Marielle Smith (SA, Australian Labor Party) Share this | Link to this | Hansard source

I'm in continuation from my remarks late last week on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. Seeing a GP regularly helps to catch health issues early, before they worsen and escalate, needing more intensive and more costly care. That's why the Albanese Labor government is investing $660 million in a workforce package that will expand the largest GP training program in Australian history. We're training 2,000 new GPs a year by 2028, supporting hundreds of nursing scholarships and helping overseas trained doctors register faster, with 17,000 joining the system in the past two years alone. We've expanded bulk-billing incentives to all Australians and introduced a new incentive for practices that bulk-bill every patient. Bulk-billing is rising again in every state and territory. We're doing this because we know bulk-billing is something that Australian families rely upon; in fact, it's a critical part of our Medicare system.

Our record investment in Medicare restores every dollar the Australian Medical Association says was cut from Medicare through the funding freeze implemented by the previous coalition government. This is a policy about lifting up our nation and ensuring no-one is held back and, of course, no-one is left behind.

We also promised 50 Medicare urgent care clinics, but we delivered 87, and more are on the way—another $658 million to open 50 more clinics nationwide. Five of those will be in my home state of South Australia, with an additional three announced earlier this year, including in my community of Sturt, something that our local MP, Claire Clutterham MP, was a fierce advocate for and very pleased to see announced. These clinics provide free walk-in care seven days a week, taking pressure off emergency departments and saving families time, stress and money.

Over 1.5 million patients have walked through the door of a Medicare urgent care clinic and received the free urgent care they need. I am one of those patients. I've taken both myself and my children to these clinics, instances when we otherwise would have been going to the emergency department. Our Medicare urgent care clinics have filled a much-needed gap in our healthcare system. Now patients all around the country, including parents of young children, just like me, don't have to spend hours in a hospital emergency department. We're building on our historic investment in Medicare to take pressure of hospitals and make free urgent care available to Australians in every community with the launch of 1800MEDICARE, a free nationwide 24/7 health advice line and after-hours GP telehealth service.

Of course, when it comes to women's health, an area of public policy which I have been advocating for my whole parliamentary career, we are providing Australian women with more choice and better treatments at a lower cost. When it comes to women's health, as I've said many, many times in this chamber, you simply do not need to look very far to see where women's pain and symptoms have too often been ignored. Often their pain and symptoms have been outright dismissed. We've seen this with endometriosis. We certainly see it with symptoms of menopause and perimenopause. But we see this right across the spectrum of women's health issues, and that has to change. The consequence of it is that women have been suffering in silence, and they should not have to do so in a modern Australia.

The Senate inquiries we ran in this place last year into maternal health and into menopause and perimenopause helped spark a national conversation about the level of support women were getting and where they were being let down. I am deeply proud that our government has invested in women's health so significantly—some $800 million worth of investments in women's health. This is a massive step change in the way women's health is funded, in the way women's voices are being heard and in the way we have chosen to prioritise these issues within our healthcare system, when women have been ignored and silent for far too long.

We're making contraceptives cheaper and funding more treatments for menopause. Since 1 July, new menopause and perimenopause health assessments have been available under Medicare so that women can receive the holistic care they need from their family GP when they need it. We know that, to have these conversations with your GP, you simply need more time, and that's what this investment achieves. We've also added contraceptives like Yaz, Yasmin and Slinda to the PBS, giving women more choice at a lower cost. For many of the women who use these medications, there is no alternative. The consequences of other medications are too great. We need these medicines on the PBS so that women have the choice to access the medicines that work for them and their bodies. We've also added hormone replacement therapy and IVF medications to the PBS, some of them for the first time in 20 years. For decades and decades and decades there was just simply no action to provide and fund diversity and more choices for women when it came to the PBS. That has changed now.

We're also helping Australian women suffering from endometriosis and complex gynaecological conditions to have access to longer specialist consultations—also covered under Medicare. We've opened Australia's first endometriosis and pelvic pain clinics, and we will open an additional 11 clinics to bring the total number to 33 across every state and territory. These clinics do amazing work. I've visited the Thrive Endo Clinic in South Australia. I've met with their patients time and time again, as well as their practitioners. This is life-changing care which is enabling women to not just get the health care they need but also re-enter the workforce. Endometriosis can be debilitating and so can pelvic pain. These clinics are absolutely changing lives. We need more of them and we have made that investment. It's about receiving care which is tailored to your needs as a woman, where you feel listened to, understood and well treated and your pain and symptoms are not dismissed. Women have told me that, before accessing the support from these specialist endometriosis and pelvic pain clinics, they had been dismissed and told things like, 'If you have a baby, your endo will go away.' It's nonsense, it's not true, and we need better quality care for these women.

We are also expanding the remit of these clinics to help women with symptoms of perimenopause and menopause. Again, they're not optional parts of a woman's life journey at all. Any woman fortunate enough to reach midlife will go through menopause. So that we simply haven't had appropriate care for women in this stage of life is nonsense. It is not optional for women; good-quality health care and treatment for menopause should not be optional either.

We are determined to build a stronger, fairer healthcare system—one that does not dismiss women's pain, but responds to it with compassion, expertise and the time women need with their GPs. We're strengthening Medicare with real, lasting support for women's health. I am extraordinarily proud of this work and have been extraordinarily proud to advocate for it.

We're also making medicines cheaper than ever before by cutting the maximum PBS co-payment to $25 and expanding 60-day dispensing. We know Australians have saved over $1 billion on scripts under the Albanese Labor government. This is a key cost-of-living measure. We don't want a single Australian to forgo medicine that they need because they cannot afford it, and we know this has happened. Having already slashed the cost of medicine, with the largest cut to the cost of medicines in the history of the PBS in 2023, we are going further. This represents a more than 20 per cent cut in the maximum cost of PBS medicines, which will save Australians over $200 million each year—again, delivering real cost-of-living relief for Australians. We are also investing to protect the next generation of Australians from harm, with world-leading vaping reforms and a $350 million crackdown on illegal tobacco, supporting our health and law enforcement agencies.

Finally, we are delivering an extra $1.8 billion to public hospitals next year, bringing our Commonwealth contribution to a record $33.9 billion in 2025-26, and there are further long-term reforms underway. This one-year agreement means Australians will benefit from better funded public hospitals as cooperation builds on long-term, sustainable health-system reform.

From doctors and nurses to public hospitals and urgent care, and from integrity in the system and compliance to cheaper medicines, our government is working to strengthen every part of Medicare. This is what Labor does. We created Medicare. It is part of our legacy, and only a Labor government will continue to protect and strengthen it. This is in stark contrast to the Liberals and the coalition government, who previously cut $50 billion from public hospitals and froze the Medicare rebate. We are building a system which supports Australians with the cost of their health care and which makes sure women's voices are heard—which doesn't dismiss their pain, but actually funds women's health properly and takes these issues seriously.

We are investing in Medicare, but we are also doing what we need to do to strengthen the integrity of it. It is too important for Australians not to, and I commend the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 to the Senate.

Paul Scarr (Queensland, Liberal Party, Shadow Minister for Immigration) Share this | Link to this | Hansard source

The coalition supports Medicare. Funding into Medicare increased every single year under the former coalition government. Every single year that the coalition was in government before the election of the Albanese government, year on year, there was an increase in Medicare funding. The first year we came into power, there had been $18.6 billion of funding under Labor in 2012-13. When the coalition left office in 2021-22, the funding was $30 billion. Under Labor in 2012-13, the figure was $18.6 billion and under the coalition, in its last term before the election, it had increased to $30 billion—an increase of nearly $12 billion through the terms of three coalition governments. They're the facts.

We have a system in our country where both parties of government support Medicare, and rightly so—absolutely. I should note also that Medicare bulk-billing was higher under the coalition than it was under the last term of the Labor government. It was actually higher under the coalition. Bulk-billing rose consistently across our entire term in government. It rose to 86 per cent before the COVID pandemic, and it was a record high of 88 per cent when we left government. In the coalition's last year in government, there were 167.2 million free GP services delivered, and this is 61 million more than the previous Labor government. I'd forgive those listening to the debate if they were surprised by those facts because of the rhetoric coming from the other side, but the fact of the matter is that the coalition supports Medicare and has always supported and always will support Medicare as being a foundational principle of making sure Australian people have access to the medical services which they expect in this country.

The coalition also has a proud record of supporting a strong PBS in this country. In government, we made 2,900 new or amended listings on the PBS to expand access to cheaper medicines. I know that some of the achievements which mean the most to representatives in the other place and the senators in this place is when they have advocated on behalf of constituents and their families who have sought the listing of a PBS medication where it has been life-changing, when families have been faced with the awful predicament where there's only one drug available to treat a chronic condition and, without it being listed on the PBS, it would cost hundreds of thousands of dollars and they simply wouldn't be able to afford it. I would like to place on the record in this context—and I think it's appropriate to do so—my gratitude to Senator Ruston and one of her advisers, Lilli Balaam, for the work that they've done when Senator Ruston was health minister and now in her existing role in relation to getting drugs listed on the PBS and for listening to representations I've made in that regard. It's greatly appreciated.

So the coalition has a proud record of supporting the PBS. During our last term in government, the funding for Medicare increased from $18.6 billion, when we took government back in 2012-13, to $30 billion, in 2021-22. So don't accept this propaganda, this nonsense, about the coalition not supporting Medicare, because all of the facts are to the contrary, including the money that's been spent, that increase between $18 billion to $30 billion. Those are the facts, so don't listen to the political rhetoric and the propaganda.

The coalition has also supported and focused on mental health and suicide prevention, something very close to my heart and something which is extraordinarily important to the people of Queensland. I particularly refer to those regions of Queensland which don't have access to mental health specialists and practitioners. In many cases, a few hours drive out of Brisbane, there are areas which have unacceptable rates of suicide and attempted suicide and simply do not have the practitioners on the ground to provide the services people in those areas need. I've spoken to families who've been impacted in that regard, and those discussions are absolutely heartbreaking.

In that context, I note that the Labor government took away Medicare mental health sessions from 372,000 vulnerable Australians, and in that regard they went against the advice of their own review and all of the Australian peak mental health experts. They cut away those mental health sessions, and they were critically important to some of our most vulnerable Australians struggling with mental health issues. That was a great tragedy, and I would like to see those reinstated. I dearly would, because I think that those are the things which make such a difference to people's lives.

Data from the Productivity Commission in that regard shows that access to Medicare mental health support has fallen to the lowest point in at least 10 years. We've gotten to the lowest point of access to Medicare mental health support. That's a shocking state of affairs. We all know—and people listening to this debate will know—of people struggling with mental health issues who then, when they seek help, are faced with awful waiting times to see the specialists they need to see. It's heartbreaking.

Under Labor, mental health has been completely neglected. They cut the Medicare subsidised mental health sessions in half. They abolished the National Mental Health Commission. The chair of Mental Health Australia even resigned out of frustration with the Prime Minister's neglect of mental health and refusal to meet with him. This is a crisis. There's a mental health crisis in our country impacting so many vulnerable young people in our society. This should be one of the greatest priorities of government, to try and deliver services to the people most in need in this regard.

I also refer to the Prime Minister's Medicare election promise. You all heard this many times. The Prime Minister said:

Under Labor all you'll need is your Medicare card, not your credit card

When that statement was trotted out, he would wave the Medicare card, the credit card and whatever else around. But, if you want to know what's really happening, one of the things to do is to look out for the incoming brief that the actual department prepares and submits to an incoming government, whoever wins the election. The department advises the government of the day. The department advises the government of the day, whoever wins the election, on what's actually happening on the ground.

This is what the government's own incoming government brief said. This is what the Department of Health told them. This had to be released under FOI. Someone had to go through the Freedom of Information Act process to get the truth from the government department. It estimated that a quarter—23 per cent; near enough to a quarter—of GP clinics across Australia will not bulk-bill, despite all of the Albanese Labor government's promises. That's what the specialists in the department said in the incoming brief to the government, after the Prime Minister had run around the country waving his Medicare card around and saying, 'Under Labor all you'll need is your Medicare card, not your credit card.' The government's own department, in considering the promises made by the Labor prime minister during an election campaign, actually belled the cat in relation to the issue and said that a quarter—near enough; 23 per cent—of GP clinics across Australia will not bulk-bill, despite all of the Albanese Labor government's promises.

This data from the health department shows that millions of Australians will still need their credit card—notwithstanding what the Prime Minister promised the Australian people during the course of an election campaign. What the Prime Minister said during the course of an election campaign is totally disconnected from the reality the Australian people are going to face now that the Labor government has been re-elected. The reality is going to be different from the election campaign. This data from the health department says that millions of Australians will still need their credit card, as well as their Medicare card, when they go to see a GP. Nearly a quarter of medical clinics will not bulk-bill, notwithstanding the promises and statements made by the Prime Minister.

The worst part of all this is that, when an Australian's credit card is charged to see their GP, they're being charged the highest out-of-pocket costs on record under Labor. At a time when they can least afford it, Australians are forking out more than they've ever had to before, from their own pocket, to access essential health care. It is quite appalling that the Prime Minister made those representations during the course of an election campaign and then the incoming brief—it's not like there was 12 months that passed between when the Prime Minister made these statements and when the advice was received from the department. It's not as if there was a change of circumstances that one could reasonably accept. These promises were made by the Prime Minister during an election campaign, and the incoming brief from the Department of Health, which knows the data and the reality, said: 'It can't be achieved. You're not going to achieve what you promised.' Barely a month had passed. That's the reality. This calls into serious question Labor's claims that by 2030 nine out of 10 visits to the GP will be free. How does that stack up if the department's actually saying that 23 per cent of GP clinics aren't going to bulk-bill? How do you achieve that figure of nine out of 10 visits to the GP being free? It's impossible.

The Prime Minister needs to be transparent with the Australian people: was this advice provided to the government prior to the election? Notwithstanding the Labor government's promises, did the Prime Minister know that the department of health—which knows the data, which understands the process and which is the best to give these estimates—estimated that 23 per cent of GP clinics across Australia would not bulk-bill? Did the Prime Minister know that? Did the relevant minister know that? And, if not, why not? Why not get the data and opinion from the relevant government department before you make the promise? Isn't that the way it should work? Get the data and get the opinions of the senior public servants who are across the system before you go out to the Australian people and make a promise.

Now we're in this situation where there's a complete disconnect between the promise that was made by the Prime Minister, waving around his Medicare card, and the reality as told to us by the public servants, who are the ones in charge of managing the system and who are at the coalface in terms of managing the health system. That's the situation we have.

The reality of Medicare under Labor is that Labor promised to strengthen Medicare, but it's only been weakened since they were elected. Medicare bulk-billing fell by 11 per cent under Labor. Under Labor, GP bulk-billing has fallen from 88 per cent—in the last year of the coalition government, bulk-billing was at 88 per cent—to 77 per cent. They want to pat themselves on the back as if they've achieved some great things in this space when, under their watch, there was a material decline in bulk-billing. That translates to 40 million fewer bulk-billed GP visits in the past year alone under Labor.

Australians are now paying 45 per cent more of the cost to see a GP from their own pockets, and out-of-pocket costs have literally reached the highest level on record under Labor. This data from the government's own national accounts shows that more Australians are having to use their credit card along with their Medicare card—notwithstanding what the Prime Minister promised during the course of the last election campaign—and they're being charged the highest amount of out-of-pocket costs on record. The sad reality of our healthcare system under Labor is that it has forced more than 1.5 million Australians to avoid seeing their GP because they can't afford to. It's a devastating statistic, which makes it so unsatisfactory to see Labor standing up here in this chamber patting themselves on the back.

Lisa Darmanin (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

In the months leading up to this year's May election, I spent countless hours out in the Victorian community knocking on hundreds and hundreds of doors and speaking to hundreds and hundreds of people on the phone, talking to them about what their concerns where, what their experiences were and what they want to see for our country. I spoke to parents and young people, and to those juggling jobs and care. I spoke to older Australians who have worked throughout their lives and who now need more support to access the care they deserve. I spoke to students navigating their futures and to migrants making Australia home.

What I heard was really clear. People weren't asking for the world; they were asking for something much more fundamental—something that should be a given in a country like ours. They wanted a government that listens, one that focuses on what really matters: health care, housing, education and a fair go. That's exactly why we went to the election with a clear plan to protect and expand Medicare, putting it at the front and centre of our agenda. And Australians responded resoundingly at the ballot box, re-electing a Labor government committed to delivering on these promises. I'm proud to be a part of that government.

One of the issues raised with me time and time again across Victoria, no matter their background or circumstance, was health care. Parents wanted to know if they could get their kids to a local GP when they had a fever, a sprain or a worrying rash. Women bravely shared their stories of long, painful journeys through the healthcare system, searching for answers that never came quickly or easily. Older Australians told me of the frustration and anxiety that come from not being able to afford care or get a timely health appointment. These are stories along with statistics. They are the reality for millions of Australians, and I want to thank the people who shared their stories with me over the last three to four months. It's really not easy to open up to someone that you've just met when you're talking to them on their front door step or on the phone. It is a privilege to hear these stories, but it is also a responsibility that we must act on them. That is exactly what this government is doing. Labor created Medicare, we protected it, and now we are strengthening it for the future.

When we came to government in 2022, it had never been harder or more expensive to see a doctor. After nearly a decade of cuts and neglect under the coalition, bulk-billing was in freefall, general practice was on the brink, people were delaying important treatment that they needed, they were waiting longer, they were paying more and some were walking away from the system altogether, giving up. Strengthening Medicare was at the heart of our election commitment, and it remains a top priority for our government. In just two years, we've delivered the largest investment in Medicare since it was established more than 40 years ago—a whopping $8.5 billion to strengthen bulk-billing, boost the workforce and improve access to urgent care. Let me share what that means on the ground. We promised to open 50 Medicare urgent care clinics. We've already delivered 87 urgent care clinics, well ahead of schedule. And we are not stopping there; we're opening another 50 clinics, bringing the total to 137 across the country. That means four in five Australians will now live within 20 minutes of one of these clinics. These clinics are open seven days a week with extended hours, no appointment necessary. They accept walk-ins and they don't need a credit card—just your Medicare card.

They are already having a huge impact. Over 1.5 million people have walked through the doors of a Medicare urgent care clinic across the country and received the urgent care that they need, without the wait at a busy hospital emergency department, reducing the strain on our public health system. I've seen this impact personally. Earlier this year, my dad was visiting Melbourne from Queensland when he came down with a nasty ear infection on a public holiday weekend. Rather than having him wait for hours at a hospital emergency department, the urgent care clinic near my house meant he could see a doctor quickly, get the urgent treatment that he needed and enjoy the rest of his day with us. These are the kinds of services that we hope we never need but are grateful to have when we do.

It's easy to reduce healthcare reform to lines in a budget. But the real value is what it means to people's lives—not having to wait in pain, not having to choose between groceries and a GP visit, not having to rush to an emergency room and then wait for hours because there's nowhere else to go. That's the kind of stress and uncertainty no-one should have to face. That is what good government is for, to make sure essential services are there when people need them, to provide security in uncertain moments and to ensure that care is available not just for some but for everyone. This is how Labor governs—building a country where dignity, fairness and compassion aren't just values that we talk about but principles that we put into action.

But we know that urgent care is only part of the solution. Australians need regular ongoing access to high-quality affordable care. That's why we're reversing the damage done to Medicare by the coalition's funding freeze and we're going further. In just two years we've delivered the two largest increases to Medicare rebates in 30 years. As a result, bulk-billing rates are on the rise again in every single state and territory. We're also making a transformative change to bulk-billing incentives. For the first time, we're expanding them to all Australians, and we've created a new incentive for practices that bulk-bill every patient. This will mean nine in 10 GP visits will be bulk-billed by 2030, and the number of fully bulk-billed clinics will triple to around 4,800 nationally. It's not just good health policy; it's smart economic policy.

Notwithstanding what you heard earlier from Senator Scarr, our government has a track record in health. And protecting Medicare is in stark contrast to those opposite, and I think the Australian people know it.

We all know that regular check-ups, preventive care and early intervention can catch issues before they become crises. It keeps people out of hospital and in their communities, living healthy and productive lives. We know these reforms aren't something that can be willed into existence with the wave of a magic wand. This is not just feel-good policy; it is important for a productive and healthy society.

We are conscious, always, of the impact these reforms will have on the workforce, and we know that, to achieve the level of bulk-billing that we aspire to, we need more doctors. That's why we're also investing $662 million in the largest GP training program in Australian history. By 2028 we'll be funding 2,000 new GP trainees every year. We're expanding our capacity with overseas trained doctors, too. Seventeen thousand new doctors have joined the Australian system in the last two years—more than at any time in the past decade. We're not just filling the gaps; we're building a future-ready healthcare workforce.

For Australians managing chronic conditions or filling prescriptions every month, we're delivering real cost-of-living relief. In 2023 we made the largest cut to the cost of medicines in the history of the Pharmaceutical Benefits Scheme, reducing maximum script prices by more than 20 per cent, saving Australians over $200 million a year. We've made around 300 medicines available on a 60-day prescription, and we've lowered the PBS safety net threshold, saving Australians more than a billion dollars on their medications so far—over $1 billion in savings. That's more money in the pockets of Australians. And, from January, you won't pay more than $25 for a PBS script. For pensioners and concession card holders, the price of a script will be frozen at $7.70 until 2030. The last time medicines were $25, it was 2004; we were all watching the Athens Olympics and the classic Jets banger 'Are you gonna be my girl' won single of the year at the ARIA Awards.

When people can afford their medicine, they take it. When they take their medicine, they stay well. Making medicines more affordable and accessible means people can stick to their treatment plans, manage chronic conditions more effectively and avoid preventable hospital visits down the line. When they stay well, they live better and they live longer. It sounds very simple because it is, and it's one of the most powerful ways we can build a fairer health system—a system where no-one misses out on the care that they need because of their income or circumstances; a system that doesn't just treat illness but also protects dignity, because, in a country like ours, no-one should be left behind.

We're also delivering record funding for public hospitals, with an additional $1.8 billion next year alone, bringing the Commonwealth contributions to over $33.9 billion in the year 2025-26. That's a 12 per cent increase year on year—and a stark contrast to the coalition, who cut $50 billion from our hospitals when they were in office. This investment will support the long-term reform of our health system, in partnership with the states and territories, because public hospitals shouldn't be political footballs. They should be at the centre of care, staffed and resourced to meet the growing needs of our population.

Finally, we are acting boldly on the health challenges of today, especially when it comes to young people. We've introduced world-leading reforms on vaping to protect children and adolescents, and the results are already coming in. The Cancer Council's Generation Vape study showed that vaping rates amongst 14- to 17-year-olds are on the decline. We're also cracking down on the black market in illegal tobacco, investing over $350 million to give law enforcement the tools that they need to fight criminal activity and protect public health.

All of this—the clinics, the doctors, the cheaper medicines and the cracking down on vaping—forms part of a single, simple mission: to restore fairness, equity and dignity to the healthcare system. It's a promise—a uniquely Australian promise—that we look after one another, especially in moments of vulnerability. It reflects the best of who we are—that, no matter your income, your background or your postcode, you should be able to see a doctor and get the care you need when you need it in your community.

It was a Labor government that built Medicare, against fierce resistance, because we believed then, as we do now, that access to health care should be universal. Access to health care should not be something reserved for the wealthy or the well-connected. Labor created Medicare, we defended it from cuts and attacks, and now, under the Albanese Labor government, we are strengthening it and expanding it for the future, because Medicare isn't just a health system; it is one of the defining achievements of modern Australia, a cornerstone of our social compact, which is why it was also a cornerstone of our election campaign and Australians roundly supported our agenda. It says something profound about the kind of country we are and the kind of future that we want to build—fairness, compassion and a commitment to equality. That is the Labor difference. We don't just talk about fairness; we legislate it, we fund it and, importantly, we deliver it. And we don't just protect Medicare; we fight for it and we make it better, because we believe health care is a right and not a privilege.

Under Labor, the promise of Medicare will endure, and we will never stop working to ensure that promises reach every Australian not just in name but in reality. Labor made that promise decades ago, and we will continue to deliver it. Under this government, we're making good on it again through this bill. We are investing in health care not as a luxury but as a right; we are rebuilding Medicare not for headlines but for people; and we are doing the work day in, day out to ensure no Australian is left behind when it matters most.

Jane Hume (Victoria, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. I alert the chamber now that my contribution won't be excessively long today, but I do think that it is very important to put things on the record because—let's face it—this bill in itself is not highly controversial but the issue of health care in Australia is a very contentious one.

The bill specifically seeks to strengthen the integrity of our health system. It implements recommendations from the Philip review to improve compliance, to deter misconduct and to protect the integrity of programs like the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme—all noble objectives. The coalition supports this legislation. They are sensible reforms. They respond to real challenges. They improve the detection, oversight and enforcement that are necessary to ensure that our health system remains fair, accountable and sustainable.

So this is an important bill, but—let's face it—this is compliance legislation. It's important, but it's kind of dull and it's uncontroversial. So why are we all up here talking about it? Because we cannot avoid the broader reality. While the government is bringing forward this compliance legislation—this entirely uncontroversial and rather dull but important compliance legislation—Australians are struggling with the cost and accessibility of basic health care, and that's why it is so important to speak about it in the chamber today.

Those who are listening to this debate up in the gallery and via the broadcast, had they just listened to the Labor contribution, would have been subjected to the most extraordinary spin, which is not dissimilar to what we heard during the election campaign. As much as I respect Senator Darmanin and her contribution today, I've got to say, there needs to be a correction of some of the facts. Senator Darmanin said, 'When Labor came to government in 2022, it had never been more expensive nor more difficult to see a doctor.' Well, that is not true. In fact, it had never been more difficult or more expensive to see a doctor than when Labor was in office. It got worse over the last three years. GP bulk-billing was at its highest level under a coalition government. It was at 88 per cent. Under a Labor government, the 'great champions of Medicare', it fell to 77 per cent—on their watch. In the past year, there were 40 million fewer bulk-billed GP visits. That's not marginal change; that's a system under pressure. And I'll bet you that the people that are sitting up in the gallery today will nod along—it has become harder and it has become more expensive to see a GP in the last three years. Australians are now paying 45 per cent more of the cost to see a GP from their own pocket. Out-of-pocket costs are now, under a Labor government, the highest on record.

Last year, more than 1.5 million Australians actually avoided seeing their GP because they couldn't afford it. In a cost-of-living crisis, they traded away their health for putting food on the table. That's what happened under a Labor government. This isn't just coalition commentary and this isn't just some sort of convenient narrative; the government's own data told us this. And it's not just a policy issue, is it? This isn't just about dollars and cents; this is now a public health risk. Despite all of this, the Albanese government has continually relied on spin when it comes to health care. Just two months ago, we saw the Prime Minister endlessly, over and over again, promise to strengthen Medicare, as he waved his Medicare card around. He said that you won't need to rely on a credit card, because you'll have a Medicare card. What nonsense! How many Australians still rely not just on a Medicare card but on their credit card? How many people need their credit card? How many people are suffering because they will not go to a doctor, because they cannot afford to under this government?

Why won't the Prime Minister be honest with Australians about the state of bulk-billing in Australia? The government are completely out of touch with the reality of the pressures that Australians are facing every day. The fact is that Medicare bulk-billing was 11 per cent higher under a coalition government. It's an inconvenient truth, but it is a truth nonetheless, which the Labor government simply will not mention.

Under a coalition government, Medicare funding increased year on year—again, another inconvenient truth. It increased year on year because of our commitment to a strong and sustainable Medicare system. We introduced Medicare subsidised telehealth services during COVID. Initially they were temporary, but telehealth services have proved popular and now they've been made permanent for many services, and that's expanded access for people in regional areas. If it weren't for the coalition, that would not have happened. The coalition invested in primary health networks and GP clinics, especially in remote communities, which have found it so hard to access quality health care in the past. We've also supported the need for urgent care clinics. Importantly, the coalition legislated a guarantee of Medicare and the PBS, enshrining that ongoing funding into law, a profoundly important change that should give comfort to every single Australian that the coalition is on the side of Medicare and the PBS, and that we are on the side of every Australian who needs and deserves quality health care. That's a record of action; it's not a record of spin.

Compare that to what Australians have seen today: a rise in unaffordable health care over the past three years directly because of decisions this government has made. The Prime Minister has made a lot of promises. He made a lot of promises at the election, and the coalition will be watching this situation very closely every single day to ensure that every single one of those promises is met. Let's be clear about exactly what this bill does. It strengthens the administrative tools that are needed to protect the integrity of the health system. It targets fraud—that's a good thing. It improves the ability of government agencies to enforce compliance—again terrific. They were the objective the coalition supports. That is entirely uncontroversial. But the bill does not address the affordability crisis that's currently facing families, pensioners and patients in regional Australia. In other words, it fixes the back office, but it doesn't fix the front door of the health system. Labor promised to fix Medicare. They promised to strengthen Medicare. Instead GP bulk-billing has fallen, and Australians are paying the highest out-of-pocket amount on record.

The coalition will support the bill because we understand and believe that all Australians deserve timely and affordable access to the health care that they need. Of course we will. But we also believe that Medicare must work for patients, not just for compliance departments and not just for bureaucrats. Australians deserve more than slogans. They deserve so much more than slogans when it comes to their health care. They deserve more than watching a Prime Minister wave about a Medicare card and call it a promise. They deserve to be able to go to a GP appointment with only their Medicare card, as Labor has promised. By the time we get to the next election, if they have not delivered on that promise, we will hold them to account. I hope that the electorate will too; otherwise it says we're happy to be lied to by Labor. I commend this bill, but I condemn the Albanese government for its spin over substance and for its damaging record on Medicare.

Tony Sheldon (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. This bill demonstrates yet again a clear truth in how most policies work in our country. The Liberals and Nationals, either intentionally or by their own incompetence, create a crisis, and Labor comes in to clean it up and clean their mess up. That's exactly what has happened with health care. Under the previous government, Medicare faced nearly a decade of neglect and deliberate undermining. Australians watched bulk-billing rates collapse, Medicare rebates remain frozen and our healthcare system stretched to the breaking point.

When we came to office in 2022, Australians found it harder and more expensive than ever to see a doctor. Families faced impossible choices between health care and essential bills. Hospitals across Australia felt the pressure of chronic underinvestment, starved by the Liberals' relentless cuts. $50 billion—remember that figure. $50 billion is what the Liberal and National coalition ripped out from public hospitals. Those cuts weren't just numbers on a spreadsheet; they had real, devastating consequences for Australians. It meant fewer nurses on the wards. It meant regional hospitals shutting down services. It meant cancer patients waiting longer for life-saving treatment. It meant emergency departments overflowing, parents waiting through the night with sick kids, and elderly Australians left in pain because there weren't enough staff or beds to help them. In some communities those cuts literally cost lives.

When you strip $50 billion from public hospitals, you are not just cutting dollars; you are cutting care, you are cutting staff, you are cutting hope for families who depend on the public health system. And it wasn't an accident. It was a deliberate ideological decision from a coalition government that has always hated Medicare. This was the coalition's legacy: cuts, neglect and disregard for Australians' fundamental healthcare needs. That's why Labor is reversing those cuts. Next year alone we are delivering an additional $1.8 billion in funding for public hospitals and health services. In 2025-26, the Commonwealth funding for state run hospitals will reach a record of $33.91 billion—year on year growth of 12 per cent. This isn't just restoring what was lost; it's building a stronger, fairer and more resilient hospital system for the future.

We came into office with a clear commitment to revive and strengthen Medicare, a commitment Australians decisively endorsed at the ballot box. We are delivering the single largest investment in Medicare since its creation more than 40 years ago. This $8.5 billion investment will deliver more bulk-billed GP visits, thousands more doctors, hundreds of nursing scholarships and significant improvements to patient care. For the first time, Labor is expanding bulk-billing incentives to all Australians, not just children or concession card holders, and creating a new incentive for practices that bulk-bill every patient. By 2030, nine out of every 10 GP visits will be bulk-billed and fully bulk-billed practices will triple nationwide to around 4,800.

Already our investment has delivered an additional six million bulk-billed GP visits in just over a year. This has also been recognised by healthcare professionals around the country. Associate Professor Magdalena Simonis from Victoria, from the Royal Australian College of General Practitioners, acknowledged this investment earlier this year—contrary to what people say across the way, these are the facts. She said:

… this injection of funds into general practice makes good sense after such a long period of neglect from governments …

Dr Edwin Kruys from Queensland described this as a 'much-needed boost to general practice'. Dr Tim Senior, from the RACGP Aboriginal and Torres Strait Islander Health faculty, said:

This is particularly welcome in … practices serving socioeconomically disadvantaged communities, where many people can't afford co-payments.

Labor values the healthcare professionals in this country and will be supporting their needs head on. We're funding Australia's largest ever GP training program—2,000 new GP trainees each year by 2028. Additionally, an extra 17,000 overseas trained doctors have joined our healthcare system over the past two years, more than at any other time in the last decade.

Then, of course, we've got our Medicare urgent care clinics. I had the opportunity to go out to Lindsay and to Penrith to visit one of the Medicare urgent care clinics and I spoke to a number of the patients and the parents bringing young children there. They were so delighted to see this opportunity, to make sure they get quick assistance to their families. At the election before last, Labor promised 50 Medicare urgent care clinics. Did we deliver 50? No, we delivered 87. Over 1.5 million Australians received urgent care through these clinics as a result of the overperformance of the outcome that we said we'd deliver—87 new clinics rather than the 50 originally projected. That has reduced pressure on emergency departments. They've filled a critical gap in our health system for parents, young children and elderly Australians who would otherwise spend hours waiting in a hospital emergency department. They're open seven days a week with extended hours, and they accept walk-ins. All you need is your Medicare card, not a credit card.

And it's not stopping there. The Albanese government is also making the biggest investment in mental health care that Australia has seen in decades—again, contrary to what those opposite want to say about mental health. We're investing $1 billion to make mental health care more accessible, more affordable and more tailored to the needs of Australians. This includes $225 million to build or upgrade 31 new Medicare mental health centres. Another $200 million will expand and strengthen headspace services for young people, because we know they are the front line of the mental health crisis. And $500 million will go to 20 youth specialist care centres to support young people with complex needs.

Mental health experts have welcomed this initiative, contrary to what those opposite would have you believe—the real experts, such as Patrick McGorry, one of Australia's leading psychiatrists, who called it a groundbreaking commitment that will fundamentally improve access to youth and mental health care. Carolyn Nikoloski, the CEO of Mental Health Australia, said, 'It will fundamentally increase access to free mental health support across the country.' Those are the facts and the important initiatives from those that know. That's what this investment is about—real care, where and when people need it.

Our government has significantly reduced medicine costs as well. Australians have already saved over a billion dollars because we delivered the largest price cuts in the history of the Pharmaceutical Benefits Scheme. Now PBS scripts will cost no more than $25, saving Australians over $200 million a year. Of course, we didn't stop there. We made around 300 medicines available on a 60-day prescription, saving patients even more by halving the number of pharmacy visits they need. And remember what those opposite did? They opposed these sorts of initiatives that made medicines cheaper for so many millions of Australians—those that are in need and all Australians that need to have their cost of living reduced. We also lowered the PBS safety net threshold, which means that families and pensioners reach cheaper medicines sooner. These are practical, immediate savings for households already under cost-of-living pressure.

That contrast with the coalition could not be clearer. Their record was to freeze Medicare rebates, cut $50 billion from hospitals, oppose cheaper medicines and consistently vote against measures making health care cheaper and more accessible. Even now, in opposition, they continue to oppose bulk-billing incentives, urgent care clinics and essential cost-of-living measures. Their own words highlight their intentions. Let's take a quick look down memory lane. In the seventies, you had prominent Liberal figures like Billy Snedden saying, 'We will fight this scheme continuously, and in the end we will defeat it.' In 1984, John Howard declared that he would stab Medicare in the guts. You don't even have to travel back that far. In 2015, Anne Ruston said that Medicare wasn't sustainable, and, earlier in 2014, she said that the credit card is maxed out on universal health care. That's their view. That's their consistent view. That's their opposition to Medicare. If it were up to them, the 'universal' would be stripped out of 'universal health care'. Let's not forget: Labor's investment restores every single dollar that the Australian Medical Association says was stripped from Medicare through the coalition's rebate freeze. We are rebuilding what those opposite tore down.

Labor understands that Medicare is fundamental to Australian identity. It represents the promise that health care is a right, not a privilege reserved only for those who can afford it. This bill continues Labor's mission to protect and strengthen Medicare. It shortens the timeframe for bulk-billing claims so that the system runs more smoothly and with greater integrity. It strengthens investigative powers so that, when serious fraud or noncompliance is suspected, we can act faster and more effectively. It streamlines the pharmacy approval process so communities can access essential medicines more quickly. And it reinforces our vaping and tobacco reforms, protecting young people from harmful and addictive products.

We know those reforms are working. The latest research from the Cancer Council's Generation Vape study shows that the number of young people aged 14 to 17 who vape is already in decline. We're investing over $350 million to crack down on the illegal tobacco trade, giving law enforcement the resources they need to fight back against criminal networks. It's another step in ensuring Medicare is stronger, more sustainable and more effective for generations to come, because Medicare is more than just a policy; it's part of who we are as Australians. It represents the simple, powerful belief that health care is a right, not a privilege. It means that, whether you live in a remote community or a capital city, or whether you are a pensioner, a patient or a student, you deserve affordable, high-quality care without going broke to pay for it—and that's what Labor has always stood for.

Let's be clear. This bill is about making Medicare stronger. It's about giving Australians confidence that when you need care, it will be there. It's about saying, once again, that this country will never go back to the days when you needed both a Medicare card and a credit card just to see your GP. I say this not just as a legislator but as someone who has seen firsthand what Medicare means for ordinary Australians. I met those parents in regional towns that told me that without bulk-billing— (Time expired)

Corinne Mulholland (Queensland, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. Medicare and our Pharmaceutical Benefits Scheme are the cornerstones of Australia's world-class health system. Indeed, they are the envy of the world, and they light the way for what a fairer, more decent health system can look like. That's why the Albanese government has committed to making the single largest investment in Medicare in this nation's history: an injection of $8.5 billion. That record funding for Medicare and the PBS is an example of this government living its values: a belief in a universal healthcare system.

This massive funding injection will increase the number of bulk-billed doctor visits every year. It will fund more doctors and nurses to care for our growing and ageing population. Our investment will also reduce the out-of-pocket cost for Australian families—something that skyrocketed under the former coalition government. In fact, Labor's record funding for Medicare will mean nine out of 10 GP visits will be bulk-billed by 2030.

We have also committed to delivering 50 additional urgent care clinics across the country. Already 1.2 million Australians have been treated at over 87 urgent care clinics nationwide—over a million patients! In my home state of Queensland, there are 10 additional urgent care clinics being delivered under this government. These are fully bulk-billed walk-in GP clinics that are free to attend. In Queensland, our urgent care clinics have already treated hundreds of thousands of sick patients.

Last month I visited one of our busiest urgent care clinics in Morayfield in the federal seat of Longman. While I was in the urgent care clinic, the clinic was busy treating little kids, elderly patients and workers seeking treatment. These are the patients who would otherwise be forced to find a pay-for-service GP appointment or wait a long time for a bulk-billed appointment at another clinic. Every one of those patients arriving at the Morayfield urgent care clinic came with just their Medicare card, and they were entitled to world-class care from a community GP in their local area. Earlier this year I travelled to the seat of Groom and visited our urgent care clinic in Toowoomba. The Toowoomba urgent care clinic has delivered over 6000 bulk-billed GP appointments to Toowoomba locals. With a shortage of GPs and bulk-billed appointments in regional Queensland thanks to a decade of inaction by those opposite, the urgent care clinic is turning around that tide.

We have worked hard as a Labor government to reverse a decade of underfunding by those opposite, but wait, there is more. In addition to Labor's urgent care clinics Labor has committed over $255 million for 31 new Medicare mental health clinics. From 1 July, just earlier this month, a number of those new Medicare mental health clinic services commenced across Queensland. We now have Medicare mental health clinics funded by this Labor government operating in locations including Caboolture, the Sunshine Coast, Redcliffe, Bardon, Rockhampton, Townsville, Redlands, Strathpine, Logan and many more. These are locations where patients can get much-needed walk-in mental health appointments, taking pressure off our hospital system, which particularly right now is under a lot of pressure in Queensland, as we can see in the local newspapers. I look forward to joining the assistant minister in the near future to officially open some of these bulk-billed Medicare mental health clinics, and in doing so we can get the word out about these great new clinics.

This side of the chamber know the job is never done, and we are always fighting to secure the future of our world-class health system as we continue to improve it. Labor will always fight to protect its future, a commitment we took to the last election. When Labor came to government in 2022 it had never been harder or more expensive to find a doctor in Australia. Bulk-billing rates were in freefall after a decade of coalition cuts and neglect to Medicare. Australians chose to elect the party that created Medicare, Labor, to stand up and defend our health system. In November 2021, six months before the 2022 election, the financial viability of general practice was in serious trouble after the coalition's six-year freeze on Medicare rebates. Labor has delivered the two largest increases to Medicare rebates in 30 years. We have increased Medicare rebates by more in just two years than the former government did in nine long years. As a result of this record investment, bulk-billing has started to rise again for every state and territory, delivering an additional six million free visits to the GP in just 12 months.

We must always fight against attacks on Medicare from those opposite, who believe access to Medicare should depend on your credit card, not your Medicare card, and that is a commitment that Labor took to the Australian people—that we would always stand up and protect Medicare and the PBS from ideological attacks from those opposite, who seek to get their hands on it and rip away vital funding from our health system. But also, just as importantly, we must protect Medicare and the PBS from bad actors who would—and some do—seek to defraud our health system and take advantage of vulnerable patients. Part of that is continually enhancing and modernising Medicare and protecting it from those bad actors to ensure Australia remains among the healthiest countries in the world. The amendments in this bill will help protect the integrity and the ongoing sustainability of Australia's health benefits scheme, including the MBS, the PBS and the CDBS. This bill strengthens the powers of Medicare to investigate incorrect billing and fraud in the system. Medicare costs, as we know, billions of dollars annually, and we know that fraudulent behaviours, incorrect billing and overpayments are a drain on public money and reduce the funding available for those patients who need it the most. This bill also introduces tougher penalties for those making fraudulent Medicare claims, which take vital funding away from much-needed primary care in our local communities. Stronger integrity measures like those in this bill create a more level playing field for all users, which makes our record funding go even further.

It also ensures that we are focusing on patient care and the right appointment and the right service in the right location for the right patient, not the other way around—having appointments or claims driving care. Where patients are having their appointments cut short or are required to come back for a new chargeable appointment when they are already there receiving care, this comes at an additional expense for taxpayers and at a cost in time for both the patient and the practitioner. The Independent Review of Medicare Integrity and Compliance, undertaken by Dr Pradeep Philip—the Philip review—specifically referred to the need to ensure patient safety in all aspects of health services. This must include a review of billing practices to ensure ease of visitation for patients, to keep health care affordable, to reduce duplication of appointments and to cut down on wait times for families.

But, in saying this, I want to be very clear: the measures introduced in this bill today will, importantly, directly impact upon only a small percentage of practitioners and businesses—those engaged in noncompliance and fraud. Australians know that the overwhelming majority of our doctors and other healthcare professionals are decent, honest and hardworking and comply with the Medicare rules and guidelines. This system protects those practitioners doing the right thing and takes action against those doing the wrong thing. Overall, patients and practitioners can expect to benefit from better protected health schemes that will provide more secure access to safe, quality services closer to home. This bill focuses on incentivising the good behaviour amongst our hardworking medical practitioners and cracking down on the bad behaviour. Improving patient integrity, deterring misconduct and reducing fraudulent claims is critical to ensuring that Australia can afford Medicare. Strengthening Medicare also means safeguarding the taxpayer funds that underpin it, and this government is committed to that task. I support the important amendments in this bill to detect, respond to and investigate instances of misconduct, fraud and noncompliance, because it's Australian families that are paying the price for the misuses and abuses of our system

But, as Labor people, we know that the job is never done and we must always fight to protect and secure Medicare's future and to continue to improve it. As a new mum, I have been so proud of the reforms delivered by Labor to deliver incentives to increase bulk billing rates for children. When you are holding a sick child in your arms, the last thing you need to be thinking about is whether you can afford for your child to get the treatment they need. I am so proud that bulk-billing rates have increased for children under Labor. We know that getting care closer to home with a trusted medical professional leads to better health outcomes for our littlest people. We know that Medicare ensures that, no matter where you live, how much you earn or what's happening in your wallet, you and your loved ones can get the care you need under Labor, and Labor will always fight to strengthen Medicare.

Josh Dolega (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to speak to the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025, and I note that this is not my first speech. When I think about Medicare, three names come to mind: Whitlam, Hawke and Albanese—three Labor legends who have championed universal health care. It was Labor who established Medicare in Australia over 40 years ago, and only Labor will protect and strengthen it.

The outcome of the 2025 election couldn't have been clearer. The Australian people sent a clear message: they will not stand for cuts to or degradation of our green and gold national icon. When we came to government in 2022, it had never been harder or more expensive to find a doctor. Bulk-billing was in freefall and, after a decade of cuts and neglect to Medicare, people were forgoing healthcare to make ends meet. This was not okay. That's why strengthening Medicare was a key focus of Labor's 2025 election campaign. When I was on the doors in Tassie's north-west during the campaign, I heard time and time again about the importance to Medicare and how access to high-quality and bulk-billed health care changes outcomes for everyone.

In Labor's first term of government, we delivered more doctors, more bulk-billing and cheaper medicines, and we opened 87 Medicare urgent care clinics across the country. This was just the start of generational investment in and improvements to our health system, and we're going further. On this side of the chamber, we stand for more bulk-billing, more doctors and more urgent care clinics. The Prime Minister has told Australians that this is Labor's year of delivery, and we aren't wasting any time. The Albanese Labor government is making the single largest investment in Medicare since its creation. We're investing $8½ billion to deliver more bulk-billed GP visits each year, hundreds of nursing scholarships and thousands more doctors. This means Australian families will save hundreds of dollars in out-of-pocket expenses. For the first time, our government is expanding bulk-billing incentives to all Australians, and we will create an additional new incentive payment for practices that bulk-bill every patient, meaning that nine out of 10 GP visits will be fully bulk-billed by 2030. Labor's record investment restores every dollar that the Australian Medical Association says was cut from Medicare through the Liberals' funding freeze.

I do know how important it is to see a GP regularly. It helps to catch issues early, before they worsen and before they lead to more intensive and more costly care. I've been really lucky to have had the care from the amazing doctors at the Glebe Hill Family Practice and Nurture on Hobart's Eastern Shore. To Dr Tim Jones and Dr Boris Tan: hi, I can't thank you and your amazing staff enough for your support and care over the years.

Our policy lifts up our entire nation and ensures that no-one is held back or left behind. We need more doctors. That's why we're investing $662 million in a workforce package that will expand the largest GP training program in Australia's history. By 2028, we will fund 2,000 new trainees every year. This complements the massive increase in overseas educated doctors joining the Australian health system, with an extra 17,000 registering in the last two years—more than at any time in the past decade. More GPs mean more Australians can get the care that they need closer to home. It means shorter wait times, better continuity of care and stronger support for families, especially in rural and regional communities like Tassie. That's why growing our GP workforce isn't just a health investment; it's a commitment to a healthier and fairer Australia.

We initially promised 50 Medicare urgent care clinics at the 2022 election. As I said before, we delivered 87. We're building on the historic investment in Medicare to expand the availability of free Medicare urgent care clinics in all states and territories. This means that four in five Australians will live within a 20-minute drive of a Medicare urgent care clinic. In Tasmania, we currently have five urgent care clinics: two in Hobart CBD, one in Bridgewater, one Launceston and another in Devonport. During the 2025 federal election campaign, the Albanese government promised another three for Tassie: one in Burnie, one in Sorell and one in Kingston. This will have a real impact on Tasmanians.

Nationally, more than 1½ million patients have walked through the door of a Medicare urgent care clinic and received the free urgent care they needed instead of waiting hours in a busy hospital emergency department. In Devonport, we have an urgent care clinic close to my electorate office. The community have embraced it with open arms. I drove past this clinic the other day. People were there, and they were lined up for over an hour before the clinic even opened, just wanting to see a doctor for free. People are even travelling from the neighbouring city of Burnie to be able to access the Medicare urgent care clinic. I know the community on the north-west coast are looking forward to the next clinic opening up in Burnie. Our Medicare urgent care clinics have filled the gap in our health system, and now patients all around the country, including parents and young children, don't have to spend hours in the hospital emergency department.

I have seen firsthand the benefits of urgent care clinics. On an amazing sunny Hobart afternoon, my partner and I decided to go for a bike ride along the beautiful Howrah Beach waterfront. Unfortunately, during this bike ride my partner fell off his bike. As the day progressed, it was clear that something wasn't right and that he needed to see a doctor. Without the Medicare urgent care clinic, we would have needed to go to the Royal Hobart Hospital. When we arrived at the Bathurst Street urgent care clinic, my partner was able to see a nurse and then a doctor, have the appropriate X-ray scans, get into a sling and get a script for pain meds. No credit card was needed, just our Medicare card.

It's not just Medicare that we are improving; we are making medicines even cheaper. The Pharmaceutical Benefits Scheme is the envy of the world. Having already slashed the cost of medicines with the largest cut to the cost of medicine in the history of the PBS in 2023, we are now going even further. The government will make cheaper medicines even cheaper, with scripts to cost Australians no more than $25 under the PBS. This is more than a 20 per cent cut in the maximum cost of medicines, which will save Australians over $200 million each year. It's another key cost-of-living measure delivered by the Albanese government which will also put downward pressure on inflation. Australians have saved more than a billion dollars on the cost of their scripts thanks to the commitment to make medicines cheaper.

Our government is taking strong action to protect health of our young people. One of the pressing issues we face today is the rise in vaping among children and teenagers, and I'm sure senators are as concerned as I am. That's why we've introduced world-leading reforms to tackle vaping head on. These reforms are making a difference. According to the latest figures from the Cancer Council's Generation Vape study, the number of young people aged 14 to 17 who vape is now in decline. This is a clear sign that our policies are working and that we are moving in the right direction. But our commitments don't stop there. We are cracking down on the black market in tobacco. The illegal trade not only undermines public health but fuels criminal activity. To combat this, we are investing over $350 million to support law enforcement agencies, and these funds are helping them to take the fight directly to the criminals who profit from illegal tobacco. The Albanese Labor government is leading the charge in protecting young Australians from the dangers of vaping and illegal tobacco. Through groundbreaking reforms and substantial investments in law enforcement, we are seeing real progress. Together we are building a healthier, safer future for the next generation.

We are also delivering a major boost to our public health system with an additional $1.8 billion for public hospitals and health services next year. This one-year agreement is more than just a funding announcement; it's a commitment to ensuring Australians have access to better funded, more responsive public hospitals. It's a step forward in our long-term vision for health system reform. Let's not forget, it's a stark contribution to the previous Liberal government, which cut $50 billion from public hospitals. We're not just reversing those cuts; we're building something better.

And we're not stopping there. The Albanese government is working closely with states and territories to deliver a new five-year funding agreement that ensures our public hospitals are sustainable and ready to meet the needs of every Australian. The Albanese government is making Medicare even stronger. We are helping with cost-of-living pressures and ensuring that every Australian gets the best health care that they absolutely deserve. I know Tasmanians are behind this. I support the bill and I encourage senators to do the same.

Lidia Thorpe (Victoria, Independent) Share this | Link to this | Hansard source

I rise today to speak about the health crisis this country continues to impose on First Peoples of this country. The so-called gap in health, in housing, in justice, grows with every preventable death, every child removed, every prison sentence, every community left without basic health care or housing. They call it a gap. We call it what it is: a system of racial segregation. Our people are being killed through the destruction of country and culture, systemic neglect, targeted state violence, racist institutions and mass incarceration at the highest rates in the world, not by accident but by a system designed to assimilate or exterminate us. This is racial segregation, it is apartheid, and it is a slow and sophisticated genocide.

Health care in prisons isn't just a service or a hospital or a policy area; it is a human right that continues to be selectively denied to our people. People who should have been cared for by family in safe, secure housing or in a doctor's waiting room or in a hospital are sent to prison. There they often die alone in prison cells, without proper medical care, and too often their deaths are labelled 'from natural causes'. Let me be very clear: there is nothing natural about dying in a prison cell from a treatable illness. There is nothing natural about a child taking their own life while on remand. There is nothing natural about shackling a woman while she's giving birth or shackling a palliative-care patient. This is outrageous. There is nothing normal or natural about losing your hearing from an untreated infection or having your fingers amputated because your pain is not taken seriously until it's too late. These are real stories, real people. There is nothing natural about a man hitting his head against a wall to try and get relief from excruciating dental pain caused by an infected tooth left untreated for weeks. These are not natural injuries or deaths; this is systemic neglect at the hands of a state, including police officers and prison guards, who do not see our people as worthy of being looked after.

Those of us who have been around long enough have heard, time and time again, stories and reports about racism that festers in every police department and in every prison. Health care in this country is not equal. It is not safe. If you're black, disabled, criminalised or all of the above, you're far more likely to be denied the care you need to survive. This is how racism harms and kills. The brutal reality is that this country continues to deny incarcerated people their right to health care. As First Peoples, we are the most incarcerated people on the planet, which means we are the ones dying from this neglect, abuse and torture, all of which are very well documented. Behind closed doors, where international observers are denied entry, adults and children are being physically and sexually abused by the state. They are being shackled and spit-hooded. They are denied food and water, as punishment, and monitored on screens 24/7, with the lights on. If someone says they are depressed, the response of the prison is solitary confinement—for their so-called safety, in cells that still have hanging points.

The Royal Commission into Aboriginal Deaths in Custody included a number of recommendations on health care. One of these recommendations was to remove all hanging points from prisons. This was 30 years ago, and it still hasn't been acted on. The Guardian Australia recently revealed at least 57 people died by suicide, using known hanging points, over the past two decades, despite numerous warnings from coroners over that time. What message does that send to families? What message does that send to young people who are in the crisis? When someone in custody reaches out for help, they should not be punished for it and they should not be placed in solitary confinement. They should be met with care, support and connection. Instead, we are seeing suicide risk treated as a threat, and that only makes things worse.

We've had report after report from coroners, ombudsmen and royal commissions all saying the same thing: the prison system is not safe for people in custody, racism is rife, proper health care is extremely rare, mental health support is inadequate, chronic illnesses go untreated and deteriorate, medication is delayed or denied and antipsychotic medications are used as silent handcuffs to sedate and placate people, contributing to a number of side effects and chronic diseases. And people are dying as a result. Our community controlled organisations are doing their best to reach people inside, but they are underfunded, overstretched and forced to operate in hostile environments that continue to criminalise and punish our people for being unwell. Ministers and governments are quick to promote our services to cover up their failures and to showcase them as evidence of progress while routinely making community controlled organisations work harder.

The government has acknowledged some of these failures, in the National review of First Nations healthcare in prisons. That review was a long time coming. It made one thing very clear: the system needs to be transformed. The review calls for a range of measures, but we have not seen any action on this yet. I commend Minister Butler for showing more interest in this area than other previous health ministers did, but the truth is that we have not seen any change. It's all talk, no action. And we can't afford to wait any longer, because people are literally dying—children are dying.

I want to talk about medication in prisons. People in prison are still being excluded from the Pharmaceutical Benefits Scheme, the PBS, and that means they don't have access to the medicine they need, including basic things like insulin for diabetics. We know blackfellas, in particular, have high rates of diabetes—they can't access insulin in the prison system. It's like you just want us to die. There's no access to antipsychotic medications and there's no access to HIV treatment. People inside should have access to the same standard of health care as people on the outside, but we are failing to meet that standard in this country.

We've seen reports of prisons substituting medications with cheaper, less-effective options. We've seen delays that have caused seizures, infections and permanent disabilities. We've seen people denied treatment because it's too expensive or not available on site, and the vast majority of these people are Aboriginal and Torres Strait Islander people. This is not only dangerous; it's a violation of people's rights. It is one of the strongest and most effective levers the federal health minister has at his disposal. I've spoken to the health minister about fixing this a number of times. There is a range of solutions available, and I've provided those as well. One of my amendments to this bill also provides solutions. But people are still waiting. While we wait, people are dying.

It is time for the government, if they are genuine, to get on with it. Pull the states and territories into line. Use the Medicare scheme to implement the recommendations of last year's view that you paid for; establish nationally consistent standards; improve access to essential medicines, disability supports, drug and alcohol support, sexual and reproductive health care and post-relief care; remove all hanging points in custodial settings as a matter of urgency; address the widespread neglect of mental health and disability in youth and adult prison populations; and ensure First Peoples have access to community controlled, culturally safe models of care before, during and after incarceration. I foreshadow moving the second reading amendment as circulated, which outlines some of these priorities.

This is just the start. I also want to touch on health care for our elders, the ones who carry our stories, our lore and our culture. For our elders in custody—yep, they're there too—the situation is terrible. Prisons are not equipped to care for ageing people, to support complex needs, to treat cancers or for dying with dignity. There must be full and independent oversight and accountability for healthcare services in prisons. This is something that requires national coordination and leadership. Crucially, any work to transform custodial health systems should be designed, led and governed by First Peoples, including through adequate resourcing of Aboriginal community controlled health organisations. Health care is also where some of our strongest resistance has come from and where the community controlled movements come from—from our old people who fought against the system that saw them as less than human and who established our own services on our own terms.

To the families that reach out on a daily basis: I hear you, I see you and I stand with you. To our young people: your lives do matter, your future does matter and your health does matter. To our elders: thank you for your strength, your knowledge and your endurance. Let us honour them not just with words but with justice because until our people are safe in hospitals, in homes and in prisons none of us should be comfortable with the status quo.

Charlotte Walker (SA, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. I note that this is not my first speech. This bill, whilst primarily technical in nature, is part of this government's pivotal agenda to strengthen Medicare. Almost all Australians have come to see Medicare as very precious. We know how precious they see it by how they react whenever it is threatened by conservative governments, and also by how overwhelmingly they voted in an Albanese Labor government, with strengthening Medicare as one of our central promises.

Labor cares about Medicare and making it work better for all Australians. That little green card we have in our pockets or on our phones is one of the most powerful symbols of how Australians provide for each other in a fair society. Our government is making the single largest investment in Medicare since its creation 40 years ago, with $8.5 billion to deliver more bulk-billed GP visits each year, hundreds of nursing scholarships and thousands more doctors. Australian patients and families will save hundreds of dollars a year in out-of-pocket costs because we will expand bulk-billing incentives and create a new incentive payment for practices that bulk-bill every patient. There is little doubt that the undermining of bulk-billing and Medicare was an agenda of the former conservative governments. So, when Labor came to government in 2022, bulk-billing was bordering on being obliterated. We want nine out of 10 visits to GPs to be bulk-billed by 2030, and we are investing to make that a reality.

We have delivered 87 urgent care clinics around Australia. Already, over 1.5 million patients have gone to these clinics for free urgent care that they need. They have got access to free care seven days a week, using that little green card. Labor has also delivered the two largest increases to the Medicare rebate in 30 years. This has made a real difference, with bulk-billing rising across the country.

I come from a single-parent family. Medicare is essential to us, to our friends and to our extended family. It underpins the health of our country. So Labor is investing in the workforce, to expand access to GPs so that we can continue to expand access to health care. By 2028, we will fund 2,000 new GP trainees each year. This expansion of our medical workforce at the community level will make it easier to see a doctor whenever you need. We are also, of course, making medicines cheaper. Labor has already slashed the cost of medicines under the PBS and made over 300 medicines available on 60-day prescriptions. And there is more to come. We will now make medicines even cheaper, with a script to cost Australians no more than $25 under the Pharmaceutical Benefits Scheme.

The health legislation amendment bill that I'm speaking on today is part of that large suite of reforms we are making to Medicare. This bill will work to protect Medicare by implementing some important fraud prevention measures and enhancing investigation and administrative seizure powers. It will also streamline the pharmacy approval process so that communities will be able to get quicker access to pharmaceuticals in certain circumstances.

To reduce fraud and incorrect claims, this legislation will shorten the timeframes for making bulk billing claims. By reducing the timeframe to submit bulk-billing claims, to one year rather than two years, we will reduce the number of incorrect and fraudulent claims. Maintaining the integrity of Medicare is critical to protecting it into the future, so it is important to crack down on potential fraud, and this reduction in timeframes is an administrative pathway to doing this. Importantly, to make sure patients aren't disadvantaged, there will remain a discretion to extend the timeframe to pay bulk-billing claims.

This bill will also improve investigative powers across Medicare and the Pharmaceutical Benefits Scheme. The bill will improve investigative powers and allow them to be used consistently and effectively across Medicare and the Pharmaceutical Benefits Scheme to deal with potential misuse and fraud. It will also allow investigation of Criminal Code offences so that the department will not need to involve the AFP to execute warrants for suspected offences. This will strengthen our responses to anyone trying to rip off the system so that we can be assured that every dollar is going where it should be—to supporting Australia's health.

This bill also amends the Therapeutic Goods Act to improve the Department of Health, Disability and Ageing's ability to manage and alleviate therapeutic goods shortages. Currently, the department has to wait until critical therapeutic goods are not available before the secretary can approve the importation of substitutes. This change will allow the secretary to exercise this power in anticipation of such shortages.

I'm very pleased to say that this bill will also support the government's important, world leading vaping reforms. Vaping has replaced smoking as a real and present danger to young Australians. Australians of all ages vape, and this is not good for the health of our nation. Contrary to the misinformation that has circulated for so long, vaping isn't a harmless replacement for smoking. Vaping causes real harm to the lungs. Tiny particles are inhaled deep you’re your lungs when you vape, and these particles spread through your airways. These chemicals can cause inflammation, cell death, scarring and DNA damage. Due to the reforms led by the Albanese government, non-pharmacy retailers such as tobacconists, vape shops and convenience stores have not been allowed to sell any types of vapes for one year now. Vapes can only now be imported, manufactured, possessed or supplied in Australia if they are for the genuine purpose of helping people give up smoking. The bill amends the Therapeutic Goods Act to improve the investigations and enforcement action that can be taken by state governments after states adopted our important vaping reforms. It also clarifies the legal authority for the secretary of the department to make orders to cease the supply of vaping goods and make directions to stop misleading information about vaping being advertised. Vaping is an insidious threat to the health of young Australians, and I am pleased this bill will help strengthen the powers to help stop this threat. I strongly commend this bill to you as part of the package to deliver what Australians demand: a strong, universal and mighty Medicare.

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

():  Australia has a world-class health system, and that is largely thanks to the various health benefits schemes such as Medicare which help Australians pay for the health care they need. In 2023-24 payments for health benefits including medical services, pharmaceutical services and private health rebates totalled at least $65.1 billion. The government is committed to protecting this investment and strengthening Medicare by improving the compliance framework that ensures its integrity. As other speakers have observed, the government commissioned the Independent Review of Medicare Integrity and Compliance, known as the Philip review, in November 2022 to respond to concerns about the operation of the Medicare system. The Health Insurance Amendment (Professional Services Review Scheme) Act 2023 and the Health Insurance Amendment (Professional Services Review Scheme No. 2) Act 2023 made amendments in response to the recommendations of the Philip review.

This bill too will support the integrity and sustainability of Medicare by addressing a range of issues to enable the department to conduct more efficient, timely and effective compliance activities. The government is committed to tackling issues of fraud, integrity and noncompliance wherever we see them. That includes Medicare but also has implications for me in my role as Minister for the NDIS. When we see issues of this kind we know we also see poorer outcomes for Australians who rely on our systems of social support. The bill will improve payment integrity by reducing the timeframe for making bulk-billed claims, allow investigative powers to be used consistently and effectively across health schemes including Medicare and the Pharmaceutical Benefits Scheme and improve the processes associated with pharmacy approvals. The bill also makes several sensible amendments to the Therapeutic Goods Act 1989 to enhance the Department of Health, Disability and Ageing's capacity to manage and alleviate the consequences of therapeutic goods shortages and to support compliance enforcement activities undertaken in relation to unlawful therapeutic goods and unlawful vaping goods. These amendments are consistent with this government's unwavering commitment to public health and mitigate the public health risks associated with therapeutic goods and vaping goods by supporting strong, effective regulation under the act.

The bill also amends the Public Health (Tobacco and Other Products) Act 2023. These amendments are largely clarifying in nature and have been identified as necessary during implementation to ensure the smooth and consistent operation of the act. I know that a number of senators have either flagged or moved second-reading amendments, and I may give an indication about the government's position in relation to each of those. Senator Steele-John has moved an amendment on sheet 3360, and the government won't be supporting this amendment. The amendment is unrelated to the purpose of the bill. The bill, as I have just set out, seeks to improve the enforcement of Medicare integrity measures and support the implementation of world-leading vaping and tobacco reforms. Senator Steele-John's amendment relates to dental services.

I'll make the following general remarks in relation to the issues that you raise in that amendment, Senator Steele-John. Our government has provided $107.8 million in the 2025-26 budget to state and territory governments to support public dental services for adults. We are also working in partnership with states and territories to develop a new National Oral Health Plan for the next 10 years. We recognise, of course—and Minister Butler has said this also—that in the longer term there is a lot of ambition for dental to be covered by Medicare, but our focus right now is on strengthening Medicare and rebuilding general practice after decades of cuts and neglect from the Liberals.

I will speak briefly, too, about the government's approach to the second reading amendment to be moved by Senator Thorpe. I listened very carefully to her contribution when she was in the chamber earlier. I understand that Senator Thorpe has had a number of discussions with the Minister for Health and Ageing on this subject and that he has agreed to have regular discussions with her to work on this very important issue. The government supports in principle many elements that are set out in her amendment. We acknowledge, in particular, the disproportionate representation of First Nations people in corrective settings nationwide and the implications that that has for health outcomes. Our government has taken and is taking significant steps to address this issue. At the 6 December 2024 Health Ministers' Meeting, all health ministers endorsed the release of the report of the independent National Review of First Nations Health Care in Prisons. Health ministers also released a joint response to the review, and in this they thanked all of the stakeholders who contributed to the review's findings and they committed to ensuring health care is delivered in custodial settings by upholding the fundamental human rights of people in places of detention. Both the report and that statement are publicly available.

As an outcome of the review, all health ministers jointly wrote to ministers responsible for adult and youth justice regarding the review of health care in prisons, and they collaborate on this work, which is progressing. The Minister for Health and Ageing has also written to states and territories seeking advice on actions taken by them to remove hanging points in custodial facilities and has sought their support to further reduce preventable First Nations deaths in custody. The government will continue to progress these reforms through these channels with our state and territory counterparts, who do hold the primary responsibility for the justice system, and it would be premature to support this amendment while this work continues.

To conclude, Australians are, of course, rightly proud of the systems of social support that we've built, and we've built them in the Australian way over generations. The PBS and Medicare are so significant. They are a significant part of our national fabric, and I am proud to be part of a government that is strengthening these great Australian institutions. I thank senators very much for their contributions to the debate on this bill.

(Quorum formed)

Andrew McLachlan (SA, Deputy-President) Share this | Link to this | Hansard source

The question is that Senator Steele-John's second reading amendment be agreed to.

Lidia Thorpe (Victoria, Independent) Share this | Link to this | Hansard source

I move the amendment on sheet 3375:

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

(a) notes that:

(i) people are continuing to die preventable deaths in custody due to incarcerated people being denied the right to proper healthcare,

(ii) entrenched and systemic racism throughout corrections and health systems in this country is the greatest barrier to equitable and culturally appropriate interventions and necessitates bold action to improve outcomes for First Peoples in custody,

(iii) the 1991 Royal Commission into Aboriginal Deaths in Custody (the 'Royal Commission') provided a range of recommendations for addressing systemic racism and improving health outcomes for First Peoples in custody, which remain yet to be implemented,

(iv) building on what families, coroners, Ombudsman reports, Commissioners and First Peoples advocates have called for, for decades, the National Review of First Nations Health Care in Prisons (the 'Review') identified urgent reforms needed to address substandard healthcare in prisons,

(v) recent investigations revealed that at least 57 people died by suicide using known hanging points over the past two decades, despite numerous warnings from coroners to remove these over that time, and

(vi) the Federal Government has obligations under international law, through the United Nations Standard Minimum Rules for the Treatment of Prisoners (the 'Nelson Mandela Rules'), to ensure people in custodial settings receive equitable healthcare; and

(b) calls on the Government to:

(i) work with States and Territories to:

(A) implement the recommendations of the Review,

(B) establish nationally consistent standards for culturally appropriate, timely and equitable healthcare in custodial settings, in line with the Royal Commission's recommendations, the Review's findings and the Nelson Mandela Rules,

(C) improve access to essential medicines, disability supports, drug and alcohol support, sexual and reproductive healthcare and post-release care,

(D) remove all hanging points in custodial settings as a matter of urgency,

(E) address the widespread neglect of mental health and disability despite high rates of these in incarcerated people, and

(F) ensure First Peoples have access to community-controlled, culturally safe models of care before, during and after incarceration, including access to Medicare-equivalent services; and

(ii) ensure full and independent oversight and accountability for healthcare provision in prisons, including through data transparency, public reporting and enforceable quality standards, and

(iii) ensure that any work to transform custodial health systems is designed, led and governed by First Peoples, including through adequate resourcing of Aboriginal Community Controlled Health Organisations".

Andrew McLachlan (SA, Deputy-President) Share this | Link to this | Hansard source

The question is that the second reading amendment moved by Senator Thorpe be agreed to.