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Monday, 15 June 2009
Page: 5868


Mr MORRISON (1:22 PM) —The Health Insurance Amendment (Extended Medicare Safety Net) Bill 2009 is a cruel bill. It is a heartless bill. Contrary to what has just been suggested in this House, it has nothing to do with people having any restriction placed on them as to how many IVFs they can undertake. This bill will put up the cost by between $1,500 and $2,000 a cycle for those who are looking to use assisted reproductive technologies. That is what the impact of this bill will be and, for many Australians, that will mean the end of the road of their dream to have children. It is a heartless bill and it is a cruel bill, and to sit here in this place and listen to the suggestions put forward by those on the other side that this is all about overcharging doctors and there not being caps on how many times you can do it says one thing to me: they just do not get it. Those opposite really do not understand what the impact of this bill will be on people who are desperate to have children.

Infertility is not a choice. It is not something you wish for. It is not something that you elect. It happens to you, like many things in life happen to you. Just under one in six couples of reproductive age in this country have a fertility problem. IVF is responsible for some 11,000 births each year. Around 40,000 treatments were provided in 2008. Around one child today in a classroom of 25 is in that classroom because of IVF and other related treatments. Forty per cent of fertility problems relate to men, 40 per cent to women and 20 per cent are of non-specific cause, which is one of the hardest things to deal with when you just do not know why. IVF and related assisted reproductive treatments are the only hope for people afflicted with infertility. I make reference to a statement made by Sandra Dill, the Chief Executive of Access Australia, which is the group that supports, represents and provides assistance to those who are going through this horrendous ordeal. She says:

 IVF is the last chance for many to have a child of their own and the Medicare Safety Net has ensured that every Australian has that opportunity. The Government’s decision has taken away many Australians last chance to have a baby.

This is a cause which sits very close to my heart. I have taken the unusual step today of returning from leave. My wife gave birth to a child last Thursday—our second child, Lily Alice. Our first child, Abbey Rose, was born on the 7th of the 7th of the 7th—14 years from when my wife and I began assisted reproductive treatments, which consisted of 10 IVF cycles. It was a horrendous ordeal. My wife had very difficult surgery and we were finally able to conceive a child without the ultimate assistance of IVF. Everything we learned along the road—every day, every lesson, every treatment and every piece of advice—was critical to our path and to the process of having children.

The desire to have children is the most positive, life-affirming instinct we as human beings have. The desire does not go away when you are told that you cannot have children or that you will have difficulty having them. The feeling of loss at every failed attempt is indescribable. Others, removed from the emotional hell, rationalise the failure of embryos failing to take, while parents and want-to-be parents grieve the loss of children. We console ourselves with the thought that one day we will be reunited with our unborn child beyond this life. Added to this physical and emotional torment is the pressure that it places on extremely fragile relationships working through these very difficult issues.

Most families understand the sacrifice involved in having children. They understand that as they have those children and see them growing up in their homes. It means many changes to our lives—many welcome changes, I must add. But one of the reasons we as parents can deal with those sacrifices is that it is accompanied by the sheer joy of parenthood—and there is nothing to match it. Some people go through fertility treatment over extended periods of time. You would have heard the member for Dickson recount an incredibly moving story, which I am so pleased had a happy ending even though so many of these stories do not. For those going through the hell of fertility treatment over an extended period of time, their first experience of parenthood is only sacrifice. That is all that many will ever know; the joy of parenthood never comes. The pain of these experiences is not altered by your level of income. It does not change how you feel and what goes on inside you. Regardless of how much or how little you have, you do whatever it takes to make this work. You make the sacrifices. You take out the extended loan or the second mortgage. You do whatever you need to do to try to realise that dream. For families going through this very dark chapter of their lives, it is all consuming.

The reason I am pointing this out is that I do not believe that those in the government have got a full handle on the depth of this issue or a real appreciation of the pain that they are going to inflict on their fellow Australians as a result of this measure. When you go through this, everything comes into question. You are challenged spiritually, emotionally, physically and financially. You question everything—God, each other, your priorities, your future. Nothing escapes scrutiny when you are going through this treatment and this ordeal. Along this road you will find the wreckage of shattered lives, marriages and families. But when you do this you know the risks you take, because you are so committed to and so passionate about the fact that one day you might be able to realise that dream of bringing a child into the world, which I believe is a very pure dream.

Against this background, the government has introduced this bill and has moved, as the previous speaker said, to cap payments under the Medicare safety net for IVF and related fertility treatments. The bill also imposes caps on a range of other services—including obstetric services, pregnancy related ultrasounds and cataract surgery. I will not touch on these; the shadow minister has already mentioned these. The saving that is expected to be gained from this measure is $475 million. Just to put that in context, that is less than two per cent of what the Labor government borrowed and gave away in cash payments. So what we are seeing right here before us in this bill is one of the many costs of the spending that this government has engaged in.

As I mentioned at the start of my remarks, the cost for couples is estimated to rise from $1,600 or thereabouts—and for many it is far more than that—in out-of-pocket expenses to around $3,000 to $3,500. So when the previous speaker, the member for Shortland, makes the assertion that this measure will not end the dream of Australians seeking to have children she clearly does not understand what the consequences of the cap will be. The cost will go up significantly. It will more than double for some families and some couples—for many couples, I expect.

I think Labor are in complete denial when it comes to this measure. I think they are looking to run and hide. I think they want this legislation to move through this parliament as quickly as possible because they are, frankly, ashamed and embarrassed about it. They have taken a position on this matter which is in complete contradiction to what is outlined in this bill, so they sit here in denial and put forward these arguments, but, frankly, they should sit silent because this is an indefensible measure, particularly as it relates to IVF and related procedures. The pressure on these couples is hard enough—and I have given some of my own insight into that—without the added anguish of having to find that extra money. It is bad enough. It is hard enough. The relationships are already under enough stress. Having watched my wife go through these procedures many, many times and seen the health impacts on her as she dealt with them, to know that she then would have to also endure additional financial stress would be simply too much to bear. It will be too much to bear for many, and they will just say, ‘I can’t go on.’

I know what it is like to have reached that point: after 10, we actually did reach that point. At some other time, we thought, we might go forward again. Thanks be to God, we had the situation where, after the surgery and some years later, things happened. But that is not a normal story; that is actually quite a miraculous story. That is why we refer to our little girl, Abbey Rose, as our miracle child. It does not always work out like that—in fact, it rarely does. So I ask the government to be kind enough to listen. A week or so ago I recounted the story of Jenny and me in the Sunday Telegraph and I have had an enormous response from people going through the same situation. I want to read out some of those responses. One said:

My husband and I are currently going through IVF and it is not an easy path. Even with government subsidies, it is expensive. I can’t believe that the government is going to implement changes which will make it even more difficult for couples who are already going through great emotion in their lives.

Unless you’ve experienced the grief of infertility and miscarriage, I doubt that anyone would be quite aware of the impact it can have on a person’s day-to-day life. The grief is ongoing, mourning because of a failed cycle, utter devastation at yet another miscarriage. Yes, some people go on to live fulfilling lives without children, but for my husband and I this is not an option we want to consider without first exhausting all possible options, including IVF first.

I strongly encourage those affected by Mr Rudd’s heartless decision to keep fighting this as it is the only way that we can even try to stop this very cruel funding cut.

Again in 2008, another said:

My husband and I had four unsuccessful IVF attempts. This year is now a recovery year, emotionally and financially, and we had all intentions of starting up again in 2010. This now looks to be unlikely due to the new changes the government will be putting in place. Unless we win Lotto, the government has forced us to accept the fact that we could well remain childless forever. Not an easy realisation.

These are not my words. These are the words of those who are affected by this measure, and their voices should be heard. Another said:

I think a lot of people do not realise that, even with the existing rebates, IVF is not free. Far from it, in fact. Not to mention all the in-between appointments, tests and exploratory procedures that seem to come with the territory. And no-one ever thinks that they will need to go to IVF once, let alone four or 10 times, so how can you properly save or prepare for that expense when everyone including the doctors, nurses, friends, families tells you to never give up, the next cycle just might be the one that works. How can you simply give up and walk away from that hope or possibility?

I wonder if Kevin Rudd or Wayne Swan would have made the same decision if any of their own children or friends needed fertility treatment.

And again:

We are the unlucky ones: 13 cycles, one with a miscarriage of eight weeks, nearly $80,000 poorer. I would have kept going too. We borrowed money on three credit cards then finally had to extend our mortgage because we could not keep up with the payments. It would have been worth every single penny if we had conceived successfully.

And another:

I think the Rudd government did a good beat-up of IVF in the months coming into the budget with false facts that were made to look like IVF companies were profiting and the community was paying 80 per cent of the IVF when in fact they only pay for a quarter of the total bill. Partly as a result of this beat-up, the general community are indifferent to the cause. The cost that is included in the statements to the media only included the Medicare part of the cost of IVF and not the day surgery, fertility specialist, appointments, non-refundable tests like the SSA, which we had done. This test cost approximately $800 alone, but made us realise we had a problem and contributed to us changing some vitamins, succeeding in our second ISCI.

These are the stories of those who deal with this problem every day, and they understand what the impact of this bill is.

Those who practise in the area also understand that it will put increased pressure on the actual medical procedures themselves, because those who are going through these procedures will not want to risk the loss of an opportunity of going through a further cycle for financial reasons and they will ask to have additional eggs put back in. That increases the risk to a mother and increases the risk to both children in a multiple birth. This has not come from the opposition; this has come from medical practitioners in the area. I know, as a parent now but as one who went through this process, that these are the things that go through your head. These are the issues that you have to try to resolve. You do not want to have to take that extra risk. You do not want to have to go through that process again if you can avoid it. But you also have to try to maximise your chances of success—and if you do not have that next chance, then you will take greater risks.

I think what makes this measure even more disgraceful is the hypocrisy of the government in bringing it forward. In 2005, the then shadow health minister, now the Deputy Prime Minister, said:

Labor completely opposes any cutbacks to Medicare funding of IVF. Labor will be launching a petition against the changes to Medicare funded IVF by the Howard government, tomorrow in Canberra.

Then, in a doorstop interview in 2005, she said:

Tony Abbott and John Howard before the election, were wandering around saying the best thing about Medicare is that it’s an uncapped scheme, a patient-driven scheme. The Prime Minister went so far as to say that’s fundamental. Well, what was fundamental before the election is expendable after the election with this plan to cap Medicare funding for IVF.

John Howard and Tony Abbott should listen to the Australian community, to the Labor Party and to women within their own ranks, and back down today on this proposed very cruel cutback. And at the same time they should rule out capping Medicare for other things that Minister Abbott deems non-essential.

Frankly, the Deputy Prime Minister and the government should take their own advice, because on that occasion the government did listen and did change their policy. They listened and they understood. They became sympathetic and understood the challenges that were faced by couples in this situation. They showed a heart and reversed the measure.

That measure is in this parliament today, brought forward by those who gave that advice to the previous government. I can think of no more bitter hypocrisy than that. But it went further, because not only did they say those things in the press; they took up petitions. They collected, in total, 1,759 signatures, including those in a petition lodged by the previous speaker, the member for Shortland. I am interested to know whether she is going to write to the 240 citizens who signed her petition to oppose cuts to Medicare funding for IVF and tell them that her government are now going to do exactly what she was trying to get their support to stop the then government from doing. Is she going to write to those 240 citizens? Is the Deputy Prime Minister going to write to the more than 1,300 citizens whose signatures she collected and apologise to them for her act of hypocrisy in being supportive of this bill coming before the House? She would not even answer questions, when put to her in this House, about whether she supported this bill, given the fact that she had collected more than 1,300 signatures opposing the measures that she in fact has brought before the House. There were also petitions from the Treasurer, from the Minister for Agriculture, Fisheries and Forestry, from the Minister for Small Business, Independent Contractors and the Service Economy, and from other members. The government said one thing and are doing another. Either they were being deceitful and disingenuous at that time or they are being heartless today. They can take their pick, but either is abominable. Either should bring them to the table, as the shadow minister was saying before, to talk to the opposition about how these things can be avoided.

The government’s budget is dripping with spending, yet they put through a cut like this which will deny a person the opportunity to become a parent. For that, I think they need to take a good, hard look at themselves in the mirror. There are savings that can be found in this budget. In my shadow portfolio alone, the first home saver accounts have underperformed by 96 per cent. Even if we just capped the scheme at 10 per cent of what its projected take-up was going to be, the savings over the next three years would be $700 million. The Minister for Housing did not bring to the table one dollar of savings in the housing portfolio that could have avoided the government bringing forward this measure. She did not do that, and it was left to the Minister for Health and Ageing to find savings. I must say that on other matters I have found the Minister for Health and Ageing to be very encouraging, particularly in relation to epidermolysis bullosa and the support given in the budget to children suffering from that condition. I welcome that and I applaud and commend the minister for taking what I think is a very compassionate position. It cost $16 million and she was very supportive of our representations on the matter. I encourage her now to speak to her colleagues and encourage them to be compassionate on this matter. When in opposition, the government opposed the very thing they have brought forward in this House. They cannot justify it on the basis that they have lost control of their budget. They should get control of their budget. They should avoid the inclination to bring in such heartless and hypocritical measures. Most importantly, they must listen to the people who are affected and they must come to the table and change this measure immediately.