Monday, 2 May 2016
Questions without Notice: Take Note of Answers
Education Funding, Medicare
That the Senate take note of the answers given by the Attorney-General (Senator Brandis) and the Minister for Regional Development (Senator Nash) to questions without notice asked by Senators Dastyari and Gallagher today relating to schools funding and to funding for pathology and diagnostic imaging.
Honourable senators: Fantastic!
It's fantastic! Sorry, I am trying to compose myself after the hilarity of the comments coming from this side of the chamber.
The answer we heard earlier from the Leader of the Government in the Senate, Senator Brandis, really defied belief. This notion that the government are trying to dress up a $29 billion cut in future education funding as some kind of achievement really defies belief and it defies logic. This is the journey the government have been on, and let's be clear: they started off by saying that they were going to be on a unity ticket with Labor when it came to Gonski funding. Then the new minister, Senator Birmingham, indicated that he would be somehow favourable to funding the Gonski model. Then, on the eve of Christmas, right at the end of the year, in the dead period, the government came out with an announcement that no Gonski funding was going to be made available. Then we had the thought bubble that came from the Prime Minister himself: 'Hey, not only should we not fund the future funding that's needed in our schools, but let's not fund schools at all. Let's just palm it off to being a state responsibility.' This is a matter which, we discovered in evidence given to a Senate committee, was not even discussed with or run past the department itself. I see Senator Birmingham leaving. His own department found out about it from the media statements or by watching it on television. Then, the weekend before the budget and a week before the calling of an election, there was this weak, measly announcement from this government that it is going to find a few extra billion dollars in the next couple of years. This is not a plan to fund schools; this is a plan to get the government through an election. This is an election strategy, not a school funding plan. Frankly, the government keeps changing its position here.
I will take your interjection in a moment, Senator Bernardi; do not worry about that. Funding matters. Funding schools matters. How you fund also matters. The Gonski proposal that has been put forward allows us to fund our schools properly. That is the proposal that was taken to the last election. That is the proposal that this government had purported to be signed up to, and now it is trying to hide behind this notion.
By the way, their position has changed on this. Two weeks ago, it was, 'Money doesn't matter at all.' Now it is, 'Oh, well, we're going to make the money be spent better.' The best way to spend the money is by following the Gonski model, the proposal that was developed, and you are not going to be able to achieve that without putting the money there. You are not going to be able to achieve that without actually having that funding available. What the government have now done is cut $30 billion of future funding from our schools, and the consequences of that will be devastating.
I see Senator Bernardi there shaking his head. Senator Bernardi has issues about funding schools. I appreciate that, and I understand that. It must have been a tough week for Senator Bernardi in Adelaide. There was the A-League final. His city was overrun by a bunch of halal-eating, drum-beating, Sydney-loving football fans.
I am not quite sure that was really in line with the question. I am not sure how to cop those comments through the chair, Mr Acting Deputy President. The school funding proposal the government has put forward is a $30 billion cut in future school funding, and that is disgraceful.
I am not sure where to begin, but I should make reference to the sledge that Senator Dastyari has made against my great state of South Australia and my home city of Adelaide. I find it extraordinary that Senator Dastyari can talk about education modelling and then weave in there some halal-eating or whatever it was—abuse of South Australia. It just goes to show how Senator Dastyari and the Labor Party are fixated only on Sydney-oriented issues and are out of touch, completely, with what is going on out there in the economy.
Going to the education of our youth, which is absolutely vital to our success and future prosperity as a nation, Senator Dastyari glosses over the fact that education funding, in real terms, has doubled over the last 20 or so years and yet, by almost every performance measure, the literacy and numeracy standards of our children and our students have been in steady decline. Something is not working. Senator Dastyari said it is just about more money. It is actually not just about more money; it is about delivering good and positive outcomes. That is something—accountability—that those on the other side of the chamber have never been very good at accepting. Their answer, like a lot of the socialist policies, is to throw other people's money at something with the appearance of achieving an outcome. They are never, ever held to account or hold themselves to account. They never put in performance standards that are going to be measurable, because it exposes how flawed and failed their policies generally are.
It is, I think, a testament to that that Senator Dastyari cannot even fill five minutes talking about education policy. He has to turn and slam Football Federation Australia and the championship league, which has been fantastic for the sport in this country, and then has to turn his ire on Adelaide and Adelaide United Football Club, which has been, I think, an inspiration to so many. Not only have we fought a number of finals; we finally took the championship home. We took the Premier's Cup home, of course, which was very important to finishing on top of the table and making the final. So, while Senator Dastyari wants to profess he is sticking up for students, he is actually sledging perhaps one of the most popular games in the country and in the world by making fun of the Adelaide United Football Club.
But that is the sort of thing we can expect. They get sidetracked. They cannot focus on one particular thing. We have seen them jump all over the place today in question time. They have not been focused, and it is clear, from my point of view, that they are like a rudderless ship over there. Their question time committee, which is planning the questions, does not know where to start. They do not have any fixed narrative, because the only thing they are consumed about on that side of the chamber is their own preselections and keeping their jobs. We know how they are tearing themselves apart, ripping into each other about who should be getting seniority in their preselections and things of that nature. It is unedifying to read about and to hear about. The whisperers, who come up to you and say, 'I am looking after myself but I am going to stick it to someone else over there in the preselection process,' are grubby to say the least but they are the sorts of side deals we see in the Labor Party all the time.
I think it is entirely unreasonable that Senator Cameron, who is a shadow minister, is put behind Senator Dastyari on the Senate ticket for the New South Wales Labor Party. It just does not make a lot of sense to me. Senator Cameron has seniority and high ranking, and it seems to me he has been marginalised and shafted just because of his extreme political views. I find that rather unusual. You have then got Senator Dastyari, who has been promoted to shadow opposition manager of whatever it was—business in the Senate or something—leading the charge against increased funding for education by the government. That is extraordinary. Here is a man that is playing the tactics of the Labor Party. He has got unfunded election promises coming out by a leader that is only supported by a tiny minority on the other side. They cannot wait to replace him—we know that from the conversations that we have on this side of the chamber with our opponents over there.
The budget tomorrow night is going to be an opportunity— (Time expired)
I did listen with interest to Senator Bernardi's five minutes. I would say, after making comments around Senator Dastyari's presentation, Senator Bernardi got to the budget in the last second of his five-minute speech after spending a lot of time on preselection for some reason, which was not raised too much in question time today.
I am going to focus my comments on the answer to the question that I put to Senator Nash on the $650 million worth of cuts to pathology and diagnostic imaging that were contained in the government's MYEFO in December last year. I have to say, it would only be this government that would dare to run the line that there would be no impact when cutting $650 million out of the health budget. It is probably only this government that could be that barefaced and argue that there will be no impact on patients when $650 million worth of funding is cut out of the health budget. This is off the back of $80 billion worth of cuts to the health and education budgets in the 2014 budget. This government pretended for almost 18 months to two years that there had been no cuts, only then to replace small amounts of funding—$2.9 billion in health and $1.2 billion now in education—and pass it off as new money that we should all be grateful for. I think this is the only government that could pretend after cutting $80 billion that putting $3 billion back is something we should be grateful for and is new money. This government has sought to cut the health budget in every budget and MYEFO since elected. There is a real difference between the Liberal Party and the Labor Party when it comes to attacking Medicare, when it comes to cutting hospitals, when it comes to cutting the health system.
The minister today in her answer referred to the $650 million that is being cut from pathology and diagnostic imaging which goes to supporting bulk-billing rate—over 85 per cent of consultations are bulk-billed—as 'wasteful spending'. That was a quote from the minister in question time today. She also said that the campaign to stop these cuts was based on miscommunication and scaremongering. I do not think that is correct. I think everybody who has looked at this closely understands that when these cuts come in on 1 July—and the professional groups have been very clear about this—there will be increases to the costs for people who are getting medical tests, imaging and other diagnostics. They have not only been clearly detailed by industry but also acknowledged by the government.
The way the system will work is when a bill needs to be paid, it will have to be paid in full prior to any Medicare rebate. We have been advised that patients will have to pay up-front for individual tests up to $93 for an X-ray, $396 for a CAT scan, a minimum of $85 for a mammogram and up to $186 for an ultrasound. If you need a PET scan, which hopefully you will never need, the up-front costs could hit $1,000. Let us focus for a moment on those with chronic and ongoing conditions who have to have frequent tests and ongoing tests. This incentive program has supported and maintained bulk-billing rates in pathology and diagnostic imaging. It is actually a good outcome that bulk-billing rates are sitting at about 86 per cent. It means that people are being supported to have their tests and that financial considerations do not come into it. It means they will come to get screened; they will take preventative action to maintain their good health and that is a good outcome.
This $650 million cut, which the minister referred to today as 'wasteful spending', will increase costs for patients. It will increase out-of-pocket costs and it will have pathologists and diagnostic imaging businesses reconsider bulk-billing. They will be the results of these cuts and to pretend otherwise is disingenuine.
I have a very personal interest in the debate before the chamber and that is in relation to pathology testing. I do not keep it a secret—I do not think anybody else is interested—but I have a plastic valve in my heart which was put there 20 years ago. As a result of that, I have got to keep my blood thin, which means that I am on warfarin, which means I have to have a regular tests at a pathologist to make sure my blood is thin enough on the level to go through the artificial valve. So I am very familiar with pathology services. They perform a great service to Australians. In the 20 years I have been intimately involved with them I have seen other people there. The staff at these pathology collection places are brilliant. I have actually been through one of the pathology headquarters in Townsville and looked at some of the amazing work they do. They do very significant work. My GP and other medicos tell me that it is important to be able to refer people to pathologists to double-check for various illnesses that pathology can detect before anything else. It is a great service. I have to say that when I last went to my pathology place there were little posters on the chairs saying, 'Pathology money going up as of 1 July.' I said to the people there, whom I know very well, 'How much is this going to cost me after 1 July?' Their answer was accurate: 'Nothing—as it does now.'
That is a long way of getting around to making it quite clear that the government is not changing the Medicare rebate payable to patients. In spite of the massive campaign by the Labor Party to the contrary, the facts are there. What is happening is that this bulk-billing incentive, which I think costs something in the order of half a billion dollars, is being taken away. For half a billion dollars of expenditure by the Labor Party when in government, the increase in bulk-billing rates has been one per cent—one per cent for half a billion dollars.
Mr Acting Deputy President, I make the point that this is not government's half a billion dollars spent on trying to get more people into bulk-billing and wasted, effectively, because it clearly did not work. This is not the government's money because, as I keep saying, the government do not have any money. They only use taxpayers' money. Strangely, taxpayers never like giving the government—any government—any more than they are already giving. It is a question of value for money. Half a billion dollars has been wasted by the Labor Party, as always. That in itself is not a profound statement; that is what the Australian public have come to expect. Put Labor in charge of the money and they will just waste it. That is what happened with this. I suspect they probably had a good policy thought, but if they did it has clearly not worked.
What we want to do is take away that half a billion dollars and divert it to other areas of the health budget. I understand that an area it is going to is one that I and Senator Dean Smith, amongst many others, have had a particular interest in, which is trying to help those with hepatitis C. Fortunately, this government has recently put these miracle drugs for hepatitis C onto the PBS. In rough terms, the drug costs about $80,000 to $90,000 for a 12-week course that will almost 'cure' hepatitis C, but the patients will now get it for $36. Someone has to pay for that $90,000 per treatment that is going to people with hepatitis C. Part of it will come from the half a billion dollars wasted by the Labor Party in this silly bulk-billing incentive. I repeat: the government is not changing the Medicare rebate payable to patients. That will go on after 1 July as before.
I will pick up on those words 'someone has to pay'. I will tell you who that someone is: any Australian who has to make an out-of-pocket payment to their diagnostic imaging service or pathologist before they can get access to vital information about their health and wellbeing that will inform their doctor's decisions about how to treat them.
We know that over 70 per cent of medical treatment decisions rely on pathology. The sorts of people who Senator Macdonald thinks should be paying out of pocket before they get their tests were described by Dr Wriedt, the President of the Australian Diagnostic Imaging Association, when he described what would happen for a mechanic with a suspected brain tumour. I want to acknowledge Senator Bilyk here, who is a very significant champion for recovery from brain cancer. She does great work in that area. This mechanic:
• Will no longer be eligible for the bulk billing incentive…
• His Medicare rebate will be cut by $62
• To pay a gap of $62 or more, he will have to pay at least $403 up front before being able to claim the Medicare rebate
Can you imagine the scenario, Mr Acting Deputy President? Your doctor says: 'I fear that you have a brain tumour. I want you to go and have an MRI.' Already you can imagine the distress in the family. I am thinking about families right across New South Wales, the great state that I represent. What do they do if they have not got the $403?
The minister today seemed to think it was quite okay. She had no shame at all in saying, 'We will cease this bulk-billing.' The cost will be a human cost in people not being able to overcome the impediment of that up-front fee before they can even get their diagnosis, to say nothing of the ongoing testing that will be part of their journey of health recovery. That is the heartlessness of this particular government and the foolishness of the sorts of decisions they are making about the way in which money is being spent. It is such a false economy to prevent people undertaking the sorts of tests that preventive health constantly recommends to us, like people with diabetes getting their blood tested to manage their illness. We know that this is a vital part of the service, yet this government believes it is a great idea to put another barrier between people and good health and wellbeing.
Dr Wriedt described this particular injustice as a non-evidence-based change. He said, 'This is a cash grab and a co-payment by stealth.' There has been no consultation: 'This is a minister who has been at pains to say she wants to work with clinicians, and yet this announcement has come completely out of the blue with absolutely no consultation.' Dr Wriedt also said: 'In simple terms, this will make it much more difficult for many patients to receive the life-saving level of care they need.' And that is the problem with this government—as if destroying Medicare was not enough, they want to have a go at access to pathology and to diagnostic imaging as well.
I also want to make some comments around education, because we have seen from this government, in the course of the period in which they have governed, a constant litany of comments along the lines of, 'the money does not matter'. Even though they promised before the last election to match Labor's funding dollar for dollar, they changed their mind upon election and they withdrew $30 billion. This tiny amount of money that they have now announced, just days before parliament rises, is an attempt to pull the wool over the eyes of the Australian public once again—and pretend that they are actually going to invest in education. But people should remember that on 30 and 31 March this year, the Prime Minister revealed what he really thinks about public education when he said that the federal government should continue to fund private education and walk away from government education. This government told people they would match, dollar for dollar, Labor's commitment to the Gonski funding and instead, we find that, the minute they were elected, they walked away from that. We cannot trust this government on education. We cannot trust the Liberal-National Party on education—not for a single day, and certainly not when they have made this paltry offer of some money to assist, at the last hour, having declared day after day that money does not matter. Well, money does matter for the future of our children. The Labor Party believes in investing in every child in every part of the country.
Question agreed to.