ADJOURNMENT;Medicare – 08 Nov 2016

Once again I rise to speak about an issue that the government is mucking up, playing up again and causing confusion about—and that issue is Medicare. Seriously, every time I rise to speak about Medicare issues it seems like we are watching an episode of ‘Malcolm in a Muddle’. Really, I quite despair, to tell you the truth.

Ever since the election the government has done everything they can to prove Labor’s accurate description that this is a government opposed to Medicare and to universal health care. They just cannot help but attack the universal health-care system that the Australian people hold so dear. Those on the opposite side of this chamber really should be ashamed. They should hang their heads in shame!

Tonight, I would like to raise a number of examples of this government’s attacks on universal public health care, and I will start with the Medicare rebate freeze. Recently, in Senate supplementary estimates, the health department confirmed that the six-year freeze on Medicare rebates was a decision taken by the Turnbull government, contradicting the Prime Minister and his hapless health minister, who have repeatedly tried to blame their Medicare freeze on the former Labor government.

Following questions, the health department told Senate estimates that only the coalition government is to blame. When the deputy secretary of the department was asked:

When were the GP rebates last indexed? By which government and in which year?

health department deputy secretary, Andrew Stuart, replied:

Fees for GP attendances were last indexed on 1 July 2014 and so the first indexation date that was missed would have been 1 July 2015.

So there we have it: GP rebates were last indexed in July 2014, as the last Labor government had budgeted. So the six-year freeze on Medicare rebates is entirely—entirely!—of this government’s making.

The federal government has frozen the Medicare rebate at $37.05, and doctors and their patients are facing no increase in Medicare rebates until 2020. Even Tony Abbott and Peter Dutton increased Medicare fees—something this Prime Minister and this health minister may never do, given their plans to freeze Medicare rebates beyond the next election.

This freeze is flowing through to patients and harming them. Doctors have been advised to set their recommended fees for a standard visit to $78 from 1 November 2016. Australian Medical Association vice president Stephen Parnis said that the body would recommend doctors raise the cost to $78 for a standard visit under 20 minutes, a $2 increase that will not be accounted for by the Medicare rebate. Doctors have felt this is necessary because they are being squashed by the government. AMA vice president Dr Bartone said:

Already there is significant damage being done to the ability of practices to continue to provide that quality medical care, and every day that freeze remains in place is another day that puts quality medical care firmly and more succinctly out of the reach …

The effect of this increase is of particular concern to doctors in rural and regional areas, like my home state of Tasmania. Rural doctors have to expect the unexpected, and often deal with complex health matters that city doctors can refer to a nearby hospital or to a specialist. Unfortunately, there are many people in our community who simply cannot afford such an increase, and while we continuously hear from the government about the rising costs of health and medical services we do not hear enough about the unique and divergent challenges of health professionals working in rural and remote Australia.

The increase puts more pressure on GPs to abandon bulk-billing and to add a patient copayment, which would have a disastrous impact on people already struggling—especially in remote communities. Given that the government has frozen the Medicare rebate until 2020, the new doctors’ fees will mean that from 1 November anyone who is not bulk-billed will pay even more to see their GP. Either way, more people can expect an additional cost to see their GP, contradicting the Prime Minister’s solemn pre-election promise that no Australian will pay more to see the doctor as a result of his ongoing Medicare freeze. I remind people that on 1 July 2016 Mr Turnbull told Channel 7 that patients absolutely—absolutely!—would not pay more because of the freeze. An immediate end to the Medicare rebate freeze, which has been called for by both the Australian College of Rural and Remote Medicine and by the Rural Doctors Association of Australia, would relieve much of the pressure.

Yet another issue of concern is the debacle the government has made regarding rents for pathology services co-located with GP offices. As people may recall, those opposite made a deal with Pathology Australia before the election to regulate the rent of pathology service providers that are co-located with general practitioners. Unfortunately, this policy will have significant impact on general practitioners.

AMA President Michael Gannon has written to the Minister for Health, Ms Ley, outlining his concerns and calling for a change of course. He said: ‘These practices are small businesses that have negotiated leases in good faith with the much larger pathology providers. They have made business decisions based on projected rental streams, including investment in infrastructure and staffing. For many practices feeling the impact of the current Medicare indexation freeze, this source of rental income has helped to keep them viable.’ The AMA estimates the government’s policy will rip up to $150 million from general practice each year. That is $150 million that will be passed onto their patients through higher fees or lower rates of bulk-billing. This is a disappointing outcome for our health system and shows that this government has no interest in acting for the good of Australian patients. The government has acted in its own short-term political interests and not for the good of the nation.

Another area that the government has dropped the ball on is vaccinations. There are serious questions around the Turnbull government’s decision to dump an initiative designed to improve vaccination rates in young people. The Turnbull government is axing the Australian Schools Vaccination Register despite the legislation already being passed and at the same time quietly announcing a possible plan to scrap the year 7 whooping cough booster. This government knows it has an appalling record on health and is desperate to hide from it. This register is critical to making sure we have the information we need to improve vaccination rates in young people. Australia’s vaccination programs are too important to be treated with such contempt by a government that cannot be bothered standing up and explaining the changes to parents. The health department said that the register was important to improve vaccination rates in young people. Now the government is dumping it—only two months before it was due to start. It is appalling that the Turnbull government think they can get away with quietly scrapping it on a Friday afternoon—something they are quite fond of doing as it is a slow news time. Parents and the community are owed a clear explanation of how the government will improve vaccination rates without this important data.

It has been reported in the media that the Turnbull government is preparing to dump the booster dose of whooping cough vaccine given to children in the first year of high school as rates of the disease nearly double. Whooping cough is a terrible disease and it is entirely preventable with the vaccine. As reported by the removal of the vaccine boost has come even though the US and Australian studies show the effectiveness of the new acellular whooping cough vaccines wears off quickly, with only three or four out of 10 people fully protected four years after vaccination. The number of whooping cough cases has almost doubled in the last four years, with 14,392 cases recorded in the year to date. This is a government that does not care about the health of all Australians. This is a government that is asking doctors and other health providers to do more and more with less than less—and patients are paying the price.

I want to turn to the outcomes from an incident that happened earlier this year under former minister Stuart Robert, who sought to shut down the local Medicare office in Kingston, in Hobart, near my electorate office. Due to intense pressure from the local community, and with the support of the member for Franklin, Julie Collins MP, and me, the government backflipped on that and collocated the Medicare-Centrelink office with Service Tasmania. The minister responsible for the office gave a promise that the services offered would be maintained after the collocation. Unfortunately, many people have complained to us about the lack of staff, access, service and privacy in the new location. So Ms Collins and I recently announced a survey—and I encourage any Kingborough or Huon Valley locals with concerns about the collocated Medicare-Centrelink office to come into our electorate offices and have your say through the survey. It is an opportunity to gather feedback about how the new office is operating so we can hold the minister and the Turnbull government to their commitment.

Labor cares about the health of all Tasmanians and Australians. In the recent election campaign, Labor committed to reversing cuts to Medicare bulk-billing incentives for pathology and diagnostic imaging, price hikes to PBS medicines— (Time expired)