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Wednesday, 25 June 2003
Page: 12489


Senator CROSSIN (2:00 PM) —My question is to the Minister for Health and Ageing. Can the minister inform the Senate of the current national rate of bulk-billing by GPs? Is it true that the rate of GP bulk-billing has fallen significantly since the Howard government came to office but has dropped even more dramatically since this minister took over the health portfolio 18 months ago? Can the minister explain why the rate of bulk-billing by GPs has fallen so much since she became the minister?


Senator PATTERSON (Minister for Health and Ageing) —As I said yesterday, and have said continually, the Labor Party are totally fixated on bulk-billing—absolutely and totally fixated. That is the only path they can think about. They do not talk about outcomes or access and equity; they are focused on bulk-billing. They are so focused on bulk-billing that they are prepared to treat people in different parts of Australia differently—as second-class citizens if they live in a rural area—because they think it is okay to have bulk-billing rates of 70 per cent in a rural area and 80 per cent in the city. That is how much they care about bulk-billing.

The Labor Party never mention access. When we came into government we inherited an absolute mal-distribution of general practitioners—far too many in the cities, far too few in the outer metropolitan areas and far too few in rural areas. Since we came into government we have seen a 4.7 per cent increase in doctors in rural areas in the last 12 months—4.7 per cent in estimated full-time doctors. This is the first time we have seen a turnaround. They did not care that people in rural areas did not have doctors, because they do not have anybody representing rural areas. They did not give tuppence that there were people in rural areas who could not get access to a doctor.

We have put $562 million—over half a billion dollars—into getting doctors into rural areas, increasing the number of doctors in rural areas by giving them retention payments, increasing the number of doctors in rural areas by giving them scholarships and increasing the number of doctors in rural areas by giving them an incentive if they do their GP training in rural areas. But all those opposite care about is bulk-billing rates. Behind those bulk-billing rates are hidden gross inequities of people on health care cards who have never seen a bulk-billing doctor, who are never likely, if those opposite were in government, to see a bulk-billing doctor. We have said that access is an important thing. People want to be able to see a doctor, and the more doctors you have in an area the more likely you are to have bulk-billing.

We inherited an appalling mal-distribution of general practitioners. As I have said before, you can go down to Hawthorn and within walking distance of my home you will most probably find 20 or 25 doctors. People in rural areas do not have that access to doctors. I can get bulk-billing anywhere within walking distance of my home. There are people who cannot get bulk-billing doctors within miles of their homes in country areas, because Labor left us with a mal-distribution of general practitioners. Nor do Labor care about the fact that in outer metropolitan areas we do not have enough general practitioners. We have put $80 million into getting doctors into outer metropolitan areas. Access is very important. People want access to a general practitioner. Whether they bulk-bill or not, people do not care. We have put $80 million into the outer metropolitan program. We now have 75 doctors who have committed to moving into outer metropolitan areas.


Senator Crossin —Mr President, I rise on a point of order. My question was specifically about the decline in bulk-billing by GPs, not about the number of doctors who are in remote Australia. I ask you to suggest that the minister answer the question that I have asked.


The PRESIDENT —I cannot direct the minister on how she should answer the question. She still has a minute to go and I am sure she is doing the best she can to answer the question.


Senator PATTERSON —Senator Crossin reinforces what I have just said: all they care about, on the other side, is bulk-billing and bulk-billing rates—headland rates—and also that you can have a 70 per cent bulk-billing rate in rural areas. That is their goal, but they will not achieve it, because there is no way they would guarantee it. There is nothing in place to leverage the doctors to have a bulk-billing rate of 70 per cent in the country and 80 per cent in the cities. So they would treat people in rural areas as second-class citizens. They are only focused on bulk-billing rates, not access, not on people being able to go to a general practitioner.

Senator Crossin says, `I am not talking about the number of doctors.' Well, I am, because it is very important. The Labor Party did not care about it. They did not give tuppence about the number of doctors, where they were located and whether people had access to them. The issue is that people, first and foremost, require access to a doctor. We are putting in place incentives to encourage doctors to bulk-bill—particularly those people on health care cards, particularly those people in rural areas who have never seen a bulk-billing doctor—and to ensure that those people who are the poorest and sickest in our community, particularly—(Time expired)


Senator CROSSIN —Mr President, I ask a supplementary question. Given that the minister has monumentally failed to answer my first question, I ask: given that the national rate of GP bulk-billing has dropped by 6.7 per cent in the short time that she has been the minister, does the minister accept any responsibility at all for this decline in bulk-billing and the withdrawal of access for many Australian families? Is the minister concerned that, after she has gone, she will only be remembered as the minister responsible for the disappearance of bulk-billing?


Senator PATTERSON (Minister for Health and Ageing) —I would have thought that Senator Crossin might have had a more sensible question. Let me just say that the Labor Party had a monumental failure in addressing the issue of location of doctors and access to them, which is of absolutely vital importance. They will never talk about that; they will never admit that. Almost seven out of 10 visits to a GP are now bulk-billed. Almost eight out of 10 visits to a GP by people over 65-years old are bulk-billed. The issue is that there are many people on very low incomes who do not have access to a bulk-billing doctor. We are hoping to put in place, if the other side agree, a package which has as one of its planks increasing the likelihood that people on a heath care card are bulk-billed, particularly those in areas of particular need in rural and remote areas. This is a package that addresses equity and fairness. It is not about some headland figure of bulk-billing.