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Wednesday, 28 May 2003
Page: 15242


Ms HALL (5:23 PM) —As I stand in this parliament tonight, I am really overwhelmed by the importance of the Health Care (Appropriation) Amendment Bill 2003. This legislation is about making sure that all Australians can access health services. It is about properly funding our health system and, unfortunately, the government have really let the Australian people down. I will document some of how they have done that as I move through my speech. This bill provides the legislative authority for the Commonwealth to continue making payments to the states as well as for a number of changes to the Health Care (Appropriation) Act 1998 which relate to the grants of financial assistance under the Australian health care agreements. All the changes are to the functioning of our health system.

Unfortunately for the people of Australia, we have a government who do not support Medicare or the right of all Australians to access a quality health care system where every person has equal access to every health service. The Howard government have moved to demolish Medicare and to change it to a two-tier system similar to the one that operates in the United States—a system that has proved to be both costly and inequitable. Medicare, as it operates in Australia, provides the same service to a pensioner in Swansea, a worker from Belmont, a veteran from Toukley or a family from Lake Haven as it does to a company director from the eastern suburbs of Sydney. We on this side of the parliament believe that access to health care and health care services should be determined by a person's health care needs and not by their ability to pay for health care or the service that they need.

The Howard government are philosophically opposed to Medicare and have been vigilant in their campaign to undermine and destroy it. Prime Minister Howard and his government believe that Australians should get the level of health care and the quality of health and medical care for which they are prepared to pay and not the level of health care they need. Labor believe services should be determined by need, whilst the government believe services should be determined by the ability to pay. That is a big difference, and it really shows the difference between the two sides in this parliament. One side, the government, say that you can get the best possible health care available provided you are willing to pay. We say that the health care you get should be determined by your need.

It is because of this philosophy of the government that bulk-billing has declined under the Howard government. The Howard government have had absolutely no commitment to bulk-billing for all Australians. When the Labor Party introduced Medicare, the rate of bulk-billing went up every year. Since the Howard government have been in power, it has declined from 80.6 per cent to 68.5 per cent Australia wide. I think that is an indictment. It shows you the philosophical bent of the government and the direction in which they want to take health care in Australia.

In the electorate of Shortland, the level of bulk-billing is 53.4 per cent. That has come down from 71.1 per cent in the last two years—a decline of 17.7 per cent.


Ms Ellis —That is absolutely outrageous.


Ms HALL —That is an absolute disgrace, and the member for Canberra agrees. I look at the electorates around me, and in the Hunter there have been similar declines. Then I look at the Central Coast. In Robertson, the level of bulk-billing is now 59.8 per cent. It has come down from 77 per cent—a decline of 17.2 per cent. In Dobell, bulk-billing is down to 59.1 per cent from 78.9 per cent—a decline of 19.8 per cent. When I then look at the list of speakers for this very important debate, I find that neither the member for Robertson nor the member for Dobell is listed to argue for more health care dollars.

I will be concentrating to a large extent on the problems that we face on the Central Coast, because there are enormous health issues there with the decline in bulk-billing and access to medical services, and the failure to address these problems. I conducted a survey at the end of last year and the beginning of this year, and I asked people to rank in order of importance the issues that were most important to them. The top three items for 70 per cent of all people in the Shortland electorate were: being able to see a doctor when you needed to, having Medicare in its current form and being able to access bulk-billing. Seventy per cent of all the people who answered that survey—and over 2,500 people responded—ranked those items in the top three. I think that really shows the feeling of the people in the electorate.

Unfortunately the government has not listened to the voice of the people in Shortland, who have been coming to me constantly and telling me how important these issues are. I have on many occasions in this House raised these issues and brought to the attention of members the fact that we have a crisis in bulk-billing and a crisis in doctor shortages in the area—which I will talk about a little later. Because of that crisis, I decided that we really needed to do something about it at a local level. We have had a series of meetings within the Shortland electorate in recent times, and over 1,000 people have attended those meetings.

At a meeting that was held on 8 May—and the Leader of the Opposition actually attended that meeting—the following motion was passed:

This public rally held at Halekulani bowling club on 8th May 2003 condemns the Federal Health Minister Kay Patterson for her cowardice, in her failure to sit down to negotiate with State Health Ministers regarding funding for their health systems and the maintaining of Medicare in it's original form, to ease the burden on the public hospital system, of which will not cope with the Howard Governments proposed changes that are aimed at the dismantling of Medicare.

Further this rally demands that the $2.5 Billion dollars given to private health annually, be channelled back into the public health system, where all Australians will get the free treatment paid for in the Medicare Tax levy. This rally condemns the Them and Us mentality, that this arrogant Federal Government holds for the people of Australia.

There were 350 people at that meeting and this motion was passed unanimously. The Liberal candidate who ran against me in the last federal election was also present, and he supported the motion. When I put to the meeting, `Is this motion unanimous?' they all agreed. Maybe the Liberal Party needs to talk to some of its own members, because they are supporting this motion also. I have 518 letters from concerned residents within the Shortland electorate condemning the government and asking for some action to save Medicare. I would like to table these letters as part of my speech, and I seek leave to do so.

Leave granted.


Ms HALL —I thank the House. I think those letters are very important, because they are the voice of the people I represent in this parliament. They say it in a way that is even stronger than when I say it.

The failure to bulk-bill has led to enormous problems within my area. The accident and emergency departments of both the hospitals that service the area are overworked and waiting times are increasing because people cannot afford to go to the doctor. People have to make the choice between seeing the doctor and putting food on the table. From the Central Coast to Sydney the train costs $2.20 return. Pensioners are travelling to Sydney to see a doctor who bulk-bills rather than going to their local doctor, who charges them a difference of somewhere between $5 and $13. It is a very sorry state of affairs when pensioners are prepared to spend three hours on a train to get medical treatment at a price they can afford.

The government needs to look very carefully at what it is doing to the people of Australia. The government's failure to cater for the health care needs of the people of the Shortland electorate has manifested itself in many ways. We had the closure of the Medicare office at Belmont and, coupled with the fact that doctors are not bulk-billing, pensioners and families have to travel quite a distance to even get a rebate. Very few doctors are bulk-billing even elderly patients, and that includes pensioners. Most doctors—as I just mentioned—charge pensioners between $5 and $13.

This is exacerbated by the enormous doctor shortage that exists on the Central Coast. People have to wait for between seven and 14 days to get an appointment with their doctor. In the last four years the number of GPs on the Central Coast has declined from 310 to 253, and it is expected that in the next five years there will be a further decline of 30 per cent. I thought it only right that I share with the House the ratios of people to doctors on the Central Coast. For the whole of the Wyong shire area, it works out at somewhere around 1,000 to 2,000 people per doctor. For the area of Doyalson-Blue Haven-San Remo—that is, an area of about 6,000 people—there is not one doctor. I find that very disturbing. I think it has enormous health implications. I really feel that, unless something is done soon, we will be facing a catastrophe in that area. There is a similar situation when you put Charmhaven in with those other areas as well.

I have a print out here from the Central Coast Division of General Practice. There is an interesting figure that shows there are five GPs in the suburb of Norah Head. That is quite a good ratio, and they service a lot of areas. Already one GP has gone and two are about to leave; that leaves two working there. There has been an enormous problem: the doctor in that area has been trying desperately to attract a new GP to the area. She has advertised, the area has been identified as an outer metropolitan area and an area of work force shortage, yet still there is no doctor. They thought they had organised one recently.

I was speaking to Dr Christine Wade on the phone yesterday. She told me she believed that her practice would be closing in three months time, simply because she has not been able to attract a doctor and the government's policies have failed; they have let her down. She found a doctor, but this doctor has been denied the right to move to the area because she is on a permanent residence visa as opposed to a temporary residence visa. Once again, it is going to be the people of the area who miss out. This doctor said to me that it makes her feel like a failure. She set up her business on her own and now she is going to have to walk away from it and let all those people down who have depended on her. She says it is all because the red tape, the bureaucracy and everything works against it. She suggested to me very strongly that the government should be talking to doctors about this issue and to all those doctors who have left the medical profession and stopped bulk-billing, to find out what their reasons were.

I would like to look at some of the issues on the Central Coast. I pointed out the decline of 30 per cent that was expected over the next five years. At the same time, the population is going to increase by 30,000. Of the electorates in the area, Robertson is the fifth oldest in the country, Dobell is the 29th oldest and Shortland is the 10th oldest. It is an area where there is a shortage of doctors. In the northern part of the Wyong Shire Council area the ratio is one doctor to nearly 3,000 people. There is a shortage of doctors and patients with very high needs. The policies this government has put in place have failed, failed, failed. A recent survey was given to all the GPs on the coast and nearly 70 per cent of the practices responded. They were asked what they thought of the government's package. Of all those surveyed, only 13 per cent said they were considering signing up. This was because the government failed to recognise the issues that are important to the GPs on the Central Coast.


Mr Hockey —Who wrote this for you, Jill?


The DEPUTY SPEAKER (Mr Mossfield)—Order! The minister will cease interjecting.


Ms HALL —I can understand the member for North Sydney's embarrassment. If I was a member of the government, I would be so embarrassed that I had failed the people of the Central Coast and the people of the Hunter to the degree that this government has. On the Central Coast only seven per cent of doctors universally bulk-bill. The government has constantly failed the people of the Central Coast and the Hunter. If doctors were to take up the initiatives outlined in the government's package, they would get an extra $1 for bulk-billing pensioners and health care card holders.


Mr Hockey —Did you write this? You have to do better than this, Jill.


The DEPUTY SPEAKER —Order!


Ms HALL —Currently, doctors are charging between $5 and $13. It was worked out that one practice at Wamberal, in the member for Robertson's area, would stand to lose $114,600 a year if it were to sign up to the government's package. At The Entrance, in the member for Dobell's area, another practice calculated it would lose $63,000. To me, that is not the kind of package that is going to attract doctors to sign up. The big issue for me is that there are going to be losers in this, and the big losers are going to be the people who live in that area.


Mr Hockey —Oh, come on! Who fed you this?


The DEPUTY SPEAKER —Order!


Ms HALL —The people who live in the area are hopping on the train and going to Sydney at the moment to get the health care they need. The proposal put forward by the Labor Party has been detailed very ably in this House by the Leader of the Opposition. It puts in place a proposal that will really work for the Australian people, not a proposal that is going to deliver the second-rate, two-tiered health system that this government is hell-bent on forcing on the Australian people.


Mr Hockey —Why don't you stand up for Newcastle?


The DEPUTY SPEAKER —Order! The minister will not interject.


Ms HALL —Once again, the member for North Sydney, the minister, is showing just how embarrassed he is by his government's policy. It is a disgrace, and every person in the electorate of Shortland realises it is a disgrace. That is why they turn out in force for the meetings and the rallies that we have been having in our area—and I tell you, Minister, there will be more of those. In the Shortland electorate we are concerned about the health implications of the decline in bulk-billing, about the doctor shortage and about the fact that the elderly in the population with their high health needs are not being serviced. This is all because of the government's failure. We are so concerned that we have formed a `Save Medicare' group in Shortland, which is working with groups throughout the Hunter and the Central Coast. We are determined to save Medicare and restore bulk-billing. (Time expired)