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Wednesday, 16 March 2016
Page: 2132


Senator O'NEILL (New South Wales) (15:52): I note that we have some young people here with us who are visiting from school. I am not quite sure what school you are from, but you are paying great attention to the debate that is happening here, and I thought I might commence my remarks by explaining what is happening here. I used to be a teacher, and one of the things that teachers do from time to time is set homework. When you go away and you do your homework, you are responsible for returning it to your teacher and, in a way, what we are talking about is some homework that was set for the government. There is a budget and there is also a thing called MYEFO, which is the budget that happens at the end of each year; so we have the budget in May and then we have the MYEFO in December. In the lead-up to that MYEFO in December, the government made some decisions about more things that they were going to cut. We know that they got advice from very important people who advise the government—that is, the Department of Health—and we also know they got advice from the Department of Finance.

Senator McKenzie: Mr Deputy President, I rise on a point of order. As we are conducting what seems to be a lesson in the Senate today, I would like it to be an accurate one. When we are speaking in this chamber, it is appropriate to actually speak to the chair of the chamber rather than to the gallery.

The DEPUTY PRESIDENT: I am not sure there was actually a point of order. It will be a moot point any moment now, anyway.

Senator Polley: Mr Deputy President, I rise on a point of order. I want it to be noted on the record that the good senator has chased away these schoolchildren, who were listening intently.

The DEPUTY PRESIDENT: All right. Thank you for your assistance, Senator McKenzie. There is no point of order. Senator O'Neill, you have the call.

Senator O'NEILL: Perhaps the students, on leaving the chamber, might decide that they want to have a look online where they can read what I say, because I am going to continue the lesson. Let me tell you that the lesson is not just for the students who were sitting in the chamber today; it is also for this shameful government, which is abrogating its responsibilities. Young people would understand about homework. There are only two reasons why you do not hand in your homework: you do not hand it in because you have not done it—and we know that is not the case because they did it. They actually made these cuts in the MYEFO, in the mid-year budget, so we know they did their homework. The reason that it is not on the record and the reason why the minister has not provided the answer is because their homework, for want of a better term—their answer to this question—is so bad that they do not want to put it in the light of public scrutiny. They do not want anybody to see it.

I am thinking back to what was going on in my life on 16 December, which was when this notice was given. I remember that 12 December was a big day in my family—my son turned 19 and, just a few days before, my grand-niece was born. It seems quite a long time ago. An awful lot has happened in the lives of most Australians between 16 December and now—people have paid bills, people have responded to inquiries, people have done their work. But this government are so arrogant that they do not think they should answer the questions that are put on the public record to let the Australian people see what they are doing.

What was the question that was asked? The question that was asked was from Senator Wong to the Minister representing the Minister for Health, as long ago as 16 December, with reference to the Mid-Year Economic Fiscal Outlook. A measure in it was identified—a title, if you want—that says: 'More efficient health programs'. The question was: 'Can the minister provide a list of the 24 health programs which will be cut to achieve $146 million worth of savings over four years?' The second part was: 'Can the minister provide a profile of the amount cut from each program over the forward estimates?'

Those opposite told us in black and white in the figures that they presented that there would be $146 million gone. They know it adds up to $146 million but they are refusing to tell the Australian Senate and, through refusing to tell the Australian Senate, they are refusing to tell the Australian people and we know why. What they have done to the health of this nation since they have got in is absolutely shameful. There has been $57 billion cut from health—$57 billion! This has a massive impact on our hospitals all around the country.

And what did the minister have to say when she did come to the chamber and in response to Senator Wong saying, 'Well, it has been three months. It might be time for an answer.' I think I got her words accurately. She said: 'The government is considering its response and will return an answer in due course.' That is, basically: 'We do not want you to know, and I would rather come down and be embarrassed and say: "I am hiding my homework because it is so bad. I would rather do that as a minister of the Crown than come in and tell you the truth about the savage cuts that they are going to take to these important programs in health".'

What are those programs? What do we know at this stage? The little bit of information that they had to leak out for their budget revelation in December is that they are cutting $40.4 million in 2014-15; $36.9 million in 2015-16; $36.9 in 2016-17 ;and $31.8. And they say they are going to achieve these savings by—and this is a carefully abused word, I think, in this context—'redesigning'. They say they are redesigning 24 health programs. They say they are going to make these programs operate more efficiently, including programs associated with four things; firstly, population health.

Population health is where we have investment in finding out about what is going on—epidemiology, figuring out what is going on in our community—but it is also where we have programs that help to keep people well. What are those opposite cutting? Are they cutting the colon programs? Are they cutting advertising about BreastScreen? What are they doing? What are they cutting in terms of population health? They do not want to answer the question.

If we really believe in keeping ourselves healthy as a nation we should be investing in preventative health and using population health data to make our country more healthy, not less healthy. But that is what they have cut.

They have also cut medical services but we do not know which ones because they will not tell us. They are also cutting e-health, electronic health. We know there is a massive transformation being undertaken around the country to try to get all of our records and details into electronic form, so that if you are travelling you can get your records. I know that many Australians who come to visit us here in the parliament travel around the country. If you become unwell when travelling and if your records are digitised, the person who looks after you when you are away from home has full access to your records. That is e-health. The government are cutting that.

They are also cutting their investment in health workforce. Whether they are directly cutting the health workforce or cutting the preparation and planning for an effective health workforce, we do not know because they will not answer a question, despite the fact that they made the announcements before Christmas. They know what they are cutting. They know right now, today, that they could bring that information forward and put it out publicly, but they are avoiding that scrutiny.

All of these things are vitally important. What we are seeing is a very significant problem and we are seeing it day after day with this government. They are determined to take away the health care of the people of this nation. They call it 'efficiency', but ordinary Australians call it something very different. We call it cuts to health. We call it cuts to access. We call it a deliberate attack by a Liberal-National coalition on Medicare in many, many circumstances. We have seen the cuts of $146 million over four years as the 'more efficient health program'. We have seen them call another program of cuts to the tune of $141 million over four years as 'mental health streamlining'.

I know that people here in the chamber and people who might be listening to this see many, many images of their local members—and they are particularly numerous at the moment as the Liberal-National Party are in government—crying crocodile tears all around the country and bleating about how much they care about mental heath, how much they care about mental health in the bush, how much they care about mental health for men, how much they care about mental health for women. But they have cut $141 million from mental health and they call it 'streamlining'.

Senator McAllister: Because there is no money.

Senator O'NEILL: There is no money because they have actually spent money on absolutely the wrong things. They have ripped money hand over fist out of health. They cannot help themselves. Many people would be well and truly aware of the incredible impact that the changes that this government have been pushing for in diagnostic imaging and pathology services are having on the community. People are scared to death—and perhaps that is not too much of a stretch. They are scared because of the growing cost of getting the basic services that they need to look after their bodies.

We know that people with chronic illness or people who need tests for cancer or breast screening, or tests on a regular basis to manage their diabetes or their mental illness in this new 'streamlined' world that we are hearing about from this government are incredibly anxious. In the last couple of weeks, I have had almost 2,000 emails from people saying, 'Please stop this government from attacking the bulk-billing incentive in pathology labs.'

I want to put on the record the fact there is a very different view between the Liberal-National Party and the Labor Party about people getting access to essential services, particularly essential health services. As a senator for New South Wales with my office in the seat of Robertson, I was very pleased, along with two Labor candidates—Anne Charleton, Labor's candidate for the seat of Robertson, and Emma McBride, our candidate for the seat of Dobell—to welcome Mr Shorten to the Central Coast. When Mr Shorten arrived, we did a tour of the pathology lab in Gosford, which is about an hour and a half north of Sydney.

This pathology lab provides an opportunity for real-time testing of samples so that the hospital next door can get the pathology results and do the operation and respond appropriately in real time. That can only happen because that pathology lab is active and working on the Central Coast right near the hospital. It is a small region with only about 350,000 people. It is a great region, nonetheless it is a regional centre. Over 1,500 pieces of pathology action are taken every single day at that lab for our direct and local community. It employs eight to 10 people on a regular basis with great jobs.

Mr Shorten said, 'What the bulk-billing incentive does is provide just enough money which allows the pathology centres to be able to let people be bulk-billed for vital tests, including diagnosis and treatment of diabetes and other chronic diseases. It is about providing bulk-billing for patients who need cancer treatment for leukaemia.'

When we were in the lab that day, I saw a blood sample of a local young person who has acute lymphatic leukaemia. We looked down the microscope and we saw it. That diagnosis is absolutely essential. When I looked at the sample, I could not tell if that blood came from a rich person, a poor person, a black person or a white person; it was just blood cells—blood cells that needed analysis and blood cells that are being analysed in a fair and equitable way under the current system. But that system is under incredible pressure and is just about to be pulled away.

I was very well informed by Dr Stephen Fairy, a representative from Sonic Healthcare. He explained about the way the government are currently using statistics around diabetes testing, which really misrepresent what is going on. The scale of diabetes in our community is not registering on the Medicare items that are related to diabetes. That is because there is a thing called 'coning' in Medicare that prevents overuse of the system. When our doctors order a full blood count and we go off and have our blood taken, the top three items will be charged but not the following parts of the doctor's order. So many of the items at the bottom, including the diabetes testing, which costs about $10 per item, are actually done for free as part of a job lot, every time somebody gets a full blood count done that has more than three items. So there is no fat in the system. This is what Mr Ferry had to say: 'Pathology is so critical that without pathology medical practice would be almost impossible. Laboratories like the one we have seen today perform thousands of tests every day, providing results to doctors and hospitals that allow them to diagnose and treat patients with a variety of medical conditions, including cancer and chronic diseases like diabetes.'

We are fortunate in Australia because our pathology laboratories are among the best in the world in terms of quality, safety and efficiency. What is more, 98 per cent of all pathology services provided outside of hospitals are currently bulk-billed. If the proposed fee cuts come into effect, that will change. The Medicare fees that allow pathology companies to bulk-bill are absolutely vital. The pathology industry has absorbed fee cuts for many, many years, but now with intense cost pressures that is no longer possible. Many of our laboratories are financially stressed. Mr Ferry said—and I think about what this means for the people I live and work with—that if that laboratory goes from the Central Coast, the people who are in having operations will no longer be able to get real-time analysis. If somebody has an operation where they might have their lung being checked and the doctor is able to get an analysis and do a treatment straightaway for some sort of cancer, there is only one operation involved. But this government knows better. They believe that it is okay to put a barrier between people and the health-seeking behaviours that they have been encouraged to undertake. Labor has built a culture in this country that it is good to prevent ill health, that it is great to seek assistance, that it is a good thing to go and get your blood checked, to manage your diabetes, to manage your mental illness, to keep your medication levels right. Labor believes that, and we made sure that funding was in place to ensure the best possible health outcomes for people.

I am really concerned about with the failure of this government to answer this important question. I have described some of the things that we know this government are doing. What they are hiding is more that they do not want us to see, that they are refusing to give us an answer on. There is this culture of silence. It seems to be endemic in the Liberal-National Party. I said yesterday when I spoke on a matter related to this that, in the great state of New South Wales, under the leadership of Premier Baird, we have two very different views about fighting for fairness for the state between two ministers. We have an education minister, Minister Piccoli, who has actually been able to stand up to this federal government and say, 'Give us the money that you took out of education. Give us your 5 and 6 of the Gonski funding. Don't leave us without the money. Give it to New South Wales.' He is fighting for it. In contrast, the health minister for New South Wales, Minister Skinner, has gone AWOL—absolutely missing in action. We cannot find her on the record, at all, saying anything to the federal government about the cuts that have been inflicted on the state of New South Wales. Let me tell you: it is the worst of the whole country. If we break it down, using the best evidence that we have from the Parliamentary Budget Office, we see that $17.7 billion has been ripped out of New South Wales, with barely a word of complaint from the minister for health in New South Wales. Indeed, on every occasion when she has been invited to come and put the case for New South Wales on the public record, to help us get the information to stand up for the people of New South Wales in this parliament, she has been missing in action. I repeat my invitation for the minister to come and give evidence to Senate Select Committee on Health and put on the record just how much Tony Abbott, Malcolm Turnbull, Joe Hockey and Scott Morrison have decided to take away from the great state of New South Wales and the health budget that we are entitled to.

In Queensland $10.8 billion has gone, in the Australian Capital Territory it is $1.7 billion and in Victoria it is $13.5 billion. In Victoria, where we did have the health ministry come and speak to us, we have had it put on the record and it is in The Age, where it says, 'federal funding cuts to Victoria's health system over the next decade equate to closing down two major institutions.' That is what the Victorians put on the record: a massive cut to their budget. In Tasmania it is $1.2 billion, in South Australia it is $4.2 billion, in the Northern Territory it is $0.8 billion, and in Western Australia it is $6.5 billion. These are the real cuts and they are written into the budget. This government actually put those numbers in the budget, but they continue to deny that they have cut funding from health. And that is why it is of great concern that this minister has chosen not to bring in her homework and not to show the tardy and disgraceful piece of work that she has been complicit in, in taking away more and more health services from the people of Australia.

Question agreed to.