Mr SCIACCA (10:12 AM) —In rising to speak on the Appropriation Bill (No. 1) 2002-03, may I simply say that I have a great deal of regard for the honourable member for McPherson, but she really did carry on with some codswallop there. It was one of those self-congratulatory speeches that you hear all the time in this House emanating from the government and that, of course, is part of the chest-beating that members opposite have been carrying on with in this debate about the budget. They crow about how it has delivered the government's election commitments in full, on time and on budget, but they do not say that they are hitting the needy—those people in the community who need assistance to pay for the mistakes that the government has made in relation to a number of matters—or mention the bribes that it took to win the last election.

The community response to this budget has been much less enthusiastic. Many residents in my constituency of Bowman who have contacted me agree that the government have managed to find the dollars necessary to fund their big spending pre-election pledges in this budget, but have failed to invest in important areas such as education and the environment, areas vital to ensuring a safe and secure future for all Australians.

The overwhelming majority of people in my community who have phoned or written to me, or who I have met in the streets in the aftermath of this budget, have expressed concern about the rising cost of health care and the lack of services as our health system is run into the ground. In the past, when Australians have faced misfortune, they have commonly taken solace in the thought, `At least we've got our health'—small consolation, perhaps, but one that is increasing in value given the Howard government's ongoing attack on the health system and on the sick.

Particularly concerning for some families in my electorate has been the government's speedy implementation of measures such as the baby bonus, and their failure to deliver help where it is most needed. In the eyes of many, they are delivering middle-class welfare while important decisions about possible changes to private health insurance reimbursement to cochlear implant recipients for the cost of upgrades or replacements of their speech processors, decisions which will have a significant impact on the quality of life of many hundreds of hearing impaired Australians and the financial security of their families, have been deferred indefinitely.

Members may be aware that, following the recent review of the National Health Act 1953, the Private Health Insurance Medical Devices Expert Committee, PHIMDEC, recommended that, while the implant and the initial speech processor should remain on the Surgically Implanted Prostheses Schedule, and therefore continue to be compulsorily covered by private health insurers, subsequent speech processors required by patients would no longer be required to be covered by health funds.

The Wharton family of Birkdale in my electorate recognise that such a change would place their son Matthew in a position of considerable disadvantage. Matthew, who is now 14, received a cochlear implant in November 1997. Although he was born with full hearing, when he was aged some two years and nine months he suffered from a cold for a couple of weeks. He was put to bed one evening and awoke the next morning profoundly deaf. Nobody could tell them why or how it had happened. The Whartons have worked hard to ensure that Matthew enjoys all the opportunities available to other children. Matthew adapted well to hearing aids, attended a preschool which specifically caters to the needs of deaf children and, having been involved in an early intervention oral program, he was able to be fully integrated into the Catholic education system in Brisbane.

Despite Matthew's determination to live his life as normally as possible, by the time he was nine it was evident more would be needed to ensure his language and speech development were on par with those of his peers. Deciding whether to go ahead with the cochlear implant was an agonising process for the Whartons, knowing that there was no guarantee of marked improvements with the procedure, but, having gone ahead with the implant in 1997, the family have been delighted with the difference it has made to his life, and they have not looked back; or rather they had not until the beginning of this year when they learned that the provisions relating to private health insurance and speech processors were looking like changing.

For some 15 years private health funds have been required to cover speech processors for cochlear implants. Given that in order to reap the full benefits of the implant recipients require speech processors that are well maintained and in line with the most up-to-date technological advances, this appears to be a logical requirement to help hearing impaired Australians to live as fully integrated members of the community. Yet the review by PHIMDEC concluded that it:

However, it goes on to say:

The decision on whether to proceed and remove speech processors from the Surgically Implanted Prostheses Schedule has been deferred. Maybe the health minister thought this budget was enough of a kick in the guts for disabled Australians for the time being. I take this opportunity to illustrate to the government the very real implications such decisions can have for families like the Whartons—families who, induced by the stick of Lifetime Health Cover and the carrot of the 30 per cent rebate, have signed up to private health insurance only to find themselves on the brink of being abandoned when they are in most need. The Whartons said in their correspondence to me:

Although four-year-old James Morris of Capalaba can take comfort from the fact that he will be covered by the program for the next 17 years, his parents are understandably concerned that the added demand the decision being contemplated by the government will place on Australian Hearing Services will mean longer queues for services, putting hearing impaired children at a disadvantage during their formative years. Some private health insurers may decide to include speech processors for cochlear implant recipients in items covered by ancillary insurance. But the composition of the ancillary tables is dictated by the individual funds' business considerations and is therefore in a constant state of flux.

I call upon the health minister to take a stand against the harsh treatment that this budget deals to the disadvantaged in our community and to ensure that the profoundly deaf, especially children, can continue to secure upgrades and replacements for their cochlear implants by requiring private health funds to continue to cover the costs of the prosthesis.

Placing an unfair burden on the disadvantaged—being strong on the weak and weak on the strong—is a strong theme in this budget. Proposed changes to the disability support pension are not, as the government would have us believe, about getting people back into the work force. They are about shifting the goalposts and cutting benefits. They are about reducing by $52 per fortnight the income of members of our community who experience physical or psychological disadvantage. Combined with the loss of supplementary payments like the $68 pensioner education supplement and the loss of their pensioner concession card, these changes will in reality reduce the ability of those with disabilities to find and engage in work or training. In fact, the argument that cutting someone's pension will help them to find work holds as much water as the Prime Minister's bizarre contention that more Australians will find employment if it is easier for bosses to sack them. It is a line that is not washing with members of the community.

These changes are causing a great deal of anxiety amongst DSP recipients and their families. I recently received, from a woman living in Capalaba in my electorate whose husband is a disability support pensioner, a letter which typifies the concerns about the government's proposal that have been raised with me since the budget was brought down. She writes:

The prospect of being forced into actively seeking work is a worrying concept for people with disabilities and their families, not because they do not want to work but because they are understandably concerned about the impact training requirements and workplace conditions will have on their health status. My constituent asks:

Even when people who are placed on Newstart as a result of reassessment are able to find a job, it must be remembered that many debilitating conditions fluctuate. While a person may be generally deemed to work 15 hours a week or more, there may be other times when their condition leaves them unable to attend the workplace for days or weeks on end. If such a situation arises, my constituent asks: what would the employer's responsibility be to him? Would his job be safe? Will the government guarantee any part-time job he may have found? If he were on Newstart, would Centrelink be understanding during such times?

There are also many questions left unanswered for the partners of disability support pensioners, who devote much of their time to providing appropriate care to their husbands or wives, about the impact a reassessment would have on their own income levels and activity requirements where they are in receipt of a Centrelink benefit. The letter concludes:

Labor is prepared to support genuine disability reforms and programs that genuinely assist those who are able to participate in the work force to gain skills and find employment. But I am pleased that, despite the threats levelled by the Minister for Family and Community Services, we will not be supporting this proposal that is little more than a crude cost cutting exercise that will actually diminish the ability of the disabled to engage in work and move off benefits.

But, not content with reducing assistance to an estimated 100,000 disability support pensioners Australia wide, the government has in this budget attacked people with disabilities across the board. While in his budget speech the Treasurer, Peter Costello, announced a new five-year Commonwealth State Disability Agreement, with the Commonwealth providing the states an extra $547.5 million over five years for unmet needs, this announcement was simply a repackaging of funding agreed to in July 2000. There has been no growth funding allocated to this important area, which means a reduction in the respite, accommodation and support services that are vital to maintaining the quality of life of hundreds of people with disabilities across the country, their carers and their families.

As details of cuts to disabled Australians began to emerge in the days leading up to the budget, I began to receive a steady stream of letters from individuals and support groups across my electorate, letters from people like Ron Murray, who has extensive experience in delivering disability support services to Bayside and Redlands residents and understands the enormous amount of stress and hurt that this budget has caused for disabled Australians. Ron writes:

Amongst other correspondence I received on this matter, I was sent a petition with 400 signatures, collected in only two days, from residents in the Bayside and Redlands suburbs that make up my federal constituency of Bowman and from surrounding areas, calling for the federal government to commit funding to address the growing unmet need for services and support for people with disabilities and their families. So, while disability services are not a priority for this government, I am pleased to see that community expectations that the government should provide appropriate support for the frail, elderly and disabled and their families is still strong.

Another of my constituents, Mrs Fran McWaters of Alexandra Hills, knows only too well the physical and emotional stress borne by those who care for people with disabilities and those whose age and fragility prevents them from looking after themselves. She has been active over a number of years in the battle to secure better support for carers in our community. Carers are of tremendous assistance to government. The Queensland Council of Carers estimates that there are more than 14,000 carers in the Redlands district of my electorate alone. That is over 14,000 people in that community alone who are providing services that would otherwise need to be provided by government—a figure that is certain to rise given the ageing population and the growing popularity of the Bayside suburbs in my electorate as a retirement destination.

If fewer family carers are able or willing to care, and if governments argue that they cannot afford to provide care or choose not to do so, then the care gap may be increasingly filled by private services or paid volunteers working in the grey economy. Such developments are quite widespread overseas, where they are causing concern because of the difficulty of ensuring adequate standards of care and the potential for exploitation of both carers and care recipients.

The Treasurer's own Intergenerational Report highlighted what we already knew: Australia has an ageing population, a trend exacerbated by increased life expectancy and the ever declining birth rate. While there is much work to be done to address the acute shortage of places in institutional care across the country—work which was seemingly overlooked by the budget, which announced no new nursing home beds—Mrs McWaters has raised with me her very legitimate concerns that, though important, an exclusive focus on institutional care is the wrong path to go down.

Members of our community who require assistance to get through everyday life should have the option of remaining in their own homes, where they are comfortable and where they are close to their families, for as long as possible. But, in order to make staying at home a viable option, it is incumbent on government to provide carers with access to proper support services. For a long time, caring was viewed simply as an extension of family duties. But the community is increasingly becoming aware that providing care for people with disabilities can be emotionally and physically draining work. Community education must continue, but there is growing acknowledgment that people like Mrs McWaters, who are at the coalface, need improved access to support services to help them to help others.

These very important members of our community do not ask for thanks but they do ask for support to ensure that they are able to continue to provide the highest level of care possible. Sadly, that support is not readily available. Mrs McWaters provided care for her mother on a full-time basis for 10 years after her mother suffered a debilitating stroke. During that time, she became acutely aware of the lack of support, in particular the limited availability of respite services available to carers in the Redlands district of my electorate. The day centres that operate in the area have restricted hours, only operating between 10 a.m. and 2 p.m., Monday to Friday. Outside these hours, carers who have commitments outside the home find it very difficult to access respite services. As a consequence, Mrs McWaters has observed that many carers will put their own needs aside. For instance, the difficulty in obtaining emergency respite care where a carer takes ill will mean the carer tends to forgo doctors appointments and generally neglect their own health requirements, whereby their role as a carer is compromised.

May I place on record my sincere admiration for Mrs McWaters and people like her all around Australia in their hundreds of thousands that do this work, save governments a lot of money and ask for no thanks. The least we can do is give them some support. From her own experiences and having spoken to many people who provide full-time care for their loved ones, Mrs McWaters knows that there is an urgent need for carers to have access to flexible respite arrangements seven days a week or overnight if need be. It is time that the government recognised the valuable contribution made by carers and ensured that disability services receive appropriate growth funding in that area.

We also have the Pharmaceutical Benefits Scheme changes proposed in this budget. These changes would put even more financial pressure on Australians when they are down, obliging pensioners and cardholders to pay an additional $52, while others must foot the bill for a further $190 for pharmaceuticals. It is not on, and Labor will oppose this measure both in the House and in the Senate.

The other matter that creates concern in my electorate is that the Treasurer has persistently refused to increase funding to ensure a viable universal health system. Fewer and fewer doctors are prepared to bulk-bill. In fact, some of them are receiving notices like one that I have in front of me which says, `Cessation of bulk-billing from 1 September 2001,' and it goes on to say, `Pay the total fee and then go to Medicare for your rebate.' In my electorate of Bowman, the Wynnum Medicare office was closed by this government so, even if you can get some of the money back, you have to catch a bus or a taxi, which costs money, to get your money back from Medicare. It is an absolute disgrace. This government is not really worried too much about the health care of our people in Australia and certainly not those in Wynnum in my electorate.

I wanted to mention other constituents in my electorate who have written to me. Mr Stan West of Alexandra Hills is just one of many of my constituents who has contacted me about these important issues. These issues need to be addressed. I would hate to think that if we do lose our Medicare system, if the medical system does fall down because of meanness on the part of the government, the government would only act to restore the Medicare system if a human tragedy shook them into action. I can assure you that could well happen, because people, particularly pensioners, do not have a lot of money and every dollar means something to them. We would never want a situation where health care is seen as a luxury in this country, where people have to choose between that and feeding themselves.