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Wednesday, 23 October 2002
Page: 8537


Ms HALL (10:15 AM) —The Health Care (Appropriation) Amendment Bill 2002 amends the Health Care (Appropriation) Act 1998 and allows the Commonwealth to discharge its financial responsibilities under the 1998-2003 Australian health care agreement. Under the Australian health care agreement, the Commonwealth provides financial assistance to the states and territories for the provision of hospital services—hospital services that are very important in all communities, which we represent in this parliament. Under section 4, this amendment will increase the maximum amount that the minister may grant by way of financial assistance to the states and territories, or to a hospital, or to a person from $29,655,056,000 to $31,800,000,000. Also it requires the Minister for Health and Ageing to present to each house of the parliament, as soon as practicable after 2003, a statement of the total amount of financial assistance paid under section 4.

As you can see, this is a very important piece of legislation because it ensures the operation of our hospitals in the states and territories which we represent. I must say that, while this increase in funding is welcome, it is nowhere near enough. In looking at funding to hospitals, you need to look at a number of different issues, such as the changing demographics of the population. As everyone in this House would be aware, the Treasurer spoke at great length—and in a moment the Minister for Health and Ageing will be in the chamber—about the Intergenerational Report and the impact that the ageing population is having on our society. I happen to represent one of the older electorates and I see first-hand how the ageing of the population is impacting on the health services and hospitals within our area. So there is a need for increased funding to the states for hospitals, based on the age of the population and the ageing population, and the associated complicated medical needs.

There is also a need for increased funding to hospitals because there have been technological advancements and there are new medicines and new equipment—these are all very expensive. If you speak to any health economist or anyone who is familiar with the health industry or involved in health administration, they will tell you just how technology and advances in that area are increasing the costs of health to our community.

There is a dilemma for government in the amount of money it wants to place in health. I see health as being one the most vitally important areas of government, and I have to say that people within the electorate that I represent also see health as one of the most vitally important areas of government. Recently I conducted a survey in my electorate; to date, there have been just under 2,000 responses, which is a significant number of the population of my electorate. That survey identifies that health is, by far, the most pressing priority for people living in the electorate of Shortland. Forty three per cent of those who responded to the survey identified health as being the most important issue. That was followed by employment and job creation of 19 per cent and education of 14 per cent. So you can see that, within this community—and I believe that my community is no different from any of the communities that other members of parliament represent—health is indeed seen as being vitally important.

Because many people have contacted my office about health issues over the last four years, I also included in that survey a section that related to health. The questions that I included on that survey related to doctors and bulk-billing; being able to see doctors locally when you are sick—and I will talk a little more about that and how this relates to funding of hospitals—the retention of Medicare; the increase in the price, as we all know, of scheduled drugs under the Pharmaceutical Benefits Scheme; the increased costs of prescriptions; whether or not we need a Commonwealth dental health scheme; being able to see medical specialists in your area; affordable private health; and the importance of paying the gap when you are in a private hospital. Overwhelmingly, people put within the top three: having a doctor that bulk-bills, being able to see a doctor locally when you are sick and retaining Medicare.

Within the Shortland electorate, there is a shortage of doctors and there is a shortage of doctors who bulk-bill. That is forcing residents of the area to go to hospital, to sit in the accident and emergency department of hospitals and to wait an inordinate amount of time to see the doctors. There is one general practitioner per 2,500 people on the Central Coast in my electorate. The national average, and the desirable average, is one per 1,000 people. So if you come from an electorate where there is not one doctor per 1,000 people, you need to be making a noise about it, because it means that the people of your electorate are missing out.

Because there are so few doctors to service so many elderly people, people are waiting between seven and 14 days to see their local doctor. This is unacceptable if you are really ill. That is why these people are going to the hospitals and waiting to see doctors. This situation transfers the cost of providing that service from the Commonwealth to the states. I see this as another factor in arguing for more money to be given to the states rather than less. It is also an argument for saying, `This money that has been given, whilst an increase is always welcome, it is insufficient.'

The Shortland electorate is the 12th oldest electorate within the country and it has the 10th lowest median income. Together these create a situation where people do not have a lot of money and are unable to afford to pay for medical services up front. It is one of the lowest bulk-billing electorates within the country—only 60.5 per cent of the doctors bulk-bill. If you look at the services that are bulk-billed and break them up a little more, you will find that very few doctors actually bulk-bill. Just using a page in the phone book I did a survey of doctors in the northern part of the Shortland electorate. We contacted 24 doctors, and out of those 24 doctors only 17 bulk-billed pensioners. That is quite a serious situation. We have elderly people, we have doctors who do not bulk-bill and we have people having to wait a long time to see doctors. What does this result in? It results in people going to the public hospital system, increased costs for the states and a shortfall in funding to the states.

I thought I would quickly share with the House another survey that I conducted within my electorate with a social work student from Newcastle university. I spoke a little about this in the grievance debate on Monday. This social work student undertook a research project within the electorate based on a sample of 560 people over the age of 55. The majority of those people fall within the age bracket of 70 to 79. That was 45 per cent of the people. There were only five per cent in the 50 to 59 age group, 31 per cent were in the 60 to 69 age group and 14 per cent were in the 80 to 89 age group.

This survey identified health as being the most important issue for older people within the electorate. Once again, I think that most members would find that situation if they were to survey their electorate. I thought that I would put into Hansard a couple of comments that were made by those people that completed the survey and also run through a few issues relating to health. Some 88 per cent of the respondents to this survey—which was looking at quality of life issues—ranked good health as being very important to their quality of life. A further eight per cent ranked it as being important. Overall, 96 per cent of people put it in that category. The participants expressed a desire for more GPs, a return to bulk-billing by doctors and improved hospital services. Once again, this is showing the strain that the lack of bulk-billing is putting on doctors and also the importance of putting more money into our hospital system. The people that responded to the survey commented on the need for better health facilities, better health services, better hospitals and, more importantly than anything, more doctors in the area.

Minister, I think it is very important that we ensure that the states are adequately funded for health and that we take into account all those issues that I have mentioned: the ageing population; the changes in technology; the impact that this changing technology has on the delivery of health services, how it leads to an increase in costs; and the importance of really making a commitment to Medicare, ensuring that Medicare is retained and that doctors bulk-bill, because if they do not it is transferring the cost of the delivery of those basic health services to the states. Be it the state or the Commonwealth, the bottom line is that, if we do not have a properly funded health service in our communities, in our society, in Australia, it is the people that each and every one of us represent in this House that miss out.