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Thursday, 15 May 2014
Page: 3921


Ms KING (Ballarat) (15:15): We know that before the last election the Prime Minister had a fair bit to say. But some of the words that have come back to haunt him are that he made a very strong promise that there would be 'no cuts to health, no cuts to pensions, no cuts to education and no new taxes'. We know with this budget that he has not only broken those promises, he has absolutely smashed them.

We know, revealed in the budget, that there is $80 billion being taken out of health and education. That is $80 billion, $50 billion of which is being taken out of public hospitals in this country, ripping up the historic agreement that Labor reached with states and territories to improve our emergency departments, to put more beds into hospitals—both acute and subacute—to fix elective surgery waiting lists, to provide more staff in hospitals, to provide better infrastructure for hospitals and to make sure we were fixing a lot of the mess that had been left to us by a Liberal government that saw a declining Commonwealth share of public hospital funding.

Now, we have had a bit of mean and tricky stuff from the Minister for Health, where he has tried to argue—and he has been running this false argument around the sustainability of the health budget—that, in fact, part of the problem has been a blow-out in hospital spending. In fact, it was a deliberate decision of a Labor government to make sure that there were investments from the Commonwealth in public hospitals, to do our share of the heavy lifting to make sure that people continued to have access to a universal healthcare system, Medicare, that provides access to public hospitals. That was a deliberate decision that Labor made.

In this budget, this government has smashed that. It has ripped up those historic agreements with states and territories. I asked a question of the Prime Minister in question time, whether he would guarantee that no hospital beds would close, that no nurses or doctors would be sacked from our public hospitals, that no further beds would close and that we would not see a blow-out in our emergency department waiting times or in our elective surgery waiting times as a result of this direct cut to hospitals in every state and every territory, and in every community across this country. He has refused to give that commitment. But I say to the Prime Minister: every bed that closes, every emergency department waiting time that blows out and every patient that is denied access to a public hospital as a result of these cuts will be on your head. And we will make sure every day from now until the next election that the Australian public in communities right the way across the country understands that.

The other thing that we know—finally, after the months and months of speculation—is what the cuts to health more broadly are going to be. We saw in the budget the introduction of the $7 GP tax. Let me take you to some of the detail of what this is actually going to mean to people. This is about the substantive policy detail; this is what we will see. The government is trying to claim, 'Oh, no—it won't affect bulk-billing. It will be fine. We're going to let doctors continue to bulk-bill, if they want to. It's okay.' They have been mean and tricky about that. The way in which they have administered this measure and the way in which they have reduced the schedule item actually means that there is a disincentive for doctors to bulk-bill. Doctors will have reduced wages, reduced income, if they actually bulk-bill. So there is no incentive for doctors to bulk-bill. Currently there is an MBS item to provide incentives for doctors to bulk-bill. It is greater in the country than it is in the cities, where it is still a bit unclear about what is happening to that MBS item. But what is actually built into this budget is a disincentive to bulk-bill. Doctors will be punished if they bulk-bill.

So here we have, across the country, some of the highest rates of bulk-billing than we have ever had before. They were achieved under Labor—82 per cent of MBS GP visits were bulk-billed under Labor. We will be watching every single day to see what happens to bulk-billing rates in this country because we know the measure that has been introduced by this government is deliberately designed to get rid of bulk-billing in this country.

And why is that so important to this government? I fail absolutely to understand why they want to smash bulk-billing. But you have to go back to some of the history of this. This party that is now in government has never believed in universal access. It has never believed in Medicare, which is a system of insurance where everybody pays through the Medicare levy. Through the Medicare levy, we pay for our universal access system. Through the Medicare levy surcharge some people pay even higher for the universal system. That is in fact the system that ensures that people have access to general practice and that they have access to the public hospital system. That is what we voted for back some 30 years ago. We celebrated the anniversary—this year it would have been 40 years had it not been for the Fraser government. What the Prime Minister and what this Minister for Health are trying to achieve in this budget is what Howard could never achieve: the end of Medicare. Be in no doubt: that is absolutely what they intend to do.

There are a whole lot of other budget hits within the budget that are hidden. They claim that they are reforming the Medicare safety net, but somehow making a $270 million saving from doing so. It is mean and tricky! What that actually means is that while some people may hit the extended Medicare safety threshold a little bit earlier, they in fact will actually have to pay more in out-of-pocket costs. That is really what this is, so look at the devil in the detail.

We know this budget is full of pain for ordinary Australians. Every time an Australian tries to access a general practitioner, whether it is because they feel unwell or because they are trying to manage a chronic disease like asthma or diabetes or because they have heart disease or cancer in their family and they are worried about how they keep well, about what the markers are or the things that they need to do to ensure that they can stay well in the course of their lifetime—every time someone tries to access a general practitioner because of that—they will be slugged $7.

The way in which this government has implemented this policy is an absolute nonsense. Nobody in the health sector has said this is a good idea. The only people who are advocating this are all of those on the opposite side of the chamber and the Commission of Audit. The Australian Medical Association—you would think they would know. The Royal Australian College of General Practitioners—you would think they might know something about health. The Consumer Health Forum, representing some of the most vulnerable people in the health system in this country—no, they do not think it is a good idea. The Australian Council of Social Service also represent some of the most vulnerable people in this community. From right the way across the health spectrum, there is nobody saying that this is a good policy or a good idea except for the Abbott government, because they know that the design of this policy is to end bulk-billing. It is to impose substantial costs on patients so that they avoid going to the doctor. That is what it does. It is designed to make people avoid going to the doctor.

Somehow or other, the Abbott government thinks it is in a better place to decide when people should go to the doctor or not. This is putting a substantial barrier in the way of people accessing general practitioners. What a stupid policy. What a stupid thing to do. Apart from the enormous pain it will inflict on families and on families' budgets, it is also stupid health policy. It is putting a barrier in the way of general practice, the part of the system which is in fact, as the minister will know, the cheapest part of the system. It is putting a barrier in the way of accessing primary care, where you want people to go to stay well, to manage their chronic conditions and to keep out of the more expensive part of the system—hospitals and specialists. Putting a barrier in the way of that system is just plain stupid health reform. It is not health reform; it is ideology.

What we have seen from this government is an absolute hit on the budget of every family as they go to the doctor. How on earth are people on fixed incomes, people who are on marginal incomes in this country, supposed to budget for when their family gets sick? How on earth are they supposed to do that? But somehow that is exactly what this government believes they should do. Factor into your family budget just how many times you are going to need to go to the doctor a year and how many times your kids are going to get sick—how many of you are going to get sick at what time. You need to factor that into your budget.

Shame on this government, frankly. It is an appalling measure and certainly not something that Labor will support under any circumstances. I know the Prime Minister started to talk about horse-trading. You do not horse-trade when people are sick. Only the Prime Minister would make such a statement. The government now is obviously facing a substantial backlash from all of the states and territories. I do not know any state or territory telling you that this GP co-payment is a good idea. I do not know any state or territory saying that your slashing of $50 billion out of public hospitals is a good idea. And there are not many states and territories which think taxing people to go to emergency departments is a good idea. This is a stupid policy that will inflict pain on Australian families and pain on their budgets.