share this | | Hansard source

I note the interjection. We can go back and check the contribution on Hansard. The contribution was this: 'The health budget has increased. It has gone up.' And that's right. This is a question about trust. In 2012-13, the federal contribution for health was over $13 billion. In 2021, it is forecast to be over $22 billion.

Mr Champion interjecting

Photo of Kevin HoganKevin Hogan (Page, National Party) Share this | | Hansard source

The member for Wakefield will stop interjecting.

Photo of Keith PittKeith Pitt (Hinkler, National Party) Share this | | Hansard source

I'm fairly confident, after four years of engineering and after high school and primary school, which I'm sure you attended, that $22.6 billion is more than $13.3 billion. That sounds like an increase.

Mr Champion interjecting

How substantial would that be? I know the opposition struggles with numbers, and I note the interjections from the member for Wakefield. I have said to the member for Wakefield that I have some sympathy for his situation. We certainly find ourselves on a unity ticket in some things. But this is an increase. You may well recall from your schooling that there were these coloured blocks and they would demonstrate when one thing is bigger than another. In fact, they'd demonstrate if it was twice as big or three times as big. It may well be a worthwhile investment for those opposite, because the reality is quite straightforward. In my home state of Queensland, in 2012-13, it was $2.66 billion; in 2024-25, that will be $6.5 billion. That is an increase. You cannot go out on radio and say to the people of Australia that there is a cut when there is an increase. It is an absolute outrage. I know they're bad at maths. I'm not sure if it's incompetence. I'm not sure if it's just plain deceit. I'm not sure how they sit there with a straight face and say to the Australian people that it's a reduction when in fact it's an increase. But we've got to say they've got form—and I note the previous contribution—from when they raised 'Mediscare'. 'Mediscare' was a completely deceitful campaign. It was false. It was untrue. It did not happen. I say to those opposite: you really should consider some of the people who listen to what you say. You went out and you scared people in my electorate, those seniors who are concerned about their health. You ran a false campaign. It was untrue.

I think they've got form. Let's look at the Leader of the Opposition. He goes to Melbourne and, when he talks about mining, he says: 'I'm against mining. I'm with the Greens position.' When he flies to Moranbah, he says: 'I love miners. Miners are my kind of people. We'll back you guys up.' But, as the leader of the AWU, what did he do? He gave $100,000 to GetUp! to campaign against the resources industry. I think you should be ashamed of yourselves. They were your people. They were and they are no longer. You only have to listen to Patsy from Caboolture. Patsy had a fantastic line. She was absolutely right. She spoke to the Leader of the Opposition on radio and what did she say? 'I am frustrated because you are not telling the truth.' So the people of Caboolture have got you lined up. They know exactly what is going on. They do not believe you.

It's a long line of people who do not believe them. There is a long line of people who want to get rid of the Leader of the Opposition. I noted the contribution from the member for Grayndler. He's certainly got form. He wants to line up. The member for Bass—I noted his interview yesterday, and, once again, I have some sympathy for him; we all find ourselves in those positions at times when working with journalists. But I didn't hear any support for the Leader of the Opposition—none, not a single bit. And today the member for Canberra had a run, on radio with Tim Shaw, and wasn't getting on board, wasn't supporting the Leader of the Opposition and certainly wasn't supporting the proposition that they wind back tax cuts for hardworking people in this country.

We come back to the ultimate issue, and that is that health funding in this country is increasing and it is increasing substantially. It is increasing substantially in my electorate. In the Wide Bay region in 2014-15 it was $114 million. In 2016-17 it was $152 million. That is an increase, and you should all get out your maths books, work out what it is, stop telling lies and tell the people the truth.

3:52 pm

Photo of Cathy O'TooleCathy O'Toole (Herbert, Australian Labor Party) Share this | | Hansard source

Firstly, let me say this. The Minister for Health made a comment that Labor has done nothing and made no mention of mental health. Let me tell him quite clearly: I came into this job from 15 years of mental health experience, and the best mental health programs we ever got came from a Labor government. We had the first federal minister for mental health, in Mark Butler, and the best programs we have ever seen in this country. How dare he say that Labor doesn't talk about mental health? He should withdraw his comment, and quickly.

History clearly demonstrates that Labor is the party of health reform and investment, and it's not at all surprising that the people in Longman and Braddon are concerned about their health care. Labor believes that, when people are sick, they should receive the care that they need in a timely manner, regardless of their credit card. In contrast, the LNP is the party of cuts to healthcare services, hospitals and Medicare, which it would love to privatise. The Turnbull government wants you to pay more when you visit your doctor and pay more for your private health insurance.

The Herbert community has had enough of the LNP's cuts. This government has inflicted massive cuts on the hospitals in Herbert, which hurts, because our public hospital is the only tertiary hospital in Queensland outside of the south-east corner. The Townsville Hospital and Health Service will receive a $9 million cut under the Turnbull government. What does that mean? It means four fewer beds a year for three years, 12 fewer doctors a year for three years, 25 fewer nurses a year for three years, 21,825 fewer outpatient appointments, 30,468 fewer emergency department visits, 2,491 fewer cataract extractions, 1,488 fewer births and 345 fewer knee replacements.

Where will the women go when they are in labour if the hospital does not have a bed for them in the labour ward as a result of the Turnbull government cuts? Where will pensioners go when they need knee replacement surgery, when the hospital has no funding for their surgery because of the Turnbull government cuts? Where will the veterans go when they want to visit the emergency department? Because of the Turnbull government cuts, the emergency department is now overcrowded. The Turnbull government has no understanding of what its cuts mean on the ground, especially in rural and regional centres. Allow me to read an email from a Townsville constituent that clearly explains how these cuts hurt. Karen from Townsville wrote on 2 June this year:

Hi Cathy I need your help.

In fact the whole state & country needs your help.

My carer just had his 3rd heart attack on Wednesday.

He was stabilised & scheduled for a procedure on Friday.

All prepped & ready but the queue was so long he was bumped to Monday.

Instead of being home today, it'll now be Tuesday or Wednesday.

Cathy can something be done to reduce the queue, increase staffing (no one - except nurses - works on weekends)

Yes, Karen, something can be done; we can vote out this out-of-touch Turnbull government at the next federal election. I am here every day fighting hard against this top-end-of-town government. I will fight for people like Karen and her carer because their hospital needs are really important and these cuts are not fair. All of this is in a community where the unemployment rate has almost doubled under the consecutive LNP governments. How can the Turnbull government think that cutting 12 doctor positions or 24 nurses is a good idea? My community is already hurting, yet the Turnbull government is hell-bent on creating more hurt by cutting doctors and nurses. It's disgraceful.

Let's not forget the axe that is being taken to Medicare. More than $3 billion has been cut from Medicare by LNP governments. This has increased out-of-pocket costs to see a GP. The average out-of-pocket cost for seeing a GP is now more than $38. That's a $4 increase since Prime Minister Malcolm Turnbull's pre-election promise that no-one would pay more to see a GP. Out-of-pocket fees to see a specialist have soared even higher, up to almost $88, an increase of more than $12 since the election. The Bureau of Statistics' figures show that those cost increases are forcing many Australians to skip basic health care. Those cost increases have resulted in one million Australians saying they cannot go to see a GP—they're avoiding it; they can't afford it—and 1.7 million people are saying, 'I can't afford to see a specialist.' Labor will fund our hospitals and fund Medicare because we won't be giving $80 billion tax cuts to big business and the banks. Labor created Medicare and we will protect it.

3:57 pm

Photo of Tim WilsonTim Wilson (Goldstein, Liberal Party) Share this | | Hansard source

Sometimes there are emotions or debates in this place that, frankly, reduce the public's appetite and support for our democracy because what they hear is deception. They hear lies. They hear information or ideas that underwrite or corrode the very integrity of the institution that I, at least, ran to serve. The objective of this parliament should and must be to serve the best interests of the people of Australia with honesty and integrity. I would hope that most members would come into this place believing that, when they left, our democracy would be healthier, more successful and carry greater trust.

And then we get motions like the MPI today, which is built on a lie, a deception, a falsehood about what is happening in health care in this country and what this government is seeking to do. Make no mistake that the objective of this government is to make sure that every Australian, whether they walk into their primary healthcare clinic to see their GP, into a hospital run by a state government or into a private hospital, gets the opportunity to get the support and the care they need to live their best lives. Yes, sometimes there's a debate around money—and there is around health care—but our focus is and has been consistently focused on making sure we get dollars in and outcomes out. What we have in this motion today is a deception that there is some decline in funding. In fact, it is the complete opposite of what this government has sought to achieve. As you'll have heard consistently throughout this government, our focus is on what we can do to grow the economy.

But we know that growing the economy is not an end of itself. Growing an economy is good. Yes, there's a larger pie. Yes, it means everybody's standard of living can rise. But it is about delivering a social, environmental, economic and human dividend, and a critical part of delivering a human dividend is, of course, providing health care for the Australian people. We do this against a backdrop of incredible challenges.

Mr Champion interjecting

Of course we know that one of the biggest areas of increasing expenditure that faces us regardless of who is in government, the member for Wakefield, is around the ageing population—people at a time when they need the most healthcare support because the vast majority of healthcare service provision is towards the end of life. It's not just health care directly in getting support and assistance from doctors; it's the increasing costs associated with aged care and, of course, an increasing dependence on the Pharmaceutical Benefits Scheme, particularly in dealing with some chronic conditions.

At every point this government is actually delivering precisely what the Australian people need, and it's no clearer than from the record amount of investment that is going into the public hospital system. From 2013-14 to 2020-21 we have increased the investment by $13.3 billion, but apparently this is a cut. Under the new hospitals agreement, the government has committed an additional $30.2 billion in public hospital funding from 2020-21 to 2024-25, taking overall funding during this period to $130.2 billion. And we know this. In the wonderful Goldstein electorate we have one of Melbourne's best local community hospitals, as part of the Alfred Health group, at Sandy hospital. The Alfred Health group has had an increase from $219,913,309 in 2013-14 to $318 million in the last financial year—growth of $98 million. That's a fair amount. That's a big increase.

What we're seeing more and more because of the focus on the economy to deliver for the human dividend is the amount of money we're able to contribute in increasing access to the Pharmaceutical Benefits Scheme so that people can manage their health condition. Yes, there have been approximately $9 billion in increased listings in this government, but increasingly we are seeing innovative new drugs like Kisqali and the whooping cough vaccine for pregnant mothers, which are being added as of 1 July, and we should be immensely proud of that.

4:02 pm

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I would really like to say one thing before I commence on this matter of public importance, and that is that I am utterly ashamed at the way the minister has attempted to politicise the PBS. The PBS, since its inception in the 1940s, has had bipartisan support, and the attempt to politicise it is shocking. It is completely wrong. The minister and those opposite, if they attempt to politicise it, which is what they're doing, do not understand the basis of how the PBS and the PBAC work, and it is just shameful what this minister has attempted to do.

I will say something else that has relation to this matter of public importance, and that's not about the health care provided to Australians. It's about the health care provided to our near neighbours. It is shocking the way this government has cut our foreign aid budget. Evidence of this can be seen in the really horrible outbreak of polio in Papua New Guinea. I would urge this government, through the Minister for Foreign Affairs, to urgently increase our aid budget looking at health care in our northern neighbours.

The government clearly has no understanding of public health policy, and it is in their DNA to slash this crucial portfolio. Time and again they've demonstrated their ignorance about health policy, and it's quite clear to me from their other policies around housing, education and social supports that they have a very poor understanding of the social determinants of health. Their response to drug and alcohol problems seems to me one of blame and punishment and really very little fundamental understanding of health as it evolves around addiction.

Regardless of whatever spin those opposite attempt to pull off in this chamber today and in the outside world, you cannot trust a single word they say on health care. They've taken an axe to Medicare and failed to rein in soaring private healthcare insurance costs. The Prime Minister and this government have a very warped agenda for and perception of public health and indeed all social services. When the Liberal National government look at our public hospitals, Medicare and other health services, all they see is a stack of cash to raid and give to their mates. I cannot put this more succinctly: this is a twisted government, content to rip essential funding from our healthcare system only to throw it at big business and their mates. It seems completely paradoxical to me that this government thinks it's fine to give millions of dollars in tax cuts to some of our biggest companies such as Healthscope, Ramsay Health Care, Primary Health Care, Sonic Healthcare, Medibank Private, NIB and many more, yet not fund our public hospitals adequately to provide comprehensive public healthcare measures for chronic diseases such as heart disease, diabetes, obesity, chronic obstructive pulmonary disease, et cetera. The profits go to these major companies, and they pay bigger dividends to their shareholders, but those requiring health support are left to wait.

We get longer waiting lists, ballooning gap costs to see specialists for interventional care, and lack of funding for essential best practice services, yet businesses seem to be given a blank cheque. Our public hospitals are clearly in a state of crisis. I've worked in hospitals for decades. I see longer waiting lists in emergency and people unable to access the best care, and I worry about what's going to happen to my children and grandchildren. Only about 60 per cent of urgent individual patients presenting to emergency departments in my state are seen within appropriate time limits. I reiterate: health care in Australia is in a state of crisis. The minister is attempting to politicise many of the issues, particularly the PBS, and there is a lack of understanding of proper public health policy about chronic illness. Australians are furious with the current government over their handling of the healthcare system. The cuts extend all over Australia, particularly in areas of rapid growth, like Caboolture Hospital, which is getting almost $3 million cut by the coalition. In Longman, where I've visited— (Time expired)

4:07 pm

Photo of Nicolle FlintNicolle Flint (Boothby, Liberal Party) Share this | | Hansard source

I'm pleased to speak on this matter today. I want to congratulate the Minister for Health and the Minister for Aged Care on the wonderful work they are doing in the health and ageing sectors. The Minister for Health demonstrates such care and compassion in speaking to patients suffering from conditions like endometriosis or chronic pain. It makes me very proud to be a member of the Turnbull government. The Minister for Aged Care has helped me convene and conduct several fora for my senior Australians. He is a truly inspiring senior Australian himself and is doing wonderful work to look after all our senior Australians.

We, the Turnbull government, are achieving record funding for our healthcare system in Australia. We have record GP bulk-billing rates of 85.8 per cent, which in my electorate alone means residents can visit their doctor without any out-of-pocket cost, thanks to the introduction of an additional 22,000 GP services. In the 2018-2019 budget we announced a $2.4 billion investment for new medicines on the PBS, including $1 billion set aside for the provision of future medicines. In fact, since coming to government we have listed one new medicine per day on average—and these are often life-saving medications—with an overall investment of about $9 billion. These are things like treatments for stage IV clear cell variant renal cell carcinoma, which would otherwise cost one patient $129,000 per year—completely out of reach for most Australians. Through Kisqali, we're investing $703 million to support women with breast cancer. Otherwise, these women would have to pay $71,000 each to access this medication. The medication Spinraza, for spinal muscular atrophy, would cost patients $367,000 each per year. These are life-changing, life-saving medications that this government is funding.

Unfortunately, those opposite have a terrible track record, whether it's the federal Labor Party or the state Labor Party in my home state of South Australia. I need to once again remind the House of the dreadful things that the now, thankfully, former Weatherill state Labor government did in South Australia. They cut $7.4 million of funding for public hospitals between 2015 and 2016 and a further $20 million of funding between 2014 and 2016. The state Labor government shut down the iconic Repat hospital. That was a devastating decision for veterans in our community, many of whom had been treated there. It was a devastating decision for my community, and I'm so pleased to see that the Marshall Liberal government in South Australia is already reopening services on the Repat site so that people in my community can once again use the hydrotherapy pool, for example, which is absolutely critical for rehabilitation services.

I want to reflect on one of the incredible things that the Minister for Health has worked with me on and that I'm very passionate about, and that's the issue of endometriosis. Once again, because we are the party of responsible government, because we are balancing the budget, we've been able to begin to invest in finding cures and better treatments for this terrible disease that affects women.

Opposition Members:

Opposition members interjecting

Photo of Kevin HoganKevin Hogan (Page, National Party) Share this | | Hansard source

Members on my left will cease interjecting.

Photo of Nicolle FlintNicolle Flint (Boothby, Liberal Party) Share this | | Hansard source

Already we have committed $1 million in the May budget towards awareness and education within the medical profession because we know there are a lot of medical practitioners who are still not aware of what endometriosis is, the sorts of support and treatment that women need to access and how critical early intervention and treatment is. We announced a further $2.5 million from the Medical Research Future Fund, which will be used to accelerate research and make areas of endo research a priority once the National Action Plan for Endometriosis is launched, which will occur very soon. I'm very proud of our record in the health space.

4:12 pm

Ged Kearney (Batman, Australian Labor Party) Share this | | Hansard source

I rise today to speak about the government's abject failure to properly fund public health care for all Australians and its failure to control the spiralling costs of the private health insurance industry. Just this morning I read an article about the rising number of women who opt to use public rather than private hospitals to give birth because of the high out-of-pocket costs involved in the private system. This is just one more example of the soaring costs of private health insurance and the growing number of Australians who are choosing to ditch their cover in response to relentless price rises, unexpected out-of-pocket costs and growing exclusions.

Australians are paying a lot more for their health insurance policies and getting a lot less. Ten years ago only 8.6 per cent of health insurance policies contained exclusions; now it's 40 per cent. These exclusions, often hidden in the fine print, mean that people are paying for insurance without being covered. It's turning health insurance into a con. I've had personal experience. We all have. My elderly mother-in-law has had lengthy periods in private hospitals with chest infections. She's paid her private health insurance premiums for decades, and we are always pleasantly surprised on discharge to be told we don't have to pay anything there and then. But, over the following weeks, the bills roll in—pharmacy costs, pathology costs and other tests not covered—to the point where we start to wonder when they will stop.

I know this is a familiar story. We know that Australians pay some of the highest out-of-pocket costs in the OECD to the for-profit health insurance industry, which made around $2 billion in profits last year. Some of the biggest health insurance providers make a return of over 20 per cent. And, as we know and have heard in this House before, this is an industry that's holding about $6 billion over and above the legal capital requirement and gets $6 billion in taxpayer-funded subsidies each year. Still, despite all this, the industry continues to increase its costs, year after year. For decades, in fact, Australians who have opted to buy private health insurance have been getting hit with price rises double or even triple inflation from an industry that enjoys generous government subsidies, and this is just plain wrong.

Labor, on the other hand, has a strong policy to cap premium price increases at two per cent for two years, effectively tying them to general inflation, a policy that will put $340 back into the pockets of Australian families. But private health insurance is a choice—a choice that more and more people can't afford. The article I read this morning about mums deserting private health insurance quoted Libby Nuttall, a 32-year-old mother of three, who said she'd heard stories about the private system such as that, when a doctor at 5 pm on Friday wants to go home and the woman's in labour, they will do a caesarean rather than let the pregnancy take its natural course. Of course, not all doctors and not all hospitals in the private system are like that. But it seems to me that the trust in the private system is waning. It is waning due to excessive out-of-pocket costs and poorer quality of care, and more and more people are turning to their trusted public health system.

It tells us that our public health system is vital for so many Australians. We cannot afford to starve our public health system of funding. The Liberals have cut billions of dollars from our public hospital system, putting stress and strain on our hospitals and causing anguish for patients and their communities and for the people who work tirelessly in our public health system to keep it going. We are lucky indeed to have such a wonderful health system. I myself worked there as a nurse for years and totally appreciate the importance of the services. I congratulate our doctors, nurses, allied health workers and all the auxiliary staff who keep the system running with fewer and fewer resources, but they can't do it forever. They can't keep doing more with less.

We need to reinvest in our public hospitals, and I'm proud to say that Labor will reverse the government cuts, giving vital resources to our hospitals, because we deserve a public health system that stays the envy of the world. As for our primary healthcare system and our beloved Medicare, out-of-pocket costs are beginning to become a barrier to people seeing their GP. What does that mean? It means that more and more people stay sicker and present to our emergency departments, putting more and more pressure on our public hospitals and, in fact, increasing costs, because, as we all know, our tertiary healthcare system is far more expensive than doing good, decent primary health care.

The pressure on our public hospitals means that fewer and fewer people can get there. Fewer and fewer people will be receiving the care they need. Trashing the promise of universal health care exacerbates this. So the choice at the next election and in next month's by-elections could not be clearer: more savage cuts under the Liberals or record healthcare investment under Labor.

4:17 pm

Photo of Andrew LamingAndrew Laming (Bowman, Liberal Party) Share this | | Hansard source

Obviously, we reach silly season at the end of a sitting week, and then out rolls the health MPI from the opposition. It's remotely disappointing to have to engage every third or fourth week, when they run out of agenda, in an industrial revolution debate about Medicare, because Australians sitting up watching today and Australians sitting in the galleries understand that we have an excellent GP-centred system. We've got public hospitals doing an incredible job under trying financial circumstances that they've had under any government, not just a blue or a red one. We have an independent and successful private health system. We have a functioning PBS and MBS that are the envy of the world.

We can go back and engage in a 1970s debate about who founded Medicare and who is the defender of Medicare, but you can't debate the figures that were presented by my colleague just a few minutes ago—that is, big jumps in the number of bulk-billed services; 6.2 million more services in remote and regional Australia, an absolute priority for this government. These kinds of increases—1.19 million more bulk-billed specialist services—are the true indicators that access to medical professionals, be they general or specialist, is about the same as it has always been.

We have new regional medical schools producing graduates who are staying in the bush—train in the bush; stay in the bush. That's heading in the right direction. No-one's pretending today that all the problems are fixed the minute you change the government or that we've massively changed the direction of health policy, but I tell you what: when there's a hard problem, increasingly, when you have a Labor government in place, they really don't do much about it. That is because, as I pointed out before, when a government is utterly fixated on how many dollars are pumped into the system, it actually loses sight of value and quality. What we're asking is that both sides of this chamber, as we debate the national direction for health, really focus on the quality of spend. But, no, we can't do that, because we have the industrial revolution mob over there, the Medicare Luddites, who think it's just about the total amount of dollars pumped into a system. Increasingly, as we look around the world at the quality of hospital and health performance, we see it's not all about the dollars. It's actually about how it's directed into areas of people's lives and into health investments that truly make a difference. We need both sides of the chamber to be engaging in that debate, and we simply don't have it. So, no matter how many times you sit in the gallery or turn on the television, you will simply hear this general traducing of each other at the end of a sitting week, but actually no engagement on what really matters, which is how we purchase with our dollars the best possible health outcome we can. No, it is not just about how many dollars we spend and how many services are delivered. It is about being responsible and talking to general practice about the rate of servicing. You can only look after patients at a particular rate before quality declines—when time becomes a proxy of quality.

We've talked about GPs. Give them the incentive to stratify their patient population and say, 'These 200 people genuinely need my extra care and I need to be reimbursed for that extra amount of time.' Don't have them practising what we call 747 medicine—the person who had seen a single patient 747 times in a year. That can't be quality practice—it's never been engaged with over on the other side. What happens when the Labor Party comes into government? They scurry around in an almost rodentesque manner, seeking to do deals with individual sectors and governments, both in health and education. You're left with this farrago of health funding confusion, where there are tiny bits of money chucked in here and a bit more there and a bit of clever play with the numbers. But we know that the fundamental challenge of Australia's double-tiered health system—moderately unique in the developed world—is that there is a simple moral hazard: the more we put in, the more the states pull out. It is very simple. We write up four-year agreements and the states, to save money, simple turn the switch up or down.

It was good to have the member for the Townsville area talking about the Townsville Hospital, because the Commonwealth contributions for Townsville just keep going up, up and up. But it is the state contribution that goes up, down, up and down again as they try to save a little money, because they've got an $80 billion debt in Queensland. State funding to Townsville has gone from $329 million to $346 million to $374 million and then down again to $346 million last week. So the health funding doesn't go up. The Commonwealth contribution to the Townsville region went from $166 million to $181 million to $200 million to $226 million. Clearly, the guilty party isn't down here in this chamber. But you've got the Labor Party completely unable to talk to their mates in Queensland and get a dollar-for-dollar contribution. If the state Labor money to Townsville was actually replaced and you still had the Commonwealth contribution, you'd have more doctors, more nurses and more services, and you'd have less stress on your ICU and a better functioning health system. But we don't sit here and nickel and dime that side of the chamber about whether or not there's an extra dollar, because we keep asking about quality. In the developed world and in the international contest on health quality, we know that the truly effective systems take hard decisions and don't focus purely on the money.

Photo of Kevin HoganKevin Hogan (Page, National Party) Share this | | Hansard source

The discussion is now concluded.