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Tuesday, 21 June 1994
Page: 1798

Senator HERRON (11.23 a.m.) —I was fascinated also by the document entitled National action plan: Australia, particularly in respect of health policy. It is obvious to me that the authors of this document were totally unaware of the ACTU-caucus working party. The objectives in this report have no relationship at all to the government's ACTU-caucus working party and the decisions that it handed to cabinet yesterday. This is yet another example of the government having no idea what to do about the crisis in health care in this country, other than pretend that it does not exist.

  As far as I am aware, the only thing that the former health minister did in relation to health in the year he occupied that position was to recognise there were problems. He produced a mechanism to do something about them, which has been effectively dumped by the ACTU-caucus working party. No solutions at all have been put forward. I was fascinated to read on page 24 of this document:

Specific action includes:

.  restructuring the way general practice is organised and financed . . .

It is a pity the Royal Australian College of General Practitioners or the Australian Medical Association were not aware of this document. Effectively what happened in the budget in May is that the rebates to patients were reduced to half of what they would have been had the original decision of the government and the line that it sold those two bodies before the budget gone ahead. The patients were duchessed by the government, because only when they get their rebates will they discover that the rebates are half what they should have been with the increase. It is another way of bringing in co-payment, because that is eventually what will occur.

  Another thing that is occurring in terms of restructuring is the introduction of divisions and accreditation into general practice. Already accreditation has fallen foul of the organisers, and the RACGP is not prepared to go ahead under the government's design. It is an attempt to do away with fee-for-service practice and to introduce that amount of money into the accreditation process. Page 25 of the action plan states:

. introducing further measures to reduce waiting lists for public patients by allowing public patients to be treated in private hospitals . . .

Honourable senators will recall that that was the $100 million. It was not spent, and $78 million of it has gone into the Aboriginal health program. Nobody denies that that money needs to be spent. This document, tabled today, states what the government is going to do. It is going to introduce further measures to reduce waiting lists for public patients by allowing public patients to be treated in private hospitals. That has been withdrawn totally, yet the action plan still states that that is going to occur. The thing that really drew my ire was this statement on page 25:

The Breast Cancer Screening Program aims to screen 1.7 million women over 40 years old by 1995/96 and to continue to offer screening every two years.

The government's own accreditation process states:

The program is being progressively implemented in all states and territories over a five-year period and is planned to be fully operational in 1996 when it is anticipated that 860,000 women per year will be screened.

That is exactly half the number that is stated in this report. I put to you, Mr Acting Deputy President, that this report is almost a farrago of lies. It is a wish list, a pious presentation to the international community as to what the government would like to do but has not got the wit to do. There is nothing about, for example, the free fall that is occurring in private health insurance where people are dropping out of the private health system and are dependent on the public health system.

  Whether Senator Crowley likes it or not, there are only two systems: the public hospital system and the private hospital system. If patients drop out of the private hospital system, they need to be looked after by the public hospital system—not by the Salvation

Army. There is no other body available. They are dependent on the public hospital system. No matter what anybody says in the government, somebody has to look after those people. They still have accidents, they still have babies. They are going to be dependent on the public hospital system. That issue is not addressed in this document; it is not even mentioned.