Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) acknowledges the Government's commitment to strengthen Medicare, including $8.5 billion to deliver an additional 18 million bulk billed general practitioner (GP) visits each year, hundreds of nursing scholarships and thousands more doctors in the largest GP training program ever;

(2) notes:

(a) this measure has already seen practices around Australia become fully bulk billed, with nine out of ten GP visits expected to be bulk billed by 2030 and around 4,800 fully bulk billed practices, which is triple the current number; and

(b) that while the Government is expanding access to bulk billing by expanding the bulk billing incentive, by contrast the Leader of the Opposition, as the Minister for Health:

(i) never increased Medicare rebates, the only health minister in Australian history to do so;

(ii) doubled-down on the then Government's $50 billion cut to hospitals; and

(iii) continued the fight for the former Leader of the Opposition's GP tax; and

(3) further acknowledges that only the current Government will strengthen Medicare.

I am proud to move this motion, which notes that the Albanese Labor government is delivering on its promise to strengthen Medicare, delivering the single largest investment in Medicare in 40 years.

Our government is committed to universal health. We are investing $8.5 billion into Australia's greatest policy achievement: Medicare. This investment will deliver an estimated 120,000 additional bulk-billed GP visits in the community that I represent. From this Saturday, 1 November, every Australian will be eligible for the bulk-billing incentive, while GP clinics that fully bulk-bill their patients will be eligible for a new, additional incentive payment on top of that. This is great for patients, and it's a pay rise for our doctors.

This reform is already delivering in my community. The Werribee Medical and Dental Centre, run by ForHealth, has been fully bulk-billed since 8 September, meaning locals can already see their GP without worrying about out-of-pocket expenses. ForHealth has stated that Labor's investment in Medicare and bulk-billing will see an increase from one in 10 of their clinics being fully bulk-billed, to seven in 10 by this Saturday. This is just one of many clinics across the country, operated by this company, that are now going fully bulk-billed, including the Craigieburn Medical and Dental Centre in the electorate of the member for Calwell, who will second this motion today. It's another example of how Labor is delivering for the outer suburbs, across Melbourne and across this nation. This change alone will save my local community an estimated $570,000 in out-of-pocket costs every year. When you go to the Werribee Medical and Dental Centre, all you will need is one of these: a Medicare card. This is part of Labor's broader agenda to strengthen Medicare and ensure it continues to deliver affordable, universal health care for all Australians, from the smallest to the elderly.

One of the real game changers in reversing a decade of cuts and neglect under the former Liberal government has also been Labor's Medicare urgent care clinics. Since it opened, more than 27,000 locals have been treated at the Werribee Medicare urgent care clinic, one of the first of 90 clinics across the country to open. These clinics are making a real difference, allowing people to get urgent care when they need it without waiting in an ED or paying out-of-pocket fees and taking pressure off our public health system. We've also made medicines cheaper, saving families money at the pharmacy. We've capped the cost of PBS listed medicines at $25, ensuring people can afford the medicines they rely on.

Labor created Medicare, and the Albanese Labor government will always work and act to strengthen Medicare because it is more than a policy; it is a statement of our values. It says that, in this country, access to health care is determined by your Medicare card, not your credit card. It says that no matter who you are, where you live or how much you earn, you deserve high-quality, affordable health care. That is what Labor stands for.

Labor stands for an Australia where people's health is a priority. Labor stands for an Australia where preventive health has benefits that are acknowledged by all. That is what this great investment delivers. It will undo 10 years of neglect by those opposite. Worse than neglect; the freezing of the Medicare rebate for nine years meant doctors didn't get better pay. This changes all that. That is what this investment delivers, and that is why I am proud to move this motion to strengthen Medicare for every Australian.

Marion Scrymgour (Lingiari, Australian Labor Party) Share this | Link to this | Hansard source

Is there a seconder for the motion?

Basem Abdo (Calwell, Australian Labor Party) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

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

I thank the member for Lalor for moving her motion. It is true that Medicare is at the very heart of our healthcare system, but, unfortunately, the ideal of universal health care is fast becoming a mirage. Universal health coverage means all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. The reality is that Medicare has been undermined by years of rebate freezes and rising costs, and Medicare schedule fees remain unrealistically low.

Australia's ageing population, the growth of chronic health conditions and our increasing mental health needs mean GPs are having to schedule longer and more complex appointments. Average consult times have risen, reflecting the increased complexity of those consultations. The fee schedule forces GPs to prioritise short consultations over complex ones and to charge significant out-of-pocket fees to patients. Female GPs on average spend more time with their patients, so they're disproportionately disadvantaged. Unsurprisingly, medical graduates are deserting general practice for the specialties.

According to the recent Health of the nation report, nine out of 10 specialist GPs regularly manage conditions that would typically be managed by specialists because patients have to wait too long to see specialists or simply can't afford to. Multidisciplinary team care in primary health clinics is valued and expanding. More than half our GPs engage in MDT care. Two-thirds say they'd like to participate more but workforce shortages, lack of funding and infrastructure gaps remain limiting factors for this type of care.

Tragically, just this week in Melbourne, I've been contacted by a number of constituents concerned about the imminent cessation of GP services at three cohealth community health clinics. These clinics serve vulnerable patients with complex needs, including refugees, people facing homelessness and people experiencing family violence. The current funding method does not adequately address the needs of these individuals.

The government's Bulk Billing Practice Incentive Program commences this week, but, for too many GPs, it's going to be too little, too late. The program means GPs and practices will receive added financial incentives if they bulk-bill every eligible service and patient. While four out of five GPs in the Health of the nation report said they wanted to provide more and better preventive care to their patients, 82 per cent said that Medicare benefit scheme rebates are simply insufficient to allow them to do that. As a result, only one-third of our GPs are able to offer preventive care to patients. Preventive medicine covers a range of services. It aims to identify problems that could lead to chronic illnesses or diseases.

Our GPs' inability to provide those services means they're going to be struggling to cover all bases in health care. They'll be struggling to test blood pressure and cholesterol, struggling to undertake weight management, struggling to screen for cancer and for diabetes, and struggling to touch on drug and alcohol diversion programs, on mental health assessments and on nutrition. The GPs are simply unable to offer us the best care possible, because of financial and time constraints.

In my electorate of Kooyong, according to the recent Cleanbill report: only 16 per cent of consults were bulk-billed in the last financial year; the average out-of-pocket costs for a GP consultation was $49.91; and only 12 per cent of GP clinics in Kooyong are able to bulk-bill every patient. Realistically, schedule fees need to double. For standard consultations, that would mean the government paying out about $100, and even that's going to be less than the call-out fee for your average plumber.

We know that young people are increasingly putting off seeing a doctor, because they simply can't afford it. These are false and harmful economies. Avoiding vital medical care often results in later and more-severe presentations to urgent care clinics or emergency rooms. If this government really values primary health care it has to be prepared to pay to have the best primary health care provided to all Australians and to look at new models of multidisciplinary and preventive care within our universal healthcare system.

Basem Abdo (Calwell, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the motion moved by the member for Lalor and I thank her for her commitment to her community and to protecting and strengthening Medicare, one of the proudest achievements in our national story. When Labor came to government in 2022 it had never been harder or more expensive to find a doctor. Bulk-billing was in freefall. After nearly a decade of coalition cuts and neglect, the very foundation of our universal healthcare system was eroding.

That is the legacy of those opposite: a neglected health system that led to bad health outcomes, longer wait times and Australians paying more out of pocket for care that should have been free. Under the coalition, Medicare rebates were frozen for six years, stripping billions from primary care and making it harder for doctors to bulk-bill. The Royal Australian College of General Practitioners estimates that general practice lost around $3.8 billion due to that freeze. And who was at the helm of that policy? The current Leader of the Opposition, then the health minister, who oversaw the continuation of that freeze and supported a GP co-payment, a policy that would have forced Australians to pay every time they saw a doctor, set in stone. In 2014-15 the coalition government proposed a $7 co-payment for GP visits and a $5 cut to that rebate, defended until public outrage forced its withdrawal. That's the Liberal record on health: freezes, fees and funding cuts. It left GP clinics struggling, bulk-billing collapsing, and patients paying the price, in money and in health.

Labor is rebuilding Medicare from the ground up. The Albanese Labor government is proud to be delivering the single-largest investment in Medicare history: $8.5 billion to deliver 18 million additional bulk-billed GP visits every year across the country; hundreds of new nursing scholarships; and thousands more doctors through the largest GP training program in our history. In 2023 we tripled the bulk-billing incentive and delivered the largest investment in bulk-billing in Australia's history. More than nine in 10 visits for concession cardholders and children under 16 are now bulk-billed, with 6.5 million extra bulk-billed visits in the last year alone.

From 1 November, Labor is expanding bulk-billing incentives to every Australian—by the end of this week—and creating a new bulk-billing incentive program, giving practices that bulk-bill every patient an additional 12.5 per cent incentive payment. This reform means that nine out of 10 GP visits will be bulk-billed by 2030, and around 4,800 clinics will be fully bulk-billed—triple the number from when Labor came to office. Importantly, this isn't just good for patients but also good for doctors. A metro GP who bulk-bills every visit will earn $5,300 more than a mixed billing GP delivering the same number of services, and in rural areas that figure rises to nearly $24,000.

We see the difference every day in Calwell. As the member for Lalor mentioned, just a few weeks ago Craigieburn Medical and Dental Centre, in my electorate, announced it will move to 100 per cent bulk-billing for medical visits. That's a big win for our community. It means families don't have to worry about gap payments or putting off care because of cost. We're backing that up with 90 Medicare urgent care clinics already open nationwide, exceeding our initial promise of 50, with another 47 on the way this financial year. I'm proud to have announced a full Medicare mental health centre in my community to roll out more places that locals can go for free public mental health care backed by Medicare. This is in stark contrast to their plan to drive up gap fees and make waitlists longer. We've also cut the cost of medicines, reducing the PBS co-payment to $25 from January 2026 and saving Australians over $200 million a year on prescriptions.

This is what a government that believes in Medicare looks like. Where the Liberals froze, we funded. Where they cut, we rebuilt. Where they put up barriers, we are breaking them down. That is because Medicare in our community keeps kids healthy, older Australians independent and families secure in the knowledge that their government has their back. That is the promise of Medicare, that is the Labor difference and that is why only a Labor government will always protect and strengthen Medicare.

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

():  The member for Calwell has fallen into the trap of coming into the chamber and just reading the talking points that Labor has given to him, making out as if all is well in the area of health. Well, all is not well, particularly in rural and regional Australia and especially in remote Australia. He talks about the urgent after-hours care clinics. That would be great if the urgent care clinics were distributed fairly across the nation, but, unfortunately, they are not. While the urgent care clinics are a good initiative, there are areas in need that do not have access to them. These areas in need are outside Labor seats, and the need and desire for them are just not being met.

The Labor Party talks about the decade of neglect. What Labor doesn't realise, or conveniently forgets, is that we were dealing with COVID. It was a worldwide pandemic.

I hear the minister at the table scoffing, but our response to COVID, according to the Hopkins Centre, was second in the world. We made sure that, health-wise, we provided the vaccinations which saved tens of thousands of lives. Not only that, we also provided the economic benefits to save many, many businesses from bankruptcy. That is what we did in that decade and, indeed, towards the back end of that decade.

When Labor talks about taking over in May 2022, with bulk-billing in freefall, the facts don't stack up, because under Labor bulk-billing rates have dropped 11 per cent, from 88 per cent to 77 per cent. That would be even worse in regional areas. What we heard from the health minister at one stage was, if you can't get a bulk-billing doctor, just make another appointment with another doctor who bulk-bills. The fallacy of that is that that might be all well and good in the leafy suburbs of Adelaide, but it doesn't cut the mustard in regional Australia and particularly in remote Australia, where, if you can find a doctor at all, you're doing well. You can't be fussy about whether they bulk-bill. You just need to get a doctor, particularly if you have chronic pain. It shouldn't be a truism, 'when in pain, catch the plane', in remote Australia. You should have access to a doctor right there and then. One of the worst things Labor did when it came to government was change the distribution priority areas, whereby many doctors in rural Australia literally took the plaque off their practice and moved to Newcastle or Wollongong or the Gold Coast, which, quite frankly, had plenty of doctors. I will never say 'enough doctors', because there are never enough doctors.

But what we have done and did do in regional Australia was put in the Murray-Darling Medical Schools Network. I was proud to finance and fund that as part of a coalition government. I know that, in a few short weeks, the Minister for Regional Health will open the new facility at Wagga Wagga, where I went the other day. They celebrated quite a milestone. They were a clinical school; now they've become a medical school. They have produced a number of doctors who have then stayed in regional Australia. That's the crux of the issue: staying in regional Australia to practise. They come to regional Australia, fall in love with regional Australia or fall in love with somebody in regional Australia, and then they know that there is a future for them in regional Australia.

But we know that, certainly in Senate estimates the other day, health department officials admitted that Australians are not seeing a benefit from Labor's bulk-billing health policy. They won't see this for four long years. At the same time, people are sick, and they need to get better. If they can't see a bulk-billing doctor in regional Australia, they have to pay on the nose for it. That's just the way it is. We've got a very good health system, and we should never talk it down. I'm far from doing that. But we still have many, many Australians for whom the truth, despite the Prime Minister's claim on any number of occasions that all you need is your Medicare, not your credit card, is that it's not being seen regional Australia in particular. But right across the nation, it is a fallacy. It is just not true that you can go to any doctor, produce your Medicare card and receive that service for free. That is not the case. The Prime Minister and Labor people should stop saying it. They should stop just reading their talking points that are produced for them, because what they're saying is simply not true. It's not correct. And Australians out there are reeling from the effects of poor health policies by this government.

Marion Scrymgour (Lingiari, Australian Labor Party) Share this | Link to this | Hansard source

The time allotted for this debate has expired.