Sussan Ley (Farrer, Liberal Party, Shadow Minister for Women) Share this | Link to this | Hansard source

I rise to speak on the Health Insurance Amendment (Professional Services Review Scheme No. 2) Bill 2023. The purpose of this bill is to improve the ability of the Professional Services Review, PSR, to investigate potential inappropriate practice by health professionals, by addressing issues and ambiguities in the Health Insurance Act 1973.

The Professional Services Review is an independent statutory agency responsible for maintaining the integrity of Australia's Medicare program, through investigating and sanctioning inappropriate practice by health professionals. This bill builds on the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023 passed in September this year. That act continued the reform to the PSR, commenced by the former coalition government, to strengthen the review mechanisms—primarily the claims on MBS items. This bill also continues to implement changes arising from recommendations of the Independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip.

The bill amends the Health Insurance Act 1973 to clarify and improve administration of the PSR scheme, including to: better align requirements for qualifications of committee members to the definition of inappropriate practice and clarify how these requirements should be applied; ensure that committees can be properly established for practitioners who hold a rare combination of specialties, or are practising in a different field to their formal specialist qualifications; make it clear, where appropriate, that a reference to a practitioner includes a practitioner who is not currently registered, such as a deregistered or suspended practitioner, to ensure that the PSR scheme applies consistently; clarify the requirements for a person under review to notify a committee that they are unable to attend a hearing due to a medical reason, including that the person must provide a medical certificate supporting this; and provide the director with the power to extend the statutory time frame of 12 months for deciding a matter if the person under review leaves Australia or if there are ongoing court proceedings in relation to the matter.

The coalition support this bill, as it contains sensible changes in line with our strong and long-held commitment to protecting the integrity and financial viability of Medicare. Australia's Medicare system underpins our world-class health system. Importantly, it is there for all Australians. We in Australia are so fortunate to have a health system that is accessible and available to every Australian no matter where they live or how old they are. Protecting the ongoing viability of Medicare is key to this.

Medicare, including the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme, continues to provide Australians access to free hospital care and more affordable health care and medicines. When the coalition were last in government investment in the MBS and PBS grew significantly under our leadership. In fact, the coalition oversaw record investment in this area and we were committed to continuing that record through our commitment to invest $133 billion over four years into Medicare.

Our approach to Medicare saw the highest bulk-billing rates on record. That is why it has been extremely disappointing to see since Labor came into government that bulk-billing rates have been dropping consecutively every single month. The latest annual data shows a Medicare bulk-billing rate of 77 per cent and 80.2 per cent for non-referred GP appointments in the 12 months to June this year. These are the lowest bulk-billing rates recorded since 2013. This is in stark comparison to the 12 months to June 2021, which saw rates at an all-time high of 88.8 per cent under the coalition.

The Albanese government has overseen plummeting bulk-billing rates at a time when Australians are struggling to pay the bills, let alone cough up for an unexpected GP appointment. We know that the cost of seeing a GP could rise to over $100 per consultation. This government was elected with a promise to strengthen Medicare, yet all the data is suggesting otherwise. In fact, it has only become harder and more expensive to see a doctor under Labor, despite all the headline promises. Bulk-billing rates are falling and the cost of seeing a GP is increasing, creating an unacceptable barrier for Australians in need of critical health care. This proves how important it is to ensure the viability of Medicare is safeguarded into the future.

Right now it is clear that Medicare has been weakened from every angle, and Australians cannot afford for this concerning trend to continue. That is why the coalition will always be committed to supporting the integrity and financial viability of Medicare to ensure that all Australians have access to the critical support provided by Australia's healthcare system into the future.

We were glad to see the government pass the Health Legislation Amendment (Medicare Compliance and Other Measures) Bill in December last year. This was a coalition bill, which we proudly introduced into the 46th Parliament to strengthen the compliance powers of the PSR and add a degree of flexibility to their ability to address any inappropriate practice. We understand how vital it is that there continues to be rigorous and effective health practitioner compliance to protect the financial integrity of Medicare.

We also have a strong track record of supporting our hardworking healthcare practitioners and peak bodies to correctly claim health payments, with a clear focus on education, engagement and consultation. Australians rightly expect that their tax dollars are being used appropriately and effectively, particularly when they are being spent on our health system, which is facing increasing pressures. We need to not only support practitioners who are doing the right thing by the taxpayer and by their patients but also identify the healthcare practitioners who are not acting in good faith.

We do have concerns, however, with the amount of consultation undertaken prior to the introduction of this bill, particularly with respect to the review which prompted these reforms. Time and time again we are concerned by this government's refusal to allow for appropriate levels of consultation on their policies and to follow proper processes. Dr Philip stated in his report:

Given the timeframes set for this Review, my formal consultation with stakeholders has been necessarily limited, supplemented by informal discussions with participants, and I have based most of my work on desktop analysis.

Once again, we record our disappointment in the way that the tight time frames set for this review acted as a significant barrier for Dr Philip to undertake a necessarily thorough consultation. This is now a well-entrenched theme from this Labor government—they do not take the consultation process seriously, and any consultation that is formed by this government seems to be merely a political exercise. Their approach continues to be all headline and no fine print.

The coalition will support this bill and its proposed changes in the interest of improving the Professional Services Review scheme. We acknowledge that this bill builds on the coalition's work to strengthen the PSR, and we are committed to supporting sensible reforms that protect the viability of Medicare long into the future. I thank the House.

Debate adjourned.