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Legislative Assembly for the ACT: 2003 Week 10 Hansard (24 September) . . Page.. 3626 ..

MS TUCKER (continuing):

I am not entirely happy to welcome the particular initiatives that make up parts of the agreement. The tiny incentives for particular programs are an administrative burden and they do not go to the heart of the problem. For example, in April this year, the AMA raised doubts about whether the bulk-billing incentive program would be enough to persuade significant numbers of doctors to provide bulk-billing again, and contested the federal health minister's assessment that the vast majority of doctors would be better off.

The Public Health Association's comment was:

The title, "a fairer Medicare"for the changes being proposed to Medicare is nothing but misleading claptrap. The changes will destroy Medicare and the PHAA will continue to work with our colleagues in the National Medicare Alliance and others to do all we can to oppose those that will increase "co-payments"and/or create a two-tier health care system.

I am actually having a problem-do you mind speaking a little more quietly?

MR SPEAKER: Order!

MS TUCKER: It is just so loud. I normally do not mind whispers. Thanks.

This is because there is not enough of an increase to keep pace with doctors costs and, in the end, patients will have to cover it. Evidence given to the Senate yesterday by Victorian researchers showed that costs paid per doctor visit will have to go up 53 per cent, as I understand it, because the federal government has failed to increase Medicare payments across the board.

The increase would not be so great if the Medicare rebate were increased for all patients, not just for Commonwealth concession card holders. The incentive for outer metropolitan GPs to bulk-bill is an extra $2.95 per bulk-billed patient for holders of Commonwealth concession cards. Again, the problem included bribes for what should be basic improvements. If doctors signed up, then the federal government would provide nurses to assist in the practice. The ACT's nurse practitioner program may also help to augment the work of busy GP practices, but this is not set up as a bribe program.

It is difficult to welcome such initiatives. This means of working out funding between states is reprehensible. It can also lead to shortfalls later. Mr Stanhope said in a media release on 2 July this year that the ACT government had to come up with an extra $2 million for elective surgery at Calvary because:

The Commonwealth's sweetener for the Carnell Government to sign up to the last Australian Health Care Agreement, the Critical and Urgent Treatment Scheme (CUTS), ran out last year leaving Calvary with a $2.7M funding shortfall.

Let's be clear on how much help this is going to give us. The areas listed in Mr Hargreaves' motion are areas of need: bulk-billing, access, workforce shortage, transitional aged care beds and after-hours access for GPs.

I think it has been clear for some time that the Commonwealth is not going to fund the ACT to the level that is needed to meet our health care needs. There are a number of

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