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Wednesday, 28 May 2003
Page: 15150


Ms GEORGE (10:37 AM) —I rise to speak on the Health Care (Appropriation) Amendment Bill 2003. I found it amazing, when I read the background material to this bill, that the Parliamentary Secretary to the Minister for Health and Ageing, in her second reading speech used these words:

This bill delivers on the government's strong commitment to the principle of universality under Medicare.

She could not be serious, surely, because we know exactly what this bill is intent on doing—that is, cutting almost $1 billion from the government's forward estimates for health care in the public hospital system. On top of that, as the community well understands, the money that will be taken out of the hospital system will be diverted to fund the so-called A Fairer Medicare package. As anybody who follows the debate on this issue will know, that money will target a program that will be the beginning of the end of Medicare as we know it and the beginning of the end of universality. Talk about doublespeak! The parliamentary secretary comes into this chamber and professes that this bill delivers on the government's strong commitment to the principle of universality under Medicare when people out there in the community know very well what the agenda of this government is all about. We cannot pretend that this is not a cut because the forward estimates provide $43 billion over five years but, as we know, the offer to the states under the health care agreement is $42 billion. Interestingly enough, as I said earlier, the cut of $918 million from the hospital system is almost exactly the same amount as that allocated to the new Medicare package. As we all know, far from adhering to the principle of universality, that will set about destroying that very fundamental principle.

I find it amazing that the member for Boothby and others in this debate can rationalise and pretend that a cut is not a cut when the Prime Minister, at a press conference on 28 April, said:

... the figure in the forward estimates was based upon different utilisation rates, and the figure that we have offered is based upon the utilisation rates that have been revealed through the significant increase in private health insurance...

So the Prime Minister himself acknowledges the cut. But what is behind the statements he has made—and behind the statements just made in the chamber by the member for Boothby—is the inference that the states are getting less money because fewer people are using public hospitals. We all know that simply does not stack up. In responding to the federal government's proposals, the Victorian Minister for Health, who surely knows more about her health system than does the member for Boothby, in her press release, said:

The Victorian health system treated around 50,000 extra patients in the year 2002. Increases in emergency admissions are shooting upwards by around eight per cent per year.

Similarly, the New South Wales Minister for Health, in his press release, said:

Emergency department attendances in New South Wales topped 2 million for the first time last year (2002).

Although we are hearing this defence that the private health system is taking the pressure off the public hospital system and that that justifies a cut of almost $1 billion from forward estimates, the reality, as is known by all members of parliament, who deal with these issues on the ground, is different. The statements from the health ministers who are responsible for these systems tell quite a different story. These cuts can only place further pressure on our public hospital system. They will be compounded—make no mistake about it—should the government get its way and introduce its Medicare changes. The community understands that these changes will mean a two-tier, user-pays system, where the low-income earners in our community will increasingly be forced to avail themselves of access to services in our emergency hospital departments.

Far from this bill doing what the parliamentary secretary claimed it would do when she introduced it, the bill will in fact help to deliver Australian families a double whammy, courtesy of the Howard government. On top of the Medicare announcements that will destroy the universality of Medicare—an argument that has been very comprehensively put in the submissions by our shadow minister—people understand that the government is going to fund the demolition of Medicare by short-changing public hospitals. It is a double whammy, and people understand that. The cuts to the hospitals will increase the pressure on our emergency departments. The cuts will also mean fewer nurses and less opportunity to deal with the shortfall in the number of nurses in many of our hospitals. They will mean fewer operations, they will mean longer waiting lists for elective surgery and they will mean more pressure on our emergency departments. Any member of parliament will tell you that people, when they go to their local hospital, can wait there for hours and hours for treatment, particularly in areas where bulk-billing is going through the floor and where it is difficult to access medical care after hours. So this is certainly a double whammy that the Australian community will be hit with if the Howard government has its way. The double whammy will mean that the money from the cuts to the public hospital system will be reallocated to the so-called `A Fairer Medicare package'—more doublespeak. The package is, as people out there in the community know, the beginning of the end of Medicare.

The government should be condemned for this bill. It should be soundly and resoundingly condemned for its attempt to put into practice a longstanding belief by the Prime Minister that Medicare should have only ever been a residual safety net—a second-rate system for the poor, the pensioners and the disadvantaged—and that everybody else should be slugged again, under the user-pays philosophy, for access to basic medical attention. The government's health policy failures are manifest not only because of their implications for the nation but also because of their failure to deal with matters in my electorate that I have brought to the minister's attention on several occasions. I raise these issues in this House because, in my opinion, the matters of concern to my electorate have not been reasonably or properly addressed. Where they have been addressed, I fail to see a rational explanation for not agreeing to the requests that have been made of the government, other than an explanation that any request that is made by me on behalf of my people gets rejected because I happen to represent a seat that has historically been a strong Labor area. If that is not the reason, I want the minister to be more forthright and open in the reasons why the health needs of my electorate are not being adequately considered and responded to.

The first issue is that we have made repeated requests for a Medicare licence for the MRI machine that the state government has committed to install at the Wollongong Hospital. The Illawarra is a large and growing region. The people I represent and the regional generally find it absolutely amazing that, despite the fact that the New South Wales government has listed Wollongong Hospital as a priority area, the federal government will not provide a Medicare licence for that machine to function at our local hospital. The second issue is the failure of this government to address in any meaningful way the growing and severe problem of doctor shortages in nearly every suburb in the electorate of Throsby. I have worked with the Illawarra Division of General Practice to get some idea of the equivalent numbers of doctors per head of population in my electorate. The best estimate I can come to, based on material from the Illawarra Division of General Practice and from local media accounts, is that the electorate of Throsby has one doctor per 1,362 people. Compare that with the national average of one per 908 and the even better average in New South Wales, my state, of one per 864. So Throsby has a really severe problem. The suburb of Port Kembla, in my electorate, has only one GP per 4,581 people, yet this government will not classify the area that I represent as a district of work force shortage. There is one GP per 4½ thousand people at Port Kembla, and I cannot get this minister to acknowledge that we have a problem.

I took up the case recently of Dr Peker, a doctor from Russia with overseas qualifications. The minister's response was totally unacceptable. The New South Wales Medical Board has approved Dr Peker's conditional registration under the area of needs program. She was offered a position at a surgery in Berkeley, a suburb of Throsby, that has one doctor per 1,732 people, but this minister and this government denied her a Medicare provider number despite the fact that she had been offered a position in a surgery in an area that has a patient to doctor ratio that is almost double the national average. Where is the fairness and justice in that response? There is none at all. I ask: am I being denied reasonable responses to representations that are made on behalf of my electorate for reasons other than those that should appear logical and based on fact? The health policy failures continue in my electorate. Constituents tell me that they have waited five, six and sometimes even seven years for dentures, yet this government has done nothing to reinstitute a very important program that was there under Labor that provided low-income earners with access to dental health care.

Before we go on to consider the regressive impacts of the so-called `A Fairer Medicare package', let me say what my constituents are already telling me. In a response to a recent electorate survey, 60 per cent said it is becoming harder to get an appointment with their local doctor. No wonder, when in some suburbs we have double the national rate. This government will not even provide doctors who are willing to take up practice with a Medicare provider number. Fifty-nine per cent said their local specialist does not bulk-bill, 48 per cent said it is harder to find a doctor that bulk-bills, 46 per cent said it is difficult to find a doctor that bulk-bills after hours, 41 per cent said the cost of visiting a GP had risen, 36 per cent said they had not sought medical attention on occasions because of the cost of visiting a doctor and 27 per cent said their doctor had stopped bulk-billing. I am lucky in Throsby in that our rates of bulk-billing are pretty high, at 92 per cent, but with the increase in doctor shortages the pressure is there to maintain the bulk-billing services. In that kind of restricted market it is no surprise that some doctors who had traditionally bulk-billed are now charging for the costs of medical attention.

The same survey asked the people I represent what their views were about private health insurance. On the latest figures that I had, I think about a third of my electorate are in some form of private health insurance and two-thirds rely on the Medicare system. But, of those who have private health insurance, a very high 62 per cent believe they are not receiving value for money from their private health insurer. Again, this is another serious public policy failure on the part of this government. They talk a lot about the additional numbers of people that have taken private health insurance, but they do not talk about the other part of the equation—that is, a lot of the people who took it up believed the government when they said that there would be downward pressure on the cost of private health insurance and that, in the beginning at least, private health insurance was not going to rise above the rate of inflation. So 62 per cent of my constituents said they are not receiving value for money from their private health insurer. One of them wrote to me recently—and I will just quote his example, as one of many—and said that he wanted me to take up:

... my complaints about my Health Insurance increase of 14.84% with “Lysaght Peoplecare”! ... I hope you can take it up with the Minister for Health and Aging ... and ... find out why it is so!

The Federal Minister of Health and Aging, Kay Patterson, always talked about an increase of 7% or 7.4%, never more then that!

Now I received a letter for Lysaght that my contribution will increase by $56.45 a Quarter, from $380.35 to a sum of $436.80 from the first of April.

I complained to them about the massive increase and I received a letter back ... informing me that ... the ... 14.84% was approved by K. Patterson ...

A while ago, I complained to the Lysaght club about the name change, from “Hospital and Medical” to “Peoplecare”! The previous name explained all there was to know about the medical insurance but Peoplecare could be anything!

It was explained in a letter to me, with a lot of gobbledygook. The cost of changing a name on all the stationary, advertisement and so must be massive. Maybe that is why the increase in contribution is so steep

He goes on to end his letter:

I'm ... a Pensioner and have a Family of 5 Girls and 2 Boys, 17 grandchildren and 8 great grand children and it was not easy to bring them up and be in a private Health Insurance as well! I found it objectionable from the spokesman of private insurance, Mr. Schneider to say, the increase is not even the cost of a hamburger in a week, must be a very large one!

Mr Gnter Leimbach is one of the 62 per cent of my constituents who in a recent response to a survey said to me that they are not receiving value for money and asked me if I could get an explanation from this government as to why that is so. Of course I cannot. On the one hand, the government said there would be downward pressure on the cost of private health insurance; on the other hand, just recently, for one of the health funds in my area, this same government approved an increase of almost 15 per cent—well and truly beyond the rate of inflation—with no explanation, because there is a lack of accountability, regulation and monitoring as to what the private health insurance funds are up to.

In my view, on behalf of the people I represent, this government stands condemned for not responding to the genuine requests that I have made to improve the lot of people in the electorate of Throsby. In particular, I want to know why our region cannot be classified as an area of work force shortage and why there cannot be a greater degree of empathy and sympathy as far as the patient-doctor ratios are concerned, translated into the provision of provider numbers for people who are willing to work to address this local shortage.

I want to end by again quoting the words of the Parliamentary Secretary when she introduced this bill, because the hypocrisy is so obvious. She said:

... I confirm the government's strong commitment to the principle of universality under Medicare.

I think this government stands condemned and exposed for its health failings, because the Australian community understand very well that there are already existing problems that are not being addressed, particularly in my area. They understand that the government's package is the beginning of the end of Medicare as a universal system. They understand that that package, as regressive as it is, is being funded directly by the cuts that have been taken out of a hospital system that more than ever needs additional commitment and additional resources to meet the needs of our communities. (Time expired)