Sue Lines (WA, Australian Labor Party) Share this | Link to this | Hansard source

I rise tonight to speak about the GP tax the Abbott government wants to impose—one of the harsh, cruel measures in its recent budget. I particularly want to focus on the effect that imposing a GP tax will have on Aboriginal community controlled health services, and I will focus on those services in Western Australia.

The AMA recently spoke at the National Press Club, where it, too, condemned the government's intention to introduce a GP tax, and it was certainly not for selfish reasons. When fairly conservative bodies like the AMA come out and criticise government, then government surely must realise that its proposals are well and truly on the nose. The AMA said that whilst our universal health system was not without its faults, the president of the AMA said it is 'one of the most efficient and highly performing health systems in the world.' That is an amazing approval rating from GPs and specialists.

The AMA president said:

It is a system that is worthwhile protecting, improving, and investing in for the future.

The AMA say there are key foundation aspects of our health care system, and those go to three key areas, which the AMA say that we as a country must value and guard. The first key function of our health system is that it is a universal system. The second key function is that everyone has access to care. The third key function is that it is affordable, even for those on low incomes.

A GPs ability to bulk bill patients who cannot afford out-of-pocket expenses is an important part of encouraging access to health care. That, again, was one of the planks that the AMA thought was critical—that is, the doctor's ability to choose whether or not to bulk bill the whole practice or some patients in particular.

As the AMA says, the independence of the doctor-patient relationship is sacrosanct. In order for doctors to provide the best care, they must be free to order tests or prescribe a course of treatment, without worrying that patients will not be able to afford the treatment because of the imposition of an additional cost by government. I further quote the AMA president:

The lack of protection for vulnerable patients, and the multiplier effects of pathology and diagnostic imaging co-payments, threaten the universality and affordability for health care for the neediest and the sickest in the community.

This GP tax proposed by the Abbott government goes against the grain of conventional health policy: encouraging people to see their family doctor for measures such as vaccination—although, if you believe what you read in the media, the government seems to be backing away from that—and the monitoring of problems such as the silent killer of hypertension. This GP tax especially jeopardises policies that support the efforts to improve Aboriginal health and to close the gap. It penalises those with chronic disease.

The government's response to questions from Labor about its GP tax would be laughable if only the consequences of the tax were not so dire. The Assistant Minister for Health, Fiona Nash, has repeatedly said in this place, 'It's up to doctors what they charge.' Whilst the assistant minister might fiddle with the truth, there is no doubt that the Abbott government wants to impose a GP tax on patients. If doctors choose not to impose this tax, they lose out on their rebate. The government's ideology to slash and burn Australia's universal health system is a lose-lose deal. If doctors choose not to impose the tax, they lose; if they do impose the tax, patients lose.

It is a difficult decision for health providers to make and one that the Aboriginal Health Council of Western Australia has considered and made a decision about. The Aboriginal Health Council of Western Australia is the peak body for Aboriginal community-controlled health services and it supports 20 services in Western Australia. The council has undertaken an impact and risk assessment on the Commonwealth budget. More recently, the council announced that WA Aboriginal community-controlled health services will not charge their patients the $7 GP tax if it is implemented.

This is a bold and brave move by Aboriginal community-controlled health services, as it represents a $2 million loss in revenue. But they made that brave and bold decision out of concern for their patients and the outcomes for patients. That is what has motivated this tough decision. These WA health services have more than 60,000 registered clients, of which 50,000 are Aboriginal clients. In a year, they undertake over 200,000 clinical appointments and 400,000 occasions of service. That is in just one year, across those 20 WA Aboriginal community-controlled health services. These health services believe that the GP tax will affect their patients. Despite that massive $2 million loss in income that they will suffer by not charging the GP tax, they are going to go ahead and implement that measure in any event.

Aboriginal community-controlled health services are also concerned by the introduction of a new form of checking by the government, which is a new Medicare item number called a MIN. That will be used by the government to track the number of individual visits to doctors. Doctor visits will be tracked, under the Abbott government's GP tax, by the Department of Human Services. Whilst the government may argue that the collection of the number of doctor visits is necessary in order to trigger its 10 doctor visits before the threshold to enable the Medicare rebate to kick in, it is nevertheless an invasion of privacy. Currently, there are no individual doctor visits counted in our health system. This will be the first time that any government will be able to track the number of GP visits individuals make.

I can imagine the Abbott government in a year or two saying, 'Well, there is an overuse of doctors here, because we deem that perhaps 10 visits a year is enough and the minute you get to 15 or 20 somehow the overuse comes in.' Who knows if, into the future, that charge of $7 will creep to $8 and then up to $10? And up and up it goes. In making the decision to not collect the GP tax, these Aboriginal community-controlled health services will lose around $2 million per year based on their current client load. No organisation or association working in health in Australia supports the government's proposed GP tax. What's more, the government—in its usual fashion—has failed to provide any data or research to support its GP tax. Of course, it was either another broken promise or an outright lie by the Abbott government that there would be no cuts to health and no new taxes.

The key theme of the Abbott government's harsh budget has been its attack on those who can least afford it and those who are least able to defend themselves. We know that Aboriginal Australians have poor health outcomes. I would plead with the government that it is time to drop the GP tax. It is a tax on the sick, it is a tax on the poor and it is an attack on our universal health system, which the Australian Medical Association says is one of the most efficient and the best in the world. Let's give our Aboriginal community-controlled health services back their $2 million and not make Aboriginal health outcomes worse in our community.