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

This omnibus bill, the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025, seeks to make changes to the process for claiming a private health insurance rebate. The private health insurance rebate enables, as we know, eligible people to have the cost of their private health insurance subsidised by the government. Right now, the IT systems responsible for administering these rebates simply can't meet the expectations set out in the legislation, so this bill will update the law to better align with what the system can actually deliver. The Greens have been clear on our position in relation to private health insurance. Our priority, in our view, is that we should be improving and strengthening our public health system. However, while there remains a private health structure in Australia, we see the need and the value in aligning these systems.

Let me move to the issue of head and neck cancer. I would like to take the opportunity presented by this legislation to talk about an issue that I am incredibly passionate about: access to affordable oral and dental health care, particularly to dental prosthetics for people who have undergone treatment for head, neck and oral cancers. Head, neck and oral cancers can cause significant damage to a person's mouth and oral health. In some people, this might be through the removal of parts of the face or mouth, such as their lips or gums. For others, the radiation treatment around the head area can cause permanent damage to the salivary glands, which play a crucial role in keeping the mouth healthy. If it were any other type of cancer that we were talking about, Medicare would cover the post-treatment rehabilitation, including prosthetics. But, because we are talking about cancers of the head, mouth or neck, these prosthetics and that rehabilitation aren't covered by Medicare. Instead, cancer patients need to pay hundreds or thousands of dollars out of pocket for it.

We have heard of people having to mortgage their house and pull from their super in order to pay for dental prosthetics that they need. While millionaires are living large on government funded tax cuts, it is unacceptable that Medicare can't cover prosthetics. In 2023, the dental inquiry that I had the honour of chairing uncovered these huge gaps in the Medicare system and made two recommendations. These recommendations were to further investigate the ways in which cancer and cancer treatment could impact the mouth and to look into addressing these impacts, including reviewing the Medicare Benefits Schedule with a view to improve access to care.

Today I call on the government to implement those recommendations so that survivors of head and neck cancer can access prosthetics and post-treatment care that they need without going broke trying to afford it. I moved the second reading amendment in my name last night during the debate, and I would ask the government to consider supporting that amendment and to action those recommendations. Somebody who has won the battle with cancer of the head, neck or mouth should never have to then think about where they will find the money for the postcancer treatments or the prosthetics that they may need. I am so sick and tired of hearing that yet another member of my WA community has survived cancer and that, after a battle that has claimed a large section of their face or a large part of their mouth and has taken their ability to produce spit in their mouths—can anybody actually imagine what it is like to live with that as a reality day in, day out? And that's their life. The one thing that can collectively be done is to make sure that, when they are in need of medical treatment and prosthetics, they can get it through Medicare.

I'm often asked where we should begin the work of bringing dental care into Medicare. Well, here is an opportunity. Let us start by uniting around the idea that people who have survived cancer should be able to get rehabilitative treatment covered under Medicare, regardless of where on the body that care needs to be administered or where the prosthetic might need to be attached. Can we all just do that? Could we all just agree that that is something that should be done?

Back this amendment. Let's have it be a unanimous position of this Senate that it should be the case that head, neck and oral cancers are covered under Medicare and that you can get the prosthetics and the treatment you need without having to mortgage your house. Come on—let us do this together. It's a good thing, and the time has come.

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

I rise today in support of the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025 because this bill strengthens Medicare and modernises our health system and makes it fairer for patients, doctors and communities right across Australia.

For Western Australians, particularly those in our regions and remote areas, this bill is about more than just administrative fixes; it's about addressing those inequities in access, in the workforce and in the outcomes that have persisted for far too long. Medicare is one of Labor's proudest achievements, and it was built on the belief that, no matter your postcode, your income or your background, you should be able to see a doctor when you need one. This bill carries forward a vision that is about cutting red tape and modernising the systems that support our health workers.

Right now it takes too long for new doctors and health practitioners to get their Medicare provider number. For overseas trained professionals, that delay can be up to a couple of months—months that could have been spent treating patients in our communities that are crying out for care. This legislation changes that. It allows the Chief Executive Medicare to use secure computer systems to automatically issue a provider number where the decision is straightforward, while keeping human oversight in place for anything that's complex or discretionary. It is a simple, practical change that means doctors, nurses and allied health professionals can start the work they need to do much sooner. In places like the Goldfields, the Wheatbelt and the Great Southern areas of my home state of Western Australia, where the nearest GP can be up to hundreds of kilometres away, that matters a lot.

Another key part of this bill is making bulk-billing fit for the 21st century. A law that underpins bulk-billing was written when everything was still done on paper. This bill gives patients and doctors the flexibility to assign Medicare benefits digitally and securely, and it also extends the time for clinics and software providers to transition to their new systems, ensuring that absolutely no-one misses out on the care they need. Labor is delivering the largest investment in bulk-billing in Medicare's history, with $7.9 billion to make sure that all you need is your Medicare card, not your credit card, to access world-class health care. This legislation ensures that Labor can deliver on those reforms.

The bill also strengthens our ability to get more doctors in regional, remote and outer metropolitan areas. Under the old Bonded Medical Program, if a bonded doctor failed to complete their return-of-service obligation, they could have faced a six-year ban—a blunt penalty that punished not just the doctor but the very communities that needed their care the most. Under the reformed system, we'll ensure that doctors who've acted in good faith, working in rural hospitals, Aboriginal medical services or regional clinics, will have their contributions recognised. It is a fairer system that supports doctors and, importantly, the patients they serve. For First Nations communities, continuity of care is vital. So when bonded doctors are supported, rather than penalised, communities retain trust and stability in their local health services.

At the heart of this bill is integrity, efficiency and equity. Australians deserve to know that every taxpayer dollar is handled properly and that our public and our private systems work together to keep health care affordable. This bill will strengthen the integrity of the private health insurance rebate system so that the $7 billion paid to insurers each year is managed lawfully and transparently. Our government's approach is very simple. We modernise where it makes sense; we reduce red tape when it gets in the way, and we make sure fairness and accountability stay at the core of Medicare.

As a Yamatji Noongar woman who was born in the great southern region, in my home town of Kojonup in regional WA, I know that the health system has not always worked equally for everyone. Too many regional and remote communities still face unacceptable gaps in accessing doctors, specialists and mental health care. That's why bills like this one are so important. Every time we make Medicare faster, fairer and stronger, we take another step towards health equity—towards a system that truly serves all Australians.

It's really simple. This bill is about making health care and the healthcare system work better for patients, for healthcare workers and for communities that rely on them. It's about ensuring that the next doctor who wants to serve in Kalgoorlie or Albany does not have to wait months for a provider number. It's about ensuring that a patient in Leonora can be bulk-billed by their GP service just as easily as someone in Fremantle. It's about ensuring that Medicare, one of Labor's proudest legacies, continues to grow stronger for generations to come. I commend this bill to the Senate.

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

The Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025 is about strengthening Medicare. It's about making sure that Australians can see a doctor when they need to, our health system keeps up with modern technology and every dollar of public investment in health delivers better care for patients. For more than 40 years, Medicare has been at the heart of who we are as a nation. It reflects our belief that access to health care should depend on your Medicare card, not your credit card.

Under the Albanese Labor government, Medicare has been renewed and strengthened through cheaper medicines, record investment in bulk-billing, new Medicare urgent care clinics and support for doctors and nurses across the country. This bill builds on that work. It makes practical, sensible changes to help health professionals do their jobs and make it easier for Australians to get the care they need. It also helps to protect the integrity of Medicare, ensuring that systems, payments and regulations are modern, secure and fair.

This bill makes targeted amendments to four main areas, automating the allocation of Medicare provider numbers, strengthening the private health insurance rebate system, supporting the transition to modern, digital bulk-billing and simplified billing, and updating the Bonded Medical Program to better reflect today's workforce realities. Each of these changes contributes to a stronger, more efficient and fairer healthcare system.

The first part of the bill deals with Medicare provider numbers, the unique numbers that identify health professionals and their practice locations. Under current arrangements, new practitioners, especially overseas trained doctors, often wait weeks or even months before receiving their provider number. That means they cannot bill Medicare, even if they are ready and qualified to work. The review that was conducted into this, an independent review of Australia's regulatory settings for overseas health practitioners, found that in some cases these delays could stretch to three months. During that time, doctors are unable to see patients, and communities go without much-needed care.

This bill fixes that. It allows the chief executive of Medicare to approve the use of secure computer systems to allocate provider numbers automatically where all eligibility checks have been met. Importantly, any decision to refuse an application will still be made by a person, not a computer, ensuring human oversight and accountability. This reform will speed up the process for new practitioners to begin work, reduce administrative burden and help address workforce shortages, particularly in areas where doctors are needed most. It is a practical measure that reflects modern realities. We should not have highly trained doctors sitting idle because of paperwork delays. By supporting automation where appropriate, this bill will make it faster and easier for health professionals to start treating patients, while maintaining strong safeguards that protect patients and uphold Medicare's integrity.

The second key reform in this bill ensures that the private health insurance rebate system operates consistently with the law and continues to support affordability for millions of Australians. The Australian government spends about $7.8 billion each year, helping Australians with the cost of private health insurance premiums. These rebates are an important part of keeping private cover affordable and relieving pressure on the public hospital system. However, over time, some administrative systems used to process these rebates have not fully aligned with legislative requirements. The bill corrects that, aligning the registration and the claims process, under the Private Health Insurance Act 2007, with current technology and practices. It introduces a new self-assessment model for private health insurers, ensures appropriate checks and documentation and allows the chief executive of Medicare to approve automated decision-making for certain administrative tasks. These updates will not change the rebate amounts people receive, but they will strengthen the integrity of the system and protect taxpayers' money. They ensure that payments are lawful, accurate and recoverable if errors occur. This is about making sure every rebate dollar is correctly spent and that consumers continue to benefit from affordable health insurance.

The third and perhaps most significant part of this bill focuses on modernising the assignment of Medicare benefits—the process that underpins bulk-billing. When a patient assigns their right to a Medicare benefit to their doctor or clinic, Medicare pays that benefit directly to the provider. That simple transaction—signing over your benefit so you pay nothing upfront—is what makes bulk-billing possible, but, for decades, that process has been based on outdated paper based systems designed in the 1980s. This bill brings Medicare into the digital age. It remedies technical issues identified in the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 and allows time for the new digital assignment systems to be built, tested and adopted safely. Specifically, it postpones the start of the new arrangements from January 2026 to July 2026, giving software developers, medical providers and patients more time to prepare. These changes are essential to ensure a smooth transition. By allowing the digital assignment of Medicare benefits, Australians will be able to bulk-bill without needing to sign paper forms. It will make life easier for patients and providers alike. Because the Albanese Labor government has tripled the bulk-billing incentive for pensioners, concession card holders and families with children, this bill will help make sure that those new incentives flow smoothly and securely through the digital system.

This work is part of Labor's broader commitment to strengthen Medicare and to make it easier to see a doctor. Labor's reforms have restored bulk-billing for 11 million Australians and delivered on an extra six million bulk-billed visits across the country. This bill ensures the technology behind Medicare keeps up with that progress. It protects the foundations of a fair, modern healthcare system where bulk-billing remains central to how Australians access care.

In Tasmania, these reforms will make a real difference. We know Tasmanians value Medicare deeply, but too many still struggle to find a bulk-billing GP or face long waits for appointments. The government's investment in bulk-billing and urgent care clinics are already helping to change that. In Hobart, the two Medicare urgent care clinics have provided thousands of free, walk-in consultations, offering an alternative to hospital emergency departments for families needing care for urgent but non-life-threatening conditions. Across the state, more Tasmanians can now see a bulk-billing doctor without worrying about the cost. Tripling the bulk-billing incentive has made it viable again for many clinics to return to bulk-billing.

This bill ensures that those new incentives roll out from 1 November 2025 and the technology and payment system supporting them are up to date and functioning properly. For Tasmanians, that means smoother billing, faster payments to clinics and fewer administrative barriers for doctors, especially those in regional areas who are already carrying heavy workloads. It will also help ensure that the $7.9 billion in bulk-billing incentive payments announced in the 2025 election reach frontline providers on time. Combined with Labor's new investments in women's health, mental health and cheaper medicines, this bill supports a health system that works better for everyone, from families in Hobart's northern suburbs to older Tasmanians on the north-west coast. Labor's Medicare urgent care clinics, endo clinics, pelvic pain clinics and Medicare mental health centres are all designed around the same goal: accessibility, affordability and community based care.

These reforms are delivering real results. In Tasmania, families are saving money on prescriptions; older Australians are seeing doctors without out-of-pocket costs; and patients who once turned to emergency departments can now access timely, free care in their own communities. This bill supports that success by ensuring Medicare systems are modern, secure and efficient.

The final part of the bill makes important changes to the Bonded Medical Program, a program that encourages medical graduates to work in regional, rural and remote communities. These amendments remove that outdated, six-year Medicare ban for doctors who do not complete their return-of-service obligation, balancing fairness with community need. They also ensure that workers complete it in good faith, including under earlier schemes or in eligible areas misidentified by government. They can still count towards that obligation. These changes make the program more consistent and fairer for participants while ensuring communities continue to benefit from access to doctors. The aim is clear: to strengthen regional medical access by supporting a fair and sustainable approach for the health professionals who serve those areas.

This bill is a practical step towards a stronger Medicare, one that works for patients, practitioners and the community. It makes it easier for doctors to get provider numbers and ensures rebates are handled lawfully and efficiently. It modernises the way patients assign their Medicare benefits and keeps the Bonded Medical Program fair and effective. Together, these measures help deliver the government's vision for a health system that is fair, modern and fit for the future. They also sit alongside an historic investment in bulk-billing, cheaper medicines, hospital funding and urgent care, all central to Labor's mission to make health care universal and affordable. The Albanese Labor government believes that, when Australians are healthy, our communities are stronger. That is why we are investing in Medicare like never before, with more doctors, more bulk-billing and better care across every state and territory. I commend the bill to the Senate.

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

Given the hour, I don't intend to go over all of the elements of the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. I thank very much, though, senators who have made contributions about different aspects of this bill which ranges across quite a broad range of areas in the health system.

I do, however, want to make a number of remarks in relation to schedule 4, given the amendment that has been circulated by the opposition. Schedule 4 to the bill amends part VD of the Health Insurance Act 1973 to enhance elements of the Bonded Medical Program. The intention of this bill is to ensure that the consequences for participants who withdraw from the program or fail to complete their return-of-service obligations are fair, and the changes balance the personal circumstances of the bonded participant with the broader interests of the community. I need to address a number of issues which have been incorrectly asserted in the contribution made by the opposition earlier in the debate in relation to the Bonded Medical Program—in particular, the impact of this bill on that program. Senator Sharma made the contribution on behalf of the minister yesterday. I note that Senator Sharma is in the chair as we speak, but he said this:

Despite the Bonded Medical Program being designed to address the shortage of medical professionals in regional, rural and remote areas of Australia, the government's changes to distribution priority areas now allow doctors to work in major metropolitan cities and still meet their obligations under the program, further worsening doctor shortages in truly underserved areas and obviating the intent of the program.

This is not correct.

The current Bonded Medical Scheme was established by amendments made by the Morrison government in 2019, and the explanatory memorandum to that bill describes the operation of the return-of-service obligations. It says:

The statutory scheme provides a legislative basis for the Bonded Medical Program; that is, it requires participants to complete a return of service obligation (i.e. working in regional, rural and remote areas and areas of workforce shortage as defined in the Bonded Medical Program rules to be made under the Act) in return for a bonded Commonwealth supported place in a course of study in medicine at an Australian university.

The key thing in that quote is its reference to the rules to be made under the act. The rules affecting the eligible areas for the return-of-service obligations under the Bonded Medical Program have not changed since 2020. The eligible locations for the Bonded Medical Program are defined at section 10 of the rules, and there has been no change to that section of the rules since they were introduced in 2020. I wanted to get that on the record because I don't wish people who may be listening to the debate or other senators to be uncertain about the intent of the legislation that we're considering this afternoon. With that, I note the thoughtful contributions from various speakers over the course of the debate. I thank senators and commend the bill to the chamber.

Question agreed to.

Original question, as amended, agreed to.

Bill read a second time.