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Wednesday, 9 October 1991
Page: 1537


Dr BOB WOODS —-My question is addressed to the Minister for Health, Housing and Community Services. Is the introduction of a patient co-payment the most effective way to tackle the over-servicing which is crippling Medicare?


Mr HOWE —-I thank the honourable member for his question, which goes to part of a comprehensive package that the Government announced in relation to the Budget. I want to spend a moment on the comprehensiveness of that package, which certainly went far beyond the issue of co-payments. We have a problem in the growth of medical services in this country. That was documented in the Deeble report and in the second background paper which came out of the national health strategy. One can deal with that problem in a range of areas, which we sought to do in the Budget context. For example, there were a number of changes to radiology, pathology and diagnostic services, which I hope all members of parliament would support.

There was also a recognition that general practice required attention, both in the growth in the number of services in the general practice area and in the deterioration in the quality of the service being provided by general practice. The Government was concerned with the growth in the number of services. The Government was also concerned to have improvements in the quality of service. I indicate no desire on the part of the Government to finally determine or to direct on the question of quality; that is something the profession can make its own judgment about. But the view is that the pressures that exist in relation to general practice are producing not only a growth in services but also a deterioration in the quality of service being provided. The Government, if it is to deal with that issue, needs to deal with its various aspects.

Part of the approach that the Government announced in this year's Budget also went to the question of Supply. It is well known, as shown by the Government's study of these issues and also by the AMA and the medical profession, that we have an oversupply of doctors in general practice in this country. That has produced a situation in which doctors are pressured to overservice to make up their income in a situation of great competition. So questions of supply obviously need to be addressed.

The Government made some proposals in the Budget in the area of co-payments--this was referred to by the honourable member--linked to proposed changes to the rebate. The Government, through processes within the Party, has sought to address all those issues. As this is a far-reaching package, our concern is to get to the root of the matter, to develop good policy, to ensure that we get a handle on the costs so that we are able to restrain costs in the longer term, and to do something comparable to the reforms to the pharmaceutical benefits scheme last year, but to ensure that over time what has been the finest system of health insurance and health care in this country, in the form of Medicare, is enhanced and strengthened. We link that to a process of reform of health care.

Unlike the Opposition, this Government has a history of directing itself to fundamental reform. It is a tradition that will continue. We have an Opposition that has had eight years in opposition and many opportunities to develop some line of coherent policy, but what do we get from the Opposition? We get very little contribution to this Parliament, almost no questions from the Opposition spokesmen, and no indications of what its policy might be. The Government is in the business of making policy, making it credible and ensuring it fits our very tight Budget strategy.