Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2026

Mrs McINTOSH (Lindsay) (12:26): I rise to speak on the Private Health Insurance National Joint Replacement Register Levy Amendment Bill 2026. Let me say at the outset that the coalition will not oppose this bill. It is a sensible technical change, but it comes at a time when the Albanese government is making it harder for the very people this registry exists to protect to get a joint replacement at all.

The National Joint Replacement Registry has been tracking hip and knee replacements nationally since 2002. It's run by the Australian Orthopaedic Association and captures data on nearly every hip, knee, shoulder, elbow, wrist and spine procedure in both public and private hospitals. Last year, it recorded its one-millionth joint replacement, and that data tells surgeons which devices perform well and which do not.

When someone has a new hip or knee put in, they want to know it will last. This registry means surgeons can see how every device is performing, and patients can be told what to expect. When a device starts to fail, it is often this registry that raises the alarm first.

Australia's registry was one of the first in the world to identify problems with a metal-on-metal hip that was later recalled around the globe. That is the value of good data. It protects people.

The registry is funded through a levy on medical device companies. At the moment, that levy is capped at $5,000 per device each financial year. This bill removes the cap, so the levy is shared according to how many devices each company actually supplies.

It is fairer. It has the support of the Australian Orthopaedic Association, Private Healthcare Australia and the Medical Technology Association of Australia, and it comes at no cost to the Commonwealth. I also note that this bill was referred to a Senate committee because, once again, the government did not give the opposition notice or a briefing before introducing it.

Even a simple bill deserves basic courtesy. The committee reports on 16 October, and the coalition will consider its findings. I cannot speak about a registry that measures joint replacements without talking about whether Australians can actually access them.

Joint replacements are classed as elective surgery, but try asking anyone waiting for a new hip or knee whether it feels optional. A joint replacement might be called elective, but, for the person waiting, it's not optional at all. I know that many people in this place will understand that, for ageing parents—and we have an ageing population—it is a difference between walking to the shops or not, and it's sometimes the difference between that and walking at all.

People need to be able to live independently. They need to be able to pick up their grandkids, to stay in work and to not have that pain, and this is why people have these operations. Between 60 and 70 per cent of hip and knee replacements are performed on Australians aged over 65, and around 70 per cent of them are done in private hospitals.

The people most likely to need a new hip or knee are older Australians, and most of them get it through their private health insurance, which is exactly why the Albanese government's cut to the private health insurance rebate for over-65s is so damaging. Up to three million older Australians will lose part of their rebate. Around 1.2 million of them are pensioners and around 700,000 are on the full pension.

The department's own figures show a single person over 70 on gold cover will pay around $400 more a year. The Health Minister has told Australians that 44,000 older people will drop their cover. Documents released under freedom of information show departmental records are indicating 78,000 by 2029-30, and that is only the people who walk away altogether.

Many more will downgrade. This government has a habit of announcing first and doing the work later. It did not brief the opposition on this bill.

Its own department has confirmed it did not consult on the rebate cut either, and it did not know how many pensioners this would hit until it was asked in the Senate. A department official told the Senate inquiry: We didn't know they were pensioners … I therefore moved the following second reading amendment circulated in my name: That all words after "That" be omitted with a view to substituting the following words: "whilst not declining to give the bill a second reading, the House (1) notes that: (a) despite joint replacements being considered elective surgery, they are often critical for a patient's overall health and wellbeing as well as their broader productivity; (b) approximately 60 to 70 per cent of total hip and knee joint replacements are performed on individuals aged over 65; (c) the majority (around 70 per cent) of total knee and hip replacement surgeries occur in the private sector; (d) the Government's proposal to cut the private health insurance rebate for over 65s will force many older Australians to downgrade or abandon their private health cover; (e) individuals who are no longer covered by private insurance for joint replacements will join public waiting lists; and (f) public elective surgery waiting lists have blown out with some patients waiting months or even years to access joint replacement operations; and (2) criticises the Government for cutting the private health insurance rebate for over 3 million older Australians, including over 1.2 million pensioners".

Here is why that matters for this bill. The department told the Senate inquiry that joint replacements, along with cataract surgery and dialysis, are among the most common services older Australians use that are only guaranteed under gold cover. Catholic Health Australia estimates that one in five affected over-65s will change their level of cover.

That is around 665,000 downgrades. Every one of them risks losing guaranteed cover for a new hip or knee. When they need that operation, they will not stop needing it; they will join the public waiting list.

Those lists are already far too long. Across all elective surgery, one in 10 patients waits almost a year—329 days—and knee replacement patients wait longer than most. Half of all patients waiting for a knee replacement in a public hospital wait more than nine months.

That is nine months of pain, nine months of broken sleep and nine months of losing strength, fitness and independence, and the longer people wait, the harder their recovery becomes. I hear from older people in my own community who have done the right thing all their lives and who now do not know if they can keep their cover. They are worried that, if they lose it, they will be waiting in pain for an operation they cannot afford to go without.

This rebate cut is not a saving; it is a cost shift onto public hospitals and onto patients. This registry does important work. It can tell us how well a new knee performs, but it cannot tell us about the people stuck on the waiting list.

A registry can only record the operations that actually happen. So the coalition will not oppose this bill. We will support the registry and the work of the Australian Orthopaedic Association, but we will keep fighting the government's cut to the private health insurance rebate for older Australians.

Many of these people have paid their premiums for 40 or 50 years. They have done the right thing. They deserve better than being pushed onto a public waiting list in their older age.