Bill's Transcripts

Doorstop: Canberra - Malcolm Turnbull continues the attack on Medicare; Liberals cuts to pathology and imaging services






SUBJECT/S: Malcolm Turnbull continues the attack on Medicare; Liberals cuts to pathology and imaging services; Stuart Robert; Government in Chaos.


GAI BRODTMANN, FEDERAL MEMBER FOR CANBERRA: Well thanks everyone for coming here to Capital Pathology this morning. It's great to be joined by my colleagues Bill Shorten and Catherine King and also to see Ian Clark who's the CEO of Capital Pathology here, as well as John Crothers who's with Pathology Awareness. Now, this facility is just four months old, as you can see it's a very impressive facility Capital Pathology employs 300 people in the Canberra region and services half a million people in Canberra region each year. So I now thank you again for being here and I now hand over to Bill to talk about the impact of the Government's cuts to pathology.

BILL SHORTEN, LEADER OF THE OPPOSITION: Thanks Gai, and good morning everyone. We're here at Capital Pathology to talk about dreadful cuts which the Turnbull Liberal Government is wreaking upon pathology and patients who require pathology. We will not be distracted by the Stuart Robert scandals, by the chaos in the Government, by the resignation of ministers because even though that's dominating the Government's attention, Labor's even more concerned that this chaos means bad decisions are getting made about the healthcare of Australians. This week we've seen the Government announce that they want to privatise large chunks of Medicare. This is the real problem with the Government. When they're not too busy killing Medicare, they're just trying to sell it off. We're here because there are pathology cuts which will damage the care that patients receive in this country. The Government has said they're going to cut what's called the bulk billing incentive. It is $650 million provided to pathology service providers which helps defray the cost of the service they provide. If this money gets cut, it is beyond doubt that the service providers who provide pathology services to no less than 12 million of our fellow Australians every year will have to introduce a co-payment.

The Government's basically cutting this money to the system and, as a result, it's forcing the pathology providers to put a co-payment or an extra charge or a new charge in some cases on what they charge patients. Now, the services which are going to see the brunt of these cuts and, therefore, an increase in prices are the things which we need every day to keep us living lives full of quality and meaning. Diabetes, a chronic condition like that - pap smears, cancer treatments, diagnosis. The evidence is beyond doubt, that if you take too much money out of the medical system when it comes to pathology tests, it will force an increase in the price of pathology services to patients. The truth is that patients who are trying to make ends meet, balance the budget, pay for everything else they've got to do in life, will delay medical treatment. The cost of delaying medical treatment forced upon patients by the Government means that, in some cases, people will make decisions which damage their health and, indeed, their own life expectancy. 100 per cent of all cancer treatments in this country require pathology. 70 per cent of clinical diagnosis in this country require pathology. You just can't look at a patient, just look at them and work out everything that's going wrong with them. You need pathology. We've got the best scientists in the world in Australia. We've got a very good pathology system. What we want to make sure is that Australians get access to the best quality care at an early stage and we have that in Medicare. What's happening is that the Turnbull Liberal Government are cutting pathology services, which will increase the cost of vital life-saving medical treatment, and the consumer is going to pay more if in fact, they do or alternatively they may just delay treatment. Labor will oppose these cuts with every breath in our body. Even though the Government is in disarray this week on a range of other matters, we're not going to let up on opposing this cuts. I might ask Catherine King, my Shadow Minister for Health talk further about this very important issue .

CATHERINE KING, SHADOW MINISTER FOR HEALTH: Thanks very much, Bill. Every single day thousands of patients across the country are heading into collection centres, into general practices, not sure, feeling a bit unwell, not sure what's going on or have already been diagnosed with a disease and need to make sure they are on track to manage that chronic condition. Every day there are pathologists, there are scientists in testing centres around the country analysing samples of patients. Here in this centre, over half a million patients in the Canberra region have been tested and had their tests analysed by this centre. These are patients who may have low liver function or kidney function, may be wanting to know how to manage their diabetes better. It is about prevention and about treatment. The Government's decision to cut $650 million out of the bulk billing incentives for pathology and diagnostic imaging is a very blunt instrument. What they have decided to do is basically impose a co-payment. They tried it in the 2014 Budget and they had to drop it very quickly because pathology and diagnostic imaging billing is incredibly complex and very sensitive and you have to be careful about how you go about working with the sector to get efficiencies. They tried it in 2014 with the co-payment and this is exactly the same decision and it will have the same outcome. It puts a co-payment onto pathology and onto diagnostic imaging, requiring patients, particularly in diagnostic imaging to pay hundreds of dollars up-front to get the vital tests that they need. Time and time again we have seen this Government make an absolute, and I can't use any other words but, stuff-up, when it comes to health policy. They go out, they make a really big announcement, somehow try and bluff their way through and then they start to realise the consequences of those decisions and they back down. They accuse Labor that we're running scare campaigns, they accuse patients, they accuse pathologists in this case of being greedy in essence, they go and do that and then they have to back down. It is time that this Government stopped messing with our healthcare system. This week again through Senate Estimates we found that the Government has had a secret plan, 20 people on a taskforce, $5 million, to privatise the Medicare, the PBS and aged care payment system. This is billions of dollars of taxpayers' money that is paid in benefits to people who are going to see their doctors, to get their scripts or in aged care provision every single day. This is a system that works well and the Government now wants to say let's throw it out to the private sector to actually manage this incredibly complex payment system. I don't think you could get any area where there is so much chaos than when it comes to health policy and it is time this Government learnt its lesson and backed down on these cuts. I might hand over to Ian to say a few words on behalf of the Capital Pathology and Pathology Awareness Australia.

DR IAN CLARK, CHIEF EXECUTIVE OFFICER OF AUSTRALIAN PATHOLOGY FOR SONIC HEALTHCARE: Thanks very much Mr Shorten and Ms King, and I do appreciate your visit today. I thank you on behalf of all the staff here for your interest in Australian pathology. As you've said we are an organisation that's an integral part of the Australian and Canberra community. Our 300 expert staff, as you have said, provide 500,000 patients with 5 million test results every year. We provide the critical results that hospitals and doctors need in blood tests, biopsy results, pap tests, swabs. The system of pathology in Australia is the core element that underpins the entire health system. That we would put that at risk is quite surprising to me. The fact that we are being criticised for doing what is so good for the Australian people is also quite surprising to me and to all who work in pathology. This is a pap smear and we looked at it earlier, it has hundreds of thousands of cells on it; we need to find the one rogue cell that will save the woman's life. That will reduce her risk; it will eliminate the risk of developing cancer of the cervix. Cancer of the cervix is now very rare in Australia, thanks to the success of the pap smear campaign. Pathology is essential to so many aspects of Australian medicine. It's vital for diabetes care, for cholesterol control to prevent heart attacks, to prevent cancer. Pathology is of vital importance to so much that we do. If these cuts come in in July, as the Government has told us they will, then we will be forced inevitably to increase co-payments for patients. We are particularly concerned about those who are in need, that we can support them - pensioners, healthcare card holders and those with chronic diseases. If these cuts are not reversed, then many patients will choose not to have the life-saving tests they need. We are already seeing that. Our people here, our team, get up every day to help patients and they don't like seeing people upset.

JOURNALIST: Can I just ask you very briefly, so if the doctor says I need a blood test, where would I have to pay if these cuts do come in? Can you explain that?

CLARK: Where would you pay?

JOURNALIST: Yeah, where would I have to pay, what would be the change?

CLARK: The whole system is predicated against a payment at the moment which is one of our problems in instigating a co-payment. You come to us and we do the test, we would then issue you with a bill, an account that you would take to Medicare, they will give you back the rebate and you will have to pay the difference, that's how it will work.

JOURNALIST: Sorry I just have one more question for Ian.

SHORTEN: The fact that you've got people in the health industry doing the unprecedented, which is speaking up themselves, I'm going to get Ian back to answer your question but please, just understand the people in the pathology industry don't want to be politicians but they do want to look after people. I think it is really powerful that people are willing to step off the sidelines of political debate because these people and the tests they do are saving lives. I just wish that Malcolm Turnbull and his team would just keep their hands off Medicare and if they want to make changes, just talk to the experts.

JOURNALIST: Just one brief question, have you done modelling Ian on how much extra it would cost to patients come the middle of the year if this goes ahead? How much you would have to charge?

CLARK: That's something we don't have at this stage. It is such early days, we are still working through. We are hoping the bulk billing incentive cut will be reversed.

JOURNALIST: Have you had discussions with any government bureaucrats or any government politicians on trying to reverse this?

CLARK: That's something you should ask Pathology Australia about.

KING: They've certainly been walking the corridors.

SHORTEN: Trust me, I think Pathology Australia representing, you know the 12 million Australians who have tests have been trying to speak to the Government, but I don't know if you've noticed a pattern with the Turnbull Government, if you criticise them, they don't tend to sit down and talk to you, they demonise you. In fact that was the Abbott Government's pattern too and nothing much has changed. I have noticed the Turnbull Government has started attacking the pathology industry and saying that somehow that they're gold plating the system and that they don't know what they're talking about. I tell you what, if I had a family member who had a condition which required a blood test, I wouldn't be going to Malcolm Turnbull or his Health Minister, I'd go to the pathology industry to sort it out. You know, I think Malcolm Turnbull and his team have got to realise they are not the smartest people in the room when it comes to the health system of Australia. For me it is about the patients, it's about the nurses, it's about the allied health professionals, it's about the pathology labs and all the people there. I don't understand for the life of me why Malcolm Turnbull thinks he is smarter than the pathology industry.

JOURNALIST: Yesterday the secretary of Health Department Martin Bowles told Senate estimates that based on their analysis there would be no discernible change in bulk billing rates if this went ahead. Would you like to see that analysis?

SHORTEN: Not only would I like to see the analysis but again, when it comes  down to weighing up do I believe the Turnbull Government or the bloke who runs Capital Pathology, I'm not going to put the health of my kids and my family in the hands of the Government, I will put it in the hands of the professionals. This industry between 2000 and now, has seen a reduction in payments in the order of 15 per cent so it is not as if they have stayed static, it's not as if there hasn't been any change. In life there comes a tipping point where beyond that point they are going to have to charge a co-payment. I do not believe the industry is exaggerating, I do not believe that they are saying that they don't know what they're talking about. What I do believe, what I know, is that when patients confronted with a co-payment, or a tax on the services they are currently receiving, some people because they have scarce financial resources will make decisions to delay medical treatment and that will prove ultimately very detrimental to their healthcare but also the taxpayer. This Government, they know the price of everything and the value of nothing. What is the benefit in discouraging people from seeking medical care - that's the evidence that co-payments will do that - and then they get sicker and they've got to go to hospital and get more emergency treatment and it is going to cost the taxpayer more? This Government is just worried about the next day and not thinking about the future of our healthcare system and Medicare.

JOURNALIST: We have seen the retirement of two Ministers, do you welcome this upcoming reshuffle as a chance to see some younger, newer faces on the frontbench?

SHORTEN: I think to lose one Minister is careless, to lose two Ministers is unfortunate but I don't know what they are going to say when Stuart Robert goes. Then you've got other senior ministers, respected politicians, Andrew Robb, Mr Truss. Malcolm Turnbull is losing his experience at a rate of knots. I think he promised there would be strong economic leadership when he rolled Tony Abbott, but we haven't seen them focusing on the day jobs of Australians, we have seen them focusing on their own day jobs. The chaos and dysfunction of this first two weeks of Parliament is clear for all to see. In fact, it's only a matter of time before Mr Turnbull says in his courtyard "good government starts today".

JOURNALIST: On Stuart Robert, some in the Government are suggesting that if the then Prime Minister approved this trip, that absolves Stuart Robert of any breach of the ministerial code because it is up to the PM of the day to enforce it. What are your thoughts on that?

SHORTEN: A crocodile wouldn't swallow that. I think Malcolm Turnbull is pretty keen to throw Tony Abbott under the bus for a second time and blame him for the Stuart Robert scandal. But what is going on? What is it that Malcolm Turnbull doesn't understand about a Minister acting in his private capacity, not his official capacity? It is not standard business for Australians when they are having a holiday in China to turn up at the signing ceremony of a mega-financial deal between a resources company and the Chinese Government. This Stuart Robert is acting like Forrest Gump, he is in the photo but he’s got nothing to do with him. No one buys that. Then you've got a meeting with the Chinese Government - the Chinese Government just don't have meetings with people who turn up in China. Mr Robert was accompanied by executives of Nimrod Resources, and of course it’s all a big coincidence. There is a Carlton Mid-Strength ad, the beer ad where the bloke and his wife are on holiday, they're sitting around the pool, then all of a sudden another one of his mates turns up and says 'fancy seeing you here', and then there's another mate comes along and that's really what Stuart Robert is doing. He wanders into a room in China, sees the big donor, Paul Marks fancy seeing you here. Then the vice minister of resources, fancy running into you. No, this doesn't pass the credibility test at all. If Stuart Robert is still a Minister by the end of the day, it reflects abysmally on Malcolm Turnbull and his judgment. As much as Malcolm Turnbull may want to blame someone else, he is the guy in charge.

JOURNALIST: Will your team you have now be the team you take to the election?

SHORTEN: Yes, I expect so.

JOURNALIST: With Andrew Robb, aren't your claims of government chaos a little exaggerated? He is staying on until the election in his trade role in Cabinet - there isn't that much going on, he just announced his intention he won't stand again?

SHORTEN: I like Robby, he’s a good bloke. He has been probably even more noticeable as a minister in this Government because he has been more successful than most of the rest, hasn't he? The real issue here is that you have a bit of chaos and dysfunction, and not just a bit of it. Before Christmas the Special Minister of State, the Prime Minister had full confidence in him, now he is on the backbench. The Minister for Cities, he is sitting up on the backbench. You've got the Stuart Robert saga just dragging on. Now you've got senior ministers jumping ship. No question Andrew Robb has had a distinguished career but - Barnaby Joyce could well be Deputy Prime Minister of Australia? I'm afraid to say that chaos is the order of the day in this Government. And again, when you look at the policies behind it, they haven't ruled out a 15 per cent GST on everything. They are making terrible and ridiculous cuts to pathology and diagnostic imaging services which will harm patience's welfare. They are always talking about going after penalty rates and they want to privatise big slabs of Medicare.

JOURNALIST: There are reports the wife of terrorist Khaled Sharrouf has died over in the Middle East. Should their children be allowed to return to Australia?

SHORTEN: I do not understand for the life of me what parent would have taken their children to this zone. As a parent, I do not understand. I don't understand what they were thinking as adults going to this conflict zone and backing ISIS but to take your kids to it, it is a form of child abuse. I'm more interested frankly in what happens to the children and we are going to be asking for briefings from the Government.

JOURNALIST: What is so bad about Barnaby Joyce becoming Deputy Prime Minister?

SHORTEN: That's up to the National Party but the point about it all is that you've got clearly the relationship between Malcolm Turnbull has been strained with Barnaby Joyce in the past. They have a diametrically different view of the world. If the leader has a different view on many policies to the deputy leader, that's not good for the unity of the government. Clearly, Barnaby Joyce was a fan of Tony Abbott's and not Malcolm Turnbull's, so I think it is cementing division into the future in this government. What Australians want is they don't want a government focused on their own in-fighting, they don't want a government focused on trying to protect ministers who shouldn't be protected. They want a government to focus on what matters to Australia - good quality well-funded schools, good quality well funded universal healthcare where it is your Medicare card not your credit card which determines the level of care you get in this country. They don't want a 15 per cent GST on everything. They want a government who can outline a plan for the future, not a government or a Prime Minister who says one thing and does something else.

Thanks everyone, see you later in Parliament.