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- 3 September 2003
Central Coast Doctors Bulk-Billing
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Page: 3078
Ms ANDREWS: My question is directed—
Mr SPEAKER: Order! I cannot hear the question. Members will remain silent.
Ms ANDREWS: My question is directed to the Minister for Health. What is the Government's response to the decline in the number of doctors bulk-billing on the Central Coast?
Mr IEMMA: I thank the honourable member for Peats for that question, for her contribution to this debate and for her efforts in her community to stop John Howard killing Medicare. The honourable member collected 1,000 signatures for a petition on this topic that has been presented to the House. It is interesting to note that the latest national data on general practitioner [GP] bulk-billing rates for the month of June was presented at the end of last week's meeting in Canberra between the Prime Minister and the Premiers. It is no wonder the Commonwealth sat on that data for a considerable time because it shows how much John Howard and Peter Costello are killing Medicare. The latest data reveals that bulk-billing rates have plunged from 74 per cent in June 2002 to just over 68.5 per cent in June 2003. That is a fall of 5.5 per cent, which is equivalent to a reduction of about five million bulk-billed services. This morning's edition of the Sydney Morning Herald highlights this issue in an article which states:
Patients in electorates with low incomes are significantly more likely to have to pay their doctors extra than those on average incomes …
The new Health Insurance Commission figures released last Friday reveal what Australian families across the country already know: The average payment to see a non-bulk-billing GP has risen to an all-time high of $13.24 per consultation. We have all seen the recent reports about out-of-pocket payments of up to $100, which are not uncommon. This is John Howard's version of a fairer Medicare. Every time John Howard talks about throwing Medicare a lifeline he throws it an anchor. These figures illustrate clearly the slow, inevitable death of bulk-billing and Medicare. Peter Costello and John Howard simply do not care. They are not interested in having a fairer health care system and they are certainly not interested in enshrining the principles of Medicare—universal and fair access to basic medical treatment—in our health care system.
Dr Bill Glasson, President of the Australian Medical Association, said recently that we need an extra 3,000 GPs to try to arrest the crisis in Medicare, bulk-billing and GP medical care. However, we saw nothing on Friday that will reform our health care system. Those opposite should not come to this place and cry crocodile tears about health. They had their chance in the past few months, and certainly last Friday, to call John Howard and tell him to do the right thing for public hospitals in New South Wales. Instead we got from the Leader of the Opposition the two responses that we always get from him. First, he never tells us where he will get the dollars to boost hospital resources in this State; and, secondly, he never uses his influence with John Howard to help New South Wales families and our hospital system.
We have only to look to the Central Coast to see the crisis that John Howard and Peter Costello have caused in Medicare and our health care system. In the past decade the population on the Central Coast has increased by 19 per cent but the number of general practitioners has declined by 17 per cent. In fact, general practitioner numbers on the Central Coast have declined to 253 from 310. In places such as San Remo, Blue Haven and Charmhaven—which are home to more than 6,000 people—there are no GP practices at all. We have heard about the public meetings at places such as San Remo at which members of the public tell how people on the Central Coast looking for a bulk-billing family doctor are travelling to Sydney to find one because there are not too many left in their local area.
A survey of 69 practices found that only 7 per cent of them fully bulk-bill. Let us consider the bulk-billing rates in the Federal electorate of Robertson: In 2001 bulk-billing was at 77 per cent but the latest available figures reveal that bulk-billing has dropped to 59.8 per cent. That is only one electorate; it is worse elsewhere. In Dobell—the Federal member for Dobell has had a few things to say about health in the past couple of weeks—bulk-billing stood at 86 per cent in 2001 but the latest figures show that it has declined 56 per cent. But how did the member for Dobell respond?
Mr McBride: What's his name?
Mr IEMMA: His name is Ken Ticehurst—he signs his letters "Ken". He has also been crying crocodile tears about health. Ken sent a letter to his constituents crying crocodile tears about the Commonwealth, State and Territory health agreement and hospitals. He urged his constituents to sign on the back of the letter another letter addressed to the Premier, attempting to deflect criticism about the Commonwealth-State and Territory health agreement onto the State Government. Ken generously told his constituents that the Commonwealth was offering such a good deal that New South Wales stood to lose $1.1 billion. You got that one absolutely right, Ken! He urged his constituents to send the letters to the New South Wales Premier, expressing their concerns about how the New South Wales Government was delaying signing that generous agreement that will cost us $1.1 billion. Good letter, Ken! Ken got some responses, and I will read out just one. The letter states:
We are both pensioners and the doctors across the road have stopped bulk billing. It now costs an extra $10 per visit. Can anything be done about it?
That letter is from Ken's constituents Mr and Mrs Hackenberg of Bateau Bay. Something certainly can be done. John Howard told us on Friday why we could not have a 12-month rollover of the existing health agreement. He said, "There's no way we'll have a one-year extension and an examination of the health care agreement and get on with the reform agenda because we're going to have an election in 12 months." So I have an answer for Ken's constituents who have asked whether anything can be done. Something certainly can be done, and Ken's constituents in Dobell should remember that when they go to the ballot box in 12 months.
John Howard and Peter Costello will begin to understand and care only when Ken Ticehurst's constituents begin to make him care about the fact that bulk-billing in Dobell has dropped from 86 per cent to 56 per cent. That is the kind of message that Kay Patterson, accompanied by Ken and no doubt the member for Robertson, is getting today on the Central Coast. If they do not believe their own figures, today they will hear first-hand from doctors such as Tim Armitage, a general practitioner who shares a practice at Point Clare. In a Central Coast newspaper this morning Dr Armitage said:
I think there is an overall shortage of general practitioners on the Central Coast, and the problem has to be addressed—
Absolutely. He continues—
The financial returns are not good. There are no financial incentives.
That is interesting because in April John Howard announced $918 million worth of financial incentives. The details showed that between $1 and $3 would supposedly rescue Medicare. Dr Armitage is right, because John Howard and Peter Costello will not give doctors financial incentives to keep . Dr Armitage correctly said in that article:
The future is looking pretty bleak for GPs.
The future is also looking pretty bleak for Ken Ticehurst in Dobell.
Mr Orkopoulos: A oncer!
Mr IEMMA: That is right, a oncer when they get the chance in 12 months time. Dr Armitage and all his colleagues on the Central Coast and in the Central Coast Division of General Practice are giving Kay Patterson and, no doubt, Ken Ticehurst and his constituents the message today. It is the collapse of bulk-billing and Medicare that is driving some of the pressures on our public hospitals. During the past three months we attempted to convince John Howard, Peter Costello and Kay Patterson that our hospitals deserve more support. We tried to convince them that it was worth extending a good model just to the north of Dobell where the State, along with the general divisions of practice in the Hunter, is establishing the kind of reform that our health care system badly needs. But on Friday John Howard and Peter Costello turned their backs.
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