Questions Without Notice: Medicare cuts

My question without notice is to Senator Nash, the Minister representing the Minister for Health. I refer the National Party assistant health minister to the government's proposed $650 million cuts to Medicare bulk-billing rates.

I note that respected Tasmanian health professionals like scientist Richard Hanlon have warned that the effect on patients will be quite significant because it will discourage patients from going to their doctors, patients may pay up to a $30 co-payment and it has the potential to stop patients from testing for chronic diseases like diabetes and undertaking pap smears for women's cancers. It will remove a 10-year focus on primary health care so that hospitals in the future will become inundated, and cancers and diabetes will not be seen until it is too late.

Can the assistant minister produce studies or modelling which prove Tasmanian medical scientist Richard Hanlon is wrong?

Senator Nash: I am not aware of the comments that the senator referred to at the end of her question, so I cannot respond directly to those. I am assuming that the senator is referring to changes to the bulk-billing incentive payment for pathology and diagnostic imagining. I think it is very important for the Senate to note that since 2009 half a billion dollars, around $500 million, has been spent on this particular program; indeed, $99 million in the last year. The purpose of the payment was to increase bulk-billing rates—that was the purpose of the payment for those who were not aware. What we have seen, as I said, is $99 million just in the last year and roughly the same amount each and every year since 2009, and the bulk-billing rate has gone from 86.3 per cent to 87.6 per cent over that period of time. It has increased by 1.3 per cent. So the purpose of the funding through this program, to increase the rate, simply has not had the desired effect that was the intention of the funding to be paid in the first instance. Let me also be very clear: rebates have not changed for people undertaking these items. The incentives were being paid directly to the pathologists, to the diagnostic imagers—

The PRESIDENT: Pause the clock. Senator Lambie.

Senator Lambie: Mr President, I rise on a point of order. I simply asked whether any future modelling had been done to see whether women's cancer checks will be at risk, and how much it is going to cost the country in the long run. I want to know whether modelling has been done and produced. If it has, may I have a copy of that modelling, please.

The PRESIDENT: Thank you, Senator Lambie. You did have a little bit more to your question in relation to the comments which the minister addressed up-front, saying that she was not aware of those comments or that particular research. Minister, I will draw your attention to the comments just made by Senator Lambie. You have 14 seconds in which to answer.

Senator Nash: Thank you, Mr President. I am happy to take that on notice and seek advice from the health minister. I have been trying to assist the chamber with some facts around this, given there has been a lot scaremongering on this issue.

Senator Lambie: Mr President, I ask a supplementary question. I again refer to the Liberal-Nationals cuts to women's cancer tests. I note that the report from the Australian Institute of Health and Welfare indicates that people in rural disadvantaged areas are almost twice as likely to be diagnosed with cervical cancer than those in metropolitan areas. Will the National Party assistant minister explain why she has betrayed Australian country women by supporting this cruel Liberal policy?

Senator Nash: Firstly, I will correct two things from the senator: one, I have not betrayed anybody, least of all rural and regional Australia. I also correct the senator: there have been no cuts referred to the payments, as the senator said. The changes have been to the payments that are made directly to the providers. We need to be very, very clear that there have been no cuts to the rebate. Again, I draw the attention of those opposite to the fact that this was a program designed to increase the rates of bulk-billing in this sector and it has increased only 1.3 per cent since 2009.

Senator Lambie: Mr President, I ask a further supplementary question. I again refer to the Liberal-Nationals $650 million cuts to women's cancer tests. I note that the same midyear economic report released in December showed Australia had set aside nearly $650 million to resettle Syrian refugees over the next four years. Can the minister explain whether the cuts to Medicare and women's cancer tests were agreed to so that Australia could afford to resettle Syrian refugees?

Senator Nash: I indicate to the senator that portfolio decisions around funding are taken within portfolios. I would have no indication whatsoever of the assertion that the senator has put forward about trading across portfolios for a funding issue. This is an issue that has been espoused very strongly by those on the other side of the chamber and, quite frankly, there has been a significant degree of scaremongering. On this side of the chamber, we make no apologies for making sensible, balanced decisions about budgetary measures that require an outcome. We will continue to do that for the benefit of all Australians.

Take note of answers:

I move:

That the Senate take note of the answer given by the Minister for Rural Health (Senator Nash) to a question without notice asked by Senator Lambie today relating to proposed changes to bulk billing incentives.

Today the National Party's Senator Nash tried to defend the indefensible. Her party, a party that is supposed to look after the interests of rural and regional Australia, has agreed to be an accomplice to a Liberal policy which is guaranteed, over time, to increase the number of women who will die from preventable diseases like cervical cancer and diabetes. A report from the Australian Institute of Health and Welfare states: 'The number of deaths has decreased significantly, with 72 per cent of women diagnosed surviving cervical cancer. Ninety per cent of cervical cancers are preventable with early detection.'

The reason we have this good news is that over the last 10 years Australia has had a clear focus on primary health care and preventative health checks, which has saved our nation lives and money. This $650 million cut to Medicare if allowed to go unchallenged by this Senate will undermine our focus on preventable health care by dramatically increasing the costs of cancer tests like Pap smears. The costs savings the government trumps in the short term will pale into insignificance when compared with the additional costs incurred in the long term when women, our grandchildren, begin once again to lose their lives unnecessarily and too soon to preventable diseases like cervical and other cancers. Why aren't we making decisions for our grandchildren?

I warn this government that I will take whatever action is necessary in the Senate, including voting against all government legislation, to ensure that cancer and other health checks remain affordable for all Australians. I will do everything in my power to stop cancer health checks like Pap smears from costing an extra $30, as predicted by the Royal College of Pathologists. The average Australian is sick of this Liberal government fiddling with bulk-billing rates for vital medical checks like women's Pap smears. It is time for the Liberals to stop their sneaky attacks on Medicare and their sly attempts to kill it off. It is time the Nationals grew a backbone and stood up to this cruelty to women.

Local Burnie businesswoman Kahli Deegan has told me she wants the Australian PM to stop messing around with our bulk-billing rates. She wants the government to make it easier, not harder, for young women like her to have cancer checks. Respected health professionals like Tasmanian scientist Richard Hanlon have warned that the effect on patients will be quite significant because it will discourage them from going to their doctors, patients may pay up to $30 extra in co-payments and it has the potential to stop patients from testing for chronic diseases like diabetes and cancers with Pap smears. We have had a focus on primary health care for 10 years or more and now we are removing that so hospitals will become inundated, cancers will not be seen until it is too late and diabetes will not be seen until it is too late either. It will have a huge cost on the health system and a huge cost on the hospital system in particular, the public system. Pathology is about as efficient as it can possibly get. We believe there is very little fat left to cut off the bone. That will mean it will be passed on to the customer. Any fool can see that reducing Australia's investment in primary health care is going to cost us more in the long run.

I commissioned a Parliamentary Library study and asked: can these cuts be disallowed by the Senate? The answer is:

Yes. The relevant regulations are a disallowable legislative instrument. The process for disallowance is explained in this Senate Brief. Broadly once the regulations are registered and tabled in parliament a Senator has 15 sitting days to give notice of a motion to disallow the instrument in whole or in part.

So I make this promise to Tasmanians, especially Tasmanian women: I will use my vote to disallow any Liberal government regulation that attacks our Medicare bulk-billing system. I look forward to working with my fellow crossbench senators, the Greens and Labor to stop this insane attack on one of the best universal healthcare systems in the world.

Question agreed to.