Federal Health Care Funding

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Speakers - Pezzutti The Hon Dr Brian
Business -

FEDERAL HEALTH CARE FUNDING

The Hon. Dr B. P. V. PEZZUTTI [4.4]: I move:

That this House condemns the Keating Labor Government's lack of support for general medical practice and the health care of the people of New South Wales.

It is obvious to everyone that there has been a decline in the nature of general practice in New South Wales, for many reasons. First and foremost among those reasons are that patient rebates for general practitioners paid by Medicare have been declining in real terms since its introduction in 1982. General practice has become a dumping ground for a large number of practitioners entering the system who are trained overseas. There will be more foreign doctors registered in Australia after passing the Australian Medical Council's examinations than there will be graduates from our medical schools in a single year. That gives some idea of the number of overseas graduates who are entering the medical work force every year. Everyone from Mr Howard down recognises that the biggest problem in this country is that there are far too many doctors, and of course that has led to an oversupply of doctors at the general practice level.

The Hon. J. R. Johnson: Not in country areas.

The Hon. Dr B. P. V. PEZZUTTI: The Hon. Johnno Johnson says, "Not in country areas". I should like him to indicate to me where in New South Wales there is a shortage of general practitioners.

The Hon. R. S. L. Jones: Tibooburra.

The Hon. Dr B. P. V. PEZZUTTI: The Hon. R. S. L. Jones suggests Tibooburra. That, of course, is just a stab in the dark, because it is not true. Two areas are still looking for general practitioners, but Tibooburra is not one of them. The problem is that under the enormous pressure of there being too many doctors and the rebate being far too low, there is pressure to bulk bill patients and reduce the time spent with patients if a general practitioner is to remain economically viable. That has led to patients moving through the surgery too quickly and to doctors too often seeing patients with a single disease. This has inevitably led to doctors practising a lower standard of medicine because it is not viable to practise under those circumstances and produce a higher standard. Of course, it is easy to provide a higher standard if patients are able to pay for a reasonable consultation, and so in the more affluent suburbs -

The Hon. J. R. Johnson: Doctors have never been better off. They are guaranteed their money.

The Hon. Dr B. P. V. PEZZUTTI: The Hon. Johnno Johnson says that doctors have never been better off and that they are guaranteed their money. Are there any other pearls of wisdom that I can put on to the record for the honourable member?

The Hon. J. R. Johnson: You do not have to put my wisdom on the record. Put your own.

The Hon. Dr B. P. V. PEZZUTTI: Good. The Hon. Johnno Johnson says doctors have never had it so good, but general practice in this country has
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never been so much under threat.

The Hon. J. R. Johnson: They get paid for every patient now.

The Hon. Dr B. P. V. PEZZUTTI: Here we go. Labor has supported the growth of entrepreneurial clinics as part of its policy. Let us have a bit of the old supermarket clinic where one drops in to receive treatment for a cold, hopes the visit is short, out comes the credit card, it is whipped through the EFTPOS system, one pays the bill and out one goes. This is the new form of supermarket medicine. Having too many doctors and lowering the price per service brings high economic change to medicine. Where is the money in groceries these days? Coles supermarket is making big profits at the moment, the largest profits it has ever made - supermarket vegetables. The service levels in those supermarkets have dropped dramatically. The Hon. J. R. Johnson was a member of the Shop Distributive and Allied Employees Association, and service was the byline of his membership.

The Hon. J. R. Johnson: And still is.

The Hon. Dr B. P. V. PEZZUTTI: And still is. But there are far fewer quality unionists in the business. If you go into any shop these days, you cannot get proper service or advice from a properly trained person in the retail area. You pick up an item from the shelf yourself, you see what it costs, you have a look to see if the expiry date is all right, you go to a counter and usually a young woman passes it over the machine that tells the price, it goes on the computer and she tells you how much it all cost. The level of service in supermarkets with union membership has dropped dramatically and people are not happy about it.

Employees do not have the opportunity to provide service, because of the economic changes; there is no opportunity for them to help their customers. When was the last time the honourable member saw a frail 85-year-old person in a supermarket given assistance, perhaps when trying to get something from the top shelf? They usually ask another shopper to get it for them. I have done it myself.

The Federal Labor Government encouraged the growth of entrepreneurial medical clinics; clinics owned by non-medical people providing medical services. One of the best examples was the great friend of the Labor Party, Dr Edelsten. Despite clear evidence of fraudulent activity being presented to the Health Insurance Commission, he has never been charged under any Commonwealth Act. All the offences that he has been successfully prosecuted for here and in Victoria were under the Medical Practice Act of each State. Not once has this man, who plainly has been fraudulent, who plainly has been an associate of criminals, and who plainly was found to have had a problem with the law, been caught by the HIC - because he helped the Labor Government deliver a lower quality of medicine and a lower price.

Debate adjourned on motion by the Hon. Dr B. P. V. Pezzutti.

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