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Thursday, 17 June 2010
Page: 5753


Mr DUTTON (1:22 PM) —I rise to speak on the National Health Amendment (Continence Aids Payment Scheme) Bill 2010. Whilst serious health and quality of life impacts of incontinence may not be widely recognised, it is an important area of health that has deservedly received government support over many years. The coalition government, in 1998, established and funded the National Continence Management Strategy. This important initiative provided funding for research and service development programs aimed at prevention and treatment. The Continence Aids Assistance Scheme, which the government will amend with this bill, has provided funding to assist Australians with permanent and severe incontinence to purchase continence products. The previous coalition government invested to expand the program on a number of occasions.

Most recently, in July 2007, the coalition expanded the scheme to provide access to subsidised continence products for an additional 54,000 Australians with permanent incontinence. The 2007 budget measure expanded the program for people aged five to 15 years and those aged 65 years and over with a neurological condition causing incontinence as well as pensioner concession card holders and their dependants in those age groups with non-neurological causes of permanent incontinence such as dementia and prostate disease.

Previously, the program had been available only to people of working age with a neurological cause of incontinence. The coalition’s expansion of the program trebled the number of people receiving assistance for continence products and provided those affected with the opportunity to remain active in their homes and communities. As a result of the changes in 2007, the coalition provided an additional $98.5 million over the forward estimates to assist Australians to access continence products.

The bill before us today enacts the 2009-10 budget measure and provides a saving of $10.7 million over the forward estimates in the area of continence aids assistance. The bill amends the National Health Act to provide the minister with the legislative authority to create a scheme by means of legislative instrument that provides payments to eligible persons to assist with the costs of incontinence management products.

The Continence Aids Payment Scheme will replace the Continence Aids Assistance Scheme. Under the assistance scheme, products up to the value of $489, indexed annually, were provided to eligible people with severe and permanent incontinence by a single supplier on behalf of the Department of Health and Ageing. Under the government’s new scheme, those eligible will now receive a direct payment into their nominated bank account and it is to be administered by Medicare Australia. According to the explanatory memorandum, the amount of the payment will be specified in the legislative instrument. The Department of Health and Ageing fact sheet indicates that the payment will equate to the current value available under CAAS—that is, $489 indexed annually.

The government argues that the new scheme will provide greater choice to consumers, enhance competition and reduce administrative costs. For a person receiving assistance directly before the commencement date of 1 July 2010, under proposed section 3(3) of the legislation that person is entitled to receive a payment under the CAP Scheme for the financial year starting 1 July 2010, provided they supply the requisite details by 30 November. After 1 July 2011 the Medicare Australia CEO will be entitled to make eligibility decisions regarding the CAP Scheme. I note the department’s fact sheet states that the eligibility for the CAP Scheme will remain the same as it is now, and this is an essential point to underscore. It is claimed that people who are five years of age or older and have permanent and severe incontinence due to a neurological condition or caused by another specified condition will continue to be eligible.

Unfortunately, this government has a terrible history of backflipping on major health promises and, understandably, many people are concerned about the government’s intentions beyond 1 July 2011 as specified in this legislation. According to the government, 55 per cent of people accessing support under the existing program are over 65 years of age. Many of these people will clearly remember the actions of the Minister for Health and Ageing on the cataract rebate and the Rudd government’s attempt to rip millions of dollars out of Medicare through a savage 50 per cent rebate cut. The people affected by the change to the National Health Act under this legislation will also recall it was Minister Roxon who on 26 September stated:

Federal Labor has made it crystal clear that we are committed to retaining all of the existing Private health Insurance rebates …

As we know, they have now tried on multiple occasions to rip $2 billion out of health through changes to the rebate. Patients affected by this legislation are also in age groups affected by the Rudd government’s proposed and enacted caps to the Medicare safety net for macular degeneration. Varicose vein treatment and cataract treatment are part of the Rudd government’s attempt to rip another $450 million out of Medicare. Of course it was then opposition leader, Kevin Rudd, and health spokesperson, Nicola Roxon, who gave the iron-clad promise on 22 September:

With about one million people each year receiving some cost relief from the safety net, federal Labor will not put more pressure on family budgets by taking that assistance away.

These are just some of the reasons why the Rudd government, and this minister in particular, have lost the trust of the Australian people when it comes to their promises and in particular their promises in relation to health. It is certainly the case—and the Australian people now realise this—that the Rudd government’s word cannot be believed, particularly in relation to measures in the health portfolio.

There have been concerns raised regarding the distribution of products and any additional associated costs for those eligible for the scheme. It is argued that increased competition as a result of the new scheme will ensure delivery costs will not be passed on to consumers. This may turn out to be the case but it does seem a big assumption. Also, many people receiving access to the scheme do not live in major metropolitan areas, so it is important that the government is able to give some assurances that their timely access to products will not be disrupted. There is a risk for some people on fixed incomes and pensions that a direct cash payment may be used to offset the rising cost of living in other areas. It would be a terrible situation if people are forced to forgo these important products to pay rising electricity costs or, indeed, basic food items.

As I have outlined, the coalition strongly support appropriate assistance for continence products and recognise the important impact it can have on a person’s health and quality of life. That was our record when we were in government. That is our record now in opposition. We do have a number of concerns, though, regarding the Rudd government’s ability to implement this measure without disadvantaging eligible Australians. So, while we do not oppose this legislation, we will be monitoring very closely the Rudd government’s handling of this change and we put them on notice to that effect.

Debate (on motion by Ms Macklin) adjourned.

Leave granted for second reading debate to resume at a later hour this day.