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Tuesday, 28 September 1993
Page: 1322


Senator HERRON (10.05 p.m.) —I rise to support the remarks of my colleague Senator Newman in relation to the Health and Community Services Legislation Amendment Bill. The changes are minor. It is another example of the water pouring in through the holes in a colander, with the government inadequately trying to put its fingers around it to stop the water pouring out. The reason this is occurring is that the fundamentals are wrong. They have always been wrong. They will continue to be wrong, because the government does not have the wit to understand what is going wrong.

  Senator Richardson, the new Minister for Health, has been racing around the country meeting with every interest group around the place trying to come to terms with it. I have no doubt that Senator Richardson is a person of ability and that he will do his best.

  The reality is that, since this government has been in power, the people that were prepared to put money into the system are no longer prepared to do so. It is bankrupt. It is as simple as that. The levy was increased to bring in what appeared to be an increased sum of money and all it did was make up for the numbers that have gone out. Only a little over a third of the population in this country pays any Medicare levy. People do not realise that.

  When we speak to people and ask, `Do you pay a Medicare levy?', they say, `Yes, I pay my Medicare levy'. How much do they pay? It can be as little as $50 a year. They pay their Medicare levy but, because the income level at which the Medicare levy comes in is higher than the taxation level, they may pay as little as $50 a year. They feel that they are entitled to the benefits that they get. The average expenditure on health care for people in Australia is now about $1,700 a year. Because some people pay $50 a year they believe they are entitled to it. That is what they have been sold by the government—`It costs you nothing. Be in it, mate. You are entitled to it. You are entitled to free health care'.

  Since this government has been in power the 75 per cent of the population who were prepared to be covered by private insurance has decreased to less than 40 per cent. In my own state of Queensland, the figure is down to 30 per cent. That may be rock bottom level. The same 30 per cent who are privately insuring are paying the Medicare levy. The rest is coming out of taxation. Any system that is funded by taxation is bust. It is bust because we have an aging population; two-thirds of the health care dollar is spent on people over the age of 60. It is bust because of the cost of technology. The only answer which the government has is rationing.

  Senator Richardson discovered a couple of months ago that one has to wait two years at the Royal Hobart Hospital—he believes it is unconscionable—to get a hip replacement. I have news for him: it is a three-year wait at the Royal Brisbane. In Queensland, the mortality rate whilst waiting for coronary bypass surgery has now exceeded the operative mortality rate. There are people dying on the waiting list. We will not hear about it. People do not like going to the press to complain about this. They are grieving. They are not going to create a fuss about it. The people affected most are those people who are not accustomed to complaining. They have been browbeaten to the extent that they are not willing to come forth.

  In Queensland we have had wholesale desertions of doctors from the public hospital system. The answer from the government: `They are money grabbing doctors, getting out of the system; they can make more money outside'. There are 2,000 specialists in Queensland who contribute to the public hospital system for about one-third of the rate that they could earn in the private system. Do we ever hear them being praised? There is never a mention of them. They do not get a mention at all.

  The system is bankrupt. Senator Richardson has been floating balloons all over the place that say, `We should privately insure. We have to increase the money people pay to privately insure'. The answer? Give them rebates or tax deductions. Interestingly, the new, brave, Democrat Clinton plan will allow tax deductibility for private insurance in the United States. The big difference is that 80 per cent of premiums in the US are paid by employers. In essence, there will be a compulsory levy in the US which will come out of the pay packets paid for by employers. That is not an answer either. The answers are there; it is as simple as `get out'. Senator Richardson does not have to go running around the country to find out from everybody what the answer is. It has been as plain as a pikestaff for the last 15 years. We should encourage people to go into private insurance, to accept responsibility for their own health and to contribute towards it.

  There has to be a symbiotic movement between the public and the private sectors. They exist. To a large degree the public sector contributes to health care through major surgeries, such as liver and heart transplantations, which none of us could afford because of their intense cost. The private system can do it equally as well, and in many respects does it better. As a Queenslander I am proud to say that Queensland has the best private hospital system in Australia. For example, more gastroenterology is done in the private hospitals in Brisbane than in the public hospitals because of the long waiting lists there, and the standards are higher. The only machine that can mash up kidney stones, to use the vernacular—a lithotriptor—is in a private hospital in Queensland and public hospital patients have to be transported across to have the procedures done there.

  That is the success of private medicine—it aims at excellence. The American system has gone along that way but at tremendous cost to the community. Nobody in their wildest dreams would think that we should go along the same track.

  Allied to this are all the other pressures that Senator Richardson is finding out about now. He will run up against the rock that every Labor health minister has run up against and that is the ideology that the state will provide. He will come to the same conclusion. It will be interesting to see how he goes. There will be some sort of deal, much along the lines that the employer will pay, and there will then be an added cost to business.

  These changes in this bill in relation to pathology are of a very minor nature, backed by the royal colleges. It will be interesting to see what Senator Richardson does about fraud and overservicing. I have challenged him on numerous occasions. That started off at $400 million, it is now down to about $25 million, and during estimates, the government admitted that it does not really know—it is just a figure. It will be interesting to see what it actually is. I put the government on notice that in a year's time I will be asking that question.

  Of course there are other problems, including the maldistribution of medical personnel, the shortage of doctors in the country and the low rate of return for some specialties. A taxi driver in Sydney earns more in a weekend than a obstetrician—or a patient—gets refunded for having a baby.


Senator Woodley —It doesn't take as long.


Senator HERRON —It takes nine months; did they not tell Senator Woodley?


Senator Newman —He delivers it; he doesn't have it.


Senator Patterson —He looks after her.


Senator HERRON —He or she looks after the lady, because there are many women obstetricians. I was trying to show the analogy that the female obstetrician may have the baby. The woman has antenatal care for nine months, there is the postnatal care and then the baby is delivered, whether it be by caesarean section or by natural delivery. That care is given for the princely sum of just over $400. As was said in the Sydney Morning Herald recently, that is what the average taxi driver earns on a weekend in Sydney.


Senator Patterson —How much do they pay for their litigation?


Senator HERRON —Ten thousand dollars is the litigation fee for an obstetrician. Half the obstetricians in Australia have given up obstetrics in the last five years.

  These are the problems that are facing Senator Richardson. He is now on a fast learning curve. There are many other problems. He should know them because this side of politics has been telling him about them since their fruition. These are the problems that are facing him and I do not believe he has any solution.

  The national health strategy was the last solution. It went for three years—from 1990 to 1993—and cost the taxpayer $4 million. Half a million dollars went to one consultant—a former departmental officer—to write one book on the problems confronting the public hospitals. I wish I was a consultant and got paid $500,000 to tell the government what the problems are in the public hospital system. I did it for nothing in my maiden speech. An amount of $286,000 was given by the federal government along with a matched grant from the state governments. Great if you can get it.

  Getting back to the national health strategy, at least Senator Richardson has had some wit by cancelling it. It was going on forever, producing papers, all of which have gone nowhere. I put on notice today a motion to ask him what improvements have occurred as a result of the national health strategy—a three-year inquiry which cost over $4 million of taxpayers' money. I can tell him. We have gone backwards. The waiting lists have got longer, there are no solutions and there have been no improvements. We will see what he comes up with. He keeps saying that something will be produced by the end of this year. We look forward with interest to see what occurs as a result.

  I could go on. I refer anybody to my maiden speech. Nothing has changed in three years. The figures have altered a little; they have got worse. Waiting lists have got longer, the percentage of those covered by private insurance has decreased and the problems of the public hospitals have got worse. Now there is a paper being produced by Dr John Deeble, one of the architects of Medicare. He is setting up a committee to look into the capital costs of our public hospitals, how run down they are and how much money needs to be spent on them to bring them up to modern day standards.


Senator Panizza —Yet in expanding areas they are closing wards and theatres.


Senator HERRON —Exactly; it is called rationing, which is the government's response. Some day, somewhere, members of the Australian public will wake up. They have not got there yet. They were lied to in the last election in relation to things. It was part of that general behaviour. One day they will wake up. Poor little individuals wake up now when they try to seek access to our private hospital system but one day, collectively, the Australian public will wake up.