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Wednesday, 27 October 1993
Page: 2640


Senator ZAKHAROV (4.38 p.m.) —Because this debate has ranged rather widely, I would like to bring us back to the terms of the motion, which states:

  "That, in the opinion of the Senate, the following is a matter of urgency:

The changes to Medicare foreshadowed by the government revealed the falsity of its pre-election rhetoric and highlighted the need for urgent reform of the health care system.

My immediate reaction to that claim is to ask myself the question: what sort of reform of the health care system would the present opposition have instituted if it had won the last election? Its pre-election policies—and I assume they were not rhetoric in the opposition's view—would have meant the end of Medicare as we know it, as a universal health care system. Medicare is the envy of many comparable countries overseas.


Senator Herron —I have just said that, Olive.


Senator ZAKHAROV —I said Medicare. I find many people in countries of Europe and visitors from the United States who cannot believe the health care cover and the security that we have under Medicare. In travelling around Victoria in the lead-up to the March election, I found the retention of Medicare to be the most important and most often mentioned issue, particularly among older people and people living in isolated areas without ready access to community health centres—which were also a Labor initiative in the 1970s—or public hospital casualty departments or outpatient facilities.

  The cut and slash policies of the present Kennett government in Victoria have made the maintenance of Medicare even more important to people in my state. Moving away from the negative wording of the opposition's urgency motion, I quote directly from the budget papers a few of the measures which relate directly to the Labor Party's election promises—not rhetoric, but promises now being fulfilled. The paper states:

The 1993-94 Budget includes measures from Election Commitments 24 February 1993 which:

.  introduce a Commonwealth Dental Program for Health Card holders to improve access to emergency and basic dental care.

That is something that we did not have before. The paper continues:

.  make bone densitometry testing available under the Medical Benefits Schedule for those people at risk of osteoporosis.

This is of particular value to women. It continues:

. . . the Government is introducing further measures to reduce medical overservicing and fraud.

Further on the paper states:

The 1993-94 Budget includes measures from Election Commitments 24 February 1993 which:

.  make available additional funding to reduce clinically excessive waiting times for elective surgery. In excess of $100m is to be allocated for this purpose over the next four years; and

.  provide additional funding to expand the provision of palliative care, with a further $57.7m to be allocated to this area over the next four years.

I would like to expand on the question of reducing waiting lists. I know that Senator Richardson has already dealt with this to some extent, but this measure has had a lot of recent publicity and has been mentioned many times today by people on the opposition benches.

  As Senator Richardson has said, people do not have to wait for emergency service. The existence of waiting lists for elective surgery is not an indication of the failure of the public health system. Rather, booking lists and waiting lists are essential planning tools. From memory, which goes back many years—more than most people in this place—such lists have always existed and will always exist with or without Medicare. The non-existence of lists could indicate a serious oversupply of hospital resources, which perhaps should be allocated elsewhere.

  Waiting lists relate not only to bed supply but also to the availability of specialist doctors, for example. There are growing numbers of procedures available now that were not available in the past, such as hip replacement, which has been mentioned today, and major heart surgery. Those procedures were not available to anyone when I was younger. Therefore, there were no waiting lists because there was nothing to wait for. The real issue is whether patients have to wait longer than is clinically acceptable. Senator Richardson has spoken about what has been done to increase bed capacity.

  I return to the quote from the budget papers which said that `palliative care funding will also help reduce waiting lists'. Senator Lees said that particularly in country hospitals many beds are being occupied by people who would be more appropriately cared for in other sorts of facilities—for example, people with a psychiatric illness could be occupying hospital beds—including palliative care facilities. What most people would prefer if they were in need of palliative care is to be at home with intensive palliative care assistance. The measures in the budget will help to make that possible.

  Personally I am a wholehearted supporter of Medicare, without private cover, who would be happy to pay a much higher levy as long as I still had Medicare cover. I do not have a great deal of faith in the private hospital system for good reasons, which I will not go into here because they might be defamatory.


Senator Panizza —Come on, give us a few.


Senator ZAKHAROV —I am not into slagging people in this place. I believe the Medicare levy should be progressive, like income tax, so that wealthy people pay the same proportion of their income as do people on low incomes.

  I do not know where the figures that Senator Herron quoted came from. I have no doubt that they were valid figures but I do not know what the figure was that he was multiplying to come to that result. It would all depend on the proportion being paid.

  Such a scheme would not only maintain the present funds for Medicare but also allow its cover to extend to other health areas, such as clinical psychology which is dear to my heart. As a psychologist I have had to refer people to a psychiatrist knowing they would get more appropriate treatment from a clinical psychologist. This is due to the fact that there is no Medicare cover for that and, therefore, there is no alternative but to send them to a psychiatrist. In a similar way more money could be released for preventive health measures of various sorts as we saw in the budget with the provision for dental treatment for health card holders. I urge senators to oppose this urgency motion.

  Question put:

  That the urgency motion (Senator Newman's) be agreed to.