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Monday, 14 October 1991
Page: 1807


Mr CHARLES —-I direct my question to the Acting Prime Minister. Does he agree with his colleague the honourable member for Makin, who has said that Labor parliamentarians who voted for the changes to Medicare should be ashamed to call themselves Labor members? Does he agree that the co-payment is effectively a consumption tax on the sick?


Mr HOWE —-The changes that the Government announced as part of the Budget in relation to health and, particularly in this case, general practice represented a considered response to a range of problems going particularly to the growth of medical services but also going to the problem of oversupply in this country--the AMA has talked of there being more than 5,000 too many doctors--and the quality of general practice, which I believe is in urgent need of attention. The purpose in terms of Medicare is not simply to arrive at a financing system. Australia is one of many countries which have a system of universal health insurance. We are not particularly special in that regard; it applies to Canada, Germany and many other countries with mixed economies.

The changes were designed to address that problem of rising levels of services, linked to the parallel and essential issue of the number of doctors and linked in turn to the structure of general practice. In a health system, in the way that doctors are rewarded it is important to ensure that there is an incentive to provide a better quality health service.

The changes that the Government announced were about putting some limits, albeit at the margin, on the growth of services but were also linked to an opportunity to address the issue of supply in such a way that the gains that might occur out of those negotiations with the profession ought to be shared in terms of a better quality of service to patients. The three things are interlinked--not to be seen in separation from one another. In the public debate that has occurred so far, that simply has not been recognised. Very few commentators have referred to the fact that the Government's concern is with general practice, that it is with supply as well as with putting a curb on the number of services, including by way of a price signal in relation to the so-called co-payment.

So I believe that when we commence negotiations--and the AMA has indicated that it is ready to commence negotiations this week--we will be able to achieve a very significant package of reform. This area of health is not easy and the issues are very complex. They will need to be worked through over some months. That is one of the reasons why we separated out some aspects of the package from the point of view of implementation to 1 July next year. That was a concern that led to a change in the announced package to include $12m to make practice grants financially possible, at least on a pilot basis in the first part of this year. The Government has announced a package of measures designed to improve general practice.


Mr Lloyd —-Let's face it; it is a very badly disguised consumption tax.


Mr HOWE —-It has a policy basis that is thought through, unlike the consumption tax, which has not been thought through in terms of a policy basis--


Mr Braithwaite —-Not by you.


Mr HOWE —-We have this situation in which the Opposition bleats about unemployment, but at the same time its answer--its cure-all, its economic strategy--is essentially a consumption tax that will put a 15 per cent increase or something of that order on every new house. So what I said earlier this afternoon about recovery in the housing industry would be done in because the Opposition has a policy response that does not take account of its implications for employment.