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

Senator STEELE-JOHN (Western Australia) (12:04): I am pleased today to speak to the Health Insurance Amendment (Incentive Payments and Other Measures Bill) 2026. The Australian Greens support primary care incentive programs and recognise their role in ensuring people have access to safe, affordable and effective primary health care. The Bulk Billing Practice Incentive Program has contributed to much-needed rises in the rates of bulk-billing, which the Australian Greens welcome.

The Workforce Incentive Program stream allows a general practice to hire nurses, midwives and allied health professionals, as well as Aboriginal and Torres Strait Islander health workers. This enables practices to utilise multidisciplinary teams. It allows general practices to do this in a way that enables interprofessional working.

The Greens are supportive of this because we know that these allied health professionals are the best placed to work together in support of better outcomes for those that they work with, because they see a person as more than simply a set of symptoms; they see the whole of the person before them. Another stream of the Workforce Incentive Program is the Rural Advanced Skills Stream, which provides payments to doctors working in rural and remote communities who have advanced skills or training in emergency care.

These programs are just a few of the incentive payments that are within the scope of this bill, and the Greens believe that these should be protected. The purpose of this bill is to ensure that there is a clear legislative mandate for these programs and to ensure their continued operation. As stated, we absolutely support the objective of these programs.

We understand they are central to ensuring that our Medicare system is able to provide funding to primary health care. However, we do question why these programs have been operating for years without a clear legislative mandate. The practice incentives program has been running in various forms since 1998, and it is only now, in 2026, that the government has realised that these programs need a clear legislative basis.

It's not really good enough. The government should do better when it comes to these vital programs. People expect better from the politicians they elect and the governments that they fund with their taxes.

This bill also changes the name of the Health Insurance Act to the Medicare Act. In the minister's words, 'This change better reflects the scope and purpose of the legislation and improves public recognition and understanding of the act.' It is important that the legislation stays up to date with what people need. This is why it is so important that the telehealth rules within Medicare are updated to better reflect the needs and circumstances of the people who rely on telehealth medicine.

Access to telehealth appointments isn't just a matter of convenience; for many Australians it is a vital lifeline. Yet Medicare rules typically require people to have attended an in-person GP appointment within the last 12 months before they can book a telehealth appointment. For disabled and chronically ill people, that requirement can place care out of reach, especially for people with conditions like ME/CFS, where travelling and securing support can place an unnecessary stress on a body that is already struggling to cope.

For those in rural and regional communities, it can mean hours on the road, added expense, and time away from work, family, daily life and daily responsibilities, simply to preserve access to a service that could be safely accessed remotely. This just does not make sense. The government needs to fix these dated rules so that people who cannot reasonably attend appointments in person can have access to affordable, appropriate GP care through telehealth.

I foreshadow that I will be moving a second reading amendment to this bill which calls on the government to update these telehealth rules so that they are not preventing access to health care for disabled people, for people with chronic illnesses and for others who struggle to attend in-person appointments. I would also like to take this opportunity to highlight some of the suggestions that came through to us throughout the period of inquiry into this bill.

The committee heard that the bill should use the opportunity to further strengthen the role of nurses, midwives, allied health professionals and other non-medical healthcare professionals in primary care. The Australian Nursing & Midwifery Federation explained in their submission: Allowing health services to access practice incentive programs will support their sustainability and … provide high-quality consumer care and create opportunities for consumers to obtain accessible, equitable— health— care, particularly in rural and remote communities where access to general practices can be challenging or even impossible.

Nurses and other non-medical professionals play an important role in primary care. But, for too long, their skills and contributions have been overlooked in government policy. This is the reality.

This is an opportunity to incentivise and encourage better utilisation of the expertise of nurses, midwives, allied health professionals and Aboriginal and Torres Strait Islander Health workers. We know that interdisciplinary care, supported by a culture that enables interprofessional working, can be transformative for patient health and wellbeing. It is so important that this legislation is sufficiently flexible to allow a broad range of models of care to be included in future programs.

This flexibility is particularly important in rural and regional communities, where alternative models of care play a critical and often unique role in improving access to high-quality, equitable health outcomes. Another concern that was raised through the inquiry was around the bill's use of automated decision-making powers. The Royal Australian College of General Practitioners highlighted that these concerns are serious and are genuinely held.

In their submission to the inquiry, they said: Decisions relating to eligibility, compliance and participation often involve complex clinical and operational circumstances that require professional judgement and cannot be adequately reduced to a set of automated rules. Eligibility determinations may involve nuanced clinical and practice-level considerations that automated processes are unlikely to fully capture, increasing the risk of inaccurate or unfair outcomes.

Here we see, again, government pushing for automated process, thinking that an algorithm or a computer can do better than an expert, a clinician or a trained professional. Senator Allman-Payne would know a bit about this in the aged-care space. I certainly know a lot about it in the disability space.

How many times do we have to learn the lesson? Automated decision-making processes that remove human beings from the loop or constrain their ability to intervene and utilise their expertise do not work. They place people at risk of harm.

The private sector tech whiz-kids selling this crap to government have figured out just how to pitch it. They say that it is quicker and cheaper, that it will prevent people from challenging outcomes, improve government efficiency and deliver an improved bottom line. It's nonsense; you're falling for the con.

The people who will pay the price are the people who will be subjected to faulty decision-making about their aged care, their health care and the disability supports that they need. There is a reason why administrative systems in the social care spaces were built originally with the idea that human beings would get to know human beings and their unique and individual circumstances before making decisions that would affect their lives.

It was recognised that, without that, there was a huge danger to health, safety and wellbeing. We must turn back. We are going the wrong way, and people will be harmed.

The Greens will continue to fight automation and to fight these programs that will remove your ability to appeal, request review and articulate your expertise everywhere that the government attempts to insert them. These concerns, as I say, are genuinely held. They reflect this broader pattern of government decision-making, this preference for automation.

Once again, they appear to be accompanied by inadequate safeguards, human rights oversight or adequate pathways to appeal. When the analysis of these programs is ultimately written, I fear we will see yet another report identifying yet another systemic and cultural failure that put people at risk, that caused harm, injury and potentially even loss of life. We cannot just sit by and let that happen.

Both sides of politics cannot say they are not now being warned. Act, for goodness's sake. Think of your loved ones subjected to these systems, and act.

Use the power given to you to push back. The Greens are supportive of calls to ensure that automated decision-making in healthcare incentive payment programs is subjected to meaningful human oversight, transparent decision-making criteria and appropriate review mechanisms. This bill protects, as I said, important programs that help Australians access affordable primary health care.

But we must go further by making telehealth fairer, supporting nurses and allied health professionals and ensuring rural and regional communities can access the care that they need. When important decisions are being made about people's health care, there must always be human oversight, transparency and a right to review. The Greens support this bill and will continue to push for primary care systems that work for everyone.