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Legislative Assembly for the ACT: 2002 Week 12 Hansard (13 November) . . Page.. 3591 ..

MS TUCKER (continuing):

Moving away from a failed Medicare system is a healthy process overall and will lead to better care for those who can afford to pay.

I do not agree with that. He went on:

It will however disenfranchise the less well off who will be left with diminished access to services.

I realise that the ACT government is aware of these problems and that there have been a number of explorations of possible initiatives. I understand that there are dangers in accepting responsibility for the costs of what is properly the responsibility of the Commonwealth government. But can we be satisfied holding disadvantaged people to ransom? Relying on the Commonwealth government means exactly that.

While this situation has been primarily caused by the federal government's failure to adequately maintain the Medicare system-and they should not be allowed to get away that-ultimately we in the territory have to take responsibility for protecting the health of the residents of the territory.

This motion does not specify how to go about boosting access. It is up to the government to work with all the stakeholders, community members and its resources. But the point of the strategy I have asked for-under the amended motion it will be a report-is that we will be able to see clearly where we are going. A strategy does not have to be bound and printed on glossy paper. It can be as simple as a set of dot points printed double-sided on recycled paper and tabled here in the Assembly. But having a strategy means that we have a plan in place, we have a vision of the scope of the problem and of what we can do, and we have time lines for putting the plan into action.

Though the government's amendment will remove the word "strategy", the motion will say that the government will report to the Assembly on what measures it is currently taking and proposes to take, and the report will include time lines, so I am satisfied with that.

The ACT is not powerless. There are several options within our control that I can suggest-assisting bulk-billing doctors with their rent, reintroducing health centres and salaried medical officers, sharing premises with other health professionals, and making the best use of the coming medical school to try to increase the number of doctors in the ACT.

I want to talk a little bit more about the community health care model, because it illustrates so well the fact that we do have powers here. Unfortunately, as we remember, Mrs Carnell removed them but we could bring them back. The ACT in the past had a more robust system in the community health centres. Many people here will remember the Liberal government's changes to our system of primary health care in 1996. These changes are close relations of the other economic rationalism-inspired silo building, such as purchaser/provider, which have now been shown-for instance, by the Reid review-to reduce our ability to care for health. When Kate Carnell removed community health centres and salaried medical officers from the Canberra landscape, it was predicted that this would ultimately reduce the access of low-income people to GPs.

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