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Wednesday, 12 May 2010
Page: 3328


Ms LIVERMORE (5:57 PM) —I, too, add my support to the Health Insurance Amendment (Pathology Requests) Bill 2010. This bill removes the requirement that a request for a Medicare-eligible pathology service be made to a particular pathology provider. Currently, when a doctor sends a patient off for a diagnostic test, the patient will be handed a request form including the name of a particular pathology provider. This has been a feature of the existing Medicare arrangements, according to which a Medicare benefit is only payable if a designated pathology provider is named in the referral request. The patient is therefore required to go to the pathology provider specified by his or her doctor. This means that the choice of pathology provider is one for the doctor to make. Usually the doctor hands the patient a form produced by a pathology provider headed up with that provider’s brand and logo and that is the provider the patient goes to. The referral request, as I said, must nominate a specific pathology provider for the service to then be eligible for a Medicare rebate.

The bill before the House seeks to amend the Health Insurance Act to remove that requirement. Our proposal is for patients to be free to take the pathology request to any approved and accredited pathology provider. As previous speakers have highlighted, we anticipate that this will lead to increased competition between pathology providers and hopefully keep costs down for both patients and the health system. The act will still require a pathology provider to be in receipt of a referral from a medical practitioner. There will, however, no longer be a requirement for that referral request to specify a particular pathology provider in order for the service to be rebatable through Medicare. Under this new system, the patient will be free to go to any accredited pathology provider and a rebate will be payable for that service.

Importantly, there is nothing in the bill to stop doctors from advising their patients on their choice of pathology providers and providers are still allowed to produce branded request forms and to provide these to medical practitioners to hand out to their patients. Changes to current regulations will, however, mean that those forms will now also include an obvious statement to make patients aware that requests can be taken to any approved pathology provider of their choice. This is a change, but it is important to note that the proposal in this bill is similar to the system that has operated in the diagnostic imaging sector for some time.

In contrast to the pathology sector, right now when a patient is referred to a diagnostic imaging provider there is no corresponding requirement for a particular provider to be specified in the request. Patients with a referral to a diagnostic imaging service can therefore take their request for service to any provider. This change brings the pathology sector into line with the existing practice in the diagnostic imaging sector.

On the face of it, this measure is a simple one. It is, however, part of the government’s broader response to the challenge of preparing our health system for the future. We know that we face rising health costs due to our growing population, the ageing of the population and the increase in chronic disease. These are all big challenges that will put huge demands on our health system. We came to government knowing that we had to undertake reform of our health system to make sure it was ready to meet those demands. To do that, we have to remove the duplication and inefficiencies from the current system. We have to make sure that our health-spending dollar is spent as efficiently and effectively as possible. This measure to increase patient choice and encourage competition in the pathology sector is consistent with those goals.

I want to also use my contribution tonight to record my support for the government’s proposals to improve Australia’s health system, and that list is growing longer by the day. There is already a very long list of reforms, more in the budget last night, and important investments in the health system that this Labor government is delivering on in stark contrast to the record of inaction and neglect of the previous government. We are dealing with the legacy of the previous Minister for Health and Ageing, now the Leader of the Opposition, who did nothing to improve the health system and its capacity to meet the needs of the Australian community. On the contrary, the opposition leader took money out of our public hospitals, capped the number of doctors being trained and did nothing to rein in rising costs and inefficiencies that threaten the viability of the entire system.

We want the health system to work better. The Australian people are looking to us to restore faith in the health system and to make sure it is prepared for the future. We have spent our term in government working on the longer term question of how best to structure and fund our health system, but in the meantime we certainly have not ignored the immediate challenges and problems we inherited from the previous health minister. That is why very early in our term we negotiated the current Australian Health Care Agreement with the states, which includes a 50 per cent increase in hospital funding in the life of the five-year agreement. That amounts to a $64 billion investment in health care.

Already we have committed an unprecedented $1.1 billion towards training more doctors, nurses and health professionals. Under this plan we were already on target to increase GP training places by 35 per cent over the numbers that the opposition leader left us when he was the health minister. Earlier this year, we announced that we would build on that existing commitment to training with an additional $632 million. This will make it possible to train a record number of doctors. We will finally be able to turn the tide on the shortage of doctors that has been at the heart of so many of the problems with our health system for years now, a problem that was completely ignored by the previous government.

We are talking about doubling the number of places available for medical graduates to train to become GPs from 600 when this government took office to 1,200 a year by 2014. It more than doubles the current number of places available for medical graduates to undertake training to become specialist doctors from 360 to 900 by 2014. In even better news for electorates like mine, priority will be given to providing training places in rural and regional areas where access to specialists has been particularly difficult for many years.

There will also be more opportunities for junior doctors to experience a career in general practice before they become fully fledged doctors. The current Prevocational General Practice Placements Program gives junior doctors the opportunity to undertake a 10- to 12-week placement with an experienced general practitioner after they graduate from medical school. This program will be expanded from 400 places to 975 places by 2013-14.

The previous government ignored all the warnings about doctor shortages and even took decisions that made matters worse. Our government is serious about health reform and a big part of making the health system work for all Australians is making sure that there are enough doctors and that there are doctors located right across the country in towns and cities, big and small.

The new funding announced in March shows that we have listened and understood the warnings and that we are determined to build a health system that will be strong enough and flexible enough to meet the growing demands for health care. This latest package of measures will deliver an additional 5,500 new or training GPs, 680 medical specialists and 5,400 prevocational training places over the next 10 years. Finally, we are turning the tide on doctor shortages. That is great news for all Australians and particularly for the people in my electorate who have first-hand experience of what the doctor shortage means for those living outside the capital cities.

I am pleased to say that our commitment to better health care goes even further than that. There has been unprecedented direct investment by the federal government in the capital needs of local hospitals. There was $76 million in the 2009 budget for the Rockhampton Base Hospital alone. That is happening right around the country and shows that this Labor government wants to work with local hospitals and health services to understand the present and future needs of their communities and to make the necessary investments in the infrastructure to meet those needs. Another local example from my electorate is the full-time MRI licence the Rockhampton Base Hospital was promised in the 2007 election and granted in 2008. Thanks to the Labor government, we now have a full-time MRI machine operating in Rockhampton and the Commonwealth government is providing Medicare rebates for those services. Other reforms include our investment in preventative health. This is something that everyone agrees is necessary if people are to live healthy and productive lives and something that needs to be a central part of our health system if we are to manage increasing rates of disease and the escalating costs associated with that.

All of these are important reforms, and there are so many more that I could mention. These reforms all now fit within the broader structural reform the Prime Minister and the premiers signed up to last month—that is, the pledge by the government that the Commonwealth will assume the majority funding responsibility for public hospitals through a National Health and Hospitals Network that will be funded nationally and run locally.

I have outlined what is just a part of the government’s plans for major health reform in this country—health reform that is all about delivering better services to the people—to demonstrate our determination to do what needs to be done. The opposition leader had his chance when he was health minister to show that he cared about the health care that people received in communities around Australia, but he failed that test. He walked away from that responsibility time and again. However, not content with his failure to deliver as health minister, he now wants to get in the way of the government’s plans to fix the mess he and the previous government left us with.

One of the goals of health and hospital reform is, obviously, to deliver better care, but that is not possible unless you put the health system on a strong and sustainable financial footing. We cannot go on ignoring the warnings, like the Intergenerational report, the way the previous government did. We would end up with the health system buckling under its own weight and being completely unaffordable. That is why all of our reforms are very focused on spending money where it needs to be spent so that spending is as efficient and effective as it can be in delivering health outcomes.

In contrast, the opposition are intent on blocking every savings measure we put forward—sensible, responsible savings measures that help underpin the reform that is needed to the health system. They opposed the means-testing of the private health insurance rebate, at a cost to the budget of $2 billion. They backed the ophthalmologists when the government tried to adjust rebates for simple procedures. They blocked the government’s efforts to close down the flawed chronic disease dental scheme, a program that was supposed to cost $377 million over four years but which has cost $800 million in the last two years alone. The list goes on. Altogether, the opposition are blowing an $11 billion hole in the health budget over the forward estimates. The opposition’s failure to implement changes like these is financially irresponsible and puts our health system at great risk of not being able to cope with the rising demand from our growing and ageing population. We know we need that money to be put to work in a better health system.

The people of Central Queensland have been telling me for years about their priority when it comes to health services: there is a great need for an improvement in cancer services in Central Queensland to stop the heartbreaking reality of so many people having to travel to Brisbane and be separated from their family to receive the treatment that they need once they have been diagnosed with cancer. That is why I welcomed the call in November last year for applications to the government’s regional cancer centre program and I strongly supported the application which went forward to that program from the Rockhampton Base Hospital. I was delighted when the Prime Minister came to Rockhampton just a few weeks ago to announce that, indeed, the Rockhampton Base Hospital would be the site for one of those regional cancer centres. We will be putting $67 million towards the upgrade to cancer services in Rockhampton which will serve the whole Central Queensland community—people in places like Emerald and Gladstone as well as in the rural towns around Rockhampton. Among other things, the funding will provide for additional chemotherapy chairs, taking the number of chairs from five, I think, to 16, and also for moving towards being able to provide radiation therapy in Rockhampton.

I raised the issues of the MRI and the cancer centre just to illustrate once more why the government are so focused on finding efficiencies and savings within the health budget. We need to get the most out of every health dollar to ensure Australians can get the care that they need now and into the future. The change contained in the bill before the House right now is a fair and common-sense proposal and it is consistent with this goal. It increases choice for patients, and we also hope it will increase competition in the pathology sector. It is a very sensible reform and one that I am happy to support.