Dr LAWRENCE (5:47 PM) —I was amazed, I must say, to hear the Prime Minister (Mr Howard) suggesting a couple of days ago that the Leader of the Opposition (Mr Beazley) was not to be trusted to keep his promises to the nation about tax reform to assist low and middle income earners. This from the great pretender, the man who devised the distinction between core and non-core promises and then shamelessly broke most of them anyway. This from the man who said in a speech in June 1995:

I would rather promise half of what people might want and honour 100 per cent of it than commit myself to everything and deliver only half of it.

This from the man who placed his hand on his heart before the last election and told listeners to Radio 2UE:

Look, I have made it clear . . . I am not going to break the promises.

This from the man who, when questioned further about whether his promises were contingent upon the state of the budget, maintained his position. The interviewer, Mr Laws, said:

So what you are saying . . . is if you had a choice between breaking election promises and running a budget deficit, what would you choose?

Howard: Well, we won't break . . . we would always give preference to keep our promises.

Laws: So even if it means running a deficit?

Howard: Well, if it means that we have to delay achieving the underlying surplus, because we've always said it will, that is the answer.

While increasingly more weasel words were inserted into his statements before his first budget, he did say again before that first budget:

We don't intend to hurt people who need help. Anything we do . . . will fully honour the commitments we made to individuals in relation to pensions and the level of unemployment and sole parent benefits—things of that character.

So he shifted ground a bit, but still there with a promise. Of course, he broke that promise, and many others, in the first budget, and again in the second and again in the third, all the while claiming that it was due to unforeseen budgetary problems—the ones that would not bother him, he said to John Laws. It is the oldest trick in the book. During the election debate in February 1996, the Prime Minister solemnly intoned:

. . . every single dollar of the promises that I made to the Australian people are going to be kept.

Who is not to be trusted? As well as being grammatically incorrect, this assurance was also wrong. Howard short-changed the Australian people to the tune of $17 billion worth of broken promises over four years.

This budget gives us an opportunity to measure the Howard government's performance against the promises they made to the electorate before the last election. Since their betrayal has been so comprehensive, I do not have time in the 15 minutes available to me to cover all the territory, so I will focus on a few areas which are critical to the wellbeing of all Australians and to the future of our nation, in particular health care, child care and employment, education and training.

One of the clearest promises made by the coalition before the last election—and I had cause to notice it—was that they would not change Medicare. They were insistent they would retain it in the form that it was developed and implemented by Labor. They would not revert to the Fightback formula, with which we had become familiar. In February, the coalition health policy launch contained the assurance:

We will maintain Medicare in its entirety.

That is a very simple promise, very clear and unequivocal. Further, they said:

None of the health policy initiatives will entail cuts to funding for public hospitals.

That is very clear again. These were very important promises to the Australian people, since it is almost certain that one of their reasons for rejecting the conservatives in 1993 was the fact that the conservatives were going to wind back Medicare and the public hospital sector. Howard was very keen indeed to distance himself from his predecessor, Dr John Hewson.

Once in government, however, the Liberals' longstanding antipathy to Medicare became very obvious. It was quickly in evidence and has been consolidated in a series of moves which undermine Medicare's integrity, contrary to the promises that they made. For instance, in 1996, $800 million was cut from public hospitals by a combination of cuts to financial assistance grants to the states and direct cuts justified on the spurious grounds of cost shifting. They actually penalised the states who had done the least, not the most.

The Commonwealth dental program, worth $400 million, was simply abolished. Pharmaceutical co-payments for pensioners and families reduced government funding by $732 million and transferred the costs directly to the users. A further billion dollars was saved from freezing the GP rebate and restricting provider numbers and other measures. So health was hit hard.

This was a full frontal attack on the cornerstones of the Medicare compact with the Australian people—a direct breach of all their promises, especially since a good portion of these funds went to their spectacularly unsuccessful attempt to prop up the private health funds. As Kennett remarked in his typically pungent fashion, this was `money down the drain'.

The use of money from the public hospitals to pay for failed private health insurance rebates was also a clear breach of another policy in their 1996 statement, which stated:

. . . the private health insurance incentives will not be funded from the public hospital system or the health grants to the states.

Yet that is what they did. I can only presume that the `not' was a typographical error. It is clear that they always intended this switch, as they did in Fightback.

This was a cynical attempt to undermine our faith in the capacity of Medicare to provide a reliable and quality health care system for Australia. What we have is longer and longer waiting lists, industrial disruption, increased costs and, as a result, greater anxiety about standards. All of this takes a toll on the people of Australia.

Our hospitals and their dedicated staff are now working under clearly intolerable pressures and it is starting to show. For instance, in my own state of WA, nurses have for the first time in the history of that state gone on strike. Their pay and conditions have deteriorated dramatically under the conservative Court government. These cuts have compromised it further and they are not prepared, incidentally, to stand by and watch hospital standards compromised further. Noteworthy is the AWA—the so-called new award—being offered to the new graduates. It contains some very unpalatable elements including, for instance, an allowance for a 7½-hour break between shifts. They are supposed to leave the hospital at 10 o'clock at night, drive home—however long that takes—have a sleep and a meal and get back within 7½ hours. Not surprisingly, they are rejecting that so-called offer.

As if this was not a sufficient indication of the government's desire to corrode the key elements of Medicare, in 1997 a further $673 million was removed from the pharmaceuticals budget. Plans were also launched for the closure of Medicare offices—there have been 43 so far, mainly in Labor constituencies—restricting access to full payment services. The substitutes are definitely second-rate. This action was from the same government, incidentally, which promised at the last election to open new offices in practically every marginal seat in the country. I followed them around as they announced that. Instead, they are closing them.

Mr Lee —Even Chisholm.

Dr LAWRENCE —The Minister for Health and Family Services (Dr Wooldridge) has moved from there so he does not have to cop the consequences.

It is astounding that there is no remedy at all in this budget for the No. 1 problem in this country—that is, health. The crisis in our public hospital system deserves priority attention from this government; instead, the government has compounded the problem created by conservative state governments systematically ripping funds out of hospitals over the last five years by not only slashing its own funding but also now offering totally inadequate funds under the next round of Medicare agreements.

Despite every major commentator agreeing that more is needed, there is not one extra dollar on the negotiating table. It is the same offer which resulted in the walk-out of the Premiers when it was last discussed. While Borbidge has either sold out or been bought off for the Queensland election—it is not clear yet which of those is true—the other states have held firm. They need to, and they know they need to.

The Howard government's claims that this is a generous offer involving significant extra funding have been dynamited too by the former leader Dr John Hewson. Again, yesterday, he made it clear that this offer is no such thing—certainly not generous. In an article in the Financial Review, Dr Hewson wrote:

The Commonwealth claims a 15 per cent increase, but the States have to adjust for demographic factors—

in other words, more people—

the ageing of the population and the requirements of service delivery—the 15 per cent becomes 1 per cent, insufficient to deliver what patients now demand. The impasse means poorer quality health services and longer queues at hospitals. How long do the queues have to get before the Commonwealth and the States talk again, let alone actually solve the funding-service delivery imbalance?

That is a question we have been asking, too. Dr Hewson goes on to observe in the same article:

The States attitudes have hardened as they've recognised how easily the Commonwealth has moved back into budget surplus on the back of growth taxes that have delivered them substantial real revenue gains. Much of the limited expenditure restraint has been by cutting payments to the States or by the States' fiscal contribution.

And they know what is going on.

Furthermore, the so-called new money in the package for mental health and palliative care is simply a continuation of existing services. It is not new at all. The Commonwealth's offer would, according to the states, result in more than one million extra patients on the waiting lists. There are already some pretty appalling examples and I will just give two from my own electorate.

There is one lady living in my electorate who has been waiting since 7 April last year for an eye operation at Royal Perth Hospital. There is only one specialist in the state who can perform this operation. This woman is unemployed and is forced to wear an eye patch. One of the reasons she continues to be unemployed is that she finds it difficult to apply for jobs. She is sensitive with the eye patch. It causes her stress and is very upsetting. In another case, there is another older woman who has ongoing problems with her knees and has had numerous operations. She has been waiting, too, for over 12 months for the final operation. She waits in pain. She is unable at this stage to find out when that operation will take place and, as a result, is experiencing mobility problems, affecting her ability to care for her household. They are sadly not unique stories. They could be repeated all around this country.

At the same time as we have seen these waiting lists grow, we have seen that the government have been prepared to pour funds into their ill-conceived and now failed rebate scheme for private health insurance. Even though not all of it has been taken up—some $300 million, I understand—none has been returned to the public hospital system, from which it was pilfered in the first place. I would have to say that any halfway numerate health economist could have warned them—and many did—that the introduction of rebates into an open-ended private health insurance market would simply result in higher costs, and it did. There was a windfall for all the suppliers of services and nothing for the consumers.

Some states are now threatening to abandon one of the central tenets of Medicare—the free hospital treatment—and start charging for services. This would take us back to the disastrous days of the failed Fraser policies, which appeared to change almost weekly and which Dr Wooldridge, the minister responsible, described at the time as being wrong and as alienating even their best supporters. Following the Prime Minister's clear intervention in health policy, we now face the prospect of the Treasurer (Mr Costello) re-engineering the health system, as he put it. Make no mistake about it, the Treasurer has designs on Medicare.

As journalist Karen Middleton pointed out last week, the Prime Minister has never wavered in his belief that the key elements of Fightback were the way to go. We have seen the IR changes, the reintroduction of a GST, the increased Medicare levy for high income earners, the rebate for those with private health insurance, and now the Treasurer has clearly enunciated threats to GP visits and hospital costs, a change which the Prime Minister has refused to rule out in question time. Fightback is back in all its threatening and funereal garb.

I want to briefly mention a couple of other areas where we have seen similar betrayals of the promises of the Howard government. One of them is child care. We were told before the last election that this government would `maintain the non-means testing of the child-care rebate'. They junked that promise in the first budget. They also reassured worried families that `the coalition has no plans whatever to change the operational subsidy to the community based long day care sector'. Perhaps they did not have plans then, but they soon implemented them with a vengeance. They completely cut the subsidies, raising average child-care costs from between $14 and $20 a week, forcing many families out of child care. Overall, in the last two budgets this government has cut $800 million from child care. So harsh have been the cuts that many families have had to withdraw their children from care and use unsatisfactory alternatives or, in the case of many women, leave the work force altogether or cut their hours. The result is a significant underspend—revealed in this year's budget—of $117 million for child-care assistance. This is projected to grow to $300 million—so many families are pulling out. Families simply cannot afford the care now. In fact, they cannot afford this government.

There are other choice examples, in this budget and the ones before it, of blatant broken promises presented without any apology at all to the Australian people. I will quote a couple in conclusion:

We will maintain the level of funding of operating grants to the universities and there will be no cuts in university places.

We are going to maintain the expenditure on labour market programs in real terms.

What really happened? University operating grants were cut by $623.5 million over four years and enrolments have declined. Labor market programs were cut by $1.8 billion, and the once free public employment service was dismantled. I end where I began. Who is it that can be trusted? Certainly not this Prime Minister.