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Tuesday, 14 February 2012
Page: 1227


Mr CROOK (O'Connor) (22:41): Thank you, Mr Speaker, for the opportunity to discuss the Fairer Private Health Insurance Incentives Bill 2011 and related bills today.

As a member of the Nationals WA who sits on the crossbench, I consider two main issues when considering any piece of legislation that comes before this House. Firstly, I ask, 'How will this legislation impact or benefit my electorate of O'Connor?' And, secondly, I ask, 'How will this legislation impact or benefit the rest of regional Western Australia?'

Over the months I have held various discussions with a range of stakeholders on this issue. I have discussed the issue with doctors, insurance companies, government representatives and analysts. Importantly, I have also discussed this issue at length with various constituents and community leaders. Following this consultation I have come to the conclusion that in imposing a means test on the private health insurance rebate, residents of O'Connor and regional Western Australia will be worse off and, as such, I will not support this legislation.

The first issue that I would like to address this evening is the state of our regional public health system. From the outset of this debate I have consistently stated that my major concerns about this legislation relate to the impact it is likely to have on the public health systems of regional Western Australia. As a former national president and chairman of the Royal Flying Doctor Service Western Operations, I have a strong understanding of regional health issues.

Since my election to this House, I have done my best to keep regional health issues on this government's agenda. Sadly, this government, like previous governments, has failed to give regional health the attention it deserves. As a result, throughout regional Western Australia all aspects of the health system have been underfunded by successive federal governments on both sides. The neglect is most evident in regional Western Australia's doctor shortage. Right now in regional Western Australia alone there is a shortage of 97 doctors. There are shortages across the wheat belt, the goldfields, the south-east, the south-west, the Great Southern, the Midwest, the Pilbara and the Kimberley. Around 80 per cent of these vacancies are classified as an area of need.

Whilst to many ministers, government members and opposition members this doctor shortage is just a number, the situation for many families in my electorate, as indeed around the state, is much more real. The reality for many regional Western Australian families is that they are simply unable to access basic healthcare within a reasonable distance or reasonable time frame. It is not uncommon for families in regional Western Australia to have to wait a month or longer to access a doctor, nor is it uncommon for families to travel up to 200, 300 or even 400 kilometres on a round trip to visit a GP in another town. The reality for many regional Australian parents is that they do not have the local GP to take their children to when they are sick and they never have a family doctor that lives in their town long enough to really understand their family's medical needs. The reality for many local governments in regional Western Australia is that they are forced to use their limited cash flow to pay extraordinary incentives, including the provision of houses, cars, a surgery, practice management and additional cash benefits in an effort to attract a doctor to the town.

The reality for many doctors in regional Western Australia is that they are professionally isolated, forced to work without proper support networks and burdened with the responsibility of being the only lifeline for their entire community—and sometimes neighbouring communities as well. This is a fundamental issue for my electorate.

The neglect by governments of regional health continues to undermine efforts to create vibrant regional communities while placing the wellbeing of many of my constituents at risk. Through this debate, through these negotiations and through the years of previous governments, these issues have not been addressed. In the interests of regional Western Australia I will not support a proposal that puts more money into the federal government coffers without proper investment into the regions.

Further to this issue, I have always had concerns that removing incentives for people to have private health insurance may further burden the ailing public health system. These concerns were validated by the Deloitte report, which indicated that this legislation could see as many as 1.6 million Australians drop their private health cover over the next five years. This is equivalent to the entire population of Perth. This would involve a shift of patients to public hospitals which are already operating the recommended occupancy rate. This would also result in waiting lists for surgery increasing to untenable levels. Analysis of the Deloitte study has suggested that this may result in waiting lists for surgeries blowing out from an average of 65 days to 295 days by 2015. In the areas where our health system is already struggling, these events would be disastrous.

Not only will the legislation negatively affect our overburdened public health system but it could also have damaging effects on our existing private health insurance schemes. The government has failed to address the reality that the abandonment of private health insurance by a significant number of Australians will lead to the increase of costs in private health insurance. HBF has estimated that if the 30 per cent rebate was lost it could add around $500 to the average premium for an individual with combined hospital and ancillary cover. For families, HBF estimates that the average increase at well over $1,000. This will impact on the families with private health insurance regardless of means testing.

I would like to take the opportunity to briefly address the assumptions that have been made about the effect that these reforms will have on regional Australians. Many commentators, and indeed some members of this government, have argued that regional Australians have more to gain from these reforms because regional Australians have less access to private health facilities. As such, they argue that the regional Australian taxpayers have more to gain from winding back private health insurance rebates. There are a number of problems with this assertion.

First and foremost, the argument assumes that the money saved from the rebate reforms will be redirected to regional health systems. However, many years of neglect of regional health issues tells us that this will not happen. In fact, many of these rebates will come directly from the hands of regional voters straight into the federal government coffers, where it will quickly disappear into projects promoted by the east coast and metropolitan centric policies of the major parties.

Secondly, the argument incorrectly assumes that regional Australians do not see private health as significant. From the many discussions that I have had with constituents, I can firmly say that this is not the case. Even if it means travelling to a larger city in the case of an emergency, many of my constituents view their private health insurance and the rebate that comes with it as extremely important. Thirdly, given that the state of the public health system in regions is more dire than in the city, the damage that will be done by people migrating from private health cover will be much greater.

I have clearly outlined the tremendous uphill battle that regional Western Australia has ahead of it in relation to health care and the doctor shortage. While I appreciate that there is no silver bullet to resolve this issue, I am not convinced that the Labor government has addressed this issue with the urgency that it demands. I believe that many families and communities in regional Western Australia would have looked on this legislation much more favourably—as I would have—had the federal government made a commitment to reinvest the considerable savings from the legislation back into regional health. Even a portion of the $2.4 billion worth of savings would have a dramatic and positive impact on regional Western Australia. I am very disappointed that the Labor government has not made any steps to address these concerns.

As already mentioned, this government is not solely responsible for this issue, and I am disappointed that the opposition has not done more to put this issue on the agenda. We must acknowledge that this issue did not develop overnight; it has been ongoing for the last 20 to 30 years. Both parties must accept responsibility for the poor state of the regional Western Australian health system. For the past two years I have tried to convince the government of the need to support regional health in Western Australia. We are currently 97 doctors short. People do not leave the region because the roads are no good; they leave because they cannot see a doctor and they cannot educate their children.

In the interest of creating sustainable and vibrant regional communities, I call on this government to address the doctor shortage and associated health issues rather than concentrate on cost-cutting measures to counterbalance their other misspending. This federal government needs to look at addressing the issues and addressing them urgently. I will not support any reforms to the private health insurance rebate until the health system in Western Australia is properly supported by the federal government.