While doorknocking during the election campaign, I met a young mother named Michelle.
She had just moved to the area with her 4 year old daughter, having fled a violent relationship. She is staying with her mother for now, but hopes to find a place of her own soon.
Michelle’s mother is worried about her granddaughter’s development, because she hasn’t started at preschool yet. Michelle told me she couldn’t enrol her as they’ve been moving so much and living in temporary housing, but as soon as they are settled she will.
Michelle is diabetic, a chronic condition that requires constant attention and equipment.
I was asked a simple question – where can this family find a doctor who bulk-bills?
It’s a story which demonstrates a simple, but often overlooked, fact.
Health care does not exist in isolation. How ‘well’ we are cannot be separated from where we live, how safe we are, and what access we have to basic services like education and housing. It should never be because of it.
That the Coalition Government accuses Labor of participating in a scare campaign on Medicare shows how fundamentally and hopelessly they miss this point.
We are right to be fearful of their approach. In the three years of the Abbott Turnbull administration we have seen an unprecedented attack on public services - billions cut from schools and hospitals, underinvestment in infrastructure and a relentless attack on the social security safety net.
I have spent more than 20 years working in the health sector, a large proportion as a specialist pharmacist in the mental health unit of Wyong Hospital. I know that there has never been a more worrying time to be a health practitioner, or for that matter a patient.
The Liberals have flip-flopped from one health policy to another – from Abbott’s ill-conceived GP co-payment to Turnbull’s Medicare rebate freeze – but the intention has remained the same: to end universal health care.
The current freeze on the Medicare Benefits Schedule for six years leaves bulk billing doctors with two options – continue to bulk bill and lose more money each year or increase fees.
The Coalition is also ploughing ahead with changes to the Pharmaceutical Benefits Scheme which would increase the price of medicines for general patients by $5 and for concessional patients by $0.80.
In addition, they have also cut $650 million from pathology and diagnostic imaging, meaning patients will pay more for vital preventive and diagnostic tests such as MRIs, X-Rays and CT Scans.
These are barriers to primary health care which puts our public health system, which is already under pressure, at risk.
According to the Health Department’s own figures, a patient presenting at an Emergency Department costs around 8 times as much as if they had seen a GP for the same consult. The Medicare rebate for the most common kind of consultation is $36.30, whereas the average cost of a non-admitted level 5 triage visit to a hospital – the most likely substitute for a GP visit – is a staggering $290 per consultation.
Sufferers of ill mental health are particularly vulnerable. There is an alarming lack of resources available to public hospitals and community support teams working in mental health and it must be addressed. Patients are increasingly cared for in the community, but if the support services are not in place to cope then patients, their carers, and the community suffer.
Professionals working in the health sector do an incredible job and meaningful reform can only be achieved when it is made in recognition of, and in consultation with, those who work within it. The Government’s failure to consult with health professionals and their inept approach speaks volumes.
As a pharmacist I saw patients in a clinical setting, wrapped in the relative security that short term hospital admission and medical intervention provides. However, managing a patient’s condition in their homes and supporting them to function in their community is an entirely different prospect. One of the reasons I sought to become a Member of Parliament is to help address health issues in my community; to be part of the discussion about our model of care, how patients and carers interact with it and how legislators can support it.
But for so long as health policy is driven by ideology we will never achieve effective reform.
There is nothing cost effective or compassionate about making it harder for people to see their doctor. Cuts to primary health, community care and welfare are short-sighted and will lead to more strain not only on the health system, but all the public services that work alongside it.