Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
 Download Current HansardDownload Current Hansard    View Or Save XMLView/Save XML

Previous Fragment    Next Fragment
Tuesday, 7 March 2023
Page: 5

Senator SCARR (QueenslandDeputy Opposition Whip in the Senate) (12:27): Before I deal with some of the details of the Private Health Insurance Legislation Amendment (Medical Device and Human Tissue Product List and Cost Recovery) Bill 2022, I would like to counter some of the remarks of Senator Steele-John. I know that, when he comes into this place, he is always sincere and passionate and he believes everything he says in this place—there can be no doubt about that. But let me say this. The best strength of our healthcare system in Australia, and what makes us different from other countries, is the strength of both our private health system and our public health system. Each buttresses the other. If this country were ever to undermine the strength of our private health system, it would be a disaster—an absolute disaster for those who need to access the public health system.

Let me give you one example from my home state of Queensland which I think summarises the position extremely well. In 2012, on dental health lists in the public system in Queensland there were 62,513 people. There were more than 62,000 Queenslanders who'd tried to access dental health care in Queensland under the previous Labor government, before the LNP government was elected in 2012. That's 62,513 Queenslanders. Some had been on that waiting list for up to 10 years. In 10 years, they couldn't access the public health system.

The LNP government was elected in 2012. Within two years, how many people were on the public health system waiting list for dental health care? Remember: it was over 62,000. Was it 20,000? No; fewer. Was it 10,000? No; fewer. Was it 500? No; fewer. There were none—none. In two years, that waiting list had been taken from 62,513 to zero. How? By leveraging the private health system—by the government giving people vouchers so they could go and see a private-sector dentist and get their teeth fixed. Within two years no-one was on that dental healthcare waiting list—not a single person. That is the power of having a system which mobilises the private health system. Those who can afford it, such as I, get private health insurance, and if we don't get it we're punished under our tax system. And that's the way it should be, to make sure that our public health system is there and available for those who are most vulnerable.

In my home state of Queensland, there are 2,354,000 Queenslanders with private health insurance. I say to each and every one of those Queenslanders: it would be a disaster, an absolute disaster, if this country adopted the Greens policy. This was their policy, and I've got it here: the Greens policy from the last federal election was to abolish the private health insurance rebate. That was the Greens policy. It would be a disaster. We would see waiting lists far in excess of that 62,513 if we abolished that healthcare rebate.

We all know, and the people in the gallery will know, for friends and family it's nearly their No. 1 priority to make sure they have got their private health insurance coverage. Many pensioners, many people on retirement incomes, scrimp and save to make sure they have that private health insurance, and they deserve a rebate. They deserve to be rewarded by that insurance rebate, and those of us in higher income brackets deserve to be punished if we don't have private health insurance. That is how we get the best outcomes in our healthcare system—the public system working together with the private system.

It will be a disaster for the people of this country if we ever change that system and rely simply on a public healthcare system, which is what the Greens are advocating. It will be a disaster for the most vulnerable of Australians, and I will certainly make sure, up to the next election, that people who voted Green at the last federal election in my home state of Queensland—in the seats of Ryan, Brisbane and Griffith—know that the Greens policy is to abolish the amount you get back for getting private health insurance coverage. I will make sure that every one of those voters knows that the Greens are coming after their private health insurance rebate. The Greens don't believe in the private health system. They're coming after your private health insurance rebate. I will make sure I remind those Queenslanders every day between now and the next federal election that the Greens are coming after their private health insurance rebate, because I think it would be a disaster for the health system in this country if the Greens were successful in what is clearly, patently, an ideological obsession against private providers of anything. It's an ideological obsession which would be a disaster for the most vulnerable in our community.

Having made those introductory comments, I'll move now to some of the particulars of the legislation in this case. The coalition, of course, supports this legislation. It reflects much of the work that was done by the coalition government. This is an example of an orderly transition in our democratic government, with policies which were introduced by a prior government being continued under the next government where they're in the best interests of the Australian people. It is something we should acknowledge.

There are concerns, however, with respect to the lack of detail in the legislation. As senators know, I have a particular concern, wherever it applies, when there isn't sufficient detail in the legislation to understand how a system is going to work in practice. On this occasion, there are a number of areas where the legislation is lacking, and we haven't seen all the regulations and delegated legislation which actually put the meat on the bones of a lot of this legislation and how it will operate in practice.

There are some significant issues which are going to be dealt with in regulations that we haven't seen yet, and, as we all know, the devil is often in the detail. These are some of the issues: eligibility criteria with respect to the crucial health items that fall within this legislation, listing pathways, specifications for the calculations of cost recovery, regrouping and payments for removal items et cetera. Bear in mind that, with respect to this legislation, those who are providing private health insurance, private health coverage and these sorts of services and items in the Australian community were given less than one week to consider the draft legislation—less than one week. We need to do better than that, surely.

The concern I have is that when legislation is introduced in a rush there are always unintended consequences. The devil is always in the detail. There are fundamental concerns about the process with respect to this legislation and how it's made its way into the Senate. The bills provide little detail about the extent or specificity of the powers to be implemented through unsighted subordinate legislative instruments and mechanisms. We just don't know the powers that underlie this legislation. Who's going to exercise those powers? What are going to be the ramifications of those powers? It's also done in regulation, which means this chamber has less opportunity to oversee that legislation and to assert our will and our concerns through disallowance procedures.

Our opposition shadow minister, Senator the Hon. Anne Ruston, raised specific concerns and asked a particular question. I'll put that particular question here again today: are there going to be any changes to the ability of private health hospitals or other private institutions to provide particular surgeries and undertake particular procedures? Let me put it this way: will a private hospital undertaking a type of surgery today be able to do it tomorrow, once the regulations come into effect? Now, that's a pretty basic question. What is going to be the impact of the regulations on private hospitals in terms of the surgery they can undertake? Are they going to be prevented tomorrow, through the operation of the regulations, from doing a procedure that they can do today? That's the sort of detail we should have as we're discussing this legislation.

But, because so much of the detail—and this happens again and again in this place—is going to be buried in regulations, senators from all jurisdictions, all the states and the territories, aren't going to have the ability, transparency and visibility to identify particular concerns for their constituents. The system shouldn't work that way. We should have that visibility and transparency so we can raise legitimate concerns with respect to how this legislation is going to work in practice. But at the moment we just don't have that visibility, and I think the government should reflect on that. It is simply not good enough. It is not good enough for draft legislation to be released by the government of the day—I don't care of which political persuasion—and for key stakeholders to only have one week to actually give feedback on that draft legislation. If there are unintended consequences, as invariably there are—no-one's perfect—then the only way we can introduce in this place legislation which is effective and efficient and protects the interests of all Australians is to have a genuine consultation process with respect to the draft legislation so that we can get the views of those who know the most about how legislation like this applies in practice. This chamber and the Australian people have been denied this opportunity because this legislation has been so rushed.

In this legislation, we can also see one of my key bugbears in this place. We have subordinate legislation which is going to be introduced, potentially, and there are questions over whether or not that subordinate legislation is going to be subject to disallowance. This is, again, unacceptable from my perspective. Any subordinate legislation and any regulations which are going to impact rights, liberties, freedoms and opportunities, or which are going to have any negative impact on Australians and their interests, should be subject to disallowance in this place. They should be subject to any of us as senators introducing a vote, saying, 'This isn't good enough,' and prosecuting our arguments on the floor of this chamber and trying to persuade a majority of our colleagues to our view. We should have the opportunity to have that debate with respect to regulations that can have such a serious impact on the lives of Australians.

With that, I certainly do support the intent behind this legislation. I do have material concerns with respect to how that intent is going to be translated into the regulations, because those regulations could have a material impact on Australians seeking particular surgery in the private health sphere. We need to have detail with respect to that.

In conclusion, the strength of our health system is built on two foundations: the strength of our private health system and the strength of our public health system. We get the best health outcomes for all Australians when we have both a strong private health system and a strong public health system. I say to those Queenslanders who voted Green at the last federal election: we will be reminding you, between now and the next election, that the Greens are coming after your private health insurance rebate. That will be a disaster for many thousands of people. Over two million Queenslanders have private health insurance. In my view it will also be a disaster for our public health system because a successful Australian health system depends on a strong private system and a strong public system.