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Thursday, 14 May 2020
Page: 37


Ms CLAYDON (Newcastle) (12:56): It gives me great pleasure to stand in support of the amendment moved by our shadow minister for health, the member for McMahon. In this environment where we're all faced with the challenges of the COVID-19 pandemic there can be nothing more important than primary health care in this nation. If this is not a time when all our minds are extremely exercised about the importance of health care then I don't know what is. I cannot imagine the idea that this government and this parliament would have a debate on any piece of legislation in the field of health without drawing attention to the radical importance of a universal health care system in this nation. I cannot even begin to imagine the state that we would be in right now had we not had the benefit of a universal safety net in Australia.

Actually, we do know what it looks like when you don't have universal health care, as we need only look to the United States of America and the diabolical destruction that has occurred in that nation. The gross inequities of access to a quality health care system results in unfathomable death and misery. That is something our nation has avoided. All of us in this House have been so thankful that there has been a prioritisation of science and medical health expertise at this time of a pandemic and that these experts have applied all of their skills and knowledge to ensure that our nation has been, in the scheme of things, spared so much pain and so much trauma. This parliament needs to spend every moment we can debating health issues, ensuring that we are doing all we can in this place to better support, to better finance, to better ensure the strength of our universal healthcare system in Australia.

It's astonishing now to think that the Prime Minister started this year of 2020 with a fresh round of cuts to Medicare bulk-billing. If we just think about what we were doing at the start of this year, before we actually knew what we were facing with the pandemic, it is gobsmacking now to think that the Prime Minister would have thought that that was a good plan for this nation. Newcastle is one of the 14 areas that he and his government targeted to cut the bulk-billing incentive payments. The government encourages GPs in Australia to bulk-bill vulnerable patients by paying them each time that they bulk-bill. It's called a bulk-billing incentive payment. In Newcastle, like my neighbouring areas of Maitland and Kurri Kurri, Scott Morrison slashed this payment. The loss of that incentive payment is estimated to cost the Newcastle and Hunter region some $7 million. I've met with many of my local GPs and representatives of the Hunter primary care sector. We've talked about the detrimental impact that these cuts to the bulk-billing payment incentive scheme have had for our region. As I said, they've taken $7 million out of our primary healthcare system overnight. This has meant that doctors have started making very, very difficult decisions about whether they are bulk-billing children, whether they're going to bulk-bill more than one sibling in the household, and whether they're going to be able to bulk-bill concessional patients and pensioners coming in. Well, you know what? They've already had to start making decisions about not bulk-billing those vulnerable people in our community. It's already happened. And, indeed, I have lost GPs. I have had GPs' surgery doors close. If anybody in this House thinks that now is a good time—if, indeed, there is ever a good time—for our GPs to be hit to the point that they are closing the doors of surgeries in the middle of a pandemic, I would be astonished. Nobody in my community thinks that this is okay, I can assure you of that.

I have written to the minister on many, many occasions about this issue, and, indeed, have launched a campaign locally in Newcastle with regards to the devastating impact that the changes to this bulk-billing incentive payment scheme have had. There were almost 1,000 petitioners on my online petition, but, additionally, more than 2,000 people had written in to me with a petition prior to the COVID-19 pandemic starting. Three thousand people is nothing to be sneezed at in this House. That is 3,000 people who had the capacity and time to actually petition and contact their federal member. For every one of those, you know that there's a 10-fold number of people who don't realise they can contact their federal member about these issues. They just turn up to the doctor, only to find out that they cannot be bulk-billed anymore. Imagine what it's like taking your three kids off to the doctor because they've all got sick at the same time, which is not an unusual scenario for families. You used to be able to bulk-bill. Now, you're up for three consultations. Or you make difficult decisions about maybe not taking them to the doctor, or just taking one. And if the doctor actually prescribes something, you've of course got all the additional costs then of follow-up pharmaceuticals. At a time when this pandemic has really made abundantly clear the importance of strong, universal primary healthcare in this nation, it is astonishing that the government should even contemplate proceeding with this cruel scheme to cut bulk-billing incentive payments.

And it is in regions that we feel this pain most acutely—although I don't wish to take anything away from others; I've listened to my colleagues from Western Sydney talk about the impacts it's had in their regions as well. This is a time when our GPs are under even more pressure. Many of them are now reporting to me that they are doing a lot of unpaid work where they are calling people who are trying to get advice and follow-up around COVID-19 at the moment. Many of my GPs are making those kinds of follow-up calls to many, many poor people on their own time and at their own expense. For those GP clinics there have also been significant additional costs in securing enough PPE, personal protection equipment, and the scrubs that are required in their surgeries. And there's been, simultaneously, a reduction in the number of face-to-face visits to GPs. People are actually quite scared of going to their GPs at the moment—hence the increase in telephone advice—for a couple of reasons. Some people in my community say, 'I don't want to pester my GP,' assuming they're going to be superbusy. 'They should be focused on people with COVID-19-related illnesses.' Or they are concerned about going there, thinking that it's a place of infection or possible source of infection. Either way, it is a diabolical situation for our citizens at this very time when we have asked them to heed health advice, and they have made many personal sacrifices to do so.

It is the obligation, then, of this government—indeed, this parliament—to ensure that we utilise the Commonwealth of this nation to support those people making sacrifices to ensure that this pandemic is contained. Therefore, any contemplation of a reduction in bulk-billing payment incentives now really should be unthinkable. I really do say to the government: there's no shame in realising you've made a mistake. There is no shame in that. You can come back to the House on this. I'd love to hear the minister say: 'We got that wrong. We should be, in the midst of a pandemic especially, doing all we can to support our GPs and frontline health workers.' It's no good sending platitudes of thanks and appreciation for everything that our frontline health workers are doing whilst you're simultaneously pulling the rug out from underneath a whole bunch of frontline GPs.

I'd like to just share with the House comments from one of the clinics that contacted me in relation to the impact of that withdrawal of the bulk-billing-payment scheme, on top of all these additional expenses of the unpaid work that they're currently doing—the increased spend on PPEs and scrubs and the reduction of actual visits into the surgery at the moment. This doctor, a doctor of many decades in my community, said, 'We feel that primary care doctors have been abandoned by the government and left to fend for themselves in the front line of this pandemic.' I don't think I could have put it any better myself. That is shameful. That is a shameful indictment of this government—at this time—to leave frontline GPs feeling abandoned.

I ask the minister to reconsider this short-sighted measure and to come and support the member for McMahon's amendment here. That is what a great health minister would do right now—come in and say, 'I got that wrong. Those cuts to rural and regional bulk-billing incentives were short-sighted.' He could come here and realistically argue that he didn't know what was coming at us with this pandemic. He could say, 'I didn't really understand the full consequences, but now I do, and we're going to reverse those bulk-billing measures.' That's what I want to hear Minister Greg Hunt come in here and say. I want him to make sure that the changes to the district work shortage and distribution priority areas for our health workforce classifications actually work for our rural and regional communities again. Really, the abolition of the Rural and Other Medical Practitioners Program—what's going on?

Anyway, Minister, if you are listening, this is a great opportunity for you to come into the House right now, back in Labor's amendment—

Mr Coulton interjecting

Ms CLAYDON: Well, that's right, Minister Coulton. You could jump up and support this amendment for us now.

Mr Coulton interjecting

Ms CLAYDON: Indeed. You'd be hard pushed to not be supporting our front-line medical workers in the bush—your community, your constituency, Minister. Your constituents stand to benefit enormously from Labor's amendments here right now. It's just a matter of standing up to that despatch box, making your commitment, joining with us now to express your concern about the government's cuts and changes to Medicare. Everybody in this House should be concerned about those cuts and changes to Medicare, particularly people in the bush, particularly those of us in the regions; and particularly in relation to those changes that are making access to medical practitioners more and more difficult right now, at a time when we need GPs more than ever to be focused entirely on delivering the very best primary health care service we can. I really do feel for your own constituents, Minister. I think that they would welcome increased levels of support into rural and regional areas of Australia.

So I look forward to Minister Hunt joining you, perhaps, in this move to support Labor's amendment on the table. It's done with good heart and good intention, and it's based on some very clear evidence that we've witnessed firsthand in our own communities.