Henry Pike (Bowman, Liberal National Party) Share this | Link to this | Hansard source

I move:

That this House notes that:

(1) families across Australia are paying the price for the Government's broken promises on Medicare, with out of pocket general practitioner (GP) costs now almost $50 on average;

(2) the former Government left office with bulk billing rates at almost 90 per cent and lower GP out of pocket costs;

(3) the Prime Minister has broken his promise that Australians would only need their Medicare card, not their credit card, with costs continuing to rise and bulk billing continuing to plummet in 32 electoral divisions;

(4) only 13 per cent of metropolitan clinics have signed up to the Government's bulk billing program, with local GP practices struggling under the Government's rising cost of doing business crisis, including skyrocketing energy bills and rent; and

(5) the Government is using Medicare as a political football while ignoring the real pressures facing patients and GPs, leaving families in Australia saying it has never been harder or more expensive to see a doctor.

Families across Australia are paying the price for the Albanese Labor government's broken promises on Medicare. Labor's new bulk-billing policy is already unravelling. Figures released by the Department of Health, Disability and Ageing reveal that just 13 per cent of metropolitan GP clinics have signed up to Labor's new bulk-billing program. That means the vast majority of Australian will still face out-of-pocket costs when visiting their local doctor, costs which health department officials admit now average almost $50 per visit and are expected to continue to rise. When the Prime Minister stood before Australians and promised that all you'd need to see your doctor was your Medicare card, he gave a commitment of affordability and access. The reality has proven very different. Under Labor, more and more Australians are finding that they also need their credit card because GP costs are at record highs.

Since the coalition left office, Labor's mismanagement of Medicare has seen bulk-billing collapse across the country, including in my electorate within the Redlands, where it has fallen from 84.7 per cent under the coalition to just 71 per cent today. Only 1,051 of Australia's 6,940 GP practices have joined Labor's new incentive scheme. Why? Because, like many small businesses, local clinics are struggling under Labor's cost-of-doing-business crisis, with sky-rocketing energy, higher rents and insufficient rebates that simply don't cover the real cost of providing quality care. One GP clinic in Cleveland, within my electorate, recently emailed its patients to tell them exactly why they could not afford to join Labor's new plan. Their email reads:

While we support initiatives that aim to improve access to healthcare, the new program does not provide the level of funding required to cover the true cost of providing high-quality, comprehensive GP medical care. The Medicare rebates, even with the new incentives, continue to fall well short of the cost of delivering the time, expertise, equipment, and staff support involved in your care.

Signing up, they told patients, would mean shorter appointments, rushed consultations and compromised care. So, instead, they've chosen to remain with private billing to protect the quality and time their patients deserve.

The Queensland president of the Australian Medical Association, Dr Nick Yim, said in October:

We all know across the country expenses are increasing. That includes mortgages, electricity, staff wages, insurances. And obviously, when we see these rebates, if they're not keeping in touch with the cost of living expenses, it just means that we cannot bulk bill everyone.

  …   …   …

we also know that our population is getting older, diseases are increasing, becoming more complex, and we do want to incentivise those longer consultations for those increased complexity as well. We want to incentivise taking the time, seeing the patients and for those long consultations.

It is clear that Labor's cost-of-living crisis is largely to blame for the inability of many GPs to sign up to the bulk-billing scheme. The bulk-billing scheme does not give GPs the ability to take the longer consultations they need to understand increasingly complex health issues. This is encouraging shortcuts and a preference for quantity over quality when it comes to receiving health care.

When you or your child gets sick, you shouldn't have to check your bank balance before seeing a doctor. But that's exactly what more and more families in my electorate and right across Australia are having to do. I've heard from a single mother in Wellington Point forced to choose between petrol and a check-up. A retiree in Victoria Point recently contacted me, outlining that she's delaying an appointment because she simply can't afford it. And a young family from Russell Island who I met recently told me they're now forced to travel deep into Logan, quite a distance from Russell Island, just to find a bulk-billing clinic. These are the real stories of real Australians being failed by this government and its promises to strengthen Medicare. Unfortunately, it's only become harder and more expensive to see a doctor.

Australians deserve a government that delivers solutions, not spin. The Prime Minister must stop using Medicare as a political slogan and start addressing the real pressures facing patients and GPs. They deserve a health system that rewards doctors for time and care. It's time for Labor to listen to the families, clinics and communities crying out for support. Australians deserve more than just broken promises and political slogans. They deserve affordable and accessible health care. That's what my motion is calling for, and I commend it to the House.

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

Is the motion seconded?

Aaron Violi (Casey, Liberal Party) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

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

I rise to speak against the motion moved by the member for Bowman, which is really laughable, because the reduction of bulk-billing over the past 10 years is a direct result of the nine years of coalition policies—a direct result of the big six-year freeze on GP rebates implemented by my opponent, Peter Dutton, in 2014, when he was Minister for Health, and then continued under the now opposition leader, Sussan Ley. And let's not forget the ill-conceived GP fee in 2015, where those opposite actually publicly campaigned for people to be paying for a GP visit, with the former minister, Sussan Ley, now opposition leader, saying, 'If you don't pay for something, you don't value it.' We all know that this led to an unprecedented decline in bulk-billing as doctors found it increasingly difficult to recover their practice costs without charging a fee. So I would say to those opposite, if you want to know why we are now doing everything possible to bring back bulk-billing, you should just look in the mirror and say to yourselves, 'It was the coalition that destroyed bulk-billing,' because that is the truth.

After a decade of cuts and neglect under the former coalition government, bulk-billing was in freefall. Many patients who had only ever been bulk-billed were having to pay a fee for the first time to see a GP, and as a result some were skipping care because they couldn't afford it, resulting in poorer health outcomes for vulnerable Australians. The Albanese Labor government is turning that around. I've heard too many stories over the past eight years of campaigning in Dickson—parents forced to choose between groceries and a visit to the doctor; people going without treatment because they couldn't afford to pay upfront and ending up in A&E. That was the reality of the system that was neglected for far too long by those opposite.

That's why the Albanese Labor government, since its election, has been delivering the single largest investment in Medicare. When we first came to government, we moved to triple the bulk-billing incentive for vulnerable patient groups, children under 16 and concession card holders. Now, for the first time, we're expanding the bulk-billing incentive to everyone—to all Australians. We're providing incentives to general practices that bulk-bill every patient, and we are seeing GP practices take up that offer right across the country. Well over 1,000 have switched to be fully bulk-billed. This is on top of the 1,600 GP practices that already fully bulk-bill. By 2030, we aim to have nine out of 10 GP visits bulk-billed. This investment will deliver an additional 18 million bulk-billed GP visits each year across the country. At the same time, we are rolling out our urgent care clinics across the country, reducing waiting times in A&E and providing more out-of-hours services. Our local Murrumba Downs urgent care clinic recently celebrated over 25,000 visits—now over 27,000. The feedback I get from locals on this service is all positive. It's a great local service. We are also opening walk-in free Medicare mental health centres right across the country, and we now have one in Strathpine in my electorate.

On this side of the House, we are restoring bulk-billing, strengthening Medicare and making sure no-one has to choose between their health and their household budget. Whether you need urgent care, mental health care or a check-up at your local GP, we want every Australian to have access to the health care they need, with their Medicare card. That's the promise of Medicare. That's the legacy Labor created, and that's the legacy the Albanese government is strengthening and will always fight for.

Aaron Violi (Casey, Liberal Party) Share this | Link to this | Hansard source

I might remind the member for Dixon that this government has been in power for 3½ years. It might be time to take responsibility for the failures under your watch. Talking about decades ago has a bit of limitation.

Opposition Members:

Opposition members interjecting—

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

Order! The member for Casey doesn't need an echo.

Aaron Violi (Casey, Liberal Party) Share this | Link to this | Hansard source

There was an awkward moment where the member for Dickson said that this government's ambition is to get to nine out of 10 visits bulk-billed by 2030—that's their ambition. The awkward part about that is that's roughly 90 per cent of visits bulk-billed, which is, coincidently, the exact number of bulk-billing rates under the former coalition government when this prime minister took over—90 per cent in the data. The whole ambition of this government is to match what the former coalition government did. The reality is that, under this government, from the facts by the department of health, not my facts—very independent—is that bulk-billing rates have plummeted under this prime minister and under this government's watch. That is the reality they do not like to admit.

In my community, it has gone from 84.3 per cent in 2019 in the Yarra ranges in the electorate of Casey—in 2023, under the Albanese Labor government, it dropped to 73.2 per cent in my community. My community knows that this prime minister might hold up a Medicare card, but he's not delivering when it comes to health. It really sums up everything that is wrong about this government and this prime minister. It is big on spin and it is big on optics and it is low on delivery. It does not deliver for the Australian people. The Prime Minister stood, during the campaign, and said, 'All you will need is your Medicare card,' knowing that that is not true, deliberately misleading the Australian people, because the Minister for Health and Ageing confirmed that you would still need your credit card to go to the GP. This is what this prime minister does. He spins. It's now about $50 short that you need to go to the GP, because, on average, it costs $50.49 to see a GP under this government.

This is the same prime minister that was very happy to cut the Medicare funded mental health sessions for Australians from 20 to 10. One day, he stands up and holds a Medicare card, talking about how important Medicare is, and, the next day, he makes the heartless decision to cut Medicare funded mental health sessions from 20 to 10, abandoning the Australian people when they need it the most. Coming out of the pandemic, cost-of-living pressures, young people struggling with mental health, needing the support—what does this prime minister do? He heartlessly cuts that support for the Australian people. He's happy to say one thing but delivers the complete opposite for Australians.

What are we seeing for Australians now? Not only is bulk-billing harder to get; fewer and fewer people are going to the doctor to get the medical support they need, because they can't afford it. Under this government and this prime minister, 10,000 GP visits are cancelled and delayed every day because the Australian people cannot afford it. What is the health impact of that? For those single mums who need to see a GP to maybe get a breast scan or to get something else—what is the long-term health impact on our communities and families of people not being able to afford to see a GP? That is the lived reality of 10,000 Australians every day.

Each week, 70,000 Australians cannot afford to get the medical help that they need, yet this prime minister and those opposite have the gall to stand up here and talk about how important Medicare is despite it failing under their watch. That is the most frustrating part about this prime minister. This prime minister lives in an alternative reality. He talks a big game but fails to deliver, and, when this prime minister spins but doesn't deliver, it's my community in Casey—it's communities across the country—that pays the price. Spin doesn't get it delivered for the Australian people. Whether it's health, energy bills or the cost of living, this prime minister always fails to deliver for the Australian people, and you pay the price.

Kara Cook (Bonner, Australian Labor Party) Share this | Link to this | Hansard source

I love holding mobile offices in my electorate of Bonner. I recently met with Garry at my mobile office at Mount Gravatt Westfield, in my electorate. Garry had lots of things he wanted to talk about, but at the top of his mind was health care. Bulk-billing, cost of medication—these are the things that people in my community of Bonner care about. We made time to chat some more just last week, and, when I caught up with Garry, I talked to him about the fact that, from 1 November this year, every Australian is eligible for bulk-billing under Labor; around 1,000 GP practices have already indicated that they will become 100 per cent bulk-billing, which is on top of the 1,600 that are already bulk-billing right across our country.

I was able to let him know that, in Queensland alone, bulk-billing has increased by 1.2 million additional visits under Labor and that we take a different approach to that of those opposite. That means more doctors, more bulk-billing and more urgent care clinics. That is our approach to strengthening Medicare. I told Garry that no Australian should ever have to choose between buying groceries and seeing a doctor and that the phrase 'I can't afford to see a doctor' is something that should never be spoken in a country like ours. Labor has tripled the bulk-billing incentive, the single biggest investment in Medicare's history. That means more Australians seeing a doctor for free and fewer families putting off the care that they need.

Over the next four years, 4,800 clinics across the nation are expected to convert to be fully bulk-billing practices, and it's already started in my electorate of Bonner. In my electorate, we now have 11 fully bulk-billing GP clinics; that's doubled. These include Archer Medical Centre; Doctors On Manly Road; Garden City Family Doctors; Good Health medical centres in Garden City, Mount Gravatt and Carindale; Mansfield Family Practice; Mount Gravatt Family Practice; Realcare Medical Centre; Tingalpa Family Health Care Centre; and Yulu-Burri-Ba. These clinics are delivering real relief for households and real confidence that, when you're sick, you can see a GP for free.

Tripling the bulk-billing incentive goes hand in hand with cheaper medicines. In Bonner alone, families have saved more than $12.8 million across two million scripts. In just over one month, more savings are on the way. From 1 January we will see the cost of PBS medications drop to $25 per script. During the election this year, my community made it very clear that they wanted to see a Medicare urgent clinic in our community. Labor has already opened 90 Medicare urgent care clinics across the country, and there are 47 more on the way. I am so excited that in the coming months we will see one of those 47 right in my electorate of Bonner. The new Karridale Medicare Urgent Care Clinic is on the way. We know that over 2.1 million patients have walked through the door of a Medicare Urgent Care Clinic right across Australia, and that includes 360,000 Queenslanders who have now received free, urgent care for non-life-threatening conditions through these clinics seven days per week and close to home. The Karridale clinic will cut out-of-pocket costs, and I cannot wait to cut that ribbon in the coming months.

No Australian should be punished for their gender when accessing health care but we know that women still pay more, wait longer, and their concerns are too often dismissed. Last year, the Medical Journal of Australia reported that 9.4 per cent of women delayed or did not fulfil a script because of cost compared with 5.5 per cent of men. Labor's $800 million women's health package is changing that. Some 300,000 more women will save $400 a year in Medicare rebates on IUDs, and 365,000 women have already accessed 715,000 cheaper scripts for contraceptives and menopausal hormone therapies through changes to the PBS. This is one of the largest health investments by any government, because women's health must be a priority and healthcare gender bias must be eliminated.

Labor are delivering and will keep delivering because we know that all you should need is your Medicare card, not your credit card, to get free health care in this country.

Simon Kennedy (Cook, Liberal Party) Share this | Link to this | Hansard source

Yes, all you should need is your Medicare card, but, sadly, that is not the case in my electorate of Cook. The numbers are absolutely damning. Since 2022, there has been an 18.8 per cent fall in bulk-billing rates in my electorate. This is the biggest drop of any electorate in all of New South Wales. This is what breaking Medicare looks like. In my electorate of Cook, we only have two clinics that bulk bill. We have no federally funded urgent care clinic. Why, Prime Minister, are you denying the people of Cook essential medical services while parading a Medicare card around through the election campaign saying 'all you will need is this'? In my electorate, having seen the doctor only a couple of weeks ago, the out-of-pocket cost is over $100.

Take for example one of my long-standing clinics, the Caringbah Family Medical Practice. It has explained publicly why it cannot join Labor's new bulk-billing scheme. The message was both blunt and honest: the government's promises do not match the financial reality, it claimed. Caringbah Family Medical Practice said, 'No business can survive while losing money on every transaction.' This is the truth behind Labor's so-called reform, a policy that sounds generous but that leaves doctors and their practices fitting the bill, and patients far worse off.

The Prime Minister told Australia at least 71 times, 'All you need is your Medicare card, not your credit card.' He said it would be free to see a GP under Labor. But today the reality is very different. Paying $100 for a GP consultation is an everyday reality for the people who live in Cook. Parents who simply need a script, pensioners managing chronic disease, and young people who cannot get in to see a doctor without paying fees they cannot afford. Fewer Australians are now seeing doctors, 10,000 fewer a day. They are skipping potentially life-saving appointments, not because they don't need them but because they cannot afford them. Unfortunately, more Australians are paying to see a doctor than ever before. Some 43,000 extra Australians a day are now paying for a GP visit, many of them in my electorate of Cook. This is exactly what happens when a government uses Medicare as a political football instead of really supporting doctors and clinics like those in Cook.

Even with Labor's new incentives, the rebate does not cover the cost of providing quality medical care in my electorate. Once you add rent, staff wages, medical equipment, digital compliance, insurance and, critically, the skyrocketing bills under this government—for rent and energy costs in particular—clinics are losing money on every consultation. That's why my electorate of Cook has had the largest drop of any electorate in all of New South Wales in bulk-billing rates. It's why we have only two clinics, that are booked out and you cannot make an appointment to, that offer bulk-billing. That's why in my electorate people are paying over $100 on average to see a doctor, and it's not good enough. Prime Minister, start serving the people of Cook and start serving their needs.

To qualify for Labor's incentive, a clinic must bill every single patient every single time. This all-or-nothing requirement might sound good in a press conference, but in the real world, where rents are skyrocketing and energy prices are skyrocketing, it's impossible. These small community practices cannot survive on this government's slogans and wishful policy. This government continues to talk about strengthening Medicare, but every number, every clinic and every patient tells a different story. The truth is simple: access is weaker, costs are higher and the system is failing the very people this Prime Minister promised to help.

You cannot strengthen Medicare by driving clinics out of bulk-billing, you cannot help families by making it more expensive to see a GP, and you cannot promise Australians won't need their credit card while forcing them to use it more than ever before. Our GPs deserve respect and a funding model that works. Instead, Labor has delivered the exact opposite—a Medicare system under strain and tens of thousands of people in my electorate out of pocket.

Rowan Holzberger (Forde, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak against the motion this morning. My neighbour the member for Bowman is actually the mover of this motion, and it just proves the old adage that you can choose your friends but you can't choose your neighbours, because I feel as if I would like to offer a little bit of political advice. Maybe they're better off not talking about this issue. Maybe there needs to be a little bit of self-reflection here, because when it comes to the reason people are finding it difficult to access health care today, it is because of the policies that they presided over for more than nine years. The member for Bowman mentioned a woman who has to come deep into Logan to access a bulk-billing doctor. Perhaps that's because in Logan, on the northern Gold Coast, we managed to increase the number of bulk-billing clinics overnight from nine to 20. That's more than double, and that number has only gone up. That was overnight, between Friday night and Saturday morning. Now we have gone up to at least 21, and that number is going to continue to rise. So I would suggest the member for Bowman direct more people to Logan because that's where they are going to find it. He won't need to, because that's not the only place this constituent of his is going to be able to find a bulk-billing doctor; that number is going to continue to rise in his electorate as well.

The opposition whip mentioned that we have been in power for 3½ years and it's time that we took responsibility. We are taking responsibility for the solution—if they won't take responsibility for the problem. When I was campaigning in 2021 for the seat of Forde—unsuccessfully, mind you—and in 2022 we all noticed that bulk-billing was beginning to ebb. You could see that one clinic had decided to stop bulk-billing, and then another clinic. You got the sense that this was the beginning of a landslide, which did happen. Unfortunately, as we came to government that landslide came crashing down, and while it came crashing down as a result of the policies of the former government, thanks to the practical incentives for kids and pensioners, we have now begun to turn things around. In Queensland, for instance, as a result of those incentives, we have gone from a bulk-billing rate of 73.6 to 77 per cent. After 3½ years we are taking responsibility and we are turning it around.

The member for Casey made the misleading claim that Albo heartlessly cut, from 20 to 10, the number of mental health appointments for which you could access assistance, but I think the point needs to be made that the 20 visits was a temporary measure due to COVID, just like the bulk-billing rate was artificially high due to COVID, as people got their vaccinations. That underlines the point that the collapse was even greater, because that number was kept artificially high as people sought vaccinations. The real problem was masked by that fact.

We're talking about mental health, and, in Forde, we've not only invested in the Medicare mental health clinic in Logan but also upgraded it since the last election, and we'll be opening up a new one on the northern Gold Coast. In terms of responding to what the member for Cook had to say, unfortunately there wasn't anything I could find that merited responding to. I'd underline the fact that this is a problem 10 years in the making, and it's turning around.

I visited the Holmview clinic and the Bannockburn clinic, and there are a list of other clinics that want to get me out there, as the local member, because we have, in the words of one clinic, saved bulk-billing. One clinic had bulk-billed for 10 years, and it was going to stop bulk-billing, and, had these new incentive payments not come in, it wouldn't have been able to continue bulk-billing.

Only Labor has Medicare at its heart. Only Labor protects Medicare. While Peter Dutton was voted the worst health minister in history, perhaps those people voted too early, because there's one health minister that has the dubious record of having never approved an increase, and that's the Leader of the Opposition. (Time expired)

Fiona Phillips (Gilmore, Australian Labor Party) Share this | Link to this | Hansard source

In good news, from 1 November more people in my electorate of Gilmore will be able to see their general practitioner for free. I know that, for too long, too many people have been paying too much out of pocket when they go to their doctor, and that's why I welcome the Albanese Labor government's expanded bulk-billing incentives for GPs.

Labor are making the largest investment in Medicare since its creation to ensure people can afford to see their GP. The expanded bulk-billing incentive for all Australians plus the creation of an additional new incentive payment for medical practices that bulk-bill every patient mean nine out of 10 GP visits will be bulk-billed by 2030. I'm really thrilled that more than 20 GP practices in Gilmore have already switched to being Medicare bulk-billing practices; 11 were mixed-billing practices. I've spoken to lots of local doctors on the South Coast who are making the choice to switch their practice to be fully bulk-billing clinics. They are taking up the incentives because it's good for their business and, of course, good for their patients as well.

Grand Pacific Health in Nowra and the Queen Street Medical Centre in Moruya were among the first on the South Coast to sign on to become fully bulk-billing practices. They want to make a difference in the community and want to help their patients, many of whom are older with multiple conditions or are young families feeling the cost-of-living pinch. Grand Pacific Health Nowra Practice Manager Charise Morris said, 'Being sick was not cheap, especially for families and the chronically ill.' She told me that the change would make a huge difference, because, when people don't have to pay a gap fee to see their doctor for a general consult, that's money that can put food on the table.

In three weeks since its introduction, I can see that Labor's investment in bulk-billing incentives is working. It had already been working for pensioners, concession card holders and families with kids, and now it has been expanded for every Australian. The Albanese Labor government's $8.5 billion investment into Medicare will 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.

We are also opening more Medicare urgent care clinics across the country, and I'm so pleased that, from 10 November, the very popular Batemans Bay Medicare Urgent Care Clinic has been operating 18 hours a day—the longest of any clinic in the country. We promised to expand the hours from 6 am to midnight before the busy summer holiday period, and that's what we've done. More than 20,000 people have walked through the doors since the Batemans Bay clinic opened. The community was crying out for longer hours to take pressure off the hospital and local doctors. The population swells over summer, so now locals and visitors will be able to seek urgent non-life-threatening care for all those pesky summer colds, holiday injuries, sprains and stings until midnight every day of the year without having to wait hours in the ED. I also can't wait for the doors to open on the brand new federally funded Medicare urgent care clinic in Nowra very soon; watch this space.

We're making it cheaper for people to see a GP, no matter where they live. That's real, tangible cost-of-living relief for ordinary Australians.

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

I rise today to speak on Medicare, built by Labor and delivered by Labor. This extra commitment adds $8.5 billion for people to get in to see GPs and get the health care they deserve.

When I was playing in the United States, I took a hit to the face. My bottom lip was almost torn. The university I played for spent hundreds of thousands of dollars repairing me. A couple of years later, I blew out a shoulder—another quarter-of-a-million-dollar bill for those who were looking after me. In 2019, I had a stroke. Thanks to Medicare, I spent three days in hospital and was able to come out with a clean bill of health and no bill to pay. That is the beauty of Medicare—the equity of health care for all Australians. It is something we on this side of the House are proud of every single day. That little green card opens so many doors and gives people so much quality of life.

That's why it's exciting that we've added extra urgent care clinics right across the country, including, very soon, one for the northern suburbs of Cairns. For those unfamiliar with the geography of Cairns, the northern suburbs are cut off when the floods come through almost yearly. We are isolated from any kind of medical help. An urgent care clinic will address that need. The aged, the young and the people who need a top-up of their medication will be able to get in to see a doctor, get checked out and get home where they belong without having to brave the floodwaters that come across our highways.

I'm very excited that bulk-billing has been extended. I'm happy for the people of Australia and for my children, knowing they will have continued access to excellent health care.

Steve Georganas (Adelaide, Australian Labor Party) Share this | Link to this | Hansard source

There being no further speakers, the debate is adjourned. The resumption of the debate will be made an order of the day for a later hour.