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Tuesday, 7 December 2004
Page: 160


Senator BARNETT (11:30 PM) —I rise tonight to say that recently I had the privilege of speaking at the Australian Medical Association of Tasmania cocktail party hosted by the President, Dr Michael Aizen, and the Executive Director, Rodney Cameron-Tucker. I spoke of the number of health initiatives relevant to Tasmania, some of the government achievements and challenges, and the reform options, including the need for a greater focus on prevention to move from a treating illness to a wellness focus and to highlight the merit of lifestyle changes.

I want to acknowledge up front that the general practitioner plays a pivotal role in caring for the health of all Australians, but I also want to say that the Australian government's initiatives in Tasmania have been marked, because two years ago the Tasmanian medical school was under threat. Its viability was in question for a number of reasons, but this has now been reversed. One of the reasons is that the Australian government has earmarked $12 million for the enhancement of our medical school in Tasmania. The government has spent considerable funds on improving access for overseas trained doctors and providing doctors for rural and regional Tasmania. We have added 21 new medical places—from 61 to 82 in the school in Tasmania—and we have pumped an extra $220 million over the next five years into the state's public hospital system, going from some $700 million to $920 million.

For Tasmanian GPs there is an incentive to bulk-bill and generally remain viable as a practice. We have lifted the incentive payments from $5 to $7.50 per consultation for concession card holders and children under 16 years of age. Of course, we are the only state in Australia where there is blanket coverage and I want to acknowledge and thank the federal Minister for Health and Ageing, Tony Abbott, for ensuring that that has occurred.

The RRMA rating has changed for West Tamar and New Norfolk. I acknowledge the efforts of Senator Shane Murphy in relation to West Tamar and again thank Tony Abbott for his involvement in making that happen so that doctors can be available in rural and regional parts of the state. Certainly the support for doctors with increases in bulk-billing incentives has already paid dividends, with an increase in bulk-billing rates of 14.8 per cent to 63.2 per cent. That does not make it rosy but it is certainly a huge improvement on the previous situation.

The broad aim before the government is the health and wellbeing of all Australians, wherever they live. Since the Howard government has been in power, we have made significant improvements to the health care system. We have delivered on our commitment to strengthen Medicare through a $4 billion investment over five years and we have ensured greater access to affordable medicines by increasing PBS expenditure. It is now a sustainable arrangement. Where in 1990 it was about a $1 billion taxpayer investment, last year it was about $5 billion and next year, in the 2004-05 financial year, there will be an estimated $6.2 billion.

At the same time we have enhanced the cost effectiveness of the PBS through a public education campaign. That has been of help. We have helped with the increasing cost of diagnostic and specialist services by announcing 23 new Medicare eligible magnetic resonance imaging machines in underserviced locations throughout Australia. We fully realise the value of prevention and early detection. This is a key theme that I wish to stress. On our coming to government we found that the child immunisation rates were 53 per cent. Now over 90 per cent of children at 12 months of age are fully immunised. This is a fantastic health outcome. It could not have been achieved without the determined support of GPs and the Australian government.

In that vein we have also acted decisively on the childhood obesity front, with a $116 million package announced by the Prime Minister in June this year at my fourth forum on this issue since I became a senator in February 2002. I have held forums in Launceston, Hobart and Canberra. If you would just indulge me for a moment I would like to say that I helped convince McDonalds Australia chief, Guy Russo, to offer healthy food options and to label his food packaging with nutritional information. McDonalds is now doing both. I called for nutritional information on fast food packaging in mid-2002. The fast food industry response at the time was, `It is too hard and can't be done.' But two years later McDonalds is doing it. At the Hobart forum I held, McDonalds announced that they had cut back advertising to children by 40 per cent. At the Canberra forum they announced nutritional information on their labelling. I congratulate Guy Russo and McDonalds for their initiatives in the hope that the remainder of the fast food industry will follow suit shortly.

I also want to acknowledge and thank the Australian Association of National Advertisers for their work and effort in coming on board to address this obesity epidemic. I acknowledge the work of Ian Alwill, the President, and also the newly appointed Executive Director, Colin Segelov. I acknowledge all those who have been part of the solution and not part of the problem: the teachers, the health professionals, the nutritionists, the food and grocery manufacturers and many others.

A review of Australia's national cervical screening program was released on 18 November 2004 and it confirms that Australia has one of the most successful cervical screening programs in the world. The Howard government has put in place a range of measures to build a strong private health insurance, with almost 8.7 million Australians, or 43 per cent of the population, having private health insurance covering hospital treatment. Building on this, the government passed legislation just this week to change the private health insurance rebate. The changes will help to ensure that older Australians can continue to benefit from their private health insurance in retirement. The government is increasing the rebate from 30 to 35 per cent for people aged 65 to 69, and to 40 per cent for people aged 70 and over.

Some people may be aware that during the Select Committee on Medicare inquiry I joined my Senate colleagues on the committee Sue Knowles and Gary Humphries in calling for a general increase in the rebate because it helps to create more options for patients and acts as a buffer for the public hospital system. I am pleased that the government has applied that recommendation to assist older Australians with an increase in their private health insurance rebate. The government are now committed to delivering a health information network for all Australians and have allocated $128.3 million over four years for the implementation of HealthConnect. Tasmania was selected to be one of the first states to roll this initiative out state wide. Tasmania has a strong history in the e-health arena, with the MediConnect field test in the north and the flagship HealthConnect trial in the south.

The health priorities for this term of government are wide ranging, but I just want to comment on a few. The first is to improve access and affordability to medical care; the second is the research into, and prevention and treatment of, specific diseases that have an enormous impact on the community, such as cancer and diabetes; the third is to provide greater access to mental health care, particularly the burden of depression; and the fourth is to enhance the assistance that we currently provide to people with dementia and their carers.

The government announced that from 1 January 2005 the rebate for GP services would be increased from 85 per cent to 100 per cent of the Medicare schedule fee. This builds on the government's Strengthening Medicare strategy. This is obviously well appreciated by GPs, and they know it will be of benefit to their patients. The coalition policy Round the Clock Medicare: Investing in After-hours GP Services is going to involve an expenditure of $429.6 million over four years for increased Medicare rebates for after-hours GP services and investing in both existing and new after-hours GP infrastructure. This initiative does build on the existing framework of the after-hours primary medical care program and is another step towards the government's long-term goal of increasing access to convenient and quality GP services. I acknowledge the contribution of Dr John Davis and his organisation in Tasmania for the excellent work that they have done in providing after-hours care in our state.

Cancer care is a major cause of illness and death in Australia. Through our Strengthening Cancer Care measure, we will build on our investment in the care of those living with cancer by $140 million over four years. Ninety Australians each week die from bowel cancer. The Strengthening Cancer Care measure aims to reduce morbidity from bowel cancer in people aged 55 to 74. A national bowel cancer screening program will see Australians aged between 55 and 74 years directly invited to participate in bowel cancer screening. The measure also includes a campaign to encourage women to quit smoking during pregnancy and a national skin cancer awareness program. There will be further research on cancer and cancer care.

The government will be continuing its investment in helping people with mental health needs and has committed a further $110 million over four years. This will assist in consolidating and expanding assistance to GPs in their management of patients with mental health needs.

I turn to diabetes, support for people with diabetes and diabetes research. It does affect the health of many Australians. There are 1.2 million Australians with type 2 diabetes and 140,000 people with type 1 diabetes. I am one of the latter. The disease may cause a range of serious complications, reduced quality of life and shortened life expectancy. I can assure you that I fight it daily with tenacity in the fields of exercise and diet. The Howard government established diabetes as a national health priority in 1996 and has introduced a range of activities and programs, including the GP incentive based National Integrated Diabetes Program, which has been very successful in improving the care of people with diabetes. Building on this, the government recently announced a further $25 million over four years on a range of diabetes initiatives which will help reduce the burden of diabetes on individuals and the community. So there will be funding for research into diabetes and expanded care programs for those with, or at risk of developing, the disease. Type 1 or juvenile diabetes imposes a very heavy load on families and support services, so an Australian centre of excellence will be established which will pursue research into pancreatic islet cell transplantation, which is a research avenue that could one day lead to a cure for type 1 diabetes. Diabetes is not simply a juvenile illness, as I have said. Mature onset diabetes, or type 2 diabetes, affects approximately 1.2 million Australians.

The government will also implement a Lift for Life program, which is an innovative program developed for older Australians with diabetes. It is designed to prevent and manage type 2 diabetes, and other chronic lifestyle related diseases, through strength training. It will be implemented in part by the International Diabetes Institute in Melbourne, which is headed up by the most competent and highly regarded Professor Paul Zimmett, who was involved in conducting the AusDiab study. I visited the institute just a week or two ago and was briefed on their latest research. I congratulate them on their efforts and their initiatives. I also acknowledge, in terms of research and initiatives to help people with diabetes, Dr Peter Little of Diabetes Australia, who has been recently re-elected as president, as well as Brian Conway, the executive director, and all their team. I acknowledge the work of the JDRF, the Juvenile Diabetes Research Foundation, for the work that they do, and the outgoing CEO, Sheila Royles. She has been a very strong and able advocate for her community. To Sue Alberti, who heads the organisation, who has a most compelling and emotional personal story to tell, I congratulate you for your leadership.

I want to acknowledge the work of the Parliamentary Diabetes Support Group, of which I am an executive member, along with Judi Moylan, who is the head of this group, Dr Mal Washer, Cameron Thompson and Dick Adams, a fellow Tasmanian. We have lobbied for and gained funding for things like the insulin pump consumables, which was in this year's budget and was a $15.3 million initiative over four years to help support those people with type 1 diabetes, and we have gained funding for diabetes educators to be paid via a special Medicare item following a referral from the relevant GP.

The government has delivered an extra $2.2 billion over five years in the last budget for aged care, the largest single investment in aged care by an Australian government. In Tasmania the last federal budget provided an extra 635 aged care beds over the next three years and, in July this year, an investment of $13.5 million directly into that industry. Currently about 176,000 people are living with dementia, and this will grow considerably in the next 20 years to approximately 283,000. The government has committed $203 million over four years to enhance the assistance that we currently provide to those with dementia by providing extra assistance to enable people with dementia to be cared for at home through 2,000 extra dementia-specific extended aged care at home packages. Making dementia a national health priority is a good move. I have outlined some of those key commitments and initiatives that we have focused on in this term, but I want to say that there are two areas of reform that we will be faced with in the near future. One relates to health service delivery reform and the other to the capability of our country to respond to emergencies.

Before concluding I want to make some comments with regard to prevention and the merits of it, and I hope that over time in this country we will move from a system of treating illness to a system of preventing illness. I believe in the merits of what is being referred to as the `wellness revolution'. It is being promoted by the Complementary Healthcare Council, and I want to congratulate them on their initiatives and their proactive activities. Complementary and natural health care medicines in Australia have a very important role, and it does help the Australian community to focus on wellness rather than sickness. That sector does have a lot to offer. I have previously in this place supported the merits of establishing a centre for national health care. Indeed, I note that this is a key initiative of the Complementary Healthcare Council and some of those in the natural health care industry. It will help with research, education and encouraging greater awareness and understanding of the merits of the natural health care industry.

In conclusion, I want to say that the reforms before us will be challenging and they will be difficult, but that is what life is all about in this place and it is for us to pursue. I want to say that I fully support the Prime Minister's initiative to set up the Andrew Podger AO review into health services delivery reform. I believe that is essential in terms of who does what and when it is provided. It will help us look at the optimum efficiencies and effectiveness of health service delivery for all Australians across the primary, acute, rehabilitation and aged care sectors and, in doing so, it will help clarify the responsibilities of each. The establishment of that inquiry is welcome. We have some challenges and issues before us but I think that, as a nation and in a cooperative spirit, we can tackle them and move in the right direction to deliver better and more affordable health care outcomes.