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Tuesday, 17 June 2003
Page: 11696


Senator DENMAN (6:03 PM) —I rise to make some comments about the Health Care (Appropriation) Amendment Bill 2003. I think it is crystal clear to anyone who has paid attention to the budget this year that the Commonwealth government has no new money for health. In fact, there is even less money for public hospitals. We knew that somehow we had to pay for that war—a war that so many Australians did not want. One way to do this seems to be for the government to provide less money for hospitals and health, forcing Australians to pay more for their health care. But what about the Australians who cannot afford to pay? As a participant in the Senate Standing Committee on Community Affairs inquiry into poverty and financial hardship, I know these Australians exist. They exist in numbers much larger than we would like to think. The Senate poverty inquiry has revealed devastating accounts of what it means to be one of the many Australians who struggle on a day-to-day basis—and that is without the cost of seeing a doctor or the cost of seeking health care.

In contrast to the government, Labor consider the health care of Australians to be paramount. We promise to put up a huge fight—and we are putting up a fight—against any measures that unravel a system that delivers quality health care to all Australians regardless of income. Forecasts for our current health system are rather gloomy. You have probably heard it before: bulk-billing rates are dropping at significant rates, we are headed for a doctor and specialist work force shortage and so on. Patients are paying more to see doctors, and soon it may very well be the case that they will be lucky to find a doctor, unless we do something now.

On the north-west coast, where I live, people are having difficulties finding doctors because a lot of the doctors have retired and we have not been able to get replacements. The local hospital is getting bogged down with people who would normally go to see a doctor but cannot afford to see one or cannot find one. Those people are going to the outpatients at the local hospital. There is another forecast that I want to pay more attention to, given today's bill. The newly formed Australian Health Reform Alliance last Thursday, 12 June described our country's public hospitals as `struggling in a spartan environment'. I will come back to this later.

Let us turn to the bill in front of us. This bill will set the framework for the Commonwealth government's ongoing contribution to the funding of state public hospitals under the Australian health care agreements. The current five-year agreement period expires on 30 June this year, and the new agreements commence on 1 July this year for a five-year period. This is all very straightforward, and the Labor Party support the legislative framework. However, we do not support the level of funding or the way in which the Howard government has found this funding.

In its analysis of the government's budget, Access Economics said:

... the $917 million new spending on Medicare almost exactly matches the $918 million cut to public hospitals in the new Medicare agreement ... the Government plans to cut public hospital spending and divert the savings to initiatives to increase bulk billing under Medicare and train doctors.

The government is finding the money to fund its unfair Medicare package by taking money away from other health priorities—this time, our public hospitals. This is not good enough at a time when public hospital waiting lists around Australia have not decreased and we have not seen a reduction in the number of admissions to public hospitals since the introduction of the private health insurance incentives. Patients are still relying on our public hospitals, even though, as noted in the Bills Digest on this bill, since the introduction of the private health insurance incentives, private hospital admissions have increased substantially.

Commentary from doctors suggests that, as patients are finding it harder to see a bulk-billing doctor, more patients are going to our public hospitals for immediate medical attention or are delaying seeing a doctor at all and then ending up in the emergency wards of our hospitals. At this time it is not a responsible or fair measure for the government to take money away from our public hospitals when they are so heavily under pressure. And it could be argued that it is the government's lack of commitment to the universality of bulk-billing that directly contributes to this pressure.

This pressure is being felt all around the country. Earlier this month, St John Ambulance services director, Bob Barker, commented that about four times over the past few months in Perth they have had to bypass one of the city's hospitals. On about six occasions all tertiary hospitals have asked to be avoided. This was because the emergency departments of those hospitals were too busy. Also, during one of the nights in May of this year, four big public hospitals in Sydney were forced to turn away all ambulances apart from those bearing patients with life-threatening conditions.

I use these examples—and other examples can easily be found—to show that our public hospitals simply cannot cope with the number of patients that are relying on them for medical attention. Our public hospitals need more money, not less money. Therefore, it seems very strange timing for the government to take away money from our public hospital system. Our public hospitals are surviving in a spartan environment and the effect of this unfortunately will be that Australians who cannot afford private hospitals and have to rely on public hospitals will receive a quality of care that is compromised due to this pressure.

And why are we taking money away from our public hospitals? To fund the government's unfair Medicare package—a package that will offer incentives to doctors to bulk-bill pensioners and concession card holders only. In the eyes of the government, other struggling Australians without a health care or concession card can fend for themselves—and fending for themselves is going to be more difficult as the AMA has confirmed that, as a result of the government's scheme, doctors are likely to increase their charges. This package is going to make a visit to the doctor difficult unless you have the money to pay. The Labor Party looks forward to strongly opposing this package when we come to debate it.

Returning to today's bill, the approach of the government in its negotiations with the states and territories on our new health care agreements has not been inspiring. On two occasions Minister Patterson has refused to attend ministerial meetings to discuss the agreements. What could have been an opportunity for the Commonwealth, state and territory ministers to work on much-needed structural reform in our health system has instead been a lost opportunity. The Commonwealth government has offered an ultimatum to the states that will, in effect, mean less money for public hospitals. We are all eagerly awaiting the next meeting between the ministers on 31 July to see how this agreement can be resolved.

Labor oppose this bill today as we strongly believe in delivering better health outcomes for all Australians. We have a responsibility to ensure that our public hospitals are able to provide quality health care to all Australians. We do not believe that a bill that takes away $918 million from public hospitals is the way to achieve this.