Richard Dowling (Tasmania, Australian Labor Party) Share this | Hansard source

I note that this is not my first speech. I rise to speak in support of the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. The bill is another example of the government's commitment to high-quality public health care—health care that is affordable and accessible. I congratulate the former assistant minister for health, Ged Kearney, for her work in progressing this bill and its reforms. The bill is about making a system that's fairer, tighter and more secure.

Labor governments have had that commitment to universal health care for decades from Whitlam, the visionary who introduced universal health care to our country, to Hawke, who restored and entrenched Medicare as a fair and accessible system, and to Keating, who further refined and funded it and made sure it is the lasting pillar of Australian life that it is recognised as today across the whole parliament. Labor prime ministers have continued to refine, improve and enhance it. This bill is part of that journey, and long may it continue. Labor built Medicare, and we're determined to keep it strong for generations to come, but it will only remain universal and sustainable if every dollar is spent where it is meant to be spent—on the care of Australians.

When we came to government in 2022, it had never been harder or more expensive to see a doctor. Bulk-billing was in freefall after a decade of neglect and cuts to Medicare. That is why strengthening Medicare was a key focus of our election platform, and it's why we've acted decisively on it in our first term. In just two years we've delivered more doctors, more bulk-billing, cheaper medicines and opened 87 Medicare urgent care clinics across the nation. Our investment in Medicare urgent care clinics is making a real difference. I know that because there are five of them in Tasmania, and every day people are asking for more accessibility and the presence of more Medicare urgent care clinics. I'm glad to see that we have committed to expanding them by three more across Tasmania.

Let's take a moment to talk about the practical difference that these urgent care clinics make to people's everyday lives. I'm reminded of hearing the story from an elderly man in Bridgewater during the election campaign. That man was forced to travel over half a day on a round trip by bus to Rosny to his closest healthcare centre. Now, with an urgent care clinic open in Bridgewater, he can walk to get the health care he needs and deserves, completely free with no appointment required. More than 1.5 million patients have received similar free urgent care, without waiting for hours in medical emergency departments. These clinics are open seven days a week with extended hours, and no credit card is required, just the Medicare card. That's exactly how it should be. Your health care shouldn't depend on the limit of your credit card. That's why investing in Medicare is so important.

The bill in front of the chamber today is another step to improving the integrity of it. It is so critical that we know that when we allocate such a large proportion of taxpayer money—public funds—it is going towards its intended purposes. That's why we're putting in place these integrity measures. It's so we can continue to maintain the trust that that great system has. Labor created Medicare, and only a Labor government will protect and strengthen it. That's what we're doing, with the single largest investment in Medicare since its creation more than 40 years ago—$8½ billion to deliver more bulk-billed GP visits, hundreds of nursing scholarships and thousands more doctors.

For the first time, we're expanding the bulk-billing incentive to all Australians and introducing a new incentive for practices that bulk-bill every patient. By 2030, nine out of 10 GP visits will be bulk-billed and the number of fully bulk-billed practices will triple to almost 4,800 across the nation—an extraordinary achievement. Bulk-billing rates are already rising again, in every state and territory, delivering six million additional free visits in just over a year.

We know regular GP care prevents serious illness and reduces pressure on our hospitals. That's the beauty of this measure. Hospitals are always going to be under pressure, but trying to keep people out of emergency departments by getting them the care they need through the urgent care clinics, so they're getting that advice and staying out of emergency departments, is systemic reform. It's not just making health care accessible and affordable, so taking pressure off the cost of living; it's systemic reform. That's why we're also investing $662 million in a workforce package to expand the largest GP training program in our history—2,000 new GP trainees every year by 2028, complemented by an unprecedented increase in overseas-educated doctors joining our system.

We're delivering cheaper medicines, with the cost of a PBS script capped at $25—the largest cut to medicine prices in the history of the PBS. We've seen discussion recently around the world about our PBS, in trade discussions. We hold it up as a source of pride; it is something that we will never compromise on. There's much to admire about the American healthcare system in terms of some of the great innovation that they produce, but, certainly, as to what they spend in relation to healthcare outcomes, it's not something we would ever seek to replicate. They spend about twice the amount Australia does per capita and they produce worse outcomes. So I think that investing in and protecting our great system, which is admired around the world, is something we should continue to celebrate. Australians have already saved more than a billion dollars on their prescriptions under this government. We've made around 300 medicines available on 60-day prescriptions and lowered the PBS safety net threshold. Again, that's real cost-of-living relief.

The bill in front of this chamber helps crack down on serious non-compliance and fraud more effectively, because we know that every dollar we stop from being misused is a dollar that stays in the system for the care of Australians, including families in regional communities like mine in Tasmania. We're also taking strong action on vaping and illegal tobacco, protecting young Australians and cracking down on organised crime.

We're investing $1.8 billion in public hospitals next year, taking Commonwealth funding for hospitals to a record $33.91 billion in 2025-26 and delivering year-on-year growth of 12 per cent. That's in stark contrast to the $50 billion cut to hospitals from those opposite, which is not mentioned very often anymore but is there in the budget papers. Colleagues, these numbers represent real improvement in the lives of everyday Australians: a Tasmanian parent who can now take their sick child to an urgent care clinic on a weekend and get seen quickly, without an appointment and for free; a pensioner who can afford all of their medicines; a young GP getting their start in a regional practice.

And you see, when these young GPs come into regional communities, how quickly they are embraced by the communities, who are crying out for GPs. I know that, in every Tasmanian community I travel to, they always ask, 'When we can get more GPs?' The University of Tasmania is training a record number of GPs right now, and there are great incentives for those GPs to move into regional clinics, serve those communities, become part of the communities and become trusted advisers—and to do it under a system that rewards them for providing bulk-billing. That's what some of Labor's reforms are all about—improving the incentives in the system so that patients get seen more quickly, with more accessibility and more affordability. Ideally, they are bulk-billed; the target for 2030 is nine out of 10 Australians being bulk-billed.

Labor's record is clear. We are making Medicare stronger, fairer and more accessible so that nobody is left behind and every Australian can get the care they need when they need it. These are responsible, forward-looking measures. I cannot see why anybody who supports Medicare would oppose improving the integrity of Medicare. We must maintain the trust in this system that has served Australia well for decades. It is such a powerful brand. Every Australian recognises it. Every Australian has a Medicare card. They should cherish that. It's not something many citizens around the world have in their wallet—a card of equivalent performance or equivalent entitlements. That little piece of plastic, or the digital card on your phone, is such a powerful vision of what it means to be an Australian. It's so entrenched now that nobody would dare challenge Medicare.

But to protect it, we must continue to ensure every dollar spent and invested towards it goes back to Australian citizens, to patients, to delivering quality healthcare through the system, from GPs right through the rest of the system. That is what this integrity process is all about—restoring and continuing to keep trust in our system where we know those dollars will flow to patient outcomes. These are responsible, forward-looking measures that protect Medicare, protect public funds and protect every Australian. That is something that I want for every Australian.

Finally, I commend the work. This wasn't just a policy process that happened overnight; the integrity measures were part of the Independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip, who is a respected policy official who has been around for decades in various government agencies. He knows what he is talking about. The government's ongoing investment in and improvement to Medicare will see the system continue to go from strength to strength for future generations.

There is a lot of discussion about intergenerational equity at the moment and of young people in many respects, such as housing, not having things as good as previous generations did, but one gift that previous generations will be giving to future generations is a universal Medicare system. Imagine being born today in Australia under a system of universal healthcare. You are very lucky. You have won the birth lottery, in a sense, in terms of growing up in a country that gives you universal healthcare. Your parents will be supported through the Medicare system—your mum, your dad, whatever your family makeup is. You will be supported right from your birth, and it will support you as you grow up in age. Your name will be printed on the family Medicare card, and when you grow into adulthood you will have your own Medicare card.

I hope that we never let people forget how critical that system is. It didn't just come around by accident, and it was opposed for a long, long time. It was Whitlam's bravery to put it up at the time. It was a radical idea that really was before its time. He fought on with that, and then it was sort of repealed in many respects, and it took Hawke and Keating to double down on it. Today, nobody dares challenge the system of Medicare. As I said, there are people around the world who yearn to have a similar system that delivers such great outcomes for our country, for our constituents. I don't think anybody takes that little bit of green plastic for granted.

So I do commend the work of the review panel. I commend the work of the Albanese government in making Medicare a centrepiece of its election agenda. As the Prime Minister has made very clear, this term is all about delivery. Whilst there have been lots of cries around to distract the focus of the issue of the day—there's something happening overseas—we will never be distracted from what we promised in the last election and making sure that we actually deliver, because Australians put their trust in the Albanese Labor government. Every one of us, particularly new members and senators, know we're here, in large part, because people trusted us to deliver. This measure around Medicare, in terms of backing it up with funding, is part of the delivery process. I do commend the bill. Thank you.