Senate debates

Friday, 28 June 2013


Health and Other Legislation Amendment Bill 2012; Second Reading

10:01 am

Photo of Concetta Fierravanti-WellsConcetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | | Hansard source

I rise to speak on the Health and Other Legislation Amendment Bill 2013, which is yet another bill which is going to be guillotined in the dying hours of this parliament, to add to the other 55 bills that will be guillotined and the 216 bills that this government, with their Green alliance partners, are guillotining in this place. It is absolutely outrageous, but I am not surprised that this bill has been shuffled in. It has been on the Notice Paper about five or six times, but it is little wonder that we are seeing it now in the dying hours, because this is a bill that is intended to clean up another major stuff-up by this Rudd-Gillard government. This one is sheeted home to Mr Rudd, because when the stuff-up occurred he was at the helm. Here we are, in the dying hours, trying to retrospectively fix a major problem that this government has created.

This bill contains a number of non-contentious issues. It deals with various changes in relation to food standards, medical training and industrial chemicals. I will not dwell on those. The contentious issue of this bill surrounds Medicare. Medicare is a brand, as we all know, that belongs to the Australian people. As the law currently stands, the use of the word 'Medicare' is protected by section 41C of the Human Services (Medicare) Act 1973. This provision creates an offence of the use of the name 'Medicare' in connection with a business, trade, profession or occupation. Where the name 'Medicare' or a prescribed symbol is used as part of the name or emblem of an association, or in connection with any activity of the association, the association, if it is a body corporate, is guilty of an offence. If the association is not a body corporate, every member of the committee of management is guilty of an offence. Section 41C(6) does state:

Proceedings under this section shall not be instituted without the consent in writing of the Attorney-General.

And so we have, in 2010, then Prime Minister Rudd announcing his grand health reform agenda, which included replacement of divisions of general practices with new primary healthcare organisations to be known as 'Medicare Locals'. Of course, at the time they initiated this so-called health reform agenda, the member for Griffith was Prime Minister and former Attorney-General Roxon was the Minister for Health and Ageing. It is a matter of public record that their working relationship was, suffice it to say, less than ideal. It is very clear from comments that have been made recently how Ms Roxon actually feels about Mr Rudd. Having trawled through the innards of that so-called health reform, it is very clear why their relationship was such a negative one. One can only imagine the conversations when Prime Minister Rudd and then Minister Roxon trawled through those hundred hospital visits in their white coats—Doctor Rudd and Nurse Roxon trailing around the countryside, basically photoshoots. The photoshoots were really what it was all about.

Now that Prime Minister Rudd is back, no doubt it will all be about photoshoots and spin, because that is all the so-called health reform was about—that and the billions of dollars that have been wasted on all those new bureaucracies which are doing very little and not serving patients. All this money has been wasted on bureaucracies, and not one patient has been assisted. But let me return to the bill at hand.

Nineteen Medicare Locals were established in July 2011, and the full 61 were operational in July 2012. They have been established as companies and receive funding from the Department of Health and Ageing. According to the act, those entities may be guilty of an offence for use of the name Medicare. Clause 22 of the bill repeals section 41C(6) and replaces it with an exemption to offence provisions for activities authorised by the secretary or a prescribed delegate. What does that basically mean? The clear purpose of this legislation is to retrospectively legalise the government's franchising of the Medicare brand to Medicare Locals and also give the government greater scope for similar future activities—as I said, nothing more than retrospectively fixing a bungle that this government created. Now they are doing it in the dying days of this parliament in the hope that it will all be shuffled under the carpet and nobody will notice.

Under Ms Roxon, the then Minister for Health and Ageing who set up these entities called Medicare Locals, it is very clear that all Labor were trying to do was look for the headline. That is why they chose to use the name Medicare; it was to dupe people into thinking they were going to receive some sort of medical service. You would think that, when a member of the Australian public enters a Medicare local, they would have some very reasonable expectations of some form of medical service, but under this government nothing can be assumed. You cannot enter a Medicare local office and receive any form of Medicare assistance. You cannot enter a Medicare local office and have a Medicare claim processed. You cannot enter a Medicare local and see a doctor. You cannot enter a Medicare local and see a nurse or receive any form of medical attention. In fact, Medicare Locals have absolutely nothing to do with Medicare or with any form of medical assistance.

When I first heard the name 'Medicare local', I thought it was a place to get a refund and a beer! Indeed, over estimates I have actually asked what bright spark in the Department of Health and Ageing came up with the name. I asked back in 2010. Now I understand why the bureaucrats gave me a weasel-word answer. I never got a straight answer to my question. I asked again in 2011 and again I did not get a proper answer. On 6 June this year I again trawled through, and it was very clear by the gobbledegook that I was given—the bureau babble speak—that this was nothing more than a massive stuff-up that the government is now trying desperately to rectify, because all Medicare Locals, as the law stands at the moment, are in breach of the law. It is another monumental display of incompetence from a desperate and dysfunctional government in a blatant attempt to fool the Australian people into thinking that they are getting some form of health benefits.

I would like to know from the minister how much money has actually been wasted by this government on building the brand name 'Medicare Locals'. I would like to know from the minister when this government was first advised that using the name 'Medicare Locals' was a clear breach of Commonwealth legislation. I would like to know what exactly a Medicare Local is—what do they actually do? We have trawled through hours and hours of estimates, hours and hours of discussions in relation to—

Senator McLucas interjecting

Yes, that it is right, Senator McLucas, because they do nothing. They do absolutely nothing; they are just a waste of—

The Acting Deputy President:

Order! It is disorderly to interject, and, Senator Fierravanti-Wells, you will not respond to the interjections.

Photo of Concetta Fierravanti-WellsConcetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | | Hansard source

Medicare Locals are just another layer of bureaucracy which removes even more money from frontline services. For this reason the opposition will be moving the second reading amendments in relation to this. In an act of desperation to justify over 3,000 new bureaucratic positions in the Medicare Local network, Minister Plibersek has sought to misrepresent the findings. In a report released by the—

The Acting Deputy President:

Order! Senator Fierravanti-Wells, under standing order 193, imputation of improper motives is disorderly.

Photo of Concetta Fierravanti-WellsConcetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | | Hansard source

Minister Plibersek has sought to indicate that the findings in a report released by the National Health Performance Authority, Australians' experiences with primary health care in 2010-11, are not what they seem. In her press release, 'Report highlights the importance of Medicare Locals', she makes the following two inconsistent statements: 'The National Health Performance Authority report reinforced the importance of Medicare Locals.' She also states: 'while the data in this report predates the establishment of Medicare Locals'. So, in one quote the minister pretends that a report justifies 3,000 staff that have grown from a couple of hundred in 12 months when the report, by her own admission, was compiled under data predating the establishment of Medicare Locals. This is the first time that we have seen Minister Plibersek confirming that there are over 3,000 people, mostly staff, who do not see any patients and are employed across the Medicare Local network. Now this government is spending over a billion dollars on its dozens of new bureaucracies, new structures, and it wonders why it has no money left for patients.

From a coalition perspective, we have consistently said that we support a role for the coordination of primary care, but we do not support money being prioritised away from patients into vast bureaucratic structures. It is also worth noting that the Department of Health and Ageing and its existing agencies already employ over 6,000 people. According to the minister, this number has effectively increased by 50 per cent. When the sad and sorry saga of the Rudd-Gillard government comes to an end, Minister Plibersek will be remembered for pouring taxpayers' money into bureaucratic positions and not pouring money into more doctors, nurses or beds. For this reason the coalition has indicated that we will be formally reviewing the structure of Medicare Locals if we are elected in September.

In this debate it is worth pondering on some of Labor's health record during its time over both the Rudd and the Gillard governments: $1.6 billion ripped out of public hospitals; $4 billion ripped out of private health insurance; and $1 billion ripped out of dental health through the closure of the Medicare Chronic Disease Dental Scheme. There was the promise of 16 early psychosis prevention and intervention centres, EPPICs, which were supposedly to be in partnership with the state governments. Whilst the agreements were about to be signed with some of those governments, all of a sudden Minister Butler changed his mind, ripped all that up, and decided to change his tack on the centres, and all we have is a one-page press release with very, very little detail as to how all of this is actually going to occur.

I am conscious of the time, so I will make some general closing comments, because I do know that Senator Back wants to make a contribution in this space as well. The coalition, as I said, continues to support a role for coordination of primary health services. However, it is very, very clear that there remains a considerable lack of detail and conflicting information regarding the objectives of Medicare Locals. In relation to the current level of practical assistance provided to general practice there is a lack of detail about allied health professionals and patients and about how funding is being administered. We know that there is a lot of money being channelled through Medicare Locals, but we do not know how that money is being administered. More importantly, is it being administered effectively and is the Commonwealth getting value for money for these so-called 'services'? Are they effective in regard to their cooperation with the local hospital networks to keep people out of hospitals? We keep hearing that the lists in our hospitals are growing, and supposedly Medicare Locals are assisting with those lists, but the lists are increasing. We know that there is a duplication of function with existing state health programs, but we do not know how Medicare Locals determine market failure in their area and intervene without disrupting existing services. It is very important that, given the significant investment the Commonwealth is making, the coalition ensures that that funding is being spent as effectively as possible.

I conclude by saying that this bill is mostly uncontentious, barring the issue surrounding Medicare Locals. It is nothing more than a blatant attempt to fix up what has been a massive stuff-up by the government by trying to pass off a name, which is well known to the Australian people as an office that delivers a particular service, to somehow buy themselves goodwill with yet another bureaucracy that we now know employs 3,000 people. We do not really know what they do and they certainly do not provide any services to Australians. It is an absolute disgrace. It is so typical of not only the dysfunction but the waste of these governments under Mr Rudd then Ms Gillard and now under Mr Rudd again. Of course, it will not be finishing there because, now that the ego has landed, I am sure we are going to see so much more spin and many more photo shoots that were so characteristic of his previous time as Prime Minister. As I said, the coalition will be moving an amendment to this bill.

Photo of Christopher BackChristopher Back (WA, Liberal Party) Share this | | Hansard source

With regret I reflect on the gross embarrassment that has been visited upon this government when, on the last day that the 43rd parliament is sitting, we have to rush in through the back door and try to undo a gross level of incompetence that started with this Prime Minister, who was 'that Prime Minister Rudd', and is now the recycled Prime Minister Rudd, along with his then health minister Ms Roxon. What a shame Yes Minister or Yes, Prime Minister are not still alive, because there would be richness in the incompetence of this government should the writers of those series ever want to pick the pen up and have another go.

They, of course, reflected on the hospital with no patients. Here we have something far worse: the action of a government led by an incompetent minister with oversight from a grossly incompetent Prime Minister. They managed to establish a scenario in which the name Medicare, a prescribed symbol, should be used only in relation to Medicare itself. They found themselves in a circumstance where, by using the term Medicare Local, they made the body corporate of any association using the term guilty of an offence. If an association that used the term Medicare Local, as approved illegally by this government, was not a body corporate, then every member of the committee of management of that association was guilty of an offence.

What a scandalous situation—a Prime Minister who by that stage was totally out of control, a cabinet who could not in any way bring the man back to focus on good policy. The most endangered thing at that time was anyone who got between Mr Rudd and a camera or between Mr Rudd and a member of the media, who had been duped by the plethora and the football team of spin doctors. A health minister found herself in a scenario in which she was oversighting a circumstance where, under the Human Services (Medicare) Act 1973, section 41C, entities would be guilty of an offence if they used the name Medicare.

We have to look to the future because the present and the past, unfortunately, are littered with failure by a man whose own side had to remove him as Prime Minister simply because in their minds he was so incompetent that he could not govern the country. We then had transparency, we then had the light being let in for three years and—almost to the day—Ms Gillard, who replaced Mr Rudd herself, was then deposed only this week. I do not know if the young people in the gallery were here earlier in the week but, if you were, you were actually part of history when the second Prime Minister unelected in this circumstance was replaced by the first.

Should the coalition be privileged with government after the election—whenever that is held; it was to be 14 September and, if it comes forward from that, that is the end of the local government referendum, and if it is after that, who knows what will go on?—there is one thing that the Australian people have to know. The country will be led by a man who was an outstandingly successful health minister—Tony Abbott, a person who during his ministry significantly increased medical research funding in this country, a person who was able to extend the benefits of Medicare to allied health services including diabetes treatment, a person who singularly and spectacularly was able to significantly decrease the incidence of smoking by young people with the introduction of graphic health warnings. Contrast that with the efforts of this government recently with the new world-first legislation that has completely and utterly removed the names on packages to no effect. In fact, we do not know the reason and we are going to try to examine it. A large retailer in Perth recently told me there has been an increase of 25 per cent in the purchase of cigarettes through his retail operations since that came in.

I go back to the excellence of Mr Abbott as health minister and the introduction of the Gardasil vaccine against human papillomavirus for young girls and women in this country, a world first. We have heard from the other side again—we hear it quite often from the person who is now the Leader of the Government in the Senate, Ms Wong—about the fact that Mr Abbott seemed to rip $1 billion out of the health budget. Let us actually examine what happened in that case, because in their last days the Labor government might learn something. Mr Abbott sat down as the minister and consulted widely with the health industry, with his own leaders and with state leaders. And you would not believe what they did: they set a budget to achieve clear guidelines and clear objectives—and they achieved those objectives and those key performance indicators. Like a good steward of good government showing good use of Australian taxpayers' money, they came in at $1 billion under what was budgeted. Was that a waste of taxpayers' money? If people think so, let them make that decision on the day the election is held.

But I go on further, if I may, because I understand from my leader in this area, Senator Fierravanti-Wells, that in government the coalition will commission a formal review and it will look at those key elements upon which this government, the Labor government of Mr Rudd, has been a failure. I have already been part of that review process, when we brought the now shadow health minister, Mr Dutton, to the town of Narrogin in the Great Southern of WA some weeks ago. Nine or 10 shire representatives, aged-care providers, doctors, nurses and others came in and Mr Dutton sat down and did something this crowd would not know about: he actually listened. And I am very proud to say: in the aged-care area, Senator Fierravanti-Wells will be doing exactly the same thing in my home state of Western Australia in the near future.

In the time left available to me, I want to reflect on the terms of reference for the review that will be undertaken by the coalition. It is to evaluate the practical interaction with local hospital networks, including their boundaries. It is to examine tendering and contracting arrangements. It is to look at general practice and the capacity, as Mr Dutton so eloquently said in Narrogin recently, to actually recognise general practice as the cornerstone of primary care, which, of course, this government has removed. It is to ensure Commonwealth funding supports clinical services—clinical services rather than administration. I hope the young people up there in the gallery are feeling healthy and well and I hope they are attending to their studies, because what they need to know is that, under this government, under the leadership commenced by Mr Rudd, now having picked up that mantle again, this country today is paying $1,000 million a month interest on the debt that the Labor government has run up. That is $1 billion a month in interest—not in repayment of the debt; just in paying the interest.

Senator Eggleston is himself an eminent doctor. How many hospitals around Australia, Senator Eggleston, through you, Mr Acting Deputy President, could be built in this country for the $1 billion that we are now spending a month on interest? How many nursing posts around Australia could be established? How many medical practices could be supported? What medical and related research could be undertaken? What dental activity can be undertaken for low-socioeconomic members of our community just with the money that would be saved if this government had not squandered your money? I say I hope you are all in good form because it will be you, and even your children, who will be paying back that debt over time.

This is the tragedy in rural and regional Western Australia now. Provision of medical services in many areas is now broken. It is a joint responsibility between federal and state governments. But as Senator Eggleston and I know in WA, local governments themselves are paying money that they really do not have, up to a quarter of a million dollars a year, just to provide doctors in those small communities. If there are no doctors, you cannot expect families to stay.

So therefore we have a circumstance, unfortunately, where local government is having to stump up its own money. Why in heaven's name local governments in rural Western Australia would be supporting a referendum to give the federal government some control over their affairs where they currently have none I cannot possibly conceive. All I can do, as Senator Fierravanti-Wells has said, is to hope this crowd do not do more damage before they are kicked out.

Photo of David FawcettDavid Fawcett (SA, Liberal Party) Share this | | Hansard source

Order! The time allotted for the consideration of this bill has expired. The question is that this bill be now read second time.

Question agreed to.

Bill read a second time.

Photo of John HoggJohn Hogg (President) Share this | | Hansard source

The question is that schedule 1 stand as printed.

Opposition's circulated amendment—

(3) Schedule 1, items 20, 21 and 22, page 5 (line 15) to page 6 (line 26), items TO BE OPPOSED.

10:36 am

Photo of John HoggJohn Hogg (President) Share this | | Hansard source

The question now is that amendments (1) and (2) on sheet 7341 circulated by the opposition be agreed to.

Opposition's circulated amendments—

(1) Clause 2, page 2 (table item 4, column 1), omit "items 20 to 23", substitute "item 23".

(2) Schedule 1, page 5 (line 14), omit the heading.

Question negatived.