Liberals are eroding public health system

Published on Tue 22 June 2021 5:59pm

The COVID-19 pandemic has reinforced the foundational importance of good health and a strong health system, and it’s shown the sadly inbuilt incapacity of the Morrison government to grasp that essential point, to shoulder its basic responsibilities and to deliver even the ground-level standard of administrative competence that people should be able to expect.

Mr Wilson (5:59pm) – The global pandemic has brought the fundamental importance of good health to the front of all our thinking—the value of good health in our own lives, the lives of our families and the wider community. We’ve been reminded that our individual health is not separate from community health. We’ve been reminded of the ways that physical, mental and emotional wellbeing are entwined. We’ve been given an opportunity to consider how health circumstances can be very different, more difficult and fragile for some parts of the Australian community, including older Australians, especially those in residential aged care, Indigenous Australians and Australians living with a disability. I’m sure the circumstances we’ve faced together over the last 15 months and the circumstances we’ve all seen overseas have made us reflect with gratitude on the quality and accessibility of Australia’s public health system, particularly on the expertise, skills and commitment of our health workforce—the doctors, the nurses and all the staff who make our GP clinics and our hospitals function to such a high standard.

As difficult as the COVID-19 experience has been and continues to be in many ways, it has undoubtedly been an opportunity to recognise and acknowledge the special features of Australia’s universal public health system. The building blocks of that system include Medicare, the Pharmaceutical Benefits Scheme and the National Disability Insurance Scheme. Each represents a reform that was made in the name of increasing our shared national wellbeing and each represents a reform delivered by Labor as part of our enduring commitment to that cause. Coalition governments, by contrast, have not only failed to imagine and create those kinds of reforms but actively resisted them and, once they were created, sought to whittle them away. It is amazing to think now that Liberal oppositions opposed Medicare. In fact, Labor had to create Medicare effectively twice—once under Whitlam and then once and for all under Hawke.

In recent times the Coalition has intentionally underspent funds allocated to the NDIS and now it is seeking to bring in so-called independent assessments that will require participants to go back through the process of evidencing their needs without the benefit of the input of specialists who best understand their situation. There is no doubt that the manoeuvre is principally motivated by a desire to reduce funding. It’s designed to reduce funding.

In a week or so we’re going to see hundreds of changes to Medicare Benefits Schedule items that will increase out-of-pocket costs and decrease access to many forms of treatment. Something like 1,000 different Medicare benefits procedures will be pulled from the schedule, altering the cost of hundreds of orthopaedic, cardiac and general surgery items, which could mean that patients with upcoming procedures will have to choose between cancelling or delaying life-improving surgery and being lumped with huge bills they had every right not to expect. Many of the patients affected will be those who have already copped massive increases to private health insurance over the past decade.

Sadly, in the eight long years of the Abbott-Turnbull-Morrison government the cost of accessing health care has soared across Australia and in my electorate of Fremantle. According to the latest annual Medicare statistics that were revealed through the Senate estimates process just the other week, out-of-pocket costs for patients in Fremantle, East Fremantle and Cockburn have risen 21 per cent when it comes to seeing a GP or a whopping 54 per cent if you’re talking about access to specialist care. In terms of the broader neglect of Western Australia as a whole state, WA has the lowest rate of GPs per capita of all the states and territories—79 GPs per 100,000 people compared to the national average of 96 GPs. We’re also below the national average for aged-care beds at 62.1 beds per 1,000 head of population compared to 75.5 beds nationally, and that number has seen a 23 per cent decline since 2001.

We have to remember that the 2019 Morrison-Frydenberg budget included a measure to cut $359 million from WA hospitals over five years, which was a significant retreat from the previous Labor government’s approach of sharing tertiary healthcare costs 50-50. When you think of the Morrison government’s stewardship of our health system as a whole, all those details make pretty grim listening, but they have to be put alongside the government’s recent performance.

In the circumstances of a pandemic, this government, our national government, has two crystal-clear responsibilities: to provide and support an effective national quarantine system and to deliver a smooth, sensible, practical, strategic vaccine rollout. But we have seen neither of those things. We haven’t seen an effective national quarantine system, which is squarely the responsibility of the Commonwealth, and we certainly haven’t seen a smooth or sensible vaccine rollout.

The government’s been entirely missing in action on quarantine. It’s spent most of the time it’s given to that issue criticising state governments, pressuring them to open up in the early part of the pandemic, haranguing them when lockdowns occur and doing nothing to take up its responsibility to fund and deliver quarantine around Australia that is fit for purpose—and we’re going to need that more in future, I’m sure, particularly as we look to open up.

The vaccine rollout has been an eye-watering shambles. Every passing week throws up more examples of how the government is apparently intent on demonstrating how not to do a national vaccine rollout program. We never had enough vaccine options. That was pretty clear early on, and it’s become super clear with every passing month. Pretty much all our eggs were put in the AstraZeneca basket, and we now face significant challenges as a result of issues that have arisen. They could have been managed. AstraZeneca is still a very effective vaccine, and people should have confidence in the way that our public health experts have adjusted the approach to AstraZeneca to ensure that people get the benefits from it while having it administered to them on a safe basis. But, when you’ve only got AstraZeneca and a trickle of Pfizer, it’s no surprise that we still haven’t got three per cent of our population vaccinated when many like countries are north of 50 per cent.

We’ve never had security of supply. The government said that we were top of the queue and that they would guarantee this flow of vaccines. From earlier this year, it became clear that that wasn’t the case. Countries in Europe held on to vaccines that they didn’t want to send our way, and as a result we didn’t get what we needed. We’ve heard this week that Pfizer were in conversation with the government and were prepared to deliver 40 million doses by January this year. They were prepared to work in partnership with us and make Australia essentially a demonstration, a model nation for the global vaccine rollout. For some reason, the government decided to turn away from that.

Despite the government constantly telling people that there has never been a supply issue and being very thin skinned and wounded whenever that’s suggested, the state governments of both Victoria and New South Wales have confirmed that they could vaccinate more Australians if only there were more vaccine available. Lieutenant General Frewen, who the government has appointed to help get the vaccine rollout on track and address any number of the disabling practical glitches that have emerged, is quoted today in the Australian as saying:

We are still in a resource-constrained environment …

That is military speak for, ‘We just don’t have enough vaccine.’ As a result, when there was a breakout in Victoria we saw that less than 10 per cent of the aged-care workforce was vaccinated. We still see drivers who haven’t been vaccinated transporting aircrew. This is holding Australia back. It is holding our recovery back. It means that we will remain shut to the world for longer. It means that the economic consequences will run deeper.

The COVID-19 pandemic has reinforced the foundational importance of good health and a strong health system, and it’s shown the sadly inbuilt incapacity of the Morrison government to grasp that essential point, to shoulder its basic responsibilities and to deliver even the ground-level standard of administrative competence that people should be able to expect. Without question, our future well-being and our recovery from the pandemic rest on that approach changing and changing fast. But it’s virtually impossible to see that happening under this government. They have failed comprehensively and harmfully on aged care, they’re failing on the vaccine roll-out, and their plan is to weaken Medicare and to make life harder for those who depend on the NDIS. That is a recipe for hardship, inequality and suffering.

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