Anne Stanley (Werriwa, Australian Labor Party) Share this | Link to this | Hansard source

The Albanese Labor government clearly laid out its priorities in the recent election, and it gave our communities a clear choice. One of those priorities was health. We have proudly showed our accomplishments so far and our ambitious plans to make things better. I believe this passion for health resonated with many. Whether you're on your own or have a family, health is always the biggest issue in your life.

We are improving all aspects of the health system. Whether it's an occasional doctor's visit or a life-threatening emergency, we want to make sure the system works better for people who use it and need it. We've made a massive $6.1 billion investment in Medicare and started work on the rollout of Medicare urgent care clinics and Medicare mental health centres. My community will benefit from both a Medicare urgent care clinic and a mental health centre, which was an election commitment at the last election. When the government's $1.4 billion investment in urgent care clinics is fully implemented, it's estimated that four out of five Australians will live within a 20-minute drive of one of these clinics. I look forward to being at the opening of the clinic in my electorate soon.

Medicare has been one of Labor's greatest achievements, and Australians have entrusted us to protect and strengthen it. Today's bill is part of the government's work to do that. The Health Insurance (Pathology) (Fees) (Repeal) Bill 2025 will implement the Albanese government's budget commitment to remove fees imposed on the pathology sector for the approval of certain categories of accreditation applications. The removal of these fees is required to address the findings of the 2022 Health Portfolio Charging Review, which identified the fees charged under the Health Insurance (Pathology) (Fees) Act 1991 which do not align with the Australian Government Charging Framework (2015). In fact, the fees were found to exceed the administrative cost of processing the applications.

This bill will repeal the pathology fees act, which specifies the fees that must be paid for the acceptance and approval of the following three categories of accreditation applications: an approved pathology practitioner, an approved pathology authority and an accredited pathology laboratory. The approval of these applications allows the providers of pathology services to claim Medicare benefits for rendering those services.

The bill will also make consequential amendments to the Health Insurance Act 1973, which prescribes the payment for fees for acceptance and approval of the applications. The bill provides fee relief and reduces the administrative burden on the pathology sector, as well as retaining the requirements for pathology service providers to meet accreditation requirements. These accreditation obligations will remain unchanged to ensure the quality and safety of pathology services provided under Medicare is maintained.

The bill applies retrospectively, with measures taking effect on 1 July 2025. The Albanese government has conducted consultation with the pathology sector in preparing the legislation, including the Royal College of Pathologists of Australasia, Australian Pathology and Public Pathology Australia. The bill is in addition to the $509.8 billion of funding for the sector included in this year's budget. This includes a $174 million investment to increase the Medicare rebate for many common pathology tests for the first time in 25 years, as well as adding PCR tests for COVID-19 and other respiratory illnesses to Medicare. This means that Medicare rebates will rise each year for labour-intensive pathology tests. This will support the pathology workforce and allow funding to flow through to increase wages. Technological advances continue to drive down the cost of providing other pathology tests. As new technologies get cheaper over time, they will become more commonplace.

We know Australians want to see pathology services continue to be bulk-billed. I spoke with many constituents in my own community who've expressed concerns at the prospect of rising costs. That is why it is good that less than one per cent of tests provided outside hospitals are not bulk-billed, and this investment will ensure that it stays that way. Our priority is to ensure that all Australians have access to affordable health care, and that it is why we are continuing to invest in strengthening Medicare.

I commend the bill to the House.

Ali France (Dickson, Australian Labor Party) Share this | Link to this | Hansard source

I rise in support of the Health Insurance (Pathology) (Fees) (Repeal) Bill 2025. Medicare is Labor's heart, but it is also my heart. Medicare saved my life and gave my Henry the very best chance of surviving leukemia. My family has benefited from bulk-billed pathology over the last decade, which would probably amount to many thousands of dollars that we didn't have to pay upfront.

The Albanese Labor government is committed to delivering more bulk-billed services—not just more GP visits but also more pathology, diagnostic imaging like MRIs and more—and we want to ensure that the current bulk-billed health services continue. Our priority is to ensure that all Australians have access to affordable health care. That's why we are continuing to invest in strengthening Medicare.

This bill delivers fee relief to the pathology sector, in addition to the $509 million of funding for the sector included in the budget. This will ensure there is no gap and that services will continue to be bulk-billed. We're investing $174 million to increase the Medicare rebate for many common pathology tests for the first time in 25 years, and we're adding PCR tests for COVID-19 and other respiratory illnesses to Medicare. Medicare rebates will rise each year for labour-intensive pathology tests. This will support the pathology workforce and allow funding to flow through to increased wages.

We know Australians want to see pathology services continue to be bulk-billed. Less than one per cent of tests provided outside of hospitals are not bulk-billed at the moment. This investment will help ensure it stays that way. Labor will always—

A division having been called in the House of Representatives—

Sitting suspended from 10:51 to 11:06

I may as well say a couple of lines again because I just love them so much! Medicare is not only Labor's heart but also mine. I have had probably thousands of pathology tests over the past 10 years. My family in general has had thousands of bulk-billed pathology tests over the last 10 years. That's one of the reasons this bill is so incredibly important: we need to continue the bulk-billing of pathology services.

Labor will always protect and strengthen Medicare. We're committed to more and better health services, no matter where you live. This is a stark comparison to those opposite. Let's not forget that, in their first term of office, the previous coalition government cut bulk-billing payments for pathology and diagnostic imaging, to make patients pay more. Labor is investing in pathology and diagnostic imaging. In my electorate of Dickson, more people in Strathpine now have access to more MRI scans funded through Medicare. The people of Dickson should only need their Medicare card, not their credit card—and that's what we are working towards—to receive the health care they need. That is exactly what our government is working to deliver. This licence is saving locals who get their scans done in Strathpine, and it will give patients in Dickson more choice on where to get their scan. Making MRIs more affordable is another way the Albanese government is strengthening Medicare.

This bill relates to the fees imposed on the pathology sector for certain categories of pathology applications. It specifies the fees which must be paid for the acceptance and approval of an approved pathology practitioner, an approved pathology authority and accredited pathology laboratory applications. The approval of these applications allows the providers of pathology services to claim Medicare benefits for delivering those services.

The 2022 Health Portfolio Charging Review identified that the fees set against each of these application categories have not been reviewed or changed since the pathology fees act came into force a very long time ago. This bill repeals the pathology fees act. It will resolve this misalignment and provide fee relief, in addition to reducing the administrative burden for the pathology sector. The consequential amendments included in this bill remove all references to the payment of fees for these application categories from 1 July 2025. Accreditation obligations associated with these applications will remain unchanged, thus maintaining the quality and safety of pathology services provided under Medicare.

As I have said, the Albanese Labor government is laser focused on strengthening Medicare. We are delivering more bulk-billing for all Australians. We are making the single largest investment in Medicare ever. This will deliver an additional 18 million bulk-billed GP visits every year so Australians can see a bulk-billing GP. We're opening more Medicare urgent care clinics. We're expanding and growing our network of Medicare urgent care clinics, opening an additional 50 clinics. Four in five Australians will live within a 20-minute drive of a Medicare urgent care clinic under Labor, and I should mention our amazing Murrumba Downs Medicare Urgent Care Clinic. I've visited the facility many times. So many locals have gone there with their kids and family members, and it's avoided a trip to the emergency department. They love it.

We're making medicines even cheaper. Labor is providing cost-of-living relief to millions of Australians by making medicines cheaper. From 1 January 2026, the maximum cost of a prescription for a PBS medicine will be cut from $31.60 to $25. This makes a huge difference, particularly for people with chronic illnesses. Cutting that fee will make a huge difference to how much they spend on their medicines and other things over the year. We're hiring more doctors and nurses. Labor is growing the health workforce to deliver more doctors and nurses than ever before. This includes having the largest GP training program in Australian history and hundreds of scholarships for nurses and midwives to extend their skills and qualifications.

We're investing more than $790 million in women's health, something I am incredibly proud of. And I tell you what, at every door I knocked on that was answered by a mum or a young woman, I talked about our women's healthcare package, and people overwhelmingly said, 'Thank you so much.' Reducing the cost of women's health is incredibly important to me and my electorate. Labor will provide Australian women with more choice and better treatment at a lower cost, making contraceptives cheaper and funding more treatments for menopause. We're helping Australian women suffering from endometriosis and complex gynaecological conditions have access to longer specialist consultations covered under Medicare. We're supporting women's health by opening endometriosis and pelvic pain clinics. Labor will open an additional 11 clinics for a total of 33 clinics across every state and territory. This will mean that Australian women can access the care they need closer to home. All 33 clinics will be supported to extend their focus to also provide specialist support for menopause and perimenopause.

We're investing in free mental health support for Australian parents. New and expectant Australian parents will get free, personalised mental health support thanks to a $16.7 million investment by the Albanese Labor government to open another eight perinatal mental health centres around the country. I should quickly talk about our Medicare mental health centres that we're setting up across the country. This is going to be a game changer for people who need immediate mental health support. They can walk straight into a clinic and get the help they need. I'm really pleased that we're going to have two in my electorate of Dickson. I'm really looking forward to those opening up and being able to support our community with mental health services.

Overall, Labor is delivering more bulk-billing services across the board for all Australians. I'm so pleased to support this bill, which will mean that pathology services continue to be bulk-billed for most Australians.

Tim Wilson (Goldstein, Liberal Party, Shadow Minister for Small Business) Share this | Link to this | Hansard source

I rise to support the bill. It's wonderful to be here supporting legislation that's looking specifically at the challenges of the pathology sector, because it's so important for making sure that Australians get access to the health services they need and, of course, for making sure Australians are in a position to get the tests at the time and stages of their lives when they need them. We know a huge number of health services are coming under increasing stress and demand as a consequence of an ageing population. The consequence of that is, of course, that more Australians are living longer. We all agree that this is a wonderful thing. The trade-off from that is that costs continue to escalate in the context of the health sector. In particular, the costs of structures are shifting more towards management of chronic conditions. As a consequence of that, people need more testing to make sure that they're keeping up with their existing medical conditions, managing things like medicine regimes and working more and more with their doctors. That's why primary care is such an important part of facilitating healthcare services where people need support and assistance in community rather than escalating things up to tertiary hospitals and, of course, why it's so important to have access to services within the community, including pathology testing.

We have a massive gap in Australian society right now. We have relatively well serviced electorates in inner urban areas—particularly those that are affluent—but so many communities are less well off, particularly once you get outside of capital cities and into rural and regional areas. Access to health services quickly becomes quite limited and often dire. I want to congratulate the new member for Grey on his first speech last night, where he talked explicitly on the limitations of access to health services once you're outside of capital cities. It's something I'm very mindful of and something that I know the member for Riverina, who is here in the chamber with me, is also very concerned about. When we're talking about limitations on access to health service in rural and regional areas—and, I might clarify, often in lower socioeconomic parts of capital cities—you have inequity in provision of health services, which ultimately extends out to diminishing quality of life, particularly towards the later stage of your life. In addition, there are limits on services, which means you spend more time waiting. There is inequity in accessing and getting the best healthcare outcomes.

This is something we take very seriously, Deputy Speaker Boyce. I know it is very important in your electorate as well. To understand that, you have to understand what happens outside of capital cities. That is often a challenge for the current government, which has taken a casual disinterest in health care outside of capital cities in this country. One of the limitations of services outside of capital cities is pathology centres and pathology services. You want to go into remote Indigenous communities and look at the limitations they have to accessing pathology services. The Royal Flying Doctor Service has to deal with this all the time. They literally have to fly into communities to get blood tests, then fly out, then send back medicine later to be able to help support people managing their conditions. This is a big problem that has other big costs and problems that flow down from it that then mean, because of the inefficiencies of access to these types of services, like pathology, more of the health budget is consumed where it shouldn't be.

Of course, we also know that this is a much bigger story about the limitations of health care under this government and, frankly, under the state Labor governments. Victoria is a classic example. We basically have the complete collapse of our hospital system. If you go to a public hospital, you are increasingly concerned about whether you are going to go in and be at risk of co-morbidities or other conditions and whether you'll get into certain types of services, particularly what is deemed elective surgery. I hear from my South Australian colleagues that, despite all the promises from the Malinauskas Labor government, their health services are a complete bin fire despite the promises that they were going to fight ramping and everything else. Nothing has gone in the right direction. It's like the broader conversation around the economy under this government, but that's getting to another topic.

They you get to the federal government and say, 'Okay, the states are failing—the state Labor governments are failing on access to tertiary services. Let's go to primary care and what needs to be provided by the Albanese Labor government.' They like to crow about certain urgent care clinics et cetera. They hold them up and say, 'This is the perfect answer to everything,' but the reality is it's part of—at best—a bandaid solution to a much bigger problem. The Prime Minister is very fond of it—he likes that Medicare card. He likes to bring it out in question time and show it around. It like a little totem that he thinks gives him some sort of license, or magic powers, like he designed the system. Then, all of a sudden, he can take full ownership of it and he wants to own this conversation. Actually, we have seen a reality under this government. We have seen an 11 per cent reduction in the number of people using bulk-billing under this government. It's not about what I want or what you want or what the opposition wants. It's about the government's own data to reflect on the number of Australians using Medicare, and when they go and say, 'I need to access health services,' often in urgent circumstances—often, frankly, when they're facing other challenges in their lives, like the cost-of-living pressure. They go to the supermarket are already having to make a decision of whether they can afford what's in the trolley. Then they've got kids who are sick. They're going to their local doctor, and the answer from the government is, 'You should be able to get it bulk-billed.' But access to fully bulk-billed doctors is quite limited, and despite the promises of the government, since the Albanese government was elected we have seen a decline in the volume of people who are successful in getting things bulk-billed. There's an 11 per cent decline.

This is the tragic reality. The promise and the reality are completely different things. Now, 45 per cent of Australians are paying more out of their own pocket to see a GP than they were when we were last in government. It doesn't matter how many times the Prime Minister held it up—he can hold it up 45 per cent more times—it's not going to change that. It could hold it up 100 per cent more times in question time if he wanted to; it doesn't change the outcome. The reality is, having a Medicare card and being able to use your Medicare card are slightly different things, and the Prime Minister hasn't quite figured that bit out. That's part of the limitations of this government. They like to talk, they like to scare, they like to campaign and they like the politics, but they don't like the governing bit so much. That's what we're now living with and that's what Australians are living with. Australians have only one of two choices: either deny themselves access to health services, and that has a long, downstream consequence, or turn up and pay with their Medicare card. The promise they were sold does not match the reality that they live. We know more and more GP clinics are not bulk-billing. We've seen a decline in the number of those, so Australians are finding it harder and harder. The irony is the people they claim to want to represent—which are those from lower socio-economic communities—are the ones most badly hit.

We need to be realists. We need to start being honest with the Australian community about where our health system is. Once you start being honest and know where you are, you can at least have a conversation on how we're going to fix it. Unfortunately, the government isn't prepared to have that conversation because they think the answer is a bit of plastic they can wave around in question time. That is not the answer to the problem that Australia's healthcare services face. Without meaningful support or meaningful outcomes, when you go to use it, it's like with bankcards. Some of the members over the other side have those cards—I've seen them in your wallets sometimes. These days you actually get them on your phone as well—you can tap them at the supermarket or any other retail outlet. You tap them. And if you don't actually have the money that sits behind them, they don't work. There's this thing called 'declined'. You've heard of that, member for Riverina?

You have! That's kind of how Australians are engaging with Medicare right now. They go to a doctor and say: 'I would like to redeem this card, the plastic one. The Prime Minister holds it up in question time! I saw him on television! I saw him do it on television, so it must be good, because if the Prime Minister says it's going to work, it's going to work.' But, of course, they go and do the effective equivalent of a tap-and-go at their local GP clinic, and the clinic says, 'Here's the top-up payment—the co-payment.' And they say: 'But the Prime Minister said I wasn't going to have to do that. The Prime Minister said in question time that it was going to work.' In any other profession you'd say that was misleading and deceptive conduct. You'd be off to the ACCC. But it's not so for this government. Tap-and-go on Medicare doesn't work, and he's getting away with it because so many of his new Labor colleagues are actually deeply afraid to challenge this Prime Minister and the Minister for Health and Ageing for their limitations and failings. That is the political reality.

Going through all the first speeches of all the new Labor members, as I have been doing, is always an interesting and fascinating insight. I haven't gotten to all the Labor members who were in the last parliament, but I'll get there—don't worry. They appreciate that—that's right! I know the Labor members opposite appreciate that, because I've said to the Labor members opposite, 'I will send you a copy of mine in return.' But a lot of them talked about health care and Medicare in the process. They talk about how it's so important and how it's part of why they became Labor. I have some sympathy for their commitment to it, but the problem we've got is that what they're delivering is not living up to it. When you can't deliver what you promise, the public starts to lose trust and faith in our institutions.

That's one of the reasons the Prime Minister has been vetting and vetoing all of these new Labor members' first speeches, taking out anything about policy or detail that makes them interesting. The Prime Minister has this obsession with control. He wants to control everything. He wants to control his government. He has all these new Labor members of parliament, and it makes him feel like he's unlimited in his power. But there is a reality that sits behind that which means that he simply has no capacity to go on and deliver. He's not getting the feedback loop, including from some Labor members who are qualified general practitioners themselves, who would knock on the door and say: 'Prime Minister, I know you keep flashing your Medicare card around the House of Representatives in question time. I know you're proud of it, and I get it—we all believe in Medicare and its role in the healthcare system. We've got a problem. People are going to their GP clinic, and it's not being redeemed. People are going there, and the clinics are asking where their credit card is so they can access the services.'

I know it must be very uncomfortable for Labor's new members to have that conversation. It's intimidating; it's a big office, and it's flashy. They've decorated it. They've put lots of nice flags in there and that sort of thing. It's always nice the first time you go in there. I do understand that as well. But part of the challenge of being a member of parliament is that sometimes you have to speak truth to power, and when the Prime Minister is misleading the public, you've got to say, 'PM, it's not right.' The people paying the price on the ground are Australians who can't access health services and are having to make choices between that, their rent, feeding their kids and, of course, making sure they put food on the table.

All I can implore is that, in considering this legislation, the Prime Minister wakes up and the Labor backbench stand up, because we need a health system that will actually meet the challenges of the future of this country, and we're not getting it under the timidity, lack of ambition and, frankly, lack of courage of the Labor members opposite.

Gordon Reid (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

A lack of courage! What a fascinating statement—a lack of courage. Can I just say that it was the courage of this Albanese Labor government that invested in Medicare after 10 years of Liberal-National neglect. They decimated our universal healthcare system, making it harder and more expensive for people to see a doctor, whether that be to access a GP, pathology, imaging or an emergency department. They chronically underfunded our nation's hospitals through the national health agreement. It was an absolute travesty.

I still vividly remember—this is pre COVID—standing in the emergency department, looking out through the window, and there was a TV in the waiting room. And I remember the former member for Cook, the then prime minister of Australia, continuing to parrot the lines that the Liberal-National government were continuing to invest in primary health care, in the health care of Australians and in Medicare. I looked around in that waiting room and I looked around at the sick people who couldn't access health care because it had been chronically underfunded, and that was part of a tipping point for me. That was part of a moment that—like the member for Goldstein just said—made me a Labor MP. That made me put up my hand, doorknock tens of thousands of houses, talk to constituents right across my electorate, talk to people in Dobell and in Shortland—the great Central Coast region of New South Wales—and say, 'Hey, this isn't good enough.' People are waiting too long in EDs. People can't see a GP. People can't get access to the pathology services and imaging services that they need to live long, happy, healthy and productive lives. And that's what made me run for parliament.

When we heard the first speeches of some of these amazing Labor members who sit in this chamber here today, they talked about the importance of Medicare, because it is important. It is important. Medicare is important, and bulk-billing is the beating heart of Medicare; it is the beating heart of Australia. It's what allows us to do the things that we want to do and not have to worry that going to the doctor, going to the hospital or having surgery is going to bankrupt us and send us onto the street. That's why Medicare exists.

It's not just about Medicare. The whole package of health care that this Albanese Labor government has brought forward in both the 47th parliament and now the 48th parliament is one for the history books. It is fantastic. We are looking at making sure that pathology and imaging services are more widely available for the Australian people. But let's talk about urgent care. If you're too sick for the GP but not sick enough for the ED, now you've finally got somewhere to go, and it's bulk-billed. I can only imagine what those opposite would do if they decided to set up some sort of network like that. You would be paying for it and you would be paying deep into your pockets for a privatised health system, and that is just not good enough.

Let's move on from urgent care; let's talk about the tripling of the bulk-billing incentive. I know that, following the tripling of the bulk-billing incentive—which is now going to be expanded to every Medicare card holder to make sure that we can improve access to bulk-billing right across this country so that people can access a GP—preventive healthcare is important. It stops people going to the emergency department in the middle of the night. We treat the hypertension. We treat the hypercholesterolaemia. That stops it from becoming a myocardial infarction. That stops it from becoming a CVA. That stops people from becoming critically unwell and needing those tertiary- or quaternary-level services. That's what general practice and preventive care is all about. I support our GPs on the Central Coast and right across Australia, and I know that the Albanese Labor government supports our general practitioners, through the tripling of that incentive.

There is one more thing I want to talk about that I think is important and that has been chronically underfunded for decades, to be frank, by governments of every persuasion, but particularly by the former Liberal-National coalition government. That is investment in women's health care. Investment in women's health care is so important, not just for the fact that women make up half the population of Australia but for the fact that the chronic underfunding of women's health care has meant time off work and significant morbidity and, in some cases, mortality in the female population. That's just not good enough.

Out-of-control misdiagnosis or delayed diagnosis of endometriosis impacts lives. It impacts lives and it impacts families, and, quite frankly, the chronic underfunding of women's health care under the previous government was just not good enough. It took our prime minister, our cabinet and our majority-female Labor government to take a stand and to say, 'That's not good enough, and we need to invest in women's health care.' It's the endometriosis clinics. It's the pelvic pain clinics. It's access to contraceptive options. It's making sure that, when women see the GP, they can actually see the GP for a timeframe wherein they can actually address the issues that affect women in their lives and affect women in their health care journey. And I believe that is really, really important.

Locally, on the Central Coast, there are those federal policies, but there are also the local policies. We are investing millions of dollars in our maternity services on the Central Coast, making sure that, after the closure of our private hospital, women have choice about where they can give birth, making sure they don't have to go to Newcastle, making sure they don't have to go to Sydney. They can give birth in our public hospital, Gosford Hospital. We're making sure there is up-to-date, world-class infrastructure in our maternity and birthing units. We're making sure that our gynaecology and our colposcopy clinics are adequately funded and making sure that people have access in our public hospitals to world-class, world-leading obstetrics and gynaecology services.

I'll make a final point, on what has often been a taboo subject in Australia: mental health. Under this government, in the last parliament and now in this parliament, we are making sure that we are talking about mental health and that we are investing in mental health. That is a really important part of the healthcare journey of a patient. My good friend the assistant minister and member for Dobell, Emma McBride, along with the broader health caucus, and the Prime Minister and every Labor member in the parliament have backed the introduction of the Medicare mental health centres. These will be walk-in clinics where you can access psychologists, where you can access counsellors, where you can talk to people—bulk-billed, importantly—about your mental health issues and either have them addressed onsite or be referred to a specialist pathway. Ultimately, that will reduce the disease burden not just on yourself but also on our society more generally.

For the member for Goldstein to come in here and talk about us underinvesting in Medicare, despite everything that we did in the 47th Parliament and despite everything we are doing now—one of the first pieces of legislation this fortnight was to cut the cost of medicines. As Minister Butler, the Minister for Health and Ageing, continues to say, bulk-billing is the beating heart of Medicare, and Medicare is the beating heart of Australia. It truly is. I know, as the Labor member for Robertson, I will continue to support universal health care. I will continue to support cheaper medicines. I will continue to support the expansion of women's health care and access to health care. I will continue to support our mental health services. I will continue to support our public hospitals. These are important not just to the Central Coast but to New South Wales and Australia more broadly.

Michael McCormack (Riverina, National Party) Share this | Link to this | Hansard source

That was a good speech by the member for Robertson. I commend him on many aspects of it and acknowledge the fact that he said one of the reasons why he became a Labor candidate was because of the lack of services within his local area. I'll just point out this: if he came to some of those rural and regional areas where there is a severe lack of services, he might well have become a Nationals candidate, because we all support our own electorates. We all stick up for those people who send us to Canberra to do a job.

I also acknowledge the fact that he is still working in his local hospital and I appreciate that. It must be very good for the patients of Robertson, the electorate he represents. And I acknowledge the fact that he talked about mental health being a taboo topic. For many, many years it was, particularly amongst men.

On 11 July, we had the member for Dobell, the Assistant Minister for Rural and Regional Health, the minister who assists the Minister for Health and Ageing with the prevention of suicide, in Wagga Wagga. She was attending the local headspace, a walk-in clinic. She made some announcements that were very well appreciated. That walk-in clinic is open to people seeking to obtain the services that they desire. Particularly for regional people who are doing it tough, that's a welcome addition. I acknowledge the good work Assistant Minister McBride is doing in rural and health. It is so very important.

The member for Robertson mentioned the endometriosis and pelvic pain clinics. They were also mentioned by the member for Dickson, who spoke previously on the bill. We'd very much like one in Wagga Wagga for the Riverina. That is an important topic. I note Dr Freelander is in the chamber; I know how important it is for the western suburbs seat of Macarthur that he represents—how important it is for him—too.

Now, we talk about urgent care clinics. The problem with urgent care clinics is that they have been placed in areas of political necessity for the government, not necessarily where they are most needed. If you look in rural, regional and, particularly, remote Australia, people don't have the ability to just walk in, produce a Medicare card and receive the services that they so desperately desire. All too often, particularly in remote Australia, it's, 'When in pain, catch the plane.' There's no treatment available there. People actually have to go to a capital city to get the treatment they need.

I hear this great clamour from Labor members—and I appreciate we're severely outnumbered at the moment—about cheaper medicines and cheaper scripts. The fact remains that the government had to be dragged kicking and screaming to come to the table to sign the latest accord in the pharmacy situation. We all remember the white coats when the Pharmacy Guild were in the public galleries complaining about Minister Butler's lack of empathy, care and concern for their needs. In fact, for many hundreds of those country centres, they faced the prospect of losing—and it was a very real threat—their only health professional in town. That was the local, friendly pharmacist—the local, friendly chemist—who for years had provided services because they didn't have a doctor, they didn't have an urgent care clinic or an endometriosis or pelvic pain clinic and they didn't have a headspace. They were doing it all on their own. And, all of a sudden, when the coalition—it was the Nationals, in fact—said, 'Enough's enough; we have to support our pharmacists,' we saw some action.

I've heard members of Labor in their first speeches talking about what Labor's doing as far as funding training for rural medical students. Well, that came under the Nationals. That is probably the legacy that I leave, because I know that the negotiations I had with then prime minister Turnbull—

Thank you, Dr Freelander. I had negotiations with then prime minister Malcolm Turnbull to get that Murray-Darling network of rural medical schools—so very important. They're in Orange, Mildura, Shepparton, Wagga Wagga, Dubbo—the list goes on. Just take Wagga Wagga, for example, which each year is providing 30 new doctors the opportunity to train from start to finish in a rural setting. And we all know that, if you train doctors from start to finish in a rural setting, where there are unique challenges and unique opportunities for rural medicine, such as snake bites and road trauma that you don't see in the middle of capital cities, where some of the sandstone universities are providing clinical and medical schools—you do see that in regional settings. It is providing the hope and the opportunity for those young people in Wagga Wagga with 30 places each year. I know that, with the big, new, shiny buildings that are being erected and finished, there is the opportunity under that $94.5 million program to have more students come on board, because heaven knows we need more doctors.

This particular bill, the Health Insurance (Pathology) (Fees) (Repeal) Bill 2025, removes the fees imposed on the pathology sector for certain categories of pathology applications. It responds to the findings of the 2022 Health Portfolio Charging Review by doing a couple of things—firstly, addressing the misalignment of fees charged under the pathology fees act with the charging framework and, secondly, providing fee relief and reducing the administrative burden on the pathology sector. You're not going to get the coalition complaining about that. The opposition leader has said we will certainly divide on bills where we must, but, when there's good policy put forward, we'll agree with it.

But we do get this feeling from the Labor members—and I appreciate that Medicare started under Labor—that they think they're the only party for health provision in this country. And Labor is not. I appreciate that the urgent care clinics are great—good luck if you have one—but GP bulk-billing fell from 88 per cent to 77 per cent and there have been 40 million fewer GP bulk-billed GP visits in the last year alone under the Albanese government. That issue is particularly exacerbated in rural and regional areas, where you don't have the luxury of having a number of GPs. We have quality GPs. We just don't have the quantity of GPs.

When questioned about bulk-billing rates and the proliferation thereof, Minister Butler came out with this famous quote during the last term of government. He said: 'If you can't get a doctor to bulk-bill you, don't worry about that appointment. Pick the phone up and get the next doctor and see if they'll bulk-bill you.' That might be all well and good in the leafy suburbs of Adelaide, but, I'll tell you what, when you're out in regional Australia, you take the first doctor's appointment you can get, and usually that doctor's appointment is weeks down the track, because they're just not available like they are in capital cities. That is a truism. I'm not exaggerating. I'm not catastrophising. I'm not being alarmist. It is the truth.

We appreciate what our doctors do. My family doctor, Dr Ayman Shenouda, is a member of the Royal Australian College of General Practitioners. He has done a power of good for country doctors. Not only has he tried to lift immunisation rates and been a spokesperson for GPs generally; he has also provided wonderful health care at Glenrock. GPs in Glenrock, by and large, bulk-bill, but a lot of practices in and around Wagga Wagga and in and around the Riverina do not. Australians are now paying 45 per cent more of the cost to see a GP from their own pocket, and out-of-pocket costs have literally reached the highest level on record.

So it's all well and good for Labor members to come in and spruik about Medicare. It is the brainchild of Labor. I appreciate that. But the data that I just talked about—the decrease in bulk-billing from 88 per cent to 77 per cent, the 40 million fewer bulk-billed GP visits and Australians paying 45 per cent more of the cost to see a GP—are from the government's own national accounts. It shows that more Australians are having to use that little green and yellow card that the Prime Minister is so fond of pulling out in question time and in press conferences. He can do that as often as he likes. It doesn't take away the fact that more Australians are having to use their credit card along with their own Medicare card. They're being charged the highest amount of out-of-pocket costs on record. Despite Labor's protestations to the opposite, we are seeing more Australians having to pay more in a cost-of-living crisis.

The Prime Minister told Australians that under Labor all you'll need is your Medicare card, not your credit card. But that's not the lived experience of so many Australians, particularly Australians who live in rural, regional, and especially remote areas. The Department of Health's incoming government brief, released under FOI, estimates that a quarter—23 per cent—of GP clinics across Australia will not bulk-bill, despite all the Labor government's promises. Doctors need to make money. I appreciate that. They run clinics. They're under strain as well, particularly in regional settings, but so too are people in the cost-of-living crisis, a cost-of-living crisis that has worsened under the Labor government.

It is appalling that this Prime Minister is willing to mislead Australians about only needing the Medicare card. That's not correct. Clearly he would have known about the health department's data before waving that Medicare card around. In an election situation, when people are looking to cast their vote, they'll listen to that and see that little grab on the news, and that's what they'll go with. But the true reality is that people are still having to pay, shell out their own money, to see a GP. And, of course, there's a coalition, as you'd expect, opposition—

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

So many people don't pay to see their GP—80 per cent.

Michael McCormack (Riverina, National Party) Share this | Link to this | Hansard source

On those figures, Dr Freelander, 20 per cent are. The Prime Minister is making out as though everybody can show their Medicare card and that will be the only sufficient cost. It's simply not right. We can agree to disagree on that one. I respect you; I've got the highest respect for you, I know you do a wonderful job and your advocacy for health outcomes and better medical provisions is second to none in this place. I acknowledge that and put that on the record. But, in this regard, the situation is that people are having to pay, and pay dearly, for their medical treatment. Often they're families and people who can't afford it, but they have to do it.

Funding into Medicare—this is an important point to make, too—increased every single year under the former coalition government. It went from $18.6 billion under Labor in 2012-13—they were the Rudd-Gillard-Rudd years, and I remember them well; I was in parliament at that time—to more than $30 billion in 2021-22. I appreciate that some of these figures are exponential and some of these just go with the rising cost of things, relative to where they were, but Medicare bulk-billing was higher under the coalition. Bulk-billing rose consistently across our entire term of government from 2013 to 2022. It rose to 86 per cent before the COVID-19 pandemic and it was at a record high of 88 per cent when we left government in May 2022. In the coalition's last year in government, $167.2 million in free GP services was delivered—$61 million more than the previous Labor government. Those statistics speak for themselves. They're on the record. I'm not making them up; they're right.

We want to see people able to live in a happy, healthy and safe society. Whilst I appreciate that this legislation to remove the fees imposed on the pathology sector for certain categories of pathology applications will be supported, and it's good, the fact remains that there are a lot of fees and costs relating to seeing a doctor—if you're lucky enough to have one—that are being imposed on the Australian public. No amount of the Prime Minister waving a Medicare card in question time or anywhere else is going to take away from that fact.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I acknowledge the work that the member for Riverina has done in rural health—together with his former colleague Mark Coulton, the former member for Parkes, who retired at the end of the last parliament—in trying to improve access to care for people living in rural, regional and remote areas.

I would like to go back to the legislation before us at the moment, the Health Insurance (Pathology) (Fees) (Repeal) Bill 2025. I thank the Minister for Health and Ageing and the Assistant Minister for Health and Aged Care for the work they've done on this legislation, which was presented to the previous parliament but was not able to go through the parliament. It has come up again now and will be passed in the near future. This legislation demonstrates that the government is working at all levels of the healthcare sector to provide fee relief not just to patients but to businesses involved in providing health care. In addition to reducing the administrative burden on the pathology sector, this bill will save costs and improve the efficiency of our pathology sector. This follows on from the findings of the 2022 Health Portfolio Charging Review, which identified that fees set against application categories had not been reviewed or changed since the pathology fees act came into force almost 40 years ago. These fees were arbitrarily set between $500 and $2,500 in 1991.

The consequential amendments included in this bill remove all references to the payment of fees for these application types from 1 July 2025. In line with this intended commencement date, provisions have been included to allow the refund of fees collected between 1 July 2025 and the commencement date of this bill where the applicant's approval has come into force on or after 1 July 2025. To preserve a high level of confidence in the accuracy of pathology testing Australia provided under Medicare, the administrative requirements, including accreditation obligations, will remain unchanged.

I will talk a little bit about the pathology sector. The work of our pathologists is often behind the scenes. Pathologists are not at the forefront of everyone's daily lives owing to the unique and important role that they have in health care. They range from anatomical pathologists, performing postmortems on people to try to find out why they may have died, to people analysing bodily fluids to bacteriological examination—microscopic examination et cetera—of body tissue and cells with a histopathologist. There are haematologists to ascertain what causes disease and the ways in which to heal them. There are also the bacteriologists, who are able to tell us which particular organisms cause illness and how they should be treated. We also have virologists, who can identify viruses that have caused human illness—most commonly, of course, respiratory viruses. Everyone is now very familiar with the PCR testing that really came to prominence in the pandemic, but it's important to know we were doing PCR testing in children for respiratory viruses for almost 15 years before the pandemic.

Pathologists do a lot of work behind the scenes and provide us with the information we need to treat our patients. As a paediatrician, I relied very heavily on our pathology sector to help me in the diagnosis of a whole range of illnesses, from leukaemia through to sickle-cell disease, a number of different haematological problems, the diagnosis of meningitis using bacteriological specimens and also histopathologists who tell us what is causing certain pathology in kidneys, liver, the brain et cetera. So pathologists are really important to us, and it's very important to note that Australia has one of the best pathology systems in the world, provided through the Medicare system to our patients and the hospital system. We rely on them to be well-trained, we rely on them to be very accurate and we rely on them to be very timely in the results they give to us as practising physicians. It's very important in cancer medicine, in paediatrics—in virtually every part of the health system, we rely on our efficient, well-accredited and accurate pathology system to lead us through dealing with the multiple diseases that can affect humans.

Really, at no other stage in human existence have we so relied on our pathologists to give us the accurate information we need to manage our patients, and that's particularly true in paediatrics. There is now an exploding field of genetics and genomics where we are using our pathologists to give us the answers to some of the disorders that have plagued human existence since it began. I rely on my pathologists and my geneticists to give me the information I need to talk to my patients. It is very important that we maintain an efficient and highly sensitive system in an accurate way. This is why accreditation is important. It's important to make regular accreditation something that happens all the time to our pathology providers. Some of them, of course, are in the public system. Most major public hospitals have public pathology providers. They are very highly skilled, particularly in things like cancer medicine. They work long hours. They sometimes work under huge pressure to get accurate diagnoses as quickly as possible. We rely on them also to provide services to our patients in a cost-effective and efficient manner.

We have private providers who are now providing pathology services around the world. I had a small involvement with Sonic Healthcare in the very beginning of their existence, almost 40 years ago. Sonic pathology now provides pathology services in the United States, in Europe, in Asia and particularly in the South Pacific. They are a fantastic company, and I'd like to give them and their CEO, Colin Goldschmidt, a shout-out because I think they've provided a wonderful service around the country over many years. At no stage in recent memory have pathologists been more front-and-centre since the pandemic. They really did lift their game and provide diagnostic certainty to Australian physicians dealing with people with COVID and other respiratory illnesses—at levels unprecedented in my lifetime. I thank them very much for their skills and their tireless efforts during that time. This legislation will make their accreditation cheaper for the pathologists, cheaper for the companies, and much more efficient and more streamlined.

In my electorate of Macarthur there are a range of pathology clinics, all of whom are excellent and all of whom provide daily diagnostic tests to my constituents in a very accurate manner. It is really important. I've seen poor pathology results in some places that have led to misdiagnoses of conditions like childhood leukaemia. Unless you have a well-trained pathologist to look at a blood film, it can sometimes be very difficult to identify the leukaemic cells. It can lead to delays in diagnoses and occasionally to death. Inaccurate bacteriological management can lead to misdiagnoses of meningitis, for example, and that can have serious complications. So, even though our pathologists are in the background, I'm very proud of the work they do and I think that it is really important for a world-class health system like Australia to have such wonderful pathology providers. We are very, very lucky. Obviously, we are a big country, and there can sometimes be difficulties in providing these services to rural and remote areas, but for the most part our pathology providers do that, and they do it in a very efficient way. We are very lucky to have them. This bill is important. The government is looking at the healthcare system across the whole spectrum of healthcare provision, and this is a sign that a government really understands and cares about the health of our people. I recommend this bill to the House.

If I can say just a little bit more in the few minutes that are left to me, we heard some of the complaints about the health system from the opposition. This is my 50th year working in the public hospital system, and it seems to me like a very short period, but I've seen dramatic changes in the healthcare system over that period. I was a medical student when Gough Whitlam first introduced Medibank to Australia, and it was a revolution. It enabled people of limited means to access good-quality health care, sometimes for the first time. I'm very, very proud of that achievement. That achievement was destroyed by Malcolm Fraser in his government, and reintroduced as Medicare by the Hawke government, and we have relied on Medicare since that time. The opposition tried again to destroy it in the Howard government, and then Peter Dutton, one of the worst health ministers that Australia has ever had, tried to introduce Medicare copayments and to break down the fundamental basis of Medicare equitable care for all. That was a great shame. Luckily, it didn't last long. The Abbott government, who also didn't value health care also didn't last long. For the opposition to say they've always protected Medicare is simply untrue, and the track record shows that.

The freezing of the Medicare rebates for almost 10 years by the previous coalition government was a tragedy, and it has led us to a position where we have to play catchup. We can't fix the health system and every problem overnight, but I'm very proud to be part of a government with the Minister for Health and Ageing, Mark Butler, who understands the importance of national access to health care for everyone in an equitable manner. I'm proud to be part of a government that understands that, and we are repairing the damage that was done by almost 10 years of a coalition government. We're not going to fix it overnight, but we are dealing with it on an incremental basis, and there are many issues to deal with. It's not just about access to GPs—we need to train more of our own doctors, for example. That's expensive, but we need to do it. We are still importing 50 per cent our GP workforce. That's too many. We need to be training more Australian-born people or Australian citizens as doctors. That's really important. We need to look at ways that we can encourage more of our medical trainees to move into rural, regional and even outer metropolitan areas. I think the present modelling, the modified Monash modelling, needs to be tweaked, certainly. And it's true in my electorate of Macarthur; we need to have better access to GPs in my electorate out of south-western Sydney. We need to look at ways that we can use other members of the health workforce—our clinical nurses, our pharmacists, our allied health professionals—to provide access to primary care for people.

I'll say a little bit about our pharmacists. My belief is that the single biggest advance in health care in the last parliament was the 60-day prescribing, which effectively halved the costs for people paying for their medication. It was a huge advance and long, long overdue. But we had to fight the coalition tooth and nail to get that legislation through, and there was a huge marketing campaign by the pharmacists against 60-day prescribing. Absolute no-brainer—virtually every other country in the world had 60- or even 90-day prescribing. This made the system much more efficient. People didn't have to go to the pharmacist every month; they could go every couple of months. It also meant that the costs of the prescriptions were mostly halved for many of our constituents—a great advance.

There is much more to be done, and the reduction in prescription costs to a maximum of $25, which the legislation introduced today, is a huge advance. The Labor government understands the importance of health care across the whole economy and across the whole spectrum of Australia. No matter who you are, you get equitable access to health care in Australia because of the work of Labor governments. There have been some reasonable coalition health ministers—Peter Baume was one—and I must say that I think the work that Greg Hunt did in the pandemic was good. But, overall, Australia can thank Labor governments for the maintenance of a universal healthcare insurance system and equitable access to care, and I'm very proud to be part of a government that does support that. This legislation is a small part of that, but it's a sign of a government that understands the health system.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.

Ordered that this bill be reported to the House without amendment.