Health Insurance Amendment (Incentive Payments and Other Measures) Bill 2026

Anne Ruston

I move opposition amendment (1) on sheet 3944:

(1) Schedule 1, item 4, page 30 (after line 32), after Subdivision A, insert:

Subdivision AA — Expert advisory committee

68A Expert advisory committee

(1) The Minister must, within 6 months of the commencement of this section, establish an expert advisory committee to provide advice, and make recommendations, to the Minister about matters relating to incentive payment programs.

(2) A committee under subsection (1) must be established in writing.

(3) The committee may provide advice, or make recommendations, to the Minister on its own initiative or at the request of the Minister.

(4) The committee consists of the members appointed by the Minister.

(5) The Minister must, in appointing members to the committee:

(a) ensure that the composition of the committee reflects the diversity of the interests in the matter or matters that the committee will be dealing with; and

(b) ensure that the members of the committee have suitable qualifications or experience.

(6) The Minister must, in writing, determine:

(a) the committee's terms of reference; and

(b) the terms and conditions of appointment of the members of the committee; and

(c) the procedures to be followed by the committee.

(7) An instrument under subsection (1) or (6) is not a legislative instrument.

This amendment, which seeks to establish an expert advisory committee, is in direct response to the fact that the government has almost made an art form out of introducing legislation into this place without properly consulting those that are affected by the legislation. So what this particular amendment seeks to do is to say this to the government: if you want to use this piece of legislation, which does give you quite substantial powers, and if you want to make changes, then you have to run it through a group of experts that will actually understand the consequences of the legislation—the changes that you are seeking to make or the powers that you are seeking give yourself under this particular piece of legislation.

As I said, it has been quite incredible that there has been a complaint with just about every piece of legislation of significance that has been brought into this place. The Office of Impact Analysis will often say that a piece of legislation could have benefited from further consultation with stakeholders. We hear it time and time again when we send legislation to committees. The first thing you hear from stakeholders is, 'We were not consulted about this legislation before it was put into the parliament.' The fact that we have got a government that is failing to even seek the views of people who are going to be impacted by its policies before seeking to shove them through this place is, I think, a very sad indictment on the government. It's the reason we are constantly, in this place, trying to repair faulty legislation that got pushed through without the benefit of being scrutinised by those people who are experts in the field.

This amendment is a reasonably small amendment, but hopefully it will start to restore some sort of confidence in the health sector in that the government will be forced to consult with the sector before making any changes. If the government were to do that, we'd probably find that legislation introduced into this place would be more fit for purpose and wouldn't require constant amendment after the event.

Jenny McAllister

The government won't be supporting the amendment. The amendment, as proposed, would duplicate existing consultation mechanisms and advisory bodies and would reduce flexibility in how the minister seeks expert advice on incentive payment programs. It also has the odd consequence of requiring this forum regardless of whether it is needed or whether it would be duplicative.

I make this point: this bill covers a range of different incentive payment programs. They are context sensitive. Each program does not have the same impact on stakeholders. The minister and the department already draw on advice from stakeholders, clinical experts, peak bodies, Services Australia and other relevant parties as they need, and, in going and seeking that advice, it is, of course, specific to the particular policy considerations, the particular issues that arise and the particular priorities that are being pursued by the relevant incentive program. So a standing committee, as envisaged by this amendment, risks duplicating existing consultation mechanisms and advisory bodies even while not actually providing the particular policy guidance and input that would be required should policy adjustments be required. If we think about existing bodies, for example, the Strengthening Medicare Implementation Oversight Committee was established to consider the broader reform program. That includes workforce incentives and after-hours services matters. That body already provided advice and recommendations on incentive program reforms, and it continues to provide advice on delivery of reform objectives. I note also that the proposed provisions do not specify membership, scope, reporting obligations, decision-making status or interaction with existing advisory bodies, which would create additional uncertainty not just about this proposed entity but about other existing advisory arrangements.

The minister can already establish advisory groups. The minister can already consult expert stakeholders. The minister can already seek targeted advice as needed without requiring a statutory obligation in the Health Insurance Act. Of course the government wants to hear from stakeholders when we're developing policy in this portfolio or in any portfolio. Of course we're committed to meaningful stakeholder engagement. Our view is that stakeholder engagement should be fit for purpose. It should be targeted. It should be relevant to the actual policy issues under consideration. It should be able to be responsive to the matters that are before the government at the time. We do not consider that that is best achieved through a fixed statutory committee model, and it's on that basis that we won't be supporting the amendment proposed by Senator Ruston.

Anne Ruston

Thank you, Minister, for your response to what I believe is a very sound amendment. In your contribution, you made the statement that the minister can set up advisory groups and engage in consultation with stakeholders and that he has the powers to do all manner of things to engage the sector when it comes to legislation. He may well have the powers, but he does not use them. You say you want to hear from stakeholders. Well, you can't hear from stakeholders unless you actually tell them what you're seeking to get their advice on prior to making a decision, because consultation following a decision is really nothing more than an information-giving exercise. It is not consultation.

I raise this in the context of another piece of health legislation that is before this parliament, and no piece of legislation could be a clearer example of this government's absolute refusal to consult with the sector before moving substantial changes that will have an impact on millions and millions of Australians. That is the decision of the government to change the arrangements in relation to the private health insurance rebate for people over the age of 65. We've just travelled around the country, and we have met with many, many stakeholders. We have had many submissions. Whether they be from individuals or from members of the health community who will be impacted, whether that be doctor groups, the private health insurers themselves, the private hospital sector and the specialists that work there or older Australians who are impacted by this, their families and the communities that support them—every single one of those stakeholders had no knowledge whatsoever of this policy change and this legislation until after they were put on the table by the minister.

So you will excuse the coalition's and the opposition's inability to take you at your word when you talk about the fact that you will be consulting in relation to any changes that are enabled as a part of this particular legislation. You'll excuse our cynicism about your genuine preparedness to actually undertake consultation, because of your track record as a government when it comes to consultation and transparency, your track record when it comes to burying things in the rules that we don't get to see until after the legislation is passed and your inability to even tell the truth about what has actually been provided in terms of advice to the government.

I draw the chamber's attention to the fact that the minister went out and told every single Australian that 44,000 people were estimated to drop their private health insurance cover as a result of the changes for the over-65s PHI rebate. We now find out through freedom of information—not through any other process but because of a freedom-of-information request—that that number is actually 78,000. That is 78,000 older Australians who are going to drop their private health cover. And that doesn't include anybody who's going to downgrade their cover. So you will excuse me, as I said, for being incredibly cynical about taking in anything that this government says in relation to an assurance that they are actually going to consult. The government has a track record of not only not consulting but actually providing false information into the public domain and only backtracks on that public information's inaccuracy when it's called out by something like a freedom-of-information request, an order for the production of documents or a Parliamentary Budget Office paper that contradicts what the government said.

So I would say to the chamber and particularly those other than the government in this place: we need greater scrutiny of what the government's doing, and we need stakeholders to have greater capacity to be involved in decision-making. The habitual failure of this government to do the homework before they put a policy into the public domain is why we are seeing problem after problem after problem, and it's why we're having to see the government backflip, backflip, backflip on so many things that they put into this parliament. So I think it would be very wise for the government to actually say: 'We are prepared to be consultative in this process. We are prepared to engage with stakeholders.' And one way in which you could get the confidence of stakeholder groups back is to support this amendment.

Jenny McAllister

I simply wish to respond briefly to the contribution made by Senator Ruston. You never, of course, want to let the facts get in the way of a good story! For example, as I've already indicated, the government has established a Strengthening Medicare Implementation Oversight Committee. It is considering the broader reform program that does include workforce incentive and after-hours services matters. It has already provided advice to government. It has provided recommendations to government on incentive program reforms.

The government is committed to engaging with stakeholders. We engaged with stakeholders in the development of the bill that's before us at the moment, and we'll continue to do that. But we reiterate that that is best done in response to the actual matters, the actual policy questions, that are before the government at any time. That's not enabled by a rigid statutory model. We don't consider it necessary, and we don't intend to vote for the amendment that has been circulated by Senator Ruston.

Dave Sharma

The question is that amendment (1) on sheet 3944 be agreed to.