Ms LEY (Farrer—Minister for Health and Minister for Sport) (15:21): I listened with growing amazement to the shadow minister. There was a string of invective, nastiness, gossip and innuendo. If the shadow minister characterises doctors and medical professionals with a certain view why is she not quoting them? If people are saying these things, why is she not giving direct information? Why is she just saying, 'I'm reading it in the newspapers,' or 'This is what we know is in the DNA of the Liberal Party.' She is saying, 'This is what we think you should do.' There is a possibility in an MPI to have a constructive, real debate, and we should start it with Medicare itself, and we should start it by understanding the principles upon which Medicare was founded, and the principles by which we, as Liberals and Nationals, are determined to sustain Medicare. If you are in charge of a system of government spending that goes from $8 billion to $20 billion to $34 billion and has as its source of revenue, partly, the Medicare levy, which every year falls further and further behind in its contribution to that source of revenue, then you should ask, as responsible managers of economic policy, 'What should we do to keep the system sustainable?' If we do not keep the system sustainable, it will collapse, and that is the last thing any of us wants. That is an area that the shadow minister and I actually do agree on. Sometimes it seems to me that Labor just wants to say, 'Hands off; we'll sit on our hands; no problem; everything will just be okay.' No, everything will not be okay, unless we work at this. And we have never said it would be easy. Nothing is easy when you come into government. The shadow minister asked what I was doing for six years. I was sitting over there on the opposition benches watching with horror and amazement while one Prime Minster followed by another Prime Minister followed by the same Prime Minister flung money out from carefully secured asset funds, secured by us, in government, by the Treasurer, attached to the Future Fund, meant for investments in the nation's long-term wealth. It was flung across the country in extravagant, unnecessary, poorly targeted projects. And I use that word with reluctance, because some of them barely did make the title of projects. So, that is what we did while we were in opposition. And now we are in government, and I do not need to be lectured to by this Labor Party and this shadow minister about what it means to have to run an economy responsibly. Now, there are some areas that the shadow minister and I do agree on, including that doing nothing is not an option. I thought that perhaps the shadow minister was running the line of her leader, which is that everything is okay with Medicare. But a couple of weeks ago, on Sky News, she actually said that the opposition would be kidding itself if it did not recognise that there were challenges in the budget and that savings needed to be found. The shadow minister then said that there is no area that is going to be exempt. So, everything is in scope, shadow minister, when it comes to your savings. We are simply doing what good governments do: consulting, listening, hearing, learning and acting. That is what the public would expect of us. So yes, I did go out there to consult on a policy that involved a $5 cut to the rebate and an associated optional co-payment. I told it like it was, I talked to general practice, they talked to me, and we came away and revised our policy. I actually think I have a pretty good relationship with the doctors and health professionals of this country. The fact that you could not quote a single one bagging me out for this measure means, I think, that we are getting appreciation for doing this. Contrast that— Ms King interjecting— Ms LEY: Well, if you want to make policy by Twitter, you probably would not make very good policy. But let's contrast that with the Labor Party. They brought in a tax that they never consulted anyone on, that they did not listen to the Australian people on. This is the electricity tax. They brought that in, and then when people said they did not want it they ignored them. They left it alone and it did untold damage until we got rid of it. That is Labor's approach to listening, consulting and acting—that is, not doing any of those things. I am proud that we are a government that listens, consults and then acts. That is a good thing to do. That is what good governments should do. The shadow minister also characterised the pause in indexation of the rebate to GPs and non-GPs, which I concluded today that we were continuing with, as a 'sneaky attack on Medicare' and 'evidence that we want to kill off Medicare' and 'evidence that we don't want Medicare to survive'. The shadow minister characterised the pause that will continue while we consult as a sneaky attack on Medicare. So, how does the shadow minister characterise her own statement, only a few days ago, when she said about the indexation freeze, 'We did it, and we will own that we did freeze rebates'? That makes absolutely no sense. So, is the Labor Party now saying that it is carrying on a sneaky attack on Medicare itself? I do not know. It does not make sense. This is a serious issue, and I want to address more remarks that the shadow minister made, and they were about bulk-billing. We are determined as a government to protect bulk-billing for the vulnerable, and I recognise, as the shadow minister has said, that there are people on low incomes who do not qualify for concession cards and for whom the cost of going to the doctor is difficult. I care about those people, just like you do. That is another area we agree on; we are finding a few more areas of agreement. Hey, we might be working together soon in some areas of public policy that matter to the Australian people! But the levels of bulk-billing for those who can afford to pay a modest contribution to the cost of going to a doctor are too high. More than seven out of 10 non-concessional patients are bulk-billed when they go to the doctor. Ms King: No, that is wrong. You are confusing services and patients again. Services are not patients. Ms LEY: Over 70 per cent of episodes of care to non-concessional patients are bulk-billed. What that tells us is that there is a cohort of people with the ability to pay a modest contribution to their medical services who are in fact paying nothing. Remember this: behind every bulk-billed consultation there is a government fee. There is a cost to government, and that payment to government is coming from a government increasingly constrained in our ability because of the national accounts left to us by Labor. So, I say to the shadow minister: if you are comfortable with the level of bulk-billing for those who can afford to pay a modest contribution, then you should stand up and say that, because that is an unsustainability in Medicare that you as members of the Labor Party should not support. You are the party of means testing. You are the party that says that if people can afford to pay then they should. But you are now the party that is saying, 'It's okay; everyone can have a bulk-billed consultation.' When we say that Medicare is universal in coverage, that does not mean that it is free. But it does have built into it a strong equity argument, and that equity argument is an important one. If we are to keep Medicare sustainable, equitable, simple to administer and universal in coverage, we need to understand that the cost of bulk-billing for those who can afford to pay is too high. Behind every one of those bulk-bill consultations lies a payment, and governments do not have money— Opposition members interjecting— Ms LEY: Shadow minister, I did not interrupt everything you said. I know it is a tactic of yours at the dispatch box— Ms King interjecting— Ms LEY: I said one thing—I said we had sat here and listened to you rack up debt—but I did not sit here and interrupt the way you have. I know that you are probably concerned because I might be about to reflect on your time as regional infrastructure minister. You are probably hoping that by presenting a wall of noise I will not get to talking about your time as regional infrastructure minister. Do you remember when the audit committee had a close look at the things you did and found that they were not quite right and that you used ministerial discretion in a way that it never should have been used in distributing funds to government projects and programs? You certainly did not do a very good job. There is an important issue here. There are areas that the government and the opposition agree on—we do want to sustain Medicare, we have listened to the professions and we are committed to working with the professions. While, I admit, we paused the rebate, the opposition has determined that it will freeze the rebate, because it admits that it owns that policy. We are saying that we will pause it, we will consult, we will continue the discussions that we are having around the country, with one aim in mind—to make sure that the Medicare system, of which we are all so proud, is kept on a sustainable footing to protect the vulnerable and to make sure that those who cannot afford to go to the doctor are supported, as they should be, by sound government policy.