Senate debates

Wednesday, 13 June 2007

Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2007

In Committee

Bill—by leave—taken as a whole.

5:19 pm

Photo of Lyn AllisonLyn Allison (Victoria, Australian Democrats) Share this | | Hansard source

by leave—I move Australian Democrat amendments (1) and (2) together:

(1)    Schedule 1, page 3 (after line 12), after item 2, insert:

2A  Paragraph 10AA(7) (definition of spouse)

Repeal the definition, substitute:

spouse,in relation to a person, includes:

             (a)    a person who is legally married to, and is not living, on a permanent basis, separately and apart from, that person; and

             (b)    another person, who although not legally married to the person, lives with the person on a bona fide domestic basis as the husband or wife of the person; and

             (c)    a person in an interdependency relationship as defined in section 10AAA.

(2)    Schedule 1, page 3 (after line 12), after item 2, insert:

2B  After section 10AA

Insert:

10AAA  Interdependency relationship

        (1)    Two persons (whether or not related by family) have an interdependency relationship under this section if:

             (a)    they have a close personal relationship; and

             (b)    they live together; and

             (c)    one or each of them provides the other with financial support; and

             (d)    one or each of them provides the other with domestic support and personal care.

        (2)    In addition, 2 persons (whether or not related by family) also have an interdependency relationshipunder this section if:

             (a)    they have a close personal relationship; and

             (b)    they do not satisfy one or more of the requirements of an interdependency relationship mentioned in paragraphs (1)(b), (c) and (d); and

             (c)    the reason they do not satisfy those requirements is that either or both of them suffer from a physical, intellectual or psychiatric disability.

        (3)    The regulations may specify:

             (a)    matters that are, or are not, to be taken into account in determining under subsection (1) or (2) whether 2 persons have an interdependency relationship under this section; and

             (b)    circumstances in which 2 persons have, or do not have, an interdependency relationshipunder this section.

These amendments deliver on the Prime Minister’s promise, which was made some time ago now—I think it was early last year—that he would remove financial discrimination against same-sex couples and other relationships that are interdependent. These amendments give effect to that promise in respect of the safety net which applies to Medicare. I know that this is somewhat outside the thrust of the legislation we are dealing with today but it does still apply to diagnostic imaging accreditation in the sense that diagnosis and the costs of diagnosis are captured by the Medicare safety net. The effect of these amendments would be to remove the financial discrimination that the Prime Minister said was abhorrent and to do so, as I said, for Medicare.

It would affect those in a relationship who were not previously known to be in the category of ‘partners who are legally married’. It would apply not just to those people in a same-sex relationship but also to those people who are in a relationship which is close and which is physical, in that they live together, where there is financial support provided from one to the other and where there is also a sharing of domestic support and personal care. This applies to siblings who may live together in such a relationship, to an aunt and a niece or to anyone who is not closely related but who chooses to cohabit and to have a relationship which is interdependent. There is no good argument for discrimination against such people. The same costs, the same encouragement and the same incentives should apply to those people who have such relationships and to those who are legally married—a man and his wife.

I urge the minister to accept these amendments on behalf of the government and to vote with the Democrats’ amendments, which honour the promise of the Prime Minister. If the government does not support the amendments, I would very much value advice from the minister dealing with this legislation as to when we can expect this to be the case. This was, as I understand it, an honest, sincerely made promise by the Prime Minister and now this chamber is looking for delivery. This is a perfect opportunity to do that. This is a straightforward amendment. I think everybody can understand it. The definition of ‘interdependent relationships’ was adopted for superannuation. The so-called ‘choice’ legislation introduced this concept of interdependency for those in the private sector, so it is not new and it should not be a foreign concept to the government. Again I say: the Prime Minister promised this. When will he deliver? Will it be now? I encourage that to be the case.

5:24 pm

Photo of Ursula StephensUrsula Stephens (NSW, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition (Social and Community Affairs)) Share this | | Hansard source

I rise to indicate that Labor support these amendments on the basis that we would like to see some improved policy coherence on these kinds of issues. This is something that the Democrats have pursued very actively on a range of legislation, so we will support them on that basis.

Photo of Brett MasonBrett Mason (Queensland, Liberal Party, Parliamentary Secretary to the Minister for Health and Ageing) Share this | | Hansard source

I understand that the Australian Democrats have raised, in similar contexts, amendments to include same-sex partners in the definition of a spouse. Can I indicate to Senator Allison that the government will oppose these amendments. There are no plans to change current government policy at this time irrespective of the views of individual coalition senators. Same-sex couples cannot register as a family because Medicare is limited by the definition of ‘family’ in existing Australian government legislation. As Senator Allison did indicate, the relevant provisions are section 10AA of the Health Insurance Act 1973 and section 84B of the National Health Act 1953, which state that a family comprises a person’s spouse and/or dependent child, with ‘spouse’ being further defined as a person who is legally married to that person or de facto of that person. ‘De facto spouse’ is further clarified in section 4 of the National Health Act 1953, which defines the term as ‘a person living with another person of the opposite sex on a bona fide domestic basis although not legally married to that person’. It is this section that would need amending if same-sex families were recognised for Medicare and Pharmaceutical Benefits safety net purposes. There are no plans to change current government policy at this particular time, and the government will oppose this amendment.

5:26 pm

Photo of Lyn AllisonLyn Allison (Victoria, Australian Democrats) Share this | | Hansard source

I am grateful to the minister for his advice about which act and which clause would need to be amended in order to deliver on this piece of social justice and human rights; however, I will confine my comments to his remarks about the coalition’s not acting on the comments—I think those were your words, Minister—of an individual member of the coalition. As I said to you, it was the Prime Minister who made this comment, not some backbencher in the Senate or the House of Representatives. We have become accustomed in this place to understanding that, if the Prime Minister says it, there is a fairly good chance it will happen. But, just to reiterate what you have just said, there are no plans here—or in any other legislation, presumably—to right this wrong despite the fact that the Prime Minister identified it some time ago. So that is very disappointing.

This is an issue that goes beyond the mere question of safety nets. This should be about an equitable society—where people are treated equally, particularly when it comes to benefits and measures such as the safety net. Whatever you think about the safety net and whatever you think about same-sex couples, the question is one of equality and fair treatment across the board. The Democrats see no reason to continue this discrimination. It is disappointing that, despite the fact that the Prime Minister also sees no reason to discriminate, this discrimination will continue for the foreseeable future under a coalition government.

5:22 pm

Photo of Andrew BartlettAndrew Bartlett (Queensland, Australian Democrats) Share this | | Hansard source

I do not want to detain the Senate for an excessively long period on this, but I do think it is worth emphasising what specifically is stated here. I am sure Senator Mason will listen to this information and take it on board—he is now in a position of much more power, authority and influence these days, as is Senator Johnston behind him. Senator Mason might not be aware of the full background to this, but the Prime Minister is capable of supporting amendments such as this because he did do so once—about three years ago. It was the only time during my period as leader that I chose to have a joint press conference with Mr Howard. I sat at one of those little lecterns out in his fancy courtyard, where we were able to talk about the fact that he had agreed to amendments that would open up access to superannuation entitlements for same-sex couples. It was part of reaching agreement on the superannuation choice regime. Not surprisingly, Mr Howard was more keen to talk about superannuation choice and I was keen to emphasise the same-sex couple changes; nevertheless, they were agreed to.

It took, I think, about three years. The government actually held up their own superannuation choice regime. They quite rightly thought the regime was a good idea—and, after it was tinkered with by the Democrats, it was reasonably good. But they were willing to hold up the entire thing for three years because of just this issue. I am thankful to the Prime Minister, and I think Senator Coonan in particular should be noted for enabling that change to occur. But it does need to be emphasised that the Prime Minister himself said at the end of 2005 that he does not support discrimination against same-sex couples in regard to access to entitlements, and he thinks most people would not. That is totally separate to issues of marriage, adoption and those things. But there has been no action.

We have had a HREOC inquiry in great detail that has reaffirmed the enormity of the discrimination that exists in a whole range of acts. To me, it really goes to the issue that there is a range of people in the coalition who, due to all the other distractions that we all have, have not been across the detail of what has been said on the record by the Prime Minister and what the past record is.

I would also point to some speeches. We are putting great store in the Prime Minister here, but I think we should not totally belittle the role of the humble backbencher, which every minister was once upon a time. I can recall some very fine speeches in this chamber towards the end of last year, again on this very topic and on the Democrat sexuality discrimination bill, which has been in this chamber since 1995, seeking to address issues like this. There was a very supportive speech given by Senator Brandis, as I recall. If I might say so myself, it was a better speech than the one I gave. It went to the point so well—it was so well constructed. Maybe that is the reason why he has become a minister! Perhaps Prime Minister Howard heard it and thought: ‘He’s a man after my own heart. We’ll make him a minister.’ Maybe that is why he got Arts; who knows? And it was not just Senator Brandis but one or two others as well who made very good, cogent arguments about how this is completely appropriate in principle. But still we see nothing happening.

It needs to be emphasised that it is one thing to just put up an argument and say, ‘No, this is bad policy; we don’t support it,’ for whatever reason. Frankly, in some ways it is worse to be continually making statements saying, ‘Yes, we do think this discrimination is bad; we don’t think it’s good; we do think it needs to change,’ and then still have nothing happening. In some ways that is actually worse. So I urge all coalition members to revisit this issue, to look for an opportunity to add to that pressure that I know is being applied to see if we can get change. There is the report from HREOC that I think will be tabled in this parliament by the end of this sitting fortnight. I fully expect that it will strongly reinforce the case that the Democrats have been making for 12 years or so in this place, as have senators from other parties and Senate committee reports, including reports from the Senate committee on superannuation and including specific reference committee reports. There is an overwhelming mountain of evidence. There are now an overwhelming number of statements in support. All we need is that action.

I would suggest that it goes to an issue of credibility, beyond just the pros and cons of the policy. If you have statements being made continually of a certain position or belief and they are not then followed up with action, it does call into question the integrity of the belief and indeed the integrity overall of that party and their leadership. If they make repeated statements and then do not follow up on them, it is a bit hard to do anything other than draw the conclusion that perhaps they are not genuine. If they are not genuine on that then maybe they are not genuine on other things either.

It might seem like a second-order issue to a lot of people, but to many people it is a top-order issue, not least because it has been promised for so long and so little has been delivered on it, despite the bits that the Democrats have managed to get over the years, particularly in the area of superannuation. So I do urge people, in the period between now and the election, to look at that HREOC report when it is tabled and perhaps even after that consider acting on it.

I should say as well that I welcome Labor’s support on these amendments. It has not always been forthcoming on all occasions, and it is pleasing to see that being more consistently applied as well, so that it is acted on if they do get into government.

Photo of Andrew MurrayAndrew Murray (WA, Australian Democrats) Share this | | Hansard source

The question is that items (1) and (2) on sheet 5279 be agreed to.

Question negatived.

Bill agreed to.

Bill reported without amendment; report adopted.