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

The Bonded Medical Program provides Commonwealth supported places in a medical program in exchange for working in regional, rural and remote areas of Australia after graduation. That is because this is a Labor government that prioritises ensuring that there are incentives for medical practitioners and medical professionals to work in the bush. Currently, former Medical Rural Bonded Scholarship Scheme medical professionals who did not complete their service within the designated period are required to repay their scholarship and face a six-year Medicare ban. The amendments will ensure that the consequences of breaching the conditions or withdrawing from the program balance the personal circumstances of the participant with the broader interests of the community. Furthermore, all work completed by a participant in good faith and in relation to the program guidelines will count towards their return of service obligation.

The six-year Medicare ban has a direct negative impact on the provision of services in regional, rural and remote communities—areas that are already the most impacted by workforce shortages. Such bans are not in the interest of either the community or individual medical professionals. The proposed amendments will extend the student's withdrawal period without penalty from the HECS census date in their second year of study until the award of their medical degree.

The measures included in this bill will ensure enhanced administration and delivery of the Medicare services that we all rely on each and every day. They are the behind-the-scenes fixes that form the foundation of Labor's commitment to strengthening Medicare. And the Albanese Labor government has made this a priority. The 2025-26 budget made the most significant investment in Medicare since its inception more than 40 years ago. Labor is continuing to back bulk-billing. From 1 November we are implementing an additional new 12.5 per cent payment—the Bulk Billing Practice Incentive Program—for practices that bulk-bill every patient. And we are working towards nine out of 10 GP visits being bulk-billed by 2030, with the number of fully bulk-billed practices nationally increasing to around 4,800. This $7.9 billion investment will result in 18 million more bulk-billed GP visits annually, saving Australian families $859 million every year.

Right at the start of this speech I mentioned urgent care clinics, and I'm constantly receiving feedback from my local community on how convenient these clinics are, saving people from long waits in hospital and from emergency departments—and of course they are fully bulk-billed. There are now 90 in operation across the country, with more on the way. When the rollout is complete, 80 per cent of Australians will live within a 20-minute drive of a clinic, and two million people are expected to use this service annually.

It would be easy to continue talking about Labor's commitment to strengthening Medicare and ensuring universal health care. And I could talk about how we are increasing support for public hospitals with an additional $1.8 billion of funding. Or I could mention wage increases in the care economy, such as $2.6 billion to increase pay for vital aged-care nurses. But I do see that I'm running out of time, and what you really need to know is that only Labor guarantees a future where your Medicare card and not your credit card gives you access to quality care every day and that Labor will always continue to increase and drive better access to Medicare.

Alice Jordan-Baird (Gorton, Australian Labor Party) | Link to this | Hansard source

I rise to speak in support of the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025, brought forward by the Minister for Health and Ageing, and I commend him for doing so. Health care is fundamental to the wellbeing of Australians, and Medicare is at the heart of our healthcare system. In 1984 the Hawke Labor government introduced Medicare, and in 2025 strengthening Medicare was the beating heart of our election campaign, because that's what good governments do: they invest in and protect our public healthcare system. I couldn't be prouder to stand in this chamber as part of the Albanese Labor government, legislating to protect and improve our healthcare system.

The amendments in this bill clean up technical issues, making things fairer and easier for our healthcare workers and supporting the growth of the health industry in Australia. The independently led Kruk review of health practitioner regulatory settings highlighted shortages in Australia's healthcare workforce, and these workforce shortages are significant. In the June quarter of 2023, 44 per cent of health professional vacancies were unfilled. An extra 13,000 medical practitioners, 40,000 nurses and 27,000 allied health professionals are likely to be needed by 2026. These workforce shortages exist in all Australian states and territories, and they are widespread across medicine, nursing, midwifery, and allied health professions, including dentistry, OT, physiotherapy, psychology and radiation therapy. Workforce shortages mean increased workloads for health practitioners, and, importantly, they mean Aussies having reduced access to care and poorer patient outcomes. Around 40 per cent of Australians wait at least 24 hours to see a GP for urgent care. Some six per cent of people wait longer than 365 days for elective surgery, with some waiting more than 500 days. When we don't have a strong and supported healthcare workforce, Aussies pay the price.

I've seen this firsthand in my electorate of Gorton, in Melbourne's west, one of the fastest-growing electorates in the country. There are over 47,000 families across the electorate, and new ones are created every day, with 10 babies a day born in the city of Melton alone. In so many ways, my electorate represents Australia as a whole, with its vitality, its rich cultural and linguistic make-up and its aspirations for the future. An electorate like mine—young, diverse and aspirational—has many needs that have yet to be met. One area that struggles to keep up is access to health services. Gorton residents experience significant disadvantage in accessing health services.

In the city of Brimbank, a staggering 28 per cent of residents aged 18 and older have been diagnosed with two or more chronic diseases, conditions that need to be managed throughout their lives. I recently met with some residents at Wintringham in Delahey, in my electorate. This service provides quality care and accommodation to elderly men and women who are financially disadvantaged, homeless or at risk of homelessness. Wintringham residents are a fantastic group of people who have an op shop open every fortnight on a Tuesday. But many are burdened with a number of chronic diseases, which means they are constantly in and out of hospital, trying to navigate appointments, scans, specialists and outpatient care. I want to see better health outcomes for people in my community in Gorton like those Wintringham residents.

This bill, along with the suite of healthcare reforms introduced by the Albanese Labor government, is so important for my community in Melbourne's west and for all Australians. The proposed amendments in this bill will take significant steps towards modernising Medicare and simplifying bulk-billing and insurance rebates. Most importantly, they will break down barriers to accessing health care and to training and qualifying doctors. We built Medicare, and today we're here to strengthen Medicare.

The automation of Medicare provider numbers is just one of the measures we're taking to update and protect Medicare. This is about reducing unnecessary barriers to healthcare professionals practising and to bringing on more skilled health practitioners in Australia. Currently, Medicare provider numbers are allocated by the Chief Executive Medicare as one of their functions under the Human Services (Medicare) Act 1973. At the moment, the Chief Executive Medicare is unable to approve the use of computer programs to make appropriate non-discretionary decisions to allocate Medicare provider numbers. This bill will change that. This bill will streamline the application process for health practitioners, enabling them to receive a Medicare provider number quicker and provide healthcare services sooner.

This is a technical change, but it's an important one. It takes between 10 and 15 years for a local GP to be fully trained. Internationally qualified health practitioners take 35 to 130 weeks to be ready to practise in Australia, nurses and midwives take up to 91 weeks and OTs take up to 135 weeks. When we need GPs in our hospitals and our clinics, we don't need qualified and trained GPs to be prevented from practising because of unnecessary wait times on Medicare provider numbers. The same goes for all healthcare professionals. We're doing everything we can to have more healthcare providers in our workforce and more health services in our health system, and that's what this bill is all about.

Schedule 2 to the bill, the amendments to chapters 2, 5 and 6 of the Private Health Insurance Act 2007, is about supporting the affordability of private health insurance and access to private healthcare services. The private health insurance rebate is an initiative designed to make private health insurance more affordable for Australians by funding part of their premiums. As a result of systems limitations, some elements of the registration and claims-processing system were being administered inconsistently with the requirements of the act, and these amendments will break down these unnecessary barriers. Again, we're talking about reducing barriers to more Australians accessing better care.

Schedule 3 to the bill allows regulations to be made to modernise assignments of the Medicare benefits process, the process that underpins Medicare bulk-billing. Last year, the Albanese Labor government passed legislation to modernise and simplify how patients assign their Medicare benefits. These changes recognise that patients and healthcare providers are no longer using paper based processes that existed when Medicare was first set up over 40 years ago. The amendments in this bill will build on these important changes, remedying legal and technical issues. This means that Labor's 2025 election commitment of providing $7.9 billion in bulk-billing incentives will not be adversely impacted by non-compliant business software. Modernising Medicare is just another step in our plan to protect and strengthen the vital healthcare system that Australians rely so heavily upon.

The final part of this bill, the amendment to the Health Insurance Act 1973, is about ensuring consistency for healthcare workers and protecting good faith in program activities. At the moment, former Medical Rural Bonded Scholarship Scheme participants who voluntarily opt in to the statutory program and who fail to complete their return-of-service obligation within the allowed 18-year period or withdraw from the program earlier face a six-year Medicare ban. Subjecting these doctors to a Medicare ban jeopardises continued service provision and access to care for Australians living in regional, rural and remote communities and in other areas of workforce shortages.

We have a workforce shortage in Australia. My best friend, Dr Melanie Johnston, is a medical doctor working across multiple Melbourne hospitals. She has worked very hard to get where she is, and she is saving lives every single day. She often tells me about the extraordinary hours, hospital staff shortages and lack of specialists across the system, which lead to burn-out for so many. A six-year Medicare ban for bond doctors does not properly address the workforce shortage issue. In fact, it's reductive. A six-year Medicare ban is not in the interests of the individual bonded doctor, nor is it in the interests of the Australian community. Removing this ban will also ensure consistency for all bonded doctors when it comes to the consequences of breaching return-of-service obligations.

The proposed amendment will also extend the existing grace period from the HECS census date, meaning a student can withdraw from the bonded medical program without consequence at any time until they are awarded their medical degree. Removing the requirement for students who withdraw to repay the cost of their Commonwealth supported place under the program is a better fit, and it's recognising that the decision to withdraw is a difficult one, often reached because of challenging personal circumstances. The amendments aim to ensure the consequences of breaching a condition and/or withdrawal from the program fairly balance both the personal circumstances of the bonded participant and the broader interests of the community. It also allows for work completed by the bonded participant in good faith consistent with program objectives to be counted towards their return-of-service obligation.

These legislative amendments build on a suite of other reforms Labor has introduced to strengthen Medicare and our healthcare workforce. We took health care to the election, and, across the board, we're legislating change. We're growing the health workforce to deliver more doctors and nurses than ever before, including the largest GP training program in Australian history and hundreds of scholarships for nurses and midwives to extend their skills and qualifications. This includes incentives like the Commonwealth prac payment, which means students on their mandatory nursing and midwifery placements will be paid for their work.

We are making the single largest investment in Medicare ever. That's delivering an additional 18 million bulk-billed GP visits every year so more Australians can see a bulk-billed GP. We're tripling the bulk-billing incentive for people who need to see their GP most often, helping pensioners, concession card holders and families with children. We have made it cheaper and easier to see a doctor, having restored bulk-billing for 11 million Australians and having created an additional six million bulk-billed GP visits. We've delivered the biggest-ever reduction in the cost of PBS prescriptions and frozen the cost of PBS medicines at just $25, the lowest it's been since 2004. We've made hundreds of medicines cheaper for Australians. We have been putting in the work to improve access to health care by expanding the availability of free Medicare urgent care across the country. I was lucky enough to open the 90th urgent care clinic in Melbourne's west with the Prime Minister and my friend the member for Fraser last month. But we are not stopping there. We've already opened 90 urgent care clinics right across the country and we've committed to another 50.

We're investing landmark commitments in women's health. For too long, women's health issues have not been adequately addressed. We are working to reverse decades of neglect to women's health, with $570.3 million to deliver more choice, lower costs and better health care for women. We have opened 22 endometriosis and pelvic pain clinics and are opening another 11. Initiatives like these will see Australian women and their families saving thousands of dollars on health related costs across their lifetime.

We're also backing men's health because for too long men's health and mental health in Australia have been overlooked. We have established and are expanding a network of Medicare mental health centres, helping Australians to have better access to mental health services. We're delivering $11.3 million for Movember to provide men's healthcare training to primary healthcare workers and to develop a campaign to encourage more men to visit the doctor. That's in addition to $20.7 million invested into grassroots initiatives that support men's mental health and wellbeing in community settings.

This bill is cleaning up largely technical issues, because clearing up details like this is really important. We're supporting simplified and streamlined billing for privately insured hospital systems so they do not have to deal with bills from multiple providers. We're clarifying wording to ensure that any eligible person covered under a private health insurance policy can assign their own Medicare benefits on behalf of the person in whose name the policy is held. The details are the difference between hospital staff spending unnecessary time on paperwork billing multiple providers and hospital staff spending time dedicated to their patients thanks to a streamlined billing system. It's the difference between bureaucratic delays and a patient having access to a doctor and receiving that treatment sooner. It's the difference between an outdated and inadequate healthcare system and one that better serves our diverse and wonderful Australian community—to support people like the Wintringham residents in Delahey, in my electorate, to support the doctors and healthcare workers like my best friend, Melanie, and to support families in my electorate and those right across the country. These amendments matter, and I commend the bill to the House.

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

When Australians talk about Medicare, they talk about fairness. They talk about the simple, powerful idea that your bank balance should not determine whether or not you can see a doctor. They talk about the dignity of knowing that, when you need care, the system is there for you. Australians are proud of Medicare, a system that Labor built and that Labor continues to defend and strengthen. That's exactly what the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025 does. It strengthens Medicare, modernises the systems around it and makes sure Australians get care more quickly and fairly.

This legislation may sound technical, but it is about something very real. It is about whether a doctor can start work sooner. It's about whether billions of dollars in rebates are paid out lawfully and transparently. It's about whether bulk-billing continues to be the foundation of Medicare and whether doctors serving rural and outer suburban communities are treated fairly and whether their patients are treated fairly as well. This bill touches all of that. It has four big reforms: first, streamlining Medicare provider numbers; second, fixing cracks in the private health insurance rebate system; third, modernising the way patients assign Medicare benefits for bulk-billing; and, fourth, making the Bonded Medical Program fairer and stronger. I will deal with them in turn.

Right now, if a doctor finishes their training or a nurse practitioner moves to a new role, they have to apply for a Medicare provider number. That number is what lets them bill Medicare. Without it, they cannot provide subsidised care. The problem is that the system is slow, clunky and paper heavy. It means wait times for approval, it means health professionals sitting on the sidelines when they should be in clinics and it means patients waiting longer for appointments. This bill fixes that. It allows the Chief Executive Medicare to approve the use of computer programs to automatically issue provider numbers for straightforward cases. If you meet the criteria, the system issues the number—no delays, no unnecessary bottlenecks and no holding back the workforce when communities need them most. Where discretion is needed, humans stay in the loop. If a provider number is refused, that decision will still be made by a Services Australia officer. That is the right balance: automation where it makes sense and human oversight where it matters.

What does that mean for the electorate of Moore? It means doctors at the Joondalup Health Campus can start sooner. It means GPs in Currambine and Ocean Reef can open their doors to more patients without waiting weeks for the red tape to catch up. It means allied health workers can deliver to families in Padbury and Heathridge without needless delays. In a community like mine—growing fast and already feeling the pressure on health services—that makes a real difference.

The second reform is about the private health insurance rebate. Every year, the Commonwealth pays more than $7 billion to insurers on behalf of Australians. That is real money, month in and month out. But, for years, parts of the system have been run inconsistently with the law. That is a risk to the integrity of the scheme, and it is a risk to public trust. This bill closes those gaps. It brings the law into line with practice and makes payments lawful and accountable. It introduces a self-assessment model so insurers calculate their claims correctly. It requires them to provide evidence when asked. It gives the Chief Executive Medicare the power to modernise systems and approve forms, and it allows government to recover overpayments when mistakes happen. In other words, the billions that flow through this scheme will flow lawfully, fairly and transparently.

Australians deserve to know that health rebates are handled properly, and taxpayers deserve to know that their dollars are being respected. We know what happens when integrity is ignored. We saw it in robodebt, where lives were shattered by a system designed to cut corners. We saw it when Scott Morrison secretly appointed himself to multiple ministries, keeping the truth from not only his colleagues but the public. That is what happens when governments treat accountability as optional. Labor takes the opposite view. Integrity is not optional. Transparency is not optional. And this bill proves it.

The third reform goes to the very heart of Medicare: bulk-billing. Bulk-billing works because patients assign their Medicare benefit to the doctor or the hospital that treated them. It is simple in principle, but the law underpinning it is outdated. It was written for a paper based system, and, in 2025, paper is the exception not the rule.

The Albanese government is delivering $7.9 billion in new bulk-billing incentives—the biggest boost in decades. But those incentives only work if the system is ready. Right now, many of the practices and software providers are not ready to implement assignment arrangements. If we stick to the old timeline, bulk-billing could be disrupted. This bill avoids that risk. It pushes the start date back from January 2026 to July 2026. That gives everyone time to prepare. In the meantime, bulk-billing continues. Extra incentives flow from November this year, and patients get the care they need without disruption.

In my electorate of Moore, bulk-billing is the difference between families in Beldon being able to take their kids to the doctor and families putting it off because of the cost. It is the difference between pensioners in Woodvale being able to see their GP and pensioners presenting at Joondalup hospital because they cannot afford it. Strengthening bulk-billing is not just good policy; it is a moral obligation, and that is what this bill helps deliver.

The fourth reform strengthens the Bonded Medical Program. This program exists to get more doctors into the areas that need them most—rural, regional and outer metropolitan communities. But, for too long, the penalties for doctors who left the program or failed to complete their obligations were blunt, unfair and counterproductive. Some doctors faced not just repaying their scholarship but also a six-year ban from Medicare. That does not punish just the doctor; it punishes the communities that are already struggling to recruit enough doctors. This bill removes the blunt ban. It makes sure that consequences are fair to the doctor and are also fair to the community. It allows all the work done in good faith to count towards the obligations, even if the work previously fell through the cracks. And doctors get a fair go when serving those communities.

This change matters. For the outer suburbs, where population growth is outpacing services, this change matters. And for the families in Carine and Mullaloo, who face longer waits for basic care, this change matters. For every community where recruiting doctors is a challenge, this change matters. Taken together, these reforms make our health system faster, fairer and stronger. They get doctors to patients sooner. They make sure that billions in rebates are paid lawfully and transparently. They strengthen bulk-billing—the backbone of Medicare—and make the Bonded Medical Program work better for both doctors and communities. We do not sit back and hope that the system fixes itself. We roll up our sleeves and we do the work. We modernise, we adapt and we prepare for the future.

The opposition had nine years in office. They had nine years to strengthen bulk-billing, nine years to fix rebates, nine years to support regional doctors and nine years to cut red tape, and they did none of it. They let bulk-billing rates fall. They let trust collapse. Why? Because secrecy suited them, because pretending was easier than governing, because spin was easier than substance.

Labor is different. We are delivering stronger Medicare, stronger bulk-billing and a health system that is fit for the future. We are building a system that is accountable, efficient and fair, a system that respects taxpayers, a system that respects patients and a system that respects the professionals who deliver care—a system built for the 21st century.

This is not abstract for me. I know what it means to rely on the health system. I am here today because of a kidney transplant. I know the difference it makes when medicines are affordable and accessible. I know the difference it makes when hospitals have the staff they need. And I know the difference it makes when governments take health care seriously. That is why I am proud to support this bill. It's not about lines in legislation; it's about lives in our communities. It's about whether families in Moore can see a doctor. It's about whether young doctors are treated fairly. It's about whether the system works for people, not against them.

Health is about trust. It's about trust that, when you need care, you will get it. It's about trust that the system is fair, efficient and accountable. It's about trust that governments will do the hard work, not just talk about it. This bill delivers on that trust. It strengthens Medicare, it makes bulk-billing stronger, it makes programs fairer, it makes the system faster and it makes it work for the people. That is what Labor governments do. We build, we strengthen, we deliver. The opposition can keep complaining and they can keep pretending, but Labor is doing the work. Labor is delivering for Moore; Labor is delivering for Australia. That is why I commend this bill to the House.

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

I rise to make my contribution to the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. The bill seeks to accomplish a wide range of outcomes. It supports the automation of Medicare provider numbers. It realigns the registration and claim-processing system for private health insurance rebates. It modernises the assignment of Medicare benefits for bulked-billed and simplified billing. It ensures the consequences of breaching a condition and/or withdrawal from the Bonded Medical Program are fairly balanced. And it allows all work completed by a Bonded Medical Program participant in good faith, consistent with the program's objectives, to be counted towards their return-of-service obligation. The bill addresses several matters that will ensure better administration and delivery of key government systems and programs.

Firstly, the bill supports recommendation 2 of the independent review of Australia's regulatory settings relating to overseas health practitioners, which is to automate and streamline the issuance of Medicare provider numbers. It will amend the Health Insurance Act 1973 to establish the function of allocating Medicare numbers in the Health Insurance Act. It also establishes a power for the Chief Executive Medicare to approve computer programs to issue Medicare provider numbers. The bill will validate Medicare provider numbers previously issued by automation and any that were declined. Medicare provider numbers are currently allocated by the Chief Executive Medicare as one of their functions under the Human Services (Medicare) Act 1973. Amendments made by the bill will enable the Chief Executive Medicare to approve the use of a computer program to make appropriate non-discretionary decisions to allocate provider numbers. Any decision to refuse a provider number would not be made by the computer program but be reviewed by a human service officer working at Services Australia. The bill will validate Medicare provider numbers that were previously issued by computer programs operated by Services Australia or by its predecessor, the Department of Human Services. The bill will also streamline the application processes for health practitioners, enabling them to receive a Medicare provider number more quickly and start providing health services sooner. The delegated legislation will map out the criteria that must be met in order for a Medicare provider number to be allocated by the use of a computer program to different classes of health professionals and any required transitional rules.

Secondly, the Australian government reimburses private health insurers for the portion of health insurance premiums that are reduced on behalf of the consumer for the private health insurance rebate under the premiums reduction scheme. Rebate payments in excess of $7 billion per year are paid in this manner. Services Australia and the Department of Health, Disability and Ageing became aware that some elements of the registration and claims processing system for the scheme had been administered inconsistently with the requirements of the Private Health Insurance Act 2007 since its introduction. That's why this bill will amend the Private Health Insurance Act 2007 to support the operation of the registration and claims system. This will be done through the introduction of a self-assessment model for claims by insurers for reimbursement of the rebate. The amendments will have a few effects. They streamline the registration requirement for individual participants to align with the current system requirements. They will introduce automated decision-making powers for the Chief Executive Medicare to administer scheme registrations and claims. They will ensure any overpayments can be recovered where there are unintended system or process defects.

There are other amendments to support these changes, including requiring the insurer to correctly calculate their claim and provide supporting information or documents on request and allowing the Chief Executive Medicare to approve forms for use under the program. These amendments will support the objective of the premiums reduction scheme and ensure persons are validly registered as participants and that the payment of the rebate to insurers is lawful. The rebate supports the affordability of private health insurance and access to private healthcare services for participants. The delegated legislation will allow the minister to specify criteria that must be met in order for the Chief Executive Medicare to register a participant in the scheme and pay the claim. This is because the current system can conduct only a limited number of checks. The criteria can be updated if the system is updated in the future to conduct a wider range of checks. The minister will also be able to change the period which the Chief Executive Medicare takes to refuse a registration if the proposed timeframe does not work as intended. Currently, administratively it allows for 90 days, but this will be reduced to 30 days to provide the applicant with certainty sooner. Additionally, the minister will be allowed to include additional decisions in the Private Health Insurance Act that are considered appropriate to be undertaken using automated administrative action. This provides allowance for future system upgrades when it may be possible to automate other actions.

Thirdly, the bill amends the Health Insurance Act to remedy identified legal issues and to delay commencement of changes introduced by the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024. Assignment of benefits is a longstanding requirement of the Health Insurance Act. It provides the basis for government paying Medicare benefits when the patient assigns their right to a Medicare benefit to a medical provider, private health insurer or approved billing agent. The government's Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act responds to the payment authority integrity risks by streamlining the assignment process for patients, medical providers, private health insurers and approved billing agents and enabling digital assignment options. This is rather than the paper based processes currently envisioned in the Health Insurance Act. This bill supports modernising the assignment of Medicare benefits by addressing limitations of the assignment of Medicare benefits act, the Health Insurance Act and supporting regulations. The ability for a patient to assign their Medicare benefits underpins bulk-billing. The bill will delay commencement of schedule 1 of the assignment of Medicare benefits act, which is due to commence on 9 January 2026. Deferring it to 1 July 2026 will support the industry and consumers to comply with new assignment-of-benefits requirements, particularly where this will occur through private sector software which must be updated to reflect the new assignment-of-benefits processes.

In the meantime bulk-billing can continue under current processes and arrangements. This will include additional incentives for bulk-billed services which start from 1 November this year in line with the government's election commitment. The government has committed $14.2 billion in 2025-26 to fund the implementation of reforms outlined in the assignment of Medicare benefits act and subordinate regulations. This includes updates to Services Australia software systems and education and communication activities to ensure stakeholders are aware of and prepared for the new digital assignment arrangements. Passage of this bill will ensure that the 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. The minister will have the power to create an instrument which categorises existing Medicare Benefits Schedule services. The intended use is in bulk-billing assignment agreements. This information will be shown as a basic service description to assigners when seeking their agreement to assign benefits before services are provided and before the exact Medicare benefit amount to assign is known.

Fourthly, the bill will amend the Health Insurance Act 1973 to enhance the Bonded Medical Program. This will ensure the consequences of breaching a condition or withdrawal from the program fairly balance both the personal circumstances of the bonded participant and the broader interests of the community. It will also allow all work completed by the bonded participant in good faith and consistent with the program objectives to be counted towards their return-of-service obligation. Currently, former Medical Rural Bonded Scholarship Scheme participants who voluntarily opted in to the statutory program who failed to complete their return-of-service obligation within the allowed 18-year period or withdrew from the program earlier face repayment of their scholarship and a six-year Medicare ban. While this financial penalty is appropriate, subjecting these doctors to a Medicare ban, which will occur for some starting December 2025, will jeopardise continued service provision and access to care for Australians living in rural, regional and remote communities and perhaps in other areas of workforce shortages. Given broader workforce shortages, a six-year Medicare ban is not in the interests of either the individual bonded doctor or the Australian community.

Removing the ban will also ensure that the consequences of breaching the return-of-service obligation are more consistent for all bonded doctors. Students can currently withdraw from the program without consequences 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 the Commonwealth supported place up to the date of withdrawal. This is in addition to their HECS or HELP liability. The proposed amendment will extend the existing grace period from the HECS census date in the second year of study to the award of a medical degree.

The bill will provide the Minister for Health and Ageing with the capacity to make additional rules to recognise work completed by bonded participants as part of their return-of-service obligation where this is consistent with the program objectives, including work completed prior to transitioning to the statutory Bonded Medical Program. Examples of work that cannot presently be recognised include work undertaken under legacy schemes that is or may become eligible under the program as well as work undertaken in locations erroneously advised by the government as eligible.

The Albanese Labor government continues to build and strengthen our healthcare sector. This legislation is an important step to protect health care and Medicare into the future. I commend the bill to the House.

Matt Smith (Leichhardt, Australian Labor Party) | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. Once again we are here discussing how good Labor is for the Australian health system. This bill will help deliver a list of technical changes that will overall ensure better administration and delivery of key government systems and programs. This will include supporting the automation of Medicare provider numbers; modernising the assignment of Medicare benefits, bulk-billing and simplified billing; and ensuring the consequences of breaching a condition and/or withdrawal from the Bonded Medical Program are fairly balanced. All of these changes will build towards a better administrated and more efficient public health system. It's a win for the Australian public and a win for medical professionals. It is a good change, with our government committed to delivering better health care to Australians.

The Albanese Labor government is strengthening Medicare right across the board, with more doctors, more urgent care clinics and cheaper medicines. We are making the largest investment in Medicare since its creation over 40 years ago. And I'll just remind everyone—just in case you haven't heard—Labor built Medicare, and we will always protect it. I'd like to take out my Medicare card and wave it, but I don't feel like testing that boundary today!

Our government is investing $8.5 billion to deliver an additional 18 million bulk-billed GP visits each year, hundreds of nursing scholarships and thousands more doctors in the largest GP training program ever. Australian patients and families will save hundreds of dollars in out-of-pocket costs, with patient savings of up to $859 million a year by 2030. We are expanding bulk-billing incentives to all Australians for the first time and boosting Medicare payments to general practices that bulk-bill every patient. This means nine out of 10 GP visits will be bulk-billed by 2030. We expect it to boost the number of fully bulk-billed practices to around 4,800 nationally—triple the current number of practices. That's why the Anthony Albanese government is tripling the bulk-billing incentive from 1 November—to get more people involved. Nine out of 10 is 90 per cent. It is a worthy aspiration and something we are going to deliver.

We also know that primary health care is important, and that's why we funded more bulk-billing and are delivering local Medicare urgent care clinics. The Medicare urgent care clinic model is simple: provide bulk-billing care for urgent, non-threatening conditions—kid rolls an ankle, falls off a skateboard or gets bitten by a dog, or you cut yourself shaving. They're open seven days a week with extended hours, with no appointment needed. The Albanese government has now opened over 90 Medicare urgent care clinics across the country, with more than 1.8 million Australians receiving treatment. Medicare urgent care clinics are taking the pressure off hospitals. It means hospitals can spend more time on the life-threatening emergencies they were built for, and it means patients can get in, get out and get back home, where they want to be. During the election, we committed to deliver 15 new Medicare urgent care clinics right across the country. Once all of Labor's Medicare urgent care clinics are open, four in five Australians will live within a 20-minute drive of an urgent care clinic. And all you will need is your Medicare card, never your credit card.

In Queensland, there have been more than 367,000 presentations. One of the busiest is the Cairns South Medicare urgent care clinic, located in the suburb of Edmonton. That's why, during the election, we committed to increase the resources of the Cairns South Medicare urgent care clinic and deliver a Medicare urgent care clinic for the northern parts of Cairns. The north of Cairns gets cut off during the wet season. During Cyclone Jasper, the Northern Beaches would have been unable to get any form of medical attention. This urgent care clinic will resolve that problem. I'm happy to announce the tender is now open, and very soon we'll be able to deliver that for the people of Cairns.

We've also delivered cheaper medicines. Labor has passed laws to cut the Pharmaceutical Benefits Scheme co-payment from $31.60 to $25 from 1 January next year, delivering on another of our election commitments. The last time PBS medicines cost no more than $25 was in 2004. That's more than 20 years ago. This is being delivered to ease another key cost-of-living pressure. Having already slashed the cost of medicine by the largest amount in the history of the PBS, we will now go even further, with a more than 20 per cent cut to the maximum cost of PBS medicines, which will save Australians over $200 million a year. Making medicines cheaper is a tangible way we are improving people's lives. You should never have to choose between medicine and a meal.

Four out of five of these medicines will become cheaper because of this investment. Pensioners and concession card holders will continue to benefit from the freeze on the cost of their PBS medicines, with the cost frozen at its current level of $7.70 until 2030. This is just the latest step in our ambition to deliver cheaper medicines for Australians. The Albanese Labor government has already delivered more free and cheaper medicines sooner, with a 25 per cent reduction in the number of scripts a concessional patient must fill before they hit the PBS safety net. That's the largest cut to the cost of medicines in the history of the PBS, with the maximum cost falling from $42 to $30. There are 60-day prescriptions, saving time and money for millions of Australians. Those are very important in an electorate like mine. If you live on the stations or in one of the communities and the nearest pharmacy is a three-hour drive away, you want to go in every two months rather than every fortnight. Cheaper medicines are good for the hip pocket and good for your health. If you don't believe me, I can tell you that, in Queensland, more than $330 million has been saved on 55 million cheaper scripts. Is it any surprise the Australian public have always supported and loved Medicare? Yet we're delivering more.

The Anthony Albanese Labor government is delivering more, lower cost and better health care for women and girls. We know that women too often experience delayed diagnosis for conditions, from endometriosis to heart disease. Their pain is dismissed. They struggle with issues such as unplanned pregnancies, menopause and miscarriage. The medical fraternity—and it quite often is a fraternity—has often gaslit women, not taking their medical conditions seriously. The Anthony Albanese government seeks to change that. It has listened and announced half a billion dollars in new investments for women for right across their entire lifespan.

Hundreds of thousands of Australian women are now accessing cheaper medicines and better health care due to our government's commitments. This includes the first PBS listing of new oral contraceptive pills in more than 30 years with the listing of Yaz, Yasmin and Slinda, saving 150,000 women hundreds of dollars a year. There is more choice, lower cost and better access to long-term contraceptives, with larger Medicare payments and more bulk-billing for IUDs and birth control implants, saving around 300,000 women a year up to $400 out of pocket. There is more Medicare support for women experiencing menopause, with the new Medicare rebate for menopause health assessments, funding to train health professionals, the first-ever clinical guidelines and a national awareness campaign. There is the first PBS listing for new menopausal hormone therapies in over 20 years, with around 150,000 women saving hundreds of dollars a year from the listings of Prometrium, Estrogel and Estrogel Pro.

There are more endo and pelvic pain clinics treating more conditions. We're opening 11 new clinics and ensuring all 33 clinics are staffed to provide specialist support for menopause. There are new endo treatment options as well, including the PBS listing of Ryeqo. There are contraceptives and treatment for uncomplicated UTIs from pharmacies, with two national trials to benefit 250,000 concession card holders, who will be able to consult a trained pharmacist at no cost. If medications are required, they pay only the usual medicine cost. Australian women undergoing IVF will receive earlier and more affordable access to fertility treatment, with Pergoveris pens added onto the PBS and the maximum number of pens increased to four instead of two per script. This is a massive and much-needed investment to ensure Australian women can access the health care they need.

Those are the facts—a list of what's going on. But it doesn't talk about the investment in Medicare and what that means to the people of Leichhardt, what that means to my own family and what that means to millions of families around Australia. My children were born in the public hospital, both of them. A midwife came and checked on us. It was all free of charge. My friend Dr Steve Sutcliffe is a cardiologist. He refuses to work in private practice; he'll only work in public. He travels the cape. He diagnoses and treats RHD, a disease that has no place in modern Australia yet is prevalent throughout our Aboriginal and Torres Strait Islander communities in Far North Queensland. None of those people have access to private medicine. They are wholly reliant on Medicare and on people like my friend Dr Steve.

From my own personal experience, having lived in a place where there is no public health care, I can say that a shoulder reconstruction costs hundreds of thousands of dollars. The plastic surgery to reattach my lip was $70,000 or $80,000. In Australia, I had a stroke. I spent three days in hospital. I came home with just my Medicare card. These are tangible differences. This is what makes Australia great—the socialisation, the Medicare system that gives us bulk-billing and gives us the confidence to go to a hospital, not worry about that insurance payment and get the medicine that we need to get back home and live our lives. It is one of the great and enduring parts of Australian culture. It was built by Labor. It is protected by Labor. It is expanded by Labor.

These changes might seem technical and small in nature, but they streamline a system that makes a difference every single day to every single Australian. We know that there's more work to be done, and I know that, as a government, we will always put the health of Australians first, because it is the most important thing that you have. Without your health, you have nothing else. And the Anthony Albanese Labor government will ensure that Australia has its health.

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

First, I thank all members for their contributions to the debate on this bill. The Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025 does streamline Medicare provider number administrative processes so that health practitioners receive their Medicare provider number sooner.

Schedule 1 of this bill will amend the Health Insurance Act 1973 to enable the Chief Executive Medicare to approve the use of a computer program to make decisions to allow Medicare provider numbers, including validating Medicare provider numbers that were previously issued by a computer program. This will only apply to positive decisions to issue a Medicare provider number, and any decision requiring assessment of a discretionary factor will still be mainly processed by a service officer. Schedule 1 also confirms that any Medicare provider numbers issued by automation remain valid so there is no impact on health practitioners or their patients for services previously provided.

Our government is committed to ensuring that there is a sufficient and sustainable health workforce to meet the healthcare needs of Australians. The Australian government, together with state and territory governments, has committed to implementing all health related recommendations from the independent review of Australia's regulatory settings relating to overseas health practitioners. This will help to ease the shortage in the health workforce by removing unnecessary barriers and improving and expediting regulatory processes for more overseas health practitioners to commence working in the Australian health system sooner. This bill supports a key recommendation from the review to automate the issuance of Medicare provider numbers.

Schedule 1 also confirms the conditions that applicants must meet to be issued an MPN, ensuring the highest standards of healthcare provision are maintained. I would like to let the House know that Services Australia, the Department of Social Services and the Department of Veterans' Affairs were consulted as part of the drafting of the bill and support this streamlining process.

Schedule 2 of the bill amends the Private Health Insurance Act 2007. This is to support processes for claiming the private health insurance rebate upfront through the premium reduction scheme. The self-assessment process will be supported by postpayment compliance activities.

Schedule 3 of the bill makes changes to the Health Insurance Act 1973 and Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 to allow finalisation of regulations to modernise and digitise the assignment of Medicare benefits and to delay commencement of the new processes from 9 January 2026 to 1 July 2026 to provide industry more time to ensure the necessary software and system changes can be made.

For simplified billing, the bill enables any eligible person covered by a private health insurance policy to assign Medicare benefits and reduces the administrative burden on providers of privately insured services associated with mandatory notification, without reducing patient access to this information. For bulk-billing, the bill will enable the completion of regulations for enduring agreements to complement the government's primary care payment reforms, such as MyMedicare. It also provides for a new legislative instrument to be delegated to the Minister for Health and Ageing and Minister for Disability and the National Disability Insurance Scheme to make service information simpler for patients and to inform an assignment decision.

Amending the commencement date to 1 July 2026 will be welcomed by stakeholders, who will now have additional time to adopt modern and simplified assignments that benefit the processes, including through updating their software products which are used to manage clinical businesses. Modernising, simplifying and making assignment of benefit easier for patients and providers will strengthen Medicare now and into the future. I think it's important to note some of those timelines included in this particular bill and the importance of progressing this legislation.

Schedule 4 of the bill amends part VD of the Health Insurance Act 1973 to enhance elements of the Bonded Medical Program. I would like to acknowledge the questions that were put by the member for Nicholls in his contribution, and I provide some answers to those questions that I hope will provide further information. The bill ensures consequences for breaching a condition or for withdrawing from the program and balances the personal circumstances of the bonded participant with the broader interests of the community. There were questions around further clarification of what this means.

We know that, due to the specialisation of some doctors, there is a risk they have breached and, as a consequence, have a ban of six years from billing under Medicare. This is bad not only for them but for patients who might be in need of services that they have been providing, so we are removing this consequence.

We also know that currently, if a medical student withdraws before the census date in their second year, they avoid any debt. What we intend to do, if this bill successfully passes, is to extend that grace period, which would mean that any withdrawal after this date—the census date in year 2 of their medical degree—up until they finish would be regarded as within the period where, if they incurred a debt, it could be waived.

We have circumstances where somebody hasn't completed their medical degree but, under this program, they have a debt raised against them, which could be between $100,000 and $140,000, that they've been asked to repay. This change recognises that, if a student hasn't completed their degree, they shouldn't be required to pay this debt, and this is due to the acknowledgement that personal circumstances change. There might be a person who is 17 or 18 and commits to a medical degree. They might be embarking on a bonded medical program, thinking that they could continue to complete that degree at that placement, and circumstances change for them. I can update the House and let you know that the cohort is very small with regard to the types of medical students we're talking about here who don't complete their degrees. However, the impact on them is enormous when they are faced with a student debt of $100,000 or more and they have no qualification to show for it. So we propose this amendment through this legislation to ensure this is fairer.

There were questions raised by the member for Nicholls about concerns that doctors won't have to work for as long in rural areas under the changes proposed. This amendment bill aims to simplify the Bonded Medical Program. The department administers, I understand, about 36 different contracts and different contract types due to the legacy schemes for bonded medical students across a range of different schemes over the last couple of decades. For example, there was a legacy scheme that ran between the years of 2016 and 2019 or thereabouts wherein there was only a need to do one year of a rural placement as part of the return-of-service obligation. What we are doing here is acknowledging that there are different lengths of time. We are trying to simplify and also be consistent, with a three-year requirement for the return-of-service obligation for those medical students. The explanatory memorandum, in 'Part 3—Bonded Medical Program rules', does explain in detail the reason for this change, which is about more fairly recognising work completed by bonded participants, and I draw the member's attention to that section of the explanatory memorandum.

As the member for Macarthur spoke about in his contribution, these changes to the Bonded Medical Program will make it more flexible and aid any uptake of rural bonded scholarships as an option for medical students. We understand that there isn't as great an uptake as we would like of the rural bonded medical program because there is an inflexibility to the scheme, which we are seeking to address through making these changes which provide for greater consistency and simplification.

Our government is very committed to providing greater access to health services and health care for all Australians, no matter where they live. As a member who also represents a regional electorate, I can empathise with the concerns that were raised by the member for Nicholls and appreciate his interest in ensuring that we provide access to health care to Australians no matter where they live. He will be very pleased to know that, alongside the good work of the Murray-Darling medical school that he spoke about, our government has also seen an increase in the number of medical students studying right around the country.

Since 2022 the government has invested in over 140 new medical Commonwealth supported places, with a focus on training in rural communities. In 2022 we had 3,095 commenced CSPs; we are looking to increase that to 3,450 by 2028. We've had 80 new commencing CSPs per year and funding for end-to-end rural medical training across six medical schools; 20 new commencing CSPs per year and funding for James Cook University's Cairns medical school; and 40 new commencing CSPs per year and $27.4 million in funding to establish the Charles Darwin University medical school. And, in the 2025-26 budget, the Australian government committed a further $48.4 million for up to 150 new primary care focused medical student places as one element of our $606 million GP workforce package. There are also the 100 CSPs currently out for tender now that we heard the Minister for Health and Ageing speak about in question time today. They'll be distributed by a competitive process for universities with existing medical schools, and a further 50 new commencing CSPs per year will be on offer from 2028 and open to universities that do not currently possess a medical school.

We also made two commitments in the 2025 federal election to support up to 68 additional medical places at the University of Tasmania and Queensland University of Technology by converting some of their non-medical CSPs. The University of Tasmania will be allowed to provide 20 commencing medical places based in Launceston from 2026, and Queensland University of Technology will be allowed to provide 48 commencing places from 2027, subject to AMC accreditation of its proposed medical school. We are training more doctors than we have ever before. There are record numbers this year compared to last year, and we are hopeful that next year we will see an intake that is even greater than the record numbers we've seen this year. Our government is very committed to training more health professionals, including more doctors; to providing more bulk-billing and more access to urgent care clinics; and, of course, to providing cheaper medicines to Australians.

I understand that the department has offered a briefing to members opposite to support them in getting more information about the Bonded Medical Program. I hope this provides them with further answers to the questions that were raised so that we can have the support of this parliament for this bill. There are some key dates that we need to address so that we can commence this to alleviate some of the pressure on medical students or those who have started a medical degree but haven't finished and have a debt raised against them, not only to streamline and simplify the processes for those who are in the Bonded Medical Program but also to deal with some of those other bulk-billing matters by the automation of some of our systems. That will allow more time for our general practitioners to have the software in place so that they can commence appropriately from the middle of next year, rather than the start of next year, which is what the timeline currently allows for. This bill would give them more time, and I would expect and hope that all members of this parliament would be endeavouring to support our GPs and GP practices so that they can take full advantage of bulk-billing provisions to support patients across the country.

I thank everyone who made a contribution to this bill. It is clear how important affordable access to health care is right across this country, and it was reflected in all of the contributions on this bill. Our government is working very hard to deliver on our commitment to strengthen Medicare, and this bill is another step in that endeavour. I thank members for their contributions.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.