16 June 2021

I rise to speak on this matter of public importance on the government's failures on health care, and I thank the member for Hindmarsh for bringing it. I want members to think about two things: universality and equity. People have forgotten, but the Whitlam government introduced Medibank because the commonest cause of bankruptcy in Australia in the 1960s and 1970s was health costs.


Medibank was destroyed by the Fraser government, because they didn't care about the health of the most disadvantaged people in Australia. Subsequently, the Hawke Labor government reintroduced Medicare. I started my private practice in the same week that Medicare became available for all Australians. For the first time, it allowed people access to high-quality medical care in an equitable way, so that people in the most disadvantaged areas could access health care. There was a pay-off in that for the doctors: by bulk-billing people, they didn't have to chase bad debts. So they agreed to have a fee, which at that stage was 85 per cent of the scheduled fee, repaid to them through Medicare payments and to forgo the 15 per cent, which was assumed to be a cost of having to collect bad debts et cetera. Subsequently, Medicare has continued to be attacked by the Liberal-National government whenever they are in power. This government is really just par for the course for Liberal governments.


We know there are huge inequities in health care in Australia. For example, life expectancy at birth for the average Australian born in metropolitan Sydney is 82 to 84 years. In rural areas, it's 78 to 80 years, a significant difference in life expectancy. Yet the National Party and the Liberal Party have done very little to try to change this. We know that health care is worse in outer metropolitan areas.


Access to general practitioners has become almost impossible for many low-income Australians in outer metropolitan areas. I have approached the Minister for Health and Aged Care on several occasions with supporting letters from general practices in my electorate of Macarthur and in other electorates such as Chifley, Werriwa and Macquarie—the outer metropolitan areas—saying they cannot attract general practitioners because of the changes that this government has made to District of Workforce Shortage qualifications. They can't attract general practitioners. I've had patients and their parents approach me saying they couldn't get access to general practitioners. They were having to use their local hospital as their GP because they couldn't get in to see local doctors. This government and this health minister have done nothing about it. He sent a motherhood letter back to me and to those practices, without any active change.


We know also about this latest Medicare review. It was necessary and has been six years in the making. It was headed by some really good people, like Professor Bruce Robinson and Professor Michael Besser, people of my acquaintance. They are really very smart academics and very smart doctors who've done their best to provide a review. Yet there's been no public discussion about these changes.


There has been very little information released even to medical practitioners. As the only medical practitioner in this House with an active Medicare provider number, I've seen very little information about the new changes. There's been no public discussion, and virtually every group that I speak to, from the AMA to the College of Physicians to the College of Surgeons, feels that gap costs are going to be increasing for people to access high-level medical care. This is a disgrace. It's inequitable and it's unfair, at a time when in the last week we have seen published the highest incomes by profession in Australia, where five out of the top six were all medical, with surgeons earning on average $410,000. And I can tell you that, with most surgeons I know, if they're only earning $410,000 they're not really trying. So that has been published, and yet we're going to tell the average Australian that they have to pay more to see their doctor. It is a disgrace. This is the destruction of Medicare by stealth, and there needs to be adequate public discussion of those changes.