Nova Peris (NT, Australian Labor Party) Share this | Hansard source

I rise to take note of the Abbott government's new proposed GP tax. This tax is a broken promise. It breaks the promise made by Mr Abbott that there will be no new taxes and it breaks the promise made by Mr Abbott to lower to cost of living. It is much worse than just broken promises. This new tax will have an adverse effect on the health of Australians.

The Prime Minister also promised to be the Prime Minister for Indigenous Australians. He promised to keep working to close the gap. This new tax will widen the gap. This tax is not credible right across Australia, but I strongly believe that those who will be affected the most are Indigenous Australians, particularly in the Northern Territory.

Aboriginal people in the Northern Territory already have the worst health outcomes in Australia. This tax will mean that fewer Aboriginal people will go to a GP. This will lead to worse health outcomes and it will end up being more expensive if people go to a hospital, not to a GP.

A research paper recently undertaken by the Centre for Remote Health in the Northern Territory was recently published in the Medical Journal of Australia. The paper was titled The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities. The paper found that not only do the low rates of primary health care resulted in higher rates of hospitalisation, higher mortality rates and lower life expectancy, but it also costs more. The paper concluded that there are significant cost savings and better health outcomes for patients with diabetes when access to primary care is improved. While the paper was specific to diabetes, its findings apply to all chronic conditions.

In remote areas, it is logistically not possible to charge the tax. In a remote community, the health clinic is the only option. They cannot go to hospital. If a child who has been injured is taken to the clinic, you cannot ask them for $7 to be stitched up. If a woman has been a victim of domestic violence, how do you charge them before treating the injuries? If people are charged, they will not go and that means their health will get worse. It will cost a lot more than $7 if they have to go to hospital because they did not see a doctor. As a result of this, the Aboriginal Medical Services have said that they have no choice but to absorb the tax, costing them millions a year. What that will mean is that they will have no choice but to cut preventative programs and awareness programs like nutrition programs, programs that reduce smoking, programs to warn women about the dangers of drinking whilst pregnant. These preventative and awareness programs are the most important if we are to achieve long-term gains in improving the health outcomes for Aboriginal Australians. Cancelling this program is exactly the opposite of what we should be doing to close the gap on Aboriginal life expectancy.

The president of the AMA supports this view that prevention is far better than the cure and that preventive health is far more cost-effective. In fact, just today, the Professor Brian Owler, the President of Australian Medical Association, stated:

Anyone working in health understands the basic premise that prevention is not only better than the cure, but it also makes economic sense. Diagnosing and managing chronic disease properly in general practice keeps patients out of more expensive hospital care. People with chronic diseases are very much affected by the co-payment. This proposal poses a financial barrier for vaccinations and other preventative healthcare measures and chronic disease management.

The recent COAG Reform Council report showed that, among the more disadvantaged in society, 12 per cent of people defer or do not see their GP due to cost. It will significantly increase with a co-payment.

To my disbelief, I also found out that the tax was introduced without any modelling. There was no analysis as to how it would impact on Closing the Gap targets. In fact, the associate professor also said that that was one of the main reasons that the AMA's response to this proposal is a lack of evidence. He stated that

Modern medicine is evidence-based. We are trained not to accept blind assertions, opinions or ideology in determining the best treatment without supporting evidence.

For the government to be introducing any major health policy without assessing the impact of a Closing the Gap target is dismissive of Closing the Gap. If I can just reiterate what my colleague quoted earlier from Professor Brian Owler:

The co-payment is unfair and unnecessary. Ideology has pushed this proposal too far. It is poor health policy. The Prime Minister should step in and scrap this policy. If not, it deserves to fail in the Senate.