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Wednesday, 28 May 2003
Page: 15268


Mr BRENDAN O'CONNOR (7:15 PM) —I rise to speak on the Health Care (Appropriation) Amendment Bill 2003. This is a very important debate. This debate illustrates the great divide between Labor and the conservative parties regarding the country's health system. I believe this debate reveals distinct philosophies on the way in which we want to care for people in this country. Clearly, this government has no regard for a decent health system and the need to ensure that its citizens are looked after properly. This government's lack of regard for Medicare and the decline in bulk-billing have revealed the government's true nature. Indeed, the government's true intent of killing bulk-billing and slowly killing Medicare has been revealed. Given the popularity of Medicare and the fact that it has been such a proven success over 30 years, I thought that the government would have thought otherwise. This is an extraordinary step and shows the extent to which ideology, not good policy, is driving this government. It also shows the government's growing arrogance. This government is becoming more arrogant, more aloof and more disconnected from the community. This debate is a clear example of that. The government has no regard for the general popular view that Medicare has indeed provided decent services to the community.

I took the view last year that this government and indeed any government would react favourably to an attempt to find a bipartisan approach to such an important issue in this country. I took the view that I could indeed in good faith contact the minister, Senator Patterson, and speak with her about the shortage of doctors and the cost increases for doctors' services in my electorate. I did that; I contacted the minister. I met with the Minister for Health and Ageing, Senator Patterson, last August, and I discussed with her the concerns that the doctors in my electorate shared with me about their problems. Indeed, I discussed with her my constituents' concerns about finding a bulk-billing doctor. On the one hand, I conveyed to her the problems that the doctors were having maintaining bulk-billing services in good faith. On the other hand, I also spoke with her at some length in her offices in Melbourne about the concerns that patients in my electorate, in particular in the outer metropolitan areas of my electorate, were facing. I believe that she took those concerns on board and was genuinely interested to hear the concerns. I even took a photo of both of us for my local newsletter and sent that out to the householders of my electorate indicating that I had met with the minister. On the face of it, she genuinely listened to what I had to say. However, today clearly shows that the minister and indeed the government have not listened to the concerns of the electorate and the concerns of doctors in outer metropolitan areas and in regional areas. That is clearly a problem that will not go away, a problem that this government has to face up to.

In our discussions, Senator Patterson put a number of things to me that she believed would assist in sorting out some of the difficulties. In discussing this problem, the minister outlined to me three methods to look at to attract extra doctors to the region: a restricted increase in access to Medicare provider numbers to specialist trainees, the targeting of GP registrar training places and increased access to higher Medicare rebates for selected other medical practitioners. Whilst I did not agree entirely with some of those suggestions, I thought this minister was actually going to take this matter seriously, but clearly that is not the case. We have a government that is hell-bent on fulfilling the dream of the Prime Minister, and that is, if the government has its way, to destroy the universal public health system of this country—a system that has been in place since its introduction in 1972-73. Since that period when it was introduced as Medibank and then transformed into Medicare, there has been clear evidence that, where there is a universal health system in place, people in lower socioeconomic areas and hardworking families are able to properly attend to their health needs.

I think it is also important to note that there is such a clear divide between Labor governments and conservative governments when it comes to the way in which bulk-billing has been accessible. If you look at the way in which Medicare access was available from the early periods of the Hawke government until 1996, you see a gradual increase in the capacity of ordinary Australians and ordinary Australian families to access bulk-billing. It is no accident that since 1996 there has been a steady decline in people's ability to access bulk-billing. Of course, there has never been bulk-billing in every place across the nation, but in every survey conducted there has been clear evidence of a decline in bulk-billing. Indeed, in my own electorate there has been evidence of that decline. In my own electorate of Burke, the decline has been going on for a period of time, certainly since 1996, but in the last 12 months the rate has fallen dramatically. It is free-falling in the electorate of Burke.

But before I get on to the actual figures as to the extent to which bulk-billing access has declined in the electorate of Burke, following the meetings I had with the minister I thought it was important that I survey my own electorate. I sent out over 1,000 letters in the form of a survey in order to get some sense of what my constituents were thinking about. They were asked about their health needs, doctor shortages, doctor prices and so on. Unfortunately, there was an affirmation by the respondents to the survey that illustrated my fears were correct. With respect to the difficulty of finding doctors who bulk-bill, of those who returned the survey over 80 per cent indicated that their doctor either did not bulk-bill or had stopped bulk-billing. Over 90 per cent indicated that it is now harder to find a doctor who bulk-bills in their community. Indeed, almost all who returned the survey indicated that it was impossible to find a bulk-billing doctor after hours. The answers to these particular questions asked of ordinary working families in this nation, in my own electorate, clearly confirmed the contention that bulk-billing was in decline well before I received statistics to confirm that fact.

Another interesting area that I think should be noted is private health insurance. Almost 80 per cent of the respondents who use private health insurance indicated that there had been a significant increase in their premiums. So we have a situation where my constituents are finding it harder to find doctors who bulk-bill. They are also finding that the costs associated with doctor visitations are increasing. At the same time that is occurring, they are finding that, where they are privately insured, their premiums are going up in excess of any CPI increase. Their premiums are outrunning inflation at a significant rate.

The combination of these factors means that there are significant problems in the health system. What are the government looking to do about that? Their answer, which we heard the other day, is to take more money out of the health system. The way in which John Howard's government responds to this crisis in the Medicare system—the significant lack of capacity by ordinary working families to access bulk-billing and access a decent health system—is, firstly, by robbing Peter to pay Paul, and by that I mean that they have decided to cut funds to public hospitals. This is the Howard government's response to deal with the crisis in our health system. They are going to start cutting funds to the public health system. The health care agreements funding cuts—and I am happy to relay exactly what those cuts are—over the next three to four years will total $918 million; $918 million that was to go to the states has been taken away by the Commonwealth government. Of course, as a result of those cuts, fewer nurses will be able to be employed in public hospitals, fewer operations will be able to be undertaken and there will be longer waiting lists—all as a result of the Howard government reducing funding to public hospitals in this country.

These cuts to public hospitals precisely offset the budgetary impact of the government's $917 million Medicare package—what a coincidence! The government is giving with one hand, taking with the other and expecting people not to notice. The Australian public are much more savvy than that; they are very well aware that this government is playing sleight of hand with their money. When it comes to the health system of this country, they will not abide the behaviour of the government. I think it is something for this government to properly consider. It clearly has not done so. It has shown a complete disregard for the concerns of the constituents of my electorate of Burke and, indeed, of constituents across the entire country by failing to properly attend to the crisis and then by insulting the intelligence of the Australian people by giving with one hand and taking with the other hand. That behaviour has clearly been exposed, and there has been no comeback by this government.

This government has revealed in all its glory the way in which it likes to deal with the public health system. It increasingly is finding new ways to destroy what has been a successful universal public health system in this country—one of our boasts to the world. Medicare should be one of our boasts to the world. Indeed, I know of people from other countries of comparable wealth who have visited this country and been in awe of the way in which this country has managed over so many years to look after its people by having a decent public health system. I think that we should reflect upon that. This public health system is not one that is shared across the world. There are a number of countries which have similar systems. Canada has a decent system and so have some other countries. But the fact remains that not all countries of comparable wealth have managed to deliver a decent system, a decent system that will deliver to its citizens. But Medicare is such a system—a system that is under severe ideological attack by this government. It is a system that has worked in the past. It is a service which has provided decent health care, whether through doctors being able to bulk-bill the patients that they see or whether through public hospitals with sufficient funds. That system has enabled not only those who are concession card holders but also—

Debate interrupted.