Angus Taylor (Hume, Liberal Party, Shadow Minister for Defence) Share this | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. The coalition acknowledges the intent of this bill, which contains a number of technical amendments to improve the efficiency of several important elements of our health system, including the allocation of Medicare provider numbers, the assignment of Medicare benefits processes and improvements to the private health insurance premiums reduction scheme. It also makes amendments to the Bonded Medical Program, with the aim of ensuring that penalties for noncompliance are fair and proportionate, particularly in light of the serious workforce shortages facing our healthcare system. The measures in this bill are intended to tidy up existing legislation, streamline administration and make sure the rules governing Medicare payments and bonded medical placements are clear and consistent. These are sensible objectives, and on that basis the coalition will not stand in the way of this bill in the House.

However, we will be seeking further information and scrutiny on this bill through a Senate inquiry, particularly in relation to the implications of the proposed changes to the Bonded Medical Program and the assignment of Medicare benefits for bulk-billing and simplified billing arrangements. We have significant unanswered questions that we believe it is important to seek answers to. It's vital these measures do not create unintended consequences or additional administrative burden for our hardworking health professionals, because right now it is undeniable that primary health care is in crisis under this government.

At the last election, we saw the Prime Minister wave around his Medicare card at every photo opportunity, declaring that under his government all you need is your Medicare card, not your credit card. He said that Australians can see a GP for free under Labor. He made that promise at least 71 times during the campaign. But the truth, confirmed by his own department, is very different. A department of health briefing obtained under freedom of information revealed that a quarter of GP clinics across Australia will not bulk-bill. This means millions of Australians still need their credit card as well as their Medicare card when they visit a doctor. Now the health minister is desperately trying to walk it all back, saying that Labor never said there would be 100 per cent bulk-billing. Well, the Prime Minister certainly did say that. He looked Australians in the eye and said, 'One card covers it all—not your credit card, your Medicare card.'

But today Australians are paying the price for the Albanese Labor government's disingenuous approach to Medicare. Whilst the Prime Minister was out there waving his Medicare card, Australian families were paying a combined $166 million in out-of-pocket costs at the GP in the month of the campaign, May 2025, alone. In the past year, Australians have paid over $2 billion out of pocket to see a GP—$2 billion charged to their credit cards, not covered by their Medicare cards. That is the Prime Minister's $2 billion lie. Since Labor was elected, Australians are now paying 75 per cent more out of their own pocket to see a doctor. So much for 'free to see a GP'!

Labor promised to strengthen Medicare, but it has only been weakened. Since the Albanese government came to power, bulk-billing has fallen from 88 per cent to 77 per cent. That's 40 million fewer bulk-billed GP visits in the past year alone. Medicare mental health funding has been slashed in half, and, despite all of Labor's false promises and misleading rhetoric, Australians are now paying the highest average out-of-pocket costs on record to see a GP. That is the stark reality of Labor's primary care crisis. More than 1.5 million Australians last year said they avoided seeing a GP because of cost concerns. That's 1½ million people forced to make a difficult decision about their health, a decision no Australian should have to make, because of Labor's primary healthcare crisis.

While Australian families are struggling to afford to go to their doctor, the Prime Minister seems completely out of touch, more interested in political stunts than ensuring all Australians actually have timely and affordable access to essential health care. Nowhere is Labor's neglect clearer than in mental health. When Labor tore away Medicare subsidised mental health sessions from 372,000 vulnerable Australians, it ignored the advice of its own review and the pleas of mental health experts right across the country. Since that cruel cut, access to Medicare mental health support has fallen to its lowest level in at least a decade, right at the time when demand has never been higher. Labor has cut Medicare mental health sessions in half, abolished the Mental Health Commission and even ripped away the Suicide Prevention Research Fund. Their neglect of mental health is so significant that the former chair of Mental Health Australia was forced to resign in frustration at the government's inaction. This is not the record of a government strengthening Medicare or supporting Australians' health and wellbeing. It is the record of a government that says one thing and does another.

Under the coalition, Medicare funding increased every single year, from $18.6 billion back in 2012-13 under Labor to more than $30 billion in 2021-22. Bulk-billing rose consistently through our term in office to a record more than 88 per cent when we left government. In our final year, Australians received 167 million free GP visits, which is 61 million more than under the previous Labor government. That's the coalition's record—delivering affordable, quality health care.

So, while the coalition acknowledge the technical objectives of this bill to ensure efficiency in several elements of our health system, we will not let the government use it as a smokescreen for its broader failures. We condemn the Albanese government's broken promises and appalling record on Medicare. Australians deserve a government that tells them the truth, not one that waves around a Medicare card while forcing families to reach for their credit cards. The coalition remains firmly focused on ensuring that all Australians can access timely, affordable and quality health care, no matter where they live.

Jo Briskey (Maribyrnong, Australian Labor Party) Share this | Link to this | Hansard source

I am thrilled to again be contributing in this place on our Labor government's commitment to Medicare. Medicare and universal access to health care is core to who we are as a Labor government. This legislation, the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025, is another important step in ensuring Medicare remains strong, accessible and ready for the future. It will help us deliver more bulk-billing, faster access to doctors, simpler billing systems and fairer treatment for medical graduates and overseas-trained practitioners, all so that Australians can get the care that they need when they need it and while only needing their Medicare card.

Medicare is who we are as a country. It's one of our nation's greatest achievements, built on our Australian values of fairness, equity and compassion. It's why our government is determined to strengthen Medicare, to make it easier and affordable to see your doctor, to support our healthcare workforce and to keep bulk-billing strong across every part of our community. This legislation makes important practical changes across the health system to help deliver a stronger Medicare, including more bulk-billing, faster access to provider numbers and better systems that will help doctors spend less time on paperwork and more time with their patients. This bill is a key part of the Albanese Labor government's ongoing commitment to not just strengthen Medicare but safeguard it now and into the future.

After a decade of coalition neglect and frozen rebates resulting in a rapid decline in bulk-billing and a healthcare workforce stretched to breaking point, Labor is doing the work to fix it, building a stronger, fairer and more modern Medicare. One of the most important parts of this bill tackles one of the biggest barriers that affect our healthcare workforce: the slow processing of Medicare provider numbers. When a new doctor, including an overseas trained practitioner, seeks to practise under Medicare, they have to apply for a Medicare provider number. It's a process that's still partly manual, often slow and frustratingly bureaucratic. The Kruk review found that overseas trained doctors can wait up to three months for a provider number to start work. These delays result in months of lost care for patients, and in some areas clinics struggle to keep up with demand.

This bill fixes that. It implements recommendation 2 of the independent Kruk review into Australia's regulatory settings for overseas health practitioners: to automate and streamline the issuing of provider numbers. Under these changes, the Chief Executive Medicare will be able to approve computer programs to automatically issue Medicare provider numbers for straightforward non-discretionary cases. That means that, when a practitioner meets all the eligibility criteria, their provider number can be issued quickly, efficiently and without unnecessary human delay. Importantly, any refusals or complex cases will still be reviewed by a human officer, ensuring accountability and fairness. We'll also validate all provider numbers previously issued by automated systems so there's legal certainty and no risk to practitioners who've already been approved.

In my local community, these changes mean doctors joining busy practices in Essendon, Moonee Ponds and Keilor East can start seeing patients sooner, reducing wait times and keeping care close to home. Just under a quarter of my electorate are aged over 65, a group that naturally requires more frequent access to health care as they age. These reforms will make a real difference for them, as well as for busy young families and students balancing study and part-time work, by giving everyone faster, easier access to the care that they need. By streamlining approvals and boosting bulk-billing, this bill helps local clinics operate more efficiently and focus on what matters: their patients. It means more appointments, more services and better care for every family across my community and right across Australia. This reform brings Medicare into the digital age and makes the system more efficient.

Simpler, faster and more reliable—that is what this legislation seeks to achieve by modernising the way private health insurance rebates are processed. Private health insurance plays an important role in supporting Australia's universal healthcare system. It gives Australians more choice and flexibility, helping people access the elective surgeries, specialist care and hospital services they need while reducing pressure on our public hospitals. At the same time, it works hand in hand with Medicare, ensuring that everyone continues to have access to essential care regardless of income. Every year, the Australian government reimburses insurers over $7 billion to ensure the private health insurance rebate is applied fairly and accurately to consumers' premiums. This rebate helps to keep private health insurance affordable for millions of Australians. When we came to government, we inherited a system that was inconsistent, error prone and woefully outdated. That is why we are seeking to modernise it.

This bill aligns registration with Services Australia systems, introduces self-assessment for insurers, ensures overpayments can be recovered even if errors occur, and allows computer assisted decision-making and the approval of forms by the Chief Executive Medicare. This legislation provides reassurance for local families in Maribyrnong, from young couples taking out their first policy to older residents managing chronic conditions. It's about ensuring that private health insurance remains affordable, reliable and accessible, giving people peace of mind that they can access the services they need. By streamlining the rebate process and improving efficiency of claims, the bill ensures that all insurers can pass on these benefits directly to their policyholders, reducing out-of-pocket costs and making coverage more predictable.

These reforms go beyond the technical fixes. They're about delivering real benefits for working people, reducing stress and ensuring Australians can get what they are entitled to under the law. That is what good government does. It identifies problems, consults experts and implements smart legislative fixes, rather than ignoring problems for years and leaving billions of dollars in rebate payments vulnerable to error or inconsistency.

Another key part of this bill is how Medicare benefits are assigned under bulk-billing and simplified billing. Right now, patients assign their Medicare benefit to their doctor, who then receives the rebate from the government. It's a system that has worked for decades, but it still relies on old paper based processes that can slow things down. Earlier this year, the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 laid the groundwork for digital assignment, making it faster and easier for doctors and patients alike. But before we flip the switch, we need to make sure Medicare practices, software providers and Services Australia are ready. That's why this bill delays the start of the new rules until 1 July 2026. This is a responsible move, giving everyone time to prepare, avoiding disruption, protecting patients ability to bulk-bill and making sure bulk-billing software works smoothly.

While we get ready for the digital future, Labor is investing today. Our $7.9 billion bulk-billing initiative, kicking off in November, will mean local GPs can see more patients, help more families and keep costs down. Just last week, I welcomed the health minister, Mark Butler, to Maribyrnong to visit the Moonee Ponds Super Clinic in Hall Street. We spoke with the practice manager and local doctors about what these new changes will mean on the ground. They told us how the government 's new bulk-billing incentives will help them see more patients, keep their doors open for longer and make sure that cost is never a barrier to care. They confirmed they will be moving to become a full bulk-billing service because of our initiative.

You can feel the difference this investment will make, not just for the clinics but for families right across my electorate. In Maribyrnong, around 27 per cent of people live with a long-term health condition that requires regular care and support. That's more than one in four people who rely on strong, accessible primary health care; people managing diabetes, heart conditions, asthma and other chronic illnesses who can't avoid delays or high out-of-pocket costs. That is why we're strengthening Medicare and that's why it matters so deeply to communities like mine. Your health is personal and looking after it can be stressful. The last thing anyone needs is a system that makes it harder to get the help that they need. Whether it's at the Moonee Ponds Super Clinic or your local GP practices, across Kensington through to Gladstone Park, this is about making Medicare work for everyone. Faster claims, fairer systems and less time on paperwork.

Schedule 4 reforms the Bonded Medical Program, ensuring fairness while keeping communities covered. The coalition imposed a six-year Medicare ban for doctors who failed to meet their obligations. Not only was this harsh and unfair, but it was also counterproductive. That policy risked depriving regional, rural and outer suburban communities of critical health services. Once again, Labor is fixing their mess.

This bill delivers three key changes that make the Bonded Medical Program fairer, more flexible and more effective. Under the old system, if a doctor could not finish their service obligation, they were punished twice: forced to repay their scholarship and then banned from billing Medicare for six years. It was harsh, it was unfair and it made no sense. That ban didn't just hurt the doctor; it hurt Australians as it meant fewer bulk-billing services were available. By removing that blunt penalty, we're keeping fairness and accountability in place without cutting our communities off from the care they need.

Many bonded doctors have already spent years working in our rural, regional and outer metropolitan communities, yet, under the old rules, that effort often did not count toward their obligations. This bill changes that. It ensures that the work done in the spirit of the program is properly recognised.

We know medical training is demanding and personal circumstances can change. Extending the grace period gives students more time to decide whether the program is right for them, supporting a smoother transition into the workforce and reducing unnecessary stress during study. This flexibility helps us attract more students into medicine, especially those who want to give back to their communities without trapping them in unfair or unrealistic conditions.

These reforms also send a clear message to doctors and healthcare workers: your contribution is valued, and we recognise the hard work you do. By removing punitive barriers and providing fairer conditions, the program encourages more young doctors to enter the workforce and consider service in areas that need it the most. It helps retain skilled practitioners, reduces burnout and ensures our health system is staffed with dedicated professionals who can provide the high-quality care every Australian deserves.

Labor understands that the strength of our healthcare system depends on the people who keep it running. Our doctors, nurses, allied health professionals and the support staff who show up every day for the communities they serve. Strengthening the workforce today means stronger, more reliable health care for communities tomorrow. The Bonded Medical Program is about building a pipeline of skilled and passionate doctors across the country, from our biggest cities to our smallest towns. It incentivises service in areas of need, supports workforce planning and ensures that every Australian, no matter where they live, can see a doctor when they need to.

What this bill shows is Labor in action, delivering reforms that build our promise to strengthen Medicare: faster onboarding of doctors; stronger support for private health insurance and rebates; modern, digital, simplified bulk-billing processes; and fairer rules for bonded medical graduates. For a decade, those opposite were focused more on the culture wars than on keeping our healthcare system running. When it comes to Medicare, they don't see green and gold; they see stars and stripes. They see Medicare American style: no bulk-billing, harsh penalties for healthcare workers and Australians paying more for the treatment they need. We are determined to fix their mistakes and keep our promise to strengthen Medicare for all Australians.

This bill makes our system fairer, more efficient and more reliable, ensuring Australians can access care when they need it. Australians voted for a Labor government that invests in them, invests in people, solves problems and delivers results. This bill does just that by strengthening the backbone of our health system and ensuring it keeps pace with the world around it. Automation provider numbers will get doctors working faster. Reform of private health rebate systems will protect taxpayers and patients alike. Modernising bulk-billing processes will make it easier for clinics and ensure digital integrity. Improving the Bonded Medical Program will keep more doctors where they're needed most. These are practical, forward-looking reforms, part of labour's broader agenda to rebuild Medicare after years of neglect. For the people of Maribyrnong, this means seeing a doctor sooner, fast approvals for new providers and strong bulk-billing at the local clinics across Keilor East, Tullamarine and Avondale Heights. It means fewer delays, more certainty and a fairer health system that puts patients first.

Medicare isn't just a policy; it's a promise—a promise that, no matter who you are or where you live, you will be able to get health care that you need without going broke doing it. I commend the bill to the House.

Sam Birrell (Nicholls, National Party, Shadow Assistant Minister for Regional Health) Share this | Link to this | Hansard source

I too rise to speak on the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. This bill, like so many other pieces of legislation introduced by the Albanese government, is like a scorpion. You start at the top and everything is fine. Then you get to the sting in the tail, not unlike the sting that many Australians are feeling when they need to pull out their credit card as well as their Medicare card. With that in mind, I'll start at the tail of this piece of legislation, and that refers to schedule 4, the Bonded Medical Program.

There simply is not enough detail in the bill, the explanatory memorandum or the assistant minister's second reading speech. The explanatory memorandum correctly explains that the Bonded Medical Program, first introduced in 2001, aims to address the shortage of medical professionals in regional, rural and remote areas, and, as shadow assistant minister for regional health, I am acutely aware of how important that scheme is. So we will be seeking further information and scrutiny on this bill through a Senate inquiry, particularly in relation to the implications of proposed changes to the Bonded Medical Program and the assignment of Medicare benefits for bulk-billing and signified billing arrangements. It is vital that these measures do not create unintended consequences or additional administrative burden for our hardworking health professionals.

Right now, it is undeniable that primary health care is in crisis under this government. While there have been several schemes over the decades, the fundamentals are the same: medical practitioners receive support from government in return for a commitment to work in regional settings. Under the current scheme, those who sign up receive a Commonwealth supported place, a CSP, in an Australian university medical course. In return, they make a commitment to work in eligible regional, rural or remote areas for a period of three years, or 156 weeks. This is referred to in the scheme as the return-of-service obligation, and participants have 18 years in which to complete this service obligation. The statutory Bonded Medical Program commenced in 2020 and replaced two legacy schemes. The Medical Rural Bonded Scholarship Scheme was from 2001 to 2015, and the Bonded Medical Places Scheme operated from 2004 to 2019. The legacy scheme participants are able to voluntarily opt into the Bonded Medical Program and receive a significant reduction in the return-of-service obligation and more flexible program conditions. In some cases, the length of time doctors are obligated to practise in areas of need in regional Australia is cut from six years to three years by opting into the current scheme. I can understand the reasons for wanting to streamline participation and administration to a single scheme, but we should also recognise the outcome is a significant cut to the amount of time those practitioners are required to practice in rural and regional areas to satisfy their return of service obligation.

I will remind everyone in this place that, still, doctors do not growing on trees. The bonded medical programs have played an important part for many years in delivering Australian-educated doctors to regional communities. The schemes have operated alongside similar schemes binding foreign-trained doctors to work in regional areas for a set period as part of their visa decisions. Schemes designed to address GP workforce challenges in regional and remote communities are already being undermined by changes that the Albanese government has made to Distribution Priority Areas. They've expanded the GP priority areas: 17 areas became more remote under the new Modified Monash Model classifications, but priority areas continue to extend into the fringes of capital cities; and 15 metropolitan areas gained DPA status, which allows for those areas to compete for overseas-trained doctors with the most remote and underserviced regions in Australia.

What we can't afford is further dilution of programs designed to get doctors into communities that most need them. Schedule 4 seeks to make changes to the Bonded Medical Program so that consequences for participants who withdraw from the program or fail to complete their return of service obligation—I emphasise that word 'obligation'—balanced the 'personal circumstances' of the bonded participant with the broader interests of the community. It is not clear from this bill, from the explanatory memorandum or the second reading speech, what that actually means in practice and what the implications are going to be for regional and remote Australia, who need these GPs. While a waiver is referenced, there's no detail to it. I can understand that, in some cases, there may be compassionate and compelling circumstances for a waiver to be applied, but the broader interests of the community are also very important, and these schemes can mean the difference between having or not having a local GP.

There is a third element here that's not addressed: the integrity of the scheme itself. Currently, breaches may be liable for financial penalties, such as repayment of the scholarship or CSP fees, and, in addition, former medical rural bonded scheme participants can receive a six-year Medicare ban. Without additional information gleaned through an inquiry—that's why we want to send it to a Senate inquiry—it's difficult to determine the impact of these changes. I'm a bit wary of any change that undermines the scheme and makes it easier for participants to on one hand receive the benefits but then not deliver the obligation under which they were given the benefits in the first place. We need doctors in the regions. You can wave your Medicare card as much as you want, even if you're the Prime Minister, but you won't be able to use it if there's not a doctor available.

There are alternatives are out there that I've seen work very successfully in getting medical professionals into regional areas. Initiatives of the previous coalition government are a great example of this. In my electorate of Nicholls the Murray-Darling Medical School Network—which moves Commonwealth supported places out to regional universities and regional campuses—school of rural health at the Shepparton campus of the University of Melbourne is a great example of this. The way the program works is that students will do a Bachelor of Biomedical Science—there are 15 places set aside at La Trobe University in this particular scheme, and 15 places from any other appropriate pre-requisite undergraduate course—and then the participants will go into the four-year Doctor of Medicine, which will be exclusively at the school of rural health in Shepparton, which is over the road from the hospital.

The students spend four years in a regional setting. The first graduates will come out at the end of this year, in 2025, and I'm really looking forward to the moment when they graduate. I know those students personally. They've already set themselves up in regional areas. Most of them were country kids in the first place. The reason the scheme was so attractive to them is that they were kids who, if they had to go to a university in Melbourne or Sydney to study medicine, they just wouldn't have studied medicine. They studied medicine because there was an opportunity to do it in a regional setting, close to their families, in an affordable way. So we have all of these kids who are going to be doctors who wouldn't have otherwise been. They are going to study in a regional location. They are going to be there for four years. They are going to put down roots. They've met people. In some cases, they have started families. In some cases, they are close to their existing families. I think, in some cases, people have already put down a deposit on a house. They are going to stay and practice in regional areas.

The Murray-Darling medical school is an example of really creative thinking by the then coalition government, saying, 'The evidence shows us that, if you train people in regions, they're likely to practice in regions.' We're about to yield in all regional areas, not just Shepparton but across the areas where the Murray-Darling medical school runs, the benefits of having those young people graduate and work in these regions. I think that we should look at expanding the Murray-Darling medical school beyond the Murray-Darling to other parts of regional Australia and to make sure that we contribute to that population balance by not just focusing a lot of our university courses in major metropolitan cities but moving them out to regional cities so that they grow and so that we grow Australia in an even way.

The Murray-Darling medical school, along with the bonded medical scheme and the programs that have required overseas doctors to practice in regional areas as part of their visa requirements, is an example of the government being creative and filling that need for medical professionals in regional areas. But, if you start watering down these schemes, as this bill may do—again, it's not clear—in relation to the bonded medical scheme, you are going to not only water down the scheme but water down the ability of regional communities to have access to GPs.

The other schedules in this bill seek to address regulatory and administrative issues. The coalition acknowledges the intent of this bill. It contains a number of technical amendments to improve the efficiency of several important elements of our health system. Schedule 1, for example, is on the automation of Medicare provider numbers. In my own electorate, my office has had to assist general practitioners facing extended delays on the issuing of a Medicare provider number. Schedule 2 refers to the private health insurance rebate premiums reduction scheme and schedule 3 the modernising assignment of Medicare benefits for bulk-billing and simplified billing.

Every government comes in and has a look at how things have worked. I think things worked well under the previous coalition government, but there's always room for improvement. If a new government comes in and finds ways to streamline because of new technology or new ideas then that's a good thing. I'm very supportive of that. But, once again, we are presented with a bill that has many reasonable elements but where we are concerned about one aspect. We need further explanation, further information and a Senate inquiry to interrogate those changes and make sure we don't end up with unintended consequences that leave regional and remote Australians even worse off than they are currently in relation to a trained, efficient and available medical workforce.

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

'478444X' probably means nothing to any of you here in this room, but it is very important to me. That was Medicare provider number that I got when I started my private practice, the same week that Medicare started, in 1984. It's the same provider number I use now, to this very day. Before the coalition gets too excited, I don't use it to bill Medicare. I use it because it's required for some procedures, such as referrals to specialists et cetera, and to make sure patients get access to some of the government schemes, such as the supporting kids with autism scheme, so they can get allied health approvals. I rise to speak on the public importance of the Health Legislation Amendment (Miscellaneous Measures No.1) Bill not just as a member of parliament but as someone with a deep understanding of the importance of providing efficient health care to everyone in an equitable manner and the firsthand experience of administrative bottleneck.

It took me weeks and weeks to get my Medicare provider number. Even though the scheme had been explained and well resourced at the beginning, it was a huge bureaucratic nightmare. The relief I got when I got my provider number was unbelievable. It's been the mainstay of my professional life since that time, over 40 years. I personally experienced the difficulties involved in obtaining a Medicare provider number, as have many of my colleagues, in particular my young medical students, once they finish their training and work as residents and registrars when they are looking to further their professional lives, either as general practitioners or as specialists.

Over many years there have been refinements to the scheme, but this bill is long overdue and is an important way of increasing people's access to medical care and increasing bulk-billing in ensuring the availability of doctors. In my electorate, which is outer south-western metropolitan Sydney, there are still huge difficulties in attracting doctors to work in our communities, both at a general practice and a specialist level. Improving access to Medicare provider numbers will help with that a lot.

The application processes can be quite challenging and processing time frames very lengthy, particularly for overseas health professionals, delaying them from commencing work in the Australian healthcare system and, I suspect, also preventing many from coming here. As at recommendation 2 of the Cook review, this bill will amend the Health Insurance Act to streamline the application process for health practitioners, enabling them to receive a Medicare provider number more quickly and provide healthcare services sooner.

Amendments made by schedule 2 to the bill will enable the chief executive of Medicare to approve the use of computer programs to make more-appropriate non-discretionary decisions to allocate Medicare provider numbers, whilst all decisions to refuse a provider number will continue to be checked and authorised by the chief executive at Medicare or their delegate. This bill will validate previously issued Medicare provider numbers that were issued by a computer program.

The department has been in consultation with the relevant agencies, who support the legislative component to support the automation of Medicare provider numbers and are supportive of this decision. We're working with state and territory governments, education providers and regulators to implement the recommendations of the independent review of Health Practitioner Regulatory Settings, led by the highly respected health administrator Ms Robyn Cruk AO.

This is a significant improvement made to the administration of our healthcare services to ensure that overseas doctors—who make up around 50 per cent of the doctors practising in Australia and do tremendous work providing quality care and play a vital role in easing our workforce shortage and have done for many decades—will spend less time navigating bureaucratic hurdles and instead be able to care for our most vulnerable in all areas of Australia, particularly in outer metropolitan rural and regional areas, and care for people who really need that care. Having the right skills is critical to the success of the government's agenda. We know that. This bill will make it easier for medical practitioners who are well qualified to get access to Medicare billing.

Schedule 2 of this bill will see the amendment of chapters 2, 3 and 6 of the Private Health Insurance Act 2007 to support the processes for claiming private health insurance rebates under the premiums reduction scheme. The Australian government reimburses private health insurers for the proportion of health insurance premiums that are reduced on behalf of consumers under the premiums reduction scheme. Each year, rebate repayments in excess of $7 billion are paid in this manner. The private health insurance rebate is an essential element to our healthcare system in order to make private health insurance more affordable for Australians by funding part of their premium. The premium reductions scheme allows eligible people to choose to get the rebate at the time they pay their private health insurance premium—and I'm certainly a beneficiary of that—rather than pay the full cost of the premium and then claim a deduction back through their tax return at the end of the financial year.

Under the scheme, the insurer reduces the premium payable by the policyholder by the amount of the rebate and then claims reimbursement of the amount through a system administered by Services Australia. Over time it's become clear that parts of the registration and claims process for the scheme haven't always lined up with the rules set out in the Private Health Insurance Act, resulting in some inconsistencies with its administration. To fix that, this bill is introducing some changes to help the system run more smoothly and support the operation of the registration and claims system—which is yet again another way this government understands health care and understands the importance of getting people access to health care, making the process more streamlined.

The chief executive of Medicare is now able, with this bill, to use automated systems to handle registrations and claims. These changes will make it possible to recover any overpayments caused by system errors. Changes were made to our healthcare system last year with the introduction of the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024, which modernised and simplified how patients assigned their Medicare benefits. In a modernised era, the changes were made to align with the times and move away from paper based processes and to support a digital assignment option.

This bill supports the modernising of the assignment of Medicare benefits by addressing the limitations of the assignment of Medicare benefits and health insurance act and supporting regulations, allowing the ability for a patient to assign their Medicare benefits—which will underpin further increases in bulk-billing, particularly with our new supports for bulk-billing processes in the general practitioner field. We understand that these processes and changes can be tedious and time-consuming, but we have listened to the concerns of the IT vendors, state and territory governments, medical peak body groups and other stakeholders who have expressed concerns with the timeline of delivering rebate changes and also with the extension of provider numbers.

To provide sufficient time for medical and health industries—particularly the private sector, to allow for software updates to reflect new assignment benefit processes—this legislation is being introduced. The extensions of time will allow the health sector, medical industry providers and patients to prepare for any changes. Our government is committed to easing the cost-of-living pressures and ensuring people receive the care and treatment which they need, and our government has committed funding to implement these reforms, which will further streamline the process for patients and also for medical practitioners. We are ensuring that the passage of this bill will be a further string in the Albanese government's election commitment of $7.9 billion to improve bulk-billing incentive payments, to encourage increased bulk-billing rates and further ensure that more Australians can see a GP and their specialists for free.

The Department of Health, Disability and Ageing has been in consultation with all relevant parties for this amendment—from patient representatives, stakeholders, private health insurers and hospitals to state and territory governments—and has taken feedback and recommendations to provide a seamless transition. This is what Australians deserve, and it's the one thing that Labor governments have done: ensured that the Australian population can receive the health care it needs, making our healthcare system the envy of the rest of the world. Australians deserve to have fairer and affordable access to see a doctor when they need to. This bill, furthermore, will amend the Bonded Medical Program—a program which provides eligible students with a subsidised Commonwealth supported place in a medical degree at university in exchange for a commitment to working in a regional, rural or remote area after graduation.

There have been concerns about the bonded program for some time. Students sign up when they're very young and their circumstances often change. Sometimes it can be quite difficult with partners, when people get married or when families change to continue to work in a region they thought they were originally going to be bonded to. It can also affect specialist training positions that require people to work in tertiary- or quaternary-level hospitals to complete their specialist training, and that can be quite difficult if you're on a rural bonded scheme. We want to make sure that people can access extra training when they need to, so there are changes to the rural bonded scholarship scheme which will allow more flexibility. We want to make sure that we see sufficient health services across regional and rural areas, of course, and we have done many things to ensure that those living in the farthest areas of our country can access the same quality health care that they need and deserve. This bill will amend the Health Insurance Act to enhance the Bonded Medical Program by ensuring the consequences of breaching conditions of or of withdrawal from the program fairly balance both the personal circumstances of the bonded participant and the broader interests of the community. It will allow all work completed by a bonded participant in good faith, consistent with program objectives, to be counted towards their return-of-service obligation.

I recently met with one of my paediatric registrars, who was on a rural bonded scholarship and needed some extra time to complete some subspecialty training at a specialist children's hospital. The scheme previously was very rigid and wouldn't allow that to happen. This scheme will now allow that to happen, which will mean she will still deliver her service in the regional area she was committed to, while being allowed time to complete her training at the highly specialised unit. This is a very, very good thing, and I fully support it. I've been contacted by a number of medical students who face this predicament, and it's honestly a shame to see the stress that some of them have been put under. I'm glad that this bill allows more flexibility. We have seen significant workforce shortages because of lack of uptake of the rural bonded scholarships, and this will allow more of those scholarships to be taken up, improving access to really high-level health care in rural and regional areas.

Currently, students have the option to withdraw from the program without any consequences, and I think that there still should be some consequences. If they decide to withdraw after a specific date, they face a significant financial penalty, and I think that the Commonwealth will be able to encourage more people to take up the schemes if they know that there are rules in place. This bill proposes an important change. It seeks to extend the existing grace period from the HECS census date in the second year all the way through to the completion of the medical degree. This bill will also give the Minister for Health and Ageing new powers to create additional rules to recognise work already completed by bonded participants. This means we're in a alliance with the goals of the program. Work done even before transitioning to the statutory Bonded Medical Program can count towards fulfilling return-of-service obligations, and that's a very important change.

The Albanese government is committed to strengthening our healthcare system, as always. I'm very proud to be part of a government with a Labor tradition of supporting equitable access to health care. I commend this bill to the House, and I thank the minister and the assistant minister for bringing it to the House.

Carina Garland (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

As we've heard from the previous speaker, securing and supporting Medicare's future is absolutely so important to the Albanese Labor government. We've delivered urgent care clinics right across the country, including one in Mount Waverley, in my own electorate. I know that, in the City of Stonnington area, which is in my electorate too, there is currently a tender out for another urgent care clinic, which is very welcomed by the community.

The Health Legislation Amendment Bill 2025 makes amendments to legislation in the health portfolio to make sure we strengthen Medicare. Of course, this is one of my favourite topics of conversation in this place, as indeed it is for everyone sitting on this side of the House. Schedule 1 of the bill will streamline the allocation of Medicare provider numbers under the Health Insurance Act, allowing practitioners to treat patients sooner. We know that the sooner people are able to access medical services, generally the better the health outcomes can be.

Amendments under schedule 1 will allow the Chief Executive Medicare to approve the use of a computer program to make appropriate non-discretionary decisions to allocate Medicare provider numbers in line with the review of Australia's regulatory settings for overseas health professionals. Decisions to refuse a provider number will continue to be checked and authorised by the Chief Executive Medicare or their delegate. Some Medicare provider numbers have already been allocated through the use of a computer program without any clear legislative support, and this bill will tidy up that process and validate previous computer issued Medicare provider numbers.

Currently an overseas health professional faces a wait time of up to three months for a Medicare practitioner number, delaying them from commencing work in the Australian health system and treating patients under Medicare. We all know how important it is that everyone has access to health professionals when they need them. Reducing the time it takes for Medicare numbers to be issued will absolutely support the growth of our medical workforce, which is a clear priority for the Albanese Labor government. Internationally qualified health practitioners currently supplement the domestic workforce and aid in addressing workforce shortages, making for a more sustainable health workforce overall.

Schedule 2 of this bill will amend the Private Health Insurance Act to support the process for claiming the private health insurance rebate under the premiums reduction scheme. This will ensure that registrations for the private health insurance rebate scheme and claims under the scheme are administered consistently under the act. This will also ensure that persons are validly registered as participants and that payments of rebates to insurers are lawful. The private health insurance rebate scheme is an initiative to help Australians cover the cost of premiums, supporting access to private healthcare services for participants. We know individuals who are eligible for the private health insurance rebate can claim the rebate as a premium reduction through their private health insurer or as a tax offset. Under the scheme, the private health insurer claims a reimbursement through a system administered by Services Australia and reduces the premium payable by the policyholder by the amount of the rebate.

Some elements of the registration and claims-processing system for the premiums reduction scheme have been administered inconsistently with the requirements of the Private Health Insurance Act. Schedule 2 of the bill will amend the Private Health Insurance Act to align the registration process in division 23 with requirements of the system operated by Services Australia, provide for self-assessment by participating insurers of the amount of rebate required to be reimbursed in division 279, require an insurer to provide information or documents to support their claim, ensure overpayments can be recovered despite any unintended system or process defects in division 282 and allow for computer assisted decision-making and the approval of forms and systems by the Chief Executive Medicare in division 333. Participating insurers will continue to be subject to regular post-payment compliance activities to ensure integrity of the payment process, and the amendments will support the existing registration and claims processes in such a way that there will be minimal impact on consumers and private health insurers.

Of course, strengthening bulk-billing is a priority of the Albanese Labor government, and schedule 3 of the bill will amend the Health Insurance Act 1973 to modernise assignments of the Medicare benefits process. Assignment of benefit is a longstanding requirement of the Health Insurance Act, and it underpins payments of Medicare benefits where the patient assigns their right to benefit to a medical provider, private health insurer or approved billing agent. Last year, as one of many measures our government has taken to strengthen Medicare, the parliament passed the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 with its changes to assignment benefits commencing 18 months from the day the act received royal assent. It streamlined the assignment process for patients, for medical providers, for private health insurers and for approved billing agents and also enabled digital assignment options. The bill before us now will build on those changes and address limitations of the assignment-of-benefits act. This bill will delay the commencement of the assignment-of-benefits act to 1 July 2026, which will support industry and consumers to comply with the new assignment-of-benefits requirements, and it will allow time for new processes to be developed and for IT systems to be updated. In the meantime, bulk-billing can continue under the current processes, including additional incentives for bulk-billed services which will start from 1 November this year in line with the government's election commitment.

Bulk-billing is vital for equitable access to health care. It helps with cost-of-living pressures and ensures every Australian receives the best health care they deserve. Our government is passionate about bulk-billing. The government has committed $15.2 million in 2025-26 to fund the implementation of reforms outlined in the assignment-of-benefits act and subordinate regulations. This includes updates to Services Australia's software systems and education and communications activities to ensure stakeholders are aware of and prepared for new digital arrangements. The passage of this bill will ensure that the Albanese Labor government's 2025 election commitment of $7.9 billion in bulk-billing incentive payments to encourage increased bulk-billing rates will not be adversely impacted by non-compliant business software.

Schedule 4 of this bill will amend the Health Insurance Act 1973 to ensure the consequences for Bonded Medical Program participants who withdraw from the program or fail to complete their return-of-service obligation are fair. It will balance the personal circumstances of the bonded participant and the broader interest of the community and allow all work completed by a bonded participant in good faith, consistent with program objectives, to be counted towards their return-of-service obligation.

This bill allows the Minister for Health and Ageing to make additional rules to ensure that past work completed by bonded participants delivering health services in regional, rural and remote locations in Australia, for instance, can count it to their return-of-service obligation where this is consistent with program objectives. Currently, former Medical Rural Bonded Scholarship Scheme bonded participants who fail to complete their return-of-service obligation within the allowed 18-year period or who have withdrawn earlier face repayment of their scholarship and a six-year Medicare ban. While the financial penalty is appropriate, subjecting these doctors to a Medicare ban will jeopardise continued service provision and access to care for Australians living in regional, rural and remote communities and in other areas of workforce shortage. Given those broader workforce shortages, a six-year Medicare ban is not in the interests of either the doctor or the Australian community. Students can currently withdraw from the program without consequence up to the HECS census date in their second year of study. If the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of their Commonwealth supported place up to the date of the withdrawal. This will be in addition to their HECS-HELP liability.

Our government is squarely focused on strengthening Medicare and on ensuring that we have a strong health workforce. That means that Australians, no matter where they live, are able to access high-quality medical care when they need it. This is part of our ongoing commitment to strengthen Medicare, to fight for Medicare and to ensure that bulk-billing is accessible and equitable. I'm really pleased to support this bill in the House today.

Julie-Ann Campbell (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. When we talk about Medicare, what we know about Medicare is that it is the embodiment of Labor values. It is who we are, and it represents what we care about when it comes to health, which is ensuring that it doesn't matter what's in your pay packet. No matter what you earn, you and your family should have access to world-class medical care with just your Medicare card. And this is not something that we just say. This is not something that we just talk about. This is something that we do every single day. We do it when we talk about the institution of urgent care clinics. We do it when we see urgent care clinics—more and more of them—pop up around our suburbs to make sure that people have the care they need close to home. We do it when we open up more Medicare mental health clinics, and we have one coming to the south side in Brisbane very shortly. We do it when we invest in bulk-billing so more people can access critical GP services, again closer to home. We created Medicare, and Labor works every day to make it even better.

Medicare is a vast system. I don't think that any of us, when we hand over our little green card to the medical receptionist, think about how far the services stretch and how the system is administered. That is understandable, because after all, when you visit an urgent care clinic with your injured child, you have other things on your mind, and, when you go to your bulk-billed GP because you're feeling under the weather, you're not thinking about the back-end systems behind your visit. You're just grateful, as you dig into your pocket for your Medicare card, that you have one less bill to pay. This is the foundation of Medicare—that, when you and your family are affected by illness or injury, you shouldn't have to break the bank to receive high-quality health care. But it is worth looking at the system as a whole. It helps to put into context just how valuable Medicare is to Australians. In 2004-05, the value of Medicare services delivered was $475.2 million. The total amount of benefits paid in the same period was $32.4 billion, and this is for services ranging from GP visits to obstetrics, diagnostic imaging, optometry, allied health and radiotherapy—and the list goes on and on.

I'm incredibly proud to be part of a Labor government that believes in universal health care and continues to strengthen Medicare to ensure the scheme is both robust and sustainable. At times, that means fine-tuning of Medicare's administrative systems, and that is what the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025 does. It will ensure better administration and delivery of the system that we all rely on.

As its name suggests, the bill covers a range of reforms. The first is implementing the automation of Medicare provider numbers. This is the second recommendation in the Independent Review of Australia's Regulatory Settings Relating to Overseas Health Practitioners, otherwise known as the Kruk review. The review was commissioned by National Cabinet in September 2022, with the aim of recommending measures to streamline and simplify health practitioner regulation. The overarching goal was to decrease the skills shortages in vital health professions while maintaining required quality and safety standards. In short, we need our health professionals to have stronger skills and to have the support to do it. The resulting report in August 2023, from Robyn Kruk AO, acknowledged persistent shortages in the registered health practitioner workforce, and these shortages led to some communities not having access to a GP, a nurse led clinic or a dental or mental health service within a 60-minute drive. Other negative effects of the shortages included critical health services such as maternity or dental being closed down in some places and wait times for specialists blowing out, in some cases to as long as four years.

The issuance of Medicare provider numbers is currently part of the lengthy and time-consuming process of registering to provide Medicare services. An MPN enables the health practitioner to claim, refer or request Medicare services, and health practitioners require an MPN for each practice location. MPNs are currently allocated by the Chief Executive Medicare via the Human Services (Medicare) Act 1973. The report recommended automating the issuance of MPNs to speed up the approval processes and result in more practitioners being available to provide services more quickly, and that's what this is all about—making sure that we have more practitioners and that they can provide services to the communities that need them most in an efficient and effective way. This bill will amend the Health Insurance Act 1973 to establish the function of allocating MPNs within the act, enabling the Chief Executive Medicare to approve automation, and will also validate MPNs previously issued automatically. What this means in practice is that the Chief Executive Medicare can approve the use of computer programs to allocate MPNs. However, it's important to note that a decision to refuse a health practitioner an MPN must be reviewed by a qualified employee of Services Australia.

The second focus of this bill is streamlining private health insurance rebate payments. Each year, over $7 billion is reimbursed to private health insurers under the premiums reduction scheme. This rebate helps reduce the cost of health insurance premiums for Australians, making private health care more accessible and more affordable. However, Services Australia and the Department of Health, Disability and Ageing identified that some parts of the registration and claims processing system have not been operating consistently with the requirements of the Private Health Insurance Act 2007 since the scheme began. The bill will amend the Private Health Insurance Act to correct the operation of registration and claims systems. It introduces a self-assessment model for insurers claiming reimbursements. It will also align the registration requirements for individual participants with the current system requirements. The Chief Executive Medicare will be empowered to introduce automated decision-making capabilities to manage registration and claims more efficiently and more effectively. The bill also implements a safeguard, with assurance that any overpayments resulting from system errors or process issues can be recovered. These reforms are designed to uphold the objectives of the premiums reduction scheme and will ensure that participants are properly registered and that rebate payments are made lawfully.

The third part of this bill will amend the Health Insurance Act 1973 to resolve key legal and operational issues and delay the commencement of changes introduced by the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act. The concept of assignment of benefit has long been a cornerstone of Medicare. It allows patients to assign their right to a Medicare benefit to a medical provider, private health insurer or approved billing agent, enabling the government to make payments directly on their behalf. The assignment of benefits act was introduced to strengthen the integrity of this process. It streamlined how benefits are assigned and introduced digital options to replace outdated, paper based systems, because this is a system that we all care about and it's a system that needs to be kept up to date as technology moves forward and as that technology allows people who need Medicare to access it more effectively and more efficiently. These reforms were essential to modernise Medicare and ensure it remains responsive to the needs of patients and providers alike. Importantly, the bill will delay the commencement of schedule 1 of the assignment of benefits act, which was originally set to begin in January 2026. The new start date of 1 July 2026 will give both industry and consumers the time they need to prepare and adapt to the changes, particularly where private sector software must be updated to reflect the new assignment processes. Bulk-billing will continue under current arrangements, with additional incentives commencing from the 1st of next month for bulk-billing services. These reforms are supported by $15.2 million worth of funding in 2025-26, and this is being directed towards updating Services Australia's systems and delivering education and communication to ensure stakeholders are ready for the transition to digital assignment.

This bill safeguards the Albanese Labor government's $7.2 billion commitment to bulk-billing incentive payments. It ensures that these incentives will not be undermined by non-compliant business software or administrative delays. It ensures that these amendments are here to stay. The bill's final amendment to the Health Insurance Act 1973 enhances the Bonded Medical Program. This program provides a Commonwealth supported place in—

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

Order! I do apologise to the member for Moreton. The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour. The member will be given leave to continue speaking when the debate is resumed.