ADDRESS TO PARLIAMENT - BILLS - Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024

When you sit in the chamber of the House of Representatives in the federal parliament and listen to Dr Mike Freelander, the member for Macarthur, you learn things. I have the utmost respect for the member for Macarthur and certainly thank him for what he has done in his local community as far as health outcomes are concerned. I went on a trip with the good doctor to Papua New Guinea, where we looked at Pacific global health initiatives, and I know that the follow-up we did after that trip was beneficial to one of our closest friends and allies. In fact, Dr Mike is so good he should be the health minister. If he were, I would probably get more signed correspondence from him than I do from the current health minister, the member for Hindmarsh. Of the 29 reps that I've made to the Minister for Health and Aged Care, 28 have been signed by his chief of staff and one by his acting chief of staff. I know that, when I was a minister, when I got a rep from a colleague, from either side of the aisle, I followed it up in person or personally signed the correspondence back to them in most, if not all, cases.

But I appreciate this is a debate on the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024, and I want to take the member for Macarthur up on some of the points that he made. Whilst I agree with him on some of the points that he raised, whilst I respect him always, whilst I appreciate he has probably forgotten more about health than most of us may ever know, I want to take him up on some of the points he made about the years that we were in government. I will start with bulk-billing, which, in Minister Butler's own words, is the 'beating heart of Medicare'. But it has plummeted by 11 per cent since the last election. That is a fact. That is a truism. It has fallen from 88.5 per cent when the coalition left office in May 2022 to 77 per cent under the current health minister. That is such a shame.

Whilst in government, the coalition did the following. I know the member for McArthur said that they were years of dysfunction and neglect. Well, that is not true, because we provided $99.3 million for 80 additional Commonwealth supported places so more students could study medicine at rural campuses. He mentioned National Party seats. Many of those rural campuses are in National Party seats. Sixty-six million dollars was invested to make it easier and more affordable to access Medicare-funded MRI scans in regional, rural and remote Australia from 1 November 2022. That was a big step forward.

There was $36.2 million to establish two university departments of rural health in the South West and Goldfields regions of Western Australia, in Edith Cowan University and Curtin University. I appreciate this is a long way from my electorate of Riverina and a long way from the electorate of Parkes, the seat of my good learned friend who sits supporting me. But I've been to WA many, many times as a member of this place, and, let me tell you, remote health services and outcomes are so important. There was $14.8 million to support Charles Sturt University to deliver a rural clinical school. We were also supporting, when we lost government, the National Rural Health Student Network of rural health clubs with $2.1 million over four years.

This will be interest of the member for Parkes, and I know he knows this very well. An additional $33.3 million—

Mr Perrett: He's fast asleep! What are you talking about?

Mr McCORMACK: The member for Moreton comes in and starts yelling already. He'll get his turn. There was an additional $33.3 million over four years towards a 10-year strategic agreement with the Royal Flying Doctor Service worth almost $1 billion. If there has been a champion of the Royal Flying Doctor Service, it is the member for Parkes. So many of those people who have fallen foul of accidents and farm incidents and needed the Royal Flying Doctor Service have been championing those services, that investment, via the member for Parkes. Certainly his efforts in western New South Wales have been second to none in making sure the right investment is in the right place. And the right investment in the right place has often been with those wonderful people from the RFDS.

In addition, we put $14.3 million towards: expand nursing and allied-health student training in aged care to another five locations in the Northern Territory, Victoria, New South Wales and remote Queensland; incentivise more doctors and nurses to work rurally by eliminating their HELP debts if they worked in rural towns and remote communities; and made telehealth permanent and universal, allowing timely access to health professionals no matter where they lived. That was so important in those worst years of COVID, and telehealth will never, ever—I hope—replace that personal, face-to-face consultations but, let me tell you, it was vital in those years where there wasn't face-to-face contact possible. Getting rural professionals is so difficult, and I appreciate the job that the government has to do. We need to do better and we need to do more, and I implore those regional members of government, particularly if they sit in cabinet, to do more and to be very vocal to make sure that their city friends address these rural health issues.

Upon my appointment as deputy prime minister in February 2018, I secured $95 million for the Murray-Darling Medical Schools Network. That is making such a difference in Wagga Wagga, in Orange, in Dubbo, in Bendigo and in Mildura, because it's making sure the training is done and stays in its regional setting from start to finish. The chances are, if you have a person doing a course in a rural university, particularly medicine, if they start and finish the course in that rural setting, they are 75 per cent more likely to stay in that rural setting because they fall in love with the local community—they might fall in love with somebody in the local community, because they're at that age where they're partnering up. It makes such a difference. To go to the Wagga Wagga Biomedical Sciences Centre recently, where they did the topping-out ceremony, to see the progress made was one of my proudest moments since being elected to this place in 2010. I look forward to the opening later this year.

That's some of what we did in office. Although the coalition support this bill, we are very concerned—as we should be—that the government has stated the bill 'represents more progress on the government's commitment to strengthen Medicare'. It has become clear, all too sadly, that under this Albanese government Medicare has only been weakened. Labor is overseeing a primary healthcare crisis that means it has never been harder or more expensive to see a doctor, and that's simply not good enough. One of the main problems with being able to see a doctor was the fact that the priority areas of distribution of GPs were changed when Labor came to power. Once upon a time, and certainly under the coalition government, those priority areas were considered regional, and in remote areas. Nowadays, Labor have changed it so that a doctor could put his or her shingle up in Newcastle, in Wollongong or in the Gold Coast and claim that priority-area accessibility to get the various incentives that government provides. What that means now is that doctors are less inclined and less likely to want to go and put their shingle up in a remote area where doctors are in short supply. And then we get that insulting comment by our Adelaide minister for health, who says that in a regional centre—or anywhere, for that matter—if you can't get a doctor who is happy to bulk-bill, put the phone down, ring the next doctor and see if they will. That might be all well and good in the leafy suburbs of Adelaide, but I'll tell you what: when you're out in regional Australia, it's not that easy to get a doctor first up, let alone one who will bulk-bill. Certainly, if you get a doctor and get an appointment, you're not going to then quibble about being bulk-billed—you're happy to get that appointment. You can have choice, and you can be fussy if you want, in a metropolitan setting, but you don't have that choice and you can't be that fussy in a regional area where you're lucky to actually have a doctor.

We know how much pharmacists—certainly regional pharmacists—were demonised by this Labor government, by this Labor health minister, who refused to listen to their complaints about 60-day dispensing until they came and sat in the gallery in their white coats and complained bitterly about the lack of funding they were going to receive from this federal government. Yes, of course patients always come first, are always the most important, and chemists realise that and acknowledge it. But when we have 324 country towns in Australia where the only health professional in the vicinity is the pharmacist—they don't have a doctor to speak of—then those pharmacists should be listened to. Thankfully, the minister was dragged kicking and screaming to the Expenditure Review Committee table and finally did something, when he signed the latest pharmacists accord, to make sure that pharmacists were looked after. But it took the Nationals to bring that home. It took the Nationals to make sure that was even considered by this city-centric government.

As I've said, the bulk-billing rates are nothing short of disgraceful. There is a healthcare organisation called Cleanbill. Alarmingly, Cleanbill did what was called their Blue report, an electorate breakdown, which showed that the statistics are completely at odds with what health minister Butler and the Labor government have been trying to peddle—the nonsense that they've been putting out there. Cleanbill's report found that nearly 87 per cent of electorates saw a decline in bulk-billing at general practitioner clinics over the course of 2023. I'm sure the figures aren't any better this year, and we're already into June. All the while, Labor has been pretending that nothing is wrong. We know it is. Those Labor members who are in regional electorates, whilst often they come in here and just read the talking points that have been given to them, know that in their communities there are real issues about accessing a doctor. Whilst this amendment bill is supported, there are real and widening cracks in the health system that are not being addressed by this Labor government.

As I say, bulk-billing has been collapsing since Labor came to office. I appreciate that the bill's amendments will remove some of the current rigid paperwork requirements, to allow for more streamlined processing of MBS bulk-billing claims, particularly for telehealth consults. That's good. Well done! We support those sorts of things. Anything that can cut through bureaucracy and paperwork is to be commended. It will reduce the regulatory and administrative burden for healthcare providers who provide bulk-billed services, for private health insurers and for approved billing agents. Great! But when there are fewer and fewer bulk-billing providers then that is an issue, a major issue. This will ensure that the payment of Medicare benefits is aligned with modern practice, reducing the burden for health professionals. If that goes some way to encouraging people to put their shingle up in regional or remote Australia, that's great. But I doubt it will, because of all the issues that I addressed earlier.

We support these sensible amendments; they'll streamline processes for healthcare providers and private health insurers. But it is so hard. I have a situation in the north of my electorate, at Parkes, where the mayor, Neil Westcott, tells me they haven't had a birth in the town in five years. I appreciate that this isn't just a federal responsibility and that state public hospital issues come into play. But Parkes is a town of 12,000 people, and Parkes deserves better. I've certainly written to the health minister. I've written to the Assistant Minister for Rural and Regional Health, Emma McBride, whom I also have a great amount of respect for. She comes to this place as a pharmacist. What we want to see is better and more health services for our regional communities, certainly in a town the size of Parkes. When a town the size of Parkes, which has 12,000 people, doesn't have obstetrics and maternity services, there's something really wrong. I commend the bill to the House.