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Tuesday, 7 October 2003
Page: 20649


Dr SOUTHCOTT (4:22 PM) —This MPI touches on issues which relate to Australian health and the issue of public hospitals. I want to talk a little about the private health insurance rebate, Medicare, bulk-billing and, lastly, the situation with medical indemnity. First of all I would like to restate very clearly the Liberal Party's position on health. We have now gone to three elections, and we will go to a fourth, committed to retaining Medicare, bulk-billing and community rating. That is the Liberal Party's position. Last week we celebrated 20 years of Medicare, and 7½ years of Medicare were under a coalition government. There are really three aspects to Medicare. They are: access to the Pharmaceutical Benefits Scheme, and we have seen that scheme growing, which allows access to the newer generation of drugs; free access to public hospitals; and universal access to the Medicare rebate. We have heard both opposition speakers talk about the Orwellian nature of this—but let us get a bit more specific. I remember distinctly in Animal Farm the way the tenets on the back of the shed changed over time. This is what is happening with the opposition. They used to say that Medicare was a universal scheme in which everyone had access to the Medicare rebate. They are now saying that Medicare has always been about high rates of bulk-billing. It simply has not. That is restating and remaking history.

I would like to say a little about the health of the Australian people, because that often gets lost in these debates. In fact, I think Peter Baume did tell Michael Wooldridge when he became minister for health to not purely become the minister for health financing but to actually become the minister for health. Let us talk about Australia's health. Australians have the third longest life expectancy of people in major developed countries after those in Japan and Switzerland. We have the fourth longest healthy life expectancy after people in Japan, Sweden and Switzerland. We have gone from spending about 8½ per cent of GDP on health for most of the last 10 years to 9.3 per cent of GDP now. That is the highest proportion of our economy we have ever spent on health. Our life expectancies are longer than they have ever been. Also, if you look at immunisation rates, you see that when the Howard government came in they were at 53 per cent. It was a disgrace. Vietnam and China had much higher immunisation rates. Now 91 per cent of 12- to 15-month-olds are fully immunised. We have also seen tobacco use go down by 18 per cent. We have the third lowest rate of tobacco use in the OECD.

It has been a long time since I have heard any member of the opposition say anything on diabetes, obesity, immunisation or any preventative health measures. The group which has been led by government members like Judi Moylan and Senator Guy Barnett has been doing some really good things in the area of diabetes. On rural health the government spent $562 million more in the previous year's budget. Indigenous health has increased by 51 per cent since 199697. Medical research spending doubled after the Wills review. We introduced the 30 per cent private health rebate. Anyone who was here that evening can remember the screaming of the member for Jagajaga as she was forced to realise that the private health rebate was going to come in. So we know where the Labor Party stands on that. General practices are computerised. Screening for cervical cancer is now much more common. Hospital funding has increased by 28 per cent since the previous Australian health care agreement. This government has led the debate on public health measures, such as the introduction of folate prior to pregnancy, on diabetes and on immunisation. The aggressive use of adjuvant therapy now sees that in some states, like South Australia, we have some of the best five-year survival rates for breast cancer anywhere in the world. The rates are comparable.

I want to say a little about public hospital funding, because we hear a lot of nonsense from the state premiers about it. Let us look at the report of the Australian Institute of Health and Welfare. The most recent report shows that over the last 10 years the state and territory share of public hospital funding has fallen. At the same time, the Commonwealth share has risen, from 42.7 per cent in 1991-92 to 47.9 per cent in 200001. Who is the major funder of state government public hospitals in Australia? It is the Commonwealth government. Whose share has been increasing at the faster rate—the Commonwealth's or the states'? It is the Commonwealth government's share. We hear a lot of rhetoric, but we never hear any figures to back it up. This is from the independent Australian Institute of Health and Welfare.

Over the last 10 years, the Commonwealth's share has increased by 5.3 per cent per year while the states' contribution has only grown by 3.8 per cent a year. Also, during the first four years of the last Australian health care agreement, the Howard government increased spending on public hospitals by 4.9 per cent a year compared with 2.6 per cent by the state governments. We have seen private hospital admissions increasing at something like six per cent compared with public hospital admissions increasing by two per cent. The amount that the Commonwealth government—the Australian government—is going to give to the state governments for their public hospitals has increased from $32 billion to $42 billion. That is a 17 per cent real increase. The state and territory governments need to pull their weight. They need to match the increase that the Commonwealth government is putting in. I do not care about the rhetoric of the opposition. We need to see them actually come up with something concrete, like a fact or a bit of evidence, instead of this phoney rhetoric which is constrained by ideology and a very skewed view of history.

With regard to the 30 per cent private health rebate, I am not sure but probably one of the first votes in this House by the member for Lalor was to oppose the 30 per cent private health insurance rebate in November 1998. I am sure that, just as the Hawke government removed the incentives for private health insurance in 1983 and then removed all of the subsidies for private health insurance in 1986, we will see that that is Labor's secret agenda. That is what we will see from the Labor Party—the withdrawal of the 30 per cent rebate. We know they are not committed to it.

The government believes that private health insurance plays a critical role in reducing the demand on public hospitals. As I said before, we have seen private hospital utilisation increase by six per cent while public hospital utilisation has increased by only two per cent. Some of the comments we have heard recently include the shadow Treasurer saying Labor was still working on its policy regarding the 30 per cent private health insurance rebate policy. He said:

We're going to have a look at ways in which that rebate can improve. It's quite an expensive policy and we want to ensure the Australian taxpayer is getting value for money ...

I always get nervous when I hear that the member for Werriwa has notions of how to improve something. The shadow minister for finance talked about the opposition's expenditure measures when he said:

Some of them will be tough ... and there'll be a lot of people complaining before we're finished.

I now want to talk briefly, in the time that I have got, about Medicare. The previous speaker, the member for Sydney, talked about a bulk-billing crisis in the electorate of Sydney.


Ms Plibersek —I did not say that. I said it was worse in other electorates. You obviously weren't listening!


The DEPUTY SPEAKER (Hon. I.R. Causley)—The member for Sydney!


Dr SOUTHCOTT —The bulk-billing rate in Sydney in 2002 was 84.3 per cent. But at the same time Sydney had a median weekly family income of $1,517. This is based on 2001 census figures—that is, fifth out of 150 electorates.


Ms Plibersek —I said it was worse in other electorates. Go back and read the Hansard.


The DEPUTY SPEAKER —Member for Sydney!


Dr SOUTHCOTT —Over 50 per cent of families in the electorate of Sydney are on weekly incomes of $1,500 and above.


Ms Plibersek —He is misrepresenting me!


The DEPUTY SPEAKER —The member for Sydney is warned!


Dr SOUTHCOTT —That is the No. 1 Labor seat; it is No. 8 out of all the 150 seats.



The DEPUTY SPEAKER —The member for Sydney is warned! The next move she makes will be out!


Dr SOUTHCOTT —There are only 16.9 per cent of families with a weekly income below $500. The focus on bulk-billing rates is a red herring. I raise that to show there is nothing fair about bulk-billing as it exists now. Bulk-billing is principally concentrated in inner metropolitan areas and very specifically in Sydney. I want to pose a couple of questions. At the moment, 67.2 per cent of total services are bulk-billed. In which year of the Labor government did they reach that figure? The answer is 1993-94. It took 10 years of Medicare to reach that figure. We hear sometimes that bulk-billing for GPs was over 80 per cent; it was not.

We also have in this MPI the claim that the government created the medical indemnity crisis. It is a bold claim that it all rests with the Commonwealth government. The shadow minister for health showed an intense interest in the previous occupations of the minister. If we are going to say that the Commonwealth government is responsible, we should at least say that contingency fees and uncapped liabilities did exacerbate the problem. (Time expired)


The DEPUTY SPEAKER —Order! The discussion is now concluded.