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- 18 November 2003
Bulk-Billing
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Ms NOREEN HAY: My question without notice is addressed to the Minister for Health. What is the latest information on the decline in bulk-billing and the provision of health services in New South Wales?
Mr MORRIS IEMMA: The honourable member for Wollongong has asked an important question. Last Friday the September quarter bulk-billing figures were released. They highlighted yet again the plunge in the availability of bulk-billing general practitioner [GP] services in New South Wales. That is why the Commonwealth has been forced to revisit its package, leading to today's announcement, which I will come to in a moment. The September 2003 quarter for bulk-billing showed just 67.4 per cent of GP services being bulk-billed nationally. This was down from 68.5 per cent for the June quarter and a drop from 71.2 per cent just four months ago. This is the lowest national figure for bulk-billing in 14 years. That is why the States have, ever since the first package in April, always insisted that it simply was not enough. Along with the decline of bulk-billing we have seen, for example, chronic shortages of GPs on the Central Coast.
Mr Chris Hartcher: And nurses, and Ambulance Service support staff. They are all short and you are doing nothing about it.
Mr MORRIS IEMMA: The honourable member for Gosford might be referring to Ken Ticehurst, the Federal member for Dobell. He was the one who sent out that survey to his constituents saying, "Write to Bob Carr about the state of Gosford and Wyong hospitals." They all wrote back saying, "Hang on a second, no doctor on the Central Coast bulk-bills anymore. Can you help us, Ken?" Yes, we all remember Ken Ticehurst. The Commonwealth response in April was the first Medicare package: a $918 million package designed to try to improve bulk-billing. The funding for that Medicare package in April was taken straight out of the health care agreement for our hospitals. That package was to be funded by a cut to our public hospitals.
That was the first attempt by the hapless former Minister Kay Patterson. Throughout all of the debate that took place over the next four months, we heard not one word from the Opposition and we saw not one act in support of the State of New South Wales as we all went about the job of trying to get a fairer funding deal for our hospitals. The Opposition never said a word, never took any action—not even a phone call to John Howard or Peter Costello telling them that they should put more money into the health care agreement as more support for our public hospitals.
Since April we have seen the continued collapse of bulk-billing and the Commonwealth's refusal—the refusal of Peter Costello, John Howard and Kay Patterson—to face up to the facts. Bulk-billing is in crisis and Medicare is slowly dying. Urgent action needs to be taken to restore universality to Medicare, to restore bulk-billing, to take pressure off our public hospitals and to have those measures funded by extra money, not by taking the money out of the health care agreement, out of our public hospitals. A health care agreement was forced on the States. Everybody signed because they had to, not because they wanted to. The penalties for not signing were too great and, with a gun held at every State's head, no-one could afford not to sign up.
We now have a new health Minister. The hapless Kay Patterson has gone and Tony Abbot has arrived. He has a clear understanding of the areas that need reform—and bulk-billing is one but not the only area of reform—and a genuine desire to make changes. Today we have seen the next instalment: fairer Medicare mark two or, as he has called it, MedicarePlus. What was announced today is a vast improvement on what Kay Patterson and John Howard trotted out back in April. Tony Abbott's first effort is a vast improvement, but it does not solve the problem; more needs to be done. But it is an improvement.
As I said last week, at the State level we want Tony Abbott to succeed. We want this package to succeed. If the Federal Government is fair dinkum, it will get 100 per cent support from me. If the Federal Government is fair dinkum and continues on this path, it will get 100 per cent support from us. Returning the rates of bulk-billing is one leg of the table. Other areas also need improvement. Peter Costello and John Howard have to revisit the funding formula that is the basis of the five-year health care agreement. They have to put more resources into our public hospitals, not less. The work force initiatives announced today are a vast improvement. The initiatives announced as part of today's Medicare package are also a vast improvement on what was announced in April, a vast improvement on New South Wales getting only a miserable extra 50 nursing places over the next four years.
Mr SPEAKER: Order! The honourable member for Willoughby will come to order. There is too much audible conversation on both Government and Opposition benches.
Mr MORRIS IEMMA: The challenge for the Commonwealth is this: if it can fund 1,600 nursing positions for general practice then it can fund an equivalent amount of places through our universities so that we get 1,600 extra nurses into our hospitals.
Mr SPEAKER: Order! I call the honourable member for Wakehurst to order.
Mr MORRIS IEMMA: If the Commonwealth can fund 1,600 nurses for general practice—
[Interruption]
Opposition members do not want to hear this because they simply do not want to pick up the phone to John Howard and say, "You have got to do more."
Mr SPEAKER: Order! I call the honourable member for Davidson to order.
Mr MORRIS IEMMA: The Commonwealth gets a big tick for 1,600 nursing positions for general practice, but if it can do that for general practice, it can do it for the hospitals, and it ought to be doing it for the hospitals. That is the message. That is the challenge for Tony Abbott.
Mr Chris Hartcher: Point of order: Mr Speaker, may I invite you to follow the rulings of your predecessor, Speaker Murray, when answers have gone on too long, as this has now for 11 minutes, and invite the Minister to draw his answer to a conclusion. Speaker Murray was following the rulings of Speaker Rozzoli. You have an excellent opportunity to walk in the footsteps of Speaker Murray, one of this House's great Speakers. I invite you to follow him.
Mr SPEAKER: Order! The honourable member for Gosford will resume his seat. There is no point of order. The honourable member seems to be better at speaking than he is at mathematics, because my detailed calculation shows that the Minister for Health spoke for nothing like 11 minutes. Has the Minister completed his response?
Mr MORRIS IEMMA: Yes, I have.
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