SENATOR THE HON KATY GALLAGHER
Minister for Finance
Minister for Women
Minister for the Public Service
Senator for the ACT
Date: Wednesday, 1 November 2023
ANNA VIDOT, HOST: But as you heard a little earlier, the Federal Government's Medicare changes took effect today. And the Government reckons this will mean more bulk billing options for more people. This, we know, is a challenge in many parts of the country but it’s particularly acute here in the ACT, which has some of the lowest bulk billing rates in the country. GPs say they think these changes, yeah, could help to reverse the decline in bulk billing. It’s a tripling of the incentive to bulk bill for GPs who see eligible patients, and where those patients are registered through the new My Medicare scheme at their practice. So, I guess it’s not super straightforward access across the board for everybody, but to talk about how the Government hopes that this might work, Finance Minister and ACT Labor Senator Katy Gallagher is my guest. Senator, thanks very much for your time. What impact do you think and expect this change to have for bulk billing in Canberra?
KATY GALLAGHER, SENATOR FOR THE ACT: Thanks Anna, and thanks for having me on. Look, I think the idea behind the extra investment in bulk billing rates was really representations from doctors and other professional groups around how to best support bulk billing going forward. And this is a real game changer. I mean, depending on where you are – and there’s different levels of rebates for remote and regional Australia and then those that apply in a metropolitan area – but essentially, we’re tripling those rates to act as an incentive for doctors to bulk bill those vulnerable cohorts. So, it’s children under the age of 16, those on pensions or concession cards – and the doctors’ groups themselves have said this is a game changer when it comes to bulk billing and hopefully some bulk billing rates where we have seen some pressure in recent times.
VIDOT: It requires people to have a regular GP, doesn’t it? Because you have to sign up to that one GP practice through My Medicare? And as we learned through the pandemic, lots of people, particularly younger people, don’t have a regular GP – particularly somewhere like Canberra where a lot of people come here to work from somewhere else. Are you worried that that might be a hurdle in people accessing the benefits of this change?
GALLAGHER: Well, in terms of eligibility for it, it is targeted to those groups that I’ve just outlined. But bulk billing in general can apply to anyone who sees a GP. So, I’m not quite sure about the link to signing up for continuity of care, although that is a good outcome for people because we can see often when you have that permanent relationship, that has a benefit for your health. But people can go into a number of clinics where they don’t have an ongoing relationship and if that clinic bulk bills, that is completely acceptable. But I think this investment – and it works with the indexation rates for Medicare as well that we also included in the last Budget – so together, those are substantial extra – in the order of billions of dollars of investment into Medicare, for the sole purpose, that we want Medicare to continue to ensure that people get access to either free or affordable healthcare with their general practitioner. And that has been under enormous stress in the last ten years or so.
VIDOT: This certainly couldn’t hurt. But I guess that there’s sort of a two-fold problem when it comes to accessing affordable GP care in this place like Canberra, isn’t there? There’s the cost of it, but then there’s the challenge of just finding someone that has an appointment to give you. And I guess that this doesn’t address that fundamental shortage of GPs that we have in the city. What are the Government’s plans to get more people into general practice?
GALLAGHER: Well, there’s a lot of work underway. There’s work in terms of how do we attract more doctors to remain or to train as general practitioners. So, that’s an area where that’s a long-term reform because it does take so many years for a doctor to train to become a general practitioner. But we’ve seen a big drop off in the numbers of medical graduates wanting to choose that particular specialty and for reasons that are linked, I think, to the investment in primary care. So overall, the strategy is about investing in primary care. So, that’s services outside of a hospital that people can access. But also I think that in the ACT in particular, don’t underestimate the role that those walk-in centres play in providing people access. Particularly where they have low acuity, one-off illnesses or injuries that can be dealt with quickly. And that network of clinics which we are investing in from the Commonwealth’s point of view, now, as part of our urgent care clinic program really are designed to ensure people do have access to free and accessible health care, particularly out of hours, on weekends, for those lower urgent conditions. And as you know, most Canberrans have either been to one or their family have been to one. They are incredibly successful and incredibly popular.
VIDOT: You’re listening to Senator Katy Gallagher, Senator for the ACT, Minister for the Public Service – under which capacity you’ve today published your inaugural statement on progress against the Government’s APS Reform Agenda. What’s changed in the year-and-a-half-ish since your Government’s been in charge?
GALLAGHER: Well, a lot, really. I mean, we came to Government – we had this as one of our election policies from Opposition, that we wanted to reinvest in the capability of the Public Service. We did think that it had had a lot of its capability eroded under the former government and there were steps we had to do. And so, we outlined a reform agenda. Today I gave an annual update on where we are and, you know, some of the areas where we want to focus on going forward. But I think if you look at every area of our reform agenda. We said that we thought we needed to invest in permanent jobs, we’ve done that. We’re bargaining with our employees. We're dealing with the consultants and contractors, the outsourcing that had led to a lot of loss of capability. And we are doing new things in the Public Service like capability reviews and long-term insights briefings that really build up that independent capability of the institution that is the APS. So, I think we’re sort of coming at it from a number of different ways. But the overall message is we value the APS, we’ve got to protect it going forward and we’ve got to make sure it’s resourced properly to do the job that we are asking it to do. And I think on all of those fronts, we have made enormous progress in the last 18 months. More work to do, of course, but we’ve made progress.
VIDOT: How does the hold up on bargaining affect that progress? Does it affect it?
GALLAGHER: Well, one of the pillars of reform is that the APS is a model employer. So, our approach to bargaining was one of those areas. We’re bargaining as a collective across all the agencies for the first time since the mid-90s. So, that is a new way of doing things. But we believe the fragmentation that has occurred from individual agency bargaining is not great, particularly for those at the bottom end of that fragmentation. And we’re trying to fix that and make sure that the APS workforce as a whole has some common, core conditions. So, look, we’re going through a process with the union at the moment. As you know, they went out to test their members’ views about whether or not to accept the offer that we had put, which was the largest pay offer, I think, probably, that had been put on the table for more than a decade. They got, I think – 52 per cent of their members said they should support the position the Government had put and go to ballot. But we’re still in this sort of intermediate zone at the moment. In short, we’re working with the union and we want to resolve this as quickly as we can so that people get access to the improved conditions and pay rises that will flow through this agreement. But there’s a little bit more work to do there, I think.
VIDOT: On representational matters for public servants and everyone else in the ACT – Katy Gallagher, you are, as we all know, one of two Senators for the ACT. The question of whether that remains an appropriate number for a growing Territory has certainly been a very live question of late. The Chief Minister this morning was talking to Adam about it and sort of said, he’d support more Senators – probably not going to be 12, but it might be at least four. Do you think the time has come for the ACT to get more federal representation in the Senate?
GALLAGHER: Look, it’s a bit difficult for me in the sense that there’s a committee process underway that’s looking at this. They’ve done an interim report, they’ll do a final report and that report will come to Government. And I’ll be involved in that as a member of the Cabinet. But I think it’s an important principle that regardless of where you live, there is adequate representation in the nation’s parliament. And I think there’s some strong arguments around representation in the ACT. We don’t have the same number of Senators as other places do with similar populations. So, this is an issue that’s been raised for a little while now, but let’s see what the committee which looks at all matters around the last election and whether issues were risen – they’ll report and have a view on that and then we’ll deal with that.
VIDOT: Clearly the Territories think this is all very important. Do you have the sense that your colleagues from around the country have thought about this at all, or whether they’ll be willing to contemplate change?
GALLAGHER: Look, well, the Labor Party is a very democratic – you know, it’s a social democratic party. So, I think the concept of fair representation through elected representatives is something that the Labor Party endorses. And I think that was reflected in our ALP conference that we had just earlier this year, where this was debated as well. So, I think, you know, from a political organisational point of view, there is support to make sure that the territories get appropriate representation. But in terms of the process that's underway, this report will hand down its final report, I expect that's where this will be dealt with, either through recommendation or a view of the committee. And then it will be over to the Government about how we respond to that. So, yeah, I think from my colleagues’ point of view, we're members of the greatest democratic party there's been in Australia. So, there's a good understanding of the importance of the issue.
VIDOT: Katy Gallagher, appreciate your time this evening. Thank you.
GALLAGHER: Thanks very much, Anna.