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Monday, 18 November 2002
Page: 6580

Senator DENMAN (2:11 PM) —My question is to Senator Patterson, the Minister for Health and Ageing. Can the minister confirm that since the election of the Howard government in 1996 the average cost to a patient to see a GP has gone up by a staggering 51 per cent? Under this government, why is it becoming more and more expensive to see a doctor who does not bulk-bill?

Senator PATTERSON (Minister for Health and Ageing) —With all due respect to Senator Denman, I did indicate that one of the major issues affecting whether doctors bulk-bill or not is the number of doctors—competition. In inner city areas where there are higher numbers of doctors, you get much higher levels of bulk-billing. In areas where there are fewer doctors, you get lower bulk-billing. We have put in place a program of over $560 million to ensure an increase in the number of doctors in rural areas. We have seen an 11 per cent increase in doctors in rural areas—I have forgotten the exact figure, but there were something like 5,700 doctors in 1997-98 in rural areas and now there are 6,363. It is the first time we have seen a turnaround in the number of doctors in rural areas.

What I am on about is access and affordability—to enable people to actually get to a doctor. Bulk-billing in rural areas has always been low and the Labor Party is carrying on as if bulk-billing rates have always been up at the levels they have been over the last four or five years. One of the things that contributes to decreasing bulk-billing is fewer doctors. We have put in place over $560 million of incentive programs and programs to give scholarships to young people to study and commit themselves to rural areas. We have an $80 million program to get doctors into outer metropolitan areas. We have to get this into perspective. Seven out of 10 people are still bulk-billed and a significant number— almost eight out of 10 people who are over 65—are bulk-billed. I commend the general practitioners who are ensuring that eight out of 10 people over 65 are bulk-billed.

Mr Smith said that the Howard government has effectively kept the screws on the rebate for a six-year period. I ask Mr Smith to get his facts right. In the last six years of the Labor government, the Medicare rebate for a standard GP consultation increased by $1.70. Under the Howard government, it has increased by $4.20—a significant increase compared with the Labor's increase. A D-level consultation under Labor went up from $62 to $65.20, and it has gone up in the last six years under this government from $65.20 to $80.40. So for Mr Smith to come and say we have kept the screws on the rebates is absolutely incorrect.

In addition to those increases in rebates— 14 per cent for short consultations and 20 per cent for long consultations—we have seen three out of four GPs receive a practice incentive payment for dealing with chronic illnesses like diabetes, asthma and mental illness, and for vaccinating our children. When Labor was in government, 53 per cent of our children were vaccinated and we had children dying of preventable diseases. By giving doctors increased payments for outcomes—and Mr Smith has not talked about that at all—we now see a vaccination rate which is one of the highest in the world. We are world leaders. We have increased the Practice Incentive Program. We have allocated $242 million to the program—$49 million more than last year. We have increased payments to general practitioners. What we need to ensure now is that we have access and equity and that we locate doctors in appropriate places. We have to get them into outer metropolitan areas, we have to continue to increase the numbers in rural areas and we have to ensure that people on similar incomes in different areas are treated in the same way. That is not what Mr Smith is talking about, and that is what I am working with doctors on.

Senator DENMAN —Mr President, I ask a supplementary question. Don't the figures show that, as the rate of bulk-billing by GPs has fallen by almost 10 per cent since the Howard government came to office, the cost of seeing a doctor has also risen by more than 50 per cent? Why is the government content to see increasing medical costs quickly becoming a massive burden on Australian families?

Senator PATTERSON (Minister for Health and Ageing) —I do not consider that a supplementary question; it is exactly the same question as the question I answered. The answer is very clear: we need to ensure that people on similar incomes have equal access. Under Labor, that was not the case in rural areas. Bulk-billing was very low. We need to ensure that we have doctors appropriately remunerated and located and that we have appropriate outcomes. None of that was happening under Labor. We had a maldistribution of doctors. We have seen a significant increase in rebates under us and an increase in payments to ensure that we get the sort of health outcomes we need—immunisation of our children and the management of asthma, diabetes and mental illness. Under Labor, for people in rural areas there was no access. Now, with the incentive payments, people have access to doctors in rural areas who can deliver programs to assist them with mental illness.