Andrew Wilkie (Clark, Independent) Share this | Link to this | Hansard source

Tasmania has the highest rate of chronic disease and the poorest-performing public health system in the country. One reason for this is that so many Tasmanians simply can't afford to go to their GP for a basic check-up, let alone for ongoing care. Indeed, in the last financial year only 78 per cent of services were bulk-billed in Tasmania, compared to the national average of almost 90 per cent. Even for those services that are bulk-billed, years of inadequate Medicare indexation means that around half of all Tasmanian patients pay out of-pocket costs of up to $43 per consult, and the harsh reality of this is that many people avoid their GP because bills like rent, food and power are more pressing.

Now I would like to share with you a couple of stories from my electorate of Clark, where the bulk-billing rate of 69.2 per cent is one of the worst in the country. For instance, a youth health worker from The Link Youth Health Service recently contacted my office to say they regularly receive phone calls from young people seeking information and urgent referrals for bulk-billing GPs. She told me: 'Last year I worked with a 19-year-old who needed multiple GP appointments in a short period of time for both sexual and reproductive health and mental health. She presented to The Link for assistance in finding a bulk-billing GP. I phoned every bulk-billing GP listed on the Primary Health Tasmania directory and was shocked to find that most either no longer bulk-billed or that a few doctors bulk-billed on "discretion". The few bulk-billing services in the area were not taking new patients. As a result, we offered this young person support with groceries from our Food Bank program so she could pay for appointments with money she would have otherwise spent on weekly groceries.'

Another constituent told me: 'I have to rely on a doctor's pity for bulk-billing. It's so demeaning to try and get medical care.' They then told me they had found one medical practice which bulk-bills, but it wasn't accepting new patients.

If you cannot visit a GP then your medical conditions often become deadlier and more expensive to treat, which is a crisis we see crystallised in our overstretched emergency departments, full hospital wards and premature death statistics. Moreover, any wind-back of the much-welcomed telehealth services introduced during the pandemic would only increase the disparity between people needing primary healthcare and people getting it.

No wonder the Royal Australian College of General Practitioners' report General practice health of the nation 2020shows that GPs clearly want the Australian government to prioritise primary care funding and telehealth—and also mental health, because young people are not only struggling to access GPs; they are also disproportionately struggling with their mental health. And the problem for them is that, if you have poor mental health, you need a good GP. Indeed, data published by the ANU shows that last year, during the pandemic, 22 per cent of young adults experienced severe psychological distress, compared with 11 per cent of the whole population. The modelling further showed an almost 14 per cent increase in suicide deaths over the next five years, as well as a likelihood of increased mental health related ED presentations and self-harm hospitalisations. Frankly, the harm caused by the government's chronic underinvestment in GPs in this country is shameful. The government must fix it and fix it urgently.

Of course, the federal government will tell you that bulk-billing rates are high and continuing to rise. But this is downright wrong, because the government counts the number of services bulk-billed and not the number of patients. So the fact is that bulk-billing rates continue to fall, due to years of inadequate Medicare indexation.

To be absolutely clear: this is not an attack on GPs—of whom my wife is one—because I have no doubt that GPs want to provide their patients with affordable health care. But, at the same time, they are running a business and must be given the opportunity to provide patients with lower costs, and this, of course, is why bulk-billing is so important.

Equal and affordable access to GPs must be a top priority for the government, including because Australia is a fabulously wealthy country and we can afford to ensure that every person who requires medical services receives them, and receives them to the highest standard.