Dr WASHER (1:11 PM) —The Health Legislation Amendment Bill (No. 2) 2001 covers a range of minor or technical amendments in several different areas of health legislation. Firstly, changes are proposed to amend the Australian Institute of Health and Welfare Act 1987 to cover changes relating to the nomination of institute board members. This is to remove the restriction that those members of the institute nominated by the minister because of their knowledge of the needs of relevant consumer groups are nominated only on the recommendation of organisations referred to in the schedule to the AIHW Act. The proposed amendment is not seeking, as the member for Bruce said, to change either the number of board members or the knowledge or expertise for which specific members are appointed. The objective of the amendment is to allow the minister greater flexibility to nominate members from a broader group.

This bill also seeks to amend the Health Insurance Act 1973 in order to simplify the process for recognising medical practitioners as specialists, without changing the criteria for recognition. Further amendments to the Health Insurance Act will allow the HIC to pay Medicare benefits directly to general practitioners where `pay doctor via claimant' cheques are made out to the GP and are not presented within three months of issue. This is good news for GPs as, although the majority of patients do present their `pay doctor via claimant' cheque soon after their consultation, some patients delay doing this or neglect to do it altogether. This leads to bad debts for the GP who has provided the service in good faith of receiving payment for that service. If a patient has not presented the cheque within 90 days, the HIC will be able to cancel the cheque and make a payment direct to the doctor.

The coalition government has strengthened and improved Australia's health system, making it relevant to the new century and ensuring the best level of health care for all Australians. The measures in the health portfolio announced in the budget this week are further testimony to this commitment. Medicare is now stronger, thanks to the record increases in funding of $750 million. This confirms our long-term dedication to improving the public health system in Australia. At the same time, however, seniors in my electorate who are of pension age will also be saving money through the increase in the threshold for payment of the Medicare levy. This means that they can earn up to $21,622 if they are self-funded and still not pay the Medicare levy. It also means that pensioners below the age pension age can earn up to $17,265 and not pay the Medicare levy.

The budget will also improve the level of care we receive from doctors by increasing the Medicare rebate in a way that will encourage longer consultations to promote the early detection and management of medical conditions such as diabetes and asthma. Services in the bush will be improved with a funding package allowing for more practice nurses to be employed in rural and regional areas and, I am also delighted to tell you, in outer metropolitan areas. After-hours medical care funding will give patients a better health service by reducing the workload of our busy doctors and through reducing the pressure on our public hospitals.

Preventive health care also receives some much-deserved attention through funding for such worthy projects as the Alcohol Education and Rehabilitation Foundation. The abuse of alcohol is a major cause of death and hospitalisation in this country. It is estimated that it costs the community as much as $4 billion a year. This, of course, does not take into account the tragic human cost.

The early detection of cervical cancer will be improved with a funding package for GPs to increase the rate of their female patients taking part in the national cervical screening program. Early detection of cervical cancer reduces the morbidity rates of women. But, unfortunately, some women are still yet to be persuaded to take part in this regular screening process.

Access to high quality and affordable medicines through the PBS is still guaranteed through better targeting of the use of medications. It is no secret that the level of prescribing cholesterol-lowering medicines—medicines that are subsidised through the PBS—is very high in Australia. It is estimated that around 65,000 people out of the 1.2 million Australians taking lipid-lowering agents, or medications that reduce cholesterol, probably do not benefit from taking these medications. Quite often, following a pattern of better diet and lifestyle and with a bit of exercise you can reduce cholesterol—although, for some patients, taking the medication is necessary and of great assistance. The side effects of taking cholesterol-lowering medications include myopathy—which relates to muscle abnormalitiesheadaches, rashes, raised liver function tests, neuropathy and gastrointestinal upset to mention but a few. These drugs can also interact badly with some other drugs that the patient may be taking. Patients taking a drug unnecessarily can be dangerous to their health and costly to the PBS. This measure addresses this problem.

An educational program will inform doctors and consumers of the requirements for the PBS subsidy and the HIC will undertake auditing to ensure that the subsidy is given to only those people who qualify on evidence based on the use of the drug. The only people affected by the measure will be those receiving the PBS subsidy for cholesterol-lowering medicines who, under the existing rules, do not qualify for the subsidy.

I would like to elucidate those rules because there seems to be a lot of confusion in and out of the House. The existing rules for this are as follows. Any patient with high lipids should be advised of an appropriate diet, management of obesity and modifying risk factors such as smoking, excess alcohol intake and physical inactivity. Cholesterol-lowering agents are indicated in existing coronary artery disease with cholesterol greater than four millimols per litre—that, by the way, is quite low; and patients with diabetes and/or a strong family history of hypercholesterolemia, or coronary artery disease, with cholesterol above 5.5 millimols per litre; and patients without the previously described risk factors, who are men aged between 35 years and 75 years with cholesterol greater than 7.5 millimols per litre and with triglycerides greater than four millimols per litre. All other people with cholesterol greater than nine or triglycerides greater than eight should take these medications.

I was disappointed to hear the member for Jagajaga scaring people who have a genuine need to take this medication by saying that cholesterol patients will now have to pay up to $114 a month for their medication. This is simply not true. This measure will not force any patient to stop taking medicine that their doctor has decided is appropriate for treatment. I have spoken to a number of my constituents in Moore who contacted me after reading the member for Jagajaga's erroneous comments. These people were annoyed by this misinformation. Scaring people about their health in order to score a political point is reprehensible. By the way, these constituents are waiting for the opposition to rule out scrapping the private health insurance rebate should it ever win government. Some 63 per cent of my electorate has been helped by the coalition government with cheaper health insurance premiums. These people are concerned that the Labor Party is going to penalise them by either subjecting them to means tests or taking away the rebate altogether. The rebate, combined with other measures, has dramatically improved the percentage of Australians who have private health insurance, which is helping to take the strain off our public hospitals. I support the bill before the House today, which also covers amendments to the private health insurance scheme. I commend this bill to the House.