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Monday, 18 October 2010
Page: 430

Dr JENSEN (1:33 PM) —I wish to discuss a number of issues that are impacting my electorate and the wider Australian nation. The member for Lyons might be interested to know that health care and GPs are factors that I will also deal with in my speech. In fact, firstly, I will turn to the availability of doctors and GPs in my electorate and issues relating to medical treatment and dentistry more generally. Over the past two years eight medical clinics have closed in Tangney, leaving a massive gap in vital primary healthcare services for my local community. My office is regularly approached by constituents struggling to find a GP close to home. Medical clinics that are open for business are often full and no longer able to take new patients. Ironically, some have found my office because of signage which reads ‘Dr Dennis Jensen’. Here they are able to convey their concerns to a good doctor but one who, unfortunately for them, is without medical expertise. The clinics that have closed are both fully private and bulk-billing clinics. Bulk-billing practitioners that I have spoken to say that they love practising in Tangney and do not wish to close but the rising cost of providing healthcare services means that current Medicare funding no longer allows them to remain viable. My electorate has the world-class Fiona Stanley Hospital under construction, and this should address some of the long-term healthcare needs of the electorate. But Fiona Stanley Hospital is still a number of years away from completion and, in the near future, many people will struggle to find good local health care.

I believe the problem is the rising cost of doing business in Western Australia. Bulk-bill payments no longer cover rising rent, labour and running costs facing clinics. The situation needs to be addressed either with a funding increase for bulk-billing clinics or with a tax exemption for clinics that offer bulk-billed services. This will only be a stopgap measure, though. Governments of both persuasions have presented well-meaning increases to health funding, but asking the government to continue to subsidise health care in greater and greater amounts is not a long-term solution. As the American situation demonstrates, simply pumping more money into health is a race to the bottom unless service access and service prices are addressed.

One solution that must be considered is creating greater competition in the primary health services industry. Removing impediments to the number of new graduates in medicine and dentistry will increase competition in the health marketplace. It has come to my attention that members of the Australian Dental Association and the Australian Medical Association also hold positions on university entrance boards. I have been informed these organisations, and prominent members within these organisations, influence the number of students offered university places in medicine and dentistry. The serious restraint of trade must be rectified. Operating in a similar manner to that of medieval guilds centuries ago, looking after the best interests of their members alone, ignores the far greater social obligation of medical practitioners. How can competitive market forces put downward pressure on prices if the major medical associations are running a monopolistic chop shop which dictates how many graduates can qualify and serve the community as practitioners?

The information that has come to me is specific to the University of Western Australia and certain course convenors who restrict the number of graduates to enter the course as a way of not flooding the market and keeping profits at reasonably high levels. I also spoke with a dentist from the UK who was earning as much in two days in Australia as she was in a week in the UK. She told me that what dentists charge in Australia is both exorbitant and opportunistic with established dentists not having to compete with new graduates as a well-organised ‘professional understanding.’

I understand that there are real socioeconomic factors that make the price of medical and dental care significantly cheaper in most of South-East Asia than in Australia, but in the UK these socioeconomic factors are not significantly different. In the West Australian on Wednesday, 29 September a dentist wrote in expressing his concerns over the monopoly situation in health care, calling the AMA a powerful professional body whose opinion is not challenged often. He went on to describe the situation in dentistry, saying:

The same thing is happening in dentistry.

It is the most tightly protected monopoly of all professions with dentists continuing to refuse any reform which may lessen their position of power, despite the fact that on their watch dental disease has remained the most prevalent health problem in Australia today, even though 90 percent could easily be prevented.

If dentists themselves recognise a lack of competition, it is obviously up to the parliament to legislate against the measures of monopolistic behaviour. Restraint of trade in this instance is different to a traditional monopoly, but the outcome is the same—rising costs and a greater market share.

While members of these university entrance committees might not be acting illegally, restricting competition has a much greater flow-on effect. Rising prices are a sure sign that a lack of competition exists in the marketplace. In this instance, if members of the ADA are protecting their privileged position by restricting competition to keep profits high, this situation needs to be addressed by parliament. We may have the highest quality dentists in the world, but what good is that if the majority cannot afford medical treatment, resulting in a low standard of oral hygiene in the Australian community? Neither the AMA nor the ADA or their members should be determining the final number of graduates in their chosen field.

I also wish to speak about the government’s climate change committee or, rather, the committee for predetermined outcomes. Firstly, where is my invitation? In this ‘new paradigm’ parliament, surely all members should be given the opportunity to participate. Obviously, it will depend on our leadership team as to whether we attend, but that is a moot point. We have not even been invited to join unless we completely agree with the predetermined outcome. I think my views on climate change are fairly well known and I have a great interest in the way that Australia goes about abating emissions.

Again I ask: why wasn’t I invited to this bipartisan commission? Since I am not invited I have a few comments for those about to enter the commission. Do you even know what you are signing up for? You want a commission whose members are committed to a price on carbon to build consensus on a carbon price. Isn’t that a self-defeating purpose? Sounds like you are just preaching to the converted. But wait, I thought you were trying to convince people who are not yet members of the church of global warming about the benefits of a price on carbon—so-called consensus building—or is this commission, as I suspect, being used to tread water for political expediency until the Senate changes its make-up next year? I make this statement to the commission: you want Australia to be a leader on carbon abatement but what do you call a leader with no followers? Just a guy taking a walk.

It is clear you are not going to be examining all the options. It has been stated that only two options will be investigated. An ETS is not considered viable by Labor given their position of abandoning their CPRS. There is no impetus for a scheme that lacks a globally adopted framework for implementation and accountability. That leaves the foregone conclusion of a tax on carbon. The simple fact is that the markets are actually, in a global sense, now factoring a price on carbon dioxide out. Take the Chicago Carbon Exchange, the premier trading place for carbon. After peaking at about US$7.50 a tonne, it is now down to US5c, hardly a ringing endorsement of the argument that the market has factored in a price for carbon. Rather, the global market is factoring it out.

Why have a commission? You have the consensus you need: everyone on your commission believes in a price on carbon. Just go ahead and legislate it now, I dare you. Or you could step back and consider all the options. Invite someone like me to the commission, someone who actually understands scientifically the best way to abate emissions. Even the IPCC’s own authors are now changing their minds on a carbon price approach. IPCC author Richard Tol—an IPCC convening, principal, lead and contributing author—in his work An analysis of mitigation as a response to climate change wrote:

The impact of climate change is rather uncertain. Available estimates suggest that the welfare loss induced by Climate Change in the year 2100 is in the same order as losing a few percent of income.

That is, a century worth of climate change is about as bad as losing two years of economic growth. The impact on climate policy is better understood. A clever and gradual abatement policy can substantially reduce emissions.

The DEPUTY SPEAKER (Hon. BC Scott)—Order! The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour. The member for Tangney will have leave to continue speaking when the debate is resumed.