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Legislative Assembly for the ACT: 2002 Week 12 Hansard (13 November) . . Page.. 3590 ..

MS TUCKER (continuing):

The percentage of all medical services bulk-billed in the ACT from April to June this year was 8 per cent less than in the same period last year. National average figures also dropped, but only by 1.9 per cent. The source of that is the Health Insurance Commission, table 3: Medicare-per cent bill type by state and various periods.

Between March 2000 and March 2002 bulk-billing rates for general practitioners in North Canberra fell from 67.7 per cent to 56 per cent. In South Canberra they fell from 60.3 per cent to 52.4 per cent. This contrasts to what the federal health minister claims-that over 70 per cent of people are bulk-billed and over 80 per cent of people are over 65.

In some regions, such as Civic, there are now no bulk-billing general practices. I have a list, from April, of extended-hours practices showing who bulk-bills. My office checked a sample of four of these practices this week and found that two of the four still bulk-billed as they did in April but one in Gungahlin has had to stop bulk-billing altogether. Another, in Tuggeranong, has further restricted its bulk-billing to children under nine, where previously it included pensioners. It is clear that the ACT has experienced a substantial drop in the percentage of medical services bulk-billed.

There is also a shortage of general practitioners in the ACT which the Chief Minister informed the Assembly in June was not acknowledged by the Commonwealth government. According to the Chief Minister's information, the ACT has around 68 full-time equivalent GPs per 100,000 people, whereas the national average is about 85. I understand from the minister's office that they are saying there is a need for around 50 more GPs.

It is difficult to understand in this context why the Commonwealth government does not recognise the extra needs in the ACT. But it is even more difficult to understand why the Commonwealth government is letting the Medicare system die. This means it is giving up on the aims of Medicare to make health care affordable for all Australians; to give all Australians access to health care services, with priority according to clinical need; and to provide a high quality of care.

Clearly the federal government has abandoned its responsibilities. The relative value study, jointly conducted by the federal Department of Health and Aged Care and the AMA, showed that patient rebates were underfunded by $900 million a year. The Medicare payment for GPs has not been increased to keep pace with costs. Meanwhile, the federal government is spending more money on health care, but the $2.35 billion put into the private health insurance rebate is doing nothing for equitable access. Unfortunately, that is a policy typical of this federal government.

My motion notes that this change has reduced the capacity for early intervention care, which is self-evident to a point. General practitioners are, or can be, an important part of early intervention, when they are allowed and supported to consult with their patients for decent lengths of time, when they are able to bulk-bill, allowing patients access without having to trade off the electricity bill or food for the week.

The reduction in bulk-billing makes it very difficult for people on low incomes to access primary health care. As the president of the AMA put it in the July 2002 Canberra Doctor:

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