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Monday, 25 May 2009
Page: 4229


Mr LAMING (7:52 PM) —In speaking to what is a commendable motion, I think it would be incomplete if we did not mention some of the very important budgetary and fiscal measures upon which a functional health system relies. This debate would be incomplete if we were not to note the events of the last few months, in particular the global financial crisis. What I want to cover today in the brief time available is the current government’s policies on smoking and alcohol, some of the Indigenous health issues—end stage renal failure, to name one—and their most recent announcement to cut support for cataract surgery, the most cost-effective surgical intervention known to mankind.

Before I do that, I want to recognise some very good work done by my intern, Matt Haney, on closing the gap. He has done an extraordinary piece of work on the role of Indigenous community stores, which the member for Solomon will have a great interest in reading when it becomes available and tabled. That report looks very closely at the availability of fresh fruit, vegetables and foodstuffs, the supply chain issues and profitability of community stores. I congratulate Matt for his diligence and enthusiasm.

Now to the bad news. We have seen a global financial correction of hitherto unknown dimensions, and you have to go back generations to see something quite as large. But what we have seen in this country is what I would argue to be a completely disproportionate response that makes it virtually impossible to fund some of the noble measures that are mentioned in this motion. For us to be able to afford the future price of alcohol related disease, smoking, obesity and closing the gap we need some fiscal breathing space. That has been completely taken away in the budget of this year by this government and its reckless fiscal spending. To go $188 billion in debt, to talk about having to return our budget hopefully by the year 2020 to within 3.7 per cent of GDP debt or less, is to basically iron out and wipe out for a decade chances of fixing some of these desperate health issues and the noble notions that are contained within that.

The problem is when you are presented, as a government, with a 15 per cent cigarette tax increase and you refuse it, when you have an option to reform alcohol tax and you merely come up with an alcopops tax, or when you have an option to fix Indigenous health and you merely bargain with the Tangentyere Council about $50 million, saying: ‘They will not accept $50 million? Let’s make it $100 million.’ I mean, in that bargaining process around Alice Springs, you are effectively wiping out all of the savings that you are achieving from cataract surgery reform in one single measure. So what are you going to do? You as a government are going to make cataract surgery more expensive. We are going to see people who save up and pay for private cataract surgery because surgery in a public hospital, with a three-year waiting list, is utterly impossible. People will be denied cataract surgery. People will turn away from the most cost-effective intervention in medicine because they cannot pay the gap.

I concede that gaps may possibly come down as a result of a falling Medicare rebate, but not to the extent of $350. We know that there are 20,000 people who pay, who reach into their pocket every year and pay for that cataract operation they cannot get from a dysfunctional state government hospital system. Those people will pay more. People with private health cover will pay higher premiums as a result. They will pay greater gaps as the reduced rebate is simply forced onto people who are good enough, hardworking enough and committed enough to their own health to find some way to pay their premiums.

It is a very sorry notion that the most effective intervention is effectively having its support halved by this government’s reduction of those rebates to such an extent and with no real foresight as to the impact it could have on remote and rural cataract surgery delivery. Remote and rural cataract surgery delivery is not a profitable enterprise—this is not about bashing wealthy doctors. This is about making it harder to deliver these services in remote and rural areas, where they are quite expensive to deliver.

Worst of all, what we will see with that move is that people who, at the moment, are paying for this intervention may choose to delay the operation. What is the alternative to not having your cataracts done? Blindness—not a great alternative. The alternative to not having the operation done is falling over and fracturing your hip, resulting in charges to the health system and the public purse that we do not want to contemplate. But that has been done in a small measure, for short-termism and to try and find some easy costs with which to bag greedy medical specialists. It fits into that ideological attack on private health cover which we are starting to see more and more from this government.

I commend this motion, but I ask the House to note that the actions of this government are working completely contrary to the good recommendations that are contained here.


The DEPUTY SPEAKER (Hon. DGH Adams)—Order! The time allocated for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.