Hospital Emergency Departments
Ms BURNEY: My question without notice is directed to the Minister for Health. What is the Government's response to the increase in the number of visits to hospital emergency departments?
Mr IEMMA: New South Wales has an outstanding network of emergency departments. The staff are among the best in the world. Demand in our emergency departments has never been higher. Last year, for the first time, 2 million people presented at New South Wales emergency departments compared with 1.8 million in 2000-01 and 1.6 million in 1996-97.
Mr SPEAKER: Order! I call the honourable member for Lane Cove to order.
Mr IEMMA: Our emergency departments are coping with this massive workload. However, the proposed changes by the Commonwealth to both Medicare and the health care agreement will only increase pressure on our emergency departments and hospitals. Two weeks ago the Prime Minister announced proposed changes to general practitioner [GP] services as part of the so-called Medicare package. Last Friday the Federal Minister for Health and Ageing, Kaye Patterson, provided the detail for the new Commonwealth health agreement. I regret to advise the House that the detail revealed last week shows that the Commonwealth has decided to pay for the $974 million GP package announced two weeks ago by taking $1 billion out of our public hospital system.
Mr SPEAKER: Order! I call the honourable member for Lane Cove to order for the second time.
Mr IEMMA: Friday's meeting revealed clearly and unequivocally that the Commonwealth Government is in the process of dismantling Medicare.
Mr Debnam: It was in the Sydney Morning Herald, too.
Mr IEMMA: Yes, absolutely. I wish the honourable member had looked at this morning's poll. Medicare rests on the principle of universal access. For a very long time it has guaranteed the Australian people three basic things: free health care in the public hospital system; subsidised visits to general practitioners and specialist medical services; and access to free or subsidised medicines. Following the plan outlined by Senator Patterson on Friday, it is clear that these principles are in the process of being abolished. The Commonwealth proposal will make it harder for middle Australia to access basic medical health care.
First, the package will result in a decline in GP bulk billing, which will affect up to 4.3 people in New South Wales; second, it will increase the cost of basic health care for middle Australia, as GP and specialist fees rise for people who do not have health care cards; and, third and most importantly, it will place further pressure on our public hospital system. Many people who cannot afford higher GP fees will seek basic treatment from emergency departments at public hospitals. Already one in five people attend emergency departments for basic GP-type services. For example, last financial year 9,000 people went to emergency departments for treatment of coughs, colds and sore throats; 2,800 attended for treatment of earaches; and 900 attended for treatment of ear wax. The decline in bulk billing will make this position much worse. Instead of an increased schedule fee for all general practitioners the Commonwealth Government will pay an incentive only to those GPs who bulk bill health cardholders and pension cardholders.
Medicare will become a system of health care only for people who hold a pension card or a health care card. Doctors will be free to charge what they like for everyone else. In other words, this marks the end of bulk billing, and the commencement of a two-tier health care system. It is time that the Prime Minister admitted what millions of Australians already know, that is, that they will be paying more for health care services that previously they received free. The people who will pay the most will be middle income Australians—people such as the Finos family who live at Mortdale in Sydney's south in the Georges River electorate. Mr Finos earns approximately $65,000 a year by working in a suburban bank. He is married with three children aged three years, two years and one week respectively. His wife has been a full-time carer since the birth of the couple's first child. On average, each of the children visits the local GP once a month.
Mr Hartcher: Point of order: I draw attention to Standing Order 137 (5), which states:
Questions cannot anticipate discussion upon an Order of the Day or other matter.
The House has been given notice of an urgent motion by the honourable member for Kiama on the very subject that the Minister is now addressing in his answer. I draw attention to Standing Order 137 subparagraph 5. The Minister's answer contravenes the standing orders. Mr Speaker, you should rule the answer out of order.
Mr Scully: To the point of order: It is no wonder that the honourable member for Gosford does not look after the Opposition's business in the House. The House has not yet determined which urgent motion will come before the House and then becomes the business of the House. Therefore the answer is not anticipating debate.
Mr SPEAKER: Order! The Leader of the House is entirely correct.
Mr Hartcher: How did we know that that would be your ruling?
Mr SPEAKER: Because it is in accordance with the standing orders. Notice has been given of two urgent motions, but the House has not determined which motion will be debated. There is no point of order.
Mr IEMMA: For the Finos family and other ordinary families like them, the changes will mean that they will be out of pocket by between $700 and $1,100 a year based on an average of between 35 and 45 visits to their local GP. That is a huge slug for them but it is also a huge slug for our hospital emergency departments. This will mean longer waiting times in emergency departments and more stress on nurses and doctors. Amazingly, last Friday Senator Patterson asserted that emergency departments in public hospitals are not as busy as people think. Even worse was the funding formula that was revealed on the same day for the new health care agreement for our hospitals. It asserts that emergency departments and hospitals are not as busy as all people know them to be and official figures show them to be. The Commonwealth intends to pay for the GP package, which it announced two weeks ago, by ripping more than $1 billion out of the public hospitals system.
General practitioners should be paid more, and the Commonwealth should live up to its responsibility and pay them all by increasing the scheduled fee. However an increase in the scheduled fee should not be paid at the expense of the public hospital system. I will provide additional figures that indicate just how busy our public hospitals are.
Mr Brogden: What about the code reds?
Mr IEMMA: The Leader of the Opposition should continue to listen. Our emergency department network access system monitors hospital capacity across the Sydney metropolitan area. Code green means that the hospital is managing its patient workload comfortably. At the other end of the activity scale is code red. The system has been devised by a group of clinicians, including Dr Tony O'Connell who is Chair of the New South Wales Critical Care Council. When a hospital goes on code red, it requires ambulances to access other hospitals, except for life-threatening cases. In March, I announced figures on emergency departments in our hospitals. The six busiest emergency departments had the following periods on code red: St Vincent's, 240 hours; Westmead, 171 hours; Campbelltown, 170 hours; Liverpool, 111 hours; Royal Prince Alfred hospital, 109 hours; and Prince of Wales hospital, 102 hours.
Mr SPEAKER: Order! There is too much conversation on the Opposition frontbench.
Mr IEMMA: That does not mean that these emergency departments are closed. Emergency departments never close. It simply means that that ambulance cases that were not life threatening were directed to the next appropriate hospital. Thankfully the network system that is in place ensures that we can best utilise available emergency department capacity. But the Federal Government’s proposals will make that job even more difficult. The fact is that the Commonwealth's proposal fails to keep pace with increased health care costs, which are rising at approximately 8 per cent per annum. The Commonwealth's proposal of just over 5 per cent represents a massive $1 billion in funding that will be taken out of our hospital system—something that the Prime Minister did not reveal two weeks ago when he made the big announcement of $42 billion that supposedly was on the table.
When Senator Patterson explained the detail on Friday, it was revealed that under the proposal, $1 billion would be taken out of the new agreement for the public hospitals system. The funding arrangement is based on the false premise that our hospitals are not as busy as people think, despite the reality that they are as busy as everybody knows them to be. Our public hospitals system needs the Commonwealth to pay its fair share. The State Government pays $1.60 for every single dollar of Commonwealth funding. It is time that the Commonwealth Government paid its fair share to support our public hospital system.