House debates

Wednesday, 31 July 2019

Matters of Public Importance


3:19 pm

Photo of Tony SmithTony Smith (Speaker) Share this | | Hansard source

I have received a letter from the honourable member for McMahon proposing that a definite matter of public importance be submitted to the House for discussion, namely:

The Government’s failures on health policy.

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 Anthony AlbaneseAnthony Albanese (Grayndler, Australian Labor Party, Leader of the Opposition) Share this | | Hansard source

The health policy failures of the Abbott-Turnbull-Morrison government can perhaps be best summed up by two key facts: after six years of Liberal government, out-of-pocket costs for health care have never been higher, and waiting lists for hospitals have never been longer. The Liberals will never understand—nor will the Nationals—that those two key facts are very clearly linked.

But in relation to out-of-pocket costs, I do want to say this: this is not an unintended consequence of the government's policies. Some people would say the Minister for Health is incompetent. In this regard, I would disagree—he has set out to achieve a policy outcome, and he has achieved it and he's achieved it quite competently. The Liberals have been trying, as a matter of deliberate policy, to increase out-of-pocket health costs for six years. It started in the 2014 budget with the $7 GP tax. There is one reason that that $7 GP tax is not the law of the land today, and that reason is this side of the House, who blocked it in the other place. Members opposite wanted a GP tax and they couldn't get it through the House. So then they set about a cunning plan to achieve it in a different way. They achieved it in a way which doesn't require the approval of the parliament: the Medicare freeze. I say this: they've achieved their aim. They've increased out-of-pocket costs of health care via the Medicare freeze. They've been at it for six years and, to give them their due, they've got it done. The member for Flinders has done what the member for Dickson could not achieve—increase out-of-pocket costs substantially. The government's own data shows the average out-of-pocket cost to see a GP is now $39.55, up 36 per cent since this government came to office!

It's not just general practice. It's even worse, much worse, when we think about specialists. Out-of-pocket costs to see a specialist on this government's watch have gone up 58 per cent since this government came to office! This is having a real impact, not just on the wallets of Australians but on the health care of Australians. Each year, 1.3 million Australians delay or avoid medical treatment because of the cost! We pride ourselves in Australia on universal healthcare. It's not universal while that's happening. It's not universal while 1.3 million Australians are missing out. While this government is in office, 660,000 Australians skip seeing a GP because of the cost, and 538,000 of our fellow Australians avoid seeing a specialist, care that's recommended to them, because of the cost.

On this side of the House, we understand that the impact of this is not equal across the country. People in regional areas are 25 per cent more likely to skip or avoid medical care because of the cost. People who live in the most socially and economically disadvantaged areas of our country are 33 per cent more likely to skip medical care because of the cost. Women are a staggering 66 per cent more likely than men to skip or avoid medical treatment because of the cost. There is electorate by electorate data which is available to all honourable members to check, and some honourable members opposite should check that data. I didn't hear the members for Bass and Braddon in their maiden speeches talking about the fact that their constituents are three times more likely to skip medical care than residents of eastern Sydney. That didn't come up in their speeches, and it hasn't come up since. They should be representing the people of Tasmania and they should be standing up for them.

People who skip primary health care don't get better—they get sicker. This is what we were talking about at the beginning—the link between those two policy outcomes—they get sicker and they go to hospital, because eventually they have to. Almost a million more people now than when the Liberals were elected are presenting at public hospital emergency departments. Of course, the Liberals promised to fund 50 per cent of the growth in hospital costs, and they were lying when they promised it. They were lying when they promised it and they have breached that promise. We are seeing the impacts of this in hospital after hospital across the country. We are seeing waiting times and waiting lists the highest they have ever been.

There were some recent figures from Tasmania—talking about the members for Bass and Braddon—in relation to waiting times. I'll just share with the House one of those figures. People who present at Royal Hobart Hospital emergency department with mental health concerns have an average waiting time of 19.4 hours. The longest wait is 183 hours. That's seven days—more than seven days—that people are waiting to be admitted to the hospital when they present at the emergency department of Royal Hobart Hospital with mental health concerns. This government thinks that's okay. This government thinks that it's acceptable in Australia in 2019 for that to be the case. Well, it is not acceptable and Australians deserve better than that.

Another thing Australians are waiting to access and are paying more to access is MRIs—MRIs across the country. That's why the Labor Party went to the election with a commitment for Medicare licences for MRIs—an extra 20 MRI licences. Every single one of those commitments we took to the election was for a public hospital—every single one. In relation to MRIs, the government eventually caught up with us. They delivered five MRIs in their first five years in office—just five. But they eventually caught up and started committing to MRIs. They didn't commit to the people of Macquarie. I was talking to the member for Macquarie this morning about MRIs. There is not one Medicare licensed MRI in her electorate. We committed to Katoomba Hospital. The member for Macquarie knows her constituents are having to travel to the inner city, to the North Shore of Sydney, at inconvenient hours and times to get an MRI treatment. We said that's not good enough.

The government didn't match us in Macquarie. What the minister did do is deliver an MRI in Parkside for Sound Radiology. There are nine MRIs within five kilometres. He didn't deliver one for Victor Harbor or Gawler, where there are no MRIs. He delivered one for Parkside and then said, 'I didn't know the CEO was the Vice-President of the South Australian Liberal Party.' After being found out he said, 'Oh! That Liberal Party! That vice-president!' Apparently, if you are a radiologist vice-president of the Liberal Party, if you 'have a go you get a go'. If you have a go at the minister, you get an MRI, if you're the Vice-President of the Liberal Party of South Australia. We know whose side the minister's on. He's on the side of vice-presidents of the Liberal Party, not the side of patients in Macquarie, in Victor Harbor, in Gawler, in regional Australia, who are travelling for miles and miles to get an MRI. No, they miss out—on this minister's watch. But, if you're connected, if you're a senior office holder of the Liberal Party, you pick up the phone, you have a handy, cosy, little meeting with the minister, then you get an MRI licence—a lucrative MRI licence—on this government's watch.

The Australian people deserve better than this. The Australian people deserve truly universal health care. They deserve a healthcare system which says your Medicare card is what you need, not your credit card. You shouldn't have to reach into your wallet for your credit card when you need urgent medical care. You shouldn't have to travel from one end of Sydney to another. You shouldn't have to travel into Adelaide from regional South Australia to get an MRI. You should get the treatment you deserve, as your birthright as an Australian. That is what the Labor Party believes. That is what the Labor Party believed when we created Medicare. That is what we believed when we created Medibank, against the vociferous opposition of those opposite, who abolished it when they came to office and who opposed Medicare at every step of the way, and have sought every day to dilute Medicare, to reduce Medicare.

We invented Medicare, but we recognise more needs to be done. We recognise that until Australia has truly universal health care we are diminished as a country and we are diminished as a society. We, as the people who invented Medicare, as the people who fought for Medicare, will grow Medicare, will protect Medicare and will nurture Australia's universal healthcare system. We will recognise that Australians, regardless of where they live, deserve to have that health care as a birthright—not at the whim of the minister, but as a right for all Australians.

3:29 pm

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

I am delighted that the member for McMahon has become the opposition shadow health spokesperson, because it's going to be a lot of fun. Let me begin with what he just said. He made a false statement before this parliament. He said not one of their licences was to anything other than a public hospital. St John of God Midland hospital is not a public hospital. He just made that statement up. He made stuff up. He also talked about Mount Barker hospital. It is delivered by Dr Jones radiology, a company that is very familiar to the member opposite. I know this as a fact. I just want to quote from something Dr Jones in relation to Mount Barker and the provision of the licence to a private provider.

Ms Plibersek interjecting

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

The member for Sydney is warned on props.

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

Dr Jones said: 'Mount Barker has grown immensely. The population needs support. As a business owner partnered with three sites—Mount Barker, Goolwa and Victor Harbour—it is difficult for our clients without an MRI licence.' He went on to say, 'Labor and Rebekha Sharkie have both recognised this and promised a licence to Mount Barker.' They have promised a licence to Mount Barker, the private provider which provides services in town—that is not a good look for somebody who just made a false claim before this House.

But he's not the only one. There was the Leader of the Opposition this morning on Adelaide radio. I'm just dealing with the false claims that we've already heard. The Leader of the Opposition on Adelaide radio this morning said: 'When Labor was in office, the decisions were made under the same process. The difference is that Labor awarded these licences to public hospitals. That went through processes.' In question time I named just a sample, but I can run through even more, whether it's Sunshine Coast Radiology, Queensland X-Ray, Qscan Redcliffe or CitiScan Radiology. These are all private. There's I-MED in Hurstville, Queensland. In South Australia there's Benson Radiology in Salisbury and Benson Radiology in North Adelaide. We had Dr Jones's partners in South Terrace, Adelaide. We had Adelaide diagnostic imaging in Menindee, Adelaide diagnostic imaging in Woodville and Dr Jones's partner Tennyson Centre in Kurralta Park. All of these are private.

Mr Albanese interjecting

The Leader of the Opposition attempted to say across the table, 'No, I was talking about what he promised this time.' Well, he was wrong about this time and when he said this morning that he was referring specifically to when Labor was in office. That's what he said on the public record and that's what his own transcript shows. What all this means is that Labor makes stuff up in this place.

But let's go to the essential questions here. On our health record compared with Labor's, let me start with a fundamental point that was made by them. The shadow minister talked about people's access to doctors. Guess what? The bulk-billing rate for people to be able to go to the doctor for free is up from 82 per cent under the previous government to 86 per cent under us. That means more people than ever before, not just in numbers but as a percentage of services, are accessing a doctor without having to pay anything. There were 133 million free GP services delivered in the last year—27 million more than in Labor's last year. So they're the facts. It's not just an increase in numbers but an increase in the percentage of Australians who are able to attend the doctor for free.

In terms of hospital funding, this is very interesting. We have seen an increase in federal hospital funding from $13.3 billion under Labor in 2012-31 to $23 billion to $24 billion to $25 billion to $26 billion during the course of this budget cycle. Most significantly, I had a look at Labor's costings, conveniently put out by the now shadow minister for health, the previous shadow Treasurer. We remember that one. He said, 'If you don't like it, don't vote for it,' and they didn't. It was a very, very helpful intervention, may I say. There were two things to really talk about. I wanted to talk about Medicare. I went to Labor's costings and it was very interesting. On ending the Medicare freeze, here are Labor's costings. I looked in the columns as to how much they had for this because I thought we'd done that. In 2019-20, there were zero dollars. In 2020-21, there were zero dollars. In 2021-22, there was were dollars. The total was zero. They actually said they were ending the Medicare freeze and then put zero dollars in their costings. My advice would be that, if you are going to do that, you probably don't want to pretend you are ending something and then allocating nothing.

The other thing, of course, is: what did this set of costings show in relation to additional funding for hospitals? It had nothing under the target of 50 per cent that they talk about—nothing for the current agreement, which ends in 2020. When you go to Labor's costings, there is nothing in terms of the additional hospital funding under the National Health Reform Agreement. There is nothing for those out-years through the entire next five-year agreement. But nor was there anything in the budget allocated for the five years beyond that. Out to 2030, their costings, this gentleman, this member of parliament, had zero. So for ending the Medicare freeze he had zero, zero, zero, zero. We'll call him Audi! On their side, there was not just one year, but 11 years of nothing in the costings for additional hospital funding under the National Health Reform Agreement. That is almost a world record in terms of achievements. Under us, we have an extra $30 billion over the course of the current agreement. That is real funding that will deliver real outcomes for the states. And that will mean increased opportunities for people to have services in hospitals, on top of the record GP bulk-billing.

But then we come to medicines. Medicines is an area of particular shame for the ALP. Under us, one of the signatures of our government has been the Pharmaceutical Benefits Scheme. We have listed over 2,100 new or amended medicines. Of most significance is the commitment to list everything that the Pharmaceutical Benefits Advisory Committee recommends. I go to the 2011 Labor budget because, helpfully, they put their policy in the budget. It says that, due to fiscal circumstances, the listing of some medicines will be deferred until fiscal circumstances permit. That includes medicines to treat the formation of blood clots, to treat deep vein thrombosis; severe asthma and chronic obstructive pulmonary disease; endometriosis and in-vitro fertilisation; and schizophrenia. All of these things have occurred as a moment of shame.

Opposition members interjecting

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

Members opposite!

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

There were 50 groups that came out and criticised and campaigned against the then government for this fundamental breach of faith: for the first time, when the PBAC made recommendations, they declined to pursue listings.

We will list everything that is recommended.

Mr Bowen interjecting

Let me give you an example—

Mr Bowen interjecting

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

The member for McMahon is warned!

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

Kalydeco begins from 1 August—tomorrow. We have seen Orkambi. All of these things represent the difference. Most interestingly, why did they stop the listing? Due to fiscal circumstances—they ran out of money. And what was behind it? Above all things, what was behind the fiscal mismanagement? They had a massive $5.2 billion blowout in the cost of services due to people smugglers and the flow of people associated with them. I seem to recall that there were 398 boats when the shadow minister for health was the Minister for Immigration. There were 24,000 people and a blowout of $5.2 billion. That's why they actually ran out of money. To put it very, very simply, he could not stop the boats but he did stop the medicines. This is the man who stopped the medicines. His border failures contributed to a massive budget failure, and that in turn was why Labor stopped the medicines. Those are the fiscal circumstances. That is why Labor had a horrific record in government and we will never trust them to manage health in Australia.

3:39 pm

Photo of Julie CollinsJulie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Seniors) Share this | | Hansard source

That was the most pathetic defence of the government's health system I have ever heard. We got one minute of stats that proved they had cut hospital funding and then he spent nine minutes talking about the Labor Party—nine minutes of the 10 minutes! That's because they don't have an agenda for health reform and it's because they're a third-term government looking for an agenda and something to do. Something to do, Minister, would be to fix the health system!

In my home state of Tasmania the health system is in crisis; it is crumbling. It is so bad that the health minister had to be sacked just a few weeks ago. Even his own side called for his sacking, it was so bad! We have ambulances ramping at the Royal Hobart Hospital and they have been ramping for 10,000 hours—10,000 hours! Sometimes in Hobart at the moment, if you call an ambulance for a major emergency one is not available. That's what is happening in our health system in Tasmania today. The health system has been cut by state and federal Liberals so badly it is failing. It is failing Tasmanians. We see this across the country, with other hospitals failing Australians.

The other really interesting data about the Royal Hobart Hospital that shocked me was that the Royal Hobart Hospital, in the last nine months, was experiencing bed block 93 per cent of the time. For 93 per cent of the time there were no beds available at the Royal Hobart Hospital to admit new patients. This government has failed Tasmanians and their health; it's failing Australians and their health, and for the health minister to get up here and ramble on about how bad Labor is! You are in government! You won, you know! You're actually supposed to fix the health system. That is your job.

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

The member for Franklin will address her comments through the chair!

Photo of Julie CollinsJulie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Seniors) Share this | | Hansard source

Sorry, Mr Deputy Speaker. We all know the impact that is happening. Of course, the health workers in the Royal Hobart Hospital system are really struggling to meet demand. They're doing their absolute best but they are under enormous stress. It's got to the point where the AMA has said:

Cuts to hospitals’ budgets will see patients not receiving the care they need when they need it and elective surgery patients having to wait longer for their operations, putting lives at risk.

Simon Judkins, the ACEM president has said:

This is pushing the hospital and its patients to the edge of a cliff.

The current state government has told the Royal Hobart Hospital staff to brace for $50 million in further cuts. How can Tasmania possibly sustain this? It is not okay. I see the health minister walking out of the chamber; he's not even going to stay for the rest of the debate about the health system! I can't believe that he would just walk out like that. This is outrageous.

We've seen the higher out-of-pocket costs which the member for McMahon talked about. This really impacts on areas like Tasmania, where people are on lower-than-average incomes. If you can't afford those out-of-pocket costs you put them off. You simply don't go to the doctor. You don't do it; you wait until you are really, really sick and then you end up in an emergency department. We can see that that's what's happening in Tasmania all the time.

It's the same with specialists. Specialist waiting times in Tasmania are outpatient waiting times through the Royal Hobart Hospital because people can't afford to go to a specialist and pay the out-of-pocket costs. To give the House an idea: for a neurology outpatient waiting list, the average wait is 202 days. In gynaecology, the outpatient waiting list is an average of 154 days. This is just before you see the specialist; you then have to wait for any surgery on top of that. This is just for getting in to see a specialist. How, in Australia, when we are such a wealthy nation, is this allowed to happen, particularly under what is supposed to be a universal healthcare system? It is not universal when people are making decisions not to access services because they simply cannot afford them.

When this government talks about, 'If you have a go, you get a go,' that's clearly not happening to those Tasmanians who want to access the health system. It's clearly not working for those Tasmanian workers in our health system who are struggling with the demand, who are struggling with underfunding and who are becoming more and more stressed as the system becomes more and more stressed, as the hospital is put on high alert and codes almost daily because of what is happening in the hospital. It is simply not okay.

During the campaign, we had the members for Bass and Braddon, while they were candidates, going out there and talking about how they were going to do more for health in Tasmania. Well, it wasn't true; they were not telling the truth. They should come into this place and explain to Tasmanians exactly what is happening to the health system in Tasmania and how they're going to fix it.

3:44 pm

Photo of Andrew GeeAndrew Gee (Calare, National Party, Assistant Minister to the Deputy Prime Minister) Share this | | Hansard source

Don't they love the big lies about health on that side of the aisle? The very poor contributions we've heard from those opposite today reflect the fact that they have learned absolutely nothing from the recent federal election. They still now in this place seek to peddle the same lies and deception they peddled during the federal election campaign, which have been repudiated and rejected by the electorates of Australia in the country and in the cities.

What was endorsed and backed at the last federal election was record funding for public hospitals right across Australia, including in country Australia and in Central West New South Wales. It has gone from $13.3 billion in 2012-13—that's record spending for our public hospitals and real results on the ground—up to $21 billion in 2018-19 and rising to $26.2 billion in 2022-23. That record funding for our public hospitals was overwhelmingly endorsed at the last federal election in the face of the big lies and the big scare campaigns. Remember we had the Mediscare campaign. Then they tried to run a big scare campaign on health, where they said funding to public hospitals had been cut, but this record funding was endorsed right across New South Wales and Australia.

Indeed we saw terrific results in all country seats, particularly in New South Wales, where the margin in Calare rose to 63.29 per cent on a two-party preferred basis, a great increase in the margin. In Riverina it rose to 69.48 per cent; in Lyne, 65.17 per cent—wasn't that a terrific result!—in Parks, 66.91 per cent; Cowper, 56.79 per cent and a great new member; in Page, a terrific result, up 7.51 per cent to 59.45 per cent; and, in New England, a very healthy 64.36 per cent. But, in spite of all those increases, we need to make mention of the gold medal performer in the last federal election, the record breaker

Photo of Alan TudgeAlan Tudge (Aston, Liberal Party, Minister for Population, Cities and Urban Infrastructure) Share this | | Hansard source

Who was that?

Photo of Andrew GeeAndrew Gee (Calare, National Party, Assistant Minister to the Deputy Prime Minister) Share this | | Hansard source

It was our very own member for Hunter. The member for Hunter was a record-breaker. He was the face of country Australia for those opposite and he actually recorded the highest swing against any sitting member in the current parliament. It went down to 52.98 per cent, a drop of 9.48 per cent. I think that shows that those opposite took policies of lies and deception to the last federal election, which were repudiated by electorates right around Australia, but particularly in country Australia, where on the one side of the ledger the National Party, with all these healthy margin increases and our record spending on hospitals, was endorsed, yet those opposite, including the member for Hunter, suffered what I would have to say are pretty embarrassing swings against them.

Against this we have some wonderful projects happening right across country Australia including, for example, the Murray-Darling Medical Schools Network. In the seat of Calare it was $22 million for the school that's going to be operated by CSU and WSU. Folks in this House know all about it. It's going to be training doctors for practice in the bush for generations, building the next workforce for country Australia. We have the $18 million world class medical research facility which is going to be built in Orange, which, again, is going to be operated by CSU and WSU. That facility is going to bring together the best researchers in rural health and rural medicine.

Let's not forget mental health—very important for people in country Australia and particularly so in the face of this devastating drought. The government has boosted mental health funding by $73.6 million, with $46.1 million focused on addressing youth mental health and suicide prevention. In the wonderful city of Lithgow in our seat of Calare we're just about to open a new headspace facility to support better mental health outcomes for young people. That was following an investment of over $1 million by the government, spearheaded by the Minister for Health, who really understands what country Australia is all about. Those opposite have perpetuated lies. They seek to do it again now, and those lies have been repudiated.

3:49 pm

Photo of Emma McBrideEmma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | | Hansard source

The member for Calare has just done a victory lap, spruiking the margins of his colleagues in their electorates. What does that have to do with regional health care? Have you looked at the figures in regional health care—the delays in seeing services and the delays to access? Have you seen that? I worked at Wyong Hospital in a regional community in my electorate in my area for over 10 years. I worked in the inpatient mental health units. I invite the Minister for Health, Minister Hunt, to come with the opposition health spokesperson, Chris Bowen, and me to visit Wyong Hospital and see the conditions of people's lives and why they end up in emergency departments waiting before they end up in mental health inpatient units. In my electorate of Dobell on the New South Wales Central Coast, people are doing it tough under this government. We have over 21,000 age pensioners and a youth unemployment rate sitting at 18 per cent. It is young families and older people that most need health care. And where is funding being ripped out of health care? In regional Australia.

What people in regional Australia deserve is good, strong representation and a minister who cares about them and our community, not about spruiking PBS listings. One thing about spruiking PBS listings that particularly disturbs me as a pharmacist is: what about people delaying or avoiding filling prescriptions? You can spruik listing any drug on the PBS, but what if people can't afford to fill prescriptions? That is particularly a problem in regional Australia. According to ABS data, one in 14 people—seven per cent of people—avoid taking prescribed medicine due to cost, and we know the rate of people skipping prescriptions is twice as high in the most disadvantaged areas as in the least disadvantaged; it is 10 per cent of people in the most disadvantaged areas. This means that the cost of medicines is contributing to healthcare inequality in Australia. You can spruik listing PBS drugs, but if people can't afford them then someone will delay or avoid filling a prescription. I've been there in an outpatient clinic, where a mental health patient said to me, 'Which medication can I do without?' These are real people with major mental health problems who need proper support, and they're having to make this decision that no-one should have to make: 'Which one can I skip? Which one can I delay?' People are sometimes taking medication every second day, or they might get one prescription filled one month and another prescription filled another month. This is the state of health care in regional Australia. This minister just does not get it or does not care, and I haven't even got to vaccines, the national immunisation program and the outbreaks that are happening in communities yet. This minister is neglecting regional and rural Australia.

I'd like to give you an example. The minister was spruiking MRI licences yesterday. The hospital in Wyong, where I worked, has a shell in the new redevelopment plans. The Liberals tried to privatise this hospital. First they tried to sell it off. Now they're going to introduce paid parking when there is no public transport. We know that in the redevelopment plans there is a shell for an MRI machine but no Medicare licence for an MRI machine. Elizabeth Polson from Tumbi Umbi wrote to me about a recent emergency trip to Wyong Hospital, and I say this with respect to the staff who work there; it is the strain they're under. She had to have a CT scan at the hospital but needed further scans. She was waiting, and she had to be transported by patient transport to another MRI provider because she couldn't have it at the hospital. While she was waiting, this is what she witnessed. She was saying that people were in dire circumstances. Another person, Linda, sent an email to me while she was sitting waiting in an emergency department:

I'm currently sitting in the emergency waiting room at Wyong hospital, we are now into our third hour here, my daughter just had an X-ray for her leg, we were put back out into the waiting room because "there's no doctors to see her X-ray we don't have one to look at it yet.

She further describes 'outrageous treatment sitting here near whilst a grown man lays on the floor vomiting for more than two hours of this time'. This is what this government thinks is acceptable. I repeat my invitation for Minister Hunt to come and visit regional hospitals like Wyong—emergency departments or mental health inpatient units—and see the circumstances of people's lives and the results of the government's policies not just in health care but in education, transport and housing, which lead to people being in crisis and ending up in emergency departments or having long stays in public hospital inpatient units that are under strain and are not properly resourced, with staff who are ending up at risk of burnout. The government must do better.

3:54 pm

Photo of Andrew WallaceAndrew Wallace (Fisher, Liberal Party) Share this | | Hansard source

The topic of today's matter of public importance is as short on words as it is on substance. It's as short on words as it is on fact. The previous speaker spoke about the so-called state of health care in the regions. Now, I come from regional Australia—I come from the Sunshine Coast—and I think I'm fairly well placed to speak about health care from a user's perspective.

Yesterday, today and tomorrow, each and every single day, eight Australians will take their own lives. Usually, on average, five men and three women will take their own lives. For every one person that takes their own life, 24 will attempt it. This is an absolute scourge on our society. In fact, I'm sorry, I've inadvertently misled the House: it's not 24; it's 32. Thirty-two people will attempt to take their own lives for every one person that does take their life. We, as members of this House, must always remember that mental health should be above politics.

I want to commend and set out some of the things that this Minister for Health has done in relation to mental health. In my own electorate, because that's the one I understand the most, he's done some incredible things. He's provided $7½ million of funding for the Thompson institute, a neuroscience research centre that conducts research and provides clinical care for people who suffer from dementia and for people who are in youth mental health and suicide prevention programs. The Commonwealth has funded that, through this health minister, for three years. He's provided funding of $12 million to build a residential facility for families of people having to be treated at the Sunshine Coast University Hospital. He's provided $6 million for the construction of Australia's first residential eating disorder facility.

I see the member for Sydney raising her eyes there. Australia has not had one residential eating disorder facility. When you look at other countries around the world, we know that the best form of treatment for people with eating disorders is a dedicated residential facility.

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

The member for Sydney on a point of order?

Photo of Tanya PlibersekTanya Plibersek (Sydney, Australian Labor Party, Shadow Minister for Education and Training) Share this | | Hansard source

I'd like the member opposite to withdraw his reference to me. I was not listening to him or responding in any way to what he said. I was not even facing him, so I don't know how he would have seen my face.

Photo of Andrew WallaceAndrew Wallace (Fisher, Liberal Party) Share this | | Hansard source

I'll withdraw. I thought I saw her raise her eyes at the sky, but I'm happy to withdraw that.

EndED Butterfly House is building Australia's first residential eating disorder facility. Eating disorders are a scourge on our community, and, for the first time, the federal government is really stepping up to the plate and providing funding to address that scourge. The Sunshine Coast is becoming the epicentre for the treatment of eating disorders. A $3.2 million pilot for the treatment of eating disorders commenced there.

The federal government rolled out a program for treating eating disorders and listed it on the Medicare Benefits Schedule, giving it a benefit number. It's providing 20 psychotherapy sessions for less complex eating disorders and up to 50 psychotherapy sessions for people with anorexia nervosa or other complex eating disorders. This government will invest another $110 million to roll out these programs right across the country. So it's not just a matter of what's happening in my electorate; it's happening right across the country.

4:00 pm

Photo of Tony ZappiaTony Zappia (Makin, Australian Labor Party) Share this | | Hansard source

The health system is failing Australians and the facts don't lie. On 15 March this year, one of my residents wrote a five-page letter to the health minister, in which he referred to the failings, incompetence and blunders relating to medical treatment for himself, his wife and his two adult daughters. I'm happy to make that letter available to the minister if he needs it. I don't know whether the minister has responded to that letter, but it clearly articulates and outlines everything that is wrong with Australia's health system. Sadly, his youngest daughter has died.

I understand that the responsibility for health services in this country is shared between state and federal governments, but the reality is that the buck stops with the federal health minister if we're going to get national changes to the services available to people. I heard the minister talking about Medicare bulk-billing rates. Minister, there is a vast difference between the rates, in terms of the services that are billed, and the number of people, in terms of the percentages that are being bulk billed for their treatment. Indeed, I refer the minister to an article written by Jennifer Doggett on 17 July which clearly outlines what the real situation is.

I turn to my own home state of South Australia, where elective surgery waiting lists have blown out to, in many cases, over two years. I regularly get people from my electorate coming to me for assistance to try to speed up the wait for surgery they need, because they are getting desperate. The South Australian state government, now desperate, wants to outsource elective surgery to the private system because the public system simply cannot cope. If that doesn't tell you exactly what's going on, then nothing else ever will. The reality is that that is happening right around Australia. We could go to the public dental services as well. The same applies there, where waiting lists are simply unreasonable and people have to wait for months and months before they get the treatment they need. I haven't even touched on the mental health services, both in South Australia and across the country, which are exactly the same when people are wanting to get the services they need.

I want to turn to another critical issue: that hospitals, because they cannot cope, are discharging patients before they should be getting discharged. There was a case in South Australia only a couple of months ago where a person died as a result of being discharged when they shouldn't have. That case is now before the state coroner for investigation.

I'll turn briefly to rural health in the time I have left. The front page of Adelaide's Sunday Mail last weekend talked about, effectively, the crisis in getting health professionals into country South Australia. There is a shortage, with 60 doctor positions that are unfilled and have been unfilled for months and months. It is unlikely that those positions will get filled in the near future. Again, that means that the people in those areas are not getting the services they need. They are predominantly in the electorate of the member for Grey, who is in the chamber. I'm sure he would be well aware of what's going on in his electorate.

One of the solutions to all of that was presented last night by a refugee who came to this country, Aseel Yako. He came from Iraq as a refugee and was a practising doctor in Iraq for 20 years. He had experience and expertise but had to navigate an absolute minefield just to get his credentials recognised in Australia so that he could go and practise. After a long, long period and after going through all the obstacles he needed to go through, he finally got work at the Warragul hospital in the electorate of the member for Monash, who, can I say, spoke beautifully about this person at the launch of the book Refugee Stories: In Their Own Words.

The whole argument is that if there are people out there who are willing to work in the country areas, why don't we do something about making their pathway a lot easier? Can I say to the members opposite who keep talking about their response to rural health needs: you've been in government for six years. Your 10-year plan means it will be 16 years at best before anything is really done for the people in country Australia. Quite frankly, none of the ministers who are making that claim will even be here to be held to account for promising the people in rural Australia the services they need.

4:05 pm

Photo of Rowan RamseyRowan Ramsey (Grey, Liberal Party) Share this | | Hansard source

This is an important motion. We should be debating the level of services in Australia.

I think those who have brought the motion forward don't have a great record in this area. They were, of course, the party that brought us the 'Mediscare' campaign in 2016, when they said that those on this side, the government, were going to sell off Medicare. In fact, we've lifted the funding by 75 per cent, and we've guaranteed the future of Medicare. So that was completely misleading.

But it is an issue. As our population expands and ages, the demands on our health services become greater. That is why I am so very pleased that the government is up to the task, because we are lifting the taxpayers' contribution to health, and we are undertaking many innovative things within the system to bring about a better outcome.

In fact, from when we came to government in 2013, the hospitals budget has risen from $13.36 billion to a projected $26.2 billion by 2022, which is a doubling—a doubling of money for these services. That's well, well in front of CPI or even medical inflation. So we are making a significant contribution. It is about actually getting value for money, where we have to concentrate.

As to bulk-billing, I heard conversation coming from the other side about the ever-increasing size of the gap. But they should be very pleased, at least, that the number of people paying the gap is falling, because 86 per cent, up from 82 per cent, of Medicare charge items are being bulk-billed.

I also want to speak a bit about mental health, and I'm indebted to the former speaker who spoke about mental health issues. This is a very important thing. We are lifting expenditure in the mental health field over the forward estimates by $736 million.

In my electorate of Grey, mental health services are delivered by the primary healthcare network. I've told this House before—and it's something I'm very proud of—that when the former Minister for Health, Peter Dutton, was the minister there was a proposal that there be one primary healthcare network for South Australia, and I put the case that I thought that, under any circumstances, a dedicated country primary healthcare network would be far better. I'll always trust people in the country to make decisions about things in the country, far more than somebody making decisions about the whole system. In fact, that has put more than $31 million back into the electorate of Grey since the 2015 start-up, largely dedicated to mental health.

In 2013, when we came to government, there was one headspace unit in Grey. There are now four. Since that time, we've managed to get funding for a unit in Whyalla and another in Port Lincoln, and we now have a flying headspace, operating with the flying doctor out of Port Augusta. It's a wonderful outcome.

I now want to touch on doctors and the member for Makin's comments before. He is quite right: we have a crisis as to rural doctors in South Australia. We are more than 30 short in my electorate of Grey. It is something that I have been waxing on ever since I got to this place, because I had been, as a member of hospital boards and hospital associations before I got to this parliament, dealing with the issue of trying to get doctors to work in the country for many years before I came here. There are no easy answers, Member for Makin. And I'm thankful that the government is actually recognising the issues and providing $550 million for the rural health strategy, and delivering a dedicated string of rural medical school networks to try to increase that supply. But the problem, with doctors in the country and doctors generally, is that it's like trying to turn the Queen Mary around—it really takes a long time. Once you start putting things in the pipeline, you're talking 10 to 15 years before you get the results, and we've got a crisis now.

I've spoken many times about this issue in the parliament and have put forward the proposal that we need to move to postcode-specific Medicare provider numbers in Australia. Why we allow people to set up business virtually wherever they like, when 90 per cent of their income or thereabouts is coming from the taxpayer, is beyond me. In fact, I warn now, and I have warned before—and I think we're already in that case—where we are seeing— (Time expired)

4:10 pm

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

I know quite a lot about health and health care, and this is indeed a matter of major public importance. In my maiden speech, I spoke about the difficulties of access to health care and what drove me to want to represent my community in federal parliament—to try and improve access to health care. I can speak for hours about this. There is no doubt that there is a crisis. Issues Australians face in accessing health care are getting more and more difficult. Gap costs are rising exponentially, such that many people—many working class people, many people on moderate incomes—cannot afford to access good health care in my electorate.

I'll just give you a couple of examples. Recently I was approached by a constituent, Alan, an elderly gentleman who required an MRI scan of his abdomen because of an abdominal mass. He had an implantable pacemaker present and required an MRI scan to be done at Liverpool Hospital, a public hospital. He was going to be charged $900 for this—no refund. He couldn't afford it and wanted me to contact the health service to see if we could change anything. They refused. He had to borrow $900 from his son to pay for it.

I was contacted recently by Mary, a lady who sustained a spinal injury in a severe motor vehicle accident and was incontinent. There is no public urological clinic in my public hospital, Campbelltown Hospital. So she had to see someone privately and could not afford the $500 fee. She wanted me to ring the urologist to see if he would bulk-bill her. He usually never bulk-bills anyone but he was able to do this because I rang him. I was also contacted by Daphne, an elderly lady with chronic heart failure. She couldn't get in to see a private cardiologist because, once again, we have no public cardiology clinic at my public hospital. She had to see someone privately and she couldn't afford the $600 gap fee for an ultrasound and consultation.

As you can see, everyday people are facing these huge access issues, with huge gap costs to get in to see doctors, general practitioners and specialists. Gap costs for specialists have absolutely skyrocketed. I can tell the House, as a doctor, that I'm ashamed to see people in the 21st century in Australia struggling to access good health care. We're heading towards an American style health system, and that is a huge shame. This government and this health minister seem to be quite glad to allow this to happen.

We've even seen huge cost-shifting exercises in New South Wales by the state government, with a gradual deterioration in public outpatient clinics—indeed, the public outpatient clinics should be seen as being in palliative care because they're so run down and it's so difficult for people to access public hospital care. Waiting lists are getting longer and longer and longer. According to the Australian Institute of Health and Welfare, a staggering three million Australians are putting off going to see a GP or specialist or getting tests done because they can't afford the costs. That is a great shame.

Recently I saw a pregnant lady—her doctor thought she may be pregnant with twins—but she was putting off getting the obstetric ultrasound until she could get in to the outpatient obstetric clinic, which would be when she was around seven and a half months pregnant, which is really far too late to be getting an obstetric ultrasound performed. It was a great shame.

Another area where we're struggling is private health insurance costs, which are beyond the reach of many Australians. More and more people are dropping out of private health insurance. It is indicative of the conservative politics in both state and federal systems, and particularly in New South Wales. The New South Wales government's answer to this is to privatise everything. The federal government's answer is to want to try and introduce a GP fee for every consultation, which will further punish those on low incomes. People are waiting longer than ever for elective surgery. For cataract surgery in my electorate, the wait is close to two years; for ENT surgery, it's about 18 months; and for even a simple test like a colonoscopy, it's over a year. It's a great shame. Public hospital outpatient clinics are just about dead. People are forgoing treatment. They're not getting the care they need, and it's this government's responsibility. (Time expired)

4:15 pm

Photo of Katie AllenKatie Allen (Higgins, Liberal Party) Share this | | Hansard source

I'm delighted to stand here after my first speech to speak on behalf of the fact that we as a government are delivering on health care. We're delivering in so many ways, and I'm very proud of the fact that Minister Greg Hunt has made some fantastic announcements in the lead-up to the most recent election. We've made a record investment in hospitals and in bulk-billing, and we have a Medicare guarantee. With regard to record hospital investment, the federal funding for public hospital services under the Liberals and Nationals government has increased from $13 billion in 2012-13 to $21 billion in 2018-19 and to $26 billion in 2022-23. Those are the facts. The facts speak for themselves. This means more hospital services, more doctors and more nurses.

We on this side of the House understand that investment in health is so important, but we also understand that Australia has one of the best healthcare systems in the world. It is true that we can always do better. In fact it's important that we do better, and we are doing that with record health investment and record investment in bulk-billing. With an increase of four per cent in bulk-billing in the period of time that we've been in government—with over 133 million free GP services delivered last year; 27 million more than in Labor's last year in government—I can proudly say that we've increased our GP bulk-billing rate to 86 per cent from 82 per cent in Labor's last year in government. These are important facts that speak for themselves. We've also delivered the long-term future of Medicare. This is incredibly important for those who need a Medicare Guarantee Act and ensures that we have sufficient funding to reduce the cost of diagnostic services, including ultrasound and x-rays, for patients. If you can't manage the economy, you can't manage health. But I'd like to say that I'm particularly delighted with the increased attention that this federal government has given, in this term of government, to two areas. The first of those is mental health. The second is something that's very dear to my heart, and that is medical research.

We all know someone who has been deeply affected by mental health issues. Mental health is such an important area to invest in. The government is boosting mental health funding by $736 million, with $460 million focused on addressing youth mental health and suicide prevention. Yesterday in my first speech, I talked about how mental health had touched my family very deeply, and I know it has touched so many lives in Australia and around the world. But the high rate of suicide, particularly among young people, is a national tragedy. We need to recognise the causes of suicide and that they are complex and extend into social services and finances. Our Prime Minister has recognised this and he has made suicide prevention a key personal priority by creating a suicide prevention coordinator in his department to coordinate suicide prevention initiatives across the whole of government. This is a very, very welcomed initiative. The $460 million that is committed to youth mental health and suicide prevention includes investment in headspace networks, including one in Higgins, I'm delighted to say, which will be very important since we have a very large population of young people. We also have a very large population of the LGBTI community who, unfortunately, are a vulnerable population when it comes to this particular area. I'm also delighted to say that $152 million will be used to reduce wait times at headspace centres around the country; $2 million will be invested in the Young Ambassadors for Mental Health project; and $110 million will be used to continue the Early Psychosis Youth Services program at 14 headspace centres. These are very important initiatives which are really seeking to address what is a particularly important problem for our young in our community. Our government is leading the world in addressing eating disorders, with a $115 million announcement in December, for the first time, for centres for severe eating disorders. This really is an international first.

In my remaining few seconds I'd like to say medical research is such an important area to invest in, and I'm incredibly proud to be part of a government that has delivered the Medical Research Future Fund, which is a world first.

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

I thank the member.