Ms KING (Ballarat) (15:07): I rise today to talk about the healthcare emergency that has been created by this government's $50 billion worth of cuts to our public hospital system, and the effect that these cuts will have on the hundreds and thousands of nurses and midwives across Australia, some of whom are in the gallery today, and the millions of patients that they care for every day in GP practices, in community health centres, in home based nursing care and in our public hospital system. When it comes to health care, Australians are being let down by the most uncompassionate government since Federation, and they are being let down by the most ineffective health minister this country has ever seen. These $50 billion cuts are the equivalent of cutting one in five nursing positions across the country—one in five nursing positions across the country! These are front-line services, people who are caring for some of the most sick and vulnerable in our communities, who are keeping older people within their own homes. And it comes at a time when Health Workforce Australia has estimated there is already a shortage of some 20,000 nurses in this country, and more shortages to come. Indeed Health Workforce Australia has said: … without nationally coordinated reform Australia is likely to experience limitations in the delivery of high quality health services— as a consequence of a highly significant shortage of more than 109,000 nurses. So what is the government's response to this nursing workforce crisis? The government's response is to: abolish Health Workforce Australia, and the Senate is considering those bills this week; cut $142 million in funding for health workforce planning; and to get rid of more than 140 jobs in South Australia. This is at a time when public hospitals across the country are struggling to meet their emergency department waiting times and their elective surgery waiting times. And it is not just the Labor Party that is saying it. Australia's most ineffective health minister has managed to unite the entire health sector against the government with his cruel cuts and lack of any compassion. It takes a pretty special health minister to unite the entire healthcare sector against you and against the government's unfair budget. He likes to be critical of this side of the place, but what he does not seem to understand is that there is every health expert in the country saying your budget is a dud. It is an absolute dud and will damage the healthcare system in this country. It fundamentally undermines the universal principles of Medicare and it actually changes the entire way in which our healthcare system operates. Fifty billion dollars being cut and ripping up the national partnership agreements that saw the relationship between the Commonwealth and the states starting, for the first time, to actually begin to focus on health policy reform—reform that is needed to make the system more efficient. Ripping up those agreements and ripping $50 billion out of public hospitals—it is an absolute disgrace. The Australian Medical Association President, Associate Professor Brian Owler, last month summed up the health sector's response to this government's backward, inequitable and unfair vision for health care in this country. He said: The message is clear: the measures add up to bad health policy. Professor Owler went on to say: The health measures in the federal budget are almost universally opposed by the people who provide health services in Australia. The [Australian Medical Association] is at the forefront of this opposition. And we know what the impact will be on nurses and midwives across the country and on the patients that they care for. The Australian Nursing and Midwifery Federation has said these are cuts that will damage the healthcare system. They are cuts that the acting secretary of the ANMF said: … ripped the heart out of the Australian health system and as a former Health Minister, [the Prime Minister] should be ashamed of that. And it is not just nurses working in hospitals who will be affected by these changes. Nurses working in general practice across Australia and in private practice will be hit by these cuts. In particular, I want to refer to some correspondence from a GP practice in Ingham and the effect that these new taxes will have on that practice. It said: We as a practice currently make a loss per dressing we perform. We offer this service as a benefit to the community and to the patients of our practice. We charge no dressing fee to patients due to our belief that this would cause unreasonable hardship for these 'at risk' patients … We perform 20-30 dressings per day. These are often older patients suffering from things like leg ulcers, wound care that sometimes requires up to three visits a week. Dr Elliott goes on to detail the cuts in this budget to MBS items and then said: This is clearly not affordable for the practice to absorb these costs. This would result in our practice ceasing to offer this service which would result in patients having to attend Ingham Hospital for these dressings where the costs would be borne completely by the taxpayer at a higher rate. We then would reduce our nurse numbers. This is not the Labor Party saying it. Mr Whiteley: That is you saying it! Ms KING: These are GPs delivering frontline services not in my electorate, not in Labor Party electorates, but in Ingham. This is one of the smaller, more remote communities in Queensland. Mr Nikolic interjecting— Ms KING: And I note that we continue to have significant interjections from the members who represent seats in Tasmania. Mr Whiteley: That's right! Ms KING: You represent some of the poorest seats in this country. Mr Whiteley: Yeah, and do you know why? Ms KING: I have visited those seats many, many times and every single time you have failed to stand up for those people in your community— Mr Whiteley interjecting— Mr Nikolic: What a shameful thing to say! Government members interjecting— The SPEAKER: We will have some decorum, thank you, from both sides! Ms Butler interjecting— The SPEAKER: The member for Griffith is not in her seat and will not speak! Ms KING: who need to access general practice, who need to access health care, and you have failed the members of your communities. And what will that affect? From the GP in Ingham we know what the effect on nurses will be if the government gets its way and also introduces a tax on hospital visits. Stephen Duckett from the Grattan Institute—someone who knows something about the health system and how to increase efficiency—has stated: If just one in four patients chose to go to a hospital emergency department, the Commonwealth will save no money because of the much higher costs of emergency department care; costs that the Commonwealth government now shares. And this is precisely what this government's GP tax will do. Mr Nikolic: You ruined Tasmania and then you stand there all pious. Good on you! Government members interjecting— Ms KING: I see those experts over there, those grand experts of health policy, representing some of the poorest electorates in our communities—blah, blah, blah they go; off they go again—failing to represent the people of their communities. I am looking forward to campaigning every single day until the next election on your failure to stand up— A government member: Bring it on! Ms KING: to provide healthcare services to your community. I am looking forward to doing that every day. We know that the support that this government is providing for nurses working in general practice has been poor. Consistent with the lack of transparency, lack of compassion and incompetence that has characterised this government, a fortnight ago this government tried to sneak through changes to the way health assessments are conducted by nurse practitioners in GP practices. Without any warning, the government reinterpreted the role of nurses and determined that practice nurse time does not count in Medicare Benefits Schedule health assessment items. Consistent with the way this government does business, the change was announced without any consultation whatsoever and the president at that time of the Australian Primary Health Care Nurses Association described this as having 'a devastating impact on the ability of general practice to provide high-quality preventive care.' Not long after this announcement was made, the government was shamed into backing down on yet another ill-conceived health policy idea. The government should now back down on some of its other ill-conceived policies that will result in less places for nurses, less places for doctors, less hospital beds, blowouts in emergency department waiting times and elective surgery, and bed closures. The government should back down from its $50 billion cuts to public hospitals. It should back down from ripping up national partnership agreements that saw increased funding going into public hospitals in every community across this country. It should back down on its $7 GP tax. It should back down on its $1.3 billion hike to the cost of medicines and its unfair changes to the Medicare Benefits Schedule and the PBS safety nets. It should back down on its $367 million cut to the National Partnership Agreements on Preventive Health. If the government wants to try and change the healthcare system, it has to make sure that the healthcare system is focussing on prevention. But what it has actually done is cut all of the money from preventative services. I have been involved in healthcare policy development all of my working life, whether it was working within the Department of Health, whether it was working as a consultant in health consulting or whether it was working in direct care in allied health. Mr Nikolic interjecting. The SPEAKER: We will have some silence on my right. Ms KING: I have worked in health policy all of my career and I have never seen a sector so united against a government as it is with this particular budget. The inequitable changes in the budget are the biggest attack on Medicare in 30 years. Indeed, when the changes were first announced the AMA Vice President, Professor Geoffrey Dobb, described them as setting back health care 50 years in Australia. The government's arguments that these cuts are making Medicare sustainable is an absolute mockery because the money is not going back into the system. The government knows it, and it should be honest with the Australian people and keep its hands off Medicare.