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Monday, 9 December 2002
Page: 7385


Senator MOORE (2:35 PM) —My question is to Senator Patterson, the Minister for Health and Ageing. Can the minister confirm that the latest government figures prove that last financial year almost eight million fewer GP services were bulk-billed, compared to the first full year of the Howard government? Isn't it also the case that, since the election of the Howard government six years ago, in total almost 16 million fewer GP services have now been bulk-billed? Will the minister finally acknowledge that this slow slide in bulk-billing that started when the Howard government came to office has now become a free fall under her policies as health minister?


Senator PATTERSON (Minister for Health and Ageing) —No is the answer to the last part of the question. I am really getting very tired of the Labor Party talking about Medicare, as though in 1996 we inherited a healthy, functioning health care system. The fact is we did not. We did not inherit a healthy, functioning system, we inherited a system where public hospitals had huge strain, and we have reduced the strain on the public hospitals. Labor view Medicare as a funding model, not as a health care model. They are only interested in what happens at the counter, not what happens in the surgery. As health minister, I am concerned about Medicare as the deliverer of good health outcomes for all Australians, not just for those in the inner suburbs of Melbourne and Sydney.

Our list of achievements is very long. We have increased spending on Medicare by $2 billion from $6 billion to $8 billion. The number of services covered by Medicare will increase this year to 220 million, 25 million more than in 1996. We are investing $560 million in the Rural Health Strategy, which is already delivering results. I have said before that the number of GPs practising in rural and remote areas has increased from 5,700 in 1997-98 to 6,363 in 2000-01.

Labor left us with an absolute maldistribution of doctors, and had we undertaken what—and I should not mention her name— Carmen Lawrence was advocating, which was that we reduce the number of medical school places, we would now have even fewer doctors. But that was what Labor were advocating and the deans of medicine opposed it. We have increased the number of doctors in rural areas, with an 11 per cent increase over three years. We have committed $80 million to an outer metropolitan program to encourage more GPs in this area. We were left with too few doctors in rural areas and too few doctors in outer metropolitan areas. We have also increased the number of doctors in training by 160. In medical schools, we have increased the number of GPs in specialist training. With respect to visits to GPs, about seven out of 10 continue to be provided at no cost to patients, and about eight out of 10 visits to GPs by patients aged 65 and over continue to be provided at no cost to the patient.

Government spending on general practice, including Medicare rebates, a practice incentive program and general practice immunisation incentives, will increase this year, representing an increase of around 24 per cent in the four years up to and including 2003. The Labor Party were paying doctors but they were not vaccinating children. Fifty-three per cent of our kids were vaccinated then; now we have over 90 per cent of our kids being vaccinated. Three out of four GPs receive practice incentive payments. This year, the government has allocated a further $242 million to the program, $49 million more than last year. The average payment under the practice incentive program in 2001 and 2002 per full-time equivalent doctor was $15,149. This is expected to rise to $17,928 this year, an increase of $2,779. This is so that doctors will do things like deal with patients who have diabetes and assist them with their management, deal with people who have asthma and assist them with an asthma management plan, vaccinate our children and produce health outcomes. We are focused on health outcomes. Labor was focused on the financial side, financing health rather than producing health outcomes.

In terms of GP remuneration, I am committed to working with the profession on affordable and sustainable outcomes. I point out, though, that in the last six years under Labor, the Medicare rebate for a standard GP consultation increased by only $1.70. Under the Howard government, it has increased by $4.20. More importantly, under the last six years of the previous Labor government, the Medicare rebate for the longer level D consultation increased from $62 to $65.20—a rise of $3.20. Under the Howard government, it has increased from $65 to $80—a rise of $15.20. So when Labor stand up and say that we have kept pressure down on rebates, remember that the government have done a lot more than Labor ever did. (Time expired)


Senator MOORE —Mr President, I ask a supplementary question. Does the Minister for Health and Ageing recall that in the late 1980s our current Prime Minister made public statements like:

Medicare has been an unmitigated disaster ...We'll ... get rid of the bulk-billing system—it's an absolute rort.

Minister, do these statements still represent the government's real approach to Medicare? Is that the reason that the government has been prepared to sit and watch idly while bulk-billing by GPs has gone into such a catastrophic decline?


Senator PATTERSON (Minister for Health and Ageing) —You can hide behind bulk-billing rates but you cannot hide behind the fact that, because of the maldistribution of doctors, some people in some areas on the same income pay more to see a doctor. The position was the same under Labor. My concern is about affordability and access, not about hiding behind a number of bulk-billing rates. My concern is to make sure that access to GPs is fair and equitable. One way to achieve that is by getting a better distribution of general practitioners, a distribution that will correct the maldistribution that was left to us by Labor.