Ms WORTH (Parliamentary Secretary to the Minister for Health and Ageing) (8:35 PM) —I rise to speak on the Appropriation Bill (No. 1) 2002-03. Looking back over the past year, there has been a decisive shift in the priorities of all Australians and of governments and people around the world. This time last year, terrorism was not a topic generally discussed around the dinner table. Osama bin Laden's name was unfamiliar to most, except for the occasional reference in the world pages of the newspaper. But all that changed on September 11.

Everyone's lives have been changed by the events in New York and Washington. This year's federal budget clearly reflects those changes in priorities that governments around the world are now facing as a result of attacks on the World Trade Centre and the Pentagon. It comes as no surprise, then, that this government should make vitally important decisions that ultimately will make our nation a safer place to live. The security of the nation is paramount. The defence budget includes an additional $1.3 billion over five years to upgrade security within Australia. While expenditure on securing our borders has increased to $2.9 billion over five years, it is a necessary budgetary shift given the events of the past year.

I welcome the release in this year's budget of the first Intergenerational Report prepared by the Commonwealth government. I believe it is one of the most significant reports released in many years. While the report seems to have received little publicity in the light of other key government decisions, the importance of the key messages in this document cannot be underestimated and certainly should not be ignored.

Governments are often accused of only looking forward as far as the next election. The Intergenerational Report looks beyond the next three years, or even the next decade. It is an important indicator to the issues to be faced by governments for the next 40 years to 2041-42. Not surprisingly, one of the main challenges highlighted is our ageing population and the pressures that this will place on Commonwealth government finances. To show the contrast, the report states that the proportion of the population that is very old—that is, over 85 years of age—is expected to triple over the next 40 years while the proportion in the prime working age range of 15 to 64 will fall. A recent article in the Herald Sun revealed that figure showed in 2001 that the country's 100 year-plus population almost doubled in the preceding two years, rising from about 2,500 in 1999 to 4,217 in 2001.

The impact on government finances is significant. The Commonwealth's spending on health as a percentage of GDP will more than double from just under four per cent to more than eight per cent. The impact of this spending growth is already evident. The report highlights that spending growth on the PBS has been rapid and that, of all the Commonwealth health expenditure components, spending on the PBS is projected to grow the fastest, even taking into account the current proposed budget changes. Spending on aged care will also more than double as a percentage of GDP, from 0.72 to 1.77 per cent. As Treasurer Peter Costello says:

that is, making social services sustainable—

My colleagues opposite, of course, have fallen over themselves to criticise the government's health measures in a typically short-sighted attack on the budget, yet I am reminded of the words of one of their former ministers, who clearly had a better understanding of responsible government than his current contemporaries do. Former senator and health minister Graham Richardson in 1993, while Labor was in power, expressed great concern about the rapid decline in the number of people with private health insurance and the lack of forward thinking by his own party. He said:

What Mr Richardson highlighted at the time—apart from the very key issue of the decline in private health insurance—was the complete lack of vision by his government. It is a matter of record that the coalition government acted swiftly and decisively on the matter of private health insurance. This government not only stemmed the massive decline in private health insurance but had people returning to private health insurance in their thousands. The 30 per cent private health insurance rebate and the introduction of Lifetime Health Cover showed that the coalition government had succeeded where Labor had failed. This, of course, is one part of the greater vision we must have for the future health of all Australians.

There are important parallels to be drawn between this year's health budget and the Intergenerational Report in the context of planning for the future health of this country. I thought it was worth looking back at the past 40 to 50 years to get an understanding of how rapidly our nation is changing. There is a fascinating publication put out by the Commonwealth Department of Health and Ageing to coincide with the Centenary of Federation entitled Putting life into years. It provides an invaluable insight into changes to our health system over the past 100 years.

Looking back to 40 or 50 years ago, Australia was in the midst of the baby boom, and the new Menzies government recognised its social responsibilities as part of its commitment to post-war reconstruction. As part of the plan introduced by then health minister Earle Page, everyone was to have access to free life-saving drugs. Hospital insurance and a voluntary medical benefits scheme were to reduce the cost of care, and pensioners would get free doctor services. This highlights that what are considered core services in our health system today were just being introduced only half a century ago.

What particularly caught my attention in this publication was that in 1948 the Pharmaceutical Benefits Scheme started operating. At the time, the PBS supplied drugs in the British Pharmacopoeia to pensioners as well as supplying 139 life-saving and disease preventing drugs for others. The cost of the Pharmaceutical Benefits Scheme in 1952— its first full year of operation—was £7.6 million. By 1959, the cost had already almost tripled to £21 million. Today, spending on costs and co-payments under the PBS has reached $4.77 billion. As of last year, the PBS covered 593 generic drugs, available in 1,469 forms and strengths, marketed as 2,351 different brands. It is estimated that 75 per cent of all prescriptions dispensed in Australia are subsidised under this scheme.

It comes as no surprise, then, that something needed to be done to address the cost of the Pharmaceutical Benefits Scheme to ensure that it remains sustainable. In what smacks of rampant political opportunism, or the most severe case of selective amnesia in recent memory, the Leader of the Opposition has launched an amazing attack on the government's PBS measures. What makes this attack so hypocritical is the fact that, as Alan Ramsey from the Sydney Morning Herald pointed out, he was sitting not more than a few metres from then Treasurer Paul Keating when he announced similar measures in the 1990 federal budget, measures that included introducing concessional copayments for pensioners for the first time in the scheme's 42-year history. To quote some of the lines from Paul Keating's budget speech in 1990:

He went on to say:

And what was the core of Keating's announcement? He continued:

It is the absolute height of hypocrisy for the opposition leader to now not only criticise the measures announced by this government but also say that he will have them blocked in the Senate. I hope that the Democrats and the Australian Labor Party will take the opportunity to further consider their views on this issue and realise that action must be taken now to ensure a sustainable health system in the years to come.

The Treasurer has already taken the opposition leader to task over his attempts to confuse the public by suggesting that all scripts will rise by $6.20—a claim that totally misrepresents the facts and is clearly wrong. This government announced that for non-concession card holders the maximum rate for any pharmaceutical would increase by $6.20 to $28.60. However, many commonly used pharmaceuticals are under the ceiling rate, so the price will stay the same. For example, Ventolin inhalers used by asthma sufferers cost $17.20; after 1 August they will still cost $17.20. The sedative Normison costs $7.58; under the new provisions it will still cost $7.58. The anti-inflammatory drug Voltaren costs $12.86; from 1 August it will cost $12.86. Similarly, the contraceptive pill Trifeme 28 will still cost $15.02, as it does today, and the antihypertensive drug Tenormin will continue to cost $12.61 per script after 1 August.

In fact, 45 per cent—almost half—of all items on the PBS are priced below the general copayment level, and therefore their price will not change. For pensioners and concession card holders the maximum copayment increases by $1 from $3.60 to $4.60. But it must be remembered that there is a safety net of 52 prescriptions in a particular year, after which they are free for pensioners and concession card holders. Importantly, however, medication that costs the taxpayers of this country hundreds or even thousands of dollars will still cost the consumer a maximum of only $28.60 or for a concession card holder $4.60. It is also important to remember that 85 per cent of scripts written are for concession card holders.

It should be pointed out that the PBS budget measures cover a much wider area than the changes to copayments. The budget measures also will see improvements to the rules for evidence based quality prescribing, an increase in the provision of information on PBS prescribing requirements to doctors, a strengthening of the current approach to identify and investigate pharmacy fraud, a decrease in the incidence of doctor shopping, better facilitation of the use of generic medicines and an undertaking of a review of drugs for the treatment of arthritis. This year's health budget also includes an $11.5 million commitment over four years for better diagnosis, treatment and care for Australia's more than three million arthritis sufferers. Earlier intervention and care for this complex and debilitating disease will allow sufferers to remain independent and in the work force longer.

The budget reaffirms this government's commitment to the National Illicit Drug Strategy. Since 1997, this government has provided $57 million towards 133 non-government programs that provide a significant number of treatment services for illicit drug users across Australia. The 2002-03 budget allocates a further $65 million to the Non-Government Organisation Treatment Grants Program and $14 million over four years to the Community Partnerships Initiative, which allocates grants for local projects that promote health and reduce drug related harm.

As I mentioned at the start of my speech, the events of September 11 have resulted in a significant change in budget priorities for this government, and the health portfolio is no exception. This budget has included key measures to protect Australians through the stockpiling of antibiotics, antivirals, vaccines and chemical antidotes in case of terrorist action. This is a necessary initiative in the face of the worst-case scenario of bioterrorism incidents. I recently had carriage of legislation through the parliament to enable this to happen.

I welcome another significant funding initiative—a $55 million package for palliative care. This package includes education and training for GPs to support palliative care nurses and allied health workers in their role of maintaining quality of life and dignity for people who are dying, more efficient specialist backup and better coordination between hospitals and community care, better support for families and friends who are trying to cope under such difficult circumstances and increased awareness of palliative care in the wider community.

The budget includes important initiatives that will benefit older Australians. As I indicated earlier, Australia has a rapidly ageing population, and this is reflected in the additional expenditure under the portfolio of the Minister for Ageing. The Intergenerational Report clearly highlights that aged care must be a priority for future governments. Under this budget, more than half a billion dollars will be spent on older Australians. The government will provide an extra $211 million over four years to increase residential aged care subsidies. This money will assist providers to meet labour costs and address the disparity between wages in the aged care and hospital sectors. A further $100 million in capital grants will help small aged care homes in rural and remote areas to upgrade their facilities. The Minister for Ageing recently announced an additional 8,231 new places worth an estimated $180 million for allocation in the 2002 aged care approvals round, bringing the total number of places allocated since 2000 to more than 32,000.

I would like to take the opportunity to point out that short-sighted decision making is not just an affliction of the federal Labor Party; I could not believe my eyes when I read about the actions of the new South Australian Labor government, which had recently cut funding to build aged care beds through the HomeStart Scheme, and yet it had the temerity to criticise this government's aged care budgetary measures. What is more, I am told the Labor Rann government's dumping of this funding for aged care beds was done in secret and certainly was not raised before the last South Australian election.

I would like to take this opportunity to congratulate East Timor and its people on gaining their independence. I am very proud to belong to a government that has played such a crucial role in making this possible. I was pleased that the Prime Minister was able to attend the independence day celebrations. I believe that neither he nor the government have received proper credit for the role they played in getting to this point. As Senator Robert Hill put it in a recent interview, if it were not for the courage of the Australian government and the professionalism of the Australian Defence Force, we would not have had independence day celebrations a week ago. As an aside, I would like to congratulate General Peter Cosgrove on his appointment as Chief of the Australian Defence Force. It is worth noting, too, that there are still over 1,200 Australian troops stationed in East Timor continuing their peacekeeping role.

I think a comparison of this government's role in East Timor with that of Labor governments of the past should be put on the record. In 1974, under Labor icon Gough Whitlam, advice that East Timor should be independent was rejected and Australia supported East Timor's incorporation into Indonesia. At that time, Australia's support was crucial if East Timor were to avoid the fate that eventually befell it. The situation was particularly exacerbated during the Keating years, as Australia's then Prime Minister had such a close personal relationship with Indonesia's Suharto.

Perhaps one of the most telling comments came from Mr Jose Ramos Horta, now foreign minister in the new East Timorese government. While campaigning in exile for independence in 1999, he said:

It is important to note that East Timor would not now be independent if there had not been a change of government in Australia in 1996. As the Prime Minister said during the independence day celebrations:

On matters quite specific to my electorate, I note that, in the budget, money has been allocated for the continuation of work on the Commonwealth Law Courts in Adelaide. People who have travelled in and around the CBD will no doubt have seen the demolition of the old police building, which had outlived its usefulness. I am proud to report that construction of the courts on that site is now well under way. The $76.6 million project on the corner of Victoria Square and Angas Street will provide accommodation for the High Court, the Federal Court, the Family Court and the Federal Magistrates Service.

Finally, I would like to take this opportunity to place on the parliamentary record my congratulations to the Kilburn Knights, who exacted revenge on the Broadview Tigers after last year's defeat, to take home the Trish Worth Cup in a very tight encounter.

The DEPUTY SPEAKER (Mr Lindsay)—I am pleased to hear it.