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Wednesday, 31 August 1994
Page: 684

Senator LEES —My question is directed to the Minister representing the Minister for Human Services and Health. I refer to the current financial problems affecting many Aboriginal community health services. Firstly, are patients of Aboriginal health services which are in receipt of funding from ATSIC entitled to claim Medicare benefits? Secondly, are there—or have there ever been—any ministerial determinations permitting the payment of Medicare benefits to these services? Thirdly, is the minister aware that ATSIC is reducing the funding of some services by the amount they earn from bulk-billing? Finally, does the minister consider that ATSIC funding should be the only source of federal funding for Aboriginal controlled community health services?

Senator CROWLEY —I will try to answer these one, two, three and four. Firstly, the Medicare benefits are generally not claimable where the health services are funded in some other way. Section 19(2) of the Health Insurance Act 1973 specifically precludes the payment of a Medicare benefit for a professional service provided under any arrangement with the Commonwealth, state or territory, local governing body or an authority established by a law of the Commonwealth. So, in general, Medicare benefits are not paid if there is another source of funding to cover the health costs to that institutional service.

  In the period when the Aboriginal health services were funded directly by the government through the Department of Aboriginal Affairs, it was clear that such services were not eligible for payment of Medicare benefits. However, following the establishment of ATSIC, the situation has been less clear and it is known that some services are employing bulk-billing arrangements. This issue is to be considered by the joint planning committee that has been set up by ATSIC, the Department of Human Services and Health and the national Aboriginal community controlled health organisation, which is examining funding arrangements for Aboriginal health. That is an outcome from the budget initiatives for Aboriginal health.

  The second question was whether there have been any ministerial determinations permitting payments of benefits to these services. An exemption to the prohibition can be given. There are some orders which predate Medicare which allow one or two services to be billed. There is currently a section 19(2) direction under the Health Insurance Act 1973.

  In answer to the third question as to whether ATSIC is reducing the funding of some services by the amount of money earned from bulk-billing, there is no conclusive information which can be provided to me at this time. Essentially, that is a question that needs to go to ATSIC, and we are in the process of trying to contact ATSIC—through the Minister for Aboriginal and Torres Strait Islander Affairs, Mr Robert Tickner—to see if we can provide further information on that matter.

  The answer to the last question—whether the minister considers that ATSIC funding should be the only source of funding—is no. Aboriginal health services receive funding from a variety of sources. Certainly, many attract funding from state or territory governments. Services are eligible for funding from a number of specific programs administered by the human services and health portfolio. The fact that they would get money under ATSIC does not preclude them under women's health programs et cetera. That is just one example. There is no restriction which allows the receiving of only one source of funding.

Senator LEES —Mr President, I ask a supplementary question. I thank the minister for her answer. Returning to the basic problems which Aboriginal health services face, does the minister believe that they are receiving adequate funding at the federal government level?

Senator CROWLEY —In general, I believe that the initiatives announced during the budget—which would significantly increase the funding to Aboriginal communities and Aboriginal health services—more than address the need for continuing funding. They certainly indicate the continuing commitment by the government to the importance that it places on Aboriginal health and, indeed, the infrastructure investment in those areas too—so funding is earmarked to look at needs such as sewerage, water supply and housing.

  Aboriginal health is not seen by the government as health dollars only, but as a combination of needs. The government has made that commitment. It has increased that funding. There is no doubt that the commitment is there. In terms of the specific details of whether we are giving funding with one hand and taking it away with another—which is essentially the point of Senator Lees's question, particularly the third part—as I said, we have to seek information on that, and I will certainly get that information for Senator Lees.