House debates

Wednesday, 22 August 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 five-year record on cutting health.

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

Yesterday 35 members of this government decided that they would rather have the member for Dickson than the member for Wentworth as their Prime Minister. Thirty-five members of the government, including the current Minister for Health, said that they would rather have the person who presided over some of the worst health policy in the nation as Prime Minister than the member for Wentworth. It says a lot about the mob opposite that they would rather have the worst health minister on record as the Prime Minister than the current Prime Minister. So I think it is well worth this House, as a matter of public importance, looking back at the government's greatest hits when it comes to health.

The member for Dickson was the worst federal health minister in Australia in a generation. That's not just me saying that, although I do have to say I wholeheartedly agree; that was the judgement of the nation's doctors. There has been some pretty stiff competition for the crown from those opposite. There was the member for Warringah, who, when he wasn't obsessing about how to stop women accessing medical terminations, was giving rolled-gold commitments on Medicare and then promptly abandoning them. There was the scandal-plagued member for Farrer who somehow managed to start damaging fights with doctors, pharmacists, pathologists and pretty much everyone else in the health sector. Years later, the government is still trying to clean up some of those messes that she made in the portfolio, but at least she actually wanted the portfolio and cared about it. And now we've got the member for Flinders, the man who's continued the government's freeze on the Medicare rebate. He's presided over billions of dollars of cuts to hospitals and has spent the last 18 months kowtowing to the big private health insurers, putting their profits before patients, and now he's reportedly desperate to get out of the health portfolio so that he can become deputy Liberal leader. Just 18 months in the health job, and he can't wait to get out of it. He doesn't care about the health of the nation. He is just using it as a stepping stone for his political ambitions.

On the other side of the chamber, it's a rogues' gallery of incompetence and attacks on Medicare and our hospital system. And yet none of these hopeless ministers can challenge the member for Dickson for his sheer bloody-mindedness and his assault on the Australian universal healthcare system, a system that is the envy of the world. When doctors were polled a few years ago now, 47 per cent of them named and shamed the member for Dickson as the worst health minister in 35 years. We've had about 15 health ministers in that time, but half of the doctors of the nation agreed that the member for Dickson was the worst. He was only in the job for 15 months, but the damage he did in that short time as health minister was extraordinary. Let's consider his appalling record. Bear with me, as it is going to actually take a while.

The member for Dickson was one of the chief architects of the horror 2014 budget—the cruellest, nastiest budget in living memory. It was a budget so infamously unpopular it ultimately destroyed the Prime Minister and the Treasurer who delivered it. What was the member for Dickson's contribution to that budget? It was $57 billion worth of cuts to public hospitals, for starters. That's not a Labor number; that was the number offered up by the government's own Treasury at the time. The 2014 budget tore up Labor's national partnership agreement on public hospitals, a massive broken promise and a disaster for health care in this nation. A cut like that meant fewer hospital beds and longer waiting times for emergency care and for elective surgery. It meant doctors, nurses and other hospital staff simply did not have the resources they needed to deliver top-quality care. That was his vision for the nation's public hospitals—cutting them to the bone and letting patients suffer.

The Liberals, under the current Prime Minister, eventually restored some of this money because they knew their cuts were electoral poison. But even now they are persisting with the funding formula that the AMA says will doom our hospitals to failure, a deal that is billions of dollars below what was promised and billions of dollars below what a Labor Shorten government would deliver. Of course, we also saw the $7 co-payment to see the doctor. Remember that one? This was another of the member for Dickson's bright ideas, a policy that effectively undermined the universality of Medicare that somehow he thought doctors and patients would welcome. It was a policy that would have forced up the cost of seeing a GP and the costs of out-of-hospital care. He also wanted the states—remember this one?—to charge a co-payment on emergency departments as well. These co-payments weren't just targeted at the wealthy or well-off; they were for everyone, including children, pensioners and the chronically ill—the poorest, most disadvantaged people in this nation.

It was one of the most regressive policies ever proposed. It was only because Labor and the crossbench opposed it that it was killed off eventually. As usual, we ended up saving the government from their appalling instincts to slash and burn health funding. But the member for Dickson thought it was a great idea and spent months advocating for it and then, if that was even possible, made it worse by proposing an even higher co-payment. He liked it in large part because it would deter people from going to the doctor. Deterring people from going to the doctor was what the policy was designed to do. We know that people who don't go to the doctor typically get sicker and sicker and end up costing the health system more.

But, of course, the member for Dickson's health policies didn't stop there. He wanted to also force up the cost of prescription medicines. He wanted people to pay an extra $5 every time they filled a script, and that included extra charges for pensioners and other concession cardholders. He also wanted cuts to the PBS safety net and the Medicare safety net. He wanted to ensure that people with chronic and complex health problems got less support.

But, wait, there is, in fact, actually more! The member for Dickson also began the Medicare rebate freeze. He made it more expensive to visit a specialist, allied health professional, nurse, midwife or dental surgeon. Stared down by the Senate on his genius GP tax, he decided later to extend that Medicare freeze to GP visits—a GP co-payment by stealth. That Medicare freeze still exists in form today and will endure for another two years. It has robbed more than $3 billion out of Medicare. That means it has ripped more than $3 billion out of the pockets of patients. And, as a result, out-of-pocket costs are still getting worse to this day.

Earlier this month, the Australian Institute For Health and Welfare finally laid bare the full extent of the health affordability crisis in this nation. Despite the Prime Minister's promise that no-one would pay more to see a doctor under this government, the report shows Australians are now spending nearly $30 billion a year on out-of-pocket expenses and that includes $3 billion in non-hospital Medicare subsidised services. Half of all patients have incurred out-of-pocket costs to see a GP or specialist or to have blood tests, X-rays or other scans. Seventy per cent of patients seeing specialists made some out-of-pocket payments, and more than a million people spent $600 or more on medical gap fees. As a result of these soaring costs, 1.3 million Australians are either delaying or skipping seeing a doctor or getting a test when they need it, putting their wellbeing and, possibly, even their lives at risk.

Despite all of this, the government has done absolutely nothing when it comes to out-of-pocket costs. The member for Dickson also abolished Health Workforce Australia, which was tasked with ensuring that the health workforce had appropriate skills and training. He abolished the Australian National Preventive Health Agency. He took the axe to, generally, every prevention program that there was federally, cutting millions of dollars from measures put in place to prevent cancer and to tackle obesity, problem drinking and smoking. There were massive cuts to dental funding, diagnostic imaging and ophthalmology and the destruction of Labor's Medicare Locals system. There was no corner of the health system that the member for Dickson did not take an axe to. Not including the cuts to hospitals, he cut $10.4 billion from our health system in a single budget.

Let's not forget this chestnut in the 2014 budget: the market testing of the payment system for health services by commercial payment service providers. That's a fancy way of saying that, in fact, the member for Dickson wanted to sell off the Medicare payment system. It was his idea. He wanted to start the process of privatising Medicare. It's there in black and white in the budget papers. He was an absolute disaster when it came to being a health minister of this nation, yet 35 members on the government side of the House decided that he would make a better Prime Minister. It tells you everything about the Liberal Party and what they think of health and what they think of the Prime Minister that they think he would do a better job. (Time expired)

3:32 pm

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

If you can't manage the economy, you can't manage health. The member opposite talked about what was black and white in the budget papers. Well, it is all there in black and white in the budget papers for 2011-12—the link between the economy and health and the ability to manage it. Again, in the 2011-12 portfolio budget statement, under the previous Labor government, it says:

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

They couldn't manage the economy and they couldn't manage health. Those medicines were for asthma, COPD, deep vein thrombosis, endometriosis, IVF and schizophrenia, amongst others.

I've been doing a little bit more research about the response at that time and what is interesting is that the Senate Finance and Public Administration References Committee held an inquiry into this decision of the last Labor government. What they found, at page 90, was that it:

… represents unacceptable cost-shifting to patients who can least afford to bear an increased financial burden.

They also said, at page 87:

This profound and ill-considered change in policy puts at risk affordable access to medicines for Australians, and will have significant consequences for the pharmaceutical sector, including research and development.

But it's more than just that. Submissions came from some of the most reputable organisations in the country, including SANE Australia. Their submission said:

The decision to defer the recommendation of the Pharmaceutical Benefits Advisory Council (PBAC) to list medications jeopardises the integrity of the PBS process.

Diabetes Australia said:

… we see the decision to delay listing of drugs which have been through the PBAC process as poor policy …

The Consumers Health Forum of Australia said:

Consumer concerns about the changes to the PBS listing process can be broadly summarised as follows:

1. Delays in access to essential medicines

2. Lack of transparency in the new process

3. Politicisation of PBS listing process

4. Lack of consideration of other healthcare costs likely to arise as a result of consumers not having access to essential medicines.

And then the AMA said, which perhaps sums it up perfectly:

Denying access to medicines that are proven to be both clinically useful and cost-effective is a crude and blunt instrument to attempt to control PBS outlays.

That is what the experts said, that is what the medical groups said, that is what the community groups said and that is what the mental health groups said in response to the inability of the previous government—a Labor government—when they were in power, to manage the economy, which, in turn, meant they could not manage health. That is fundamental. It is the exemplar of everything that is wrong with Labor when they seek to govern.

More than that, let's look at the record of what we've achieved compared with the previous government: record hospital funding, record bulk-billing levels, record Medicare funding and record mental health funding. Let us go through each of those. Hospital funding is up over 50 per cent from when Labor was last in power. I just want to repeat that—up over 50 per cent, from $13.3 billion in their last full year to $21 billion this year, to $22 billion next year, to $23 billion and to $24 billion in the third and fourth years of the budgets. And that means more services, more access to doctors and more access to nurses—so an over-50 per cent increase. So, when they make their claims, just check the budget papers because, when we check their budget papers, we see them denying essential medicines. But when we check our budget papers, we see an over-50 per cent increase in actual hospital funding. That's the reality. That's the truth. That is the undeniable fact, and that is what is actually occurring as a result of good economic management.

In addition to that, though, Medicare funding is increasing to record levels each year, every year, under this government. What we see is that we have gone from $19.5 billion under Labor to $25 billion this year, to $26 billion next year, to $27 billion in the third year and to $29 billion in the final year of the budget papers. So there's a massive increase of approximately $10 billion from Labor's last year to the end of the forward estimates within the budget period.

We've also seen, again, new listings on the MBS. There are new items for 3D mammography for breast cancer, new items for men's prostate cancer and new items for remote and Indigenous renal treatment—important steps forward, delivering real benefits to patients that actually make a difference to their lives. That's what's occurring when you've got a strong economy based on real jobs growth; you can actually lead and see the benefits in health.

More than that, though, we see bulk-billing, and what we've just seen are the highest bulk-billing figures on record—86.1 per cent, up from 82.2 per cent under Labor. So that's nearly a four per cent increase from when Labor was last in power to what bulk-billing is now. It's 3.9 per cent up, nearly four per cent, at 86.1 per cent. It's the first time in Australian history that bulk-billing has reached an 86 per cent level. That means that 86 out of every 100 times that people go to the GP, they go for free—they don't pay a cent to attend that service—and that's an important outcome for Australians. It's important in terms of access and it's important in terms of the ability to seek treatment. What we have also seen since 2011 is a 39 per cent decrease in terms of the rate of people delaying access to GPs. We want to drive that down further. But what we have seen is a 39 per cent decrease from 2011, based on ABS figures, compared with what it was under Labor.

There is a very important additional element here—that is, what we also see is that Labor has a proposal to rip the rebate away from all of the low-cost policies under private health insurance. They're not proposing a cap for private health insurance costs. They're proposing a 16 per cent increase because, if you take the rebate away, what you see is a massive impact on pensioners and low-income earners. And they talk about out-of-pocket costs. What will occur then is a major hit on out-of-pocket costs—not just according to us, but according to Members Health, according to Private Healthcare Australia and, in particular, according to the Queensland Teachers' Union's health fund. So these are not our views, although we agree with them. These are the views of the experts in the space, including some groups that are deeply aligned with the Labor Party.

You would see two things occur. The cost of private health insurance would soar under Labor, because Labor hate private health insurance, as we see from their record—they slashed the rebate last time. But also out-of-pockets would go up because, when you are driving up the cost of private health insurance, the insurers will seek to make savings elsewhere, and that means that there would have to be a reduction in the services that they offer, and that means an increase in out-of-pocket costs. So it's the patient who suffers. It's the patient who would be worse off under Labor. And it was the patient who suffered and was worse off under them last time, when they had private health insurance increases which hovered around the six per cent mark every year. By contrast, through reform that has changed the cost base for private health insurance, we have just delivered the lowest private health insurance change in 17 years. But we are working to drive that down further.

These are real reforms which have made a difference, in terms of record funding for hospitals, record funding for Medicare, new services from Medicare and new drug listings. On the latest figures, over 1,800 new or amended drug listings have been made since we came to government. That compares with what Labor did when they couldn't manage the economy, when they couldn't manage the budget, when they made the country suffer the consequences of their fiscal incompetence: they withheld new medicines for DVT, endometriosis, IVF, chronic obstructive pulmonary disease, severe asthma and schizophrenia. When you do that, that shows you can't manage health, you can't manage the economy and you don't ever deserve to be back in government.

3:42 pm

Photo of Tony ZappiaTony Zappia (Makin, Australian Labor Party, Shadow Assistant Minister for Medicare) Share this | | Hansard source

It's a bit rich for the Minister for Health and Aged Care to give Labor a lecture on management when he can't even manage the My Health Record rollout. It has turned into an absolute debacle.

Whichever way one turns under this government, currently led by the member for Wentworth, Australians are paying more and waiting longer for essential health services. Billions of dollars have been cut in funding to our hospitals. Three billion dollars have been cut in the last six years because of the Medicare freeze. There has been a 27 per cent increase in private health insurance costs. It's an atrocious record on health, led by the current Prime Minister; a former Prime Minister; a would-be Prime Minister, the member for Dickson; and a would-be Deputy Prime Minister, the member for Flinders.

With to respect hospitals, $57 billion was cut when this government first came to office. Seven hundred and fifteen million dollars will be cut between 2017 and 2020, and that means a cut of $31 million for the state I represent, South Australia. Between 2019 and 2025 the cut will be $2.8 billion. What does that mean? It means longer waiting times for emergency treatment, longer waiting times for elective surgery and shorter recovery times in hospital for patients. Only on Monday of this week the front page of the Adelaide Advertiser said: 'Frustrated paramedics' stress soars over ramping bottlenecks'. The article refers to three stress related incidents a week across Adelaide's major hospitals because of ramping, where ambos and patients wait for hours in hospital corridors, all because of the cuts to our hospital system.

With respect to private health insurance, there has been a 27 per cent increase under this government. Some 40 per cent of all policies now have exclusions, so people are not only paying nearly $1,000 a year more for their private health insurance but they're actually getting less, and, not surprisingly, more and more people are dropping out of private health insurance because they simply cannot afford it. Then what happens? More and more people end up in our public hospitals because they go there for treatment, or they simply don't take up treatment at all. That in turn means that their health deteriorates and, ultimately, the costs of caring for them escalate.

With respect to the Medicare freeze, GP visits are now up to about $38 on average. For specialists it's $88. In 2016, 1.7 million Australians skipped a specialist visit, another 1.7 million Australians did not fill their pharmaceutical script, one million skipped or avoided a GP visit and 1,830 personal bankruptcies in Australia were attributed to health costs because of this government's cuts. More recently, we saw the AMA put out a survey that showed one in three doctors will cut back or cut out their visits to aged-care centres. Aged-care centres look after some 235,000 Australians every year. If the doctors don't go there, they ultimately end up in the hospital ED departments where it costs even more. That happens at a time when we know more and more people are ending up in aged-care facilities because of our ageing population.

When health costs increase across the country it's the most vulnerable who are hit the hardest, particularly country folk. Country folk are already faced with higher levels of chronic ill-health, a shortage of health professionals and higher costs in accessing the health care they need. These are communities that are already seriously disadvantaged when it comes to healthcare services. This government's tenure has made their access to health care more costly and more difficult, and these are communities that are primarily represented by members of the government.

This is a time when Australia's health needs are greater than ever before. We know dementia rates in this country are rising and it won't be long before about a million people in this country have a dementia related illness. We know mental health issues affect so many people across the country and, again, it's an increasing problem. We know Australians are ageing. We know obesity rates are increasing, with about one in four Australians already obese and nearly two-thirds of Australians overweight.

Our health system needs more support not less. Yet what we're seeing from this government, from one minister after another, is cuts to the health system, passing the buck onto the patient or the states, leading, ultimately, to a deteriorating health service. It is time this government understood that, when it comes to the priorities of the Australian people, health and education are first and foremost. They should respond by supporting the health system of Australia.

3:47 pm

Photo of David GillespieDavid Gillespie (Lyne, National Party, Assistant Minister for Children and Families) Share this | | Hansard source

Here we go again. The usual lies. Everyone's used to seeing mist cleared from the eyes of confused people, from the 'Mediscare' campaign of the last election. But the propaganda that keeps coming out of the other side about cuts to health is starting to be just repeated lies. Like those masters of propaganda, if you keep saying a lie often enough people start believing it—even the people who are telling the lie. And that's where they're going with this argument.

You've just got to look at the budget papers. There was $13.3 billion spent by the federal government in 2013-14. Now it will be $22.7 billion in 2021, as of the last budget papers. At the moment, we're over a 50 per cent increase by the end of the forward estimates. In these budget papers the increase will be 70 per cent. In the latest hospital agreement the increase goes up to $30.2 billion. I will reiterate that: $13.3 billion in 2013; $22.7 billion in 2021. That is a 70 per cent increase. That is not a cut.

Look at the PBS. One of the best initiatives is from the Minister for Health who has organised savings on the old drugs to guarantee extra funds to get the new drugs onto the PBS. Since the coalition government has been responsible for the health portfolio, since 2013, we have had 1,870 new medicines listed on the PBS. That's about 31 a month: one a day.

We have from a Senate inquiry in 2011 all the things the Minister for Health mentioned. Former Minister Roxon admitted that they took drugs off recommendations from the PBAC and didn't list them. They were drugs for schizophrenia, IVF, deep vein thrombosis, asthma and COPD. All the records were delayed. They did it because they couldn't manage the economy. They didn't have the funds to pay for it. Past behaviour reflects future behaviour. They froze the rebate for health insurance. Back in March, the member for McMahon, the opposition Treasury spokesman, was meeting with health funds, saying they're going to freeze it again—at least $2 billion extra in costs for people holding health insurance. There are 13½ million people in this country holding health insurance, and 6½ million of them, many of them pensioners, only earn $40,000. Health insurance is such an important arm of our health system, and they want to increase the cost to make it unaffordable.

We've made it much more affordable for young people to hold health insurance, because we've given the 18- to 29-year-olds a 10 per cent discount. We've changed the regulations to allow people, if they haven't got mental health cover, to upgrade to mental health cover without a waiting period. We've increased a whole lot of initiatives in mental health—extra funds for mental health, for regional people to get mental health by telemedicine and for psychological counselling by telemedicine.

We've had so many great initiatives. You've just got to look at the record funding for medical research, the Medical Research Future Fund and the National Medical Industry Growth Plan—that's another $1½ billion on top of the Medical Research Future Fund. There is $2½ billion at least that's going into direct medical research through the NHMRC funding, on top of the Medical Research Future Fund, and then on top of that the Medical Industry Growth Plan. We have got extra funds for vaccinations for children and mothers for whooping cough and meningococcal disease, and that is why it is so important.

Everywhere you turn there are funding increases. We have made health insurance simpler and more understandable. There were so many complex offers there in the market that we simplified it. In mental health, as I mentioned, former minister Fiona Nash, the former Minister for Rural Health, initiated extra funding for mental health in remote Australia. We have got extra funds for immunisation and for drug treatment and prevention. (Time expired)

3:52 pm

Photo of Emma McBrideEmma McBride (Dobell, Australian Labor Party) Share this | | Hansard source

It has been really difficult sitting here in the chamber listening to the doublespeak on the other side. I'm here as a hospital pharmacist and a mental health worker, and I just want to call out this claim about patients not being able to get medication over this delay in listing. I worked in mental health units in our public hospital at the time. No patient missed out on medication. Those medications were available under the patient familiarisation scheme because the medications were TGA listed. Not a single patient in our mental health service missed out on medications during that period, and I think that needs to be put on the record. This doublespeak is misleading the community and the public about access to medications.

If those opposite want to talk about access to medications, what about the problems we have in continuity of access to medications because of the delays in access because of manufacturing problems? That's a real access problem that we have in Australia at the moment.

The health of Australians should be the No. 1 priority of this government, and yet what has it done? It has just cut. Five years of cuts are what has happened to health in our hospitals. The cost of health care is growing, and the system is under strain. The Australian Institute of Health and Welfare report has finally revealed the full extent of the crisis. Despite this government's promise that no-one would pay more to see a doctor, the report shows that Australians are spending nearly $30 billion on out-of-pocket health expenses every year. In communities like mine, that's not affordable. As a community pharmacist, I've had people come to me and say: 'Which script should I not fill? Which one can I go without? Can I go without my cholesterol medication, or can I go without my hypertension medication? Which one?' That's not a choice that anybody should have to make in Australia today.

These cuts include $3 billion a year in non-hospital Medicare-subsidised services. Half of all patients have incurred out-of-pocket costs to see a GP or a specialist or to have a blood test, an X-ray or other scans. Seventy per cent of patients seeing specialists made some out-of-pocket payment, and more than a million people spent $600 or more on medical gap fees. That is not affordable. That's putting the health of everyday Australians at risk, particularly those in regional and rural communities. And 1.3 million people are delaying or skipping seeing a doctor or getting a test when they need it, putting their health at risk.

The report exposed the bulk-billing doublespeak of the health minister. The data reveals that only 66 per cent of patients are bulk-billed by their GP, not the 86 per cent the minister has claimed over and over again. The Australian Healthcare and Hospitals Association now confirms the figures cited by the minister are misleading. Despite this, the government have said 'Medicare has never been stronger' and their commitment to it is 'rock solid'. Perhaps it's like the 'rock-solid commitment' they have to the current Prime Minister. Yet they will not fully lift the Medicare freeze, with some elements staying in place for another two years. Two years is too long for people who are already out of pocket and whose health is at risk because of the costs of care.

Labor created Medicare, Labor created the PBS and only Labor will make sure that all Australians can access the health care that they need when they need it. In my community on the Central Coast of New South Wales, health care really matters. One in five of us is under 15, and one in five of us is aged over 65. The young and the old in our communities have the biggest health needs. What is our government's answer? This government has walked away from its commitment to the states to fifty-fifty fund public hospitals. In real terms that is a cut of $2.8 billion.

I'll give you a real-life example of what these cuts mean. How did the New South Wales government respond? It was by putting five public hospitals on the market and by threatening to sell public hospitals, to privatise them. But what did our community do? Our community stood up. We stood up for our community hospital and we stopped it being privatised. And my community will stand up again. They'll stand up against these cuts.

It is absolutely outrageous what this government has done to public hospitals and health care. I challenge anybody to walk into a public hospital, particularly into a mental healthcare unit, and tell me in good conscience—genuinely—they are properly funded. Tell me that.

Photo of Emma McBrideEmma McBride (Dobell, Australian Labor Party) Share this | | Hansard source

Pork-barrelling, is it? Anyone who is waiting for elective surgery or who is waiting to be assessed by a mental health team, anyone who has been to a doctor or specialist and has been hit with a big bill, anyone who has skipped filling a prescription, anybody who has missed an appointment because they can't afford it—do you know where they end up? They end up in the emergency departments of our public hospitals at the end of a queue. That's where this ends up, with people sicker and in emergency departments. This government's record on health is absolutely appalling. It's time for a change in attitude to health. It's time for a change of government now.

3:57 pm

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

I was going to give a speech simply dismissing the absurdity of this policy motion, but the interjections by the previous speaker cannot go ignored. She went out and promoted a series of untruths about hospital funding in this country, and when a member on this side of the chamber stood up and said, 'Actually, we do have well-funded hospitals in the area and the community that I represent,' the response was, 'Pork-barrelling, is it?' This is the fundamental flaw of everything that sits at the heart of what this opposition stand for. When they disagree, they dismiss or ignore, but the facts and the evidence show them up for the political frauds that they are. It needs to be called out by people on this side of the chamber, because if this motion were put to the parliament as simply a form of wording members would be accused of misleading the parliament. It doesn't make it more true by putting it in a motion and putting it to the parliament.

As the Minister for Health outlined in his remarks in addressing and responding to this ridiculous motion, if you do not—

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

The member will be seated for a second. The member for Bass on a point of order.

Photo of Ross HartRoss Hart (Bass, Australian Labor Party) Share this | | Hansard source

I just wanted to be sure that the member's microphone was working because he was certainly yelling—

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

The member will be seated.

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

I welcome the interjection, Deputy Speaker, because I can assure you I need the microphone. As the Minister for Health said previously in the opening of his remarks, 'Without a strong economy you cannot have a strong health system.' This is nakedly obvious to the people on this side of the chamber. But the point isn't that it's supposed to just be a health system. We don't have a strong economy simply to deliver a health system. We have a health system because it is designed to deliver for Australians, to improve the standard of their care, to improve the standard of their welfare and to make sure that, through people's lived experience, when they need assistance and when they need support, particularly in times of vulnerability, the system is there to provide for them. Because that's whom we, the coalition, are for. We're here for people.

Mr Hill interjecting

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

The member for Bruce is in his wrong place and will be removed if he interjects again.

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

The foundations of this motion are based on a falsehood. We know that, under this government, funding has gone up considerably, from $13.3 billion in 2013-14 to a record $22.7 billion in 2020-21. It's an increase. It's kind of more than a little bit of an increase in nominal terms. In fact, it's about a 70 per cent increase in funding. So the very basis of this motion is a falsehood.

We know that, yes, we are moving and adjusting our spending in line with the lived experience of Australians. We have an ageing population. People consume more of their healthcare expenses in the latter stages of their life, and we need to make sure that we care for people in that moment of vulnerability. That's what's been shown up in bulk-billing rates. We have had an increase from 82.2 per cent, the last time the opposition was in government, to 86.1 per cent in the first quarter of 2018. That's quite a significant increase as well. So there has been an increase in bulk-billing rates, we are matching the funding and we are putting the best interests of Australians first. These are all foreign concepts to the opposition.

What we're doing also is backing Australians to take care of themselves. Imagine that! The very foundation of Liberal policy should always be that people who can stand on their own two feet should do so, not just so they can take care of themselves and not be a burden on others but, more critically, so they're in the best situation to help others. What do we have as part of our policy? We have an active encouragement and incentivisation for young Australians to take up private health insurance so they can take care of themselves.

That's the sort of thing that most governments would be fundamentally proud of. In fact, even if oppositions had introduced such policies and wanted to defend them, they would traditionally be proud of them—but not those opposite. Instead, they simply confect outrage because their interest is the politics of health rather than the human outcomes of health. You can say that, in every minute of every hour of every day of this Turnbull Liberal government, we will stand for Australians and by Australians and their health care.

4:02 pm

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

I've worked at the coalface of health care for many, many years, and one thing I know is that the Liberal Party just does not understand public health policy. I rise today to speak on this matter of public importance to highlight the coalition government's track record of cutting health over the past five years. It doesn't matter whether the Prime Minister, at the end of the day, is the member for Wentworth, the member for Warringah, the member for Dickson or even the member for Curtin; the track record of this Liberal-National party government speaks for itself. Every member opposite has been content with the slashing and burning of health over the past half-decade. Sadly, I do not see that a change of leadership is going to change the outcome. Health, education, the environment and the cost of living—these are the issues that we should be speaking about in this incredibly beautiful building. We should not be bickering, talking about ourselves and engaging in egocentric political games—that is not for the betterment of the Australian people.

I'm happy to speak on today's matter of public importance because it is so important to me and it is so important to the Australian people. We are rapidly developing a two-tier health system where the quality of your health care depends on the size of your wallet, and some of the poorest people are having enormous difficulty accessing health care. I've just received a letter from an eminent colleague of mine, Professor John Corbett, who is a very well regarded neurologist from Brisbane. I'll read out the beginning of his letter to me: 'After providing bulk-billed specialist EEG services for over 20 years, I've recently been forced to cease providing these services due to the freeze of Medicare rebates which has been in place since 2012 and will remain in place until July 2020, a total of eight years. It's now impossible to provide EEG services to my patients on a bulk-billing basis any longer. I'll have to cease bulk-billing. This will lead to increased patient costs. It will also lead to increased public hospital waiting lists.'

Just for the information of members opposite, an EEG is a very important neurological investigation done mainly for conditions like epilepsy. It's very important. Often people who suffer from epilepsy have other neurological disorders. They often have difficulty with employment et cetera. They are now going to face huge public hospital waiting lists or increased patient costs. This is just not acceptable to me.

This is the real coalface of health care. This is something that the Liberal-National Party just does not understand. I understand why: many of them have high incomes and good health and don't have to access health care. For many people in my electorate of Macarthur these increased gap costs are prohibitive and they just cannot get care. Those opposite, who have been intent on talking about themselves and dragging the national agenda and public debate down with them, do not really understand health care and do not understand what the Australian people want. We all need a strong Medicare, properly funded hospitals and fewer out-of-pocket expenses for the average Australian.

The average Macarthur resident couldn't care less who is the Leader of the Liberal Party. They just want this incompetent and out-of-touch government kicked out of office. The government are most incompetent in their attitudes to health care. In government, the coalition have slashed health funding. Tony Abbott did it when he was at the helm and Malcolm Turnbull has continued on this legacy. God forbid the member for Dickson becomes the Prime Minister. We know what he did to the healthcare system. He was instrumental in providing the health cuts in the 2014 budget. It was a disaster and absolutely shocking.

My particular interest at the moment is the electronic health records. I see this as a very important way of reducing health costs and providing better health care for all Australians, from children through to those in aged care. This government's rollout of electronic health records has been a total disaster, a total debacle and a complete shambles. It is just a disaster. This government's record on health care speaks for itself. Let me be clear: each member opposite wants to lock in the health cuts and wants to continue with this American-style, two-tier health system and make the poorest of our community struggle with health care. It's a shame. (Time expired)

4:07 pm

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

I am pleased to speak in this matter of public importance debate today because I am proud of our government's record on health. I congratulate the Minister for Health and the Minister for Aged Care on their incredible work in this portfolio. They are doing an excellent job of listening to what the Australian people need. Like the ministers, I'm also listening to my community and my local residents as to what they need on health. Because we are listening I worked very closely with the Minister for Health to see the delivery of a national action plan and, so far, more than $4.7 million of federal funding towards endometriosis. Minister Wyatt joined me in my electorate to listen to senior members of my community talk about the issues that are most important to them, and we are working with them as well to deliver in the aged-care space.

It is unsurprising that those opposite want to talk down our contribution to health, but our record speaks for itself. We are achieving record funding for our healthcare system in Australia. In the 2018-19 budget we announced a $2.4 billion investment for new medicines to be listed on the PBS, including $1 billion set aside for the provision of future medicines. In fact, since coming to government we have listed, on average, one new medicine per day. These are often lifesaving medications. So far we've had an overall investment of $9 billion, which is a very significant investment.

Federal funding for public hospitals under the coalition has increased from $13.3 billion in 2013-14 to a record $22.7 billion in 2020-21. This is a 70 per cent increase. Under a new national 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 billion. This means more hospital services, more doctors, more nurses and increased funding every year for every state and territory. This is what responsible governments do.

In stark comparison, those opposite have a terrible track record on health both at the state and federal levels. Nobody knows this better than I do, because I come from the state of South Australia where we saw the state Labor government make one of the most disgraceful decisions of their 16 years in government when they decided to shut down the iconic Repat Hospital. This was devastating to veterans not just in my community but across South Australia.

Photo of Linda BurneyLinda Burney (Barton, Australian Labor Party, Shadow Minister for Preventing Family Violence) Share this | | Hansard source

Take your hand off your heart!

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

If the member opposite actually cared to do a quick google on this issue, she would realise how devastating it was to these veterans, particularly our Vietnam veterans, to have this hospital shut down. It was also devastating to the senior members of my community, who regularly used this hospital, and to so many people whose loved ones had passed away in the hospice over decades. It's a much-loved hospital, which is why I worked so hard with the now member for Elder, the member for Waite, the minister for health and the now premier, Steven Marshall, to see the state Liberal government commit to reactivate and reopen the Repat.

I'm so proud that the now South Australian Liberal government committed to reopening operating theatres to reduce elective surgery waiting times, and to reopening the hydrotherapy pool, which has already happened, for veterans in my community to be able to use. They committed to using Ward 18 as an older persons' mental health facility to care for those people who suffered so badly at Oakden, under the disgraceful treatment by the previous state Labor government, and they also committed to building a new older persons' mental health facility.

The Marshall Liberal government have consulted with health professionals as to what else they can do with this wonderful, iconic community hospital site. Last week they commenced community consultation to find out what other services my local residents would like to see reopened on the site. I would encourage all of the members of my local community to have their say as to what they would like to see returned to the Repat site. They have until 16 September to provide submissions on the future of the site. Following this consultation, the state Liberal government will collate all of the feedback and release a final master plan by the end of the year. This is what Liberal governments do. We govern responsibly, we keep community health services where they need to be and we listen to our community. (Time expired)

4:12 pm

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

I rise to speak on this very important matter of public importance. Do you know, I was a nurse for 20 years. I worked in both the public and the private sectors, and I have a very good understanding of what it is to work in a well-funded public health system and in one that has been devastated by funding cuts. I worked in Victoria during the Kennett years. The Jeff Kennett cuts were devastating. They slashed, burned and cut the public health system to critical, low levels. Thousands of nurses left through forced redundancies. Many left through overwork—they simply could not cope with the cuts in that system.

I know what it's like to have to scrounge for pillows. I know what it's like to hide surgical tape in your pockets for fear of there not being any stock when you go to the cupboard. I know what it's like when waiting lists are so long that ambulances line up outside the hospital. I know what it's like to have to see patients frustrated by sitting for hours in waiting rooms at outpatient clinics.

I was at the ACTU when Campbell Newman, the then Premier of Queensland, nearly destroyed the public health sector in Queensland. I was there with nurses and saw the looks on their faces when those white slips appeared in their pigeonholes telling them that they had been earmarked for a redundancy. I know what it was like in Far North Queensland when regional hospitals had to tell their patients that they could no longer afford to fund a cardiac rehabilitation unit and that patients, post-surgery, had to travel 50 kilometres for their check-ups. Do you know what happens when people are told that they have to travel as far as 50 kilometres for appointments? They don't go, they don't do it, and their conditions exacerbate. They rebound back into hospital or worse.

Let's face it: the Liberal Party hates the concept of public health. It goes against its free market, trickle-down economic philosophy. 'If you are sick, bad luck. If you can't pay for health care, you miss out. If health care isn't creating a profit for some multinational enterprise then we don't want it'—and so it goes with this government and, I'm afraid, with its potential new leader, Peter Dutton. He hates public health care as much as Newman and Kennett did. We've heard already how he's been deemed the worst health minister in 35 years—worse than Tony Abbott—cutting billions from hospitals; wanting to dismantle our universal health care system, our beloved Medicare; increasing the burden of prescription costs for all Australians by attacking our PBS safety net; Medicare freezes; introducing co-payments for GPs; and tearing up the National Health Reform Agreement. Undermining our public healthcare system is in the Liberals' DNA. Add to this litany the fact that with the current health minister, Greg Hunt, his only focus is on supporting his mates in the private health insurance industry and plotting with Peter Dutton to run a ticket against our Prime Minister.

Do Greg Hunt and Peter Dutton have any idea of the impact of funding cuts? They are forcing services to choose which services they will cut—will it be the Indigenous community health service, diabetic nurses or geriatric psychiatric services?—and forcing nurses to make impossible decisions because of funding cuts and not enough staff. Do they understand what it's like to have to decide between walking an elderly patient for their much-needed physio and starting a complex dressing that takes a long time so they can finish it before their shift ends? They might do both, in which case they will work unpaid overtime. We already have a health system that relies on nurses working for free. They have to make decisions like: 'Do I let a sick child sit for two more hours in the emergency department or do I leave a worker with a burn injury or in pain in the waiting room? Do I sit and feed a patient who has had a stroke or do I leave an incontinent patient in a wet bed?' I know what it's like to have to make these decisions, but Peter Dutton and Greg Hunt don't know because they won't try to find out. They don't care. Cutting $57 billion from public hospitals means that our health professionals have to make these hard decisions and more. They want to cut another $2.8 billion from our health system.

I am proud to say that Labor know what it's like. We have health professionals who know what it's like to work in our public health system. We know what it means to have to make these decisions. We know the difference between working in a well-funded health sector and a sector that has had savage cuts from health ministers who simply don't care. Labor will invest in our health system, we will invest in our healthcare professionals and we will keep our communities healthy.

Dr Aly interjecting

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

The member for Cowan will remove herself under 94(a).

The member for Cowan then left the chamber.

4:17 pm

Photo of John AlexanderJohn Alexander (Bennelong, Liberal Party) Share this | | Hansard source

I would genuinely like to thank the members opposite for raising this matter of public importance. Of course health is one of the most important matters for the public, which is why I'm so proud to speak to our record today. I'm sure you've heard of my boast that I represent Australia's capital of innovation. A huge portion of this innovation comes from the pharmaceutical industry, much of which is based in Macquarie Park, or Pill Hill, as it's known. These include, but are not limited to, companies like Novartis, with Kisquali, their treatment which will help thousands of people with breast cancer; Jansen with Imbruvica, which will benefit hundreds of people with a subtype of lymphoma; Amgen's drug Neulasta, which helps the body cope with the debilitating effects of chemotherapy; Biogen with Spinraza, a life-changing medicine for those with spinal muscular atrophy; and MSD's treatment Keytruda, which is a game-changer in the way it uses the body's own immune system to fight cancers.

It is all well and good to have companies designing, creating and providing these drugs, but they don't cure one condition or help one person if they can't be accessed by patients who depend on them. That, I am pleased to say, is where this government comes in. Since coming into government the coalition has listed over 1,870 medicines, which equates to an average of one new medicine a day, on the PBS, worth approximately $9.3 billion. In this budget, $2.4 billion has been invested in new medicines, including $1 billion set aside for the provision of future medicines. These medicines will assist people suffering from conditions such as breast cancer, spinal muscular atrophy, heart disease, epilepsy and severe asthma. Some of these cost many thousands of dollars but are now available for $6.40 concessional or $39.50 for general patients per script.

Just this month the government announced it will invest $250 million to make life-changing medicines available to thousands of Australian patients. These include: 1,000 patients with a type of head and neck cancer, squamous cell carcinoma, who would otherwise pay almost $50,000 a year for Opdivo, will now have affordable access; 1,125 patients with rare types of leukaemia cancer, myeloproliferative neoplasms, who would otherwise pay more than $18,000 a year, will now benefit from the listing of Pegasys. The listing of Kisquali will save over 3,000 patients with breast cancer from having to pay $71,000 per year; 220 patients with subtype lymphoma cancer, relapsed or refractory mantle cell lymphoma, will benefit from the listing of Imbruvica as patients would otherwise pay $134,000 a year for this treatment; 1,500 patients who are receiving chemotherapy for cancer will benefit from Neulasta, which will help the body to make neutrophils, a type of white blood cell, saving patients over $4,500 per course of treatment; and there is $241.3 million for Spinraza, a life-changing medicine which treats the devastating illness spinal muscular atrophy, and, without the subsidy, patients would pay more than $367,850 per year.

This record investment in drugs and medicines is only possible because of the arrangements made by this minister with Medicines Australia. These agreements brought certainty to the market, which has brought the industry and government together to help all Australians access more medicines. The PBS needs a responsible government that can afford to pay for these medicines. The Turnbull government will continue to deliver on our promise to list medicines recommended by the Pharmaceutical Benefits Advisory Committee without fear or favour.

In contrast, the last Labor government reversed the policy of the coalition to list all medicines approved by the independent PBAC. On 25 January 2011, the then Minister for Health and Ageing, Ms Nicola Roxon, announced the unprecedented deferral of the listing of seven medicines under the PBS. If it weren't for this government, millions of Australians would be without the medicines that are improving their quality of life and sometimes keeping them alive. Our record on medical listings is a source of great pride to us all. I congratulate the minister. (Time expired)