House debates

Monday, 2 March 2020

Private Members' Business


12:33 pm

Photo of Vince ConnellyVince Connelly (Stirling, Liberal Party) Share this | | Hansard source

It's a real pleasure to rise today and just provide a little reminder of something that I sense that many Australians, at times, can take for granted. Of course, I'm speaking about the wonderful system of Medicare. In our wallets, we carry around with us a little green card, and on that Medicare card are listed our names and the names of those who are dearest to us. Should we need any medical assistance, it's wonderful to know that we have that safety net available.

I was one of six children, so, when I first got my name on a Medicare card, there were eight members of the family in total. I was roughly in the middle, so you can imagine, Mr Deputy Speaker, my excitement when I had a wife and a family of my own and I thought, 'This is great; I'm finally going to move up the card.' So I sat there with my wife and we were doing the paperwork for the card, and of course my wife said, 'No, honey, I'm going to be No. 1 on the card.' I should have noted that as a sign of things to come in our relationship, but of course my lovely wife Peta is No. 1. I know we can't really use props, but there's the wife at No. 1 and the rest of us further down the card.

It's wonderful, as I said, to know that this safety net exists. People right across Australia, including all of the families and individuals in the wonderful electorate of Stirling in Western Australia, where I'm from, take comfort in this system. More Australians are now seeing doctors without having to pay them than ever before. In fact, nine out of 10 visits to a GP are free.

The Liberal-National government has guaranteed the long-term future of Medicare. Our Medicare Guarantee Act guarantees Medicare and the Pharmaceutical Benefits Scheme via legislation. The Medicare Guarantee Fund, established in 2017-18, ensures Medicare has the first call on income taxes each and every year. We're increasing the Medicare funding every year—up from $19½ billion in 2012-13 to $26.1 billion in the current financial year and up to $30.7 billion in 2022-23. That is funding to ensure we can continue to provide individuals and families the great comfort that comes with knowing Medicare is a safety net that is there for all of us. This government has also increased the Medicare rebate for important diagnostic services like X-ray imaging and ultrasounds. This ultimately reduces the cost to patients. Patients made 136½ million bulk billed GP visits in 2018-19. This is up by more than three million GP visits on the previous financial year.

I have found some particularly interesting statistics which demonstrate just how heavily Australians rely on the Medicare system. In a report released in August 2018 the Australian Institute of Health and Welfare found that more than half of all patients—11 million people—incurred no out-of-pocket expenses for non-hospital Medicare services in 2015-17. That is an impressive statistic indeed. In that same financial year, the vast majority of patients—18 million, or 82.4 per cent—were bulk billed for more than half of their visits to their GP.

I am also pleased that this government has really taken steps to recover a lot of the elements of Medicare that fell along the wayside under Labor's previous record. In fact, Labor had started a freeze that we ended. Labor had stopped listing medicines whereas we guaranteed the listing of medicines. The indexation of the Medicare Benefits Schedule, which this government introduced, is delivering an additional $1.7 billion, including 90 per cent of diagnostic imaging items, for Medicare services. Medicare funding is up—from $19 billion under Labor to $25 billion per year in 2018-19, $26 billion in 2019-20 and expanding out to $29 billion in 2021-22 under the coalition government.

12:38 pm

Photo of Patrick GormanPatrick Gorman (Perth, Australian Labor Party) Share this | | Hansard source

I love Medicare. When you are facing a global pandemic, I think every Australian would recognise just how lucky we are to have a public health system that allows all Australians to access health care regardless of their income or station in life. It is something we are truly lucky to have. As we are talking about current health challenges, I want to take this opportunity to thank all the health professionals who are protecting and helping people suffering from the coronavirus. Thank you to the doctors and nurses, the orderlies and the cleaners. Cleaners are the unsung heroes of our health system. Without cleaners you don't have a hospital, you just have a disease factory. Thank you to everyone in our hospitals who works to makes sure everyone in our hospitals is fed and thank you to everyone who works in hospital administration. My grandmother Pat worked in hospital admin at the Charlie Gairdner hospital in Perth for many, many years. It takes a village to run a hospital, and I want to thank every single person who is probably working a little more than they would have expected as a result of some of the health challenges our nation and the world faces.

As a child, I was a chronic asthmatic. I was in and out of hospital more times than my parents can count. They probably broke most of the traffic codes rushing me to and from hospital at different times. I'm so grateful that as a child I grew up under Medicare, that I grew up in Bob Hawke's Australia. I believe that Medicare is one of Australia's greatest public policy achievements. It is, in my view, more Australian that Vegemite. It's something that didn't have an easy start in life—poor Medicare—and it is something that we have had to fight to defend, time and time again.

I'm going to go through some of the history of Medicare. In 1975, the Whitlam government introduced Medibank, described by then health minister Bill Hayden as 'the most equitable and efficient means of providing health insurance coverage for all Australians'. But then from 1976 till 1983 we saw systematic destruction of the Medibank system by the Fraser government. In 1978 they made health insurance optional, effectively ending universal health care. Medibank Private was set up. Hospital agreements with the states and territories were ripped up and bulk-billing was restricted to just pension card holders. Thankfully, in 1983 the Hawke Labor government, as one of its first acts, began rebuilding the Medicare system and on 1 February 1984 restored Australia's universal healthcare system.

This motion has some interesting facts in it. The member for Stirling earlier mentioned facts and how important they are. I note that the member for Stirling failed to mention the five-year Medicare freeze that his government instituted. We also know that, while the member for Lyne has told us that 86.2 per cent of GP services are bulk-billed, the Australian Medical Association and the Royal Australian College of General Practitioners have themselves told us that these figures are misleading. They're calculated on services rather than on patients. A more honest figure is the one provided by the Royal Australian College of General Practitioners suggesting closer to 66 per cent of GP patient consultations are bulk-billed. The Department of Health's own data shows that in 2018-19 just 52.7 per cent of patients in the Perth electorate were bulk-billed when they visited their GP. Surveys show that only 23 per cent of GPs bulk-bill all their patients and that figure is going down and down and down.

When we think about the sorts of things that happen when people can't afford to visit their GP, it might mean that they actually end up costing our health system more, something that could have really catastrophic effects as we face global pandemics like the coronavirus. I will never let this government forget that in the 2014 budget of cuts and charges of the Abbott-Turnbull-Morrison government—and I'll give Joe Hockey an honourable mention as well—they attempted to introduce a $7 co-payment for GP visits. That was a terrible idea. It wasn't means-tested; it would have captured all patients. It would have captured children, pensioners, the chronically ill and people on Newstart. It was a terrible idea, all because of an ideological obsession with sending a price signal.

We know that the privatisation agenda of this government doesn't stop when it comes to sending price signals, to Medicare freezes, or to co-payments. We've just recently seen the government thankfully back down on their plans to privatise the Aged Care Assessment Team process— (Time expired)

12:43 pm

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

I want to thank and acknowledge my colleague the member for Lyne for moving this motion. I'm very pleased to speak in support of it today. The Morrison government has an unwavering commitment to Medicare and has demonstrated this commitment by guaranteeing its long-term future through legislation. Through the Medicare Guarantee Act, providing funding for Medicare, along with the Pharmaceutical Benefits Scheme, will now be the top priority for any government into the future. We know why this is necessary. It is because, under those opposite, Medicare, the Pharmaceutical Benefits Scheme, our hospitals funding and bulk-billing really did not keep up with the expectations of the Australian people. That's why we have acted to make sure that all of these services are properly funded.

We are increasing Medicare funding every year, up from $19.5 billion in 2012-13, to $26.1 billion in 2019-20, to $30.7 billion in 2022-23. Increased funding has turned into better health outcomes for patients. More Australians than ever are visiting the GP, with no out-of-pocket expense. Over 136 million free GP services were delivered last year, an astonishing figure, and 30 million more services than when the Labor Party were in government. This translates to a bulk billing rate of 86.2 per cent, up from Labor's 82.1 per cent when in government.

The rate of bulk-billing for specialist attendances has also increased. Important diagnostic services, including ultrasound and X-ray imaging have seen Medicare rebates increased under the Morrison government, bringing down costs to patients. Reducing the payment required for these essential services helps in bringing down the cost of living for all Australians. Despite what you may hear from those opposite, Medicare has no better friend than the Morrison government.

An important part of our Medicare system is the Pharmaceutical Benefits Scheme. The PBS plays a significant role in the treatment patients receive following their visit to a GP, specialist or hospital. It allows affordable medicines to be accessed by every single Australian, the costs of which would otherwise be astronomical and completely unaffordable for so many people. Since we on this side came to government, nearly 2,300 medicine listings worth around $10.9 billion have been added to the Pharmaceutical Benefits Scheme—that is, 2,300 medicines which may have been out of reach for most Australians otherwise. These recently added medicines help people suffering from cancer, heart disease, epilepsy, spinal muscular atrophy and severe asthma. Through these additions, we have provided 3,000 women, for example, with breast cancer access to the drugs Ibrance and Kisqali, which, without the PBS, would have incurred an annual cost of $55,000 and $71,820 respectively. By subsidising Spinraza, Australian families are being spared having to spend $367,850 per year to care for their children with spinal muscular atrophy. This is genuinely life-changing stuff.

In stark contrast, unfortunately, during the last Labor government, we witnessed the unprecedented deferral of medicines, and the government at the time said: 'The listing of some medicines would be deferred until fiscal circumstances permit.' The Morrison government, in comparison, understands that funding the PBS is vital for all Australians and that the only way for us to do this is through a strong economy. Only a coalition government can deliver an economy that allows us to not only fund medicines currently on the PBS but to continue to grow the scheme into the future.

There is also under the Morrison government record funding for public hospital services, which will see an increase from $13.3 billion in 2012-13 to more than $29 billion in 2024-25. Our new five-year national health reform agreement will deliver $31 billion in additional public hospital funding from 2021 to 2024-25. This means more hospital services, more doctors and more nurses. We know that the most pressing health concerns for Australians change over time. As new technologies and treatments are brought into the system, issues that were once seen as a top health priority may no longer have such an impact on local communities and this is why we have developed the Medicare Benefits Schedule review. We want to make sure that taxpayers' hard-earned money is being spent exactly where it needs to be to deliver the most benefit for those most in need.

I just want to say again that the Medicare system provides all Australians with world-class health care and I'm very proud that the Morrison government is supporting.

12:48 pm

Photo of Sharon ClaydonSharon Claydon (Newcastle, Australian Labor Party) Share this | | Hansard source

Labor is the party of Medicare. We created it and we will fight to the death to protect it. But on the other side, there has been equal and opposite vehemence against public investment in health. In 1975, the Whitlam government made the historic introduction of universal health care to ensure that your access to health care was never to be determined by your postcode or your bank account. Since then, whenever we've had a coalition government in power, the principle of universal health care has always been under siege.

The Fraser government axed Medibank in 1981, only to have it restored as Medicare by the Hawke Labor government. Then opposition leader John Howard went to the 1987 election promising to continue the Liberals' attacks and a return to the user-pay system, only to be cowed into submission by the clear message that voters sent. However, the next Liberal government, the Abbott government, returned to form with the ongoing Medicare freeze and any number of short-sighted plans to impose a co-payment on patients. The next Prime Minister was Malcolm Turnbull, who removed incentives for bulk-billing in pathology and radiology. And he continued the Medicare freeze on top of $57 million worth of cuts to hospitals, which brings us to today.

The Morrison government, like every other Liberal government that preceded it, is no friend of Medicare. Indeed, Scott Morrison decided to kick off 2020 with a fresh round of cuts to Medicare's bulk-billing. Newcastle is one of the 14 areas he has targeted. The government encourages GPs to bulk-bill vulnerable patients by paying them for each time they bulk-bill. It's called a bulk-billing incentive payment. In my home city, of Newcastle, and in the neighbouring towns of Maitland and Kurri Kurri, Scott Morrison has slashed this payment, which is estimated to cost our region as much as $7 million.

I have met with a number of local GPs and Hunter primary care representatives to discuss the impacts of these cuts. They warned me that some GPs will have to stop bulk-billing children, pensioners and other concession payments, or close their doors entirely. I have also received extensive correspondence from my constituents, and I'd like to put some of their concerns on the record today. Firstly, I heard from Dr W, who, as a GP, knows better than most just how damaging these cuts will be. In her email to me, Dr W summed up the problem perfectly when she said:

Having access to primary care without cost to a patient who would otherwise be unable to afford care is one of the pillars of a sound and well-functioning health system. This aspect of the rural health strategy is robbing Peter to pay Paul, at a time when General Practice is already under substantial funding pressures.

These sentiments were echoed by Dr G, who said:

Our business is a local employer, and provides a vital function to the community. We also ease the congestion experienced at our hospitals by providing the first line triage. This latest change will significantly reduce our capacity to perform this role as we will have to reduce our staff numbers to keep the doors open.

Or there was Mr C from New Lambton, who also wrote to me to say:

There will be new sneaky cuts to Doctors in 2020 that will in effect, cut most if not all Bulk Billing in the Hunter and Newcastle areas. Surely this is about an attack on the Medicare system to reduce it bit by bit, and finally achieve what they set out to do a few years back.

I hope that you and the Labor Party can do something to stop these cuts along with keeping the Liberal Party to account.

Well, Mr C, I will do my absolute best. I have written to the minister about this on many occasions. I have repeatedly urged him to reverse this damaging change and to stop disadvantaging my community.

Soon, I will launch a broader community campaign against these cuts. In the meantime, I've set up a petition on my website, and I encourage anyone who is concerned about the Liberals' ongoing attacks on Medicare to register their opposition by signing it. Labor will always fight to protect vulnerable Australians and will always fight to protect Medicare.

12:53 pm

Photo of Gladys LiuGladys Liu (Chisholm, Liberal Party) Share this | | Hansard source

I rise to support the motion put to this House that the coalition government's commitment to a strong Medicare is unwavering. This is truly reflected in this year's record funding levels. There is much to celebrate when discussing the government's health achievements, and I will briefly outline some of this government's achievements.

We can celebrate that the Medicare bulk-billing rate remained high in 2018-19. This can be seen firsthand in my electorate of Chisholm, with the GP bulk-billing rate at 84 per cent. In fact, 833,759 GP visits were bulk-billed in Chisholm. This is staggering when we realise there were 145,000 more bulk-billed GP visits in Chisholm than in Labor's last year in government. I would like to note that all this simply would not have been possible without the record level of funding given to Medicare in 2018-19. The coalition committed $24.1 billion in 2018-19, which was an increase of 3.5 per cent in benefits paid.

There have been increases in the specialist attendances bulk-billing rate, up to 31.4 per cent. This is a great achievement and should be celebrated. The GP non-referred attendance bulk-billing rate is also up. It is currently sitting at 86 per cent. However, best of all, there has also been a total improvement in the Medicare bulk-billing rate, which now sits at 79 per cent. This is a great credit to the coalition government and reflects our commitment to Medicare.

I would like to take this opportunity to speak about a report released in August 2018 by the Australian Institute of Health and Welfare. This report found that more than half of all patients incurred no out-of-pocket expenses in 2016-17. This is a fantastic achievement and is tangibly making a real difference to the communities in Chisholm.

I am fortunate that my electorate office is located in the same building as a medical centre that bulk-bills. Regularly, I bump into my constituents when walking in and out of the office. I am often told of the high-quality care that they receive at the SIA Burwood Medical Centre. I have personally visited this centre and can attest to their professionalism. Bulk-billing facilities like these ensure that my constituents can receive prompt medical treatment with little to no out-of-pocket expenses. Let me also take this opportunity to mention the opening hours of the SIA Burwood Medical Centre. They are open from 8.30 in the morning to 11 at night every weekday, and slightly shorter hours on Saturday and Sunday. This is truly amazing and means that, no matter when, there is a GP available.

These incredible achievements are made possible by a coalition government. They are made possible because we are the only party that can balance the budget and make sure the money is there to fund Medicare. Let us not forget that, when in government, Labor refused to list life-saving drugs because, put simply, they did not have the money. Labor will always claim the moral high ground when it comes to health care, but, when push comes to shove, it is the coalition that backs Medicare and makes sure the money is there.

I want to thank the member for Lyne for bringing this motion to the House. I wholeheartedly support it. Making sure Australians have access to affordable health care is a commitment of this government, and we are delivering on that commitment.

12:58 pm

Photo of Pat ConroyPat Conroy (Shortland, Australian Labor Party, Shadow Minister for International Development and the Pacific) Share this | | Hansard source

It is utter hypocrisy from the Liberals to move this motion, and the last contribution from the member for Chisholm was mendacity incarnate. It was a mendacious contribution that bore little resemblance to reality. The truth is that the health of Australians is the No. 1 priority for Labor members of parliament, and the health of my community in Shortland is at risk due to the changes to Medicare that came into effect earlier this year. The Liberal Party abolished Medicare when it came to power in 1975 and took, to three separate collections in the eighties and nineties, a policy to abolish Medicare. The only change now is that they do it by slices rather than outright abolition. The GP tax was one example of their attempts to kill Medicare. We saw it only this year. On 1 January, the Morrison government cut bulk-billing incentives to doctors in the Hunter region and 13 other regions throughout Australia, making it harder for doctors to bulk-bill even those who need it most. Notices have gone up in doctors' surgeries saying they'll no longer be able to bulk-bill, and others have put up their fees. This isn't the fault of doctors or medical centres; this cut is simply one of many to Medicare by Liberal governments over the years.

The electorate of Shortland already has low bulk-billing rates. Less than 60 per cent of people are routinely bulk-billed, meaning two in five people in Shortland must pay every time they see a doctor. When they do pay, they are $37, on average, out of pocket for every visit, an increase of 38 per cent since 2013. If you have the misfortune of having to visit a specialist, it's even worse. Four out of five people aren't bulk-billed when they see a specialist, and the average out-of-pocket expense is $80. The cuts to Medicare bulk-billing centres will only make matters worse for my region. Unfortunately, the Lower Hunter combines some of the lowest bulk-billing rates with some of the highest rates of disadvantage. Windale and Mount Hutton are amongst the most disadvantaged communities in Australia, with particularly high levels of children living in poverty.

People living in these communities cannot afford to pay to see a doctor. Those who are already paying to see a doctor cannot afford to pay more. When people can't afford to go to the doctor, they do one of two things: they go home and suffer in silence, or they go to the hospital room and clog up our emergency departments, which is a much more expensive form of treatment. For those who go home, if their illness gets worse and they then present to hospital, that is much more expensive than seeing a primary healthcare provider, a GP.

I've been inundated with calls on this issue from people in my electorate—constituents such as an age pensioner who is a retired registered nurse. He was forced into retirement due to a chronic back injury. He needs to see his GP every month and says that, if his doctor did not bulk-bill him, he would no longer be able to afford to visit him. These appointments are crucial, as this is when this pensioner is provided with the prescriptions for his medication to help with his pain. Another pensioner, Cal, has rheumatoid arthritis and diabetes, and she's told me that her GP no longer bulk-bills. She can no longer afford to see a GP, so she will now have to find another doctor or medical centre who bulk-bills, which will be a challenge in my electorate, where 40 per cent of people do not have bulk-billing. This pensioner is extremely stressed about her situation, particularly if it means she must see different doctors at a medical centre and constantly explain her condition to someone new. It's not just pensioners who are worried. Families are struggling too. I heard from Karen, who says her family of five rarely visits a doctor due to the high cost and difficulties in finding a doctor that will bulk-bill. Even then, the out-of-pocket costs are too high for them. I also heard from a mother of two young children who lives off a single income. She said that, while seeing a GP is a must, it is currently a luxury due to the high cost.

These cuts to bulk-billing centres are unconscionable and are hurting the most vulnerable in our community. I have written three times to the health minister and am again asking him today: please restore the bulk-billing incentives to doctors in the Hunter. For the coalition to move a resolution bragging about their support for Medicare is hypocrisy. This party abolished Medicare when they came into power in 1975, they took policies to abolish it to three separate elections in the eighties and nineties, and we've seen attack after attack while they've been in power, whether it's the GP tax or the cuts to bulk-billing incentives that are going on right now in my region.

Medicare is the most popular institution in this country. It's the bedrock of public health in this country. It is essential to communities like mine that rely on Medicare access to get good health care. They rely on bulk-billing to see a doctor when they need it most. This is a vile attack on my community, and I will stand up to defend my community against these attacks.

1:03 pm

Photo of Angie BellAngie Bell (Moncrieff, Liberal National Party) Share this | | Hansard source

I welcome this opportunity to speak in support of the motion from the member for Lyne in relation to the LNP government's commitment to Medicare. I also defend the member for Chisholm and her delivery of her speech today in this place. The Morrison government is committed to Medicare and to ensuring that Australians are able to access the medical services they require. Under our government, Medicare bulk-billing rates for GPs and for Medicare as a whole continue to grow. The bulk-billing rates for GPs and for Medicare as a whole remained high in the 2018-19 July to March period. The GP non-referred attendance bulk-billing rate was 86 per cent, up from 85.8 per cent last year. The specialist attendances bulk-billing rate was 31.4 per cent, up from 30.9 last year. The total Medicare bulk-billing rate was 79 per cent, up from 78.7 last year.

In my electorate of Moncrieff, it's a very different story to the picture that the member for Shortland paints. The GP bulk-billing rate is 89 per cent. Last year, over 1,046,678 GP visits were bulk-billed in Moncrieff, 212,725 more than in Labor's last year in government. Australia has one of the best health systems in the world, founded on Medicare. These figures show that Medicare, under the Liberal-National government, supports the health and wellbeing of all Australians.

The Minister for Health has spoken about how the Medicare Benefits Schedule, the MBS, and the Pharmaceutical Benefits Scheme, the PBS, form a key component of primary health for patients. Beyond Medicare, the government is investing in hospitals to ensure that private health insurance remains affordable and continues to play an important part in our health system. Gold Coast University Hospital now receives record funding under our Liberal-National government. The government's hospital funding contribution to Queensland is growing 2½ times more, from 2.66 million under Labor to an estimated 6.79 million in 2024-25 under the Liberal-National government.

It's not good enough that the wait times for surgery have ballooned under Queensland Labor from 20 days to 80 days. When the new LNP state government under Deb Frecklington is elected on 31 October this year, her government has pledged to refocus on the health system, prioritise patient care and reduce the patient waiting list. Our federal health minister, Greg Hunt, who is to be commended for his work on the PBS, is also committed to preventive health measures, particularly in the area of mental health. Sadly between 2013 and 2017 the suicide death rate on the Gold Coast was 14 lives per 100,000. This was higher than the national rate over the same period of 12 lives per 100,000 people. These numbers sadden me greatly, but I, along with Gold Coasters, should be buoyed that our government is making mental health a priority. More than $60 million will be delivered to the Gold Coast in the five-year period of 2016-17 to 2021-22 for various programs for mental health and suicide prevention. I take this opportunity to recognise Southport headspace, who do an outstanding job to improve services for our youth with mental health illnesses. The Morrison government is delivering over $1.1 million in this financial year to headspace for the services they provide to those in our community in need of assistance.

Unlike Labor, the LNP government list all medicines on the independent Pharmaceutical Benefits Advisory Committee that are recommended by medical experts. In 2011, Labor stopped listening—listing, and listening, medicines on the PBS. Why? Because they could not manage the economy. They simply couldn't afford to support it. Since 2013, the Australian government has listed more than 2,300 new or amended listings on the PBS. This represents an average of around 30 listings or amendments per month—that's one per day—at an overall investment by the government of 10.9 billion. Many medicines that would cost hundreds of thousands of dollars are now available for around $40, or if you're a concession cardholder, like my dad, $6.50 per script. Ninety-one per cent of Pharmaceutical Benefits Scheme scripts are dispensed to concession cardholders. It's an amazing system that works for all Australians.

Australians who live with advanced breast cancer will have access to an important new treatment option, Verzenio, which will assist around 3,000 patients. For those suffering from ovarian cancer, the government has subsidised patient costs by spending around $25 million through the PBS health system each year, and also invested 1.6 million to trial psychosocial support.

Our strong budget management means we can give Australian patients access to life-saving and life-changing medicines quicker than ever before without raising taxes. This stands in stark contrast to Labor, who failed budget management and drove the budget into deep deficit, forcing them to stop listing the life-saving and life-changing medicines that our government has on the PBS and continues to save lives under Medicare.

1:08 pm

Photo of Libby CokerLibby Coker (Corangamite, Australian Labor Party) Share this | | Hansard source

Medicare is sacred to Labor. We initiated it in 1975, and then reinstated it after the coalition had abolished it in the Fraser-Howard years. We have defended Medicare from attacks by those on the other side for over 50 years, so it's somewhat ironic that this self-congratulatory motion notes the government's commitment to Medicare. It's a bit like Count Dracula reaffirming his commitment to not interfere with the blood bank.

It may well be that after 50 years of trying to sabotage or abolish Medicare that those on the other side have seen how loved and entrenched Medicare is in the Australian psyche, but somehow I doubt this new-found commitment. Like superannuation, there are those in the coalition right wing and think tanks like the IPA who continue to fantasise about dismantling what they see as a social experiment. You don't have to look far back to see examples: only July last year, a business mate of the coalition, Mark Fitzgibbon, CEO of nib, proposed Medicare be abolished and private health insurance be made compulsory. Minister Hunt shot the proposal down pretty quickly with a commitment to Medicare for life forever, but just say we get yet another ideological shift in the Liberal Party, how safe will their commitment to Medicare be?

The self-congratulations in this motion tells us only part of the story. It hides the truth about what is going on with Medicare and the health system. It hides the enormous pressure on our public health system and emergency departments across the country. It hides the developing crisis in the private health insurance industry, with thousands of people choosing to vote with their feet each year, especially young people. Over 9,400 people dropped out of private health insurance in the last quarter of last year alone. It hides the fact that the changes in rural and remote boundaries have reduced bulk-billing subsidies from GP practises, forcing the restriction or abandonment of bulk-billing all over regional Australia. And, lastly, it hides the fact the cost to visit a GP or a specialist is increasing, not reducing, in most federal electorates.

Take Corangamite, a seat of over 5,000 square kilometres, with a mix of rural, semi-rural and urban fringe. Data released in January shows that, for my constituents, since 2013, the percentage being bulk-billed has increased marginally from 45.6 per cent to 48.4 per cent, but that still leaves 51.6 per cent of constituents who have to pay to see a GP. That's a very unflattering figure for this government. And then there is specialist bulk-billing. If you can actually get in to see a specialist in Geelong, that has gone from a woeful 13.7 per cent of patients bulk-billed to the slightly less woeful percentage of 17.2. Indeed, almost 87 per cent of people with cancer and worse aren't thanking this government at all as they fork out for specialist visits. The average out-of-pocket expense to see a GP in Corangamite has risen by 36 per cent, or six per cent a year, between 2013 and 2019. Lastly, under this government, in my seat, the average out-of-pocket expense for specialist visits has gone up 59 per cent, or 7.5 per cent a year. From 1 January this year, the government cut bulk-billing incentives in around 13 regions across the country, including around Geelong. A number of these areas like Bannockburn, Lethbridge and Meredith in the Golden Plains Shire include high numbers of retirees and people on fairly moderate means. Lethbridge and Meredith are isolated hamlets; they are by no means metropolitan, and they are hurting under this coalition policy.

The end result of these policy decisions is that services will not be bulk-billed, and many people are faced with either paying or not going to a doctor. My message with respect to this motion is that this government needs less complacency and a lot more action and investment. Until then, the coalition's history of undermining Medicare will continue to haunt them.

1:13 pm

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

I think everybody in this chamber believes fundamentally that we want a country that is prosperous, that is safe and that is healthy. And the government plays a critical role in creating the structures and framework for a free society. As part of that, we also have the ambition of a healthy population with a just system that addresses issues of equity to make sure that people can get access to critical and basic health services so they can live out the fullness of their lives. That point has been debated at different time about how best to achieve that. At present, we have the Medicare system, and the Medicare system has never had a better friend than the Morrison government. We have consistently delivered year-on-year funding, year-on-year increases in the number of GPs who bulk-bill and year-on-year better access to the healthcare services that Australians need.

Let's not misunderstand, in this place there are people who feel they have a monopoly on compassion and believe that everything they do can never be questioned—they're called the Australian Labor Party. They sit on the opposition benches because their disinterest in outcomes for Australians always comes second to their own ambition to claim credit for their own relevance. But the reality is and the numbers show that we have seen consistent increases in Medicare funding and consistent outcomes in bulk-billing rates. They're the hard numbers. Compared to last period, the same time last year, the GP non-referred attendance bulk-billing rate was 86 per cent this year, up from 85.5 per cent last year. The specialist attendances bulk-billing rate was 31.4 per cent, up from 30.9 per cent the previous year. And the total Medicare bulk-billing rate was 79 per cent, up from 78.7 per cent last year.

We know there are those people who need extra assistance and support, who need to be able to go to the doctor and not experience a co-payment. We can trust the Australian Institute of Health and Welfare, which found that more than half of all patients, about 11 million Australians, incurred no out-of-pocket cost for non-hospital Medicare services in 2016-17, according to the most recent data, and from what we know and have seen on the ground in our communities.

Labor members come into this chamber and talk about why only they can be the solution, even though they have never been the solution to these issues. In Goldstein, we got no additional commitments of support or funding to Medicare or essential health services at the last election from the Australian Labor Party. In fact, we didn't even appear on their radar; all they wanted was to harvest the electorate of Goldstein for votes hoping they would get a third Senate candidate—they failed that but that's a separate issue. The coalition has taken a very proactive step in making sure that Medicare services are provided to the communities based on need. What we saw in the lead-up to the last election was new MRI licences for Cabrini Hospital in Brighton as well for Holmesglen in Moorabbin. That meant, for the first time, residents of the City of Bayside who have cancer, stroke, heart and other medical conditions could get scans locally rather than having to travel. The licence is expected to deliver approximately 5,900 Medicare subsidised services annually at a cost of $2.24 million per annum. This, of course, will save lives, decrease cost for patients and increase access.

On my very first visit to Cabrini, Brighton, when I was first elected as member shortly after 2016 election, they had one request, which was a Medicare-funded licensed MRI. We were able to deliver it not only through strong and effective advocacy but also because this government understands that the foundation of a strong health system is a strong economy. Get a strong economy where people are paying taxes and contributing to standing on their own two feet and they will in the best position to turn around and help those who are not. We on this side have the resources to deliver record Medicare funding, record health outcomes for Australians and, of course, deliver essential local services like the Medicare-licensed MRI in Goldstein.

Photo of Rick WilsonRick Wilson (O'Connor, Liberal Party) Share this | | Hansard source

This debate is now adjourned and the resumption of the debate will be made an order of the day for the next sitting.

Sitting suspended from 13:18 to 16:00