House debates

Monday, 21 June 2021


Appropriation Bill (No. 1) 2021-2022; Consideration in Detail

11:01 am

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

I am pleased to be able to address the house in relation to the health budget over the course of 2021-22. All up, there will be over $121 billion invested across the portfolio and related activities in other portfolios for health, aged care and sport. Of most significance are, of course, the central pillars of the portfolio. In terms of Medicare, we see growth from approximately $19 billion in the year prior to us coming into government to $30 billion, $31 billion, $32 billy and $33 billion. That includes an additional investment of $6 billion in Medicare alone this budget, including $711 million for new Medicare items. That's an incredibly important investment, whether it's in relation to blood pressure; whether it's in relation to new items for infants for aortic valve treatment; or whether it's in relation to mental health and antidepressive activities such as, for the first time, the listing of transcranial magnetic stimulation, a very important treatment. That is then accompanied by the investment in new medicines: a critical investment of $43 billion over the course of the coming four years. We've already delivered over 2,600 new medicines, but this budget specifically, for example, included the listing of Emgality for the treatment of migraine. That will help some thousands of patients save thousands of dollars a year.

In addition to that, the budget includes a very significant package in relation to hospitals. What we see is a $6 billion increase in the amount of funding for hospitals. From $13 billion when we came in, that will grow over the course of this budget to $26 billion, $27 billion, $28 billion and $29 billion a year. Then, of course, what we see is the fundamental investments in mental health and in aged care. There is $17.7 billion for aged care and, as part of that response to the royal commission, this package is built across five pillars.

First is home care, with an over $7½ billion investment, including 80,000 additional packages. We see here that we will have gone from approximately 60,000 aged-care packages when we came into government to 275,000, a rate of growth which is vastly in excess of the population growth, a rate of investment vastly in excess of the population growth in the over 70s or in any age group. So we had to take the situation as we inherited it, and we have addressed that challenge and it is fundamentally important. It also includes over $790 million under home care for support of respite, and that's to assist both older Australians and their carers—critically and fundamentally important steps forward.

The second pillar, of course, is residential aged-care sustainability, and, as part of that, there's $7.8 billion, with several fundamental elements. The first is the increase, in line with the royal commission's recommendation, of a $10-a-day basic daily fee uplift. That's an investment of over $3.1 billion. The second is the adoption of the standards of safety and care, of 200 minutes a day of care, which will lead to a $3.9 billion increase over the course of the forward estimates or projections in the budget. The third is the residential aged-care quality and safety actions, and these include the ability to ensure we have over $300 million for doctors to make in-home visits to residential aged-care facilities, backed by an over $600 million investment in workforce—in particular, with retention bonuses for nurses. Finally there is governance, with a nearly $700 million investment, which will be critical with all of the new steps that are being taken forward.

We've added to that $2.3 billion for mental health, which I will explore further on in the discussions. That's fundamental to saving and protecting lives, with a particular focus on youth suicide and Indigenous suicide prevention, and treatment right across the age groups.

11:06 am

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

In the time I have today, I want to focus on mental health—particularly the mental health and wellbeing of young Australians. Recent natural disasters, such as bushfires and floods and, of course, the COVID-19 global pandemic, have brought mental health and suicide prevention policy into sharp focus. In Australia each year, more than 3,000 people lose their lives to suicide, and suicide remains the leading cause of death for Australians between the ages of 15 and 44 years. In addition, one in five Australians experience some form of mental illness each year, with about three-quarters of common mental health problems emerging before 25 years of age.

A study conducted by Black Dog, surveying more than 5,000 people between March and April last year, saw 78 per cent of respondents report their mental health had worsened since the outbreak, with more than three-quarters of all who responded saying they felt uncertain about the future. As Associate Professor Jill Newby observed at the time:

Given that loneliness, social isolation, and financial stress are significant risk factors for poor mental and physical health these findings really are concerning.

Against this backdrop, and the findings of the Productivity Commission inquiry's report into mental health received by the government in June last year, the Victorian royal commission, and, more recently, the report of the National Suicide Prevention Adviser, Christine Morgan, the budget delivered in May provided some welcome funding commitments, including funding for a National Suicide Prevention Office, and for follow-up or postvention for every person discharged from hospital following a suicide attempt. Given my experience working in adult acute mental-health inpatient units for almost 10 years, these are significant announcements, and it is our hope, working in a bipartisan way, that the measures announced in the budget are introduced quickly, as the need is urgent and growing.

It is of concern that there have been announcements in the previous two budgets that have not yet been implemented. I am regularly contacted by members on behalf of local people desperate to know when their promised headspace will be up and running or expanded, given the urgency and growing unmet need. While announcements matter, delivery is what counts, and young people, their families and caregivers in many communities across Australia are running out of time.

Just last week I met with the City of Swan from Western Australia. With a population of 160,000 and a third of local people aged under 24, they have a headspace in Midland and a satellite in Ellenbrook and told me that young people are waiting eight to 12 months for an initial assessment. That's not for the start of therapy or a treatment plan; that's for an initial assessment. Tomorrow I am meeting with Mitchell Shire. They have a dedicated volunteer suicide prevention service but are struggling, with the nearest mental-health inpatient beds—and only 17 of them—an hour's drive away in Shepparton. In my own community, on the Central Coast of New South Wales, in 2019 there was a commitment for a $1.5 million new headspace for Wyong. Minister, you've said to me recently that this would soon be delivered, but, as yet, it's not open. For young people in my community, particularly through COVID, this is incredibly distressing.

There are significant barriers which must be overcome to implement the budget measures and other outstanding mental health announcements or commitments. The first one is workforce: the critical shortage of trained and experienced mental health workers, especially outside of big cities. We understand the National Mental Health Workforce Strategy is being developed by the Department of Health and the National Mental Health Commission to consider the quality, supply, distribution and structure of the mental health workforce and identify practical approaches for Australian governments to attract, train and retain the workforce needed to address the growing demands of the future mental health system. I understand this workforce strategy was due to be completed this month. However, we understand that it may be delayed.

Another hurdle is the ambiguity over the responsibilities and accountabilities of the Commonwealth and state and territory governments. This issue was raised both by the Royal Commission into Victoria's Mental Health System and by the Productivity Commission in its mental health report. It is hoped that work currently being undertaken with the states and territories to resolve these issues will result in existing gaps and the poor coordination of mental health services being overcome. Another significant problem which is of much concern is the accessibility and affordability of mental health services. Like other health services, access to mental health supports is a particular problem in outer metropolitan, regional and remote areas. Increasing out-of-pocket costs for both GPs and medical specialists compound these problems.

My questions: will the government make sure measures announced in the 2021 budget and previous budgets are delivered as a matter of urgency? Can the government advise when the National Mental Health Workforce Strategy will be completed? Will the government provide an update on the delivery of headspace commitments across Australia, as this is urgent?

11:11 am

Photo of Warren EntschWarren Entsch (Leichhardt, Liberal Party) Share this | | Hansard source

The Australian government is certainly committed to improving the health of people in rural, regional and remote Australia in supporting better teaching, training, recruitment and retention of our rural health workforce. Regional Australia is driving Australia's economic recovery from COVID-19 through our investment in the health portfolio. In the 2021-22 budget we continue to support the regions and local communities to prosper and to grow. This investment will benefit regional and rural communities and support the government's JobMaker plan for Australia, emerging from the pandemic with a more resilient and competitive economy. However, we understand the challenges associated with attracting and retaining doctors and health professionals to rural areas, and therefore I ask: can the minister please detail measures in the budget that will encourage doctors to train and practice in regional, rural and remote areas?

I've always been a very strong and passionate advocate for rural health because I've seen firsthand the benefits of a strong and robust rural health sector, especially in my electorate of Leichhardt. I and my good friend Warren Snowdon, the member for Lingiari, have been co-chairs of the Parliamentary Friends of Rural and Remote Health for quite some time. This is why I have to say that we were both very pleased to see that the new office of the National Rural Health Commissioner would be established in my home town of Cairns. This is another major step forward in closing the health gap between rural Australia and major cities.

A focus of the commissioner's role is to work with communities experiencing chronic workforce shortages to develop new models of care which reflect the communities' circumstances. The office will also play a key role in supporting the government's ongoing rural response to COVID-19, which includes advising on the impact of the health workforce in regional, rural and remote communities in keeping people informed about the vaccine rollout. I, along with regional health minister Mark Coulton, recently had the pleasure of officially opening the office of the National Rural Health Commissioner in Cairns. There is absolutely no doubt that the commissioner, Professor Ruth Stewart—who hails from Thursday Island, so you can't really get more remote and rural than that—and her team will do an amazing job. I look forward to working closely with Professor Stewart to deliver better health outcomes for residents right across my vast electorate.

Another initiative announced in this year's budget is the government's $65.5 million investment over four years in rural bulk-billing incentives in rural and remote medical practices. A new and progressive incentive schedule will be applied that increases the value of rural bulk-billing incentives based on remoteness. This will enhance the financial viability of practices in rural and remote areas as well as reduce the gap paid by patients. The more remote the area, based on the Modified Monash Model, the greater the incentive payment that it will receive per eligible consultation to recognise greater challenges and cost pressures. Therefore about 10,158 medical providers in country areas will immediately benefit from this announcement, including many of those in my electorate of Leichhardt. The rural bulk billing initiative encourages doctors to offer medical services without out-of-pocket costs to vulnerable populations, including children under the age of 16, senior Australians and concession card holders. On average, Australians in rural and remote areas have poorer access to the use of health services compared to people who live in metropolitan areas.

I'd like to make mention of the government's $2.3 billion investment in mental health and suicide prevention, the largest investment in Australia's history. This issue is one that I am extremely passionate about. Given that I am the independent chair of my own headspace, I have to say that I was particularly pleased to see the funding allocated towards a new national network of 57 national mental health treatment centres and satellites as well as the expansion of the headspace program. Sadly, one-in-four Australians are affected by a mental health illness every year. Headspace offers a safe, welcoming place where young people can get non-judgemental, professional help and peer support so that they can tackle their challenges in a way that is right for them. With that, I'd like to also give a shout-out to Gabrielle Gill, the manager of our headspace, and her team. They do an outstanding job.

It's critically important that young people can access the mental health services they need and to make sure that they've got access to them when they're needed. This record investment in mental health reinforces our government's strong commitment to achieving better mental health outcomes. Finally, I'd like to say thank you very much to our health minister for the outstanding job he has done during this— (Time expired)

11:16 am

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

I rise to speak on the issues still facing our healthcare system through the pandemic and into the future. First of all, to give credit where it is due, I do credit the minister with our very good response to the pandemic. I don't credit the Prime Minister, because, of course, as we all know, he was off to the footy during the beginning of the pandemic. I think he failed to understand the seriousness of the issue, and I think the minister was the one that brought us back on track. I thank him for his hard work.

I have spoken many times during my time in parliament about the issues facing our healthcare system and on Medicare in particular. Medicare was founded on two principles: of universality and equity. This has gradually been eroded during the eight-year term of this government.

The government has recently introduced some changes to the Medicare schedule, and they are very likely to make the erosion of the universality and equity of Medicare even worse, by all accounts. I've worked in the system for over four decades. I've seen what's happening to our healthcare system. It's becoming less and less equitable and more and more difficult for people on low incomes and for disadvantaged people to access the best of 21st century health care. We're still experiencing lockdowns, I know, during the pandemic, but this has made things even worse for things like waiting lists for cataract surgery and for outpatient services. The issues are getting worse and worse, particularly in those areas of disadvantage: outer metropolitan Sydney and rural and remote areas. Health care in Australia is becoming less and less obtainable.

Just before I came into the meeting today, I did a quick run around of some practices in south-west Sydney. For example, to access a private consultation with a paediatrician, the gap cost varies between $120 and $200. For a cardiologist, the average is around $200. So this is making health care less and less affordable for people who are disadvantaged and on low incomes. People shouldn't have to worry about putting food on the table and a roof over their heads before paying for health care. It erodes the primary principle of Medicare.

The shameful attacks on Medicare by the coalition have meant that for many people health outcomes and life expectancy are dramatically worse just because of their postcode or their socioeconomic status. I've stated previously that the Australian Institute of Health and Welfare has detailed that as many as 1.5 million Australians are avoiding Medicare services annually owing to costs. We've seen the collapse of our public outpatient system. Again, I did a ring around this morning to see if I could get someone into a virologist at our local hospitals and the phone either rang out or I was put on a queue of over 20 minutes to get through—just to try to make an appointment. I don't know how long the waiting lists are, but they are preventing people from accessing the best of our health care. This is people with chronic illnesses such as multiple sclerosis, strokes, seizure disorders et cetera. The cost of medical care is skyrocketing and they are making it more and more difficult to access even primary care. I have contacted the minister's office on a number of occasions about the difficulty people in my electorate are having in accessing GPs. Nothing has been done; I get a motherhood statement but nothing else. The minister is constantly trying to politicise issues such as the PBS, which for the long-term has been bipartisan, yet we get no action on people accessing primary care.

I would like to ask the minister several questions. Will the minister ask the Standing Committee on Health, Aged Care and Sport to investigate the local effects of the recently announced Medicare changes in terms of access to care and increases in gap costs? Does the minister concede that outpatient services at our public hospitals are at breaking point due to a lack of adequate resourcing and what specific plants does the government have to try to improve this? Out-of-pocket expenses have skyrocketed over the last eight years. What does the minister plan to do to rein in soaring gap costs for Australian patients? Will the minister commit to revisiting the classification of distribution priority areas for regions that are presently struggling to recruit and retain general practitioners and specialists? What will the minister do to make our health care more equitable and more universal for all Australians, not just those at the top end of town?

11:22 am

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

I rise to discuss with the Australian people how important it is that we continue to fund investment in our National Health and Medical Research Council. Our medical research fraternity should be congratulated on the wonderful work they have been doing to back in Australia's health. I would like to ask questions of the health minister about how we continue to increase and support the investment in this critical sector of Australia.

The Australian government supports the critical role of health and medical research in improving health outcomes and that has been very clear through the COVID pandemic. I would like to congratulate the Minister for Health for leading what has been an exemplary response to the global COVID crisis. Since the commencement of the Medical Research Future Fund, in 2016-17, the government has invested $1.5 billion in medical research projects through the fund. I was a medical researcher at the time of this announcement, and I have to say that this was regarded internationally as world's best practice. As Australians and as Australian taxpayers, we should feel incredibly proud of our forethought in creating the medical research future fund. It has provided surety, certainty and sustainability for the medical research sector, which results in improved health outcomes for patients right around Australia not just in cures and care but also in prevention.

The NHMRC funds over $800 million worth of competitive research grants each and every year. A total of $3.6 billion has been committed to the NHMRC over the four years from 2021-22. As of May 2021 the Biomedical Translation Fund has made 22 investments totalling $233 million in 21 companies conducting late-stage biomedical research. As someone who has been involved in the Biomedical Translation Fund, I know how important this is to the critical and innovative ideas that Australian researchers are making each and every day. We know that this research helps drive forward improved care for patients, improved prevention for concerns about illnesses that are emerging as we speak.

The government has committed $5 billion to the 10-year Medical Research Future Fund investment plan around four important pillars. The first is patients and investment in improving patient outcomes, with $1.3 billion of additional funding being provided for vital clinical trials activities and new research funding to tackle global health issues, including COVID.

The second is investing in researchers, our people who do the research, with $792 million to build the capacity of Australian researchers through the provision of additional fellowship positions. Again, I have been a recipient of a National Health and Medical Research Fund fellowship position, and I can tell you that the day on which the letter came from the minister for health was one of the best days of my life, because effectively what it was saying is, 'We back you and the research that you are doing.' It is an incredible privilege to receive one of these fellowships, and it is so important to the future of our health care.

The third area the government is investing in is research missions. These are really new and novel, and they're very strategic: $1.4 billion to support crucial Australian missions that have the potential to challenge current ways of thinking and transform medical research by inspiring researchers to be bold and change the face of medicine. We know this because we've heard the minister for health announce these missions, including missions regarding cardiovascular health and genomics—all sorts of missions that are making a change. The Million Minds one also comes to mind. This is changing the way we do health care, and Australians should feel very proud of the work that is being done.

The fourth is research translation: $1.5 billion to harness research and translate it into real-world benefits. This is not just about doing ivory tower research; it's about making a real impact and a real difference to the lives of Australians. It will also support the establishment and extension of data infrastructure to support world-class health and medical research.

Importantly, these investments are consistent with the new Australian Medical Research and Innovation Priorities 2020-2022, developed by the independent Australian Medical Research Advisory Board, AMRAB, following national consultation in accordance with the Medical Research Future Fund Act 2015. These are independent assessments, and they are very important for the integrity of the system. My question to the minister is: what is the federal government doing to continue to support the excellence of the medical research sector and the health outcomes of this country? I'd like to again say thank you to the minister for health for the amazing leadership he has shown through an incredible health crisis.

11:27 am

Photo of Patrick GormanPatrick Gorman (Perth, Australian Labor Party, Shadow Assistant Minister for Western Australia) Share this | | Hansard source

Throughout this pandemic, aged-care residents and aged-care workers have been at the greatest risk of COVID-19 infection, but we still have large concerns about the rollout of the vaccine in these facilities. Last year, 335,889 Australians used some form of aged care. The federal government is the primary regulator and funder of this system. Last year, it spent $21.2 billion on aged care. At the same time, we had a royal commission telling us that the system is woefully inadequate. When it comes to the rollout of the vaccine, again, it is woefully inadequate in what has happened and, indeed, not happened in aged care.

I've put on notice questions to the minister about the rollout of the vaccination program in my electorate. Having not received answers to those questions yet, I'm going to ask them here again. On what date were residents in each of the aged-care facilities in the Perth electorate first offered a vaccine for COVID-19? On what date were staff in each of the aged-care facilities in the Perth electorate offered a vaccine? What percentage of residents in each of the aged-care facilities in Perth are fully vaccinated, and what percentage of staff in each of the aged-care facilities in the electorate of Perth are fully vaccinated? We know that there is huge community concern about the rollout of this vaccination program, and every time we look closer we are more disappointed and we find out that there are more and more gaps in this system.

The other big gap is in the quarantine system, which we are continuing to pretend is fine. Hotel quarantine in the CBD is no longer acceptable. It was a good emergency response but, more than a year into this pandemic, we need something smarter and safer than hotel quarantine. It's the businesses and communities in my electorate in the Perth CBD who are hit worst when we have leaks out of the hotel quarantine system, and we know there will be more leaks. So I would also like the minister to explain: why did the budget contain no additional funding for new national quarantine facilities? Is the minister actively considering the proposal from Perth Airport to have a quarantine system on the grounds of Perth Airport? Is the minister talking to his colleague the defence minister about using RAAF Base Learmonth as an alternative location or seriously considering the proposals from the state government to use somewhere such as Busselton, close to Busselton Margaret River Airport, to provide proper quarantine facilities for Western Australia?

On a note of curiosity, as I came in here, I saw the report about the Prime Minister doing some private tourist business while he was attending the G7. We saw the Prime Minister doing private tourist business while on an official government trip. I'd be interested if the health minister can explain how we can have one rule for millions of Australians and a different rule for the Prime Minister to be able to go to a pub, visit family and track his family history. I'd be interested to know if the health minister was aware of this, whether the health minister gave any advice, whether any of the chief medical officers or any of the health officials were aware the Prime Minister wasn't just planning to attend the G7 but was also planning to go on a holiday in the United Kingdom in the middle of a global pandemic.

When it comes to mental health, I think we all need to know where all these new headspace clinics that were announced in the budget are going to be. The minister would know right now where they are intending to put those headspace clinics. There is a clear need in my electorate in Perth to have a headspace centre located in the Perth CBD. Currently, my constituents are forced to go to either Midland or Osbourne Park, and we know we have a large number of young people who need that mental health support somewhere that's easy for them to access.

Finally, when it comes to the importance of universal health care, I, like many in this parliament, have benefited from a world-class public health system. I was a chronic asthmatic as a child, in and out of the Fremantle emergency department more times than I can count. I'll always defend having a proper universal health system. So why is it that we've got these sneaky, unclear almost 1,000 changes to the Medicare Benefits Schedule, where we don't have the full detail released by the minister—again, the minister has these details and he could release more detail. Why hasn't it been released? What items have been cut? What impact will it have on public hospitals in Western Australia? Does the budget fully reflect the changes you are planning to make to Medicare?

11:32 am

Photo of Fiona MartinFiona Martin (Reid, Liberal Party) Share this | | Hansard source

Mental health and suicide prevention are key health priorities and central features of the Commonwealth's Long Term National Health Plan. The government is committed to transforming the mental health system and has undertaken an ambitious reform agenda. The government has established a number of reviews to consider the decades-long issues in the mental health system. These include the Productivity Commission inquiry into mental health and the report of the National Suicide Prevention Adviser. Together with the Royal Commission into Victoria's Metal Health System and the House of Representatives Select Committee on Mental Health, these reviews will inform and drive the long-term national reform work already underway to establish a more integrated, person oriented Australian mental health and suicide prevention system for the benefit of all Australians.

In addition, under the new national health reform committee, the government is developing a new national health and suicide prevention agreement with states and territories. It is expected that this new agreement will be finalised towards the end of this year. The agreement will help establish a single integrated national mental health system.

In the 2021-2022 budget, the government is investing a record $2.3 billion in the National Mental Health and Suicide Prevention Plan to lead landmark reform. Based on the principles of prevention, compassion and care, the plan will invest $1.4 billion in high-quality, person centred treatment, including $820.1 million for the national network of mental health centres for adults, youth and children through the Head to Health and headspace programs. The plan is based on five key pillars: prevention and early intervention, suicide prevention, treatment, supporting the vulnerable and, of course, workforce and governance.

The $2.3 billion plan is the first phase of the response to the recommendations of the Productivity Commission and the National Suicide Prevention Adviser, all of which the government has accepted in full, in part or in principle. Many of the reforms require collaboration with the state and territory governments, with a number to be pursued jointly through a new national mental health and suicide prevention agreement to be finalised by November. The 2021-22 budget builds on the additional $485.7 million in mental health services, and supports in the 2020-21 budget, including additional funding for bushfire recovery, suicide prevention and mental health support during the COVID-19 pandemic.

Pillar 1 in the mental health approach is prevention and early intervention, with $248.6 million invested and $164.9 million from Health. This includes spending in digital, to create a world-class digital mental-health service system, including commencing the transformation of the existing Head to Health gateway into a comprehensive national mental health platform. It includes support for perinatal services, with $47.4 million allocated to perinatal services; and legal services, with $77.1 million in the National Legal Assistance Partnership to support early resolution of legal problems for those experiencing mental illness. It also includes support for fly-in fly-out workers and drive-in drive-out workers, with $6.3 million allocated to that, and for workforce participation, with $5.7 million to build on the Individual Placement and Support Program. There's small business support, with Ahead for Business digital hub supporting small business owners to take proactive, preventive and early steps to improve their mental health.

There are so many aspects to this. But my question to the minister is: could the minister please outline how the $2.3 billion for the National Mental Health and Suicide Prevention Plan, and investments throughout the COVID-19 pandemic, are improving access to new and improved mental health treatments through the government's continued investment in Medicare?

11:37 am

Photo of Josh BurnsJosh Burns (Macnamara, Australian Labor Party) Share this | | Hansard source

The vaccine rollout is in disarray. We are lagging behind the rest of the world. We have had yet another confirmed case of breakout from quarantine. This federal government is looking more and more shambolic by the day, and, as I stand here, as of the last few minutes, we now have a new Deputy Prime Minister of this country, in the member for New England. This vaccine rollout is leaving Australians vulnerable, and, instead of fixing it, those in this shambolic government are obsessed with themselves—obsessed with their own internals—and are now serving Australia by returning to Barnaby Joyce, the member for New England. There is no urgency to fix the vaccine rollout, and I stand here to ask questions of the minister for health about the vaccine rollout.

Let me go back to last June and July, when this government had meetings with Pfizer where they sat down together and Pfizer reportedly offered the Australian government as many vaccines as we needed.

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

That's misleading the parliament and is false.

Photo of Josh BurnsJosh Burns (Macnamara, Australian Labor Party) Share this | | Hansard source

And I will read out a quote from Dr Norman Swan—

Mr Hunt interjecting

I can hear the interjections from the minister for health, but I'm going to read out a transcript from the ABC. The minister for health says Norman Swan's wrong. What happened with Pfizer last June is that they wanted to make Australia an example to the world about how to roll out—a bit like Israel or other places—and they said: 'How much do you want? And when do you want it?' And on 10 July there was a meeting, and what I'm told happened at that meeting was that there was an inexperienced person there with procurement. They were pretty rude at that meeting, and they said: 'Well, you're going to have to give us all your IP,' which is an amazing thing to have said, and started nickel-and-diming on the cost, and essentially the conversation stopped. And reports also are that Moderna did the same thing. Make no mistake: Pfizer and Moderna offered Australia as many vaccines as we needed, and this federal government, hiding behind whatever advice they choose, at that time decided to say no. Pfizer and Moderna offered as many vaccines as we needed, and we as a country said no.

Mr Hunt interjecting

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share this | | Hansard source

The member has the call. The minister can seek the call to answer the question when the member has completed.

Photo of Josh BurnsJosh Burns (Macnamara, Australian Labor Party) Share this | | Hansard source

The fact of the matter is that Australia does not have enough vaccines. We have repeatedly been told by the government that we are on track, and we are not on track. We have fully vaccinated less than five per cent of our population. In a private briefing to the Australian Labor Party, I remember personally asking an official—I'm not going to name the official, but it was a senior health official—'Why are we not doing deals with Moderna?' It was a very dismissive answer: we didn't need them. They felt, at that time, the decision was to go with the AstraZeneca vaccine, and that has been the strategy all along. Now the federal government are in the situation, where, instead of having adequate vaccine supply, they are stuck with a vaccine that is not recommended for under 60s.

This is a problem entirely of the federal government's own making. Do you want to know why we are way behind comparable countries? Do you want to know why people are turning up to sporting events in the United States and we're going into restrictions on the east coast of Australia? It's because the federal government hasn't vaccinated enough Australians. That's it—that's the reason. We should have way more than five per cent of the population fully vaccinated. The percentage of fully vaccinated people should be in the 50s. We have a fantastic health system. But the strategy, the procurement and the decisions from the start of this vaccine rollout have been wrong. Instead of admitting it, this federal government has doubled down. They put all their eggs in the AstraZeneca basket, and Australians are paying the price. The government should start being honest about it. (Time expired)

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share this | | Hansard source

The minister is not seeking the call to answer the questions?

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

I will next.

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share this | | Hansard source

I give the call to the member for Longman.

11:42 am

Photo of Terry YoungTerry Young (Longman, Liberal National Party) Share this | | Hansard source

In response to the final report of the Royal Commission into Aged Care Quality and Safety, the Morrison government will deliver a $17.7 billion package of support that will deliver respect, care and dignity to our senior Australians. This investment will deliver generational change, with improved quality care and increased viability in the sector, with services respecting the needs and choices of senior Australians. It is also the largest investment in aged care and the largest response to a royal commission in Australian history. The government has listened to the experiences of the Australians who gave evidence to the Royal Commission into Aged Care Quality and Safety and is taking decisive action to implement the recommendations, with the reforms to deliver vital services and improved quality, care and viability in aged care. Our plans build on recent aged-care quality reforms, including those announced throughout the royal commission's inquiry, the COVID-19 pandemic and in the immediate response to the release of the final report. We welcome the royal commission's final report and have founded our response on the principles of respect, care and dignity.

In responding to the 148 recommendations, the government has accepted, or accepted in principle, 126 recommendations. Our response includes a five-year implementation plan underpinned by five pillars. These pillars are home care, residential aged-care services and sustainability, residential aged-care quality and safety, workforce, and governance. Under home care, we understand that senior Australians want to remain independent and in control, living at home and connected to their community. The government is providing $7.5 billion to home-care support, which will enable 80,000 more home-care packages, increase support for informal and family carers, increase support for senior Australians to find the aged-care services they need, increase Aged Care Quality and Safety Commission checks, and increase pricing transparency to ensure value for money. The government will also develop a new support at home program, providing better focused services for over a million people. It will give senior Australians greater choice when it comes to their care. The home-care funding will also boost residential respite services and early referrals to carer gateway services. The My Aged Care website and contact centre will continue to be a key entry point and a source of information for services and supports.

Under the residential aged-care services and sustainability pillar, the government will invest $3.9 billion over four years to increase frontline care. From 1 July a new daily fee supplement of $10 per resident per day will give immediate support for daily services, such as food, nutrition, linen and cleaning. Additional funding will support face-to-face care for each resident.

Reforms under the residential aged-care quality and safety pillar will strengthen the Aged Care Quality and Safety Commission to further protect senior Australians. We will invest $231.9 million to enable the commission to do more site audits, to enforce regulation of physical and chemical restraint use, to expand the Serious Incident Response Scheme to home care, to increase funding for the Dementia Behaviour Management Advisory Service and the severe behaviour response teams and to give specialist dementia training to aged-care providers. A new star-rating system will highlight the quality of aged-care services, helping provide informed decision-making for senior Australians, their families, friends and carers.

Under the workforce pillar, the government is growing the home-care workforce by 18,000 and will provide additional financial support and incentives for registered nurses. We will also improve regulations and worker-screening arrangements to attract the right workers to the sector.

Under the final pillar, governance, the government will support aged-care providers to improve their governance and meet stronger legislative obligations. We will create a local network of department staff, ensuring national planning is informed by local issues and needs. The new Inspector-General of Aged Care will provide independent oversight, and older people will have a voice through the Council of Elders. The new National Aged Care Advisory Council will support reforms development and offer expert advice to government.

Every year under this government home-care packages are up, residential care places are up and aged-care funding is up. Based on the most recent data available, recurrent investment in home care in my electorate of Longman went from about $19.38 million in 2018-19 to $25.26 million in 2019-20 and investment in residential aged care in Longman went from $99.1 million in 2018-19 to $104 million in 2019-20. Will the minister please explain how the government has responded to the Royal Commission into Aged Care Quality and Safety to improve the quality of care and dignity for our senior Australians?

11:47 am

Photo of Peta MurphyPeta Murphy (Dunkley, Australian Labor Party) Share this | | Hansard source

My first question to the Minister for Health is: will the minister urgently look to reform the distribution priority area system to allow bulk-billing GP clinics, like those in Carrum Downs and Frankston in my electorate, to recruit doctors to service the people in my electorate? The minister would be aware that I have raised in this parliament and written to him about four different GP clinics in my electorate. Dr Ravi Ravoori from the Myhealth Bayside Medical Centre has said to me that the DPA classification needs to change because he cannot attract doctors to his area.

I wrote to the minister recently and outlined the situation where the only female doctor working in that clinic has had difficulties finalising her exams as part of her SAPP placement, significantly due to COVID. She can no longer work at that clinic. Dr Ravoori cannot recruit a female GP to that clinic in the Bayside mall, which the minister, who comes from my area, would be aware is an enormous shopping centre that has, extraordinarily, something like 400,000 people going through it a week. That is the bulk-billing clinic in the centre.

Dr Ravoori's concern is that there is now no one specifically to deal with the mental health issues of people who attend that mall. It has been a very successful model. Dr Naseri, who can no longer work there, has been responsible for that mental health. If Dr Naseri is unable to get her medical practising certificate, as Dr Ravoori says, it's the DPA classification, which does not set Dunkley as an outer metropolitan priority area, which will prevent him from recruiting another doctor.

Two of the other medical clinics that I have raised previously and have written to the minister about are part of a group of medical clinics. They are specifically the Ballarto Medical Centre, on Ballarto Road in Carrum Downs; and St Mary Medical Centre, which is on Frankston-Dandenong Road in Carrum Downs. It is becoming a desperate situation for these two medical clinics, which provide bulk-billing services to some of the most socioeconomically disadvantaged areas of my electorate. It means that the medical clinics are struggling to function, but, as the minister would be well aware, it also means that members of my community can't access health care when they need it.

Very recently, Rachael Hatzopoulos, the group operations manager for these two clinics, wrote to me again. She wrote: 'I wanted to touch base with you both again'—myself and my electorate officer Lauren—'to see if there is anything that can be done to try to help us. The Department of Health have made it impossible to recruit doctors to a bulk-billing clinic in a metro location. We have struggled so much with the St Mary Medical Centre especially. We open until 10 pm and all weekends and public holidays, and rely on one doctor for after hours. Our three other GPs in St Mary are so heavily booked with patients and cannot do any more than they are doing. Our patient demand is far greater than our capacity. We are turning patients away daily and often after hours have to direct them to emergency when they could easily be handled in primary care. It is so ironic given the television commercials I am seeing that say "don't call 000 or go to emergency; see your local GP". It's a very big contradiction.'

'A few weeks ago it was quite upsetting that someone put a post in one of the community notice board pages about how bad our waiting times are. We do take appointments, but patients also know if they are unwell they can walk in when needed. There were a subsequent 60-odd comments of complaints about how we should just, quote, 'Get more doctors,' along with many other comments. We have done so much to try to get more doctors to offer more appointments to patients, without any success. We have many doctors that contact us wanting to work, but the Department of Health and immigration restrictions make it impossible. I am just reaching out with the hope you may be able to help us.'

As I said, my question to the Minister for Health is: will you urgently review the entire system, but specifically these medical clinics and the issues in the electorate of Dunkley? Affordable universal health care is under threat because GP clinics that bulk-bill cannot get doctors to service some of the most vulnerable members of my community.

11:52 am

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

We've had very valuable contributions, although I may not agree with all of them, in particular across five areas: mental health, rural access, Medicare, aged-care and coronavirus and the national response. I'll respond to the first two of those, mental health and rural access, in this, and the latter three items if given subsequent opportunity. In particular with regard to mental health, amongst others, the members for Dobell, Reid, Leichhardt and Perth have all raised questions.

With regard to mental health, let me begin by saying that this has been the largest ever investment in mental health in any budget in the course of the federal parliament, with an additional $2.3 billion as part of our National Mental Health and Suicide Prevention Plan, which is our response to the Productivity Commission. It covers five particular pillars. The first is in relation to prevention and early intervention. It has a particular focus on young people but it's not confined to young people, because these issues transcend all ages, sadly, and very much in many cases tragically. That includes $250 million, of which the largest component is $111 million for expanding and extending the Head to Health online and telephone network. We want to be able to support all Australians at any time. In the dark of the night it's 3 am and somebody is having a mental health crisis, and that capacity to reach out through the Head to Health network is a critical one. It's about having a common national system. It's both a destination in itself and an access vehicle for Beyond Blue, Lifeline, Kids Helpline and so many other areas, all of which have been supported in the course of the budget and in this particular component.

The second pillar is, critically, suicide prevention, which has the support of all members on all sides of both houses of parliament. It's a $300 million investment. The most significant element—and I acknowledge the member for Dobell, who recognised and appreciated the government's commitment to this—is $158 million to establish what's called a universal aftercare system. The single group in our nation who are most likely to take their lives are those who've been discharged from hospital having previously attempted. So to offer all of those people the capacity for follow-up care and for follow-up treatment, I hope, will save not just hundreds of lives but thousands of lives over the course of the coming decade. One of our achievements during COVID has been that, to date, we have not seen the much-predicted increase in the loss of life to suicide. We haven't seen a significant decrease, so we have a lot of work to do. But what could have been has not eventuated thanks to comprehensive work, and, in particular, the telehealth system which was put in place. We'll also be putting in place $22 million for postvention to support the family and friends that have been left bereaved. We know that suicide, sadly, can have a contagion effect, and it can be catastrophic across communities. We'll be creating an office of national suicide prevention for the first time ever, charged with the singular task of reducing suicide rates and coordinating national responses.

Treatment is the third pillar and the area of largest investment—$1.4 billion, including $820 million for creating the three-tier comprehensive national approach to mental health treatment. We will have 40 initial national adult Head to Health treatment centres. We will grow to 164 headspace centres. The Wyong headspace centre, which was asked about by the member for Dobell, is due to be completed in Q4 of this year, but the Lake Haven centre will be upgraded, with a $4 million investment, from a satellite to a full headspace. We will have 15 Head to Health kid centres for treatment. Related to that, there will be $100 million for the vulnerable, including $77 million for Indigenous Australians. There will be $200 million for workforce—in particular, there was a question about workforce—which includes $59 million directly for workforce training, $16 million for GPs and $117 million for evidence. And then, on rural and remote, we have a very strong initiative of expanding the bulk billing incentive rate for the modified Monash three to seven areas, which will help both with investment and incentives for doctors. That's coupled with the expansion of telehealth, with a $200 million investment. (Time expired)

11:57 am

Photo of Warren SnowdonWarren Snowdon (Lingiari, Australian Labor Party, Shadow Assistant Minister for External Territories) Share this | | Hansard source

Could I ask the minister if he could provide detail of how the $12 million to continue the Rheumatic Fever Strategy will be spent and how the $19.1 million to continue and improve the Trachoma Elimination Program will be spent? In addition, I would like, in particular, Minister, for you to provide advice on why funding to a very successful program which treats RHD at Maningrida will be discontinued as at 30 June. You'd be aware, Minister, that Maningrida has the highest incidence of RHD per capita in Australia and amongst the highest in the world.

Mala'la Health Services Aboriginal Corporation has been funded to provide a targeted program that provides a focus on improving long-term secondary prophylaxis and a focus on new activities to prevent the incidence of acute rheumatic fever by addressing primordial causes. They provide community education, they provide screening, they have an employment and development program in which three community workers have been developed and trained to carry out education sessions and skin checks, and they employ a healthy homes coordinator, who coordinates the activities and provides support for education and community workers.

Minister, Mala'la's outcomes to date have been very encouraging. They've developed an active referral to the RHD program for clinical staff to treat clients at the clinic for scabies. This allows for home visits, which facilitates the second treatment necessary to treat mites and engage with the household for environmental assessment. Three community workers have been recruited in full-time employment, and all have undertaken training and are competent in telling the Heart Story. All schoolchildren attending school and their teachers receive regular education sessions about the Heart Story and have a good level of health literacy. More than 3,000 skin checks have been carried out and treated, if there was evidence of any skin sores or infections, with all cases of scabies treated. Over 150 homes have been checked, and maintenance issues have been reported. A partnership has been established with the West Arnhem Shire Council, Maningrida College and One Disease. Rates of compliance with secondary prophylaxis have increased significantly during the funding period: in the last quarterly report, 82 per cent of the clients on Bicillin were receiving 85 to 100 per cent of prescribed doses. None of these activities, Minister, will continue beyond 30 June without additional funding. So could you provide detail as to why funding has not been made available, and will you undertake to ensure funding is made available beyond 30 June?

Minister, I respect the fact that you have allocated funding for a working partnership with Aboriginal and Torres Strait Islander people to develop and finalise in mid-2021 the National Aboriginal and Torres Strait Islander Health Plan 2021-23 and the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021-2031. I was wondering, though, Minister, if you could provide details of expenditure on the initial plan, 2013-23? Can you advise on the implementation strategy for that original plan? Can you advise on the agreed implementation strategy and what has been funded? And could you advise on what funding has been made available for specific measures and what those measures have been? I understand that the plan is being reviewed, as I have previously said, but could you advise on the process being engaged for the reviewing of the plan, the timing and the consultation process, and could you advise on whether or not the central themes of the original plan will be continued? Will you advise further on the progress of the Aboriginal and Torres Strait Islander health workforce plan and the central elements of it?

Minister, I am encouraged by some of the words you have spoken to us about COVID in the bush, but could you detail for me, please, the extent to which COVID testing has been undertaken for remote aged-care patients in Aboriginal communities? Could you also advise us on the rollout of COVID vaccines across northern Australia but particularly in remote Aboriginal communities? Understanding that there have been huge issues around the reluctance of many Aboriginal and Torres Strait Islander people—but particularly Aboriginal people in remote places—to be vaccinated, I would like to understand what public education campaigns the government is funding in that space.

12:02 pm

Photo of Melissa McIntoshMelissa McIntosh (Lindsay, Liberal Party) Share this | | Hansard source

The coronavirus pandemic has changed the way we look at health. Hand sanitiser, masks, QR codes and contact tracing have become the norm as Australians make sure we are looking out for each other's health and protecting our communities. But one thing that hasn't changed is the Morrison government's commitment to the health and wellbeing of all Australians and our guarantee for the essential services Australians rely on. That's why, in the federal budget, we've committed an additional $6 billion to Medicare. In this budget, we've committed $30 billion to Medicare, increasing to $31 billion, $32 billion and $33 billion over the coming financial years. This will have a tremendous impact for families in my community of Lindsay.

Our plan is about delivering better health outcomes for local people, and one such example is telehealth. Since telehealth was introduced, 61.8 million services have been delivered to over 14.1 million patients, with $3.1 billion in benefits paid. Over 84,000 practitioners have now used telehealth services, and this has enabled almost 100,000 people in my electorate of Lindsay to access telehealth services during the pandemic. This is truly remarkable. As part of the budget, we've extended telehealth services until the end of the year, because we recognise the impact it has on ensuring more people and families in my community and right across Australia can access the care and support they need as we continue to navigate the pandemic.

The Morrison government are also ensuring that patients in my electorate of Lindsay have access to modern medical procedures and treatments. We've committed over $711 million in funding for new and amended Medicare listings to improve health and wellbeing outcomes. The Morrison government have overseen record levels of GP bulk-billing rates; the rate for this year, up to March, is 88.7 per cent. This is compared to a bulk-billing rate of 82 per cent when Labor were last in government. The importance of guaranteeing the services that Australians rely on has only grown during the coronavirus pandemic, and we have responded to the needs of people in our communities throughout the pandemic to adapt and provide the best services.

We are also making a record investment in women's health in this year's budget. When I wrote to women in my community about what matters most to them, so many of them wrote back to me about women's health. The Morrison government's $350 million package for women's health will go towards perinatal mental health; addressing the rates of preterm birth; breast and cervical cancer screening programs; and endometriosis. This will make such an important difference to the lives of women and their families in my electorate of the Lindsay, helping them through difficult times with life-changing and life-saving treatments and medicines.

We are committed to guaranteeing the essential health services that Australians rely on when they need them most, both now and into the future. The Minister for Health came to Lindsay and helped me launch by Lindsay Healthy Active Living Network. Like me, he knows how important Western Sydney is and he shares my passion for encouraging healthy active living. I am very committed to making sure my community is an even better place to live, work and stay healthy. We are working on important health initiatives from improving our mental health services—I'm so pleased that we have a mental health hub coming into Penrith—to tackling really serious issues around childhood obesity, which in the electorate of Lindsay is higher than the state average. I am very much committed to addressing that.

The Morrison government's plan guarantees the essential services that families in my electorate of Lindsay rely on, and that is absolutely essential. Could the minister please outline what new listings the Morrison government has funded in this year's budget, what the GP bulk-billing rate means for people in my electorate of Lindsay, how important telehealth has been for my community and right across Australia, and the important measures that were funded in our $354 million women's health package?

12:07 pm

Photo of Ged KearneyGed Kearney (Cooper, Australian Labor Party, Shadow Assistant Minister for Health and Ageing) Share this | | Hansard source

We've had a very wide range of issues and questions raised for the minister today, and I thank him for being present and doing his best to answer those questions. I want to focus on aged care. If we are honest, the way the Morrison government has responded to aged care is entirely symptomatic of its whole eight years of government: it only seems to act when it has it's back to a wall; it only acts to fix political problems and then, all too often, its response is too little too late. After eight years of neglect the Morrison government had to call a royal commission—effectively into its own handling of aged care. After the incredibly hard work of the royal commission—months of work, in fact—and 148 recommendations it's clear to everyone that the government's response falls short of solving a number of key issues within the sector and fails to deliver enduring improvements and reforms for the long term.

The government claims that it has accepted or accepted in principle 126 of the royal commissions 148 recommendations. But even when they say they've fully accepted a recommendation it doesn't actually mean they're going to implement it in full. When you look at the details in their response, times are pushed back, sometimes by years, and key sections of recommendations are often excluded. Sometimes they say they have accepted a recommendation, and their response doesn't even pretend to match it. That's a weird definition of 'accept'.

Let's look at the key areas of concern—firstly, staffing levels and minutes of care. In recommendation 86 the minimum staff time standard for residential care sets out two phases of mandatory minimum care minutes in residential aged care. The first phase mandates a minimum of 200 total care minutes per resident per day, but not until July 2022. The second phase increases this to 215 total care minutes by July 2024. The second phase also includes an all-important requirement to have a registered nurse on site 24/7. So why is the government only implementing the first phase or stage of this recommendation? Why have they ignored the second phase and the crucial step of having a registered nurse on site 24/7? Can the minister explain how the government has accepted this recommendation when only actually doing half of it? Secondly, we know that nothing will change without reform to the workforce, yet there was nothing in the budget to improve wages for overstretched, undervalued aged-care workers.

To the Minister for Health and Aged Care: while answering a question at question time on Thursday, 13 May, in response to a question about whether the government have a plan to increase aged-care workers' wages, the minister said: 'There is in relation to this $3.2 billion which goes to the $10 a day uplift fee that will flow through to our staff. This is absolutely directly about wages; $3.2 billion which goes to the ability to provide additional support to our personal care workers and for our nurses. That's how they're paid. That's how they're paid. They aren't paid directly by government; they're paid by people who employ them. And that is providing support to employers to support the employed.'

How will this money actually increase the wages of workers? How will the minister ensure that it does flow through to staff? Is there actually a plan or no plan to increase workers' wages? What measure is there to ensure that providers use this money for wages? Is there any mechanism to enforce this? The royal commission clearly stated that the wages of aged-care workers were too low. It's clear that we won't be able to attract the workers needed to fill demand until this issue is resolved. What is the government doing to raise aged-care workers' wages so they're fairly and justly recognised for the hard work that they do?

Finally, on vaccinations, we're almost four months into the government's vaccine rollout strategy and still less than three per cent of Australians have been fully vaccinated. The latest advice from ATAGI and the impact on the AstraZeneca rollout will be yet a further brake on this desperately slow, desperately behind vaccine rollout strategy. This is particularly an issue for aged-care workers. Can the minister confirm that only 11 per cent of the aged-are workforce are fully vaccinated and what is their plan to ensure that this critical workforce will have their vaccinations without them having to go on their own to that GP?

12:12 pm

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

I want to thank all of the members who have spoken in consideration in detail and appreciate their contributions. I think there are four remaining areas to be addressed, if I'm fair: Medicare and hospitals, aged care, Australia's COVID response and Indigenous care.

On Medicare and hospitals, the number of Australians who are able to access the doctor without having to pay for it is that, during our time in government, bulk-billing rates for general practices—and bulk-billing represents somebody who is able to visit the doctor without having to pay—have increased from 82 per cent to 88.7 per cent. For the people of Lindsay, that means that on average, if you take the national average, 6.7 per cent more of visits are free. It means that almost nine out of 10 visits are free. The year-to-date rates represent a significant step forward: 6.7 per cent greater than they were at any time under the previous government. Related to that, Medicare funding has reached record levels: going from $19 billion under the previous government to $31 billion, $32 billion and $33 billion over the course of this budget cycle, including an additional $6 billion all up for Medicare and an additional $700 million specifically for new Medicare items.

Hospital funding—and this question was raised by the member for Macarthur—goes from $13 billion, under the previous government, and is more than doubled to $26 billion, $27 billion and $28 billion over the course of the forward estimates. Very importantly, related to that, we have also seen the change in private health insurance fees halved on an annual basis, from six per cent under Labor to just over 2.7 per cent under the coalition. It's the lowest change in 20 years. Over the last five years it has progressively been the lowest change in 16, 17, 18, 19 and 20 years.

In relation to aged care, at the outset I set out the five pillars, but I will address matters raised by the members for Perth, Longman and Cooper. The most fundamental thing here is a $17.7 billion investment and transformation in aged care. Part of that is $7½ billion for home care, including $6½ billion for additional home-care places, as we build towards a single support-at-home program. There is $7.8 billion which goes directly into residential aged-care investment. As the member for Cooper has said, $3.2 billion is for the basic daily fee, which goes to support the operations of facilities, patients and workers—all of those things flow from that investment. It is then immediately added to the new investment of $3.9 billion under the AN-ACC system for the work that is done to support care minutes. Those care minutes are all about the employment of workers—nurses and personal carers—to provide that care. It is a fundamentally important step forward.

In relation to COVID, there has been some comparison with the UK and the US. Tragically, in the UK over 127,000 lives have been lost. In the US well over 600,000 lives have been lost. These figures are almost incomprehensible. If Australia were to have had the developed-world average, we would have had approximately 30,000 lives lost. If we were to have had the per capita rate of those two countries, we would have had 50,000 lives lost. I thank and acknowledge Australians. More than 26 per cent of eligible Australians have participated in the vaccine rollout so far. We urge them to continue. Over 6½ million Australians have been vaccinated, 100 per cent of aged-care facilities have had first doses and over 97.8 per cent of facilities have had second doses.

Finally, with regard to Indigenous Australians, $4 billion over the forward estimates goes specifically to their needs, with $781 million new. To answer the member for Lingiari, the funding in relation to Maningrida has been transferred to local community control, and I am advised they are now able to deliver the services.

Proposed expenditure agreed to.

12:18 pm

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

Australia's economy is recovering quickly from the pandemic, with more Australians in work than ever before and job advertisements at their highest level in 12 years. The Morrison government wants all Australians to share in the opportunities created by our economic recovery. We understand that this means providing extra support for those within our community who face additional challenges and barriers. The Social Services portfolio measures in the Appropriation Bill (No.1) 2021-22 being considered today will deliver an unprecedented boost to services supporting some of the most vulnerable Australians.

More than $10 billion has been committed in the 2021-22 budget for new initiatives. These will work towards our commitment to protect the most vulnerable Australians now and into the future. This is on top of the base funding for the portfolio—resourcing for the Department of Social Services is a staggering $131 billion in 2021-22 alone. This represents a historic expansion of support and recognises that safety and security are more important than ever. The measures include a historic package to address women's safety and security—a very high priority in the budget. They include a national early childhood program for children with disability and improvements to the National Redress Scheme. There's also $9 billion for a series of permanent changes to strengthen the social security safety net and ensure jobseekers have the best opportunity to secure employment.

In the big year-on-year increase to the rate of unemployment benefit since 1986, the base rate of working-age payments such as JobSeeker has been increased by $50 a fortnight as part of these extraordinary changes. This additional and ongoing support will assist income support recipients as they transition back into the workforce. The income-free area for working-age payments has been bolstered to $150 per fortnight to support jobseekers as they secure employment. These permanent changes strike the right balance between support for those Australians in need and incentives to return to work.

The changes also come on top of the unprecedented level of economic support provided to Australians to assist them through the coronavirus pandemic, including the coronavirus supplements and the economic support payments. The Morrison government's economic support payments alone benefited 5.1 million Australians who were in receipt of the age pension, disability support pension, carer payment or veterans payment or who were concession card holders. In total, these payments provided $12 billion in additional assistance to Australian households, above and beyond these recipients' regular payments. On top of these payments, the 2021 budget is further supporting retired Australians with a package of reform to enhance the pension loan scheme, providing pensioners and self-funded retirees with access to lump sum payments.

The budget also provides enhanced support for those on the cashless debit card through an economic and employment support services package for the first four CDC program sites. The cashless debit card delivers on the Morrison government's commitment to ensure that social security recipients have access to the best technology to manage their money and overcome social harm. Under the package, $30 million will be allocated to establish a jobs fund and job-ready initiatives under an economic and employment support services package to create employment opportunities for individuals residing in those sites. The CDC support services for employment, as well as funding for rehab facilities, will also be bolstered. This support complements that provided by the cashless debit card in reducing access to products that can cause social harm. Data collection arrangements and community engagement for the cashless debit card will also be improved. Further, the extension for place based income management to 31 December 2023 provides certainty and support for around 2,500 vulnerable Australians in 12 sites. It offers participants assistance to build their budgeting skills and ensures the needs of individuals and families are met from the safety net provided by income support payments.

While the comeback in Australia's economy is well underway, we know we'll continue to confront challenges. During the pandemic, the government stood side by side with all Australians, and we'll continue to support Australians as they look for work and the economy recovers. These and other measures form a comprehensive social services package to support Australians faced with challenges and barriers, as well as to secure our economic recovery.

12:23 pm

Photo of Linda BurneyLinda Burney (Barton, Australian Labor Party, Shadow Minister for Families and Social Services) Share this | | Hansard source

The past year has reminded all Australians of the importance and the value of our social security system. It exists and functions to ensure that Australians can live with dignity, no matter their employment status, their age or whether they or a loved one have a disability. Australians understand that life can be random and unpredictable. You never know when one day you may need a bit of extra help, and Labor will always seek to strengthen and improve our Social Security system. Our pensioners have worked hard and contributed all their lives. They deserve respect, and they deserve to live with dignity.

However, over the past year this government has either cut or tried to cut the pension. In 2015, they did a deal with the Greens that saw 370,000 pensioners receive $12,000 less a year. In 2014, they cut $1 billion out of the pensioner concessions. They have spent five of the last eight years trying to increase the pension age to 70, and just last year they were caught trying to freeze the pension by refusing indexation. The short-changing of pensioners by this government continues on the unreasonably high deeming rates. While the reserve cash rate is 0.1 per cent, this government continues to maintain an upper deeming rate of 2.25 per cent. My first question for the government is: why is the government pushing pensioners into risky investments by short-changing them with this unreasonably high pension deeming rate?

The cashless debit card the minister has referred to is something that we understand very well. It insinuates that Australians looking for work have chosen unemployment. The news is in: the cashless debit card has not changed behaviour in the trial sites. Labor will fight the cashless debit card every chance we get. We don't think quarantining 80 per cent of a social security payment and having, in some cases, the capacity for 100 per cent is right. My second question to the government: is why won't the government come clean about its secret plan to roll out the cashless debit card nationally? It is perfectly obvious that there is a working group with the big banks and the payment systems. Why does that exist if there is not going to be an expansion?

Most importantly, today I want to speak about the redress scheme, something that is fundamental to the work that we do in parliament and an enormously important Labor legacy. One of the major programs the Department of Social Services has been the administrator of is the National Redress Scheme. It follows the royal commission into institutional child sexual abuse and the national apology to survivors. This nation made a commitment to deliver redress—redress that is timely, redress that does not retraumatise, redress that survivors can have confidence in. The royal commission estimated that 60,000 survivors would be eligible for redress. As of 26 March 2021, three years after the Senate commenced, only 5,266 applications have been finalised. It is clear that too many survivors have been left waiting or are missing out altogether. Too many applications remain in limbo as institutions named in applications for redress refuse to do the right thing and join the scheme. Some elderly or terminally ill survivors have died without receiving redress and survivors are seeing their payments being chipped away by a low cap, the indexation of prior payments and being pushed into the costly and lengthy court systems.

In February Labor moved a suite of amendments to get the scheme more effectively delivering for survivors, to collect contributions from institutions refusing to join the scheme, for governments to act as funders of last resort, for an early payment scheme and to lift the cap on payments to reshape the assessment framework.

My final question to the government is: will the government commit to these amendments to get the scheme back on track, and when will it release its legislated two-year review?

12:28 pm

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

I rise to speak on the consideration in detail for the Social Services portfolio and the working-age payments and Pension Loan Scheme. The Morrison government is investing more than $9 billion in the 2021-22 budget to strengthen the social security safety net to ensure support is there for those who need it most. It's especially important at this time when so many Australians have been through such difficulties and changes in their circumstances. We have already legislated a package of measures that permanently increases the base rates and income-free areas of working-age payments, including JobSeeker. From 1 April, 2021 the base rate of these working-age payments was increased by $50 a fortnight and the income-free area for JobSeeker payment and youth allowance was increased to $150 per fortnight. Australians without access to paid leave who are required to quarantine, self-isolate or care for someone as a result of COVID-19 can also continue to access income support under those measures. The increases for working-age payments strike the right balance between support for people who need it and incentives for people to take up work. Approximately 1.9 million working-age-payment recipients are already benefiting from these measures.

At home in Moncrieff on the Gold Coast, at the height of the pandemic, there were over 15,000 in my community who received the JobSeeker coronavirus supplement, and now that number has fallen to 10,158 people on JobSeeker payments who will continue to benefit from this historic increase. There are almost 2,000 students in my electorate who will also benefit from the increase in support, as well as over 1,500 single parents.

This is the biggest year-on-year increase to the rate of unemployment benefits since 1986, when I was about 17, and it has been delivered under this government, the Morrison government. It's also the largest-ever budget measure in respect of working-age payments. The pandemic caused a once-in-a-lifetime disruption to the labour market, and, while the comeback in Australia's economy is already underway, we know we'll continue to confront more challenges ahead. During the pandemic, we have stood side by side with all Australians, and these new permanent arrangements continue to make good on that commitment to supporting Australians as they look for work.

The Morrison government is also improving the Pension Loans Scheme to increase its flexibility and make it more attractive to Australians of pension age. We want our older Australians to enjoy greater financial independence and quality of life. The Pension Loans Scheme is a reverse-mortgage loan product. It allows Australians of pension age to unlock the equity in their home to generate additional retirement income. Participation in the scheme is voluntary and participants have complete discretion as to how they spend their money.

From 1 July 2022, Pension Loans Scheme recipients will benefit from a no-negative-equity guarantee and access to capped advance payments. We're also introducing a campaign to raise awareness of the scheme. The no-negative-equity guarantee means participants will not have to repay more than the market value of their secured Australian property. Up to two lump-sum advances in any 12-month period will be accessible for recipients, up to a total value of 50 per cent of the maximum annual rate of age pension. Based on current rates, lump-sum payments of up to around $12,385 per year would be available for singles and up to around $18,670 for couples. As highlighted by the retirement income review, drawing on a small portion of home equity can substantially improve the retirement outcomes for older Australians. The changes to the scheme will give our older Australians more choice and more options to enjoy their life in retirement.

This government is giving a leg-up to all those Australians who need extra help with our safety net, whilst also balancing taxpayer contributions to our great liberal democracy. My question to the minister is: can the minister advise how many older Australians could benefit from these changes to the Pension Loans Scheme?

12:33 pm

Photo of Peta MurphyPeta Murphy (Dunkley, Australian Labor Party) Share this | | Hansard source

My question to the minister is: what is this government doing to ensure that older Australian women—the fastest growing cohort of homeless people—aren't forced into homelessness because of housing affordability issues and, in particular, the enormous rise in rental costs across this country but also in my electorate of Dunkley?

I have been contacted by many, many locals who are concerned because they can't get into the housing market, or their children can't, but they're absolutely petrified because they are currently in rental accommodation, have been asked to leave—because landlords want to sell those properties because of the extreme rise in value of houses across the country and in my electorate as well—and they can't find anywhere else to rent that they can afford. These constituents are predominantly single parents. A huge proportion of them are women who have fled violent or controlling relationships, or whose marriages have broken down and in the divorce the matrimonial house has been sold, and they are left with children. They are not able to buy back into the housing market and are relying on renting.

Is the minister concerned that the rental assistance provided by his government and his department isn't going to be able to assist these people and people like them to be able to live in safe and secure accommodation? Given that Anglicare Australia's recently released Rental Affordability Snapshot reveals that in the last 12 months there has been a massive drop in the number of affordable places for working families to read is the minister working on anything to address this struggling cohort of often hardworking but socioeconomically deprived Australians who can't find a place to live that they can afford? A year ago, 22 per cent of rental properties were affordable for two parents both working full-time on the minimum wage with two young kids. Now, it's only 14 per cent of those types of families who can afford a rental property. How is a single parent supposed to be able to afford to rent let alone buy a home?

Overall, housing affordability across Australia has declined with the proportion of income required to meet loan repayments increasing to 34.7 per cent, according to the latest Real Estate Institute of Australia quarterly Housing Affordability Report. We know there is no simple or single solution to improving housing affordability, but why is it that this minister and this government have ignored one of the biggest answers that we have: an investment in social and affordable housing? There are more people on social housing waiting lists than ever before. The wait lists continue to grow. There are people in my electorate contact me who are on the disability support pension, single parents, who are on 20-year waiting lists for social and public housing. There is less public housing today that there was 10 years ago. The percentage of social housing as a proportion of all national housing stock also continues to decline.

Why won't the minister and this government follow Labor's policy to create a $10 billion off-budget housing Australia future fund? It will build social and affordable housing now and into the future, and it's good for the people in our community who just want safe and secure housing for themselves, for their children and for their retirement, and its good for the economy. Given the statistics show that the program for the early release of super has hit low-income women particularly hard, and there are so many now who don't have superannuation because they have withdrawn all of it or all of it bar $1,000, what is the minister and this government going to do to make sure that those women aren't retiring into poverty and homelessness like so many others?

12:38 pm

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

Thank you for the statements made by members of this House, which I'm pleased to respond to. The member for Moncrieff asked about older Australians benefiting from changes to the pension loan scheme and how many older Australians could benefit from changes to this scheme in this year's budget. I am pleased to advise that any Australian of age pension age can benefit from the pension loan scheme subject to how much equity they own in Australian real estate, if they choose to use it. This is because the scheme, which is a reverse mortgage loan product, is not just available for pensioners and part pensioners but also for self-funded retirees. Age pension recipients can combine their pension payments with the loan amounts provided by the scheme up to a total of 150 per cent of the maximum rate of age pension. On the other hand, self-funded retirees can receive the whole 150 per cent of the maximum rate of age pension as a loan.

Participation in the scheme is voluntary and participants have complete discretion as to how they spend their money. Since the reduction in the scheme's interest rate in January this year, participant members have more than doubled. At the end of March, there were over 4,000 older Australians participating. We're also introducing a campaign to raise awareness of the scheme so that more Australians of age pension age are aware of the options available to them. As the member for Moncrieff has stated, these changes mean that older Australians will be provided with more choice to enjoy their life in retirement. The retirement income review has shown that, by tapping into a small proportion of their home equity, older Australians could substantially improve their retirement incomes. Can I say I'm particularly proud of the way the government has supported pensioners in the way in which we're delivering for older Australians.

In response to the member for Barton asking questions about pensioners on the cashless debit card, let me be absolutely clear on government policy: we have no such plan and never have had such a plan. The cashless debit card is for those Australians on working age payment to help stabilise their lives, become job ready and get back into the workforce. Overwhelmingly, Australians in Cape York were excited that they could use the cashless debit card when they travelled to Cairns, Townsville or wherever else they might go. One issue that has been raised a number of times concerns the amount of misinformation—much of it perpetuated by those opposite, unfortunately. Any campaign aimed at suggesting that age pensioners will be moving in this direction is patently and utterly wrong.

Can I respond to the member for Dunkley on the issue of affordable housing. When it comes to social housing, social housing has and always has been the responsibility of state governments—any failing in social housing is a failure of state governments period—notwithstanding the federal government's intervention through programs such as NHFIC, which has sought to put over $1 billion into the community housing sector to assist. It's also important the member for Dunkley understands that the federal government spends over $5 billion per annum in Commonwealth rent assistance, on top of other primary payments. Likewise, we've increased the base rate of unemployment benefits for the first time in 35 years. That's the first time since there have been five Labor prime ministers and four liberal prime ministers. It's this government that has put more money into the base rate of unemployment and more money into Commonwealth rental assistance than any government in living memory.

Can I also respond to another question asked by the member for Barton in terms of the National Redress Scheme. I acknowledge her heartfelt interest in the scheme and the requirement and desire for the scheme to do better. The scheme recognises that survivors of institutional child sexual abuse have been waiting for a long time for redress. I think we all acknowledge the enduring pain of survivors and their families who are waiting for resolution. No scheme is perfect; not this one, not any one. There is always trauma in coming forward. But the government is working hard to ensure that every institution with a history of working with young people joins the scheme to ensure all survivors who come forward can access redress. Institutions will be able to join throughout the life of the scheme, maximising access to redress for survivors. If institutions named in applications do not join the scheme, they will be publicly named, will become ineligible for Commonwealth grant funding and may be stripped of their charitable status.

12:43 pm

Photo of Fiona PhillipsFiona Phillips (Gilmore, Australian Labor Party) Share this | | Hansard source

I thank the shadow minister for families and social services for allowing me to ask some questions to the minister on behalf of constituents in my electorate. I look forward to the minister's reply. I was contacted not so long ago now by a young woman, a mum, named Bianca. I was absolutely surprised, almost beyond belief, at what Bianca told me. Of course there are the cashless debit card trials, and I want to make it crystal clear that Labor will scrap the cashless debit card, but never in a million years did I think anyone in the electorate of Gilmore would be impacted, because we're not a trial site. How wrong was I?

Bianca, now residing in my electorate, originally lived in Bundaberg for several years. However, Bianca moved to Brisbane to escape domestic violence. While living in Brisbane, Bianca was placed on the cashless debit card in July 2019. Not long after, Bianca moved to Sydney and was unfortunately hit by a car, and then had a carer due to her permanent injuries. When Bianca was in hospital after being hit by the car, Bianca tells me she could not use the cashless debit card to pay for the TV to be connected, because it sold gambling products. In November 2020, Bianca complained to Centrelink about being on the cashless debit card because she went to pay for a meal in a bistro and, because they sold alcohol at the venue, she was not able to pay for her meal. Bianca said it would take up to two weeks for her rent payments to be cleared by the cashless debit card hotline, so she was constantly behind.

Bianca's complaint resulted into an investigation into Bianca's previous leases, and it was discovered that Bianca was not living in Bundaberg, the trial site for the card, at the time of the cashless debit card rollout. Bianca was then told she had been placed on the cashless debit card in error, and she was subsequently taken off the cashless debit card. But this terrible story does not end there. Now residing in my electorate, Bianca got a phone call from Services Australia saying that she had been taken off in error and had now been placed back onto the card, with no explanation. Bianca's carer also tried speaking with Services Australia and could not get any answers.

Bianca is afraid that she will not be able to pay for things, because 80 per cent of her payment goes onto the card and she only gets 20 per cent in cash. She is also worried that when she buys her groceries at Aldi, if they have only one register open and it sells alcohol, she will not be able to buy her groceries. Bianca says she has a large bust and her bras cost a lot of money. She can get the ones she needs on eBay, but, because they sell alcohol, they are not an approved seller. To purchase her bras, she must first seek approval from Indue and provide photographs of what she wants to buy. Then, if approved, she must provide proof of purchase. Bianca said it is humiliating to have to get approval to buy her underwear.

Bianca said she fled a domestic violence situation because her partner would restrict her access to money. Bianca tells me it appears that the government is now doing exactly the same thing. So, as Bianca's federal member, I worked to have Bianca permanently removed from the cashless debit card. I am assured this has now happened. I am told that every Centrelink or Services Australia office has spare cashless debit cards. Here I was, thinking it was limited to the trial sites.

So I have three questions to the minister: No. 1, how many people are on the cashless debit card in the electorate of Gilmore: No. 2, how many people are across Australia who reside outside the trial sites are on the cashless debit card; and, No. 3, given the high number of pensioners in my electorate, can the minister rule out completely that pensioners will be put onto the cashless debit card?

12:47 pm

Photo of Melissa McIntoshMelissa McIntosh (Lindsay, Liberal Party) Share this | | Hansard source

Everyone deserves to be safe—safe in their homes, their schools, their workplaces and their communities. But, sadly, we know this isn't always the case. This is particularly important for people in my electorate of Lindsay, an area that experiences higher rates of domestic violence than the New South Wales state average. Between April 2020 and March this year, the Bureau of Crime Statistics and Research measured domestic violence assaults in Penrith at nearly 614 per 100,000 population. This is significantly higher than the New South Wales state average over the same period, 395.

I'm working closely with Penrith Women's Health Centre to ensure we have the services in our community for women and their families when they need them most. We really must continue to support these on-the-ground services, who work incredibly hard to support women and children in our community. That's why I delivered funding for two specialist domestic violence case workers at Penrith Women's Health Centre. In speaking with the staff at the centre and the women they support, I have seen firsthand the difference this has made, increasing the availability and accessibility of services. When I have written and spoken to women in my community about this issue, so many have shared their own personal experiences and stories, including very distressing and devastating stories. It shows how important this work is and how much we must support it to continue, particularly in a community like mine, where the rates of domestic violence are significantly higher than average. Our local police know how important this issue is, and we're working together on how we can tackle some of these critical issues.

The Morrison government also takes the safety of Australian women and families incredibly seriously. Our $1 billion Women's Safety Package is contributing to the target of ending violence against women and children. This is an historic, record investment in the safety of women across Australia, and as part of this package we're investing $600 million in this year's budget across 16 new women's safety measures. Among the initiatives is a new two-year funding agreement where the Morrison government will commit $260 million to partner with states and territories to boost local frontline services and trial new initiatives in the transition to the next National Plan to Reduce Violence Against Women and their Children. The funding is on top of the $130 million provided to states during the COVID-19 pandemic and the $340 million under the fourth action plan as well as the investment from state governments. This combined effort acknowledges the work of frontline services in tackling domestic violence and allows us to trial innovative initiatives and focus on prevention, early intervention and perpetrator responses. Our women's safety package also provides support for Aboriginal and Torres Strait Islander women. We have over 6,000 Aboriginal and Torres Strait Islander people in my electorate of Lindsay, so I'm particularly passionate about ensuring that they've got the best support possible.

Preventing and responding to violence against women and children is a shared responsibility of all governments—of everyone in society, actually—and it's why we're working with the states to provide this historic level of funding. We recognise that the impacts of the pandemic on women's safety and that there continues to be demand for support from frontline family, domestic and sexual violence services, just like at Penrith Women's Health Centre, and we're committed to removing the barriers and streamlining support for people escaping domestic violence.

Another program, Stop it at the Start, aims to break the cycle of violence by encouraging adults to reflect on their own attitudes and have conversations about respect with young people aged 10 to 17 years. This message needs to get through every sector of society. Violence against women is not acceptable under any circumstances. I'll continue to work closely with my local organisations in Lindsay and to support them where I can.

Along with the measures I've just highlighted, could the minister advise what further programs the Morrison government is committing to in the 2021-22 budget to secure women's safety—particularly those programs helping women leave violent situations?

12:52 pm

Photo of Anne AlyAnne Aly (Cowan, Australian Labor Party) Share this | | Hansard source

It's quite serendipitous that I follow the member for Lindsay here today, because I too have questions about the government's commitment to women, particularly those fleeing family and domestic violence as well as more broadly. But I want to start by focusing on domestic and family violence. While we accept that there are some good measures in the budget for women, let's not forget that this is a government for whom women's safety and security only became a thing after their own disastrous record was revealed. The first budget statement on women was revealed in the previous budget, and one wonders why it has taken so long for this government to recognise that women's safety and security as well as a number of issues for women need to have a specific focus within the budget.

With regard to family and domestic violence, of course we welcome any additional funding for women's safety. I know that in my own electorate of Cowan the services that are on the front line, helping women leave family and domestic violence situations, are absolutely inundated. Last week I met with Broken Crayons Still Colour, which helps women to get out or flee family and domestic violence. They have had a 50 per cent increase in the number of women that they have had to help, and they are staffed solely by volunteers. They get absolutely no funding from the government. Similarly, No Limits, within my electorate, has been recognised with several community awards for the work that they do in helping women flee violence and helping them get back on their feet after fleeing family and domestic violence. Again, they are inundated with requests from women and children leaving domestic violence.

Last week in this House I spoke about a case in Cowan of a woman who fled a domestic violence situation with her four children, one of whom has severe autism, and was turned away by a service provider because there simply was no room. She had to return to her abuser, who allows her to stay in the house during the day to look after the children and at night turfs her out to sleep in the local park. Our office and some of the charities in the area were able to provide her with a sleeping bag and some blankets to keep her warm at night. She has to drive 20 minutes to go to the nearest bathroom. And she's not alone in that situation.

Even before COVID-19, the government's own figures suggested that almost 10,000 women and children would be fleeing domestic violence or turned away from shelters. We know that number has increased. So my question to the minister is: why has it taken eight years for the government to realise that we have a crisis here for family and domestic violence accommodation? Fifteen years ago, when I was a volunteer for a family and domestic violence organisation, I wrote a report on a needs analysis for women fleeing domestic violence. That report was called No place to go. Today, I have agencies asking for that report and quoting that report, because there is still no place to go.

The budget sets aside $29.3 million to improve migrant and refugee women's safety over the next three years, but there is $464 million to bolster immigration detention. Let me put that into perspective for everyone here. That is 15 times more money to lock up women and children than to help set them free. Why has the government underinvested in helping women and children flee domestic and family violence, given the scale of the epidemic that we have in this country? We know that First Nations women are 32 times more likely to be hospitalised as a result of domestic violence. Why hasn't the government made an investment that meets the scale of this problem? Like I said, any funding is welcome, but it is simply not enough. Can the government please explain how it came up with the level of funding to put into family and domestic violence given the scale of the problem and given the specific increases in the issue with COVID-19? Why doesn't the funding match the scale of the issue? I'm a little concerned that it's all too little, too late, which happens to be a hallmark of this government, just as with its Women's Budget Statement. I would like the minister to answer those questions specifically. I would like to know where the funding is that actually addresses and meets the scale of this problem. (Time expired)

12:57 pm

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

I thank the member for Lindsay specifically and other members for their questions and the points they have made. The member for Lindsay has specifically asked what further measures the government is investing in to secure women's safety. I'm pleased to advise her that the 2021-22 budget provides unprecedented funding towards ending violence against women and children.

The priority of the Morrison government has always been keeping Australians safe—safe in their home, safe at work and safe in our communities. Working towards this goal, we are focused on making Australia a place that is free from violence against women and children. The funding committed in the budget is the federal government's single largest investment in women's safety and domestic violence support in history, across any government. The billion dollar Women's Safety Package includes a $600 million investment in women's safety measures under the Social Services portfolio that contribute to the 'towards zero' target, forming part of the measures considered today in Appropriation Bill (No. 1) 2021-2022. As the member for Lindsay has highlighted, these measures build on the work of the Fourth Action Plan of the National Plan to Reduce Violence against Women and their Children and the funding committed through COVID to assist frontline services. This historic budget funding is a down payment for the future. It ensures a seamless transition to a new national plan to end violence against women and children, which will commence in July next year but looks at issues facing today and builds a base for new and emerging issues.

As part of the package we are also providing funding of $12.6 million for five additional projects under the Safe Places initiative. These projects will provide emergency accommodation for women and children escaping violence in regional and remote communities. We want women to know they have somewhere safe to go when they make a brave decision to escape violent situations. Women and children in regional and remote communities in particular face specific challenges, especially when they're not able to stay with family and friends. The new emergency accommodation created by these projects will not only give women and children a safe place to stay but also provide access to specialist family and domestic violence services to help them get back on their feet. These projects build on the $600 million commitment announced in September last year to the Safe Places program, which will help around 6,000 women and children each year to escape violence. The additional funding is expected to help a further 450 women and children annually.

We are also investing a further $164.8 million to establish the new escaping violence payment. The government are committed to breaking down all the barriers to women leaving violent relationships, and we recognise that financial dependence or isolation can be one of the largest barriers for women to overcome. This two-year pilot program addresses the significant barrier to women leaving a violent relationship. The payment will provide women with $5,000 in financial support to help women escape violent relationships as they establish a home free from violence. This support includes up to $1,500 in immediate cash, with the remaining amount available for goods and services such as rental bonds, school fees, whitegoods, car rego and the like.

We are also committed to continually improving the National Redress Scheme for survivors of institutional child sexual abuse, as I have said previously this afternoon. This year's budget includes a further investment in the scheme which will provide for initial and immediate action in response to the two-year review of the program. Importantly it will help ensure the scheme remains survivor focused. These measures are among 16 new women's safety initiatives that will ensure a seamless transition to a new plan to reduce violence against women and children.

The government's budget is securing Australia's recovery by ensuring women, children and vulnerable Australians have better access to the support they need. This is evident not only in the comprehensive women's security package but also in the measures considered in Appropriation Bill (No. 1) for the Social Services portfolio.

I turn now to responding to the member for Gilmore on the issues she raised on the cashless debit card. As we in the House all know, the cashless debit card is a Visa debit card and operates exactly the same as a Visa debit card. It operates throughout the payments network, the EFTPOS network, which has over one million outlets. It can be used at pubs, clubs and restaurants to buy meals and non-alcoholic drinks—it can be used at pubs, clubs and restaurants. To confirm what I have already said once today—I will reconfirm it because apparently it is having trouble sinking in on the other side—there is no plan for it to be moved to pensions; it is for a working-age payment only. I can't be clearer than that.

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

The Federation Chamber will now consider the National Disability Insurance Scheme and government services segments of the Social Services portfolio in accordance with the agreed order of consideration. The question is that the proposed expenditure be agreed to. I call the minister.

1:02 pm

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

Thank you, Mr Deputy Speaker. It is wonderful to see the member for Maribyrnong once again on the other side of the chamber. I thought I had lost you when I moved. It's good to see you back. The NDIS, as we all know, is a world first that all Australians justifiably should be proud of and was introduced with bipartisan support. The Morrison government is ensuring Australians can receive vital supports and services by investing a staggering $13.2 billion extra into the world-leading NDIS in the 2021-22 budget—$13.2 billion. The Morrison government has always said it is committed to funding the NDIS as a demand driven scheme, and this is reflected in more than $17 billion in additional funding in the last two budgets alone.

The 2021-22 budget also makes a significant investment in enhancements to the care and support workforce and improving the way government services are accessed and delivered, particularly for Australians living remotely. We are also delivering the NDIS and making sure it is equitable and affordable for Australians today and tomorrow. The government intends to introduce reforms based on creating a fairer, respectful and more consistent NDIS. The government is committed to improving the NDIS in line with the vision embodied in the 2011 Productivity Commission report and supported by the 2019 Tune review. The NDIS is fully funded and demand driven, with 450,000 Australians now accessing life-changing supports.

The budget provides hundreds of millions of dollars in funding to further improve the way Australians interact with the government online, over the phone or in person. The government has reaffirmed its commitment to quarantining essential services now and into the future by allocating $200 million to design and deliver an enhanced myGov over the next two years as a single front door into government for all citizens. Consequently, there are 18 remote service centres assisting people living in remote parts of Australia to access Medicare, Centrelink and child support payments and services. Last financial year Services Australia had 350 agents and 235 access points throughout regional, rural and remote Australia, and will continue to step up to the plate in supporting Australians now and into the future.

1:04 pm

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

Before I start, I understand that there were two ministers due here for the one-to-1.30 slot? Where is Michael Sukkar? The government is not bringing its ministers; is that what's happening?

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

It's nothing to do with the chair, as you would know.

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

No wonder there's a homelessness crisis. My question is to my sparring colleague who was the Minister for the NDIS. I'll put background to the question. The government keep changing their justification to cut the NDIS. First of all, they came up with this concern about consistency and fairness. The Morrison government sprung on Australians a plan for independent assessments when it announced its response to the Tune review in August 2020. When people were shocked, the government claimed that the independent reviewer, David Tune AO, PSM, had called for independent assessments to be introduced in order to fix issues with consistency and fairness. Labor agree that there are issues with consistency and fairness, but when Labor FOI'd the report we found that the government had inserted in the report the entire chapter and recommendation for independent assessments—perhaps it was not so independent a review with not so independent assessments. These assessments will be done by companies who not only are in cahoots with the government but also used to be the government, in the case of one of the companies. One company is linked to former NDIA CEO Robert De Luca and another company is led by a former Liberal MP, thus confirming the old cliche that this government has never seen a government opportunity that it hasn't sought to monetise.

'Consistency and fairness' still reverberates from the new minister, like a parrot of her predecessor, my friend Stuart Robert. The new minister has said, 'Your postcode absolutely determines your package.' You could be mistaken for thinking that the independent assessment is intended to increase NDIS funding for those who are missing out—communities whose first language is one other than English, First Nations communities and people in remote areas. But what this government really wants to do is reduce the packages for people who are able to navigate the NDIS bureaucracy well enough to get a decent level of support. In other words, the answer of this government to some people not accessing it is to have independent assessments which make it harder for everyone to access it—because misery loves a friend. This postcode discrimination issue isn't solved by making it harder for the people currently enjoying this world-class scheme to get the necessary supports.

When the government was caught out on consistency and fairness it went back to an old favourite of the antiwelfaremeisters and said this was about participant fraud. Minister Robert claimed that the NDIS needed to change because people with disability were scamming the system to get themselves yachts, jetties and other services, which he felt wouldn't pass the pub test. This came from an MP who famously claimed $38,000 for his home internet bill—there is nothing that NDIS participants couldn't learn from him! The NDIA have since confirmed that, out of a thousand fraud tip-offs made against 430,000-plus participants, none have revealed fraud from the participants. In too many cases the government assumes that, if you need government support to access a wheelchair, you must somehow be a malingerer. The fact that, as early as March this year, the former minister felt he needed to employ the welfare-cheat dog whistling to garner public support just shows how desperate they are to cut the NDIS.

The government's third explanation for independent assessments is that it's unsustainable. Somehow the government thinks that aspiring to an ordinary life is too expensive. In terms of sustainability, my question is in several parts. How much is currently being spent by the NDIA on consultants? How many matters are currently in the backlog of cases appealing to the AAT? How long have these cases been waiting for a decision? How much of the NDIS's spending is on private sector lawyers to get through the AAT case load and why isn't it being handled in house? How many positions are currently vacant in the NDIA's AAT branch? Is the minister aware of how much NDIS funding is currently being lost to fraud by shonky service providers? What is being done to combat systemic provider fraud? When will the government come clean on the NDIS costs and release their financial sustainability report and the modelling beneath it?

1:09 pm

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

The NDIS is a world first that all Australians should be justifiably proud of. It was introduced in a bipartisan way. In fact, we have members in the House who were the architects of this. We should really pay credit where credit is due. From the outset it was envisaged that the NDIS would support participants with permanent and significant disability to exercise control and choice over their life with a fair, flexible and consistent package of reasonable and necessary support. The need for the NDIS to remain affordable was also integral to that initial vision.

Almost 450,000 people with permanent and significant disability are now being supported by the NDIS. Incredibly, 50 per cent are receiving support for the very first time. This is an initiative that is being supported enthusiastically by those Australians who need it. We all want an Australia where disability doesn't limit the choices you have available but opens up possibilities for different ones and an Australia where disability doesn't limit what decisions you get to make about your life or require others to make those decisions for you, but there is evidence that the current approach to assessing a person's functional capacity is inadequate, leading to inconsistent and inequitable eligibility, planning and budgeting decisions.

The data also clearly shows that those with lower socioeconomic status on average have lower plan budgets than those with higher socioeconomic status, which suggests that those who have greater means have greater access to systems, assessments and reports. We don't want to see this. We don't want to see it depend on where you live as to how you get access. That is why the Morrison government is looking to ensure fairness and equity for all Australians with disability.

The principles of the NDIS have always been that the government decides who gets the NDIS and how much they get and that the participant with the disability decides how they spend it. That is fair and equitable. As a result, the use of standardised objectively administered assessments is a core element of insurance based schemes such as this. In fact, in 2011 the Productivity Commission recommended the NDIA engage independent health professionals to undertake the assessments of those wanting to receive NDIS support. These are clear integrity measures to ensure a fair and equitable outcome for all.

The Productivity Commission noted that, in order to promote independent outcomes, assessors should be drawn from an approved pool of allied health professionals and that, in order to reduce the potential for sympathy bias, they should be independent from the person they're assessing. Independent assessments will ensure the NDIA can gather more consistent and robust information to better understand how it can support participants.

We also need to be sure that we can sustain the NDIS, not just now but into the future. I will say that parents of children with disabilities understand this very core. They understand that if we destroy the NDIS because it's out of control then we are going to destroy it for the future of these children. We need to make sure that we are fair, equitable and reasonable.

Updated forecasts suggest that there's going to be an increase to the 411,000 Australians between the ages of zero and 64 who would join the NDIS as modelled in 2011. Updated forecasts project 532,000 Australians will join the NDIS by June 2023. On the current trajectory, the NDIS is estimated to cost more than the MBS in just a few years time. We need to ensure that we have a scheme that can financially endure for many generations to come. We all want this. We all need this.

The Minister for the NDIS, Linda Reynolds, has visited Higgins. We had a roundtable to talk about independent assessors. She is listening carefully on this issue. We are engaging with providers, with those who are in the scheme and with the experts. The Morrison government is fully committed to ensuring the NDIS is here to support Australians for years to come. I thank the minister for meeting with us in Higgins to talk about this highly sensitive and very important topic and engaging with the sector, the providers and the participants to make sure that we can together provide great outcomes. Can the minister please provide an update on how the Morrison government is delivering a strong, skilled and sustainable NDIS workforce for now and into the future?

1:14 pm

Photo of Jason ClareJason Clare (Blaxland, Australian Labor Party, Shadow Minister for Regional Services, Territories and Local Government) Share this | | Hansard source

My question is to the absent Minister for Homelessness, Social and Community Housing, who's supposed to be here right now answering questions but hasn't turned up. But we shouldn't be surprised, because this is a minister who doesn't do his job. This is a minister who has been in the job now for six months—or, to be exact, 181 days—as minister for homelessness, and he's uttered the word 'homelessness' publicly on only six out of those 181 days. No wonder he won't turn up here to answer questions about what he's doing.

Worse than that, he even refuses to meet with organisations whose job is to help the homeless. This is a letter from Australia's peak homelessness organisation, National Shelter. It's a complaint to the Prime Minister about this absent minister. It's dated 21 April, and it says they've been 'unable to secure a meeting with the minister himself despite repeated requests'. Three weeks later, they got a response from the Prime Minister's office telling them, if the minister wouldn't meet with them, to try Minister Ruston. So two weeks ago we asked Minister Ruston in estimates, 'Were you aware that the Prime Minister had flicked this organisation to you?' She had no idea. But, to her credit, straight after estimates, her office picked up the phone, contacted National Shelter and organised a meeting. My question to the absent minister is: after 181 days in the job, why won't you meet with them? Why won't you do your job?

They're not the only ones being ignored by this absent minister. The head of Homelessness Australia can't get in the door. Why won't the minister meet with them? They've tried and they've been rejected. They've been refused entry. Here's another organisation: the Community Housing Industry Association, CHIA, a peak body for community housing organisations in Australia. This is another organisation that has tried to meet with this absent minister and been rejected. They have been refused a meeting. This is his job. It's part of his job to meet with organisations who are trying to reduce homelessness and give this government some ideas about what to do.

Heaven knows they could do with some ideas, because there are more people homeless in Australia today than ever before. In some parts of Australia, there are more people sleeping rough now than before COVID. Last year, 10,000 mums and kids fleeing domestic violence got turned away from refuges because there wasn't a bed—because the inn was full. That's 27 a night. It'll happen again tonight: another 27 mums fleeing in the middle of the night and getting turned away because there isn't room. Last financial year, 95,000 individuals got turned away from homelessness services in this country just because the services didn't have the resources they needed to help them. The people who are trying to help this minister fix it can't even get in to see him.

Whenever he gets asked about this, what's his answer? Unbelievably, he says it's not his job. He says it's the job of state governments. The name on the door is 'minister for homelessness'. Why does he even have the title 'minister for homelessness'? Why won't he have the guts to turn up here and answer these questions? Why on earth does he deserve to keep his job?

1:18 pm

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

Before I respond to the previous speaker, let me respond to the member for Maribyrnong, from Victoria, who spoke prior to that. The member for Maribyrnong would have you believe the government is doing all sorts of nefarious things. The member for Maribyrnong has more front than Myer. He is coming out and saying the government is cutting the NDIS, after $17 billion extra has been put in. I dare the member for Maribyrnong to find that level of estimates variation and increased expenditure across two budgets across any government program in living memory in Australia. There is none. Silence over there; as always, silence.

I will also remind the member for Maribyrnong as to the reason for independent assessments. It came out of the 2011 Productivity Commission. John Walsh, appointed by the Labor government at the time—an excellent appointment; an incredible and deserving Australian; the father of the NDIS—is on the record as saying that independent assessments must go forward. I ask the member for Maribyrnong: do you disagree with your hand-picked member on the Productivity Commission?

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

Point of order.

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

Sit down, son, I'll let you speak when the time's up. The Productivity Commission also noted on page 327 of the report—and I know the member opposite hasn't read it, but I would encourage him to pull it out. I will read it for the member opposite, only because he won't actually read it himself and it is an inconvenient truth that the member doesn't like to look at. The Productivity Commission said, and I will quote it so there is no confusion:

In order to promote independent outcomes, assessors should be drawn from an approved pool of allied health professionals. Assessors should be independent of the person being assessed to reduce potential for sympathy bias. This means that health professionals, GPs and others with past treatment and support responsibilities for the person would not undertake assessments.

The Productivity Commission recommended independent assessments. The Tune review that followed recommended independent assessors. John Walsh, the father of the scheme—a very worthy appointment to the Productivity Commission, recommended by the Labor Prime Minister at the time—recommended independent assessments. But I guess it just doesn't stack up to what the member for Maribyrnong wants, which is just a political fight. I would encourage the member for Maribyrnong to put people with disability ahead of his own political ambitions and then we might get a better outcome.

If I could respond to the previous speaker from Victoria. Let me thank the member for Higgins for all her hard work and what she has done, for her questions and for her ongoing work in supporting the NDIS. The member for Higgins is a qualified professional in her field and knows how important the work is that this government is doing, as opposed to the hack, the member from Maribyrnong, for whom it's just all politics and no expert knowledge.

On 10 June in Perth, the minister for the NDIS launched the national workforce plan. Data from the plan estimate that the NDIS workforce comprise 270,000 workers in 2019-20 and forecast an additional 83,000 workers will be required to service over half a million participants by June 2024. The new NDIS workforce plan is a comprehensive blueprint for today and tomorrow. It's designed to attract workers with suitable skills, values and attributes while also improving existing workers' access to training and development. We need Australians to have a much greater appreciation of the rewards and opportunities that working in this beautiful sector provides, as well as an understanding of the personal satisfaction that is gained through care and support careers. It is a message we need to reinforce at every opportunity and by every means at our disposal. To achieve this, we need more attractive entry pathways and better conditions.

The NDIS workforce plan focuses on pragmatic actions the government can take in partnership with the sector to generate benefits for participants, workers, providers and the broader economy.

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

Point of order.

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

The member will resume his seat.

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

The plan focuses on the following areas. Improved training and career opportunities, strengthening entry pathways to the sector to provide students, school leaders and jobseekers with the ability to upskill with the development of more credentials. I recommend the importance of the report to the House.

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

The minister will resume his seat. Has the minister completed his speech?

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for Employment, Workforce, Skills, Small and Family Business) Share this | | Hansard source

I have completed.

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

What is your point of order?

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

That says it all.

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

I remind members that as much as they are experienced and have spent a lot of time together in the chamber, the courtesy of parliament still exists in this chamber.

1:24 pm

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

Thank you.

Photo of Steve IronsSteve Irons (Swan, Liberal Party) Share this | | Hansard source

To both members, I am talking about.

Photo of Bill ShortenBill Shorten (Maribyrnong, Australian Labor Party, Shadow Minister for the National Disability Insurance Scheme) Share this | | Hansard source

Yes, very wise. In terms of ongoing issues about government services and the NDIS, I have a little more on the NDIS question I had, which I did not get any answers to.