Ms GILLARD (10:58 AM) —I start by noting that once again the Minister for Health and Ageing has refused to attend for consideration in detail on the appropriations for the Health and Ageing portfolio. He is clearly in the parliament. Indeed, both he and I were just in the House dealing with a piece of health legislation. There is no reason why he could not have taken the same walk up the stairs that I did. The consistent refusal of the minister for health to defend the appropriations for Health and Ageing, I think, reflects poorly on his competence and on his understanding of the importance of parliament and is obviously meant to shroud from the opposition’s inquiry the appropriations in Health and Ageing. If he is too incompetent to defend his appropriations, one wonders why he is drawing a ministerial salary.

The DEPUTY SPEAKER (Hon. BK Bishop)—I remind the member for Lalor that this is a question on the detail of the appropriations, and it must be connected to the financial matters or policy. We have had the introductory remarks. I remind her that the Parliamentary Secretary to the Minister for Health and Ageing is present and that that is perfectly appropriate. Perhaps she could proceed with her questions.

Ms GILLARD —Thank you, Madam Deputy Speaker. We will ask some questions of the parliamentary secretary for health, but of course much of what we would have wanted to question him on he will say he is not responsible for. This is just a mechanism to avoid accountability. Having said that, I will direct some questions on mental health to the parliamentary secretary, and I would appreciate very detailed answers to them.

Madam Deputy Speaker, as you are aware, the Howard government has announced additional expenditure in mental health—$1.05 billion appears in the forward estimates of this budget—but none of the measures in the government’s mental health package have an implementation date. Will the parliamentary secretary, who is responsible for mental health, detail when each measure that the government has in its mental health package and which is the subject of appropriations in this budget will commence? Very little detail has ever been given about the measures that are the subject of the package. Given that detail must still be in the stage of development because it has not been publicly released, will the parliamentary secretary indicate whether it is the Department of Health and Ageing or the Office of the Prime Minister and Cabinet that is the lead agency for the development of that detail? I also ask: will the parliamentary secretary indicate what mechanisms are in place to ensure coordination with the states and territories on mental health issues?

One of the measures is to allow Medicare rebating for mental health services. A fact sheet released by the government says that in the fifth year of operation it is expected that 35,000 people will see a psychiatrist under this Medicare rebating program and 400,000 Medicare services will be delivered by psychologists. I note that this compares with 100 million GP services and 20 million specialist services a year, so in the scheme of things it is not a large number. Will the parliamentary secretary at the table confirm whether or not psychologists will have direct access to Medicare—that is, will a GP referral be required? Can he indicate whether psychologists will have direct access to Medicare for all services that they provide? Will every psychologist in the country have direct access to Medicare or will there be some credentialing process in order to get access, which means some psychiatrists may not qualify?

Will the parliamentary secretary at the table confirm whether or not it is the intention of the government to scrap the Better Outcomes for Mental Health program? Will he confirm the average out-of-pocket cost now experienced for a patient seeing a psychiatrist? What average out-of-pocket cost is it that the government factors that patients seeing a psychologist under this new program will experience in using the program?