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Tuesday, 7 October 2003
Page: 20643


Mr ABBOTT (Minister for Health and Ageing) (3:57 PM) —The shadow minister for health, the member for Lalor, has just given us a fine, scripted speech. I am sure she has been working on it, literally, for weeks. She may even have brought Bob Ellis in to help craft some of her lines. But there were two fundamental problems with what the member for Lalor has just said. First, she is playing politics with other people's health, the health of ordinary Australians. Second, she is consistently spreading lies about what is actually happening to our health care system. The member for Lalor will have no credibility at all until she withdraws the dodgy dodges and the bodgie petitions which her colleagues are now circulating to the Australian people, presumably with her encouragement. She knows that the factoids, the so-called facts in these dodgy dodges and spurious petitions, simply are not true. She knows, because she told us in the Canberra Times on Friday, 19 September this year, when asked about the allegations that were being made by the member for Lowe and the member for Scullin that the government was going to charge people $20 to visit the doctor. The Canberra Times said:

A spokesman for Ms Gillard conceded that the claims were not true ...

In other words, the shadow minister, the member for Lalor, knows that claims being made up hill and down dale right around the country by the member for Scullin, the member for Lowe, the member for Sydney, Senator Ludwig, the member for Banks and numerous others are not true. Now, if she is to have a shred of credibility as a health spokesman, she must forget about Bob Ellis and scripted speeches that she works on for weeks, repudiate this scare campaign and withdraw those dodgy documents which she and her colleagues have been using to con ordinary Australians about the state of our health care system.

There are some problems in our health care system—of course there are some problems in our health care system. This government cannot solve all of those problems overnight. At least some of those problems are fairly and squarely the responsibility of the states. But this government is determined to make a difference. This government is determined to do what it can to ensure that as far as is humanly possible all Australians have access to affordable high-quality health care.

One of the things that the member for Lalor has done consistently today is to resort to something known as the big lie technique. She has constantly talked about what she alleges is the government's plan to destroy Medicare. Let me make it absolutely and perfectly clear: this government supports Medicare. This government will strengthen and extend Medicare. This government believes in Medicare. This government thinks that Medicare is an article of faith. How can there possibly be a plan to destroy Medicare when this government is spending $8 billion dollars plus on the medical benefits schedule? We are spending $31 billion on health.

The federal government's spending on health has been increasing fast, much faster than the states' spending on health. Health is now 18 per cent of the total federal government's spending compared to just 14 per cent in 1996, when members opposite were in power. In 1996 the federal government's total spend on health was 3.7 per cent of GDP; today the federal government's total spend on health is 4.3 per cent of GDP—a sustained, consistent and significant increase in health spending under the Howard government. While federal spending as a percentage of GDP has gone from 3.7 per cent to 4.3 per cent in that same time, the states' spending has gone from two per cent to just 2.1 per cent. Let me make it absolutely crystal clear: this government supports Medicare. This government is determined to deliver affordable high quality health care to all Australians. We will strengthen Medicare. If members opposite were serious about Medicare, they would at least talk constructively to the government about the Fairer Medicare package now before the Senate.

Let me make it very clear. Members opposite are trying to say that Medicare equals bulk-billing; Medicare does not just equal bulk-billing. Yes, bulk-billing is an important part of the Medicare system but it is not necessarily the heart of the Medicare system. The heart of Medicare is a universal insurance system—a system for all Australians to ensure they get reasonable access to affordable high quality health care and, in particular, that they get reasonable access to an affordable local GP. That is the heart of Medicare. That is the system that Neal Blewett put in place. As I said today in question time, we support what the original architect of Medicare intended when in 1987 he said:

What we mostly have in this country is ... compassionate doctors using the bulk billing facility to treat pensioners, the disadvantaged and others who are not well off or who are in great need of medical services—

That is what Neal Blewett said the Medicare system was—

which was always the intention.

And today, as then, that is what the government supports: a system which has widely available access to bulk-billing but which does not necessarily pretend, as members opposite have, that bulk-billing must be universal, that Medicare equals universal access to bulk-billing. Again let us go back to the father of Medicare, Neal Blewett. At the beginning, back in 1983, he said:

Where the doctor agrees, direct billing will be available to everyone.

But Neal Blewett said this is a choice left to the doctors. It is interesting, isn't it, that in their determination to try to ensure that every person, every time he or she goes to the doctor, is bulk-billed, they are really threatening a campaign of medical price control. We know why members opposite are doing that—because deep down they do not like doctors. They think that doctors are the class enemy.



Mr ABBOTT —Here she is, the former lawyer who ran all these `no win, no fee' campaigns on medical indemnity and other issues. They do not like doctors, they have never liked doctors, and now they are trying to destroy the medical profession with their insistence that everyone should be bulk-billed. I am the Minister for Health and Ageing. I am the minister for the health of all Australians. I am not the minister for doctors, but let me say that I respect doctors and I think they do a good job. Doctors are highly qualified, highly committed professionals with a strong sense of vocation. The Australian Medical Association is an organisation which should always be given a fair hearing and it should nearly always be listened to with respect. As long as I am the minister for health I will continue to work with all reasonable and responsible people to try to ensure that we have the best possible health care system.

The other thing that the member for Lalor asserts as part of the big lie technique of which she is becoming so practised an exponent is that the government has somehow created the medical indemnity crisis. This government did not create any medical indemnity crisis. To the extent that there is a medical indemnity crisis, it has been created by our legal system. I am not in the business of criticising judges. Judges apply the law as they understand it, consistently and conscientiously, to the facts that come before them. Notwithstanding the conscientiousness of Australian judges, it is a fact that tort law—particularly where it deals with medical indemnity—has become a mess. Until recently, Sydney was developing the reputation of being the medical litigation capital of the world, but I do want to congratulate the New South Wales government on their recent efforts at tort law reform. I also want to congratulate my predecessor, Senator Patterson, and my distinguished friend and colleague the Assistant Treasurer on their efforts to work with the states to try to control the tort law liability issue—in particular, the medical indemnity issue.

Because the New South Wales government, unlike members opposite, have acted responsibly throughout this issue, we now have a much better system of tort law in New South Wales. The New South Wales tort law is now substantially under what is called the Bolam principle, which is that, if you do something which professional colleagues would recognise as reasonable, it is not negligent. That is a perfectly reasonable principle. It is a principle which should never have been departed from in Australian law, and I congratulate the New South Wales government on re-establishing the Bolam principle in New South Wales law.

I note that, while many doctors are still understandably nervous about what will happen to medical negligence claims notwithstanding the tort law reforms, it is reported that new claims to United Medical Protection, the main medical indemnity insurer in New South Wales, have fallen from 60 to just 15 a month since July last year under the new tort law. I think there is every possibility that the so-called medical indemnity crisis will be defused in part by the work of the federal government but very substantially because of the good work of the New South Wales government.

What we cannot have is the courts using the tort law as a de facto compensation system. The tort law must be a system based on actual fault. I announced an 18-month moratorium on the IBNR levies over $1,000. In that time, the actuarial estimates will be redone. They will be recalculated on the basis of the practical experience of tort law outcomes under the reformed system. I am confident that over time, if these tort laws work as they are intended, medical indemnity costs will come down to the great benefit of not only the medical profession but also, ultimately, patients and all Australians.

I do not believe that people should be playing politics with people's health. I do not believe that we should be playing politics in this very important area of deep concern to all Australians. The thing about health is that health is important to everyone. There are all sorts of issues that come before this House. Some of them are of great moment on any particular day, but the fact is that health is always important to everyone. It is particularly important to the families of those who need health care, and Medicare is safe with this government. This government will protect and extend Medicare. This government will do its best to ensure that, as far as is humanly possible, all Australians will have access to affordable, high-quality health care.

It is not just this government that will not play politics with health. I was very happy to stand beside the New South Wales acting health minister, Frank Sartor, last Friday as we tried to do our best to ensure that doctors do not leave the public hospitals in Western Sydney. Frank Sartor said:

There are times when federal and state ministers must stand shoulder to shoulder to find practical solutions in the public interest. This is one of those times.

I am quite happy to stand shoulder to shoulder with Frank Sartor and other responsible Labor people, but I do not believe there is any responsibility in the shadow minister for health, who is playing the grubbiest politics with this particular issue. (Time expired)