Senate debates

Tuesday, 25 March 2014

Adjournment

Health Funding

10:14 pm

Photo of Deborah O'NeillDeborah O'Neill (NSW, Australian Labor Party) Share this | | Hansard source

I rise to speak on a matter that I consider to be of national interest—it is certainly something that excites me whatever time of day it might be—and respond to Minister Peter Dutton's call for a national conversation on the future of funding for Medicare and public health care in Australia. The very nature of conversations is that there are participants—listeners and speakers—and both feel empowered. Labor historically has always been very happy to engage in a conversation about the provision of decent public health care. In fact, if we were to identify historically who has been the initiator of those conversations, I think it is fair to claim that it is Labor who has said we need to talk about this, to discuss this issue and to make sure that the provision of medical services for the Australian population is at the forefront of our conversations. Of course, there is no better testament to the initiation and delivery of that conversation than the establishment of Medicare and its re-establishment after it came under considerable threat from other participants in the conversation who thought it was not of such importance.

Building and supporting our public healthcare network is essential Labor DNA and central to our very being as a party. We stand proudly on our record. From Medibank to Medicare and to the National Disability Insurance Scheme, which we initiated in the 43rd Parliament, Labor has delivered and expanded our public healthcare system to provide for all Australians. To Labor, universal public health care is an inalienable right, not a privilege to be whittled away or denied to those who are unable to afford it. Regardless of one's age, gender, wealth, ability or locality, access to a decent universal public health system is a core principle of Labor. It is a principle that we fought long and hard for—to establish, expand and deliver—and we fought harder still to protect it from the many attacks from those opposite, who have sought on too many occasions to dismantle or wind back access to health care.

In case Mr Dutton has been living in an alternative universe for the last 40 years—which, considering his tin-eared approach to public health funding, cannot be completely ruled out—our nation has long been engaged in a national conversation. This is nothing new. We have been talking constantly on this side of the chamber about the public funding of health care and the future funding of health care as the needs of Australians emerge and change. Ever since Gough Whitlam called a double dissolution election to pass Labor's Medibank reforms in the face of intransigent Liberal opposition, this conversation on medical care and access to medical support has for decades underlined one of the clearest policy contrasts between Labor and those who now abide on the government benches.

Put simply, Labor believes in delivering, expanding and protecting universal public health care to provide for all Australians—the young and the old, the rich and the poor, the city dwellers and the regional and remote citizens of this country. Under Labor, public health care is expanded, and funding is generally increased, to the benefit of all Australians. The coalition on the other hand have proven time and time again that they have a very different view of the way access to health care should operate. They have, in my view, complete disdain for the adequate provision of universal public health care in this country. We would have to see the enactment of the policies of those opposite as a reflection of their belief that health care is a privilege and that one's means appropriately determine access to decent health care, rather than one's needs determining one's access and the response that one receives.

History provides countless examples of this Liberal Party war on public health care. The coalition's shameful record in the area of health speaks for itself. It is that history we need to remember to inform the debate that is underway in this country right now. The Liberal Party enjoys notoriety for dismantling Australia's first universal public health care system, known as Medibank. For those who might be listening to this broadcast—there are precious few citizens here in the chamber to observe it at this time of night—the reality is that we have taken it for granted for the last 40 years that people have easy access to public health care. But it was not always that way. Despite the fact that the universal public healthcare system has been around for a long time, being able to go to your GP and access Medicare is unique to Australia and was formed in a particular way in Australia.

The dismantling of our universal public healthcare system, originally known as Medibank, by the Liberal Party is a very clear indication of the very different policy stands our two parties have on access to health. We on this side call it an act of policy vandalism. Australia is currently celebrating 30 years of health care but we should be celebrating 40 years. We were robbed of 10 years of health care because of the Liberal Party's decision to dismantle it. The vote against Medicare in 1983 and then the attempt to abolish bulk-billing in 1993 revealed that the Liberal Party is a party that cuts and decreases access to health care for Australians no matter where you live.

When Tony Abbott was health minister he cut $1 billion from public hospitals, broke a 'rock solid, ironclad guarantee' not to raise the Medicare safety net threshold and placed caps on GP training places, which resulted in 60 per cent of the country facing health workforce shortages. It was into that climate that the Labor government came and made massive investments in the training of young Australians to fill the positions in the healthcare sector—nurses, doctors and allied healthcare professionals who are now at the point of completing their studies and moving into the healthcare sector. That was Labor's vision and Labor's investment. It was Labor who provided the workforce that is now being celebrated right around this country in regional newspapers, as Liberal members from state to state across this country welcome the product of Labor's vision and investment in a proper and well-prepared health workforce.

But, despite all that and despite the celebration of the outcomes of Labor's visionary investment in health, we have Minister Dutton sitting on a commission of cuts, hiding the Liberals' sinister plan to impose a tax on people just to see their local GP. That is on top of Minister Dutton's already flagged intentions to savagely cut from the health budget by abolishing key primary healthcare services, such as Medicare Locals and GP superclinics. I want to make some more remarks about those two amazing Labor policy initiatives, which were enacted in the last parliament, which have changed the way people access health right across this nation and which have improved health access and outcomes. Our focus needs to be on outcomes and the delivery of better health for Australians. Surely that is core business for any Australian government. But, sadly, it seems not for the Liberal Party, and it is certainly not part of the conversation that we are hearing about public health care. Rather than hearing bold and visionary statements about the health of Australians, we have heard about more miserly cutting, more shutting down and more arrogant dismissal of requests for a revelation of the cuts that seem to be on the horizon.

I want to make the point at this late hour that the Liberals cannot be trusted with our healthcare system. Many local residents in my community are extremely concerned about the impending cuts the Abbott government has planned for local public healthcare services. In particular, they are worried about how it will affect the things that were instituted under the last Labor government. They are worried about our GP superclinic at West Gosford. They are worried about our Central Coast Medicare Local. These things delivered under Labor have transformed people's experience of and access to public health. The GP superclinics and Medicare Locals are two signature health policies that were implemented in the 43rd Parliament. They built on and expanded Labor's universal healthcare system by providing specialist services that are closer to home and which do critical things. They deliver primary and preventative health care. The Gosford GP superclinic provides extended hours services and is also able to offer bulk-billing. So instead of people waiting until they get to an acute stage where they have to be admitted to hospital they can get health care at an earlier stage of their illness when the early onset of symptoms emerge.

Medicare Locals are able to audit the local community and look at acute health problems that exist, both systemic and practical, and deal with these local issues in powerful ways that respond to local problems with local solutions. It is a way of using the expertise of local leaders in the medical sector to create responses to problems that have just been left unattended for too long. To make these things happen requires not only a certain degree of goodwill, good intent, capacity and vision but also money. Labor delivered over $528 million towards the GP Super Clinic Program. Sixty-four superclinics were established nationwide. These were targeted at areas most in need of additional specialist and extended hours services. The Central Coast superclinic was certainly one of those.

With the Labor Party committing over $7 million towards the Gosford GP superclinic we had a truly amazing outcome. I would like to put on the record the way in which our GP superclinic, run by Dr Rod Beckwith, and an amazing team of specialists and allied health professionals in the areas of chiropractic, pathology and radiology, as well as exercise physiologists, are providing a one-stop health shop for people.

We have discussed our own families on a number of occasions, Madam Acting Deputy President Boyce, when we were jointly looking after the Parliamentary Joint Committee on Corporations and Financial Services. However, I want to put on the record that my son, Noah, who is 17 and doing the HSC this year in New South Wales, has been very healthy for most of his life, thank goodness. We have had great service at the surgery in Terrigal. Dr Little and Dr Evershed, who is now retired, have been our primary doctors; they are great practitioners.

Recently, on a day when we were unable to get an appointment at the Terrigal surgery, we took the opportunity to take Noah to the GP superclinic. It was a novel experience for him to actually go into a surgery where he was able to show up without making an appointment and to be slotted in for an appointment with a doctor. There were multiple doctors on duty that day. He was able to meet a recently graduated young Australian doctor, trained under the funds delivered by the Gillard government. He received excellent service. He had his concerns addressed and he was able to walk out without having to make a significant payment. His whole expression of this experience was quite powerful. What did he learn from it? I actually asked him—and you would understand, Madam Acting Deputy President, why I as a former teacher might ask questions like that which, to some degree, probably annoy my children—'What did you learn from this experience, Noah?' His response was, 'I didn't realise that, if I was sick, I could just go to the doctor's if I didn't have money.' It made me realise that he had become so accustomed to fee-with-service through the great doctors we have at Terrigal that he did not think that he could go to a doctor if he were sick and did not have any money. But he can now—and he knows that he can do that at the GP superclinic at Gosford. For a commuting community like that of the Central Coast, such a clinic is extremely important. It provides access to a GP at hours commuters are able to take advantage of, enabling them to engage in consultations that prevent ill health. Over 80 per cent of people visit their GP at least once a year. That highlights for us all the importance of ensuring easy access to GPs.

Lack of access to adequate care, especially after-hours care, is one of the contributing factors to avoidable visits to emergency departments. This is one of the problems we faced on the Central Coast. There have been so many cuts to hospital funding by the state Liberal government—$3 billion was cut from the New South Wales health budget alone—that there is more pressure on our hospitals than ever before. People are using the Gosford GP superclinic as their first option rather than going to the emergency ward. This is a fantastic outcome not only for the people who are getting primary care for low-level needs but for local people with genuinely acute problems—by creating space for them to get the service they need at Gosford Hospital.

This superclinic forms a central part of building a very strong primary healthcare system on the Central Coast with a strong emphasis on chronic diseases and preventative health. In the first weekend the GP superclinic was open, there were 20 patients who went to that service instead of going to Gosford Hospital's emergency department. I took the opportunity to do a little research on a recent visit to the emergency department myself. The anecdotal testimony of staff there confirmed that incredible pressure was being taken off Gosford Hospital by the provision of the GP superclinic—a superclinic provided, with vision, by the Labor government,

GP superclinics benefit communities. They ensure the right health care is available to help people get healthy and stay healthy. They take pressure off emergency departments. They provide opportunities for high-quality training. This is an important consideration. In the last parliament, one of the research projects undertaken by the health committee was to understand the burden of training that has arisen as a consequence of the Labor government's investment in getting people into universities. We need places for our young GPs to learn. This Gosford GP superclinic has provided a powerful learning opportunity for young people emerging from their first phase of study as doctors.

Medicare Locals are a key component of the previous Labor government's expansion of the scope and delivery of accessible public health care. There are 61 Medicare Locals across this country. They service every region and they are there to reduce secondary healthcare costs and prevent hospital admissions. We are finding that they are working very powerfully to identify specific localised community needs and to develop localised and tailored programs to meet those needs.

One of the programs that are operating through the Medicare Locals—certainly on the Central Coast—is Labor's Partners in Recovery program, which received $6.5 million in funding. This support is desperately needed by families and carers who are looking after somebody with a chronic, long-term mental illness—people who need wraparound care. We are not just talking here about front-line services. Front-line services delivering medical care to people with mental health problems are a wonderful part of a whole treatment regime. But wraparound care includes things like access to housing and support with social services—these things need to be provided. They can only be provided when there is a considered, localised, full response.

There are threats to Partners in Recovery and there are threats here in Australia in the 21st century to what we consider to be a right—access to ordinary health care. These threats are very real. Public funding for health is robust and sustainable, underpinned by a Medicare levy paid by eligible taxpayers. The Australian people will ultimately reject any cynical attempt to wind back our public healthcare system.