12 May 2021

There are some things that people who live in a First World nation like Australia should expect of their government. Affordable, good-quality health care is one of them. Out-of-pocket payments for health care mean that many people, especially on those on low income, will not be able to access the health care they need. For those that can afford health care when they need it, it can still leave them and their finances severely impacted. High out-of-pocket costs prevent people with long-term or chronic conditions seeking health care. This includes delayed visits to GPs and not filling prescriptions, because of the cost.

Medicare is one of the nation's great public services; however, it only covers 80 per cent of the GP, pathology and imaging services if doctors don't bulk-bill. People with chronic conditions need additional services such as appliances, aids and pain relief for rehabilitation. For the people of Werriwa, out-of-pocket expenses have soared. The average out-of-pocket expense for seeing a specialist in Werriwa in 2020 was just over $100. In 2013, it was $64. That's an average rise in out-of-pocket costs for GP attendances of over $12 since 2013. Werriwa had the 13th-highest out-of-pocket costs for seeing a specialist in 2020, well above the national and state averages.

This is on top of unacceptable waiting times. For public patients, waiting times for significant elective surgery are a continuing problem, partly a result of specialists moving to private hospitals. Liverpool public hospital caters for the majority of residents in Werriwa. It also looks after part of surrounding electorates such as Fowler, McMahon and Hughes. It services up to 300,000 people who may need care, and people are waiting unacceptable lengths of time for that care.

But space and capacity are not the only issue. Liverpool hospital is the largest hospital in New South Wales. What it lacks is funding and staff. Many have had to find thousands of dollars for private surgery because they need urgent care, but even on private waiting lists it can still be up to six weeks before you're seen. The public waiting list can stretch over two years. I've previously pointed out in this place understaffing issues in my local health district.

I highlighted that the Liverpool Hospital Medical Staff Council commissioned a report from Westir that was released in 2018. It found that the health district is significantly under-resourced compared to other districts. That's because the original base funding for the South Western Sydney Local Health District was not adequate to fulfil its needs. Another factor is the lack of alternative healthcare providers, which puts additional reliance on the public hospital system. The social and economic inequality decreases the ability of community members to weather health shocks. The report concludes:

There appears to be greatly increased resident need and significantly less available resources compared with other Greater Sydney LHDs. This is particularly felt by Liverpool Hospital which functions as a quaternary service hospital for the district.

Analysis by the Macarthur Cancer Therapy Centre found that Sydney Local Health District receives $2½ thousand in funding per resident. In comparison, the South Western Sydney Local Health District, which includes Liverpool Hospital, only receives $1,750 per resident. The difference is 40 per cent. The evidence is clear: Liverpool Hospital does not have equitable access to funds and has a greater than average challenge in its efforts to meet health care in our community. As the state member for Liverpool, Paul Lynch, puts it, it's like building a new road and not letting cars drive on it.

Out-of-pocket costs and waiting times are significantly diminishing Australians' quality of care and most definitely their quality of life in my electorate. We must avoid the Americanisation of our healthcare system. It should not be determined by the suburb you live in or the limit of your credit card. As a child, I clearly remember conversations between my parents about who they could afford to take to the doctor. Medibank and then Medicare changed those conversations for my family and all other families in Australia. This government must do more to address the rising expenses of out-of-pocket health care and the inequity of access to high-level health care in Australia. I thank the member for Macarthur for moving the motion.