Health Insurance Amendment (Incentive Payments and Other Measures) Bill 2026

Dr WEBSTER (Mallee) (19:11): I rise to speak on the Health Insurance Amendment (Incentive Payments and Other Measures) Bill 2026. Let me say, at the outset, the coalition will not oppose this bill. We support proper administration.

We support transparency. We support accountability for the use of public money. Australians have every right to expect that health programs are properly managed, that payments are made under clear rules and that taxpayer funds are protected from waste and misuse.

But we also need to be honest about what this bill does and what it does not do. The bill is about the paperwork of Medicare. It's about the machinery behind incentive payments.

It's about how programs are approved, administered, checked and enforced. Those things matter, but they do not on their own get one single extra doctor into a country town. They do not reopen a maternity ward.

They do not shorten the drive for a sick child who needs care. They do not make a GP appointment affordable for a pensioner who is already choosing between groceries, power bills and medicine. That is the heart of the problem.

This bill may tidy up the system, but it does not fix the system. It is process reform, not patient-care reform. The bill establishes a statutory framework for Commonwealth health incentive payment programs.

It formalises programs such as the Practice Incentives Program, or PIP, the Workforce Incentive Program, or WIP, and the Bulk Billing Practice Incentive Program. It gives the Commonwealth clearer powers for approval, compliance, oversight, information sharing and payment administration. It also renames the Health Insurance Act 1973 as the Medicare Act 1973.

That is fine, but let us not pretend this is the bold health reform regional Australia is crying out for. It is not. It is an administrative framework for programs that already exist, while the very communities whom these programs are meant to help are still going without care.

In my electorate of Mallee, people do not talk about Medicare in the language of statutory frameworks and compliance powers. They talk about whether they can get an appointment to see a doctor. They talk about waiting weeks for that appointment.

They talk about paying more and more out of pocket. They talk about driving hours for care that people in the city can access in the next suburb if they need to. They talk about ageing parents, sick children, chronic disease and the fear of what happens when the local workforce simply is not there.

This is the reality that must guide this debate. Regional Australians are not asking for better paperwork. They are asking for better health care.

Across Australia, bulk-billing has fallen from its peak of 89 per cent in 2020-21, and many Australians face higher out-of-pocket costs when they are not bulk-billed. The AIHW, the Australian Institute of Health and Welfare, has reported that GP bulk-billing rates peaked at around 89 per cent, as I said, before falling to 79 per cent in 2025. That is not a minor change.

That is families being asked to find money they often do not have. That is people delaying care. That is small health problems becoming serious health problems because someone could not afford the first appointment.

Cleanbill's 2026 reporting also shows the pain for patients who cannot find a fully bulk-billing clinic. The average out-of-pocket cost for a standard consult at a clinic that does not fully bulk-bill has risen to almost $50. That is not a statistic on a page.

That is a mother putting off her own appointment so the kids can be seen first. That is an older Australian waiting until things get worse because they're worried about the bill. That is a worker in a country town losing half a day's pay to travel, wait and pay again—and sometimes many more days.

The government says it is strengthening Medicare, but, in too many places in regional Australia, Medicare is becoming harder to use in real life. A card in your wallet does not help if there is no doctor to see. A rebate does not help if the gap fee is too high.

A program name does not help if the local practice cannot keep its doors open. Let us talk plainly about the pressure being placed on general practices. GPs are not the enemy.

They are small businesses, community institutions and essential health providers. They are facing rising wages, rent, insurance, equipment costs, compliance costs and workforce shortages. Many are doing everything they can to keep fees low while staying open.

They should be supported, not threatened. They should be listened to, not lectured. They should not be used as cover for political promises that do not match the reality on the ground.

The deeper issue is this: Medicare's fee-for-service model was never designed for every regional circumstance. You cannot run rural health care on a city business model. A practice in a small town does not have the same patient volume as a practice in a metropolitan suburb.

It often has higher costs, fewer staff, longer distances, more complex patients and fewer backup services. When the funding model assumes the conditions of the city, it fails the country. That is what we mean when we talk about thin markets.

In many regional communities, there are not enough providers, not enough patients, not enough competition and not enough of a workforce to make a simple market model work. If a practice closes, people cannot just walk around the corner to another one. If a maternity unit shuts, families cannot simply choose the next local service.

If a town loses its health workforce, it loses far more than appointments—it loses confidence, it loses families, it loses jobs and it loses part of its future. This is why regional health needs structural reform, not just administrative reform. We need funding models that are built around access, not just volume.

We need blended funding that recognises the fixed cost of keeping primary care available in smaller communities. We need multidisciplinary teams, stronger local training pathways, better support for nurses and allied health, and real incentives that help doctors and health workers build a life in regional Australia, not just fly in and fly out. We also need to stop treating maternity services as optional extras.

Access to maternity care close to home is not a luxury; it is foundational. When a woman is forced to leave her community weeks before giving birth, when a family must travel hours for basic maternity care or when a town loses the ability to safely welcome its own babies, that is not just a health issue. It's a community issue.

It's an economic issue. It's a workforce issue. When maternity services leave a town, families often follow.

Regional Australians already carry a heavier health burden. They face longer travel, fewer specialists, fewer GPs, fewer allied health services and worse access to timely care. Too often they're told to be patient, to wait, to travel and to make do, but people in regional Australia pay taxes too.

They contribute to this nation, I would say, exponentially. They grow its food, move its freight, care for its land, power its industries and hold together communities that are the backbone of Australia. They deserve a health system that sees them, values them and works for them.

This bill does not answer that challenge. It may improve oversight of incentive payments, and that's worthwhile, but it does not make those incentives strong enough, targeted enough or practical enough to solve the crisis in regional access. It does not fix workforce maldistribution.

It does not ensure a viable GP clinic in a small town. It does not deliver maternity care close to home. It does not end the two-tier experience, where city patients have options and regional patients have road trips.

The government must do more than rename an act and tidy up program rules. It must face the truth that regional Australia is not just a smaller version of a city. It must design policy for the real conditions of rural and regional communities.

It must back local practices, support local workforces and fund care in a way that keeps services open and is not just statistically neat. We will not oppose this bill, but we will not pretend it is enough. We will not let the government claim administrative change as a substitute for real reform.

We will not stop speaking for the people who cannot get an appointment, cannot afford the gap fee, cannot find a local doctor, cannot access maternity care close to home and cannot understand why their postcode still decides the health care they receive. Regional Australians do not need more spin, nor are they asking for sympathy. They do not need another announcement that sounds good in Canberra but changes little in Mildura, Swan Hill, Ouyen, Birchip, Hopetoun or towns right across Mallee—indeed right across regional Australia.

They need doctors. They need nurses. They need maternity care.

They need affordable appointments. They need services close enough for them to actually use. They need a government that understands distance, understands thin markets and understands that access is not real unless it reaches the people who need it.

That is the standard this parliament should set: not only better paperwork and cleaner administration but also better health care closer to home for every Australian, including those who live beyond the tram tracks, beyond the suburbs and beyond the easy reach of a city hospital. Until this government understands that, it will continue to fail the very communities that need it most, and I will continue to stand here and say clearly that regional Australians deserve better than better paperwork.

They deserve better health care.