Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Hansard source

I am more than pleased and willing to explain to the minister how legislative instruments work. A determination under a the bill is, and remains for all intents and purposes, a legislative instrument. There is only one single thing that changes, and that is the time any such instrument that may be made by the government in the future will come into effect. I will read out for the benefit of the minister the process that is involved according to the amendment that I have moved. It says:

A determination made under subsection (1) does not come into effect until it has been approved by resolution of each House of the Parliament.

The process that you were so keenly interested in is exactly the same process as for any other legislative instrument. There is one exception, one important exception: it will not come into effect until both houses of parliament have agreed to it.

I remind the Senate again: we are dealing here with a broken promise. We are dealing with one of many broken promises in the health portfolio. Before the election the government promised that they would not reduce the Medicare safety net, and I have read out the media statement of the Minister for Health and Ageing on 22 September 2007, a few weeks before the last election. This is a broken promise which will lead to increased out-of-pocket expenses for patients. Because of the pressure that was put on them by patient support groups, healthcare professionals and the Senate, the government have backflipped on some things, and we seriously and genuinely welcome that. We would like to think that they have still got one more backflip in them—that is, in relation to the injecting therapeutic drugs into the eye measure, which I have outlined.

But the reality is this: if we were to pass this legislation without this amendment, the government would be able to introduce future determinations and these determinations would come into effect before the parliament would have an opportunity to express a view. Given that this is a broken promise in the health portfolio, given the impact that measures under this legislation could have on out-of-pocket expenses for patients, given the impact that this legislation and determinations down the track could have on affordable and timely access to quality health care for patients, we do not think that the government should be able to pursue those measures unless they have a majority in both houses of parliament, and that includes a majority in the Senate. That is the reason why I have moved these amendments. The minister said that this was part of a delaying tactic. Let me just make it very, very explicit: we have been committed to moving this along for some time. It has been the government that have been delaying things.

Their backflip happened on 3 September, a short little while ago. It took the minister five days to formalise her backflip, by tabling the relevant papers in the House of Representatives on 8 September. She tabled those on a Tuesday in the late afternoon. We immediately asked questions, given the minister’s assertions that they had increased benefits but that there was not going to be any impact on the budget bottom line. Immediately after the minister tabled those determinations we asked for a briefing. We got it first thing the next morning. At that briefing the department said: ‘Sorry. We cannot tell you what the fiscal impact is going to be on a year-to-year basis in terms of the additional expense of increasing particular MBS items. We do not have that information. Sorry. This meeting was called at too short notice.’ So, quite constructively, genuinely and with all sincerity, we said: ‘Okay. Please go away. Think about the questions we have asked and send us the information when you can.’ As I said before, Wednesday went by, Thursday went by, Friday went by, and Saturday and Sunday went by, and we heard nothing. It was Monday when we finally got a piece of paper, which completely ignored the key question that was being asked.

So it is not the opposition wasting time; it is the government wasting time. When we finally got a document that gave us some indication as to what the past cost had been in relation to the MBS items in question, the government was still not prepared to answer the question: what will be the impact of increasing those Medicare benefit items over the forward estimates? That is the information we require to assess whether the minister’s assertions are correct. To this day the minister has not been prepared to provide information to the opposition that would help substantiate her assertions that the changes she has made are budget cost neutral.

Irrespective of that, because we are very accommodating people in the opposition, we want to see this legislation get up. We said, ‘Okay, we think we have taken this as far as we can. We do not agree with the government’s line, ‘Trust us, we’re from the government, we’re here to help and this information is all right.’ But let us move on and let us review in 12 months time what the effect on patients and what the effect on your budget bottom line has been. Let us pass this legislation. However, it is subject to this one amendment, and we would like to see you make one more change. If this amendment is successful, and if the government was pragmatic and accepted the amendment in the House of Representatives, I on behalf of the opposition give the commitment that we will facilitate speedy passage of the determinations that need to be approved under this legislation in the Senate this week. This is based on the backflip in relation to the IVF measures and the hope—or anticipation, perhaps—that the government might find it in its heart to make one more small change. It is a small change that will cost $4 million a year. The cost of increased falls because of people who lose their sight and their vision on the health system will be much worse than the $4 million cost every year, and, of course, this $4 million cost is part of a $14 billion budget.

Given all the waste and mismanagement going on in the government, we do not see why people going blind have to pay the price for Labor’s reckless spending. As I said before, I call on Senator Faulkner to have a very close look at the impact of this measure. On behalf of the opposition, I make it very clear that, given the changes that have been made to the IVF part of the determination, if the government were to take one further step in relation to this part of the determination of injecting drugs into the eye, then we as the opposition will facilitate very speedy passage of the legislation. So there is no suggestion whatsoever that we are holding this up, we want to make sure that you, the government, are held to account for the impact that this broken promise is going to have on patients, for the impact that this broken promise is going to have on timely and affordable access for families needing access to IVF treatment and for the impact that this broken promise is going to have on families needing access to eye surgery et cetera.

The government can deal with this very quickly: just agree to the amendment, cop it, agree that you need a majority in both houses of parliament to impose further burdens on patients across Australia and you will be fine. This week will go very quickly, but if in 12 months from now you want to make patients across Australia pay for your reckless spending yet again then you will not be able to do so unless both houses of parliament agree with you. We think that is an important safeguard for the patients of Australia. That is why, despite your remarks, Senator Ludwig, I hope the Greens and Senator Xenophon will continue to support the amendment that I have moved.