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Legislative Assembly for the ACT: 2005 Week 07 Hansard (Wednesday, 22 June 2005 2005) . . Page.. 2126 ..


We can happily support this. Indeed, as I have already noted, the adoption of the clinical streaming model, which the health minister seems to be working towards, will allow us to ensure that accessibility to public funded treatments and services will be based on objective clinical merit.

Paragraph (2) states:

notes the negative implications associated with restricting Medicare subsidisation for In Vitro Fertilisation (IVF) treatments on an arbitrary basis.

We agree that restricting subsidisations for IVF and ART treatments on an arbitrary basis should be opposed. Restricting them on a clinical basis is another matter. If the evidence shows that there should be some restrictions, then that is something that I think we actually should have the courage to consider. But we do not accept that all treatments are sacrosanct and not subject to an objective and clinical assessment of their effectiveness and value to the patient.

Paragraph (3) states

affirms its commitment to accessible and affordable health services for all ACT residents, including the provision of IVF, at the discretion of the individual, in consultation with their medical practitioner.

The idealist in me would say, of course, that health should be free and everyone should be able to access it to his or her heart’s content, la, la, la. Sadly, apart from Mr Quinlan and his accounting techniques, we do not live in la la land. The harsh unpleasant reality is that health costs are rising, and someone has to pay for it. It has to come out of the budget. We pay for health through our taxes, through the Medicare levy and through our own payments. This is an extremely reasonable mix, in our view. If you do not think so, I suggest you go to the USA where a GP consultation will set you back over $200 and health insurance is roughly 20 per cent of salary. Given that there are these constraints and there are competing priorities, I do not see that access to affordable health services is at any risk.

In summary, the opposition fully supports the public funding of access to IVF and ART. The quantum of how much and how often is a debate that needs to be had, informed by solid clinical data. I hope Ms Porter has had time to actually read Mr Corbell’s 2003-04 health annual report, in which he talks at some length about clinical streaming. I will read the important paragraphs again:

The portfolio has begun to move to the clinical streaming of a number of services as part of an increased emphasis on establishing a client-centred health system. Clinical streaming builds on the networking of services, to focus on the provision of services across the care continuum in a number of care settings. Streamed services operate under one management model and cover services from health promotion, early intervention, community health services and outpatient services, through to acute care services.

The partnering of health professionals across a number of settings has provided opportunities to assess the demand and service needs of patients.


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