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Monday, 18 November 2002
Page: 6595


Senator CHRIS EVANS (3:16 AM) —I move:

That the Senate take note of the answers given by the Minister for Health and Ageing (Senator Patterson) to questions without notice asked today relating to Medicare and a decline in the rate of bulk-billing and to private health insurance.

In particular, I would like to look at what Senator Patterson had to say about the question of the decline in bulk-billing. I think this is an important issue that concerns a lot of Australians. Today we particularly tried to raise with Senator Patterson the very worrying statistics that show that there has been a 9.4 per cent reduction in the number of GP visits which are now being bulk-billed. At the same time, since the election of the Howard government, we have seen a corresponding 50 per cent increase in the cost of visiting a doctor in terms of the gap payment.

We have two worrying trends: first, an increase in the number of patients who are being bulk-billed, or the number of GPs who are making bulk-billing available, and secondly, a rise in the gap payment for families that represents an increase of about 50 per cent in the last six years. Both of those measures are starting to have a real impact on the cost of health care for Australian families and their ability to access bulk-billing and to afford the gap payments.

The minister was asked questions regarding that today. It is a very serious issue and one that is affecting not just rural Australians, but Australians in metropolitan areas. The minister's answer was to say that it was all just the fault of the last Labor government, which was a bit confusing given that the Howard government has been in office for six years and the figures have only recently started to show a decline in bulk-billing rates. The minister's second response was to say that it was all to do with the number of doctors and that it was because of the lack of doctors in rural areas. She said that when she had 160 more doctors trained, that would be the solution to the problem. I am the first to admit that more doctors in rural areas will help in terms of bulk-billing. However, it will not go anywhere towards solving the real issues that are occurring in our health system.

The minister has no explanation for why we have a very serious decline in bulk-billing rates, why we have a very large increase in the cost of gap payments and what she is doing to help Australian families deal with those two trends. She had no answers at all to those issues and no explanation as to how the government might seek to tackle them. I think that is very important because these are important public policy issues. It is starting to bite on families. We know, for instance, that those on low incomes and others who might have a response to increasing costs and lack of bulk-billing will be affected by lower health outcomes. People stop going to the doctor and stop seeking treatment if they cannot afford it. The trends that we are seeing now with the decline in bulk-billing and the increasing costs of gap payments will lead to worse health outcomes in the long term as people stop accessing health services because of the cost pressures. Those are really serious issues confronting our health system. I think that the minister does need to come to terms with those arguments and with the public policy challenges that they represent.

What we know is that, under the Howard government, in the last three or four years we have seen a decline in the number of people being bulk-billed in every quarter. The proportion of visits that are bulk-billed by GPs is declining. This is not just a one- or two-month trend, this is a long-term decline. After a steady increase under Labor governments, we are now seeing a constant decline in the numbers of GP visits which have been subject to bulk-billing. That is a really worrying trend and it threatens to undermine Medicare.

We know that Mr Howard, the Prime Minister, when he was in opposition, was highly critical of Medicare and at various stages talked about dismantling it. One of the things he did say at the time was:

The second thing we will do is get rid of the bulk-billing system. It's an absolute rort.

What we are seeing under John Howard is that he is actually starting to fulfil that claim. We are seeing the end of the bulk-billing system. We are seeing a steady decline. It is something that is concerning a number of people who work in health in this country. We are going to make it less and less affordable for low-income earners to access proper health care and we are seeing the virtual undermining of the Medicare system due to the decline in bulk-billing. Bulk-billing is critical to the maintenance of Medicare and it is critical to providing a good quality health service to low-income earners. Under the Howard government, we are seeing that service rapidly diminishing. The minister is offering no explanation and no policy as to how the government might be able to tackle those issues or how it might be able to preserve bulk-billing and thereby preserve the fundamentals of Medicare. (Time expired)