Claire Clutterham (Sturt, Australian Labor Party) Share this | Link to this | Hansard source

Specific changes that this bill prescribes include a change in the timeframe during which Medicare claims for bulk-billed services may be made, from two years to one year. With respect to investigative powers across the legislative framework—including the National Health Act, the Health Insurance Act, the Human Services (Medicare) Act and the Dental Benefits Act—they were found to be inconsistent and fragmented, resulting in difficulty in identifying which powers of investigation might be used in relation to offences. Further, there were unnecessary restrictions on the ability to search with consent and on the retention of important evidence, which could have the consequence that matters requiring prosecution, such as a serious criminal fraud prosecution under the Criminal Code, might be compromised or unable to be prosecuted at all. The current powers in this respect were found to be so narrow that the proper exercise of functions to detect, investigate and refer fraud matters was compromised.

The bill amends the National Health Act to improve the efficiency of the process by which the minister may exercise discretion to approve a pharmacist. This is achieved by combining the two stages of the current process into one stage, restricting repeat applications, allowing the minister to delegate the approval of a request form and increasing the term of appointment for Australian Community Pharmacy Authority members to three years. These amendments will reduce the administrative burden and support more timely access to pharmaceutical benefits.

The measures in the bill collectively improve powers to detect, respond to, investigate, disclose and deter misconduct, fraud and noncompliance and will support the ability to conduct efficient, timely and effective compliance activities. The overall effectiveness and efficiency of the government's compliance systems will be supported, and timely and proportionate responses to incorrect payments and fraud under health benefits schemes will be better facilitated.

This legislation also encompasses amendments to the Public Health (Tobacco and Other Products) Act 2023, which are directed at clarifying the intended operation of the legislation, which commenced on 1 April last year. Of particular importance to me are the amendments that seek to harmonise the approach on advertising in the Tobacco Act and Therapeutic Goods Act in relation to e-cigarettes, otherwise known as vapes. Both acts prohibit the advertisement of vapes. These amendments reflect the changed approach to vaping goods following the introduction of vaping reforms and ensure the approach is harmonised.

Earlier this year I visited the Charles Campbell College at Paradise in the electorate of Sturt to meet with the principal, Mr Kevin O'Neil, and talk to students about the impact of vaping reforms, which were aimed at limiting access. The federal government's action to outlaw the sale of vapes in a recreational or retail setting, meaning vapes can only legally be bought in pharmacies, had had a profound impact on the students of Charles Campbell College, on their learning and on their understanding of their own personal health and wellbeing. This, together with a series of information campaigns directed at young people to make sure they know the facts about vaping, know the harms that are caused by vapes and know the skills and methods to just say no to something so harmful to their health, had resulted in many students not only at Charles Campbell College but more broadly never having tried vaping and never having smoked a cigarette. The students I spoke to say that, following the education campaign, they were just not interested. The prohibition on the advertisement of vapes as prescribed by this legislation is yet another measure the Albanese Labor government has designed with a specific purpose of protecting the health and wellbeing of young people in this great country.

Medicare is a Labor creation and an Australian institution. It is the envy of the world. We know that Medicare works best, provides the healthcare support and services Australians need and deserve best and is funded most effectively and efficiently when shaped by integrity. Promoting integrity in the Medicare system is exactly what this bill does.

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

I welcome the opportunity to offer a contribution on this legislation, because making sure we have access to affordable and viable health care is key to the sustainability of the country and to getting the maximum benefit from the human capital of our nation. It's also of critical importance to the Goldstein community. It has always been something I've taken a deep interest in, having a comparatively older population in the Goldstein community. Access to healthcare services has been of critical importance for people in getting the support and services they need at different stages of care. Last week we were in this chamber talking about access to all sorts of essential medicines to manage comorbidities and chronic conditions at later stages of life, but it's also important to make sure that people have access to the essential medical services they need and integrity in the health system.

That is why the state of health services in the great state of Victoria is such a challenge at the moment. We have a state government completely incapable of managing its budget; as a consequence, the decay and decline of health services through tertiary hospitals is a lived reality every single day. We do not want to see this at a national level through primary care services, but we know that, because the Albanese government can't contain or manage its budget spending, more and more Australians are looking directly at their credit card or wallet every time they go to the GP, just to be able to get by. They're told by their government that their Medicare card is all they need, but their lived reality is that they need extra co-payments just to get the support they need, despite what they voted for at the ballot box.

But it's more than that. More and more, we're seeing cons perpetrated against Australians, despite the claims of integrity being part of the health system. In 2017, when I was last a member in this chamber, we got an MRI Medicare licence for Cabrini Brighton. It was the first Medicare-funded licence for an MRI machine in the Goldstein electorate. I remember, when we secured it, many residents asked me the simple question of why it was secured for Cabrini Brighton rather than the local public hospital, Sandringham Hospital, part of the Alfred Health group. The answer was quite straightforward. It was that Sandringham Hospital didn't have an MRI machine. There is no point getting in an MRI licence funded by Medicare if you don't have an MRI machine to use it.

Funnily enough, it shocked me slightly at the start of 2025 when it was brought to my attention that Sandringham Hospital had, as part of the Alfred Health group, been granted an MRI licence. Don't get me wrong, I welcome an MRI licence. I think it is an enormously wonderful thing where there is an MRI machine. There's just one problem: Sandringham Hospital still doesn't have an MRI machine. The Albanese government, for some very obscure reason, issued MRI licences to three hospitals in Australia. Two were at hospitals that had MRI machines and one—which curiously happened to be in one electorate where they desperately wanted to make sure that the incumbent teal member of parliament was returned—didn't have an MRI machine. But it enabled that member of parliament to go around deceiving the community by claiming they had secured an MRI Medicare-funded licence, even though the hospital didn't have an MRI machine.

Have you ever seen the episode of Yes Minister, Deputy Speaker, about the idea of a hospital being built without any patients. It's kind of like having a hospital that has an MRI licence but no MRI machine. I have a simple and baseline expectation: since the minister for health has granted Sandringham Hospital an MRI licence, perhaps, as part of a system of integrity, the health minister could grant us an MRI machine so we could actually use it! If not, the expression 'gaslighting', which I seem to be using an awful lot when talking about at this government at the moment, justifiably comes to mind, because what we're seeing now is how our health system in the Goldstein community is being taken for a complete ride.

We've not just seen it on this issue. When I was on the board of Alfred Health, over a decade ago, we came to an agreement between Alfred Health group and the Royal Women's Hospital. The Royal Women's Hospital is of course an enormously important hospital, which had fundraising help from and was partly founded by Vida Goldstein, the woman whom Goldstein electorate is named after. As part of their maternity services, they built a partnership to make sure that maternity services were available to women in the south-east of Melbourne, through the Sandringham Hospital. That partnership ended only a couple of years ago, during the period in which I was not a member. I am not going to pass judgement. In the end, it's up to Sandringham Hospital, Alfred Health, the Royal Women's Hospital, and Monash Health to decide the pathway to best deliver maternity services. But what I see consistently is the talk of integrity and the reality of delivering integrity being completely discordant. There are MRI licences where there is no MRI machine and a loss of women's health services and delivery in the Goldstein community.

While we talk about this legislation, we've just heard from the member from Sturt about what's been happening in the context of vaping. One of the reasons that this country has a big problem with vaping right now is that this government has failed to do any proper regulation around vaping during its tenure and has actively shut down any pathway, including being practical participants in vaping regulation during the time when they weren't in government. Vaping has been a known problem for a long time now, but, because they have simply wanted to have a close their eyes and ears attitude towards discussing practical regulation, what they have done is let the criminals dictate the terms and regulation that sit behind vaping. You see this every day, at the moment. We've seen what's been happening in tobacco legislation, regulation and taxation, this obviously in the portfolio of small business, and has a direct impact of the health and wellbeing of the community.

Over summer I read a book about the prohibition movement in the United States in the early part of the 20th century. It's extraordinary how many times this government continues to repeat the errors of that period when it comes to tobacco regulation. It actively fuels criminal gangs and criminal behaviour through its policies. Of course, we're seeing that in terms of the impact it's now having on small businesses. You might as well have government ministers handing firebombs to criminal gangs and organised crime to destroy people's lives and livelihoods. That's how much the government are stoking the behaviour through different forms of taxation, which actively increase the premiums. Organised gangs then have an incentive to go and engage in criminal activity, and it's having a direct impact on small businesses across this nation.

This is the problem. We have a government that talk integrity but do not practise it in terms of operations—the people who are paying are small-business people on the ground in the Goldstein community—and they do it under the veneer of their boastfulness in talking about the government programs, but not in terms of what their building to improve the future of Australia. And Australians are suffering for it.

Speaking of integrity, we're also seeing this in areas like the National Disability Insurance Scheme; it's not just in areas around health. To give you a parallel—to show how large the problem around integrity and this government is now and to show how much people are struggling—we had a roundtable bringing together service providers in the health care and NDIS space. The attendees—Fiona White, Dr Shona Bischof, Stephanie Williams. Simone Emery, Lauren Gingold and Tarryn Dee—raised concerns specifically around NDIS pricing arrangements and, particularly, the three-weeks notice they were given for pricing adjustments in the lead-up to the 2025-26 financial year. We spoke about the adjustment of the measures that the government introduced as part of their pricing review and the human consequences of what happened when it went down the pathway of so-called integrity measures. What was the impact? They were reducing the volume of sessions they were having with clients. They were reducing their travel times and the amount of time they were prepared to directly engage in supporting people in need. There's been a decrease in the personalisation of the service, particularly for people who have acute conditions or who need additional support.

Of course, in addition to that, it's had a direct impact on those who are most marginalised. This is one of the biggest problems. You have people outside of urban communities or affluent communities. The further away you get, the more you cut travel times or reduce access to service providers. It's the people in the lower socioeconomic communities or the people who are further away, in rural and regional areas, who suffer. I think you would understand a bit of that, Deputy Speaker Chesters, considering the nature of your electorate. In the end, the impact is downstream and is greater because of the failure of early intervention, which pushes up costs in the long term which then drives up the cost to tertiary hospitals.

The most devastating thing—we've seen this with the NDIS providers and in other areas like healthcare services and social services—is that at no point has there been a focus by the government on a really critical part of service delivery: reducing red tape. We're not saying 'red tape' because we want to just get rid of regulation. We're talking about the needless burden that takes practitioners out of their core focus and effort of things like caring and supporting children. They're putting that energy into filling out paperwork. Of course there's a role for filling out certain components of forms for compliance—I'm not arguing against that—and we need to make sure that people are doing the right thing. But when a practitioner is telling us stories about how they spend more time filling out paperwork than in providing care, how they spend more time complying with the NDIA's regulation than in paediatric support for people with a disability, how they spend more time finding out how to keep their practice open than in getting to people with disadvantage—you start to think that maybe this government's priorities are more focused on how to build the bureaucracy rather than on how to build the benefit to Australians. It shouldn't surprise you. If you read the Daily Telegraph today, you'll see that union bosses' wages are increasing by 25 percent while construction workers' pay is going down by five per cent and you'll start to realise that this is just one giant cartel. It's trickle-up economics. It feeds the few at the expense of the many. Whether that's in construction, the NDIA or the services and healthcare sector—it doesn't seem to matter where their priorities or focus are—Australians are at the bottom of the pile.

It's our job to make sure that we hold this government to account and make sure that Australians have a voice and are stood up for. What's dispiriting is that there's such a dismissal and disinterest from the government when the consequences are so human. When we have a situation where we have a minister gaslighting the Goldstein community and who will issue Medicare licences for MRIs but then won't even provide an MRI machine, where they actively fuel organised crime and where they actively engage in interfering with and undermining the provision of healthcare services that desperately need integrity, you do have to start to question what this government's priorities are. You realise those priorities are itself, not the Australian people.

Jerome Laxale (Bennelong, Australian Labor Party) Share this | Link to this | Hansard source

When Australians talk about what they want from their government, fair and equitable access to health care is always near the top of the list. Medicare is one of Australia's greatest institutions and one of the proudest achievements of the Labor Party. Introduced in its current form in 1983, it remains as important today as it was on the day it was made law by the Hawke government.

Let's not forget that, if it weren't for successive Labor governments in the 1980s, those opposite would have dismantled Medicare. During successive elections in the 1970s and 1980s, Medicare was opposed by the Liberals and the Nationals. They knocked off Medibank after the Whitlam government, and, had they beaten Bob Hawke, they would have knocked it off again after promising to bring down Medicare after it was reinstated by a Labor government in 1983. But it was Labor that locked it in. That tells you why people trust Labor to protect and strengthen Medicare in the face of opposition to and ongoing attacks of it by the Liberals and the Nationals. Medicare represents the simple but profound Australian value that access to health care should be affordable and accessible—where Australians can rely on their Medicare card, not their credit card, to see a doctor. Medicare is about fairness, universality and dignity. It's about knowing that, no matter your circumstances, you can get the care you need when you need it.

When we came to government in 2022, Australians were facing the toughest conditions in Medicare's 40-year history. Bulk-billing was collapsing after a decade of neglect. Families were struggling to find a GP who would see them without huge and rising out-of-pocket costs. Medicines were becoming more and more expensive. Hospitals were under enormous strain. It had never been harder or more expensive to see a doctor. That was the reality that we inherited. That's why strengthening Medicare was at the front and centre of our election platform. We took a plan to the people, and we've been delivering on it ever since.

In just our first term, we've made multiple massive investments in Medicare. In the latest record investment, which we took to the last election, we're putting an extra $8½ billion into delivering more bulk-billed GP visits every year, training more doctors and nurses and making health care more affordable for families. We're expanding bulk-billing incentives. They work so well for concession card holders that we're going to expand that to every Medicare card holder, ensuring that, by 2030, nine out of 10 GP visits will be bulk-billed—just as it should be. We've delivered the two largest increases of Medicare rebates in three decades, reversing years of Liberal freezes and cuts. Already, bulk-billing rates are climbing in every state and territory, with six million additional free visits to GPs delivered in just over a year.

Importantly, we've also taken decisive action on medicines. Australians have already saved more than $1 billion through our reforms. We've slashed the costs of hundreds of common prescriptions. We've introduced 60-day dispensing for nearly 300 medicines. We've lowered the PBS safety net. Just last week, this parliament passed legislation to cut the maximum price of a script to just $25. That is the price it was in 2004. On top of that, we've delivered urgent care for families. We only promised 50 Medicare urgent care clinics; we've delivered 90 across the country. Already, more than 1.8 million Australians have walked through the doors of these clinics, getting free urgent care without waiting hours in a hospital emergency department. These clinics, just like the one in Bennelong, at Top Ryde, are open extended hours, seven days a week. All you need is your Medicare card to get urgent care.

On top of that, we're delivering new Medicare mental health centres, creating walk-in support, so Australians can access mental healthcare when they need it most. We've invested half a billion dollars in women's health, funding more contraceptives, and new endometriosis and pelvic pain clinics—just like the one in Hunters Hill—for treatment for menopause and perimenopause. This is what strengthening Medicare looks like in practice: cheaper medicines, more bulk-billing, more urgent care, better mental health services and historic investment in women's health.

This is what it means in Bennelong. Families in Bennelong have already saved more than $8.6 million on cheaper medicines since 2022. We've opened that Medicare urgent care clinic in Top Ryde, which has seen more than 10,000 presentations. I'm proud to tell the House that another one is coming soon to Chatswood, which will relieve pressure on Royal North Shore Hospital. Tenders are out right now, and I look forward to delivering that in this term of government. In Ryde, we'll also deliver a Medicare mental health centre, which means that locals can get walk-in mental health support when they're in crisis. These are real changes, improving the lives of families in Bennelong and across the nation.

Strengthening Medicare is not only about expanding services or cutting costs but also about ensuring the system is sustainable and trusted, because when a program is as essential to Australian life as Medicare is, we have the responsibility to protect it, to protect taxpayer funds that underpin it and to protect patients from harm. The overwhelming majority of doctors, pharmacists, dentists and allied health professionals are honest and hardworking. They do the right thing, often under enormous pressure. But, in a system that processes more than a billion claims every year, there will always be some who don't. Sometimes, that noncompliance is unintentional, sometimes it is deliberate and fraudulent. Either way, it costs taxpayers money, it undermines confidence, and, in the worst cases, it puts patients at risk.

That's why, in November 2022, our health minister commissioned respected economist Dr Philip to conduct an independent review of the Medicare integrity and compliance measures. His review made it clear that integrity measures across Medicare, the Pharmaceutical Benefits Scheme and the Child Dental Benefits Schedule needed to be strengthened. He found that our systems had not kept pace with modern challenges and recommended reforms to better identify and deter noncompliance, to safeguard patient safety and to ensure that every dollar goes where it should—that's right into patient care.

In response, the government established the Medicare Integrity Taskforce in the 2023-24 budget, and we provided further funding in the 2024-25 budget to continue this work. This bill is the next step on that much-needed and important reform. The Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 implements a key recommendation of the Philip review. It amends the National Health Act, the Health Insurance Act, the human services act and the Dental Benefits Act.

The changes are targeted but significant. They will strengthen compliance and enforcement powers, allowing for the proper investigation and deterrence of fraud and misconduct. They will modernise investigative powers that are currently inconsistent and fragmented, ensuring that serious offences—particularly in relation to pharmaceutical benefits—can be prosecuted effectively. The bill also shortens the timeframe for Medicare claims on bulk-billed services from two years to one. This will reduce the risk of delayed or duplicate claims whilst preserving the minister's discretion to allow late claims in truly genuine cases. The bill will also improve the efficiency of the process for approving pharmacists by combining two stages into one, reducing repeat applications and extending the term of appointment for members of the Australian Community Pharmacy Authority. These changes will cut red tape, reduce administrative burden and deliver timely access to medicines in communities.

The bill also makes important adjustments to the Therapeutic Goods Act and the Public Health (Tobacco and Other Products) Act to support broader reforms. It strengthens the government's ability to manage therapeutic goods shortages, supports compliance with vaping reforms and ensures tobacco regulations are clear and enforceable. Together these measures safeguard Medicare for the future by protecting taxpayer funds, by strengthening patient safety and by ensuring sustainability.

Integrity in Medicare and our systems is not only about protecting taxpayer dollars; it's about protecting patients. When fraudulent claims are made, when prescriptions are misused and when loopholes are exploited, patients are often the ones who suffer. The Philip review emphasised that patient safety must be at the centre of these integrity measures, and this bill delivers on that recommendation. By strengthening the powers, by harmonising enforcement across our health schemes and by closing loopholes, this bill will ensure we can respond quickly and proportionately to misconduct. Only a small percentage of practitioners and businesses will ever be affected by these measures. Those who deliberately and repeatedly do the wrong thing will have to be held accountable. But, for the overwhelming majority, this bill will provide confidence that their hard work is protected, their reputation is upheld and the system that they serve and participate in remains strong.

Our government is strengthening Medicare in every sense of the word. We are investing in more doctors, more nurses, more urgent care, more mental health support, cheaper medicines and better women's health services. Through this bill, we're also protecting the system itself, ensuring integrity, sustainability and trust. Labor created Medicare; only Labor will protect and strengthen it. We're delivering on these investments, reforms and integrity measures to ensure that Medicare remains strong and sustainable for generations to come. This bill builds on historic investments we've already made in Medicare, it strengthens compliance and enforcement, it supports timely access to medicines, and it cuts red tape for pharmacists. These are all really important improvements. Most importantly, it ensures that Medicare, the program that has cared for Australians for over 40 years, will remain strong and sustainable.

Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

I rise today to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025, a bill which seeks to strengthen the integrity of our Medicare system. It is entirely appropriate that the government take all steps necessary to safeguard the sustainability of our universal healthcare system. Australians deserve confidence that their Medicare contributions are being used responsibly and that our system is well regulated and protected from abuse.

The legislation currently before the House came out of the independent review of Medicare integrity and compliance, the Philip review. The Philip review was commissioned by the Minister for Health and Aged Care in November 2022 in response to fairly widespread allegations of widespread fraud in the Medicare system. Ultimately, that review dismissed the claims of an $8 billion fraud, claims which had been widely and harmfully trumpeted in the mainstream media. In fact, the Philip review found that the allegations were both inflated and speculative. The Philip review found that issues with the Medicare compliance of doctors are overwhelmingly caused by the complexity of the system. It found that Medicare is becoming outdated, that it doesn't reflect the changing needs of our healthcare system. Dr Philip cautioned that, without significant attention to the legislation, the governance, the systems, the processes and the tools of our Medicare system, which he found to be currently unfit for purpose, significant levels of fraud could well ensue.

There are a number of real and increasing vulnerabilities in our Medicare system, which were described and elucidated in the Philip review. These include the changing burden of disease in Australia, the necessary and natural changing nature of healthcare delivery over time, the unnecessarily complex and challenging nature of the Medicare Benefits Schedule, the growing corporatisation of medicine in this country, the increasing uptake and complexity of medical billing software, the opaque nature of MBS billing arrangements in public hospitals and the lack of continuous monitoring and compliance services within our public health system. Dr Philip's review acknowledged that, with more than 3000 items, it's impossible to keep up with the MBS. But those changes continue. In fact as late as last week the Minister for Health and Ageing was proposing further changes to the MBS. It is little wonder that GPs and other health professionals struggle to keep up with compliance.

This bill grants the chief executive of Medicare and their delegates expansive powers which are some concern. Under new section 129AACA any person, not just providers, can be compelled to produce relevant material within 21 days. This includes patients' records, correspondence and billing data. There is no requirement for a warrant, no judicial oversight and no obligation to explain why that information is needed. Failure to comply within 21 days is an strict liability offence with penalties of up to $50,000. This is a profound shift in the settings around such inquiries, and doctors very understandably have real concerns that these changes could override privacy protections under the Privacy Act and legal professional privilege.

There's also a significant degree of nervousness amongst medical professionals regarding the Professional Services Review and other professional compliance bodies. These concerns relate to a lack of transparency in their processes. Those fears might well be exacerbated by this bill's removal of restrictions on the admission of information obtained under the Professional Services Review agency's notices to other investigations, such as those commissioned by Australian Health Practitioner Regulation Agency or the Medical Board. While these are limited to certain circumstances, the fact that they include cases in which the practitioner is not the subject of the original investigation is concerning. There's a reasonable concern that the change might undermine the principle of procedural fairness and risk lessened cooperation with investigations by those bodies. If medical professionals fear that any information they provide may later be used later to prosecute them, it's hardly surprising that they may hesitate to engage with those investigations.

Finally, the bill introduces new powers to recover overpayments from practitioners even if they were not responsible for the error, even if they did not receive the funds, even if they were victims of fraud. The only requirement is that the practitioner was named on the claim form. This could include junior doctors, locums and deceased practitioners whose provider numbers were misused. The growing corporatisation of medicine has greatly weakened the previously simple relationship between provider, patient and payment. It often leads to practitioners being utterly unaware of what is being billed in their name. Doctors in public hospitals in particular often have limited oversight of or control over billing undertaken in their names months or years after the fact. As the Philip review found, much of the leakage in the Medicare system stems from errors, not from malice, and we shouldn't conflate the two. We must ensure recovery powers are exercised with fairness and discretion. Innocent medical practitioners can't be held liable for systemic failures or even criminal acts beyond their control.

I do support the goal of improving the integrity of Medicare, but rather than piecemeal pieces of legislation like this we should be looking at big picture Medicare reform. As has been set out innumerable independent reviews, this should strengthen the governance model overseeing Medicare, it should enable continuous monitoring of claims transactions and it should redesign frontline processes and business rules to support earlier identification of fraud and of serious noncompliance. It should redesign the payment system to a level of capability commensurate with the size and complexity of the scheme, and it should review the legislative basis of Medicare to include a more contemporary basis to regulation.

As the Philip review found, our Medicare system is overly fragmented. It's disjointed and is lacking in contemporary tools to detect and address noncompliance and fraud. That is not the fault of the medical professionals who do their very best within it. I commend this bill to the House, but I do wish that it had more vision and more effect.

Susan Templeman (Macquarie, Australian Labor Party) Share this | Link to this | Hansard source

This is the second time I've spoken on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 because this bill lapsed in the last parliament. This is something that we thought, several years ago, needed to be done, and that goes to the previous speaker's comments around the work done in the Philip review in 2022. We commissioned that in late 2022, and the report was delivered in 2023. What that really looked at was how Medicare was operating in the real world situation that we are now facing.

I just want to speak for a moment about what the Philip review recognised. It recognised that there is a change in the burden of disease. That means that there are different diseases facing people. We have a different demographic. We have an ageing population with chronic diseases that they live with but which need care and need support. I think back to when I was a kid—you'd go to the doctor when you broke something or had something short and sharp, rather than for diseases of that chronic nature, because we didn't have the means to identify and treat those chronic diseases. That's one big difference in the environment in which the Medicare system is operating compared to when it started in the 1980s.

There are also changes in how health care is delivered, and I think many people can see that there's a shift in the relationship with health providers. The family practice is not as prominent in the mix as it certainly was when I was young in the sixties and seventies or even when my children were young in the nineties through to the 2000s, and different parts of the country experience that differently. Certainly, the Philip review identified that there is just no longer the same connection between patient, practitioner and the payment that comes into it. Then, there are the changes that have occurred with the Medicare benefits scheme, with the complex nature and continuous changes—because of course things change—and then we add to that the corporatisation of medicine, which is another thing that comes into the mix. There is also the development of billing software—a totally different way—that could not have been conceived when Medicare first came on the scene, and then the general economics of medicine, and he goes on to list a few other circumstances that have changed. We're dealing with this in a very different time and place to when Medicare was first introduced. Of course, it was Labor that introduced Medicare, and it took two Labor governments, with a gap in the middle, to really ensure that Medicare was something that would be embedded. I think, from our side, we want to continue to do things that ensure Medicare is sustainable, embedded, never taken for granted and always appreciated by every member of parliament.

I'm very pleased to be speaking on this bill a second time. The key part of this that really matters to me is protecting the integrity of Medicare. The bill also contains changes that will enhance the regulation of therapeutic goods and vaping goods under the Therapeutic Goods Act, and it makes minor amendments to ensure the smooth and consistent operation of the tobacco act. I'm going to focus on the Medicare side of this bill in the time that I have available.

I think we in this chamber all know—and I know my constituents in the Blue Mountains, Hawkesbury and Nepean region appreciate—that Medicare and its programs help Australians pay for the health care they need in a world-class system. We are committed to strengthening Medicare by improving the scheme's integrity.

The areas that this bill is addressing are any that we've been able to identify, thanks to the Philip review, where there are issues that can inhibit the ability of the department to conduct efficient, timely and effective compliance activities, because you enhance integrity when you have a department that is empowered to act in a timely, effective way. The amendments include fraud deterrent provisions, such as the reduction of timeframes to make claims on Medicare, updated investigative powers and improvements to pharmacy approval processes. These really go to the core of the system. This is happening in a context where this bill is one part of many things that we have been doing to support Medicare.

When we came to government in 2022, it had never been harder or more expensive to find a doctor. The situation we found was that bulk-billing was in freefall. That followed a decade of cuts to and neglect of Medicare, which we had seen, but it was in coming to government that we really recognised how profound the impact of that had been, particularly in peri-urban areas like mine and, no doubt, in regional and rural areas. That's why strengthening Medicare was a key focus of our election platform, and it became even more key when we'd had the time in government to lift up the hood, see what was happening underneath and really try and unpack some of the issues that we were facing.

In our first term of government, we were able to deliver more doctors, more bulk-billing and cheaper medicines, and we opened 87 Medicare urgent care clinics. I want to note that there was some derision from those opposite towards our Medicare urgent care clinics for quite some time—that they were not needed and that they were just extra things that didn't need to happen. I noticed today in question time that every one of them seemed to be saying, 'Hey, give me one!' Their behaviour in question time seemed to indicate that there has been a bit of a turnaround. We know how effective the Medicare urgent care clinics have been, and it seemed to me that those opposite are starting to understand the difference that they are making in allowing people to get medical attention for things that are urgent but not life-threatening and in having a dual effect of providing people with quick attention and taking pressure off emergency departments in hospitals.

I'm very pleased to say that the Hawkesbury urgent care clinic has a tender out for it. The Nepean Blue Mountains Primary Health Network and Wentworth Healthcare are seeking GPs who are keen and interested in operating the Hawkesbury urgent care clinic, which was one of my election commitments this year.

More than 1.8 million people have walked through the door of a Medicare urgent care clinic. They've received free care—the urgent care they need. The feedback I get from the Penrith urgent care clinic is that they're seeing a lot of sporting injuries and they're seeing big demand over weekends. But also, during the week, there's a steady flow of people, as they learn that they don't need to rock up to the Nepean Hospital emergency department for some things and that they may well be able to be treated at the Penrith urgent care clinic. I think that what it's showing people is that Labor has a commitment to adapt the health system to make the changes that are needed.

I note the presence of the Assistant Minister for Mental Health and Suicide Prevention. We've taken the same approach to mental health. It is no longer a requirement in this country to go and see a private psychologist, counsellor or psychiatrist. There are Medicare funded centres now. The Medicare mental health centres, including the one in my electorate, in Richmond, that the assistant minister was so engaged in showing we could deliver on the ground, are places where people can get free mental health support. It can be ongoing support. It's not limited to a certain number of visits. It's not limited to one thing or the other. It's available and accessible. What's more, it's accessible six days a week. So, even on Saturdays or Thursday evenings, there's the capacity to just walk in and say, 'I'm not okay, and I need to talk to someone.' These are the sorts of changes that go to the sustainability and the development of Medicare, and they are backed by the measures in this bill, which is about ensuring the integrity of Medicare. It's becoming very clear to people that, under Labor, what you need is your Medicare card, not your credit card, to access health services.

I've spoken about how hard it was to see a GP when we first took office, and I want to say to my community that we know that in three years there hasn't been an instant fix to all those issues, but what we have been able to do, including in Macquarie, is increase the number of bulk-billed visits to GPs. Across the country, it's been an $8.5 billion investment into more bulk-billed visits, hundreds of nursing scholarships and thousands more doctors. Australian patients and families have been saving money on out-of-pockets. It's really the first time that bulk-billing incentives have been expanded in a very long time, and our latest round means, we hope, that nine out of 10 GP visits will be bulk-billed by 2030. This is what's coming and what will find its way onto the ground. It will boost the number of fully bulk-billed practices to around 4,800 nationally. That's triple the number of practices right now that bulk-bill.

Our record investment restores every dollar the Australian Medical Association said was cut from Medicare through the funding freeze by the Liberals. It's a policy that ensures no-one is held back and no-one is left behind, and it does make Medicare even stronger. It helps with cost-of-living pressures, and it ensures that every Australian receives the very best health care that they deserve. When we talk about the integrity of Medicare, we want to know that, when someone visits their GP or another specialist, there is transparency in the payments that they receive, that they are being properly billed and that, if there are any issues, the department has the power to look into those swiftly. That's the extra layer that this bill brings.

In the last couple of minutes that I have, what I'd like to talk about is how this legislation interacts with the other very key part of our health system, and that is the Pharmaceutical Benefits Scheme. The two really go hand in hand, and we've had to do work on both those sides. At the same time as making it easier and more affordable to see a doctor, you also have to make sure that people are able to access what will be prescribed to them afterwards, and that means cheaper medicines. So making medicines cheaper, with a script coming down to no more than $25 under the PBS, is another Labor commitment working its way through the parliament. It's another key cost-of-living measure that will continue to put downward pressure on inflation.

Remember that, along with all the things that we've done, including introducing this bill into the last parliament, we already slashed the cost of medicines with the largest cut to the cost of medicines in the history of the PBS, and that happened in 2023. Of course, we're going even further with that. It's going to save Australians more than $200 million each year. They've already saved more than $1 billion on the cost of scripts thanks to our commitment to make medicines cheaper. It has already been the largest medicines price reduction in the 75-year history of the PBS, plus there's the ability for people to get 300 medicines on 60-day prescriptions and a lower PBS safety net threshold. This is the other part of the health system where we make a difference to people's lives. I have people in my community, particularly older people, who say health is their No. 1 priority. They say, 'If I can keep my health, if I can get treated for things, then I know I can do a whole lot of other things, and I can be here for my family.' So I'm very proud to be supporting this legislation, legislation that will help secure the future of Medicare.

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

I respect the member for Macquarie. She left the best till last in her speech on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. And she's so right. People will come to members of parliament to say that the most important thing in their lives is their health. Make no mistake; you can have all the wealth in the world, but, if you don't have your health, you've really got nothing. Absolutely. But I really do take umbrage at the fact that Labor member after Labor member comes into the House and talks down what the coalition did during our nine years in government.

I am glad that the Assistant Minister for Rural and Regional Health and Assistant Minister for Mental Health and Suicide Prevention is in the chamber. I want to give her a couple of compliments. She came to Wagga Wagga recently to talk about mental health, and I appreciated the visit. I know that she understands as well as anybody in this place the issues of mental health, and I appreciate the fact that she is endeavouring to do something to help in this very important—very, very important—area. When funding was withdrawn from a town in my electorate, Gundagai, I called her, and she fixed the situation. She did it promptly, and she responded as a good minister should. That's all for compliments—although she should be the health minister, quite frankly. I don't want to put the kiss of death on her, but, quite frankly, she should be the health minister, because the health minister, the member for Hindmarsh, unfortunately doesn't respond to members of parliament when they write letters. We get letters back from his chief of staff. Seriously, that shouldn't happen. I shouldn't know the name of the chief of staff of the health minister straight off the top—I'm not going to mention his name, because I don't think it's right that we talk about staff members in the House and put it on the Hansard. But I shouldn't be getting letters back from the chief of staff; I should be getting them back from the minister. I really should. I don't think the assistant minister would do that. I can ring her, I can write letters to her, and I will get the response. I mightn't always like it, but at least I get it, and that's the way it ought to be.

It also disturbs me greatly that the Prime Minister is around and he holds this thing up—it's called the Medicare card—and says that's all you need. 'That is all you need.' He has said it over and over again, repeatedly. But we all remember, prior to the 2022 election, when he said over and over and over again, repeatedly, that there was going to be a lowering of your—when I say 'your', I'm talking about people out there in voter land—energy bills. That $275 never ever occurred. Just for once, I'd like to see the Prime Minister or the health minister admit that that isn't all you need when you go to see a medical specialist or when you go to see a health professional. It's certainly not the case if you live in rural and regional, let alone remote, Australia. You need to also take this little thing—it's your credit card.

What really irked me, what really got under my skin, was that, not that long ago, when there was a chorus of complaints about bulk-billing—bulk-billing rates dropped 11 per cent under the Labor government's first term—the health minister said, 'If you pick the phone up and you can't get bulk-billing from one doctor, just pick the phone up and make an appointment with another doctor in town.' It might all be well and good in the leafy suburbs of Adelaide. It might all be well and good in metropolitan Australia. Try getting another doctor—try getting any other doctor—in rural, regional and, particularly, remote Australia. I know the assistant minister would appreciate this, because it's impossible. Or, if you can get an appointment with another doctor—and the second doctor may well bulk-bill—it'll be quite a while. You might die waiting. I'm not exaggerating and I'm not making light of it; I'm being deadly serious. Often in regional Australia, when in pain, unfortunately, catch a plane, because there just aren't the health professionals.

We saw how the Minister for Health and Ageing disrespected our pharmacists. I know the assistant minister is a pharmacist. I know that's her trade. But the government had to be dragged kicking and screaming to sign the pharmacy accord when it should have been a fait accompli. It should have been a negotiation in good faith with our friendly chemists. It should have been agreed to with what was needed, and signed by the president of the Pharmacy Guild, Trent Twomey—who's a good man, who wasn't asking for much—and what did we see? We saw this absolute opposition from the government to what the Pharmacy Guild wanted. Then we saw the spectacle of the pharmacists coming in in their white coats, and they were disparaged because they were wearing what they wear to work. Yes, they were in white coats. They turned up en masse, and that's what it took. And it took, of course, the Nationals, and the Liberals too, fighting the good fight for it on behalf of our chemists because we on this side of the chamber know that in many communities—hundreds, in fact—in rural Australia the only health professional in town is your friendly pharmacist. That is the truth.

When it comes to policy, I heard the member for Macquarie talking about the days of the coalition government as if they were the Dark Ages—the bad old days when nothing was achieved in health. It was quite the opposite. You only have to look at the delivery under the coalition government. I'm very proud of and very pleased about the rural medical schools that we put in place. Indeed, we rolled those out in Bendigo, Dubbo, Mildura, Orange, Shepparton and my home town of Wagga Wagga, and in each of those facilities they are training dozens upon dozens of young hopefuls who will be the doctors of the future and will address the shortage of doctors in regional Australia.

That shortage has not been helped by Labor changing the distribution priority areas as soon as it got into government. They changed the DPAs and they made it such that periurban centres and coastal areas that are not in regional Australia but are in high-density areas could claim the distribution priority area funding. What happened then—and don't just take my word for it; the Rural Doctors Association and other key stakeholders said this—was that some doctors took their shingle off the practice and headed to the Gold Coast, headed to the city areas, headed to Wollongong or headed to Newcastle because all of a sudden they became eligible for the DPA funding.

This is not right, and it's particularly not right when you've got communities in rural areas that are reliant on the Royal Flying Doctor Service but also, as I described before, don't have a doctor. They don't have a doctor, let alone a bulk-billing doctor. They just don't have a doctor at all. I know the assistant minister is trying to do her best, and I commend her for it, but it's just not understood by the government. They've spurned regional Australia in so many areas but particularly in health—particularly when it comes to the wellbeing and health of those people who do not live in the bright city lights of a capital city. It's not right.

We have members coming into this place, and they've got their talking points. They read them out like robots and they make out as if nothing happened on the coalition's watch. Quite the opposite is the case, because we had this thing called COVID-19, and it was lucky that there was a coalition government in office when that occurred. It wasn't lucky at all that it occurred, but it was lucky we had a coalition government that put every measure and every possible policy in place to protect Australians and keep Australians alive. The Johns Hopkins centre acknowledged the fact that we were the second best in the world for pandemic preparedness. As the former deputy prime minister, I'm very proud of that, because we not only saved peoples' jobs but, more importantly, saved people's lives. We got those vaccines out. I have to say I was so proud of the fact that, when the vaccines were the hottest item that people were scrambling to get, the former member for Flinders and health minister, Greg Hunt made sure that our Indigenous communities and our Pacific neighbours were very much in line to get the jabs at the same time and at the same rate as any Australian. That's important because not only did we save lives and protect livelihoods in Australia; we did it in the Pacific.

Under the former coalition government, there were many headspaces put into country communities. I know headspace Cowra opened up whilst we were very much in government, and 1,400 additional nurse placements for the regions were funded and supported during a coalition government. We talk about doctors, but everyone should always put a value on what our nurses do. They are angels of mercy, and we should be doing everything we can to ensure that we have more nurses. We put in place 94 million telehealth consultations, through Medicare, to 16 million patients. I know Labor come in and make out as if they're the only ones who protect Medicare. For every election in the recent past, there's been this big scaremongering campaign saying that we're going to somehow dismantle Medicare. The next speaker will probably claim that too. It's nonsense. It's a furphy. If you don't know what a furphy is, it's a country term for something that just isn't true. Go and look it up. It's very much a furphy.

When we talk about telehealth, when we come to that very important discussion, it's important to note that you'll never replace a face-to-face consultation—I appreciate that—but telehealth with modern technology is important, particularly in rural and regional Australia. So too were the 857 new medicines put on the Pharmaceutical Benefits Scheme between 2019 and when we, unfortunately, lost government. This is one thing I will say in favour of the minister for health: any medicine that can go through that PBAC process and be placed on the register is a good thing. That is absolutely a good thing, and it saves lives. We've got a very proud record of supporting a strong PBS in Australia—a very strong record—whereas, in stark contrast, when we took over government in 2013, under Tony Abbott, the Labor government at the time had stopped listing new medicines because they couldn't manage the nation's finances. That is a sad reality. That isn't a furphy. That's actually the truth. They capped the number of new medicines that could be considered for listing on the PBS, and that created unacceptable delays for patients whose lives very much depend on them.

I appreciate that the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 is important. It also galled me somewhat when I had the opportunity to listen to the member for Kooyong. The teals come in here, and they're never happy. They're a glum lot. The member for Kooyong was talking about how piecemeal this legislation is. They never tell us what they will do. They'll bag Labor and they hate the Liberal-National coalition, but they'll never actually tell us what they'll do. They're always that pious group that have aways got every answer to every problem, but they'll never give you the solution. They'll tell you how terrible the major parties are going, but—like independents, always—they're just, quite frankly, nothing more than an inbox for complaints. They pretend as though, make out as if, they're the panacea for all the nation's ills and woes but never tell you exactly what they'd do if they were in government. Seriously, it's just a joke.

But I appreciate this particular legislation is important. Medicare is important. It's been delivering for 40 years, and I'm more than happy to acknowledge that. As a coalition government, we were proud of what we did in the bulk-billing space and proud of the fact that we did keep Medicare going. We've got the best health system in the world—we do—and, as an Australian and a member of this parliament, I'm very proud of that fact.

Zhi Soon (Banks, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to support the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025, and I am so glad to have another opportunity to speak on this government's healthcare agenda. Australians know that it was a Labor government that created Medicare, the Pharmaceutical Benefits Scheme and their predecessors. These programs help Australians pay for the health care they need in a world-class system. It is only Labor that stands to protect these programs and, in turn, strengthen Australians' access to reliable, affordable, quality health care. Part of strengthening our country's healthcare system is protecting the integrity of the Medicare program, supporting the Therapeutic Goods Administration to manage goods shortfalls and enforce legislation and enabling more effective preventive health measures to deter the take-up of tobacco and nicotine products.

The health legislation amendment bill before the parliament makes amendments to various pieces of legislation, including the National Health Act, the Health Insurance Act, the Human Services (Medicare) Act and the Dental Benefits Act, to respond to a range of issues that affect our health system as well as the administration and provision of our health benefits program. These changes come as a result of the Independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip. The budget delivered by the government for financial year 2023-24 funded the establishment of the Medicare Integrity Taskforce to consider the findings of the Philip review and implement its recommendations.

The Philip review referred to the need for the integrity activities to identify and respond to any actors in the system who are unintentionally or dishonestly obtaining payments. Australians know that the overwhelming majority of our doctors and healthcare professionals are honest and hardworking and comply with the Medicare rules—general practitioners and specialists are pillars of the community in my electorate—but unfortunately there are a small proportion out there who don't act with the integrity that the Australian people expect. The government has a responsibility to act to ensure that community expectations are met in all aspects of our healthcare system. These amendments are necessary to protect the integrity and support the ongoing sustainability of the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme and the Child Dental Benefits Schedule and ensure patient safety is protected in all aspects of our healthcare system. Importantly, the measures introduced in the bill before the House will only directly impact the small percentage of practitioners and businesses engaged in noncompliance or fraudulent activities. The vast and overwhelming majority of practitioners and patients who do the right thing should notice no difference.

Overall, patients and practitioners can expect to benefit from better protected health benefit schemes that will provide more secure access to safe, quality healthcare services. Where genuine fraud exists in our healthcare system, it is our responsibility to investigate it and pursue it through the avenues available. At present, the legislation does not provide adequate paths for government to take action in this regard. The investigative powers in part IID of the Human Services (Medicare) Act apply inconsistently across all of the health benefits programs, and, as a result, investigators do not have access to the full suite of powers for numerous offences, with particular weaknesses in relation to the Pharmaceutical Benefits Scheme. There are also unnecessary restrictions on the ability to search with consent and on the retention of important evidence, which can frustrate efforts to pursue prosecution in some serious instances that are dealt with under the Criminal Code. This Labor government isn't just strengthening the PBS by cutting the price of prescriptions to a maximum of $25; we are strengthening it by ensuring that the small handful of people out there who abuse it can be held accountable.

Further, the bill amends the National Health Act to improve the efficiency of the process by which the minister may exercise discretion to approve a pharmacist, by combining two stages of the existing process, as well as restricting repeat applications, amongst other measures that will reduce administrative burden and support more timely access to medications and pharmaceutical benefits for Australian patients. While these legislative changes are hardly the flashiest part of the government's agenda in the healthcare space, they are both timely and important for the long-term sustainability of our healthcare programs. Overall, this suite of measures will collectively improve the power to detect, respond to, investigate, disclose and deter misconduct, fraud and non-compliance, and it will support the ability to conduct efficient, timely and effective compliance enforcement activities.

It is important for this government to ensure that the PBS is not being exploited by bad actors out there, but it's equally important to ensure that the department is able to respond to shortages in the pharmaceuticals that Australians need. This legislation does just that. This bill makes amendments to the Therapeutic Goods Act to enhance the department's capacity to manage the situation and alleviate the effects on patients by allowing approval of the import of substitutable products when it becomes clear that there is a looming shortage.

In recent years, we've seen the spread of vaping and e-cigarettes, including in concerning numbers among young Australians. The Minister for Health and Ageing, Disability and the National Disability Insurance Scheme has led the reform in this space, ensuring that we keep vaping products out of the hands of young people and stop the sale of illegal vapes. This legislation continues to move forward in this space, with measures to support compliance and enforcement activities undertaken in relation to vaping goods and to support existing legislation. Further, this legislation makes changes to the Public Health (Tobacco and Other Products) Act that remove the restrictions on the public service performance compliance enforcement activities as well as enable the refresh of health warnings on tobacco products and packaging to ensure these measures are effective in deterring the uptake of smoking and in the promotion of the cessation of smoking as an important preventative initiative. The specific provisions of the legislation will ensure this refresh can be undertaken without unnecessarily or excessively burdening business owners or retailers.

As I indicated before, these provisions are not flashy and probably won't get on the front page of the paper, but they are an important part of the government's wider health agenda, making sure that we can deliver the high-quality, affordable and accessible health care that Australians expect and need. When Labor came to government in 2022, it had never been harder or more expensive to see a doctor. This is why Australians put their faith in us to repair the health system. That continues in this term of the 48th Parliament. The Labor government did the hard work and, in the last term of parliament, made record investments in Medicare to restore bulk-billing rates for those who need it most and got results. Bulk-billing rates began to climb in every state and territory as a result of millions of additional trips to the GP that wouldn't have been possible without our tripling of the incentive. Now, the Albanese government is making the single largest investment in Medicare since its creation, with $8.5 billion to deliver more bulk-billing for all Australians, meaning that nine out of 10 GP visits will be bulk-billed by 2030 and that triple the number of practices will be bulk-billing all of their patients.

Only this side of the House respects the noble work that is done by our healthcare professionals and understands that nothing we do in this place can be implemented in the health system without them. It's why we're investing $662 million in the healthcare workforce, which will expand the largest GP training program in Australia's history. By 2028 we'll be funding the training of 2,000 new GP trainees every year alongside measures such as fee-free TAFE and the prac payment, which are helping more nurses and other healthcare professionals get qualified in our communities, to help develop our healthcare system further.

During the election campaign in 2022, Labor promised that we would open 50 medical urgent care clinics across the country. We overdelivered, with 87 clinics nationwide, and I look forward to being part of the delivery of a further 50, as we promised at the latest election. The clinics that serve my community in Bankstown and Carlton have filled a gap in our healthcare system and taken the pressure off the emergency departments and the hardworking staff at the Bankstown-Lidcombe and St George hospitals. Across the whole network, more than 1.8 million patients have been seen and have received fully bulk-billed care. That is an astounding number of people who didn't have to wait in an emergency department or, even worse, forgo medical treatment altogether.

I had the opportunity last week to speak on the National Health Amendment (Cheaper Medicines) Bill 2025, and I'm so glad to be able to reiterate to the House the government's fantastic achievements in this space. In 2023 we cut the cost of PBS prescriptions from $42.50 to $30, and the legislation that passed the House last week will cut them from $31.50 to just $25 as well as maintain the $7.70 freeze for pensioners and concession card holders in our communities. The reduction in cost from the government is a cut of more than 20 per cent to the maximum cost of a script, which will save Australians a further $200 million each year, and the government's initiative to make 300 medicines available on 60-day prescriptions and lower the PBS safety net threshold will make sure Australian patients save more than a billion dollars on the cost of their scripts thanks to this government's commitment to making medicines cheaper. This is what tangible cost-of-living relief for Australians looks like, as we continue to put downward pressure on inflation while supporting our healthcare system.

The Albanese Labor government has delivered a significant boost for public hospital funding, with $1.8 billion invested on 1 July this year, including $408 million for hospitals in my state of New South Wales. The agreement means Australians will benefit from better funded hospitals—like the one I visited in Bankstown on Friday last week—shorter waiting times in emergency departments and shorter waitlists as the government continues to work in partnership with the states and territories to deliver a five-year funding agreement for public hospitals. This is in stark contrast to those opposite, who cut $50 billion from public hospitals under the stewardship of the former leader of the opposition and member for Dickson.

As I said, this government's health agenda is substantial. It covers the length and breadth of the portfolio. While the changes made by the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 might not get the headlines, they are no less important as we deliver the healthcare system that Australians deserve and expect. It is this government that continues to invest in Medicare, it is this government that continues to invest in the PBS, and it is this government that continues to invest in our healthcare workforce to make our healthcare system one of the best in the world. I commend this bill to the House and look forward to continuing to support our government's agenda in the health space in order to make sure it continues to remain affordable, of the highest quality and in line with what our communities expect to make sure that we have healthy Australians of all ages for generations to come.

Zali Steggall (Warringah, Independent) Share this | Link to this | Hansard source

This bill implements minor amendments from the government's response to the Philip review by strengthening integrity measures across Medicare, pharmaceuticals and therapeutic goods. It equips regulators with stronger powers to tackle fraud, unlawful products and the growing threat of vaping. In fact, for those wanting the detail, schedule 1 of the bill aims to improve the enforcement of Medicare integrity by, first of all, changing claim timeframes for bulk-billed Medicare and dental services from two years to one year, broadening investigative powers to ensure they can be used across health benefit schemes, streamlining the pharmacy approval processes and providing greater oversight powers to obtain information about potential noncompliance. Schedule 1 also proposes amendments to the Therapeutic Goods Act to better manage and alleviate the consequences of medicine shortages.

Critically, what I want to focus on today is schedules 2 and 3 of the bill, which strengthen legislative action against vaping by closing loopholes, strengthening enforcement and harmonising laws. The widespread availability of illegal vapes remains extremely concerning. We passed legislation during the last parliament in relation to vaping, but clearly it is not working and much more is needed. It's emerging as one of the major public health threats to Australia in our communities. Tobacconists are popping up within 300 metres of schools all over the place in our areas and communities, and it is unacceptable. Regularly I hear from parents, carers and other members of the community about the increasing number of these tobacco shops that are popping up just everywhere. I've talked about it at local government level; they are powerless about it because it's not a change of use, so we need a strong direction from the federal government to do something about this. My Independent colleagues at state level are pressing state government to do more to stop these tobacconists popping up everywhere, but we have to do something. People are alarmed about how this can continue to occur, especially in such close proximity to our schools, parks and childcare centres. It is clearly a targeted measure from vaping and illegal tobacco.

Australia has a strong history of tackling public health issues. For years tobacco use continued to fall. The measures had worked. In 2001 about one in two people in Australia, 49 per cent, had smoked in their lifetime; 20 years later, by 2022-23, this had reduced to just one in three, 35 per cent, already a great outcome. But we need to keep pushing to do better. This was possible through world-leading measures such as plain packaging, advertising bans and tobacco excise. Unfortunately it's rebuilding. The tobacco companies have invested and    moved into the vaping space, and what we're seeing is now an attack on health that is incredibly concerning. Vaping rapidly filled the gap, and there are so many misconceptions in our community about vaping. There are a number of measures that governments need to take. Vaping have read the consumer and marketing playbook, marketed in bright colours and sweet flavours and sold illegally in rapidly emerging tobacco stores around the country. According to the Australian Institute of Health and Welfare nearly 50 per cent of Australians aged 18 to 24 have tried e-cigarettes and vapes. In 17- to 18-year-olds it has tripled in just three years—a massive problem. Despite the 2024 vaping reforms the black market remains rampant, and the gap between legislation and enforcement continues to erode public trust. There has to be more done from a Border Force point of view and then policing and implementation.

This bill introduces minor amendments that align with and add greater clarity to the existing vaping reforms. These are important progressive steps, but they must be matched with so much more. They need national enforcement, penalties and education. The wider issue here remains protecting young Australians from addiction. I actually recently had the opportunity to speak to some of our area commanders, from a policing point of view, and there was a real concern about lack of resources to properly police tobacco concerns. We need implementation of greater accountability for retailers and distributors who continue to sell vapes illegally; consideration of a nationwide licence for tobacconists with stricter compliance and oversight requirements; strengthening of penalties to deter the illegal behaviour; and properly resourced and staffed policing and enforcement capabilities.

Further, we need more transparency, data around who is been provided with vapes and reporting on enforcement outcomes so communities know that action is being taken where it is needed. We need education campaigns in schools and in workplaces to counter this industry marketing, and we need to protect children. Too many do not think of vaping in the same way as they think of smoking. They do not understand that it is as bad—this is as bad for your health, community and children. The Youth Vaping Education Campaign in 2024 was good, but it must continue in our schools, and it needs to be amplified. Where is the national campaign on our screens telling people not to vape—that vaping is as dangerous and as harmful to your health as tobacco? In the past we've had strong anti-smoking campaigns to help educate Australians on those health risks and warnings. Where are the similar vaping campaigns? They are just missing, and this is a spot where the federal government must step into that responsibility.

In fact, I had a meeting that was so sobering with a young Warringah based scientist, Andie Thorpe—an amazing young woman. She's been identified through STEM projects, and she's doing the most incredible research, but it was just horribly sobering. She is studying third-hand vaping. I would question how many people realise that vaping leaves a residue where you have vapes. If it's internally, in a car, house or any room, it leaves a residue on every surface. For example, you've vaped in your car thinking you're doing it before picking up the kids from school, it's safe and you're not giving them any kind of second-hand smoke. Then you pick them up—maybe you pick them up from child care. You put the baby in the car seat. In that car seat, they will maybe touch the surfaces in the car around them and put their fingers in their mouth. That is third-hand impact. What they are seeing is that residue is incredibly toxic. Not only is there a danger to those around you of firsthand and second-hand vaping; there's third-hand, where it has left a residue in the place where it has been consumed. What it's showing is that the chemicals linger on surfaces, impacting lung function, immunity and even, in situations of pregnancy, the embryo.

This is incredibly toxic, and it's incredibly important that we quickly counter that with information. The government urgently needs to do a national campaign to warn against the dangers of vaping and the chemicals included. Andie's research shows that vaping harms extend well beyond the individual user, and this is so widespread. It affects our homes, our schools and the wider community. It really is a health menace. The government's actions with this bill are welcome, but so much more needs to be done to ensure that vaping does not entrench itself like tobacco has done in the past. Otherwise, we'll continue to see the health costs and harms escalating, and communities will lose faith that the government has an intention to protect health and the health of our communities.

On the whole, the amendments are a welcome step in the right direction, but the stakes are high. I can't stress it enough. Laws alone are not enough. We must match legislative reform with enforcement, education and a nationally coordinated campaign if we want to protect young Australians from addiction with vaping. I commend this bill but urge the government to show much greater ambition when it comes to tackling the scourge of vaping, because nothing is more important than the health of our children and our communities.

Tom French (Moore, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. This bill is about fairness, trust and the future of Medicare and the Pharmaceutical Benefits Scheme. It is about making sure these pillars of our health system remain strong, sustainable and accessible for every Australian. In this country, health care cannot be treated as a privilege. It cannot be reduced to a commodity, rationed or auctioned to the highest bidder. It must remain a right guaranteed to all. That is why, when people in my electorate of Moore visit a pharmacy or a GP, they should be able to count on certainty—certainty that (1) the cost will be affordable and that (2) the system is fair, rigorous and sustainable.

Cost-of-living pressures are real, and health expenses are often the silent burden within the household budget. When families skip medicines or delay care, the risks are not abstract. They are real and they are long-lasting. This bill helps lift that burden and remove those impossible choices. Our task is clear. We must strengthen Medicare, the PBS and their integrity so that every public dollar reaches the patients it was intended for. That is the clear purpose of this bill.

Labor built Medicare, and Labor built the PBS. And, every time Labor has been in government, we have worked to reinforce and expand these foundations. This bill continues that tradition with focus and determination. In government, we have delivered cheaper medicines, stronger bulk-billing incentives and Medicare urgent care clinics to provide timely walk-in care for urgent but non-life-threatening needs. We have also increased Medicare rebates after years of neglect. This bill builds upon that record of reform. It advances integrity, access and accountability, the three elements that sustain public confidence. It targets fraud, error and waste while backing the overwhelming majority of providers who act with honesty and professionalism. Above all, it ensures patients remain at the centre of the system.

The bill reduces the timeframe for bulk-billed claims from two years to one year, tightening oversight and improving integrity. Integrity delayed, after all, is integrity denied. A shorter window means faster reconciliation and earlier detection of abnormalities. Honest providers benefit from certainty and clear expectations while those who exploit the system lose the opportunity to rort. Regulators, in turn, gain sharper tools to detect and pursue misconduct. That is not bureaucracy for its own sake. It is targeted, intelligence led compliance. Proportionality remains central. The framework educates where mistakes are inadvertent, escalates when behaviour is reckless and imposes firm consequences when fraud is deliberate. That balance is what builds trust in the system.

Faster, clearer processes mean more timely access to care for patients in Beldon, Currambine and Edgewater. Red tape should never become a barrier at the front door of health care. When approvals are delivered on time, pharmacies can plan, invest and hire with confidence. They can expand services like dose administration aids, home delivery and extended hours. This is reform with practical results. When public funds flow back into patient care, communities in suburbs like Hillarys, Sorrento and North Beach see the benefits. Every dollar returned is a dollar available for medicines and services. This is not punishment for its own sake; it is fairness to taxpayers and providers who do the right thing every day. Integrity is what preserves confidence in Medicare.

This bill supports broader reforms to protect young people in suburbs like Woodvale and Watermans Bay from the health risks of today becoming the chronic diseases of tomorrow. Prevention now avoids heavier costs later. Integrity is not just a slogan. It is the oxygen of Medicare and the PBS. When people present a Medicare card or a prescription, they must trust the price, the rules and the system itself. Reviews have shown there is significant leakage from noncompliance and fraud in health funding. That is money not reaching patients in suburbs like Iluka, Marmion and Sorrento in my electorate. This bill responds directly to that challenge. It creates guardrails to ensure the system works as intended. It supports the majority who comply and identifies the small minority who do not. That is how integrity must operate.

Let me turn to Medicare urgent care clinics. Across Australia, these clinics offer extended hours, walk-in care and no out-of-pocket expenses for urgent, but non-life-threatening, issues. They relieve pressure on emergency departments while keeping care close to home. A child's deep cut, a sprain or an ear infection may be urgent, but it is not an emergency. Urgent care clinics treat these needs quickly, safely and affordably. Hospitals are then free to focus on strokes, heart attacks and serious trauma. That is reform rooted in common sense and proven in practice. It is Medicare doing what it does best: delivering care when and where it is needed most.

Turning to primary care, strengthening bulk-billing is vital for children, pensioners and concession card holders. It supports access, continuity and better outcomes that flow from consistent care. A fair and efficient PBS keeps people well and working. It reduces avoidable hospital admissions, and it helps families manage their household budgets with greater certainty.

Data driven stewardship is another strength of this bill. Earlier identification of unusual patterns allows correction, education and enforcement before harm spreads. That protects patients, providers and taxpayers alike. This is not about 'gotcha' enforcement. It is about guardrails, clarity and predictable rules, and public confidence demands nothing less. The principle here is simple: care first, cost fair.

Affordable medicine, supported GPs and pharmacists, convenient urgent care and honour systems create compounding benefits. That is how we build a healthier society, in Moore and nationwide. Prevention, too, saves lives and dollars. Immunisation, screening and risk factor management all reduce illness and hospital use. A stronger Medicare and a fairer PBS make prevention achievable for everyone. Health spending is not a sunk cost. It is an investment. Its return is measured in hospital bed days avoided, productivity preserved and dignity protected. This bill strengthens that return.

Integrity also means clarity for providers. Compliance should be predictable, proportionate and transparent. The system should reward good practice and correct honest mistakes. By tightening claim timeframes and modernising investigations, the bill removes grey areas. It sets expectations that providers can clearly understand and meet. That is good governance. Technology and data, when applied properly, are allies of patient safety and value for money. Reliable data enables benchmarking and smarter targeting of education and enforcement. Secure, connected systems reduce duplication and errors.

Community pharmacies remain a cornerstone of access. Transparent, timely approvals help them align staffing, invest in services and support patients with complex needs. Stronger pharmacies make for stronger communities.

This bill strikes the right balance. It educates and corrects where appropriate, escalates when necessary and applies firm penalties for deliberate misconduct. In doing so, it protects patients while respecting professional autonomy. I know firsthand what the PBS means. In 2009, I was diagnosed with chronic kidney disease, and, in 2020, I received a kidney transplant from my brother. Immunosuppressant medicines keep that gift safe, and the PBS keeps them affordable. Without those medicines, a transplant is at risk. Without affordability, adherence is at risk. The PBS turns a medical miracle into a sustained reality. That is why affordable medicines are not an abstract policy to me; they are a lifeline for Australians managing serious illness. This bill helps protect that lifeline by strengthening integrity and access.

In Moore, the benefits of cheaper medicines and stronger Medicare are felt daily. Every affordable prescription helps control chronic conditions. Every bulk-billed consultation supports early treatment and prevention. Urgent care that is convenient and free keeps people healthy and productive. It also preserves hospital capacity for emergencies, and it strengthens confidence in our local health services. This bill supports patients and providers together. Clear rules and fair processes ease the compliance load for those doing the right thing. Shorter claim windows reduce administrative tail risks. They encourage accurate billing at the point of care. They help detect anomalies quickly. Modern investigative powers allow proportionate responses. Most errors can be corrected through education, but serious misconduct demands firm consequences. Streamlined pharmacy approvals mean real-world improvements in access. Families can obtain timely medicines without unnecessary delay. Communities retain the services they depend upon, and efficient debt recovery returns money directly to patient care. That ensures fairness to contributors and compliance with community standards. It also sends a clear signal that public funds are stewarded responsibly.

Vaping and tobacco reforms are another essential step. Protecting young people today prevents the chronic diseases of tomorrow. This bill complements those efforts with a coherent package of reforms. Together, they align incentives, clarify responsibilities and deliver better outcomes. They are built on evidence, consultation and practical experience. The design of the bill respects clinical judgement. It sets system rules without intruding into the consult room. That balance ensures care remains patient-centred. Medicare and the PBS are social compacts. We fund them collectively because illness does not discriminate. We maintain them carefully because public trust sustains them. For households, affordability means dignity. It is the difference between adherence and risk. It is the reassurance that care is within reach. For the health workforce, clarity means respect. Clear and consistent rules honour professional effort. They allow clinicians to spend time where it matters: with the patients. For governments, integrity means stewardship. Every dollar must reach the front line. Leakage must be found and fixed.

This bill advances all three principles: dignity, respect and stewardship. It strengthens the social licence of Medicare. It keeps faith with the Australian public. This is Labor's enduring story in health. From foundations to modernisation, the path has always been forward. Each time Labor governs, health care is broadened, strengthened and secured. Whitlam laid the foundations. Hawke and Keating strengthened the PBS. Labor governments resisted efforts to impose higher co-payments.

Today, we deliver the largest investment in Medicare in decades and the lowest PBS co-payments in 20 years. The point is consistency of purpose. Fairness, dignity and security remain our compass, and this bill follows that compass faithfully. For families in Beldon, it means a child's inhaler without a trade-off at the checkout. For apprentices in Padbury, it means pain relief that does not jeopardise rent. For seniors in Kingsley and Duncraig, it means every script filled on time. For pharmacies in Joondalup, it means certainty to plan. For clinics across Moore, it means predictable settings that support quality care. For the system, it means integrity that is visible and reliable.

Every affordable script is a step away from an avoidable ambulance. Every bulk-billed visit frees a hospital bed. Every strong pharmacy anchors access in the community. These reforms are practical, balanced and targeted. They keep patients at the centre. They maintain the trust that makes Medicare work. This bill is not just words passed in Canberra; it is Medicare and the PBS doing their jobs. Australians expect a system that is fair, strong and sustainable. They expect governments to safeguard integrity and improve access. This bill meets those expectations. Its benefits will be seen in homes, workplaces and clinics. I commend this bill to the House, and I do so confident that it strengthens Medicare and the PBS as pillars of fairness, dignity and trust for all Australians.

Julian Hill (Bruce, Australian Labor Party, Assistant Minister for Citizenship, Customs and Multicultural Affairs) Share this | Link to this | Hansard source

This bill brings together a number of important strands of the government's ongoing work to improve and reform Australia's healthcare system. It brings together a number of elements that were contained in the bill that was considered by the previous parliament which lapsed in the Senate but which I note had been the subject of a Senate committee report recommending that those important measures be passed. The context is also important because it complements and links to all of the work—and I see the assistant minister for health here—which the government is powering ahead with, delivering on election commitments around cheaper medicines, Medicare urgent care clinics and all of the other reforms in the health system. I commend the member for Moore for his speech. Already in this place he's become a powerful advocate for his community but also has been courageous enough to share many of his own health challenges and highlight in a very personal way the importance of Medicare to everyday Australians. He's a real asset to the parliament.

To summarise the bill, the measures are principally intended to protect the integrity of Medicare, enhance the regulation of therapeutic goods and, importantly, vaping goods under the Therapeutic Goods Act and make minor amendments to ensure the smooth and consistent operation of the tobacco act. I'll just touch firstly on the Medicare integrity measures. These are not made-up. They implement recommendations from the Independent Review of Medicare Integrity and Compliance, known as the Philip review. Medicare and its programs help Australians pay for their health care. It's a world-class system that is rightly the envy of the world. My electorate in south-east Melbourne is home to many new migrants, people new to Australia, and one of the things they marvel at is that, when they become a permanent resident and then a citizen of our country, they get the little green and gold card which gives them access to the doctor, medicines and so on. Most people in the world do not live in a country where they can enjoy the kind of health care we have.

But money doesn't fall from the sky. It's incumbent on the government to make sure every single taxpayer dollar that goes into Medicare is managed properly and managed with integrity. That's important for the sustainability of the scheme. Of course it's important and a focus of the government to make sure every dollar is spent efficiently, effectively, economically and ethically by the public agencies that administer it, but it's also important for public trust because when taxpayers and citizens see rorting of public programs it undermines public trust in these universal programs which Labor governments introduce. Integrity really matters, and it is important that our agencies have the powers they need to support investigations, conduct efficient and timely and effective compliance activities and crack down on any rorting and misuse of the system that they see.

To contrast, we saw under the former government the shocking scandal of robodebt, sending fake debt notices to the most vulnerable Australians with the power of the Commonwealth logo for money they did not owe—absolutely shameful. It was a deliberate budget measure continued under successive ministers. If only they'd put the same amount of effort into pursuing rorting in schemes like the NDIS, which the government is now investing through the Fraud Fusion Taskforce and other measures, to find the crooks and charge and prosecute them.

My dad was a doctor. As I was saying to the assistant minister, I was a great disappointment to the family. I was supposed to be a doctor because he was a doctor and his dad was a doctor and his dad was a doctor—a line of obstetricians, one of them very famous actually. My mum was a nurse, and my uncle had two PhDs in nursing. I not only refused to do medicine, even though I did science and had the marks; I rebelled against my mother by refusing to go to Melbourne University—I went to Monash and studied other things. But I've got great regard, coming from a family immersed in medicine, for the work that doctors do. The vast majority of doctors serve their patients with care and distinction. My dad died when I was young, but Mum used to tell the story that when he'd come home and she'd do the monthly books for his doctor's surgery—it was back in the day where you could be a GP and a specialist obstetrician/gynaecologist—she'd get very frustrated at the end of the month and say, 'You haven't charged all these patients,' and he'd say, 'But they were sick. I had to help them.'

The ethos of care that most people in the medical profession exhibit to their patients is admirable, but the truth is there are also some filthy rich doctors who rort the system—absolutely unacceptable. Those doctors—we have seen the examples—come up rarely, but when they do come up they completely undermine public trust in our Medicare system. It's really important that those doctors are cracked down on with the full force of the law, and these measures to give agencies powers to conduct proper investigations and go after them are absolutely critical; I commend them.

As I said, this is part of the delivery of our ambitious health agenda, and one part of that, as many speakers, both government and opposition, have remarked upon in their own way is the government's measures to make cheaper medicines even cheaper and to reduce the general PBS copayment so that, when the bill passes, Australians will pay a maximum of $25 per script. I'll say that again. The Labor government is delivering on our election commitments to charge a maximum copayment, under the PBS, of $25 a script. The last time the copayment was $25 was in 2004. That's more than 20 years ago. This reduction represents a more than 20 per cent cut to the maximum cost of PBS medicines. Importantly, the bill is drafted so that, for all medicines that pharmacies can currently discount today, they'll be still able to be discounted. There's a specific provision in the bill to protect the availability of discounting, which is so important for competition and to many people who pursue and focus on saving every dollar.

One of the key cost-of-living measures is the reduction in medicine costs. It comes on top of the largest reduction to PBS medicines, which we affected in 2023. These measures will make four out of five PBS medicines cheaper. In my electorate of Bruce, more than $10 million has already been saved by people because of those changes, as at 31 July. As I said, it builds on action we've already taken to deliver important cost-of-living measures through the PBS through cheaper medicines—more free and cheaper medicines sooner, with a 25 per cent reduction in the number of scripts that a concessional patient has to fill out once the safety net kicks in. That was July 2022, and it was one of the first actions the elected Albanese Labor government took. Then, as I said, came the largest cut to the cost of PBS medicines in the history of the PBS, with the maximum cost of a general script falling to $30 from $42.50, where it had risen to under the Liberals, and then came the 60-day prescriptions, saving time and money. There was a little bit of an unhelpful debate. I think it's fair to say some of the pharmacy lobby went a little bit over the top. The sky was going to fall in, and pharmacies were going to close. There were going to be no pharmacies left. I remember them up there, yelling in the gallery and carrying on. Full credit to the health minister for persevering with this important reform.

Again, the former government had the advice. They'd been told, year after year, when they were sitting on the Treasury benches, that this was a reform that they should do for people with chronic health conditions and that there was no reason for them to have to go to the pharmacy every month and pay the prescribing fee when they were going to be on a medication for life. I'll give you an example. Often, when you talk about these things, people think of older Australians who may have more health conditions or be on more medicines or they think of people our age, my age, who may start to develop some health conditions, if they see the doctor regularly enough. But I got a rare phone call from my daughter when we made that change. Well, she calls me quite a bit, but it was rare that I got a call that said, 'Dad, you've done some useful.' I said, 'Oh, what's that, darling?' And she said, 'This 60-day prescribing is going to save me a fortune,' because she had just bought a house and her life revolved around keeping money in the offset account and trying to get me to pay for as many things as possible. That's a fairly predictable modus operandi. I see a bit of camaraderie across the chamber here; it's relatable. It's true. We've all been there, if we've got kids of that age. The point is she has a chronic DVT. She almost died, as I spoke about in the parliament at the time, at her request, to raise awareness of the issue. She got a DVT overseas. We were in Sri Lanka. They fixed her up in ICU, but she has chronic vein damage in her leg and will be a blood thinners for the rest of her life. There is no reason for people who suffer a chronic health condition to have to go to the doctor every 30 days, but, unfortunately, the former government failed to act. To this government's credit and to the health minister's eternal credit, he toughed it out and pushed that reform through, and it's saving hundreds of millions of dollars for Australians every year.

The final thing I'll just note is with respect to the measures in the bill that contribute to tobacco and vaping management. This is a really important amendment with respect to tobacco and vaping. As previous speakers—including, I note, the member for Warringah—rightly observed, it doesn't solve the problem of illegal tobacco or vaping, but it does contribute through the health portfolio to tightening the regulatory environment and taking steps in that direction.

Australia's efforts over generations now to curb smoking rates are world leading. People come from overseas to have a look at the public policy initiatives we put in place, a combination of education and interventions in the younger years and also excise increases over time. The combination of measures that Australia has taken in public education have seen smoking rates consistently decrease for a very long time now and flatline. That's a good thing. It saves lives and it saves untold billions in the health system.

But what we have been seeing in recent years, with the infiltration of organised crime into the illicit tobacco market and, of course, vaping, is deeply concerning, as previous speakers have said, and rightly so—vaping is bad for your health. Of course, people who are chronically addicted to nicotine can see their doctor and receive a prescription. If it's a harm minimisation approach—vaping versus cigarettes—then that might be the right choice for the individual. But the explosion of vaping in the next generation that we have seen and that the government is acting on is deeply concerning not only for the future health of our kids and that generation but also for society because we know that, as people become addicted to nicotine—a highly addictive substance—through vaping, at some point many people then start to transition to smoking cigarettes because, for a lot of people, it's actually cheaper to go and buy illicit tobacco than stick with the vapes. These are all publicly known facts.

There's obviously a lot of work underway. One of the responsibilities I have in the customs portfolio, with the Australian Border Force, is oversighting their fantastic, incredible work to intercept illegal tobacco and vapes at the border. You can think about it like this: there's pre border, there's at border and there's post border. The work that the ABF is doing with international counterparts on shipping and intelligence to improve our ability to detect at the border and disrupt production offshore is going well. We've seen record numbers in seizures of vapes and cigarettes over the last 12 months. Don't hold me to the figure, but I think it was in the order of 2.5 billion cigarette equivalents intercepted at the border through the fantastic work of the ABF. I've visited them in Perth and Melbourne and seen firsthand the work that the team does.

But, of course, as other speakers have observed, there is more to do in the postborder environment, particularly in working with the states and territories on tobacco and vaping. I commend the work of the Illicit Tobacco and E-cigarette Commissioner. It sits in the ABF but works across the whole of the Commonwealth and with all states and territories; there are in the order of 40 separate agencies involved, if you add up the consumer agencies, the health agencies and so on, to disrupt this trade. I commend the work that's underway while acknowledging that there's more to do and commend this bill to the House for making an important contribution to that effort.

Rebecca White (Lyons, Australian Labor Party, Assistant Minister for Women) Share this | Link to this | Hansard source

Thank you to all members who've made a contribution on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. I've appreciated listening to everybody's speeches. I'd just sum up by saying that Australia has a world-class health system, largely thanks to the various health benefits schemes such as Medicare which help Australians pay for the health care that they need. We've heard lots of contributions today talking about how important Medicare is for our various electorates and, more importantly, the people who rely on access to great health care in our country.

In 2023-24 payments for health benefits including medical services, pharmaceutical services and private health insurance rebates totalled at least $65.1 billion in Australia. The government is committed to protecting this investment and strengthening Medicare by improving the compliance framework that ensures its integrity. The government commissioned the independent review of Medicare integrity and compliance known as the Philip review in November 2022 to respond to concerns about the operation of the Medicare system. The Health Insurance Amendment (Professional Services Review Scheme) Act 2023 and the Health Insurance Amendment (Professional Services Review Scheme No. 2) Act 2023 made amendments in response to recommendations of the Philip review.

This bill will support the integrity and sustainability of Medicare by addressing a range of issues to enable the department to conduct more efficient, timely and effective compliance activities. The bill will improve payment integrity by reducing the timeframe for making bulk-billed claims. The bill will allow investigative powers to be used consistently and effectively across all health systems and schemes, including Medicare and the Pharmaceutical Benefits Scheme, and will improve the processes related to pharmacy approvals.

The bill also makes several sensible amendments to the Therapeutic Goods Act 1989 to enhance the capacity of the Department of Health, Disability and Ageing to manage and alleviate the consequences of therapeutic goods shortages and to support compliance and enforcement activities undertaken in relation to unlawful therapeutic goods and unlawful vaping goods. These amendments are consistent with this government's unwavering commitment to public health and mitigate the public health risks associated with therapeutic goods and vaping goods by supporting strong and effective regulation under the Therapeutic Goods Act. The bill also amends the Public Health (Tobacco and Other Products) Act 2023. These amendments are largely clarifying in nature and have been identified as necessary during the implementation to ensure the smooth and consistent operation of the act. I commend the bill to the House.

Question agreed to.

Bill read a second time.