Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2026
Mr McCORMACK (Riverina) (17:15): I appreciate that there has been an amendment moved by the coalition for this particular bill, and that is entirely appropriate. The situation with the Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2026 is that, sadly, there is an inequity. I listened to the member for Barton talk about fairness and proportionality, but, sadly, there is a huge gulf at the moment between country and city medical provisions.
I note that, earlier this year, in March in fact, Professor Kerin Fielding came to parliament. She is the president of the Council of Presidents of Medical Colleges. She's also a Wagga Wagga orthopaedic surgeon.
She, very much, told us how it is in regional centres. She spoke of the difficulties with regional health as opposed to metropolitan services, and she would know. As I say, she is a fine orthopaedic surgeon.
She's also, in fact, the wife of the independent state member for Wagga Wagga, Dr Joe McGirr, who is himself, obviously, a medical professional. She had this to say in relation to older Australians. She was talking about the cost, whether, in fact, older Australians could still afford health care, how long an older Australian would have to wait and how far they would have to travel.
She referenced her 90-year-old mother, and she said: They're getting bills they didn't expect, or they're avoiding a referral altogether because they don't know what it will cost. The Minister recently told Parliament that over 800,000 Australians delayed specialist care last year because of affordability. That is a serious problem.
Australia has one of the best health systems in the world and every Australian should be able to access affordable, high-quality specialist care without risking financial hardship. I don't think there would be too many people who would disagree with Associate Professor Fielding's remarks in that regard. I have referenced this in the parliament before, in relation to the statistics that she used—and there were Labor members and ministers at this particular speech that she gave in this place.
She referenced that rural Australia has 2.7 doctors per 1,000 people compared to metropolitan Australia, which has 4.3. She said: Potentially preventable hospitalisations are 30 per cent higher in outer regional areas and 70 per cent higher in remote communities. Thirty per cent of the country's population, are too often overlooked, and for too long, our health system has been built around metropolitan centres.
The consequences of that are felt every day in regional communities. The communities that grow and provide our food and much more! I reference that in relation to this bill because I think, when we talk about health, we do need to talk about and, moreover, act upon the inequities of our system.
Associate Professor Fielding is absolutely 100 per cent correct. I think the member for Barton would agree, too, that we do have a very, very good health system, and we're very lucky. It doesn't matter which side of politics is in government—well, it does.
I'd sooner be in government than be in opposition, trust me. But, as far as our health system is concerned, I know there's often at election time these fibs told about the fact that the coalition is selling off Medicare and all these other things to try to get a vote, which is, of course, not true. It worries me that the Prime Minister pulls out his green and gold Medicare card and says, 'This is all you will need.' It worries me that the urgent care clinics are not distributed fairly—and they are not—across Australia.
It worries me that there is an inequity in health between country and city. We don't need that sort of divide. This bill will remove the cap of $5,000.
It always worries me when we start talking about caps of $5,000, having had that allied health experience with the $5,000 cap with veterans, but, thankfully, the government has finally come to its senses and said that it will change that. I just wait to see the devil in the detail with that. Removing this cap from the national joint replacement registry levy act that can be imposed per medical device listed on the prescribed list of medical devices and human tissue products for a financial year—so it goes, with this change, the levy will be allocated in proportion.
I heard the member for Barton speak to that. The levy will be allocated in proportion to the actual volume of devices supplied by medical device companies, creating a fairer and more equitable distribution of the levy. Hopefully, that stacks up and certainly is as it is intended to be.
The Australian Orthopaedic Association collects information from all relevant hospitals in Australia to define, improve and maintain the quality of care of individuals receiving joint replacement surgery. I do worry as well, though, when we talk about relevant hospitals. Again, when we look at the health legislation and health policy before us at the moment, we have the situation where the private health insurance rebate that over 65 have relied upon is being taken away, and that is bad in itself, let alone the fact that hospitals are very worried that this will push their patients onto the public state hospital system.
Our state public hospitals already have long, long queues for certainly such things as hip replacements, knee replacements and joint replacements, per se. There is going to be a huge dilemma that that insurance rebate situation for over 60 fives—it's a cliff, and we're about to go over it. The worry is that we will lose some private hospitals.
We will actually have hospitals close. These are not my words. That is already the fear being expressed by many in the health sector.
Just as bad as that—and we don't want to see any hospitals close—is the fact that it is already difficult enough for our state public hospital system to cope with the number of patients they have now. I am very, very lucky in Wagga Wagga. I have the Wagga Wagga Base Hospital, which is relatively new in the scheme of things, and we've also got the Calvary Riverina Hospital, which has been operating for many, many decades, and both do a fine job.
They're all in the one Docker Street medical precinct, and long may they not only service the entire Murrumbidgee Valley, which encompasses, quite frankly, probably around a quarter of a million people, if you add up all the people who go to that hospital from not just Wagga Wagga, a population of 73,000 or so, but also the Murrumbidgee irrigation area centred on Griffith, a population of 32,000 or so, and everywhere in between but service elsewhere as well throughout the Riverina and south-west and southern New South Wales.
Fortunately, there is a good relationship between the public hospital, Wagga Wagga Base Hospital, and the private hospital, Calvary hospital, and we have other day surgeries as well. They all perform hip replacements, knee replacements and joint replacements, and that is good. The Australian Orthopaedic Association is provided funding for components of the registry's administration through a Commonwealth grants agreement which is efficiently cost recovered through the imposition of a levy under the Private Health Insurance (National Joint Replacement Register Levy) Act of 2009.
The levy is paid by the medical device industry. This is the situation with the particular bill before us. I appreciate that it has the support of Private Healthcare Australia, the Australian Orthopaedic Association and the Medical Technology Association of Australia, as you would expect it would.
I would like to think that something as important as this which will have some profound impacts upon the health sector would have received the stakeholder engagement and the stakeholder support that in fact it needs. The Commonwealth grants agreements are something that the health minister controls and runs. It is an important process not just with the public system but with the states as well.
This is important as we get older. I heard the member for the member for Barton talking about the strain on her knees while she doorknocks. My goodness, she's still in her 30s—a long way— Mr McCORMACK: Oh, 39?
Okay, well, you've given your age away. I would never suggest to give a woman's age away! But, anyway, I'll just take that interjection.
She's a long way from getting knee and hip replacements, I hope. It's her reference, not mine. Please don't think I'm doing anything wrong here.
But, rest assured, there are older Australians who thankfully do have— A division having been called in the House of Representatives— Sitting suspended from 17:27 to 17:36 Mr McCORMACK: As I was saying before the division, when the member for Barton is doorknocking around Kogarah, Banksia and Bexley North, I do hope that her knees hold up; I certainly do. That's genuine.
Older members of her community who need health care fortunately will have it in spades. But it's not that easy—the further you go from the bright city lights, the harder it gets. I appreciate that the assistant minister for health, who sits opposite, understands that too.
She in fact was at Associate Professor Fielding's address in March this year and heard the good orthopaedic surgeon from Wagga Wagga detail just how difficult it was for country people, particularly older regional people, to access those health services. It wasn't that long ago that the NSW Council of Social Services put out a report. They commissioned it.
It was conducted by the University of Canberra. It was entitled Access denied: Australians locked out of quality healthcare, and it revealed an alarming situation in primary health in my home state. Since the last NCOSS report in 2020, the Riverina has had a more than 330 per cent increase in people who can't afford to visit a GP, let alone a specialist, let alone a specialist who may well have to replace a hip or a knee or another joint.
More than one in three people, 37 per cent in fact, delay or avoid seeing a specialist due to cost, an increase of over 180 per cent since the previous report in 2020—admittedly, this was a 2024 report, but the situation hasn't improved—whilst almost a third of people, 32 per cent, visited the emergency department in the Riverina because their GP wasn't available.
This is higher than the New South Wales state average of 23 per cent. NCOSS chief executive Cara Varian said the report found that patient experiences with vital health services, including general practitioners, specialists and dentists in New South Wales, had gone backwards since its 2020 report, and regional areas were more heavily impacted than metropolitan areas.
This quote really, sadly, sums it up: This report illustrates that the health system is broken. I refer to what I said earlier. Our health system is very good, but we can do a whole lot better.
We can do a whole lot better for the sake of country people, who, as the associate professor said, provide the food and the fibre and the mining and the resources, and help our balance of payments. The obligation and the commitment and the duty of care is on governments at all levels to make sure that they do better, certainly for regional Australians.