Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

I rise today to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. The opposition will support this bill because the bill seeks to implement a suite of measures designed to protect the integrity of Medicare, strengthen the regulation of goods under the Therapeutic Goods Act and introduce minor but necessary amendments to the tobacco act.

These changes form part of the government's response to the Independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip. Dr Philip's review revealed serious issues in the administration of our health benefits scheme, particularly in the ability to detect, investigate and respond to fraud, misconduct and noncompliance within Medicare and associated schemes. The bill takes some practical steps to improve that situation. It seeks to provide the department with the tools necessary to carry out timely, efficient and effective compliance activities—measures that are essential to maintaining the public's trust and confidence in the Medicare system and ensuring taxpayers' funds are spent and used appropriately and wisely. I also note that the Senate inquiry into this bill, which reported during the recent caretaker period, has recommended the passage of this bill.

For these reasons, the coalition will be supporting those recommendations, because we've long championed the need for strong and fair compliance within Medicare and other critical programs like the Pharmaceutical Benefits Scheme and the child dental benefits scheme. We believe that preserving the integrity of these systems is fundamental in delivering a sustainable and equitable healthcare system for all Australians.

However, while we support this bill and the improvements it seeks to deliver, we must also confront the broader and deeply concerning reality of Medicare under the Albanese Labor government. Labor promised at the last election in 2022 that they would strengthen Medicare, but since they've come to power we have seen the complete opposite. Bulk-billing rates have collapsed. When we left government and Labor was elected in 2022, over 88 per cent of appointments were bulk-billed. In just three years, that number had dropped by 11 per cent, to 77 per cent, under the first term of the Albanese Labor government. An 11 per cent decline is quite a staggering thing, and it meant that we saw 40 million fewer bulk-billed GP visits in the last year alone.

Worse still, Australians are now paying 45 per cent more in out-of-pocket costs than they were just a few years ago. Last year, 1.5 million Australians said they did not see their doctor because they could not afford to do so. That is 1.5 million Australians who potentially will become sicker because they have not had the early intervention that they needed—and guess where they end up? They end up in the emergency departments of our hospitals, which are already overburdened, with ramping at some of the worst levels ever seen on record and continuing to get worse in just about every state or territory in the country.

These aren't just abstract figures being put out here by the opposition; these facts and figures are contained in reports of the government itself. More importantly, these facts, figures and statistics relate to real people, real Australians, who are having to make the difficult decision between putting food on the table and going to see their doctor. As I said, these figures come from the government's very own national accounts. This is a crisis in our primary care system that has occurred under the watch of the Albanese Labor government in the last three years.

But what do we see the Prime Minister do when he turns up at the election in 2025? We see him waving his Medicare card around and using it as a political prop—a disingenuous stunt to try to distract Australians from his track record whilst in government for the last three years. This is absolutely not leadership. It is dishonesty and spin to try to con Australians into believing the situation is not as dire as it really is, and it has become completely and utterly catastrophic under the reign of this Labor government. It's a betrayal of the promise that Labor made to Australians—and keeps on making despite the facts telling a completely different story.

The coalition, on the other hand, is absolutely committed—totally and utterly committed—to making sure that Australians get affordable and timely access to health care. That should be, fundamentally, the thing that underpins our healthcare system in Australia, and that principle is what guided us the whole time we were in government. It guided us when we were continuing to list new medicines on the PBS—2,900 new or amended listings while we were in government. The last time the Labor Party were in government, between 2007 and 2013, they stopped listing medicines because they ran out of money. In the last term of the last Labor government, they decided to put a cap on the number of medicines listed under the PBS—a sneaky way to stop listing medicines on the PBS.

The coalition is absolutely committed to Australians getting access to timely and affordable quality health care. It guided us in government, and it will continue to guide us in opposition. We support the passage of this bill because it is taking important steps towards maintaining the strength, compliance and integrity of our Medicare system. It is so important that we maintain the strength and integrity of our public health systems, because that is what underpins the strong health system that we deserve in this country.

But let's be clear that this bill alone does not fix the mess that this government has created in Medicare. It does not address the affordability crisis that is making Australians pay ever more out-of-pocket costs every time they go to see the doctor. This bill does nothing to try to meet the promises made by this Prime Minister at successive elections about Australians being able to access affordable and timely health care, and it does not address the fact that he told Australians that the only card they would need when they went to the doctor was their Medicare card. Let's be clear: Australians know that that's not the case, because they feel it every time they go to see the doctor. They feel it in their hip pocket. They don't just hand over their Medicare card; they have to hand over their credit card as well. So, despite what the Prime Minister might say, the truth of what is actually happening out on the ground is something that Australians are feeling every day.

As I said, whilst this bill does very little to address the broader issues that are facing our healthcare system in this country as we stand here, we will support this bill because it does go some way to improving issues around the integrity and strength of our Medicare system. We will continue to scrutinise every piece of legislation that comes in here in relation to health. We will make sure we hold the government to account for the promises that it has made to the Australian public—promises that, sadly, we don't believe it will be able to deliver, even though we would love to see a situation where Australians are actually getting affordable and timely access to health care. We will hold them to account and we will continue to speak up for the millions and millions of Australians who have been let down by this government, who are paying the highest out-of-pocket costs that they have ever paid, who are having trouble getting access to even get in to see the GP, and who are ramped at the moment or are having to attend our emergency departments because they simply can't afford to see a GP. We will continue to fight on their behalf because we believe that they deserve affordable and timely access to health care.

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

This is not my first speech. I rise to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. I welcome the bipartisan approach taken by the coalition in restoring integrity and maintaining the sustainability of Medicare. As you know, Acting Deputy President O'Neill, Medicare is our most important safety net. It doesn't matter how many zeros you have in your bank account or what your postcode is—once you have a health scare, it tends to level the field.

All Australians, irrespective of their background, require a strong health system that can catch them in their moment of need, and I know that acutely. I have looked after thousands of patients in my near 30-year career, from all backgrounds—rich, poor and everything in between—and a public health system is the cornerstone of our health system. Yes, 55 per cent of Australians now have private health insurance, but the private health system tends to be a high throughput system, which tends to look after slightly lower acuity patients. If you have serious health problems, you will need the public system because that's where the complex medicine occurs.

I am also aware of reports—and I was distressed by them—in the media of a spate of allegations regarding Medicare fraud. It actually made me quite angry because I know, overwhelmingly, the workforce in this sector is there to do the right thing. They are individuals who have committed their lives to delivering high-quality care to the highest ethical standard, as the Australian people would expect. Our nurses, doctors, allied health professionals, social workers, physios, occupational therapists and support staff—who run hospitals and ferry patients from A to B, carting them around in their gowns—are the people who hold up the sky, as far as our health system goes. So, when we have a small group who are using Medicare as a piggy bank—an ATM, effectively—it casts a shadow over the whole system and raises question marks in the minds of Australians.

This legislation was born out of a review led by Dr Pradeep Philip. It was initiated by the health minister, who pulled an emergency handbrake and basically brought together a team of people to scrutinise, in a rapid-review-type fashion, what was going on. Hence a whole range of amendments have been brought into place to essentially grant the Commonwealth greater powers to investigate, to gather evidence and then, of course, to prosecute. So I would caution any bad actors out there that we are watching you. This legislation will now pass thanks to the bipartisan approach in this chamber.

Medicare was, I would argue, the centrepiece program that we took to the Australian people at the last election. There is the reason the Prime Minister was holding up his Medicare card every five minutes; Australians realise that Medicare is one of the most important social, health and, I would argue, economic programs that we have in this country. It is the ultimate safety net. Medicare is now 40 years old. It was introduced by the great Bob Hawke in 1984, when I first came to Australia. I remember Bob Hawke. He was a figure writ large in my memory. He is one of the reasons why I sit on this side of the chamber, but of course Medicare is the other reason.

Medicare, however, was in trouble when we came to government. Bulk-billing rates at the start of 2022 were described to be in freefall. That's not our language; that was the descriptor used by the president of the College of GPs, who is not known to use hyperbole or to exaggerate. In fact, at the start of 2022, the College of GPs issued a circular to their members to start increasing their out-of-pocket fees because general practice was on a precipice of viability. Hence we pulled an emergency handbrake the following year in our budget, putting in around $6 billion into the system in order to triple the bulk-billing incentive for the biggest users of Medicare, who are pensioners, concession card holders and, of course, children. This patient group is around 11 million Australians. They constitute 40 per cent of patients who use general practice, and they use around 60 per cent of GP visits, so it made sense to target this group.

We learnt a lot from that process. What we actually saw was an uplift in bulk-billing rates in a year's time. Bulk-billing rates, a year after that policy was instituted, actually lifted 2.1 per cent. It doesn't sound like much, but it translates to 103,000 additional bulk-billed visits per week. That happened pretty quickly because those general practices did their math and realised that if they bulk-billed these patients, they were going to get an incentive and make more money, and that would enhance their viability.

But the interesting thing was that the uplift was greatest in our regional communities, which is just the best news ever. For too long, we have had this health-wealth divide in our country based on postcode, where the regions have always suffered on just about every metric, whether it be health or economic—the two are tied. To see an uplift of nearly six per cent in Tasmania—I have worked in the Burnie hospital and I have worked in regional Tasmania—is fantastic. To see an uplift of four per cent in regional Queensland—I have worked in Rockhampton and Gladstone—was also great. To see an eight per cent increase in Bendigo, regional Victoria, was astonishing. And that was just with one year, so we will be watching closely to see what happens to bulk-bill rates.

Having achieved some success—I don't want to overstate it; these are green shoots of recovery in Medicare, and it's about arresting and then reversing that decline, that freefall, in Medicare bulk-billing—we have now gone further. We have decided to take this thinking, the idea of an incentive to encourage GPs to bulk bill more, and slap more incentives on top incentives to the tune of $8½ billion. That's a lot of money. That's a big down payment into Medicare. That is going to flush through the system on 1 November when that triggers. That is in response to the $8.3 billion that was ripped out of Medicare a decade ago by the then coalition when they froze Medicare rebates for at least six years.

We didn't just cook up this idea. We sought advice; in fact, this idea came from the AMA. The AMA have, for a long time, been advocating for a substantial injection into Medicare. We designed it in this way in order to get the outcome we want, which is to lift bulk-billing rates and to give Australians what they want, which is the ability to see a bulk-billing doctor again. That's what they want. We weren't ever going to just tip more money into the rebates. I'm not convinced that supporting ever-increasing rebates will actually deliver the outcome we want. Rebates can keep rising, but so can out-of-pocket expenses; there is no ceiling on the two. They tend to correlate; they tend to travel together in parallel. What we're trying to do is forcibly bring down the out-of-pocket expenses and lift rebates at the same time. That's what this policy is designed to do.

Our modelling suggests that, in five years time, in 2030, nine out of 10 GP visits will be bulk-billed. I'm aware that there was recently a report suggesting that a quarter of GP practices will not be adopting this. Well, I say to those GP practices that competition is a consumer's best friend. When you are surrounded by three in four general practices that will likely adopt this, you risk oblivion, basically. Your patients will vote with their feet. They will vote with their feet.

We will be looking forward to rolling this out. I think Australians absolutely understood what this meant for them at the last election. This is ultimately about frontloading this health system—finally. As a person who spent way too much time in big hospitals, all I did was catch disasters and emergencies at the bottom of the cliff. That was my day from morning till evening, on call, seven days a week. This was my life. We need to frontload our primary health system in order to prevent patients from becoming sicker and sicker and then ending up in hospital.

There are other measures around strengthening Medicare that will also do that. One is cheaper medicines. It doesn't get talked about enough. Cheaper medicines are incredibly important for patients with chronic disease. One in two Australians has a chronic disease—that's 50 per cent of the population—everything from heart disease to hypertension, diabetes, hyperlipidaemia and a range of other rare diseases that affect a large proportion of our population. These require medications that they will be taking chronically for years—not weeks, years—and it costs money. So what did we do when we came to government? The general script was around $42. We slashed that to $31—the biggest cut in the PBS in about 20 years. We've gone further at this election by cutting that to $25, which will start on 1 January.

Now, that's good news for the three million Australian women who are aged between 45 and 64—like me, my vintage—who are struggling with perimenopause and menopausal symptoms. We are the sandwich generation of Australian women. We've been caught between raising children and dealing with aged parents. The last thing we need is another whammy—the triple whammy of dealing with the symptoms of menopause and perimenopause—when we're trying to balance so much else in our lives and maintain our physical health, which is not easy when you enter your 50s. What we have done with menopause has been an absolute game changer for women. By listing a whole range of medications, we have dropped the price of these from private scripts costing between $55 and $60 a month to now $31 and then, from January of next year, to $25. Drugs like Prometrium, EstroGel and EstroGel Pro are used by millions and millions of Australian women, but, for a long time, there has been a health-wealth gap where only women like me who have the means can afford these drugs. Now we will democratise these medications for millions and millions of Australian women. Go and have a conversation with your GP, please.

We're also ensuring that the endometriosis clinics—there are 22, and we're going to increase that to 33—will have the expertise in-house to provide information and look after women my age who are dealing with menopause. So not only will these clinics be able to manage endometriosis, which is an incurable chronic disease; they will also be able to provide advice on pelvic pain and menopause, effectively becoming hubs for women's health. For too long in our health system that's been the province of specialist hospitals in major cities, and that information has been siloed; it has not diffused out into the community. This will change that.

We've also instituted a new rebate for menopause, making it cheaper for women to actually go and see their GP and have a longer discussion on menopause treatments. We also realise that GPs do not have the necessary training, and hence we will be working with the relevant colleges to develop what are called living guidelines on how to deliver best practice care. These living guidelines are effectively a road map for medical practitioners. They are extremely important. They are evidence based, and, because they are living, they will evolve as the evidence changes with time—as new medications, for example, come online. I'd like to give a shout out to Senator Marielle Smith and colleagues in this chamber for their work in the Senate on the menopause inquiry.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

I'm speaking to the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. As I understand it, this bill has been presented to the parliament following the independent review of Medicare integrity and compliance. This review, with its final report delivered in 2023, provided observations regarding fraud, non-compliance and vulnerabilities of the payment system. It called for the focus to remain on the structural issues and controls in the system to build trust in Medicare and materially reduce non-compliance and fraud. The review found significant changes are required to ensure usability and practitioner compliance. I would also like to begin my contribution with an acknowledgement that the overwhelming majority of practitioners are well-meaning and deeply respect our healthcare system and they continue to act to provide the best possible care for their patients.

This bill was referred to the community affairs committee for inquiry in the previous parliament. The nine submissions to the inquiry mostly included support for the changes within this bill, but there were some concerns and suggestions raised that I would like to raise in my time today. A young person made a submission to the inquiry, and, in her submission, she noted the importance of addressing fraud but emphasised:

…it is important to ensure that these powers do not create additional barriers for legitimate providers, which could inadvertently reduce the availability of services.

Further she added:

Simplifying processes is beneficial, however, it must not compromise the quality and safety standards that protect public health.

The Australian Greens agree with this sentiment and call on the government to ensure that Medicare continues to be grounded in the experiences and the processes required to ensure health care for consumers.

Another topic raised at the inquiry was the need to properly educate practitioners about the changes made by this bill. The Royal Australian College of General Practitioners said in their submission:

Compliance processes can be stressful for providers and affect the quality and timeliness of patient care. We maintain educational activities should be prioritised before compliance actions. Where reasonable, health professionals must be given an opportunity to adapt or rectify their billing practices prior to being subject to compliance activities.

As presented in the Philip review, a significant part of leakage in the Medicare payment system is due to simple mistakes from practitioners rather than premeditated fraud. As such, it is crucially important that there be more focus placed on educating and enabling practitioners to comply with changes rather than relying on punitive enforcement.

I would like to note that the Australian Medical Association also made a submission to the inquiry. They wrote:

The proposed amendments aim to broaden and update investigative powers to ensure consistent and effective use across health benefits schemes and include additional offences under the Criminal Code such as money laundering, forgery, and identity fraud.

…   …   …

The AMA acknowledges the Bill intends to balance additional powers with appropriate safeguards, including restrictions on when warrants may be issued and guidelines regarding officer conduct.

In their submission, it is clear that the AMA is supportive of the need for further evaluation to ensure the balance between sufficient investigatory powers and safeguards, and to ensure appropriate protections for individual providers. Other individuals who submitted to the inquiry also believed that more needs to be done to ensure the underlying problems within that system are addressed.

With these perspectives noted, the Australian Greens will be supporting this bill. It is our expectation that the government will continue to work with representative organisations and individual providers to ensure that sufficient safeguards are in place. More needs to be done, for example, to ensure that practitioners receive education regarding the expectations on them and the consequences if they fail to meet those expectations. Above all, the quality of health care for consumers must remain at the forefront and centre of all Medicare changes.

Today I am also really proud to be moving a second reading amendment to this bill on behalf of the Australian Greens. In this country we have a quiet crisis, where so many people cannot afford to access dental care. Now, many in this place and in the community know that the Greens are calling for the mouth to be considered as part of the body, with regard to getting dental care into Medicare. The Greens took a policy to the last election to put dental care into Medicare so that everyone with a Medicare card can access the dental care they need without breaking the bank. The reality is that too many people cannot access a dentist, because going to a dentist is far too expensive and most people are not eligible for public dentistry. For those that cannot access public dental services, the wait time can be years—years of living with preventable tooth decay, headaches and, in many cases, not being able to eat the food which they once enjoyed.

My amendment today calls on the government to fully fund and implement a seniors dental benefits scheme. The establishment of a seniors dental benefits scheme would go some of the way to supporting our community to get access to affordable dental care. The idea of a seniors dental benefits scheme is not new. The community and the sector have been calling for this for years. Notably, the Royal Commission into Aged Care Quality and Safety, back in 2021, recommended this very scheme, and the Senate Select Committee into the Provision of and Access to Dental Services in Australia recommended this in 2023. Years on, we still have had no action. Years of people living with preventable dental pain, yet this government continues to leave older Australians out in the cold when it comes to their oral health.

There are many, many stories of the consequences of successive governments failing to establish a seniors dental benefits scheme. I would like to share with you the story of Don Batty, who was featured by the ABC in an article published recently. Mr Batty is 80 years old. He is receiving the pension and he is experiencing severe dental issues. The way he describes it, in his words:

My teeth have started to disintegrate … I'm very embarrassed by my teeth and I try not to smile because I frighten people.

Don has been living with this for two years because he can't afford to see a private dentist and the public system is swamped. Don's story is one that I'm sure will resonate with senior Australians all over the country who are struggling to afford dental treatment—treatment they desperately need. The consequences? People are losing their social connection; it's impacting their mental health and, in many instances, people are struggling to eat the foods they once enjoyed. Mr Batty's experience is adding to the chorus for change. It's stories like his that are why the Australian Greens are calling on the government to establish a seniors dental benefit scheme as a step towards bringing dental care into Medicare for everyone.

Older Australians shouldn't be spending their retirement dealing with dental pain or missing teeth or the negative health effects that accompany untreated dental problems, and yet here we are. On average, Australians over 65 have lost 14 teeth. Twenty-five per cent avoid certain foods due to dental issues. The reality is that across Australia people are experiencing the cost-of-living crisis and 55 per cent of Australians over 65 delayed dental treatment in the last year, with affordability being the main barrier.

The Australian Dental Association supports the establishment of a seniors dental benefits scheme. The ADA, in collaboration with Primary Dental at Maroubra Medical and Dental Centre in Sydney and the University of Sydney, conducted a pilot program of a seniors dental benefits scheme, which included individualised dental plans as part of a GP provided healthcare program. The results of the pilot showed an improvement—an improvement!—in health outcomes, particularly in the management of tooth decay and gum disease. A participant in the pilot said:

Public dental waiting lists are too long, and I haven't seen a dentist for 5 years due to cost, and it was painful to eat and drink. Since I was on the pilot project, I have my new denture and I can eat a lot more food and drink than before.

The data is in. The pilot clearly demonstrated the value in providing affordable dental care to older Australians. We should make sure that people in their retirement, on the pension, struggling, can live free of dental pain. We should make sure that they can eat the food and drink the drinks that they once enjoyed, that they can smile without fear and that they can smile again with pride.

The next step must be for the government to commit to implementing the seniors dental benefits scheme. I call on everyone in this place to support our Greens amendment, to support, in principle, the establishment of a seniors dental benefits scheme. And while this amendment today will not establish a seniors dental benefits scheme, it sends a clear message to the Australian community, especially our older Australians, that we are going to get this done in this term of government. Otherwise, it is clear that the only party here who are committed to considering the mouth as part of the body and getting dental into Medicare is the Greens, and I foreshadow the Greens second reading amendment as listed on sheet No. 3360. Let us work together to bring dental care into medical care. Let us begin by helping our seniors who are living in dental pain, who are losing their social connection, their mobility and their health due to this unacceptable gap in our health system. It will take work together, it will take time and consultation and collaboration, but let us now begin. I move:

At the end of the motion, add ", but the Senate:

(a) notes that:

(i) the Royal Commission into Aged Care Quality and Safety recommended the establishment of a Senior Dental Benefits Scheme,

(ii) the Select Committee into the Provision of and Access to Dental Services in Australia recommended that the Government consider the establishment of a Senior Dental Benefits Scheme,

(iii) Australians are experiencing a cost of living crisis, and 55% of Australians over 65 delayed dental treatment in the last year with affordability being the main barrier; and

(b) calls on the Government to fully fund and implement a Senior Dental Benefits Scheme".

Richard Colbeck (Tasmania, Liberal Party) Share this | Link to this | Hansard source

I rise to make my contribution to the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. As I commence, I note that this bill is in response to the Philip review, which identified a range of issues that need to be addressed to ensure the effective operation of the Medicare system.

As someone who has been in this place for a while now, I can very confidently assert the coalition's support for a strong Medicare system, one that serves the Australian people well, that seeks to provide efficient service and good access to health services for the Australian people, and, in that context, that stands by the coalition's record of ensuring that Medicare continues to do that. This is despite what you might hear from some of those opposite, particularly when it comes to election times, when the Prime Minister decided to spend his time wandering around the country waving a Medicare card and suggesting that the coalition might be doing something negative in the context of Medicare. If you look at the actual performance of the Labor Party compared to the coalition with respect to Medicare, it's actually the other way around. If you go to the provision of primary care services, for example, you see that, since this government came to government in 2022, the bulk-billing rate has plummeted from 88 per cent to 77 per cent—an 11 per cent reduction. Yet the Prime Minister has the gall to go around the country suggesting that Medicare will be stronger under Labor.

We welcome the arrangements that are being put in place through this piece of legislation. It is obviously backed by the Philip Review and also by a Senate inquiry that reported during the caretaker period, and so we will be supporting the legislation. What we are not going to tolerate is a continuation of the fabrications that are being put out by Labor about our performance in government with respect to Medicare. If you look at the facts, as opposed to the rhetoric and the BS that's put out there by the Prime Minister, the fact that funding for Medicare increased from $18.6 billion under Labor in 2012 or 2013 to more than $30 billion in 2021-22 under the coalition demonstrates that there has been an increase in funding for Medicare. Medicare bulk-billing funding was higher under the coalition. We're funding more services. Bulk-billing continuously rose under our entire term of government. The Labor Party cannot say that about what has happened during their time in government—it rose to 86 per cent before the pandemic and it was a record high of 88 per cent when we left government. It's now 77 per cent. In the coalition's last year in government, 167.2 million free GP services were delivered—an increase of 61 million from when we came to government. We have a very strong record with respect to support of the Australian people.

Let's not forget that, if you look at the PBS—and I think this is a very important area to consider—during the chaotic Rudd-Gillard years, the then Labor government stopped putting medicines on the PBS because they couldn't manage the finances of the country. They stopped listing new medicines because they couldn't afford to do so. Yet, when we came to government, we made 2,900 amended or new listings on the PBS. Having worked very closely with then minister Hunt, I know how focused he was on making sure that Australians had access to the best and the latest medicines and that we didn't fall into the trap that Labor fell into when they were last in government of not being able to afford to list medicines because they'd run out of money. They cannot manage the budget. Now we're starting to see those things happen again. Treasury is telling us that the budget is under stress. Where are the negative decisions going to come from under this government when they start running out of money? We know that Labor can't manage the budget. Historically, that's been one of their traits.

Of course, one of the scourges that we're seeing here in Australia, particularly post the pandemic and in the period immediately post the pandemic, is the issue relating to mental health, particularly for young Australians. What did the Labor Party do? They cut the number of services available to Australians to deal with mental health issues in half. They reduced it from 20 to 10, and, despite every recommendation that they've received since, they refuse to do anything about it. Yet they had the gall to go to the last election suggesting that people would be worse off under a coalition government, who were promising to increase it back to 20. They were not meeting that commitment. So, when we hear the crocodile tears from Labor or the entreaties about how wonderful they are at looking after Australians, remember that 75 per cent of people who are seeking mental health support are people under the age of 25, yet it was this Labor government that cut the number of mental health services available to young Australians—to Australians generally—from 20 to 10. They refuse to return it to where it was, despite all of the professional recommendations that they've had. Then they have the gall to run their fourth straight 'Mediscare' campaign, which leads me to a point that I made in this place yesterday.

You cannot believe what the Labor Party are telling you. We all remember the promise of a $275 reduction in power prices. We all remember that. We know that it will never be delivered. We know that they promised a lower cost of living and they promised higher real wages. We know that real wages have gone backwards in excess of six per cent since this government came to office. They promised us cheaper housing. How's that going? It's not. Housing is getting more expensive, and the things that the government are doing are making it more expensive. Their refusal to bring organisations like the CFMEU properly to heel are exacerbating cost issues in the housing industry. Then they have the gall to go to the election for the fourth time in a row running a 'Mediscare' campaign.

The Australian people cannot believe what the Prime Minister is telling them. It has been proven so many times now that he will say one thing, particularly in the lead-up to an election and then that will disappear. It'll disappear into the ether once the election has gone. We will not tolerate the myths that Labor continues to put in front of the Australian people. He did it again at the last election when he stood up in front of the Australian people—and I don't know how many times he did it—suggesting that the only thing you would need when you went to the GP was your Medicare card. Now, we know that that's not true and we know that will never be true. That promise will go to exactly the same place that the promise for a $275 reduction in energy bills went. It will never be delivered. We cannot believe what the Prime Minister says in respect of that.

Not even members of the Labor Party believe what the Prime Minister said. The Leader of the Opposition in Tasmania, Dean Winter, just last Saturday night, said in his speech after the election in Tasmania, 'Too many Australians can't get in to see a doctor, and they can't afford it if they can.' So even Dean Winter, the Leader of the Opposition in Tasmania—I'm not sure how long he'll hold that position, mind you—doesn't believe Prime Minister Albanese when he says, 'The only thing that you'll need to go to the doctor is a Medicare card'—if you can get in to see a doctor, that is. The promise made by the Prime Minister during the last election campaign was simply a hollow one, like so many other promises that the Labor Party have made. The reality is that, at a time when they can least afford it—Dean Winter has confirmed it—Australians are forking out more than they ever have from their own pocket so that they can get access to Medicare services, despite the promises of the Prime Minister.

The really insulting thing in relation to that promise is that his own department's data indicated that it wasn't true. His department has said that a quarter of Australians won't be able to just walk into a doctor's surgery and use their Medicare card. Yet these are the false promises that the Labor Party continue to make to Australians—the deceptive promises. There's the $275 reduction in your power bills, a promise that will never come to pass. In fact, when we get to the end of this year, when the power bill subsidies run out, the cost-of-living relief will be gone and the higher power bills will remain. They will be over $1,000 more than when this government came to office. They've got your vote. They only extended the income relief for six months to get them past the election. Now, you're on your own. You're stuck with your higher energy bill now. This government has got the vote; they're happy. They can tell us to get out of the way. They can run their hubris lines across the chamber and say we should just get out of the way and let them govern. You're hearing it in their speeches already. That's the arrogance of this government who can't keep their promises.

We are going to hold the government to their promises, and we're going to remind the Australian people every day of the broken promises. The $275 promise will never go away, and the 23 per cent—the quarter of Australians—who can't just walk into a doctor's surgery and use their Medicare card will be reminded every day, as well, that they were promised by the Prime Minister last May that all you would need to go to the GP was your Medicare card, not your credit card. It was a false promise; it was a scam. It was a scam run by the Labor Party.

We will remind the Australian people every day between now and the next election of the $275 scam, the cheaper-housing scam and the Medicare GP scam because they need to understand that that's what this government continue to do. Then they roll out their hubris and suggest that we just get out of the way and let them get on with it without raising any objections. Well, we won't.

Dorinda Cox (WA, Australian Labor Party) Share this | Link to this | Hansard source

Today I rise to make a contribution to the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. I start by congratulating the former minister who introduced this piece of legislation in the other house, Ms Kearney, for her work in ensuring that Medicare is maintained, strengthened and protected. I also want to extend that congratulations to Minister Butler, our minister for health and aged care, and to our other new cabinet ministers, including Assistant Minister White, who joins in Indigenous health—an important portfolio to me as a First Nations person—Minister Rae, who joins in aged care; and Minister McAllister, who is joining in relation to disability.

I'm really grateful to have the opportunity to be a member of the community affairs Senate committees. I will be joined by my colleague Senator Ananda-Rajah, who spoke before others in this chamber and brings an immense amount of her personal knowledge and professional knowledge to this work. Our work as a government is in ensuring that health, ageing and disability are at the forefront of what Australians see as centrepieces. This is important work. As a proud Western Australian senator—just like yourself, President—I want to ensure that our home state's issues are also presented and showcased for the good practice in our work that we are doing with our state Labor government and for the great contributions and investments by federal Labor that are working, particularly in Medicare.

We are unapologetic across this side of the chamber. We will not be lectured to by the opposition, because things like bulk-billing had been in freefall for a decade under them. The cuts to and the neglect of Medicare have been the things that this Labor government has had to fix in its first term. Australians see Medicare; it sits at the heart of our community. Whether you live in regional areas or within the metropolitan areas, Medicare universally benefits all Australians, including our most vulnerable Australians. That's why strengthening Medicare was a key focus of this Labor government's election platform. The Albanese government continue to be committed to protecting and strengthening Medicare as part of improving that compliance framework and to ensuring the integrity of rebates that are made under that scheme.

This bill, as others in this chamber have already articulated, is in direct response to the consultation with stakeholders and to the Philip review. The review was commissioned by this government to respond to some of those concerns about the operations of the Medicare system. This includes things like winding back Medicare claim timeframes from two years to one year and making sure that we improve the payment integrity system. It's about honesty, it's about consistency, it's about transparency and it's about championing the needs of those who are doing it tough and making sure that we centre patients and the care that needs to be provided.

This bill improves the investigative powers across Medicare and ensures that the PBS pharmacy approval process is enshrined in legislation, to enhance the capacity of the government to manage and alleviate the consequences, particularly of the TGA shortages here in Australia. It also supports the very important vaping reforms that were introduced by this government in our last term in parliament. It centres on the importance of harmonising different advertising provisions and adding clarity to that with its interactions with the TGA. That is an important measure because we know that, as part of the reforms introduced by this government, the Cancer Council's recent research in its latest Generation Vape study talks about a decline in the 14- to 17-year-old Australians who vape. These are important measures, and we know that.

This further investment also includes other measures. If you were in here at question time yesterday, you would have heard Senator Tyrrell ask a question in relation to tobacco. The Albanese Labor government are making that further investment—$350 million—to ensure that law enforcement agencies have the resources to tackle the black market in relation to illegal tobacco. That is an important measure we are coupling alongside our important reforms on vaping.

The PBS has been in place in this country for 75 years. Cheaper, affordable and prompt access to medicines and health care can only be a win. No-one should have to choose between the basics of a good standard of living, fuel and food. Australian patients and families will save hundreds of dollars a year in out-of-pocket costs. It ensures that every Australian receives the best health care, which they deserve. It is our job in this place to ensure that that is maintained. We cannot have a system that is being exploited at the cost of our most vulnerable Australians. Compliance with and protection of Medicare is in fact non-negotiable. It is about calling out those who are in fact not doing the right thing. This is why it's so important that a few do not spoil it for all and that we have good compliance and cheap and accessible health care.

This is exactly why the Albanese Labor government are making cheaper medicines even cheaper, with a script not going to cost more than $25 under the PBS. This is critical for Australians who may have some additional challenges or are affected by cost of living due to their circumstances. This is why the Albanese government is investing in ways to alleviate these pressures. These are part of a range of measures that this government has introduced.

I want to take a moment to reflect on my memories of my own experiences of the importance of Medicare. I was a child who grew up with hardworking parents in Western Australia—in Perth, in fact. My dad was a truck driver and my mum was a tea lady. I have a very vivid memory of when I was in primary school going to the local GP and the receptionist using one of those old credit card systems that you would swipe across to get a triplicate. In the eighties, when Medicare first came in, they were my experiences. They were my memories. I was a kid who presented with some health issues. I have a hereditary hearing impairment, so my parents were constantly taking me in for ear, nose and throat issues. The access to affordable medications and the Medicare system made a difference. It also shaped my worldview in relation to health care. If that hadn't been the case and Medicare didn't exist then I might not be standing here in front of you in the chamber today.

I also, like many parents across Australia, have taken my kids who have been unwell and distressed at night to an emergency department and sat for hours waiting for them to be seen. One of the most recent times was when my daughter fell off her scooter. She was in so much pain from an aching and throbbing wrist that she had landed on. We saw a medic on site at the event we were at, but, as a concerned mum and due to the need to ease my mind and also to settle her and reassure her that she hadn't broken anything, I took her off to an emergency department.

I see the benefit in the way previous Labor governments have invested in and built Medicare for our families and communities because, over my life cycle, I have used the healthcare system and benefited from it.

Sue Lines (President) Share this | Link to this | Hansard source

Senator Cox, we are at the hard marker. You will be in continuation.