Michelle Ananda-Rajah (Victoria, Australian Labor Party) Share this | Hansard source

An emerging theme in the lead-up to this budget has been the issue of intergenerational fairness. I thank Senator Ruston for her contribution, for her long service and for her commitment to health reform in this country. But this issue of intergenerational fairness must be addressed. Right now, if you are 70 years or older, you will get 32 per cent back on your private health insurance. However, if you are a 25-year-old or a 30-year-old or a 50-year-old, you will only get 24 per cent back. We on this side don't believe it is fair to divide Australians based on age. What we are doing is repealing this benefit first introduced by the Howard government off the back of the mining boom 22 years ago. As someone who has practised in health care in public hospitals I can tell you that I did not see with the introduction of this policy any reduction in pressures on public hospitals. There was no reduction. Public hospitals emergency department pressures have only increased as has throughput over the period of time this policy has been in place.

There is an interesting report from the National Rural Health Alliance from their snapshot in 2025. It lays out starkly the spend we make on public hospitals. From 2022 and 2023, we spent around $85 billion in public hospitals—state and Commonwealth. In contrast, in community care and public health, we spent around $20 billion; general practice, $15 billion. This is all back to front. This hospital-centric model of health funding has led to the issues that we currently see. We as a Labor government are now trying to redirect funding and skew it towards community care. That happens by strengthening Medicare. The foundation of our health system is not hospitals. Hospitals are reactive places that react to emergencies. But if you start mending the fence at the top of the cliff, you start to see a completely different picture emerge, where we reduce the pressures on public hospitals. A fine example of that is our urgent care clinics.

In our first term of government, we brought in this new model of care called the Medicare Urgent Care Clinic. We currently have 137 around the country as we gun towards over 150. These have been visited by three million Australians, a third of them children. They are open from early until late. They see a range of patients. You can have diagnostics done—bloods. You can have imaging done and it is all bulk-billed. We have seen from our own evaluation a 10 per cent reduction in emergency department presentations. That is how you reduce pressure on public hospitals. That is how you do it.

In addition to that, we have invested a historic amount—$8.5 billion—back into bulk-billing. This kicked off on 1 November last year, and what did we see? Like magic, this is working, exceeding our expectations. We have seen now over 3,700 general practices around the country adopt bulk-billing. We now have a metric where 97 per cent of the population live within a 20-minute drive of a bulk-billing doctor. When we came in, bulk-billing was in freefall—about 75 per cent. 'Freefall' was the language used by college of general practitioners—not by us but by them. We have now seen an uplift to 81 per cent in the first quarter of this year, the highest it has been in 20 years. This is how you reduce the burden of chronic disease, by making it easier for older Australians who carry that disease burden to see their doctor. The backbone of the health system is not your hospitals. The backbone of the health system is general practice.

We are also strengthening Medicare by boosting the number of early-career doctors who are entering general practice. For the first time this year we will see more than 2,000 junior doctors enter general practice training. Half of those doctors will be training in rural and regional Australia. That is how you fix our health system.