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Thursday, 13 November 2008
Page: 16


Senator MOORE (10:44 AM) —I am going to speak shortly on the committee report, but in view of Senator Boswell’s comments I am going to make a personal explanation later in the day. I want to put on record now the intent of our joint submission. It was put in separately, but it was clearly meant to be a joint submission from the Parliamentary Group of Population and Development, whose secretariat is the Australian Reproductive Health Alliance, which produced the submission. It was never intended to impugn or make any statements about the costs or about people in our community. In fact, Senator Boswell, if you had read the earlier paragraph you would have seen the statement we made, but I am not going to use this short time to speak on that. I will possibly speak later in this evening’s adjournment debate on that issue.

At this stage I wish to acknowledge the work of our committee and the extreme effort put in by the chair and the secretariat to ensure that, as the chair said in her contribution, the whole debate was focused on the issue of Medicare funding as opposed to a general debate on the topic of abortion. I admit that at times it did tend to move into the wider context, as you would expect, because of the deep commitment and care that people have across the views on this issue. We saw many people, whom we have met on previous occasions with various committees in this place, who came forward with submissions and opinions and who feel intensely strongly about the issue of abortion in our community. However, the topic before us was looking at Medicare funding, and it is important that we understand that Medicare has been a longstanding component of Australian health and that the idea of Medicare is that it provides Australians with affordable, accessible and high-quality health care. It ensures that Medicare benefits are paid to eligible healthcare consumers for services provided by eligible health practitioners. That is what is happening with the item before us.

We had extensive evidence about Medicare from people from the department who talked about how the different provisions of Medicare are governed in this country, how different practices are put onto the Medicare schedule and how there is an intense process used to ensure that this is done in a professional and objective way. The business and administration of Medicare is governed under the Medicare Act 1973. This act does not cover the clinical aspects of Medicare. That is covered through aspects of the Health Insurance Act 1973 and its regulations. Through this debate, we are looking at a regulation. In the regulation, it sets out clinical descriptions of services and fees. They are published openly on the Medicare Benefits Schedule. We have a range of professional, administrative and advisory groups that determine what the medical practice is through that process. It is not something that is determined by people’s particular beliefs; it is a medical issue determined by professional provider and practitioners.

In that way, what should happen when we are looking at medical provision is a going back to the professional areas to ensure that they review what is going on if necessary. We questioned at length a series of doctors and professionals who work in this area to establish whether there had been any complaint at any time about medical practices under this item. They checked their records and found there had not been a complaint. There is a professional provision available in our community that people can refer to if they have complaints about what service is actually provided under these regulations. We questioned a number of the doctors and asked them whether they understood this process and if they knew how it could be activated. They agreed, from the head of the professional organisation down through various practitioners, that they understood this process and accepted that it was practice. Then, under questioning, Medicare advised that there had been no complaint. We heard from people from the obstetricians professional association that various clinics referred to in evidence had probably the most reviewed and consistently observed clinical procedures anywhere in the country and were without professional complaint under the regulation.

I refer people to this report because it puts forward the issues and the evidence, both for the Barnett motion and also for those who oppose it. I commend the people who participated in the debate. I commend the secretariat for their extremely professional work. We have in this country a health system that is available to all people. The issue is between the person—in this case, the woman—and her medical practitioner, using the services provided under our legislation.