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Monday, 2 May 2016
Page: 4120


Dr GILLESPIE (Lyne) (13:06): This topic is very sensitive to everyone in Australia because health is so important to everyone. At some stage, everyone needs to end up in a hospital or at a doctor's surgery, so there is so much emotion attached to an argument about health. We will try and restrict it to the facts. I just want to point out some of the hypocrisy coming towards us from the other side.

First of all, the member for Lyons so elegantly outlined the bulk-billing rebate. At the time that pathologists are running a scare campaign, saying that we are cutting bulk-billing, it is really quite misleading. Bulk-billing itself is not being cut, but the incentive to the pathology company that does not go to the patient is being cut because it did not achieve what it was meant to. It was meant to increase bulk-billing but, over five years, it has hardly budged. That is a figure of $1.40 to $3.40. As was recently tabled, some documents for a publically listed company show a healthy profit margin and an increase in the last six months.

The ability to cherry pick knows no bounds from the other side. They miss the big picture. In a health budget, it is not just a pathology bulk-billing incentive that counts, it is things like drugs. Look at all of the new hepatitis C drugs that are available for patients, courtesy of sound financial management. Look at all of the new cancer drugs, look at all of the biologicals that are coming on-stream. People forget about the Pharmaceutical Benefits Scheme. That has to be paid by something. Everyone on the other side seems to cherry pick any remote linguistic twist to put the word 'cut' on the table—whereas health funding has gone up to record levels under this coalition government.

State funding agreements for hospitals have gone up over the forward estimates, in the next couple years, to the tune of several more billion. That is not a reduction. That is also part of the health budget. Look at what we have been doing with the Primary Health Networks. Primary Health Networks were very dysfunctional. There was the odd one that was really delivering some runs, but it has been restructured and they have clear KPIs, and they have a clear target of what to do. They are not going to just duplicate existing general practice services or providers—whether they are public hospitals or private practitioners—they have to meet targets.

There are our initiatives in chronic disease management. Chronic disease costs so much to the health budget. It is the old adage that 15 per cent of the patients cause 85 per cent of the costs. That is the nature of it. Most of the health spending that all we Australians receive comes at the tail end of our life. If most of us remain healthy, that is the logical conclusion. The chronic diseases—those recurrent spending ones such as kidney failure, diabetes, heart disease, vascular disease or chronic lung disease—are a real burden on an individual's life, but economically they are the best areas to target for savings and efficiencies. By having a healthcare home, rather than having patients shop around to wherever it is convenient at the time, you will get all your chronic disease cases focused into one practice. That will mean that 65,000 patients, in a trial across 200 medical practices, will get a system in place that works for the patient and also for the economic bottom line.

This criticism about so-called rebates was really meant to be about incentive payments. I notice that the member for Sydney is here to debate this topic, but when she was the Minister for Health she introduced an MBS freeze. The member for Ballarat actually belled the cat on Sky News on 22 February 2015. She said: 'The Opposition would be kidding itself if it didn't recognise there are challenges. There is no area in the budget that is going to be exempt.' We are already on the front foot in addressing this. That is why the Medicare Benefits Schedule Review is under way. Look at what we have announced in the Health portfolio with the Child and Adult Public Dental Scheme. That is an increase—up to $2.1 billion to provide infrastructure in public hospitals in regional and remote Australia, and to deliver what the previous schemes have not delivered.