Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Hansard source

():  Australia has a world-class health system, and that is largely thanks to the various health benefits schemes such as Medicare which help Australians pay for the health care they need. In 2023-24 payments for health benefits including medical services, pharmaceutical services and private health rebates totalled at least $65.1 billion. The government is committed to protecting this investment and strengthening Medicare by improving the compliance framework that ensures its integrity. As other speakers have observed, the government commissioned the Independent Review of Medicare Integrity and Compliance, known as the Philip review, in November 2022 to respond to concerns about the operation of the Medicare system. The Health Insurance Amendment (Professional Services Review Scheme) Act 2023 and the Health Insurance Amendment (Professional Services Review Scheme No. 2) Act 2023 made amendments in response to the recommendations of the Philip review.

This bill too will support the integrity and sustainability of Medicare by addressing a range of issues to enable the department to conduct more efficient, timely and effective compliance activities. The government is committed to tackling issues of fraud, integrity and noncompliance wherever we see them. That includes Medicare but also has implications for me in my role as Minister for the NDIS. When we see issues of this kind we know we also see poorer outcomes for Australians who rely on our systems of social support. The bill will improve payment integrity by reducing the timeframe for making bulk-billed claims, allow investigative powers to be used consistently and effectively across health schemes including Medicare and the Pharmaceutical Benefits Scheme and improve the processes associated with pharmacy approvals. The bill also makes several sensible amendments to the Therapeutic Goods Act 1989 to enhance the Department of Health, Disability and Ageing's capacity to manage and alleviate the consequences of therapeutic goods shortages and to support compliance enforcement activities undertaken in relation to unlawful therapeutic goods and unlawful vaping goods. These amendments are consistent with this government's unwavering commitment to public health and mitigate the public health risks associated with therapeutic goods and vaping goods by supporting strong, effective regulation under the act.

The bill also amends the Public Health (Tobacco and Other Products) Act 2023. These amendments are largely clarifying in nature and have been identified as necessary during implementation to ensure the smooth and consistent operation of the act. I know that a number of senators have either flagged or moved second-reading amendments, and I may give an indication about the government's position in relation to each of those. Senator Steele-John has moved an amendment on sheet 3360, and the government won't be supporting this amendment. The amendment is unrelated to the purpose of the bill. The bill, as I have just set out, seeks to improve the enforcement of Medicare integrity measures and support the implementation of world-leading vaping and tobacco reforms. Senator Steele-John's amendment relates to dental services.

I'll make the following general remarks in relation to the issues that you raise in that amendment, Senator Steele-John. Our government has provided $107.8 million in the 2025-26 budget to state and territory governments to support public dental services for adults. We are also working in partnership with states and territories to develop a new National Oral Health Plan for the next 10 years. We recognise, of course—and Minister Butler has said this also—that in the longer term there is a lot of ambition for dental to be covered by Medicare, but our focus right now is on strengthening Medicare and rebuilding general practice after decades of cuts and neglect from the Liberals.

I will speak briefly, too, about the government's approach to the second reading amendment to be moved by Senator Thorpe. I listened very carefully to her contribution when she was in the chamber earlier. I understand that Senator Thorpe has had a number of discussions with the Minister for Health and Ageing on this subject and that he has agreed to have regular discussions with her to work on this very important issue. The government supports in principle many elements that are set out in her amendment. We acknowledge, in particular, the disproportionate representation of First Nations people in corrective settings nationwide and the implications that that has for health outcomes. Our government has taken and is taking significant steps to address this issue. At the 6 December 2024 Health Ministers' Meeting, all health ministers endorsed the release of the report of the independent National Review of First Nations Health Care in Prisons. Health ministers also released a joint response to the review, and in this they thanked all of the stakeholders who contributed to the review's findings and they committed to ensuring health care is delivered in custodial settings by upholding the fundamental human rights of people in places of detention. Both the report and that statement are publicly available.

As an outcome of the review, all health ministers jointly wrote to ministers responsible for adult and youth justice regarding the review of health care in prisons, and they collaborate on this work, which is progressing. The Minister for Health and Ageing has also written to states and territories seeking advice on actions taken by them to remove hanging points in custodial facilities and has sought their support to further reduce preventable First Nations deaths in custody. The government will continue to progress these reforms through these channels with our state and territory counterparts, who do hold the primary responsibility for the justice system, and it would be premature to support this amendment while this work continues.

To conclude, Australians are, of course, rightly proud of the systems of social support that we've built, and we've built them in the Australian way over generations. The PBS and Medicare are so significant. They are a significant part of our national fabric, and I am proud to be part of a government that is strengthening these great Australian institutions. I thank senators very much for their contributions to the debate on this bill.

(Quorum formed)