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The $3 Billion Senior Squeeze

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I recently asked questions about the government’s decision to cut the private health insurance rebate for seniors. Senator Green and government officials said that the rebate will now be based solely on income rather than age, aligning support across all cohorts. The government expects to save $3 billion from this measure, which it says will be reinvested into aged care and public hospitals.

It’s estimated that 3.1 million people will be affected, experiencing an average rebate reduction (and effectively a premium increase) of $250. Additionally, it’s predicted that approximately 44,000 people may drop out of private health insurance entirely.

I expressed my concern that forcing seniors into the public system would worsen existing hospital shortages. Amazingly, I was told that the impact on the public system would be minimal (less than 1%) and spread out. It was also highlighted that $24.4 billion was being invested into the public health system, adding that workforce and bed management are ultimately the responsibilities of state and territory governments.

I accused the government of punishing seniors to fund wasteful spending and a “socialist agenda.”

Senator Green rejected this statement, framing the move as a necessary offset to fund record investments in aged care.

Transcript

Senator ROBERTS: I want to talk about the private health insurance rebate being cut. It was announced in the recent budget that the rebate for premiums paid by seniors towards private health insurance would cease; why? Is this a socialist agenda, Minister?

Senator Green: No, it’s not. We did go through this quite lengthily this morning. I don’t plan to add too much to what the minister had to say in response to questions from Senator Ruston, other than to reiterate that, under the proposed changes, all Australians will now receive the same private healthcare support based on their income and not on their age. What we’ve set out is that, through this budget and as a consequence of this decision, we will be investing over $3 billion in delivering more aged care beds, more packages and better care for older Australians.

Senator ROBERTS: I’d like to get on to some specifics after this next question. Why does the government wish to punish seniors, most of whom have chosen to opt out of the public health system and pay premiums to receive private health treatment, by now wanting to make them pay even more than they currently pay?

Senator Green: I reject that assertion in your question. We are investing a record amount of funding into improving the healthcare system, particularly for aged care and older Australians, and that’s why we’ve made this decision. Of course, as you will stand up in the Senate many times over the next couple of months and decry the spending from our government, we know that it’s important to offset decisions that we have to make. That is why we have said that this decision will benefit older Australians through the aged care system.

Senator ROBERTS: How can you deny that older Australians on private health cover will not be paying more?

Senator Green: We’ve gone through this at length this morning. If you have a question about the impact or the policy decision, I will direct that to the officials. But I can say to you that, through this budget, we are making record investments in healthcare and aged care

Senator ROBERTS: And older Australians will be paying more, which is a point that I’ll get to in a minute, and this is during a cost-of-living crisis. Currently, how many seniors, effectively, will be forced to pay more for private health cover or enter the public system? Do you have any modelling?

Mr Hawkins: As we discussed this morning, 3.1 million people will be affected by the change in the rebate. We also put on record—we talked about this at length this morning—that our modelling would suggest that potentially about 44,000 might drop out of having cover and, therefore, would then no longer engage with the PHI system.

Senator ROBERTS: That’s what I was after. What would be the effect of the extra load being placed on the public health system? Hospitals are already short of beds now.

Mr Hawkins: As I’ve said, our modelling would indicate that it’s a less than one per cent impact on the public health system and, again, as we went through in quite a lot of detail this morning, that would be spread across the system, with not everyone needing to use the system at any one time. Also, we might find that people decide to opt out of PHI but then self-fund any care that they need.

Senator ROBERTS: We’re already critically short of beds in many hospitals due to mass immigration. Post COVID injections, cancer detection has increased dramatically. Cancer deaths have decreased, because of treatment. But the available beds have decreased. This is going to add more strain to the public health system.

Ms Street: An additional $24.4 billion has also been invested into the public health system, bringing it up to $220 billion over the five years. So, yes, there might be some ‘additional’ but, as we’ve said, it would be less than one per cent. We think that estimation is at the higher end, because we do think, potentially, people will self select into private, or they may be people who are less likely to use the services anyway, so a number of factors contribute to that number. So we think this investment and this measure will have a minimal impact on that element.

Senator ROBERTS: What would be the total value of the extra premiums raised by those who choose to stay in the private health system?

Mr Hawkins: We’ve calculated that there will be an average impact of $250 on those who will have their rebate reduced. Everyone was to have access to the rebate, but it’s the size of the rebate that is reducing, and our average calculation is about $250.

Senator ROBERTS: How much does the government plan to save by refusing to rebate premiums for older Australians, or by cutting them back?

Mr Hawkins: By cutting the rebate, we are looking at $3 billion.

Senator ROBERTS: Has the government modelled the extra cost to the public system by absorbing older Australians, who are more likely to require major healthcare in their elder years?

Mr Hawkins: No, we do not have that specific level of modelling. But as I’ve said, we have looked at and modelled what we think the impact would be, and that’s under one per cent.

Senator ROBERTS: What about the chronic shortage of beds, doctors, nurses, specialists and allied health professionals in public hospitals?

Senator Green: That’s veering a little bit into outcome 1, Public hospitals. But I’ve got Caitlin O’Brien from our public hospital team here, if you want to talk about the investment that the government is putting in through the NHRA agreement that we’ve put in place. Do you want to cover that?

Ms O’Brien: As Ms Street has said, an additional $219.6 billion over five years has been invested into the state- and territory-run public hospital system. Your questions in relation to workforce capacity and beds are best directed to state and territory governments who, under the National Health Reform Agreement agreed on 30 January, are very clearly listed as the stewards of their system.

Senator ROBERTS: Would you not have assessed that, though, before making the changes?

Ms Street: As we’ve indicated, we think the ‘additional’ is less than one per cent, and we think that estimation is at the higher end. So, in terms of the fiscal impact, it will depend on the services that people need and the conditions that they’re seeking treatment for.

Senator Green: The officials have made this point but, again, we’re investing almost $25 billion into the hospital system over the next five years.

Senator ROBERTS: Minister Clare O’Neill said, reportedly, that the budget is deliberately hitting older people. It’s a tax grab because you’re paying for so much waste in government.

Senator Green: I don’t think that’s what Minister O’Neill would have said. I think you might be verballing her.

Senator ROBERTS: I’m just going on reports. It is a fact that the budget is also hitting young people. What I’m getting at is that this is a cover for the massive waste within your government spending, and now you’re going to ask older people to share in that.

Senator Green: No. We are making record investments in once-in-a-generation reforms in aged care and healthcare. That includes investing almost $25 billion into public hospitals, funding the states and territories to do the very important work that they do in making sure that the public hospital system is free.

Senator ROBERTS: It’s a fact, Minister, that older people will be paying more.

Senator Green: We’ve changed the rebate so that now it’s means tested, so it’s based on income now. We can take you through how that might impact certain cohorts, but we have changed the rebate so that now it is means tested on income.

Senator RUSTON: On a point of clarification, Minister, you just said that you’ve changed the rebate so that it’s means tested on income. Are you suggesting that it’s currently not means tested on income?

Senator Green: No, that’s not what I said.

Senator RUSTON: You just did say that.

Senator Green: I’m not going to go back over the evidence that Senator Gallagher gave to you this morning. What I’m saying to Senator Roberts is that there is a means test for the rebate that is based on income.

Senator RUSTON: Now?

Senator Green: How semantic do you want to get?

Senator RUSTON: You just said that it is now going to be means tested. It has always been means tested.

ACTING CHAIR: I think, as the secretary has said, it is ‘solely’.

Mr Comley: ‘Solely means tested’. In fact, it hasn’t always been means tested.

Senator RUSTON: It was means tested prior to this change.

Mr Comley: I think it was, but it was not means tested on introduction in 2000.

Senator RUSTON: It has been means tested up until now.

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The Price of Compassion?

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A $68.5 million budget measure (allocated over three years) intends to provide HIV treatment to people who are not eligible for Medicare.

Why are Australian taxpayers funding treatment for non-citizens when we are in the middle of a cost-of-living crisis?

Officials declined to comment on this, stating the policy and funding mechanism were developed strictly by the Department of Health.

I then shifted the discussion to the Significant Cost Threshold (SCT) for visa health requirements, which was raised from $51,000 to $86,000 in July 2024.

How this works is that if a medical officer of the Commonwealth estimates that an applicant’s health condition (such as HIV, a physical disability, or other chronic illnesses) will cost the Australian healthcare system more than $86,000, they fail the health requirement, and the visa is refused (unless a specific waiver is applied).

I asked whether this framework allows Australian citizens a “perfect way” to bring in family members with known health conditions to receive immediate taxpayer-funded care, provided the projected costs fall just under the $86,000 limit.

The Department repeatedly stated they could not answer the “family member” line of questioning.

They reiterated that immigration rules and the $86,000 threshold are applied uniformly to all applicants, independent of separate Department of Health funding measures.

Data on exactly how many people reside in Australia under the updated threshold was taken on notice.

Transcript

Senator ROBERTS: I’ll get back to the topic I started on this morning. It’s an immigration issue, not a health issue.  

Ms Foster: We’ll just get our chief medical officer up to the table.  

Mr Willard: I can speak broadly about the criteria. There’s a health criteria that applies to all visas. It looks at questions of health protection for Australians. It looks at costs to the health service, and it looks at the access to health treatment for Australians. It’s applied across all our visa types. It’s applied on a risk management basis. It looks at where somebody is coming from, and the sorts of health risks that might be presented. It looks at what the person might be doing in Australia, whether they’re going to go to a medical facility, whether they’re staying for a short time or whether they’re looking for a permanent visa. All of these factors are taken into consideration when the health criteria are assessed. Dr Grant Pegg, our chief medical officer, oversees the system that undertakes medicals. I think there are very large numbers of medicals undertaken each year.  

Senator ROBERTS: Can you tell me what the three basic criteria are again?  

Mr Willard: It’s health protection for Australians. It’s cost to the health system, and it’s access to Australian health services.  

Senator ROBERTS: This is primarily with No. 2—cost. The 2026-27 federal budget included $68.5 million, or $69 million, over three years to provide HIV treatment and pre-exposure prophylaxis, which is medication that stops transmission to people in Australia who are not eligible for Medicare. They’re not eligible for Medicare, but we are paying for their treatment anyway so they don’t infect Australians with their HIV. Is that the logic behind this allocation? I know it wasn’t allocated by you.  

Mr Willard: Because it is a measure from the department of health, I really can’t talk to the logic behind the measure.  

Senator ROBERTS: Why should Australians allow entry of people with HIV and then pay for their treatment, especially when Australia is under pressure economically and individual Australians are under pressure cost-of-living-wise?  

Ms Foster: Mr Willard is unable to comment, because the measure was developed by the department of health.  

CHAIR: Senator Roberts, I think that the right place for this is at the community affairs estimates committee next week.  

Senator ROBERTS: But I want to know. Many Australians are calling for noncitizens who have HIV or AIDS to be deported instead of paying for their medical care. We’re letting people in here with a known liability of cost to Australians. What is your response to that criticism of this budget allocation—the criticism, not the budget allocation itself? People are concerned that we’re letting in people who have a disease, and now we’re paying for their treatment.  

CHAIR: Senator Roberts, I think that is asking the officials at the table for their opinion on a matter that is not within the purview of the questions allowed to be asked at Senate estimates, particularly as it relates to the budget.  

Senator ROBERTS: Okay. I’ll move on to the next one. Australia raised the significant cost threshold for visa health requirements in July 2024, from $51,000 to $86,000. For those following this thread, I’ll give a quick explanation. The significant cost threshold determines whether a health condition, such as HIV/AIDS or physical disability, is likely to impose significant costs on Australia’s health and community services. Exceeding it typically means failing the health requirements for a visa, although health waivers are available for some visa subclasses, including partner and humanitarian. A person who comes in under your new, higher cap can access medical care and medications for free or for a small co-payment depending upon the state in which they live. How many people are here under this arrangement across all health conditions?  

Mr Pegg: I don’t have the data in that detail, so I’d have to take that on notice.  

Senator ROBERTS: If you could. Thank you. This is my last question on this topic, Chair.  Isn’t this a perfect way of getting a family member into Australia and having their care paid for straightaway? The other part of the question is that the numbers are increasing, which means the Australian taxpayer is paying more.  

Mr Pegg: Perhaps, if I can just offer, that’s the purpose of the operation of the significant cost threshold—to try and avoid significant cost to the Australian healthcare system. That’s why it exists.  

Senator ROBERTS: Could you explain that more?  

Mr Pegg: When someone is identified as having a health condition through the immigration medical examination as part of their visa process, they’re then costed by a medical officer of the Commonwealth who looks at that, on a hypothetical basis for someone with the same condition—the nature of condition and severity— to determine what their costs might be to the Australian healthcare system. That could be lab tests, X-rays, visits to the doctor—those sorts of things. There’s a comprehensive process that is undertaken to do that. When that’s undertaken, a figure is determined, and then, if that figure exceeds the number that you talked about, $86,000, that is considered to be ‘not meeting the health requirement’.  

Senator ROBERTS: The first part of my question was: isn’t this a perfect way of getting a family member into Australia and having their care paid for straightaway?  

Ms Sharp: Are you talking about a situation where the health requirement is waived? I guess what we’re saying is that the general rule is that if you fail the health requirement—as in your healthcare costs are coming in above $86,000—you will not be granted the visa; you won’t come to Australia.  

Senator ROBERTS: That’s initial assessment. Forget about the—well, the payment matters, but I’m not interested in the total amount. What I want to know is: isn’t this a perfect way of getting a family member into the country and having their health care paid for straightaway? That’s basically what it is. The government’s allocated $69 million over three years to provide treatment and pre-exposure prophylactics just for people with HIV. They’re coming in here with a known condition, and we pay for the treatment.  

CHAIR: Was there a question, Senator Roberts?  

Senator ROBERTS: Isn’t this a perfect way of getting a family member into Australia and having their health care paid for?  

CHAIR: This is a question that the officials at the table have responded to. It sounds like—  

Senator ROBERTS: Yes or no?  

CHAIR: you’re not using the same words to describe the same thing. I think the officials at the table have spoken about what their role is. I think you’re talking about it in a different way, but it’s not necessarily what the officials are—  

Senator ROBERTS: It’s about immigration, though.  

CHAIR: I think they’ve responded to your question, which is that there’s a program that exists to essentially weed out, for want of a better term, people who have costs higher than the amount the official said.  

Senator ROBERTS: No. If they’re projected to have a significant cost threshold higher than $86,000, then I understand, but, if it’s less than $86,000, isn’t this a perfect way of getting a family member into Australia and having their care paid for straightaway?  

Ms Foster: Senator, I don’t understand the link between the answers we’ve been giving and the family member issue. 

Senator ROBERTS: Yes or no?  

Ms Foster: That’s why we’re struggling to answer you.  

Senator ROBERTS: Yes or no?  

Ms Foster: We don’t understand the relation of the question to the information we’ve given, and, in a sense, it’s asking us for an opinion: ‘Is this a perfect way to do something?’ That’s not our role. Our role is to provide you with information about how the program operates.  

Senator ROBERTS: Okay, I’ll make it easier. Is it a way of getting a family member into Australia and having their care paid for straightaway?  

Ms Sharp: We might finish it where we began which is I think you need to direct this question to the department of health to ask them for the policy reasoning behind the measure—which group of people they were aiming to support.  

Ms Foster: We apply our immigration rules irrespective of whether or not the government has funded a measure such as this through the department.  

Senator ROBERTS: One of your immigration rules covers a significant cost threshold maximising at $86,000. If you assess an application to migrate here and it’s less than $86,000 then they are welcomed in. Is it a way of getting a family member in here?  

Ms Foster: We don’t understand the relationship between what we’ve told you and the question about a family. I can’t say that any more clearly. I’m not trying to be unhelpful. We just don’t understand the question.  

Senator ROBERTS: Could a citizen of Australia use this to bring in someone who is going to cost Australia money and health care immediately?  

Ms Foster: The rule would apply irrespective. We would apply that rule as part of our visa consideration to any visa applicant.  

Senator ROBERTS: I understand that, but this is a way for a citizen of Australia to bring in a family member and have their health care paid for by the taxpayer?  

Ms Foster: I’m sorry, but we have nothing further to add.  

Senator ROBERTS: Thank you. 

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Gold Rush on Black Market Tobacco

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How government greed turned citizens into criminals …

As a government, if you wish to stop a destructive public behaviour – you punish it. This can be through fines, incarceration, or economic coercion (taxes).

If you want to turn a public behaviour into a permanent cash-cow that props up the Budget – you tax it carefully.

Somehow, uniparty greed has found a way to implement a ‘worst of both worlds’ policy surrounding tobacco and nicotine products which has turned smoking into a criminal underworld gold mine.

Between 2010 and 2026, tobacco excise has increased in the order of 490% and returned half the revenue in real terms. People didn’t quit. If anything, there is evidence of Australia’s 30-year trend of decreasing smoking being reversed.

After reaching its lowest level with Millennials, smoking has become ‘cool’ again for Gen Z and Gen Alpha. Excessive taxation has destroyed all the good public health work done in this field.

Economically, this is not only a concern for the estimated $11 billion lost excise tax for tobacco.

It also involves the loss of general revenue associated with the full cost of tobacco which previously paid wages, kept stores open, and was re-invested in local communities.

Tens of billions is now being given to the black market where it funds violent crime. This tears apart Australian suburbs and has a follow-on health and economic impact that lowers the quality of life for everyone, not only those directly involved in illegal tobacco. Everything from personal safety to house prices are being affected.

Police have warned that this money, often funneled into crypto, has also been used to expand drug trafficking, firearms offences, worker exploitations, and property damage through activities such as coordinated firebombing.

Worse, if that is possible, the quality and safety of illegal tobacco and vapes is a matter of acute concern. Australians are now exposed to a considerably more dangerous product that was once strictly regulated for safety. And it’s dirt cheap. We are hearing reports of those who gave up smoking previously falling back into the habit because it’s only $10… As for kids, how likely is it that illegal traders are checking them for ID?

Every single feature of the system has been undermined.

It’s clear to me that public health, citizen choice, and the Treasury are in conflict.

And yet they should share the goal of a profitable, legal, regulated industry.

Our current incoherent approach to nicotine products is often referred to as ‘thoroughly broken’ by those trying to petition the government to act.

As Professor Ron Borland said, ‘We are worse off in every conceivable way.’

Tobacco isn’t quite Australia’s re-run of American Prohibition. However, it does share similarities. As with Prohibition, the first question we have to answer is: Should smoking tobacco (and other nicotine products) be legal?

Like alcohol, if the answer is ‘yes’, then any civil penalty or pseudo ban (vaping doctor certificates), should be discontinued.

The second question is: Do we consider smoking tobacco a health risk that costs the state money and which the state actively seeks to discontinue in the long-term?

If ‘yes’ – and this is what we were told for decades through school programs and public advertising campaigns – then the government cannot expect to use taxation on tobacco as a permanent feature in their Budget spreadsheet.

As Clive Bates said, ‘If you push it too hard – the taxes are too regressive, too brutal – then people will defect from the system and they will move to illicit trade and illicit suppliers will come in because there are enormous economic gains to be made.’

The Treasurer must have a replacement plan for tobacco revenue that does not entail continuously raising excise to the point criminals take over distribution.

Experts have suggested alternatives, such as using public information campaigns and alternate products, to wean society off tobacco long-term rather than smacking Australians with tax hikes on an addiction exasperated by economic stress.

To that point, there may never come a time when tobacco and nicotine products exit public use.

As with alcohol, they require a legally and economically stable environment that protects as many people as possible, dissuades new users, and yet does not create opportunities for crime. The most effective measure so far involved banning smoking from bars, clubs, restaurants, and residential balconies which turned it into a social inconvenience rather than a cost burden.

And here sits the heart of the problem.

Tobacco was a huge part of society until earlier suspicions of health risks were confirmed in the 1960s. Community anger and government complicity in a public health catastrophe created a lot of guilt and revenge.

Those days are almost gone. People who choose to smoke today do so knowing the risks and great lengths have been taken to contain those risks to the individual smoker. And so the conversation becomes one about public health costs similar to obesity. How is it fair, it’s said, that the public pay for the self-inflicted health problems of smokers? The numbers strongly suggest that this was never the case. Revenue on tobacco is widely held to cover the health bill. Until now.

The situation today reveals a growing smoking population with a more dangerous product and decreased revenue that doesn’t cover the cost of health, let alone the huge cost of policing the illicit trade. Economic arguments for the current excise level do not hold up to reality.

Scroll through the crime releases…

Permanent surveillance and enforcement on hundreds of tobacco shops. Thousands of online ad takedown orders. Monitoring nation-wide criminal distribution networks. Raiding shipping deliveries. Prosecuting and incarcerating those responsible. Storing and destroying the product. It’s an open-ended revenue drain. And then you have to include illegal vapes, of which the market is in the billions.

If you’re wondering how much policing this costs, the answer is, ‘we don’t know’. No full-cost figure is published. It’s estimated in the hundreds of millions just for policing itself at a state and federal level, while the government admits to investing approximately $350 million specifically for the ‘fight against illicit tobacco and vapes’.

Whatever the number is, it came out of your pocket.

The Australian Federal Police reported that 2.66 billion illegal cigarettes, 510 tonnes of loose-leaf tobacco, and 7.5 million vapes have been seized since 2016. Operation PRINTWALL saw the Australian Border Force intercept 998.5 tonnes of tobacco.

Just this year 20 million illegal vapes worth $1 billion were seized by the Australian Border Force since 2024. The Therapeutic Goods Administration removed another 2.2 million valued at $110.5 million in the same period. They also reported a 300-fold increase in requests to remove online ads for illegal vaping products.

These are not victories so much as temperature readings offering a glimpse at a thriving market.

We must sit down and soberly confront the truth.

Government informs the public that tobacco costs the taxpayer money through the healthcare system, and yet it desperately wants Australians to keep buying tobacco and funding the Treasury. When vapes entered the market, and people began to organically switch products due to health, convenience, and cost – government all-but banned the product. A cynic may say this had little to do with health and a lot to do with an absence of lucrative excise tax. The Treasury saw tobacco revenue evaporating and instead of taking the public health victory – they panicked. This raises serious questions about the government’s motives and ability to solve the current problem.

As Professor Hall with the National Centre for Youth Substance Use Research said: ‘Australia has attempted to regulate vapes by making them prescription-only products, but it’s very hard to get a prescription because doctors won’t prescribe them and most pharmacies won’t stock them.’

What can be done?

Listening at length to experts in the industry, it seems clear that we require a carefully timed approach.

The legal market must be restored before law enforcement can come down on the black market.

To do this in the wrong order risks wasting money and encouraging citizens to protect a criminal underworld to facilitate their smoking habit. This would entrench the behaviour we’re trying to resolve. As one expert said, in some communities, illegal tobacco sellers have reached a ‘Robin Hood’ status actively supported by locals. A path back to legal markets must be seamless as it would in any competitive business environment.

The suggestions that I have heard from a variety of people from within the industry include:

Setting the tobacco excise at a level that keeps cigarettes competitive against black market alternatives.

Removing the ban on vapes and adding the same location restrictions as smoking.

Considering an excise on vapes to recoup some lost revenue.

Ensuring that the tobacco and vape products on offer include a wide variety to ensure maximum customer return from the black market to legal channel.

And then…

Severe and serious penalties for black market traders and the criminal gangs involved.

Mandatory sentencing to simplify the process of cleaning up crime.

Reporting channels to allow people to alert police to continued criminal activity.

And as I have said publicly in front of the Panel of Harm Reduction Experts at the Legal and Constitutional Affairs References Committee, the solution will not be simple.

The cost of living is very high and will naturally lead otherwise law-abiding citizens toward illicit markets – in general. They don’t want to break the law. Any solution must deal with lifestyle measures right across our economy.

People are suffering and nicotine products are part of their lives.

All measures must be enacted with a least-harm approach to Australians who were pushed toward the black market due to government-enforced economic pressures.

And we absolutely must support the legal businesses who wish to help rebuild the market – this will include protecting these shops and owners from crime gangs. For example, insurers say it has become almost impossible to find cover for tobacconists after arson attacks…

Once the legal and government approach is fixed – the criminal infrastructure will have to be dismantled – rapidly – or it will adopt a new product such as alcohol – which is experiencing an almost identical problem.

Make no mistake, excessive alcohol excise has already started to push people toward extremely dangerous black market product. This is even more concerning than illegal tobacco.

No one can solve a public health problem for a product owned and distributed by the criminal underworld.

So please, help us solve it.

Senator Malcolm Roberts, Brisbane

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Scrap Net-Zero, Not Health Rebates

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One Nation strongly opposes the Albanese government’s plan to remove the private health insurance rebate for older Australians (65+).

Removing these rebates will ultimately cost taxpayers billions more than it will save and will put immense strain on the public hospital system.

One Nation rejects the government’s “intergenerational fairness” narrative. It is nothing more than a diversion.

The true causes of financial hardship for Australian people are immigration, net-zero policies, inflation and high living costs.

Rather than cutting health rebates for the elderly, we should stop mass migration and abandon all net-zero targets, which will help ALL Australians.

Transcript

I thank Senator Ruston for this motion, which One Nation supports. Currently, all Australians get a rebate on their contributions to private health insurance. For the people under 65, it is 24.1 per cent, for those 65-69 years of age it is 28.1 per cent and for those over 70 it is 32.2 per cent. These are adjusted for income. Minister Butler described the system as ‘not fair between generations’. The government has announced the additional amount paid to our elderly will be removed, making everyone equal. How very communist and how self-defeating. The rebate is higher the older you get, because the cost to the taxpayer of a person moving from private to public care is higher the older they get. The extra payment encourages older Australians to stay in the private health system and save the taxpayers from having to carry the full cost of their health care. 

Across forward estimates, this measure will cost taxpayers—including young people—billions more than it saves, and it will put more pressure on public hospitals already dealing with bed block and long waiting times. Our young people will not always be young. A measure that helps more than three million older Australians today will help younger Australians tomorrow. 

The Albanese government is promoting division in order to set one age group against another. How dishonest! Classic communism! This is the politics of envy, designed to cover up the real reasons young people are struggling, which are immigration, net zero, grocery prices, energy prices, inflation—destroying industry, making lives harder and robbing our young of the opportunity to own their own homes, to enjoy the life that my generation enjoys. To pitch to younger voters, start there. Introduce negative immigration until housing and infrastructure catches up, reducing house prices. Terminate this net zero madness and let business get on with creating breadwinner jobs that provide a future for our young. 

Intergenerational wealth transfer is a term that is a furphy, a lie, a dishonest diversion. Labor is crippling the young. In reality, this is an excuse from Labor to increase taxes on people with assets who, after a lifetime of work, are the older generations. Remember, today’s young adults are the future older people. This aims to hit all Australians, including the young. You will eventually get hit. This is a lie that is masquerading to steal more taxes. One Nation will unwind this petty, dishonest, counterproductive measure. We are one nation, one community and One Nation will not set one Australian against another.  

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Tracking Vaccine Dollars

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In this session with the Department of Health, I inquired about the total cost of our childhood vaccination program. While I didn’t receive an immediate response, the question was taken on notice.

The TGA also offered to provide a cost-benefit analysis of these vaccines. Frankly, I’m not expecting an honest reply. I will wait and see.

If they fail to deliver, I’ll pursue it at the next estimates. 

— Senate Estimates | February 2026

Transcript

Senator ROBERTS: How much do these vaccines cost the taxpayers every year: rotavirus, hep B and meningococcal ACWY?  

Dr Peatt: I don’t have the individual breakdowns of those vaccines, but I can tell you that, in 2024-25, the National Immunisation Program, which includes a raft of supporting activities that—  

Senator ROBERTS: Is that childhood vaccines?  

Dr Peatt: No, this is the full complement of National Immunisation Program vaccines and also other activities like communications and data collection, for example. We spent $762.8 million.  

Senator ROBERTS: Is there any chance of getting a breakout for the children’s vaccines?  

Dr Peatt: It’ll be dependent on whether that information is commercial-in-confidence, but I’ll take that on notice and get back to you.  

Prof. Lawler: I’ve mentioned previously that the regulator is involved in balancing the risk and benefit. I would highlight that it would be difficult to talk to the cost of vaccines unless we also recognise that these vaccine-preventable diseases cause an incredible burden of mortality, morbidity and cost. In fact, in the US, RSV is the leading infectious cause of paediatric hospitalisation. So the risk benefit is as important as the cost.  

Senator ROBERTS: That’s a good point, Professor Lawler—perhaps if you could include in that the benefits.  

Dr Peatt: Certainly.  

Senator ROBERTS: Denmark, Sweden, Norway, France and the Netherlands do not recommend rotavirus vaccines except for high-risk cases. The varicella vaccine in Denmark, Sweden, Norway, Finland, France and Portugal is not recommended except for high-risk cases, and hepatitis B vaccine is not recommended for routine use in Denmark, Norway, Finland, UK—Britain—France, Germany or the Netherlands. Surely the default is don’t vaccinate unless the need has been established. Can you show me any of these countries where the absence of the vaccination has led to a higher incidence of child harm—not infection but harm—than vaccinated countries?  

Dr Peatt: As my colleague Professor Lawler has outlined, it’s very difficult to compare different countries. That’s really because there are different disease impacts in each different country, which can be related to the public health measures that are in place and also the different diseases that are circulating. We also have different funding mechanisms. In Australia, we’re very fortunate to be in a country that has a program that provides vaccines for free that are recommended by our advisers. We are very fortunate in that sense. So I’d say that it’s very difficult to compare one country to another in terms of how they fund or recommend their vaccines. But I will throw to Associate Professor Katherine Gibney, who may be able to give you an idea about some of the assessment and information that they take into account when they recommend vaccines in the Australian context.  

Prof. Gibney: Certainly, ATAGI takes the epidemiology and burden of disease of each of these vaccine-preventable diseases into account as we consider who to recommend the vaccines for. Establishing a clinical need isn’t just about infection—in fact, counting numbers of infections is not particularly interesting. It’s hospitalisations, severe disease and death that we’re particularly interested in or long-term consequences that could be prevented through vaccination. So that’s really what we look at. The first question is: is there a need for a vaccine? Then we look at the vaccine. Considering that TGA has already assessed the effectiveness and the safety, we further review that in the context of the clinical need. Further to that, when we provide advice to PBAC, they look not only at the clinical effectiveness and need but also at the cost-effectiveness. So ATAGI don’t assess that, but that is assessed for every vaccine before a recommendation is made that it be added to the NIP.  

Senator ROBERTS: Well, could you show me anywhere where the absence of the vaccination has led to more hospitalisations and more deaths?  

Prof. Gibney: Certainly we can take that on notice and provide that.  

/1 Comment/by

Vaccine Trials: Fact vs. Fiction

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In this session, I asked about the system for testing childhood vaccines before authorisation and during use. I asked because the United States FDA has recently de-listed approximately half of their scheduled vaccines due to adverse events (side effects).

It was a simple question, yet the answer was “tag-teamed” across the panel of witnesses from the TGA to avoid answering it directly. It is damning that their own Database of Adverse Event Notifications (DAEN) shows numerous adverse events, which the TGA simply ignores.

Instead, they quote the benefits of vaccines, which have never actually been proven in field trials. I have spoken about this before: in comparisons between vaccinated and unvaccinated children, the unvaccinated were healthier. I will return to this line of questioning during the next estimates.

You will also note they relied on an answer provided to me in Question on Notice 3212, which has neither been published nor provided to me.

— Senate Estimates | February 2026

Transcript

Senator ROBERTS: Thank you. I come back to two separate points you raised. Ms Peatt, you mentioned that Australia assesses the vaccines. Do they do actual testing? What is the method of assessment? Trials?  

Dr Peatt: I’d have to throw to Professor Lawler about the assessment that the vaccines go through, but, from my knowledge, we don’t assess the vaccines. What we do do is rely on evidence and data to ensure their safety. I’ll hand to Professor Lawler.  

Senator ROBERTS: Okay. Where do that evidence and data come from?  

Mr Henderson: We have a process where we rigorously evaluate submissions provided by sponsors of these vaccines.  

Senator ROBERTS: The drug companies?  

Mr Henderson: The pharmaceutical manufacturers, who then sponsor—  

Senator ROBERTS: Submissions from the drug companies?  

Mr Henderson: Yes. We require a significant amount of evidence to support our assessments of the safety, efficacy and quality of those vaccines before they can be marketed and supplied in Australia.  

Senator ROBERTS: Let me understand this. I go back to March 2021. I think it was. I asked the previous head of the TGA, Professor Skerritt, or Dr Skerritt, what testing was done in this country on the COVID injections. He said none. They relied on the FDA. At the time he said that, it was after the FDA had admitted they did no testing themselves; they relied on Pfizer. You’re telling me you’re doing the same thing. Okay. The next—  

Mr Henderson: Sorry, Senator. I might just jump in there. No, all the COVID-19 vaccines are now what we call fully registered, so they have been assessed on a full suite of evidence to support safety, quality and efficacy of those vaccines. For COVID-19 vaccines, as well, we did have a program in place where we did batch testing of all vaccines in the TGA laboratories before they could be supplied in Australia.  

Prof. Lawler: I might add to that if I may, Senator. I note your use of the word ‘testing’. The role of the regulator—and this regulatory practice is standard worldwide—is that we undertake an unbiased and objective assessment of the evidence that is presented to us, particularly—  

Senator ROBERTS: From what entity? The supplier?  

Prof. Lawler: That was part of the rest of my answer, Senator. I’m going through the process that we follow. While, for the most part, that is supplied by the sponsor who is seeking registration of the product, it does undergo an appropriate assessment by our own experts to determine that the size of the sample, the controls that are placed, the primary endpoints, the outcomes and the adverse events—all of those elements of the study—indicate that the risk-benefit analysis is positive. The process that we undertake is similar to others.  

As Mr Henderson’s highlighted, during COVID we had a provisional registration pathway. This was during a time, as you would recall, when the risk-benefit of providing a provisional authorisation for that vaccine was high. Since then we have undertaken a transition of that vaccine through to a full market authorisation. There are other mechanisms for assessing the evidence, and obviously in this instance we can also rely on the real-world evidence that the overwhelming benefit—that the risk to benefit is positive given the number of lives saved by the administration of the COVID vaccine when compared to the incidence of adverse events.  

Senator ROBERTS: Mr Lawler, before I ask my—  

Prof. Lawler: Professor Lawler. Sorry, Senator.  

Senator ROBERTS: Professor Lawler, you said a minute ago in another answer ‘Australian disease patterns—forget overseas’. Now you’re saying they’re similar to others, so our testing is similar—or our assessment is similar to others; you don’t do testing.  

Prof. Lawler: I actually said neither of those things, Senator. I certainly didn’t say that we should forget other countries. What I said is that we make our own vaccine schedules based on the demography, the epidemiology, the disease patterns and so forth of Australia. We certainly have a mind to others. Just as an example, the disease patterns in the northern part of the world circulate to the southern part of the world some six months later. So we certainly have to be mindful of what’s going on in the rest of the world. We don’t forget what’s going on there. What I then said was that there are consistent, if not identical, approaches to regulatory decision-making around the world. There is significant positive collaboration and work sharing between regulators so that we can know what the appropriate practices are, particularly horizon scanning, so that we know what’s coming up. But I would highlight that the answer that I gave actually went to how we regulated during COVID, which was different to other countries. Other countries undertook what’s called an emergency-use authorisation. We undertook a process of provisional registration, which was an abbreviated and expedited process that did not lift from sponsors the requirement to provide appropriate evidence, particularly real-world evidence, and then the appropriate, more fulsome transition to full market authorisation thereafter.  

Senator ROBERTS: I can only go by what your predecessor said—that they relied on the FDA. Dr Peatt, you said the childhood injections are free.  

Dr Peatt: Yes.  

Senator ROBERTS: They’re actually paid for by $750,000 by the taxpayer.  

Dr Peatt: Yes. That’s correct. What I should have said is that they are provided free to people who are eligible for those vaccines. But, yes, they are fully funded by the government.  

Senator ROBERTS: The taxpayer.  

Dr Peatt: Yes.  

Senator ROBERTS: There’s no such thing as government money. It’s all taxpayer money.  

/by

The Illusion of Peer Review

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My exchange with the Professional Services Review (PSR) during the December 2025 Senate Estimates only deepened my concerns regarding the integrity of their review process. It is becoming increasingly clear that their ‘peer review’ is a mere box-ticking exercise, dominated by lawyers rather than the medical peers the legislation intended.

I questioned why lawyers, rather than the doctors themselves, are drafting the reports. While the PSR claims lawyers only “put together” the doctors’ views to ensure procedural fairness, it appears to me that the heavy lifting, sometimes over 150 hours of drafting, is done by legal staff, while committee members may spend as little as seven to 10 hours reviewing the final product.

I raised the issue that there is no legal requirement for committee members to share the same subspecialty as the GP under review. A GP in a niche field like aerospace medicine could be judged by practitioners with zero experience in that specific group.

I questioned Professor Dr Dio and Ms. Weichert on the lack of basic legal protections, such as the absence of a presiding judge, the inability to cross-examine the committee on their views of “general body” standards, and the lack of a formal merits review.

Several questions were taken on notice, specifically around providing detailed log of hours spent by both staff and committee members on reports over the last three years. We need to see if the time spent by doctors actually justifies calling this a “peer-reviewed” outcome.

— Senate Estimates | February 2026

Transcript

Senator ROBERTS: At the December 2025 Senate estimates, Professor Dr Dio, you indicated that lawyers prepare their reports from the review scheme but that the committee members review the reports. In what way does the PSR monitor the performance of the committee—including if the committee has read the entire report and the material presented to it before signing it off? 

Prof. Di Dio: The committee diligently reads the draft reports and the final reports, and we have staff who liaise with the committee at various stages after draft reports and final reports have been sent to them. So should for any reason a committee member not do their duty and read in the draft report, the legal officer in charge of giving service to that committee would firstly of course remind the committee members to review the report, and if they do not, they would then come to me. But that’s a theoretical possibility, because I cannot recall that happening.  

Senator ROBERTS: The PSR committee process is supposed to be a peer review process performed by doctors. Why then don’t the doctors write their own reports? If administrative support is needed, why are lawyers drafting their reports instead of administrative or secretarial staff, which would come at a lower cost to the department?  

Prof. Di Dio: Because the reports are incredibly important. We are passionate about according natural justice and procedural fairness to all practitioners under review. It is my view that the best way to do that is to have the best qualified, quality people writing those reports. Reports of this nature would be best written by people who are very good at supporting doctors in providing their reports.  

Senator ROBERTS: ‘Best qualified’ to me would seem to be the doctors—and then trimmed up or modified by the lawyers.  

Ms Weichert: The lawyers are writing up what the doctors have formed a view about as part of that committee process, as part of the hearing process, the concerns they have put to a person under review and the things that have come back—the lawyers are just putting it together. They are the doctors’ concerns or the medical practitioners’ concerns. It is they who sign off on the report, who approve the report. They are the peer review committee members’ views.  

Senator ROBERTS: If it can be shown that a lawyer spends over 150 hours drafting a report, but a committee member only spends seven to 10 hours reviewing the material and reading the report, is this truly considered by the PSR to be a legitimate peer review?  

Ms Weichert: That’s not taking into account any of the time that was spent in the hearing, in questioning and the time that the committee members have turned the matter throughout the process.  

Prof. Di Dio: A hearing might take eight days; it might take 50 or 60 hours. The prehearing reading might take many, many hours. The contemplation of what happened during the committee hearing might take the committee members many, many hours to turn their mind to it.  

Senator ROBERTS: Over the past three years, as an average, what percentage of the total services reviewed has the committee found the services provided by doctors to be inappropriate?  

Prof. Di Dio: I will have to take that on notice.  

Senator ROBERTS: This question is about general practitioners. The Royal Australian College of General Practitioners recognises 37 specific interest groups as subspecialities. If a GP is under review by the committee, is it correct that there is no legal requirement for the committee members to share the same subspecialty? For example, if a GP practices solely in aerospace medicine, there’s no legal requirement for the committee to have any experience in aerospace medicine, because they all fall within the category of general practitioners. Why is there no subspeciality matching?  

Prof. Di Dio: The subspecialty matching is that members of the committee are general practitioners. But the PSR strives to find general practitioners who have experience in those matters. I can assure you that for some practitioners who are in craft groups that are exotic, as you say, like me—I have particular special interests—we try to match those as much as we can. But, under the law, a general practitioner can review a fellow general practitioner.  

Senator ROBERTS: Is it correct that the legislation allows just three committee members to decide what is unacceptable to the general body of general practitioners? In deciding what the general body of general practitioners find unacceptable, do the committee members have to have any regard to any external resources or consideration of other doctors? Do the lawyers draft that part of the report as well, about what the general body of doctors think?  

Prof. Di Dio: One of the things that we train committee members to do, to absolutely and scrupulously give fairness to the practitioners under review, is try as much as possible to ask one question at a time to avoid the risk of the practitioner missing the opportunity to respond to any and all of the questions put to them. I’d be very grateful if you could ask me the first couple, and I’ll go through them with you systematically. 

Senator ROBERTS: Is it correct that the legislation allows just three committee members to decide what is unacceptable to the general body of practitioners?  

Prof. Di Dio: Yes. Ms Weichert: It’s at least three. There are certain circumstances where there could be additional committee members appointed, but it is usually three.  

Senator ROBERTS: In deciding what the general body of general practitioners find unacceptable, do the committee members have to have any regard to any external resources or consideration of other doctors?  

Prof. Di Dio: The committee members have to have regard to all of the evidence before them so that they can—  

Senator ROBERTS: All of the evidence before them?  

Prof. Di Dio: Yes. The committee members welcome from the practitioner any materials that they wish to submit as further evidence either before, during or after the hearing.  

Senator ROBERTS: While PSR committees are intended to operate as expert peer-review bodies, concerns include the absence of a presiding judge, the lack of merits review, the inability to cross-examine the committee on what they believe to be the views of the general bodies, the downweighting of significant evidence, limited engagement with defence submissions and a lack of transparency. Why do PSR procedures deny these basic elements of procedural fairness and justice, and how does the PSR contend that the peer-review function is being properly exercised in their absence?  

Prof. Di Dio: Could you ask the six points one at a time, and I’ll gladly respond to them.  

Senator ROBERTS: They’re intended to operate as expert peer review bodies. Concerns include the absence of a presiding judge.  

Prof. Di Dio: The process is a peer-review process. So, if somebody is trying to find out whether I’ve engaged in inappropriate practice, then the best placed people to do that are my peers, not a judge.  

Ms Weichert: And, ultimately, we are applying the scheme as it is set out in the Health Insurance Act, so that provides for a committee—  

Senator ROBERTS: That may be the problem. The lack of merits review?  

Prof. Di Dio: Under the act, there is no formal merits review; however, we try as much as we can to build fairness into this process by having multiple opportunities to respond and make submissions—multiple opportunities.  

Senator ROBERTS: The inability to cross-examine the committee on what they believe to be the views of the general bodies?  

Prof. Di Dio: The committee is there to ask questions and find out if the practitioner under review has engaged in inappropriate practice. It’s not the committee that is under review.  

Ms Weichert: But the person under review can put forward their information when they’re answering the questions and the information that they would like the committee to consider, and that will occur as part of the process.  

Senator ROBERTS: The downweighting of significant evidence?  

Prof. Di Dio: What do you mean by that?  

Senator ROBERTS: As I said, ‘the downweighting of significant evidence’—  

Prof. Di Dio: I don’t understand what you mean.  

Senator ROBERTS: with significant evidence being put cursorily or downgraded.  

Prof. Di Dio: What significant evidence? Who has reviewed something cursorily or downgraded it? I don’t understand.  

Senator ROBERTS: If there is significant evidence put before the committee, it’s downgraded in terms of the verdict.  

Prof. Di Dio: I don’t understand what you mean by that.  

Senator ROBERTS: Okay. Limited engagement with— 

Prof. Di Dio: I would gladly take that on notice if it’s clarified for me. I just don’t quite understand. I’m not in any way being disrespectful.  

Senator ROBERTS: Okay. I can’t understand how you can’t see that, because the words seem to be selfexplanatory.  

Prof. Di Dio: Are you suggesting that, during a committee process, a practitioner under review gives significant evidence and the committee then downgrades or chooses to ignore it?  

Senator ROBERTS: Yes.  

Prof. Di Dio: I’m not aware of that occurring.  

Senator ROBERTS: Limited engagement with defence submissions and a lack of transparency?  

Prof. Di Dio: ‘Limited engagement with defence submissions’—again, practitioners under review can make submissions. Those submissions are welcome, and they are reviewed.  

Senator ROBERTS: Okay. Next question—  

CHAIR: Senator Roberts, can I interrupt you for one quick second. There are media in the room, and I need to give a short statement. The media have requested permission to film and take photos of proceedings, and the committee has agreed to this. I remind the media that this permission can be revoked at any time. The media must follow the direction of secretariat staff. If a witness objects to filming, the committee will consider this request. The media are also reminded that they are not able to take images of senators’ or witnesses’ documents or of the audience. Media activity may not occur during suspensions or after the adjournment of proceedings. Copies of resolution 3, concerning the broadcasting of committee proceedings, are available from the secretariat. My apologies, Senator Roberts.  

Senator ROBERTS: Thank you, Chair. A former PSR director has been found liable in the Queensland court for misfeasance in public office for failing to perform her statutory duties. Given these matters raised, why should the PSR’s legislation, governance and current officeholders not be subject to a comprehensive independent review?  

Prof. Di Dio: We did have a comprehensive review in 2023 called the Philip review, which made findings. We have acted on all of those findings, including the appointment of associate directors to the scheme.  

Senator ROBERTS: The former director was found liable for making a decision without adequately considering submitted materials. Isn’t that exactly what’s still happening?  

Ms Weichert: We do not consider that to be happening.  

Senator ROBERTS: Okay. What percentage of the department’s budget is spent on the committee review process, and how many cases per year go through a committee process?  

Prof. Di Dio: I can’t tell you the exact amount— An incident having occurred in the committee room—  

Senator RUSTON: You might want to turn your device off, Malcolm; you’ll have Bridget McKenzie after you! Prof. Di Dio: It might save us all a bit of time!  

Senator ROBERTS: Only if it’s in super-rational mode—other than that, it’s just filled with garbage. Can you take that percentage on notice?  

Senator CAROL BROWN: It hallucinates from time to time. You have to be careful.  

Senator ROBERTS: Yes. I might just turn it off.  

Prof. Di Dio: I woke up this morning, and ChatGPT told me I was going to have a stress-free day, so I think it was hallucinating! Without notice, I can’t tell you exactly what percentage of the budget is spent on committee hearings, but we can take that on notice and give you an accurate reading.  

Senator ROBERTS: Thank you.  

Prof. Di Dio: The second part of your question was—  

Senator ROBERTS: How many cases per year go through a committee process? Prof. Di Dio: It changes from year to year, but we get approximately 100 to 120 cases per year referred from Medicare, which in turn represents about 30 per cent of the cases that Medicare reviews. Of those cases, a ballpark figure of approximately 10 per cent get no further action under section 91, about 80 per cent get an agreement with the director or the associate director under section 92 and about 10 per cent get referred to a committee. So maybe 10 practitioners get referred to a committee in a year. 

Senator ROBERTS: Thank you. I need to put on record that we’re not debating whether or not the PSR should be there. They are process which I now understand are legislated. That’s what the problem is for us and for doctors. It is very concerning. Take this as a question on notice. Please table a log of the hours spent on each of the draft and final reports by the PSR staff combined and each of the committee members for the last three years of PSR committee matters. It’s expected that this log will table around 60 rows for each of the cases it reviewed over that period.  

Prof. Di Dio: Thank you.  

Senator ROBERTS: Thank you very much for appearing. See you next time. 

/by

Avoiding the Next Robodebt

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I questioned the Minister regarding Schedule 1 of the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025, specifically the automation of Medicare Provider Numbers (MPNs).

My primary concern, as always, is ensuring that “automation” isn’t just a fancy word for another government digital disaster. We’ve seen the Robodebt fiasco, the Bureau of Meteorology website fiasco, Australia Post software fiasco and the Border Force Cargo management automation fiasco; my job is to make sure Australians aren’t the next victims of a “government stuff-up.”

I asked the Minister why legislation is needed for a process that is already using computers. She replied that this bill provides legislative support for existing practices and introduces safeguards, adding that computers will not be used to revoke or suspend provider numbers without a human request.

I asked if this automation of MPNs was a “Trojan horse” for Artificial Intelligence (AI). Despite the Explanatory Memorandum mentioning “computer programs” for non-discretionary decisions, the Minister stated on the record that there is no intention or requirement to use AI for allocating MPNs.

Finally, I sought clarification on changes to Commonwealth supported places. Under the new rules, medical students who withdraw from their degree, even late in their studies, will no longer be forced to repay the scholarship cost (though they remain liable for HECS). The Minister said that this is about “fairness” rather than recouping funds from students facing hardship.

I remain sceptical of any move toward “automated” government software, and I will be monitoring these automated systems very closely.

Transcript

Senator ROBERTS: Minister, schedule 1 of the bill automates the issuance of Medicare providers numbers, MPNs. ‘Automation’, I assume, means computer software. Computers are used now for the process. What is different about the process being proposed that it requires legislation to enact it?  

Senator McALLISTER (Minister for the National Disability Insurance Scheme): Thank you for your patience, Senator Roberts. I was just obtaining advice so I can advise you correctly. This new part of the act will ensure that the system can approve the use of a computer program for certain decisions relating to the allocation and management of Medicare provider numbers. It will not—and this, I think, will be important to you—enable the approval of the use of a computer program to make decisions about revoking a Medicare provider number or suspending a Medicare provider number where the suspension is not at the request of a health professional.  

It will also include safeguards around the use of computer programs to make decisions relating to Medicare provider numbers. Those safeguards include a requirement to notify a person where a computer program was used to make a decision about their Medicare provider number; a requirement to make it public when the use of a computer program to make decisions about Medicare provider numbers has been approved; a power to make substitute decisions where they are satisfied that a decision made by the operation of a computer program is incorrect; and a requirement to include information in the Services Australia annual report about the number and types of substituted decisions. 

Importantly, these things introduce safeguards, and they also, as is indicated in the explanatory memorandum, provide legislative support for an existing practice where some Medicare provider numbers have been allocated by use of a computer program, rather than by a human delegate.  

Senator ROBERTS: I think you anticipated one of my future questions, but, in the meantime, who decides if a person is qualified for a Medicare provider number, including the decision to give a Medicare provider number to a new arrival in the country? I’m asking this to see how this automation will impinge on the process of determining qualifications.  

Senator McALLISTER: May I clarify. I think what you’re asking is, ‘How would a new migrant to Australia have their qualifications recognised for the purpose of practising in an Australian context?’ Is that correct?  

Senator ROBERTS: That’s part of the question. The other part concerns any Australian who’s here right now; how would they be qualified?  

Senator McALLISTER: I’m terribly sorry. I might ask you to clarify further. You said that you’re asking about how a person who is here now would obtain a Medicare provider number. Do you mean an Australian citizen or another person? What are you trying to elicit from me?  

Senator ROBERTS: Anybody who’s qualified to get a Medicare provider number—how would you make sure they are qualified, and how would you make sure that we’re not excluding people?  

Senator McALLISTER: The advice I have is that the bill that’s before us doesn’t change any of the existing arrangements. Those arrangements, of course, include a series of processes to ensure that a person seeking to practise within the Medicare system is qualified.  

Senator ROBERTS: How extensive are the checks, and is there any hint of automation being more than just computer software? Is the bill intending to allow for the use of AI for automatic MPNs?  

Senator McALLISTER: No.  

Senator ROBERTS: So there’s no requirement for artificial intelligence to be used in allocating MPNs?  

Senator McALLISTER: The advice I have is no.  

Senator ROBERTS: I’ll quote from the explanatory memorandum:  

The Bill will enable the Chief Executive Medicare to approve the use of a computer program to make appropriate, non-discretionary decisions relating to the registration and claims process.  

Can I confirm you intend to use AI for that process? If so, what checks are in place to make sure the AI is fit for purpose?  

Senator McALLISTER: The advice I have in relation to AI is that there is no intention. We do not require AI to perform the functions that are set out in the bill. In relation to your earlier question about the process by which a person becomes eligible for obtaining a Medicare number, the Parliamentary Library’s Bills Digest in relation to this says:  

To be eligible to provide a Medicare service, health professionals must meet certain criteria. Practitioners eligible to have Medicare benefits payable for their services ‘at the place of practice as well as refer patients to other health professionals for Medicare eligible services, such as pathology and diagnostic imaging from the place of practice’, may apply online or in writing to Services Australia for a MPN for the locations where these services/referrals/requests will be provided.  

MPNs are used by health practitioners both ‘as a means of identifying themselves and their place of practice for the purposes of claiming Medicare benefits for eligible services, and as an identifier to support other Medicare-related programs …  

Senator ROBERTS: To clarify for constituents and to get some reassurance: you didn’t hesitate when you used the word ‘intention’ with regard to AI and then said there was no requirement. After the robodebt fiasco, the Bureau of Meteorology website fiasco, the Australia Post software fiasco and the Border Force cargo management automation, constituents have every right to point out that these stuff-ups keep happening because of the way in which new technology is rolled out. That’s a big concern. Now you’re giving the software decision-making powers, and it sounds like there are no plans to do that with due care. What security steps are being taken to reassure our constituents that the automations proposed in this bill don’t become yet another government stuff-up? I acknowledge that not all of the stuff-ups have occurred on your watch. 

Senator McALLISTER: This bill puts in place safeguards to ensure that, to the extent that a computer is utilised, the circumstances in which a computer is being used are made very explicit. It also puts some constraints around the kinds of decisions that may be taken by a computer in the context of this process—that is, the process of obtaining a Medicare provider number. I read to you earlier some of those safeguards, which are set out in the explanatory memorandum. As I indicated to you, the advice I have is that this process, which involves the use of a computer for certain purposes that are quite tightly defined and constrained, does not require the use of AI.  

Senator ROBERTS: This final question has a lengthy preamble. Item 3124ZH1 removes the requirement for students who do not complete their degree to repay the Commonwealth supported place cost. Students can currently withdraw from the program without consequence up to the HECS census date in their second year of study. If the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of their Commonwealth supported place up to the date of withdrawal in addition to any HECS or HELP liability. The proposed amendment, as I understand it, seeks to extend the existing grace period from the HECS census date in the second year of study to the award of the medical degree. Can you please explain that provision? It sounds like they can pull out right at the end of their degree and not have to pay back the cost. Is that right?  

Senator McALLISTER: Senator, you’re correct that at the moment a person who withdraws from their degree doesn’t need to pay the cost of the scholarship back if they withdraw prior to the census date you alluded to. I believe that they do remain liable for the HECS costs incurred by them in the pursuit of their studies up to that point. You are also correct that a purpose of this bill is to extend the period during which a person may withdraw without incurring a debt associated with their receipt of Commonwealth payments.  

Senator ROBERTS: Sorry, that was my second-last question; I’ve got another one now. What is the rationale behind extending the withdrawal date so they won’t have to pay it back?  

Senator McALLISTER: Earlier in the debate I read out an email from a person who has incurred a debt in precisely these circumstances, and they spoke about the hardship they had experienced as a consequence of that. This person made the point that the purpose of the bonded nature of this program is to ensure that people who do qualify as medical professionals fulfil their obligation to work in an area that is underserved by medical practitioners. The purpose is not in itself to recoup funds from students, and we simply seek to make the system fairer. 

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Integrity in Parental Leave

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One Nation fully supports the heart of the Fair Work Amendment (Baby Priya’s) Bill 2025. Losing a child to stillbirth is a crushing, heartbreaking tragedy and parents deserve the full support of our paid parental leave system during such a dark time. We agree that no employer should be able to unilaterally cancel leave when a family is grieving.

However, I introduced an amendment to fix a serious flaw in the current drafting. As it stands, the definition of “stillbirth” would allow a woman who undergoes a voluntary late-term abortion to claim 26 weeks of taxpayer-funded parental leave.

Our position is clear: ✔️ YES to supporting parents through the tragedy of stillbirth or infant loss. ✔️ YES to protecting mothers who need emergency medical terminations for health reasons. ❌ NO to using taxpayer dollars to provide “parental leave” for elective abortions.

Paid parental leave is a benefit designed to support families and the bond between parent and child. It should not be extended to those who voluntarily choose to terminate a pregnancy.

I called on the Senate to support our common-sense amendment to ensure this bill serves its true purpose: supporting grieving families.

Transcript

The Fair Work Amendment (Baby Priya’s) Bill 2025 amends the Fair Work Act 2009 to extend entitlements to paid parental leave in the case of stillbirth or death of a child. Stillbirths or deaths of a child are crushing—heartbreaking to parents. My wife, Christine, and I have two children and one grandchild. Nothing else comes close, as I’m sure every parent feels. Nothing else comes close to having a child, except possibly losing a child. One Nation supports the bill’s core intent for the very reason I’ve just mentioned.  

The bill only deals with paid parental leave; it does not alter the existing provisions around unpaid parental leave. The bill will prevent employers from unilaterally cancelling periods of paid parental leave in cases of stillbirth or the death of a child during the paid parental leave period. The bill will not prevent employers and employees from agreeing between themselves to cancel such periods of leave, usually so the employee can return to work early for sound reasons. And the bill does not change arrangements for payment of allowances to parents who are not employed. The bill does not impose any requirement on employers to provide employer-funded paid parental leave, because the employer does not pay parental leave; the government does, at a cost of $2.9 billion a year. Some companies pay parental leave at a higher rate. Often, they pay the employee’s regular pay and top up the government payment themselves. In this case, the bill will make those employers pay this higher rate to an employee who voluntarily terminated their pregnancy when their child was delivered stillborn. I will say that again: in this case, the bill will make those employers pay this higher rate to an employee who voluntarily terminated their pregnancy when the child was delivered stillborn. 

Why has One Nation submitted an amendment to the Baby Priya bill? Why have I submitted an amendment to the Baby Priya bill? The bill requires employers to provide paid parental leave to employees who have a stillborn baby, or where the baby dies during the parental leave period. One Nation do not oppose this measure in principle; we support it. Our amendment does not change the outcome of the bill for most women, including the situation Baby Priya’s parents, very sadly, found themselves to be in.  

The definition of a stillborn baby in the bill relies on section 77A(2) of the Fair Work Act 2009, which defines a stillborn child as one: 

(a) who weighs at least 400 grams at delivery …; and 

(b) who has not breathed since delivery; and 

(c) whose heart has not beaten since delivery. 

Yet here’s a key concern of many constituents across Australia and my state of Queensland: nothing in this definition takes account of a voluntary abortion resulting in a stillbirth, which is most late-term abortions. These involve injecting the human baby with a drug that stops their heart and then is delivered as a stillbirth. In the bill as it was introduced, a mother in that situation would qualify for 26 weeks of paid parental leave. This is the very specific issue One Nation’s amendment seeks to correct. We do not believe it is right for a woman who deliberately terminates her pregnancy to then qualify for 26 weeks paid parental leave at taxpayer expense. I must emphasise that neither this bill nor One Nation’s amendment changes anything around emergency terminations in the event of serious health issues affecting the mother. Nothing changes. That’s already protected in legislation; I want to make that very clear. For example, early delivery without killing the baby first is normal obstetric practice for emergency health conditions late in pregnancy such as high blood pressure, liver or kidney disease or cancer that requires chemotherapy. 

Here are some more important facts on abortion that have informed One Nation’s amendment. There is no upper gestational limit on abortion in any Australian state jurisdiction—none. In each jurisdiction, abortion is permitted until birth with the approval of two doctors after a certain gestation. In some jurisdictions such as Queensland, the second doctor who approves the late term abortion is not even required to examine the pregnant woman. A late term abortion is an abortion at 20 weeks or more in gestation. This is consistent with the definition provided by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in its practice guideline on late term abortion. 

How many late term abortions are performed in Australia every year? We don’t know because only Victoria, Queensland and South Australia publish the figures. The other states are obviously ashamed of how many they perform. The total number of known late term abortions in 2024 was 5,559. Of those, 75 per cent were for non-life-threatening conditions. This makes a complete mockery of the leftist talking point that women don’t abort their babies on a whim. Some do. 

There is a strong case for the productivity benefit of paid parental leave though, including in cases of natural death of the child. One Nation quite clearly supports this. It’s only the extension of this benefit to women who deliberately kill their baby, murder their baby, that One Nation objects to. I ask the Senate to support this amendment. 

In good conscience, we cannot wave through legislation that forces employers and taxpayers to fund 26 weeks of parental leave for terminated births or neonatal neglect.

While the loss of a child to natural causes is a tragedy, we are currently witnessing a horrifying reality in our hospitals: babies born alive after termination are being left to die alone in cold steel tins. This isn’t just a policy debate; it is a question of fundamental humanity.

Australia must stop and listen. We refuse to let this be treated as a tool for social media points or gender warfare. The Australian people deserve a formal inquiry to review these harrowing circumstances and have their voices heard.

Transcript

One Nation supports Senator Hanson-Young’s amendment. This bill will have far-reaching impacts on Australia. It’s not to be rushed through the parliament. One Nation is the party of the natural environment and the party of the human environment. We want to give Australians a say. Workers, employers and small businesses—the parliament needs to listen to these people and give them a say. 

I’d also like to now move my amendment to the Selection of Bills report as circulated in the chamber. 

The PRESIDENT: Senator Roberts, you can’t. We are dealing with Senator Hanson-Young’s amendment at this point. You can speak to your motion if you wish to, but you can’t move it. 

Senator ROBERTS: Thank you. I will speak to it now, and that’ll save us time later. One Nation has moved to send the Fair Work Amendment (Baby Priya’s) Bill 2025 to committee. The bill, as worded, allows employer paid parental leave for the parents of a baby who has been born still as a result of a termination or of a live birth abortion. Loss of a child due to natural circumstances is crushing, but where a child is terminated and born alive that child is cast away into a cold steel tin and left inhumanly to die from neglect in a bucket of cold steel. This is what’s going on our country. Alone, scared and suffering, the child dies a slow and terrifying death. 

This happens every few weeks in a hospital somewhere in Australia. The mother’s employer or the taxpayers should not have to foot the bill for 26 weeks paid leave for an aborted baby or neonatal murder—they should not. This is too important an issue to wave through parliament for social media likes and gender warfare points. A committee inquiry is needed to review this position and allow the public their say. The people of Australia need to have an opportunity to have their say, and we need to listen. 

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Health Reform: Australia Missing In Action

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In early December 2025, the U.S. FDA announced immediate and sweeping reforms to its vaccine approval and monitoring processes. These changes include stricter clinical trials, restrictions on high-risk groups such as pregnant women, and a comprehensive overhaul of vaccine safety monitoring.

I asked the Australian TGA whether they were following these developments and if there was a need for Australia to adopt similar measures. Their response was a “no,” wrapped in many pointless words.

Health Secretary Kennedy is making great progress in dragging the medical establishment back to the center. At present, I believe pharmaceutical companies and their profits exert too much influence on our health administration, to the detriment of common sense, honesty, and duty of care.

I will continue to hold the TGA to account.

– Senate Estimates | December 2025

Transcript

Senator ROBERTS: For now. The FDA announced immediate and sweeping reforms to their vaccine approval and monitoring processes, including stricter clinical trials; restrictions on high-risk groups, such as
pregnant women; and an overhaul of the vaccine safety monitoring system. This is going on under a new administration. The reforms closely mirror measures which operated in Australia until COVID, when our safety
assessments and monitoring were watered down with fast-track approval and emergency-use authorisation for a multitude of drugs. Will you accept that weak approval processes, high-adverse events and blanket denials that anything is wrong have undermined confidence in the entire health system in this country?

Prof. Lawler: There are a couple of things there, if I might comment. We didn’t use emergency-use authorisation. We adopted what is called a provisional pathway—

Senator ROBERTS: It’s equivalent.

Prof. Lawler: It’s not equivalent; it’s quite different. The reason that we undertook it was that, like the rest of the world, we recognised that there were risks that the community was facing, and we worked very closely with other regulators to understand what was emerging. Tonight, you previously mentioned relying on the FDA. It’s really important that, when we talk about reliance, it’s a specific term. It’s not like, if the FDA has approved it, then we automatically register it—

Senator ROBERTS: I’m just using Professor Skerritt’s words.

Prof. Lawler: I wasn’t here when Professor Skerritt gave you those words; I’m just trying to explain where we’re at.

Senator ROBERTS: He said he didn’t do any testing here—

CHAIR: Senator Roberts, can we let Professor Lawler finish his answer, please.

Prof. Lawler: It’s not like, if the FDA hasn’t approved it, we say, ‘You shall not pass.’ What happens is that we look to the information that other regulators have when making our own decisions. I think the important thing as well to note is that we do very much rely on our approvals. We do have, as other regulators have, both pre-market and post-market evaluation and monitoring. But the point that you made about trust is a very important one. We had a presentation at our International Coalition of Medicines Regulatory Authorities earlier this year about trust. There was a very strong driver of trust in institutions, in regulations and in health professionals. The very strong downward driver of it is misinformation and disinformation. Part of the challenge that we have is that, as we hear very frequently, there are a lot of studies, for instance, of very low quality that are being taken up and used as evidence or proof of causal links that just do not exist. Part of the challenge we have is that we do strive to rebuild trust. On two occasions in the last two months, the chief medical officer and I have endeavoured to do that through public statements, and it is a constant battle.

Senator ROBERTS: It’s something we’ve found agreement on. I understand there was a paper in the Lancet a few years ago that said that 50 per cent of medical papers are not valid. Now, we’ve got increasing knowledge coming out and evidence showing that big pharma has heavily influenced the scientific papers and has corruptly done so. This is my last question. Will you monitor the changes in the United States in case the new team under Kennedy is actually right about what has gone before them and right about the changes being necessary?

Prof. Lawler: We monitor all of the developments by our international collaborative partners in regulation.

CHAIR: Thank you.

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