Preserving free access to hospital emergency care in NSW - John Robertson


"The change that NSW Labor seeks to enshrine in law today is fundamental. 

Free access to a hospital emergency room in NSW is non-negotiable."

The change that NSW Labor seeks to enshrine in law today is fundamental.

Free access to a hospital emergency room in NSW is non-negotiable.

Today is our opportunity to guarantee it – and to protect our hospital emergency rooms from the obscene precedent set by Tony Abbott’s GP tax.

Our society is based on the principle that our hospitals are open to all who need them in an emergency – whether you are young or old, wealthy or poor and whether you arrive at lunch-time or the middle of the night.

Labor built Medicare.

Labor is proud of Medicare.

The Australian people are ferociously protective of Medicare.

They know how precious it is compared with the inequitable healthcare systems found elsewhere in the world.

They also know that the Abbott Budget trashes Medicare.

From a Government that promised no surprises and no excuses, I think a $7 GP tax counts as a very nasty surprise – and the $15 billion dollars ripped from NSW public hospitals counts as a complete kick in the guts.

How dare Tony Abbott and the Liberals kill off our system of universal healthcare without saying a word to the Australian people before the last election?

Tony Abbott may be wheeling the cash registers into the GP clinics, but we on this side will not allow the Premier to wheel the cash registers into our public hospitals.

Today the Parliament has an opportunity to protect NSW hospitals from this garbage.

To protect them from a weak and wobbly Premier who can’t stand up to Tony Abbott, his best mate.

Under this Bill, Labor seeks to amend Section 75 of the Health Services Act 1997 to prevent a patient in a public hospital from being charged for any health service that is currently free.

The Bill further states that even if any law or agreement between the Commonwealth and NSW is amended to provide for the charging of a co-payment, a NSW public hospital is not entitled or authorised to charge any such fee.

Labor’s reason for introducing this Bill is simple – the Liberal Party in NSW cannot be trusted to keep free access to public hospitals.

Across this nation, families are frightened out of their wits by Tony Abbott’s $7 GP tax.

It’s not just a tax that will apply to GP visits. It applies to blood tests. It applies to x-rays. It applies to infants needing immunisations for whooping cough, women worried about breast lumps and pensioners vulnerable to the flu.

In fact, if you’re a person with a chronic condition who has to see a doctor two or three times a week and maintains a constant log of prescriptions, your liability under this tax is endless.

Madam Speaker, there is something else that the people know.

A $7 GP tax introduced by Tony Abbott will never remain at $7. It will rise to $15. It will sneak up to $30. And if the Prime Minister puts his hand on his heart and rules out such an increase, who’d believe him anyway after what Australia witnessed less than a month ago in his first budget. 

Yet the real tragedy of this GP tax is that its poison will seep right across our healthcare system.

Our GP clinics do not exist in isolation. If there’s a $7 tax at the GP – many people will try and evade it by turning up at the free public hospital. This is especially the case for the most vulnerable in our society, including pensioners.

The Commission of Audit report made exactly the same point (and I quote):

“By introducing co-payments for services that are currently covered by bulk billing there is a risk of cost shifting, as some patients may seek out free treatment in the emergency room of public hospitals for services that would more appropriately be treated by a general practitioner.”


The report continued:

“To address this issue, State governments should consider introducing equivalent co-payments for certain emergency room settings.”

The Abbott Budget adopted this recommendation – explicitly permitting states to introduce a new charge for hospital emergency visits. 

It is hard to overstate how foolish such a policy would be.

The most dangerous act any Government could undertake would be to deter someone from reporting to hospital for what turns out to be a serious risk to their health. But that’s exactly what Tony Abbott’s GP tax will do – and a hospital tax would do the same.

Across NSW, thousands of families could literally be forced to choose whether to feed their sick children that night or take them to a hospital. They could be forced to stay home, anxious at how little money is in the household budget and unaware of the fact that their little girl’s earache is actually pneumonia or their little boy’s stomach pain is actually appendicitis.

We should never want to live in a State where parents are forced to make such life or death decisions, to self-diagnose from a position of ignorance while cut off from expert advice.

Our doctors never fail to remind us of the importance of preventive health. They tell us that early detection saves money and that it saves lives. A tax on our hospital emergency room would turn this decades-long wisdom on its head.

It would send a shameful message to every person in NSW – don’t bother accessing our hospital system until you are in so much pain you can barely pick up the phone to call for an ambulance.

There is a reason everyone from the Australian Medical Association to the Nurses and Midwives Association has described a hospital tax as unworkable. Under Medicare – fought for and delivered by Labor – our hospitals have traditionally been cash free zones.

Our doctors, nurses and surgeons are meant to be saving lives, not acting as tax collectors for the Government. It’s not their job to rattle the tin and demand cash before treating someone’s bloody gash to the head or performing emergency heart surgery. 

I quote from Simon Judkins of the Australasian College for Emergency Medicine who told the ABC:

·         “Trying to ask people to pay whatever the co-payment is upfront would be flawed and very difficult to manage. And doing it retrospectively once the actual diagnosis has been made and then somebody deciding whether this was a GP-type problem … again the bureaucracy involved … would be impossible.”

In other words, Madam Speaker, doctors and nurses know that the idea of a hospital tax is ludicrous. It’s obscene. It’s also self-defeating. It would cost more to collect the revenue than the revenue that would be received.

There is a final reason why Labor’s Bill must be passed as a matter of urgency – the NSW Premier cannot be trusted to stand up to Tony Abbott.

The Premier’s stance on the Abbott budget has been one of phoney opposition from day one.

The morning after the budget, the Premier said it was a kick in the guts to NSW. Two days later, the Premier was standing next to the Prime Minister and had the chance to give him a public drubbing then and there.

Dennis Napthine had an angry phone call with the Prime Minister. Even Campbell Newman had a go. But Mike Baird hoisted the white flag.

The so-called “kick in the guts budget” was downgraded to a mere (and I quote): “challenge”.

And to this day, Mr Baird has refused to condemn the Abbott Government’s GP tax, the Abbott Government’s petrol tax, its scandalous cuts to pensions and Newstart and its unfair deregulation of university fees.

When it comes to Mike Baird’s view of the hospital tax we’ve seen the same weasel words.

On Wednesday May 14, the Premier said he’d be ruling it out.

But only days later standing shoulder to shoulder with Tony Abbott he said this:

“We’ll be considering and obviously watching events as they unfold… We’re in a position where we will monitor the impact on Emergency Departments and others – it is part of the broader discussion we want to have on health.”

This was the Premier’s chance to stand up to the PM on behalf of the people of NSW. To defend our public hospitals – and do it to Tony Abbott’s face. It was a test of the Premier’s mettle and he failed.

What on earth is the Premier talking about when he says he wants a broader discussion of the hospital tax? As far as Labor is concerned there is no broader discussion to be had.

Free access to hospital emergency is non-negotiable.

But I fear that if the NSW Liberal Government supports the GP tax – then it has no option but to back the tax at the hospital ward.

The taxes are inseparable. They are like two heads of the one monster. You cannot have one without the other.


Let us also never forget that the NSW Liberal Government has already ripped $3 billion from hospitals at NSW:

  • It has closed an entire ward at Prince of Wales Hospital;
  • Cut the Cardiac Unit at Mount Druitt;
  • Forced the Nepean Maternity Ward to turn expectant mothers away;
  • Betrayed nurses from Lismore to Bathurst;
  • Left Sutherland and St George Hospitals crying out for refurbishment; and
  • Left the Hunter without a specialist eye clinic

As we sit here today hospitals at Gosford, Wyong and Maitland have some of the most stressed and overwhelmed emergency departments in the state. Their treatment times are well in excess of the National Emergency Access Targets.

And across NSW as whole during the last quarter, a whopping 33,678 patients, or 6 per cent of total emergency admissions, gave up and left the hospital without receiving treatment.

I fear very much that instead of owning up to their responsibility to properly resource our hospital emergency wards and ease these crippling pressures, Liberal members in NSW are eager to follow their colleagues in Canberra. They are itching to shift more of the burden onto the seriously sick.

A tax on hospital emergency wards is in the Liberal Party’s DNA.

If the Premier is genuinely prepared to rule one out – today I challenge him to back his words with bipartisan action. It’s time to protect our hospitals, protect our patients – and not just say it but commit our principles to paper.


Premier – if you truly oppose a hospital tax, then join with Labor and enshrine that position into law.

A tax on hospital emergency visits must never be allowed in NSW.