Tony Burke

by leave—I move:

That standing order 133(b) (deferred divisions) be suspended for this sitting.

Adam Bandt

I seek to speak on the motion. Had the government come in this budget week and said, 'We need to reorder business to pass legislation to ensure that people can go and see their GP for free and triple the bulk-billing incentive,' we'd have entertained that. Had the government come in this budget week and said, 'We want to pass legislation to get dental into Medicare,' we'd have entertained that. Had they come and said, 'We want to pass legislation to wipe student debt by 20 per cent to ensure that it's protected against whatever might happen in the next government,' we'd have entertained that. We offered the government action on all of those things because, in the middle of a cost-of-living crisis, when we have been called back for a couple of days to sit, we should be prioritising legislation that might actually help people. But, instead, the government says, 'We've got to come back and reorder business to fast-track legislation to gut our environment and climate laws and to do a dirty deal with the opposition to fast-track extinction.'

Milton Dick

On a point of order, the Leader of the House?

Tony Burke

Just on relevance, the motion that the Leader of the Australian Greens is speaking to is not the motion that's before the House. The motion that's before the House is whether or not the standing order that would defer any divisions till after question time be suspended.

Milton Dick

The Leader of the House is correct. I'm just giving the Leader of the Australian Greens some licence, but the procedure motion before the House is—

Honourable members interjecting—

Just hold your horses. Members on my right are not helping this situation either. People are interjecting outside of their place. Any member on their feet has the right to debate. Everyone on my right can just cease interjecting. But this is to deal with the standing order, so, if you wish to address the motion, you can, but you'll need to be relevant to the motion before the House before we get to other motions.

Adam Bandt

Okay. This is a motion to reorder the business of the next couple of hours to allow divisions to occur in the next couple of hours. Usually at this time on a Tuesday there are no divisions occurring. Why is it that, in a sitting that many people didn't expect to have and with a couple of days of sitting left, the government says, 'We want to change the way things are done usually to allow for more divisions to happen and more votes to happen to allow legislation to be fast-tracked through this place'? That's what the divisions are for. Why is the government wanting to do that? It's not to wipe student debt. It's not to ensure that people can go and see the GP for free and that we Dutton-proof that legislation. No. It's to bring legislation to this place and ensure that the normal order of doing things is reorganised so that they can fast-track the extinction of a species in Tasmania and introduce legislation that will gut our climate and environment laws. That is why they are moving this motion to allow for, over the next couple of hours, votes to take place on legislation that was seen a couple of days ago that hasn't been through the usual Senate inquiry process and that will not address the cost-of-living crisis that people are under when we are called back here for a budget. They will instead act, simply because the big corporations and the Leader of the Opposition have said, 'Jump,' and the Prime Minister has said, 'How high?'

The legislation which the suspension motion from the Leader of the House is designed to fast-track over the next couple of hours by rearranging the way things are usually done will not address the cost-of-living crisis that people find themselves under. That is not the government's priority in moving this motion. They have shown absolute unwillingness to legislate even their own measures, which they say are so important. They want to hold wiping student debt by 20 per cent ransom to the outcome of the election. They won't bring a motion to this parliament to say, 'Let's pass that now.' Let's legislate seeing the GP for free and tripling the bulk-billing incentive—an idea of the Greens that they've adopted. No. We won't bring a motion to parliament to re-order business and to allow debate and divisions to happen to ensure that that progresses today.

No. What this motion is about is ensuring that, over the next couple of hours, the government fast-tracks legislation that will make a species extinct, and—not just that!—the government says, 'Please pass this motion so that we can debate this legislation.' You know what, Mr Speaker? There's a reason that they're not prepared to put this to a Senate inquiry and, instead, want to go through this dodgy process here now to allow divisions to happen at a time when usually there would not be divisions. The reason that that is being proposed is to hide scrutiny of just how wide ranging this bill is.

Milton Dick

Order. The Leader of the Greens will resume his seat for a moment. The Leader of the House?

Tony Burke

I rise on a point of order of relevance to the motion that's before us, again. It might be of some assistance—while the Leader of the Greens is referring to reordering of business that might be moved in subsequent motions, the bill that he's referring to is actually scheduled to be debated and voted on this afternoon. This standing order is irrelevant to divisions that happen after 2 pm. The resolution that we have now basically determines whether or not we can deal with supply bills and whether we can deal with a transport security bill before we get to question time. The legislation that he's referring to is legislation that—even on what's going to be moved subsequently and even if that were somehow relevant—is completely outside the ambit of the motion that's before the House right now.

Milton Dick

To assist the House—it's a big day today—could the Leader of the Greens just stick to the motion regarding the standing order. I know he's bringing other materials in, but I just want him to be directly relevant to the standing order, 133(b), which is before the House now as we're making the decision whether the deferred divisions will occur or not.

Adam Bandt

Of course those other bills can be progressed through this parliament, but what the government knows that it is trying to do is to ensure that, over the next few hours, passage is cleared, including by moving any procedural motions and having any divisions on them that are necessary, for an unprecedented piece of legislation to be put through this parliament today. That's what the government is attempting to lay the groundwork for in this motion—to allow unprecedented legislation that has not been to an inquiry, that will have wide-ranging implications not just for the fast-tracking of a species to extinction but also to allow coal and gas projects to be approved, to allow other environment destruction to take place and to remove the communities' right to oppose that. The government knows full well what it is trying to do, which is to clear the procedural decks to allow the fast-tracking of legislation that will fast-track a species to extinction and open up massive loopholes in our environment laws that other coal and gas corporations and other huge developers are going to be able to drive their way through. The government knows that. The government knows that absolutely.

We'll oppose this attempt to reorder and clear the procedural decks so that the government can fast-track this terrible legislation through. I urge the government in the remaining time that it's got, as it's considering the procedural motions that it's putting here, to go back to the drawing board and say: 'Let's use these next couple of days to pass legislation that will benefit people, that will wipe student debt, that will triple the bulk-billing incentive and that will get dental into Medicare. Let's use it to do that, not to fast-track a species to extinction and to gut our climate and environment laws.'

Milton Dick

The question before the House is that the motion be agreed to.

Zali Steggall

The Early Childhood Education and Care (Three Day Guarantee) Bill 2025 is an important bill in terms of finally assisting young families in juggling those commitments of parenting, children and working. Support for our working families leads to stronger outcomes for the economy and our community.

The decision about whether to return to work or take more time off to care for a child is a decision that all new parents must face, and all too often women are left with that responsibility. That needs to change. Men and other parents and partners must shoulder more of that proportion and responsibility. Of course, there are trade-offs when that choice of either staying home or going back to work has to be made, whether they be financial or emotional, because none of these choices are easy. I've spoken to many young parents, especially women, across my electorate who rely on many different types of care, from private and public child care to relying on family, to help juggle the demands of working life and the exorbitant cost of accessing child care.

I've been there personally and I understand how incredibly hard and expensive it is. As a barrister and as a sole trader, I didn't get access to any of that assistance. It was a juggle between local childcare centres and my parents assisting me a number of days a week, and I often had to juggle leaving court and leaving chambers early because of the crazy closure times and the penalty rates that apply if you're five minutes late picking your kids up from the childcare centre. It's incredibly hard, and all too often the decks are stacked against women because all too often women are left to shoulder this responsibility. My call-out to men is: it is good for your relationship with your children to spend more time with them. The responsibility of caring should not fall on mothers; it has to fall equally on all parents. It is good for your relationship with your children and for our economy and our society because it means everyone has the opportunity to participate.

All too often for women, the frustration of wanting to go back to work but being penalised by a reduced eligibility to claim days in child care—you have this penalty cliff at which there is a point you are working to pay for it rather than working to get ahead. That is just wrong. Women juggling commitments need to feel supported by the community and our broader society. Parents need to feel supported. This is an essential part of Australia moving forward—being able to have that juggle of family, children and work and progressing careers.

Of course, support comes in many ways, through the childcare system, family support and a broader understanding of the pressure on working parents. The call for universal child care holds significant benefits for our children, and, far too often, it has quite insultingly been pitched as something that is given to women. With respect to every member, it is something given to our society, because we go nowhere unless we have children and we go nowhere unless everyone in our society has the opportunity to work and to contribute and has that equal opportunity to do those things. So universal child care holds significant benefits for our children, our community, our economy and our society.

Of course, for children, it also provides the best opportunity to be happy, safe and secure and it builds the necessary foundations and skills that children need throughout their life, especially when they then enter schooling. It's incredibly important that all children have the opportunity to access that early childcare experience. It's particularly impactful that children who come from disadvantaged backgrounds are able to get into those opportunities. So I very much support the implementation of full, universal access to child care for this minimum of three days, and this bill is a welcome start.

The bill is being introduced because the activity test is broken. The childcare subsidy does not provide an adequate safety net for working families. We have the second-highest childcare costs in OECD countries. It is prohibitively expensive, and, whilst there are childcare deserts and a lack of availability in regional communities, the cost in urban communities is exorbitant. My community would have to have one of the highest costs when it comes to child care. Australian families spend about 27 per cent of their income—that's nearly a third—on child care, compared to the OECD average of 14.5 per cent.

The Productivity Commission's report on universal child care found that 328,000 parents were not entering the workforce due to the affordability and availability of child care. We hear a lot in this place about staffing shortages and skills shortages. You can point to and blame immigration and do all those things, but, ultimately, the first and best thing we can do is utilise, to the best and the fullest capacity, our current population, making sure everyone in our communities now have that equal opportunity to participate. If you think about it, 328,000 parents are not entering the workforce due to the affordability and the availability of child care. So this bill goes some way to fixing that, and I welcome it.

The activity test introduced by the previous government in 2018, designed to encourage workforce participation, was shown not to work. The test is used to determine how much care subsidy a family can receive, but it's linked to hours a parent is working or a parent is volunteering, job hunting, on leave or studying, and it has been heavily criticised, because, unfortunately, it has not resulted in increased workforce participation. In fact, it has disincentivised workforce participation. The Australian Institute of Family Studies's evaluation found no evidence that the activity test caused any increase in workforce participation; instead, it is most likely to hurt lower income families and discourage use of access of early childhood education for their children.

The Productivity Commission, the Thrive by Five campaign and the Parenthood group all have done phenomenal work in raising this issue. This is not a women's issue; this will be a society issue and an economy issue unless we can all participate. It is very good to now be looking at this activity test and getting rid of it. It's too convoluted and difficult to understand. As it was, the subsidy didn't increase enough to cover the added cost of child care as a parent increased their working commitments. Too often parents, usually women, were left to work part time because the cost of going full time or increasing their days was simply too prohibitive. That has so many knock-on effects. It means that women may stay on part-time or casual contracts instead of going into permanent employment. It means that they are not accumulating the same amount of super. It means they are not eligible for the same promotions. You then see that pay gap and that opportunity gap widen.

The focus on the parents in that activity test does not provide an opportunity to allow all children to have the best opportunity to thrive. In fact, families have been found to deliberately keep their hours low enough to receive support. Alarmingly the Productivity Commission found that 70 per cent of sole parents and secondary earners have reduced their hours due to the reduction of childcare subsidies. If there was ever a counterproductive measure, this would have to be it! The ACCC found that families on a lower income spend a greater share of disposable income on child care and are disproportionately impacted by the childcare subsidy activity test. The impact is that some 126,000 children from the poorest households across Australia have missed out on early childhood education, and, unfortunately, that missing out is compounded over the years, and it makes a difference.

This bill reforms the activity test to ensure that families who earn less than $530,000 per year will be guaranteed access to at least three days a week, or 72 hours per fortnight, of subsidised child care. According to the Department of Education, households earning between $50,000 and $100,000 per year will save around $15,000 a year. This is really significant. It provides a guaranteed 100-hour entitlement per fortnight for parents caring for an Aboriginal and Torres Strait Islander child. And I welcome that additional provision for First Nations Australians.

It's a high-stakes road map; there is no doubt. The bill presents an opportunity to improve gender equity by providing more choice between increasing caring responsibility and entering the workforce. It's a first step to make universal child care available for all Australian families. Better access to affordable child care leads to additional hours of work by more parents joining the workforce. It's estimated that the taxation uplift will actually be in the order of some $292 million, and it will increase Australia's GDP by some $6 billion. So I dare anyone in this place to oppose the bill and say that somehow this is not a good measure.

The bill presents an opportunity for children to access high-quality child care that will set them on the right path. Now, of course, this only works if we couple this with a measure to make sure child care is available in all communities in Australia. I've heard many from the opposition, in their speeches, talk about the childcare deserts. That does not warrant opposing this bill. It means go to the table, sit down with the government. You find ways to do it on other issues, so sit down and work out how we can roll out childcare centres so they are available in every community in Australia. Pointing at the lack of availability is not a reason to not support making it available and more affordable to all. It's so important.

I've spoken many times in this place about the need to help women participate equally in work and strengthen our gender equity, including in our superannuation laws and paid parental scheme. For me, this campaign to increase the childcare subsidy to provide more support for working families is essential. That's why it is so important to be committed to having more voices in this place, more diversity. Especially, it is about having more women's voices in this place—to make sure that these issues are not pigeonholed but are put front and centre of good economic management.

This bill is welcome, but more can be done. The activity test still needs reforming. I think we need to remove the activity test completely to ensure greater universal childcare access. The affordability is one piece of the puzzle, but it doesn't work without access to high-quality childcare centres. So, as I said, we need to do more about this. During the break, the government committed to funding and constructing more. They have committed to 160 centres. Unfortunately, I remember at the time there was a media outcry about the scale of that spend. Well, you can't come into this place and complain about the lack of availability, oppose the measure to build and support more child care and then also oppose making it more affordable for families. And you can't then go out to communities and say you're somehow in this place fighting for families.

I support the government on this issue. We need to do more to make sure that there are more centres built and, in particular, that regional and rural Australia has access to child care. Victoria University has done a study which shows that 24 per cent of Australians live where there is a lack of childcare availability. There are more than three children for each childcare spot. So it's slightly better than in 2020, when it was 34 per cent, but it shows that there's still a lot to do; there is so much more that needs to be done.

Yes, I represent an urban community, but I am acutely aware that child care needs to be available to all Australians. All communities need to have access to quality child care so that all Australian children have that opportunity to develop. So I encourage the government to consider incentives to increase availability of high-quality education and early learning, such as rewarding centres if they meet or exceed national quality standards. We need to make sure there are incentives.

Of course, we have labour shortages, so the question will be whether we have enough people to staff these centres. So, again, it's making sure qualified staff are available. We know that they're struggling to find qualified staff, and it's putting extra pressure on families as centres cap the number of places due to staffing shortages. Now, of course, that is linked to wages and whether or not it's an attractive career pathway. Median wages for early childhood teachers are about 20 per cent lower than those of primary school teachers. They have poorer working conditions, fewer leave days and greater workplace pressures. More than half of graduates of early childhood education degrees choose employment in primary school, so clearly we still do not have parity across these education sectors and we are picking and choosing which ones we value. We need to do better to make sure that the entire pathway is supported and equitable.

The government's commitment to early childhood education is welcome, but, as I said, more can be done. So it comes again to that coordination piece at the state and territory and federal levels to improve the recruitment and retention of early childhood educators: removing unnecessary workforce barriers, such as moving between state and territory jurisdictions; improving opportunities for career development, such as early career support and mentoring programs; and, of course, wage increases.

So I welcome this legislation. It is an essential part of us having an equitable society where men and women—all parents—have the opportunity to juggle the responsibility of parenting with working and making a financial contribution by being in paid employment. It is so important that early child care be available. Ultimately, it is a key to us having a smart next generation. We know that the data shows that engagement in early child care helps development and improves learning outcomes as children go on to primary school.

Long debate text truncated.

Milton Dick

The question before the House is that the Senate amendments be agreed to.

Patrick Gorman

I move:

That the amendments be agreed to.

Adam Bandt

Instead of helping people, the major parties help themselves; what a stitch-up! On the last day of parliament, instead of reforming childcare laws, it's laws to help the big parties.

Milton Dick

Order! The Leader of the Australian Greens will resume his seat. The assistant minister has the call.

Patrick Gorman

I move:

That the question be now put.

Hon. Members

Honourable members interjecting—

Milton Dick

Order! We are dealing with matters before the House, and for us to deal with this we need some semblance of order in the House. Just so everyone understands what the motion is before the House—that's all I'm trying to assist with, so everyone is aware of what is happening—the question is that the question be put.

A division having been called and the bells being rung

Honourable members interjecting—

Order! I am drawing a line in the sand for this kind of behaviour. We are not going to behave in this unruly way, simply yelling at people across the chamber. I understand the issue is emotive for members, but this is not acceptable. I need members on both sides of the chamber to show restraint and some dignity while we deal with these issues.

The question before the House is that the question be put.

Milton Dick

The question before the House is that the amendments be considered immediately.

Patrick Gorman

I move:

That the amendments be considered immediately.

Milton Dick

There is a motion before the House. The question before the House is that the amendments be considered immediately, so I'll put that question.

The way the standing orders work is that, once the question is stated before the House to deal with a matter immediately, it's not debated.

Zali Steggall

Shame!

Milton Dick

We'll just get further clarification to make sure everyone is informed of what's happening in the House. The advice is that the motion can be debated.

Patrick Gorman

I move:

That the question be now put.

Milton Dick

The question before the House is that the question be put.

Michael Sukkar

I move:

That the member be no longer heard.

Milton Dick

The question before the House is that the member no longer be heard.

Milton Dick

The question before the House is that the bill be read a second time.

Tony Burke

by leave—I move:

That this bill be now read a third time.

And I move:

That the question be now put.

Milton Dick

The question is that the question be now put.

Jenny Ware

I rise to speak about the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. I do not agree with the amendment that was moved by the member for Brisbane, and I support the amendment that was moved by the member for Farrer.

This entire legislation is essentially an omnibus of health measures following legislative changes in the course of this parliament. The provisions relate to the effective administration of health benefit schemes—in particular, the power to detect, respond to, investigate, disclose and deter misconduct, fraud and noncompliance. It is intended that this bill will amend a number of acts, including the Health Insurance Act, the National Health Act, the Human Services (Medicare) Act, the Dental Benefits Act, the Therapeutic Goods Act and the Public Health (Tobacco and Other Products) Act.

In view of the title of this legislation and the fact that the Minister for Health and Aged Care today in question time referred to the fact that Medicare has recently turned 41, I think it is entirely appropriate that we look at how Medicare is performing, and I want to draw attention to some of the issues that I am confronting and my electorate of Hughes is confronting within southern Sydney and south-west Sydney.

First of all, we hear over and over again from those in government, particularly the health minister, that bulk-billing rates have improved and that there are more GPs now than there were under the former government. It did not take me very long to do a tiny little bit of research to understand that that is certainly not the case in most parts of the country and not the case in my electorate.

Only four practices in my electorate now bulk bill in their entirety. Sixteen per cent of general practices in Hughes bulk bill in some instances, usually for children 16 years and under and for those with a health services card. But, most tellingly, during the lifetime of this Albanese Labor government more than 20 general practices in my electorate have changed the way that they bill. Over two years and nine months, most of the GPs in my electorate have found that they can no longer bulk bill. I found that, overall, bulk-billing services have plummeted by 11 per cent since the Albanese Labor government came to office. That is 2.4 million fewer GP services being provided to Australians. Out-of-pocket costs overall have risen by 5.5 per cent during the term of this government.

So, when those in government, particularly the minister for health, stand there and say that we have more GPs than ever, that health services have increased and that the cost of health has decreased—we hear about cheaper health care—that is simply not true. It is disingenuous for the Albanese Labor government and a very senior minister to be floating that particular line.

The Australian Institute of Health and Welfare recently published data—this was at the end of last year, so it is very current—showing the Medicare bulk billing of GP attendances by month. What that has shown in my electorate particularly is that the rates have declined from about 80 per cent in 2022 to 68 per cent. Again, this is more evidence, not from our side but from other organisations, to say that Medicare bulk-billing under this government has failed. The Australian Medical Association announced just this week that it is putting forward a $4.5 billion plan to modernise Medicare and lift bulk-billing. So not even the Australian Medical Association supports the government's—and, particularly, the health minister's—proposition that it has provided cheaper health care and that Medicare is a success under it. I would certainly consider that if the government intends to continue with the line that Medicare is safe in its hands and that it has boosted our public health system. Again, that is simply, completely disingenuous. We've now got three reports from three different organisations that support that position.

If I can turn now to another couple of issues that the government, those on that side, have championed and called their own, we'll start first of all with endometriosis and pelvic pain clinics. Endometriosis is a debilitating chronic condition that can be very hard to diagnose. Often, those suffering wait an average of seven years before diagnosis. It can lead to infertility in women, and it is extremely, extremely painful. It is pleasing to see that the government and the health minister have opened some endometriosis and pelvic pain clinics across the country. However, this was done on the back of the initial inquiry that commenced under the former coalition government and came about as recommendations from that report.

I've written to the minister on this issue. I notice that the assistant minister is here in the chamber; I have also met with her, and I thank the assistant minister for her time on this issue. For women in my electorate of Hughes to access one of those clinics, it is at least an hour and a half's drive. I'm in southern Sydney, in the Sutherland Shire, and our nearest clinic, which the health minister very helpfully directed me to, is the Women's Health Centre in the Southern Highlands. That's in Mittagong. From Sutherland, it would take close to two hours to drive there, and the minister thought that that was acceptable for the women in my electorate. It's simply not acceptable. When I look through the list of where those clinics have been located, it appears that this has been Labor very carefully, very strategically choosing to locate those clinics in areas that are either very marginal or that supported Labor coming into power in 2022. There has been no help here for the women in my electorate, for women of southern Sydney and for women of south-western Sydney.

Then, while we're on the issue of female health, last week I was doing a mobile office, and a lady called Jodie Treuil came to me. She said that I could mention her in parliament. She said, 'If there is one thing that I could ask you to do, Jenny, it is to look at female health particularly.' I said, 'Yes, I've got a particular interest in it.' She raised a couple of things. She said first of all that, only a couple of months ago, one of her very close friends took her own life as a result of depression caused by symptoms of menopause. She said, 'We are not doing enough for menopause.' I said, 'There has been a Senate inquiry into menopause, and so far the health minister has not acted on all of those recommendations that were made.' Again, that is saying to me that this health minister and this Albanese Labor government do not care about women's health. Jodie also said to me, 'Jenny, why is it that hormone replacement therapy is generally not covered on the PBS and yet Viagra is?' She said, 'I don't want to take Viagra off the PBS, but I want women's hormone replacement therapy put on there.' She said maybe it could have saved her girlfriend's life.

That is also a very serious issue, and, again, although there are some menopause clinics that have been established throughout Sydney and throughout the country, there are none available in my electorate. My electorate stretches across Sutherland Hospital, Liverpool Hospital and Campbelltown Hospital in the south-west of Sydney, which is one of the areas growing fastest in population. There are no menopause clinics available to women in my electorate. Again, I see this as a massive failure by the Albanese Labor government, a massive failure for women, showing that the noise that they make about caring about women's health is simply not borne out by their actions. They do not seem to want to put any money into women's health in my electorate or in southern Sydney overall.

I will now talk to one other issue that I have been battling the health minister about. I have a practice in my electorate at Holsworthy. It's called Wattle Grove Family Medical Practice. It has over 3,000 patients on its books. There are currently three GPs only. Many of the patients are veterans' families because of the location at Holsworthy. Dr John Stanford, who runs that practice, has been trying now for close to a year to get another GP registrar into that practice. He said that the failure to have that other registrar is providing much longer wait times for patients, and he's also concerned about the mental health of his other GPs because of their workload with this.

I have written to Minister Butler. He doesn't reply; his chief of staff does—'a matter for the minister'. I wrote to Minister Butler on this. He kicked the can down the road and said, 'Oh, it's not me; it's the RACGP.' I went to them. I met with the president, who is in my electorate, and she said: 'No, no, no. This is firmly in the hands of the minister.' After 12 months I am still unable to get any assistance from the minister to help the men, women and children of Holsworthy and of my electorate with an extra GP registrar. Again I say that this shows that this minister and this Labor government do not care about the health of my electorate. They do not care about the health of women, men and children in southern and south-western Sydney.

When I have to sit here in question time or at other times and hear the Minister for Health and Aged Care talking about great announcements and how they've produced cheaper Medicare and more bulk-billing, that is simply not borne out by the evidence. When I have to hear him saying that Labor is the party for women, that is simply not borne out by the evidence that I have seen in my electorate. I would like the health minister to answer this: why is it that he does not care about the health of women, the health of men and the health of children in my electorate of Hughes?

Long debate text truncated.