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Thursday, 13 February 2003
Page: 11907

Mr RUDD (12:49 PM) —I wish to address the continued deterioration in bulk-billing services in my electorate of Griffith on Brisbane's south side. Last year I spoke in this place about the problem of bulk-billing. Less than 12 months on, I have to report that the problem is now endemic across my entire electorate. In September my office conducted a survey of 39 doctors across the Griffith electorate. Twenty-seven said they were offering bulk-billing. Some five months later, residents are calling my office saying that this figure is a misrepresentation. Why? Because the real percentage of practitioners now prepared to bulk-bill is far lower. This morning, my office put these calls to the test by conducting a survey of 20 doctors' surgeries in my electorate. It found seven of the clinics contacted offered no bulk-billing services whatsoever; seven only offered bulk-billing to pensioners; and the remaining six offered general bulk-billing services.

One of the faces of this story is that of Mrs Hayes, a pensioner who lives in Camp Hill in Brisbane. Mrs Hayes's situation is similar to that of many who approach my office. Before this year, Mrs Hayes had used the same local doctor's surgery for 12 years. She had a doctor who she knew and trusted located somewhere that was a short walk away whenever she needed medical attention. When this clinic ceased its bulk-billing service, Mrs Hayes was forced to go elsewhere. In her own words, Mrs Hayes is struggling to keep her head above water at the best of times. So you can imagine what happens to her weekly budget when she has to make her way via taxi to and from the nearest bulk-billing practice two suburbs away. The worst thing for Mrs Hayes now is that, like many others, she cannot afford to go to the doctor every time she needs to. Mrs Hayes told my office that most of the time when she gets sick now she just has to grin and bear it until such time as she can afford to see someone.

But the problem does not stop here. Doctors in my electorate are also facing tough times. Dr Paul Mercer of Wakeley summed up the situation in a letter to the federal Minister for Health and Ageing, Senator Kay Patterson, which he also sent to my office. It reads:

Dear Minister,

I am writing as a GP who is putting up the white flag, so to speak, on bulk-billing. As a general practice principal, I have been involved in full-time general practice since 1983. It is with serious regret and disappointment that I call a halt to bulk-billing. I believe that this decision has been brought about by two important factors: (1) a chronic underresourcing of general practice funding such that it is now quite unviable to run a small business without working in an excessive fashion. Indeed, I have recently been quite unwell, after working very hard over the last few years. I would attribute my illness in significant part to this work pressure. (2) Apart from the financial constraints imposed on general practice, workforce shortage is an additional burden. While I have worked hard for many years and have also contributed significantly to the development of general practice in Australia, taking appropriate holidays has been hamstrung by a lack of suitable and affordable locums.

I believe it is time to address health care funding as a national priority. Health is an asset for our nation. Balancing the nation's health status should carry equal importance to balancing our budget, as should education. I suspect the electoral backlash to the demise of bulk-billing will be severe, and doctors such as myself who are committed to quality outcomes in primary health care are forced into this situation. The reality of system failure is serious. The health ball is dropping. Is your government willing to catch it before it lands and shatters?

Yours sincerely

Dr Paul Mercer

In December 2001, one month after the Howard government was returned to office after the last election, a health department analysis warned the government that, beginning in late 2000-01, the rate of decline in bulk-billing had increased and that from then on bulk-billing would fall steeply, perhaps by as much as a percentage point a month; the trend to bulk-billing would be exacerbated over the coming months; and, without significant intervention, bulk-billing rates would continue to fall further again. In the September quarter, bulk-billing fell by 2.7 per cent across Australia in the three months since June—very close to the rate of one per cent a month predicted by the federal health department in an FOI document.

According to the latest figures available for the electorate of Griffith, the rate of bulk-billing has declined from 87.8 per cent to 71.3 per cent in two years—between September 2000 and September 2002—a staggering fall of 16.5 per cent. When the December quarter figures are released, perhaps this week, a further substantial decline is expected. On the final day of parliament last year, what was the Prime Minister's response to this dilemma facing the nation—not just my electorate within the nation but the nation at large? He said:

Any suggestion that bulk-billing has disappeared or is disappearing, given the rates of bulk billing in Australia at the present time is factually incorrect.

That is from the Hansard of 12 December 2002. We are facing a complete crisis in bulk-billing across the Commonwealth of Australia. If the Howard government cannot address this reality now and restore bulk-billing to its universal status, we will Americanise the health system of this country.