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Monday, 18 November 2002
Page: 6637


Senator PATTERSON (Minister for Health and Ageing) (6:21 PM) —I thank honourable senators for their contributions. I note that the opposition has commended the proposed amendments. Indeed, it has maintained the longstanding bipartisan support of the Health Insurance Amendment (Professional Services Review and Other Matters) Bill 2002 in recognition of the important role it plays in underpinning the quality of our health services. I will not go into any more detail about that, because it is really very clearly outlined in the second reading speech.

As has been noted, the bill also proposes changes to the cleft lip and cleft palate scheme. The proposed changes will enable eligible persons requiring ongoing treatment for cleft lip and cleft palate conditions to claim Medicare benefits under the cleft lip and cleft palate scheme until their 28th birthday. I think this is an important amendment because, under the current arrangements, in order to be eligible for Medicare benefits for cleft lip and cleft palate treatment a patient must be a person who has not attained the age of 22 years.

The current age limit was established on the basis that cleft lip and cleft palate patients would generally have completed most specialist dental work associated with their condition once their facial growth was complete. However, the age of 22 years has created some difficulties, as some patients require ongoing treatment beyond their 22nd birthday because their facial growth continues or their scheduled surgery has not been possible until after they have attained 22 years of age. The Department of Health and Ageing has advised that only a small number of existing patients would require continuing care beyond that which is now provided, so this measure will have minimal impact on Medicare outlays.

I anticipate that there may be an amendment. I believe that discussions are currently under way regarding this amendment, which I guess will be moved during the committee stage of consideration of the bill. The bill also contains minor technical amendments to remove redundant definitions in section 3 of the Health Insurance Act relating to health care cards and pensioner concession cards. I thank honourable senators for their contributions.

I cannot resist the temptation to respond to Senator Allison's indicating that the Commonwealth had cut a benefit. Senator Allison, the states have been responsible for dental care since 1901. They were doing such an appalling job of it that the Keating government, in an election pledge, committed $100 million over four years to assist the states in reducing their waiting lists. We have given the states a 28 per cent real increase in their health care agreements over the last five years—a $3 billion windfall—when we have not taken money back from the states with an increase in private health insurance. They now have adequate resources to deliver an appropriate public dental health scheme. They have had that responsibility for 101 years, and all the states ought to get their act together and deliver an appropriate dental health scheme.

Painful as it was, and no government would do it to get re-elected, we have now brought in a goods and services tax—a growth tax. We have given that money to the states, and the states should use it responsibly to deliver the sorts of services that the public require, such as services in dental health. That is why we went through the pain of bringing in a GST. We were operating on a ramshackle wholesale sales tax system that did not have growth in it. People were relying more and more on services and spending their money on services—getting their dogs washed, getting their hair done, eating at restaurants—and these things that the rich spend their money on were not taxed. They are now being taxed through the GST. That money is a growth tax which the states should use, and the health sector ought to be strongly lobbying the states to get its fair share of that growth tax. I had to respond to Senator Allison's remark because the Commonwealth has given the states a growth tax and the states now have to take the responsibility of delivering appropriate health services to their constituents. I commend the bill to the Senate.

Question agreed to.

Bill read a second time.