This is the second time I've spoken on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 because this bill lapsed in the last parliament. This is something that we thought, several years ago, needed to be done, and that goes to the previous speaker's comments around the work done in the Philip review in 2022. We commissioned that in late 2022, and the report was delivered in 2023. What that really looked at was how Medicare was operating in the real world situation that we are now facing.

I just want to speak for a moment about what the Philip review recognised. It recognised that there is a change in the burden of disease. That means that there are different diseases facing people. We have a different demographic. We have an ageing population with chronic diseases that they live with but which need care and need support. I think back to when I was a kid—you'd go to the doctor when you broke something or had something short and sharp, rather than for diseases of that chronic nature, because we didn't have the means to identify and treat those chronic diseases. That's one big difference in the environment in which the Medicare system is operating compared to when it started in the 1980s.

There are also changes in how health care is delivered, and I think many people can see that there's a shift in the relationship with health providers. The family practice is not as prominent in the mix as it certainly was when I was young in the sixties and seventies or even when my children were young in the nineties through to the 2000s, and different parts of the country experience that differently. Certainly, the Philip review identified that there is just no longer the same connection between patient, practitioner and the payment that comes into it. Then, there are the changes that have occurred with the Medicare benefits scheme, with the complex nature and continuous changes—because of course things change—and then we add to that the corporatisation of medicine, which is another thing that comes into the mix. There is also the development of billing software—a totally different way—that could not have been conceived when Medicare first came on the scene, and then the general economics of medicine, and he goes on to list a few other circumstances that have changed. We're dealing with this in a very different time and place to when Medicare was first introduced. Of course, it was Labor that introduced Medicare, and it took two Labor governments, with a gap in the middle, to really ensure that Medicare was something that would be embedded. I think, from our side, we want to continue to do things that ensure Medicare is sustainable, embedded, never taken for granted and always appreciated by every member of parliament.

I'm very pleased to be speaking on this bill a second time. The key part of this that really matters to me is protecting the integrity of Medicare. The bill also contains changes that will enhance the regulation of therapeutic goods and vaping goods under the Therapeutic Goods Act, and it makes minor amendments to ensure the smooth and consistent operation of the tobacco act. I'm going to focus on the Medicare side of this bill in the time that I have available.

I think we in this chamber all know—and I know my constituents in the Blue Mountains, Hawkesbury and Nepean region appreciate—that Medicare and its programs help Australians pay for the health care they need in a world-class system. We are committed to strengthening Medicare by improving the scheme's integrity.

The areas that this bill is addressing are any that we've been able to identify, thanks to the Philip review, where there are issues that can inhibit the ability of the department to conduct efficient, timely and effective compliance activities, because you enhance integrity when you have a department that is empowered to act in a timely, effective way. The amendments include fraud deterrent provisions, such as the reduction of timeframes to make claims on Medicare, updated investigative powers and improvements to pharmacy approval processes. These really go to the core of the system. This is happening in a context where this bill is one part of many things that we have been doing to support Medicare.

When we came to government in 2022, it had never been harder or more expensive to find a doctor. The situation we found was that bulk-billing was in freefall. That followed a decade of cuts to and neglect of Medicare, which we had seen, but it was in coming to government that we really recognised how profound the impact of that had been, particularly in peri-urban areas like mine and, no doubt, in regional and rural areas. That's why strengthening Medicare was a key focus of our election platform, and it became even more key when we'd had the time in government to lift up the hood, see what was happening underneath and really try and unpack some of the issues that we were facing.

In our first term of government, we were able to deliver more doctors, more bulk-billing and cheaper medicines, and we opened 87 Medicare urgent care clinics. I want to note that there was some derision from those opposite towards our Medicare urgent care clinics for quite some time—that they were not needed and that they were just extra things that didn't need to happen. I noticed today in question time that every one of them seemed to be saying, 'Hey, give me one!' Their behaviour in question time seemed to indicate that there has been a bit of a turnaround. We know how effective the Medicare urgent care clinics have been, and it seemed to me that those opposite are starting to understand the difference that they are making in allowing people to get medical attention for things that are urgent but not life-threatening and in having a dual effect of providing people with quick attention and taking pressure off emergency departments in hospitals.

I'm very pleased to say that the Hawkesbury urgent care clinic has a tender out for it. The Nepean Blue Mountains Primary Health Network and Wentworth Healthcare are seeking GPs who are keen and interested in operating the Hawkesbury urgent care clinic, which was one of my election commitments this year.

More than 1.8 million people have walked through the door of a Medicare urgent care clinic. They've received free care—the urgent care they need. The feedback I get from the Penrith urgent care clinic is that they're seeing a lot of sporting injuries and they're seeing big demand over weekends. But also, during the week, there's a steady flow of people, as they learn that they don't need to rock up to the Nepean Hospital emergency department for some things and that they may well be able to be treated at the Penrith urgent care clinic. I think that what it's showing people is that Labor has a commitment to adapt the health system to make the changes that are needed.

I note the presence of the Assistant Minister for Mental Health and Suicide Prevention. We've taken the same approach to mental health. It is no longer a requirement in this country to go and see a private psychologist, counsellor or psychiatrist. There are Medicare funded centres now. The Medicare mental health centres, including the one in my electorate, in Richmond, that the assistant minister was so engaged in showing we could deliver on the ground, are places where people can get free mental health support. It can be ongoing support. It's not limited to a certain number of visits. It's not limited to one thing or the other. It's available and accessible. What's more, it's accessible six days a week. So, even on Saturdays or Thursday evenings, there's the capacity to just walk in and say, 'I'm not okay, and I need to talk to someone.' These are the sorts of changes that go to the sustainability and the development of Medicare, and they are backed by the measures in this bill, which is about ensuring the integrity of Medicare. It's becoming very clear to people that, under Labor, what you need is your Medicare card, not your credit card, to access health services.

I've spoken about how hard it was to see a GP when we first took office, and I want to say to my community that we know that in three years there hasn't been an instant fix to all those issues, but what we have been able to do, including in Macquarie, is increase the number of bulk-billed visits to GPs. Across the country, it's been an $8.5 billion investment into more bulk-billed visits, hundreds of nursing scholarships and thousands more doctors. Australian patients and families have been saving money on out-of-pockets. It's really the first time that bulk-billing incentives have been expanded in a very long time, and our latest round means, we hope, that nine out of 10 GP visits will be bulk-billed by 2030. This is what's coming and what will find its way onto the ground. It will boost the number of fully bulk-billed practices to around 4,800 nationally. That's triple the number of practices right now that bulk-bill.

Our record investment restores every dollar the Australian Medical Association said was cut from Medicare through the funding freeze by the Liberals. It's a policy that ensures no-one is held back and no-one is left behind, and it does make Medicare even stronger. It helps with cost-of-living pressures, and it ensures that every Australian receives the very best health care that they deserve. When we talk about the integrity of Medicare, we want to know that, when someone visits their GP or another specialist, there is transparency in the payments that they receive, that they are being properly billed and that, if there are any issues, the department has the power to look into those swiftly. That's the extra layer that this bill brings.

In the last couple of minutes that I have, what I'd like to talk about is how this legislation interacts with the other very key part of our health system, and that is the Pharmaceutical Benefits Scheme. The two really go hand in hand, and we've had to do work on both those sides. At the same time as making it easier and more affordable to see a doctor, you also have to make sure that people are able to access what will be prescribed to them afterwards, and that means cheaper medicines. So making medicines cheaper, with a script coming down to no more than $25 under the PBS, is another Labor commitment working its way through the parliament. It's another key cost-of-living measure that will continue to put downward pressure on inflation.

Remember that, along with all the things that we've done, including introducing this bill into the last parliament, we already slashed the cost of medicines with the largest cut to the cost of medicines in the history of the PBS, and that happened in 2023. Of course, we're going even further with that. It's going to save Australians more than $200 million each year. They've already saved more than $1 billion on the cost of scripts thanks to our commitment to make medicines cheaper. It has already been the largest medicines price reduction in the 75-year history of the PBS, plus there's the ability for people to get 300 medicines on 60-day prescriptions and a lower PBS safety net threshold. This is the other part of the health system where we make a difference to people's lives. I have people in my community, particularly older people, who say health is their No. 1 priority. They say, 'If I can keep my health, if I can get treated for things, then I know I can do a whole lot of other things, and I can be here for my family.' So I'm very proud to be supporting this legislation, legislation that will help secure the future of Medicare.