Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025
Senator SHARMA (New South Wales) (19:11): I rise to speak on the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. The coalition acknowledges the intent of this bill, which contains a number of technical amendments to improve the efficiency of several important elements of our health system, including the allocation of Medicare provider numbers, the assignment of Medicare benefits process and improvements to the private health insurance premiums reduction scheme.
It also makes amendments to the Bonded Medical Program with the aim of ensuring that penalties for noncompliance are fair and proportionate, particularly in light of the serious workforce shortages facing our healthcare system. The measures in this bill are intended to tidy up existing legislation, streamline administration and make sure that the rules governing Medicare payments and bonded medical placements are clear and consistent.
These are sensible objectives, and, on that basis, the coalition will not stand in the way of this bill. However, it was important that we sought further information and scrutiny of this bill through the Senate inquiry, particularly in relation to the implications of the proposed changes to the Bonded Medical Program. We understand how vital it is that the changes in this bill do not create negative, unintended consequences or additional administrative burden for our hardworking healthcare professionals, because right now it is undeniable that primary health care is in crisis under this government.
The coalition remains concerned by the way that some of the changes in this bill have undermined the intent of the Bonded Medical Places Scheme. The coalition established the Bonded Medical Program, recognising the need for programs and initiatives to address workforce shortages that are felt far more acutely in regional, rural and remote parts of Australia. Despite the Bonded Medical Program being designed to address the shortage of medical professionals in regional, rural and remote areas of Australia, the government's changes to distribution priority areas now allow doctors to work in major metropolitan cities and still meet their obligations under the program, further worsening doctor shortages in truly underserved areas and obviating the intent of the program.
In this bill the government has sought to make changes that would make these changes retrospective and remove the financial penalties for doctors who take government scholarships but who break their promise to work in rural areas. This further reinforces the harmful impact of the government's distribution priority area changes and further weakens the incentives for young doctors to serve in the regions.
It shows Labor's contempt for the regions by completely destroying the intent of the Bonded Medical Program. The program is no longer meeting its original intent, and the coalition will not be supporting the changes in this bill which further compromise the scheme's goals. The coalition is standing up for regional Australia, which is why we will be moving an amendment to remove the proposed changes to the Bonded Medical Scheme from this bill.
The coalition is also standing up for Australians' needs to have affordable access to primary health care. At the last election, we saw the Prime Minister wave around his Medicare card at every photo opportunity, declaring that, under his government, all you need is your Medicare card, not your credit card. He said that Australians can see a GP for free under Labor.
He made that promise at least 71 times during the last campaign. But his credibility on Medicare gets weaker and weaker by the day. The reality is that more Australians have to use their credit cards to see a GP under Labor because the GP bulk-billing rate is now almost 11 per cent lower than when the coalition left government in May 2022.
Australian families paid more than $2 billion in combined out-of-pocket costs in the last year alone. That is more than $2 billion charged to Australians' credit cards, not their Medicare cards. This is a $2 billion black hole, and this means that Australians are now paying 75 per cent more out of their own pocket to see a doctor under Labor.
Shockingly, health department officials even admitted in Senate estimates that, even though Australians are paying the highest out-of-pocket costs on record—an average of $49.14 per GP service—these costs 'will probably go up' despite all of Anthony Albanese's promises. Officials have also exposed that Australians will not see a benefit from Labor's bulk-billing policy for at least four years—well after the next election.
This follows the Department of Health's incoming government brief, revealed under FOI, which estimates that a quarter of GP clinics across Australia will not take up the government's new bulk-billing incentive. The Prime Minister promised that Australians could see a GP for free, but instead they will continue to pay more than they have ever done. Australians deserve a government that tells the truth about health care, not one that misleads them while costs keep rising.
We know that more Australians are having to take the difficult decision to avoid seeing a doctor, because they just cannot afford it. That is the true cost of these Medicare lies. Labor promised to strengthen Medicare, but it has only been weakened.
Since the Albanese government came to power, bulk-billing has fallen from 88 per cent to 77 per cent—a decline of 11 percentage points. That's 40 million fewer bulk-billed GP visits in the past year alone. Medicare mental health funding has been slashed in half, and, despite all of Labor's false promises and misleading rhetoric, Australians are now paying the highest out-of-pocket average costs on record to see a GP.
That is the stark reality of Labor's primary healthcare crisis. More than 1½ million Australians last year said they avoided seeing a GP because of cost concerns. That's 1½ million Australians forced to make difficult decisions about their health—decisions no Australian should have to make—because of this primary healthcare crisis overseen by Labor.
While Australian families are struggling to afford going to the doctor, the Prime Minister seems completely out of touch, more interested in political stunts with his Medicare card than in ensuring all Australians actually have timely and affordable access to essential health care. Nowhere is this neglect clearer than in mental health. When Labor tore away Medicare subsidised mental health sessions from 372,000 vulnerable Australians, it ignored the advice of its own review and the pleas of mental health experts right across the country.
Since that cruel cut, access to Medicare mental health support has fallen to its lowest level in at least a decade right at the time when demand has never been higher. Labor has cut Medicare mental health sessions in half, abolished the National Mental Health Commission and even ripped away even the Suicide Prevention Research Fund. Their neglect of mental health is so significant the former chair of Mental Health Australia was forced to resign in frustration at this government's lack of action.
This is not the record of a government strengthening Medicare or supporting Australia's physical and mental health and wellbeing. It is the record of a government that says one thing and does another. Under the coalition, Medicare funding increased every single year, despite what the Prime Minister claimed during various election debates.
It increased from $18.6 billion in 2012-13, under Labor, to more than $30 billion in 2021-22, under the coalition. Bulk-billing rose consistently throughout our term in office to more than a record 88 per cent when we left government. In our final year, Australians received 167 million free GP services, which was 61 million more than under the previous Labor government.
That's the coalition's record—delivering affordable, quality health care. In conclusion, while the coalition acknowledge the technical objectives of this bill to ensure efficiency in several elements of our health system, we will not let the government use it as a smokescreen for its broader failures. We condemn the Albanese government's broken promises and appalling record on Medicare, and we condemn the government's contempt for the regions in its complete destruction of the intent of the Bonded Medical Program for regional Australia.
The coalition remains focused on ensuring that all Australians can access timely, affordable and quality health care no matter where they live.