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Thursday, 15 September 1983
Page: 893


Mr SCOTT —Is the Minister for Health aware of claims made by the Tasmanian Minister for Health that Tasmania had not agreed to replace the present Commonwealth-State hospital cost sharing agreement with identified health grants and Medicare compensation grants after 1 February next year? In view of the communique agreed to by the Prime Minister and all State Premiers following the June Premiers Conference, does the Minister accept the accuracy of these claims?


Dr BLEWETT —I am all too well aware of the rather shoddy behaviour of the Minister for Health in Tasmania. In fact, the House will also be well aware of that because the honourable member for Bass, I think in a somewhat disappointing way, lent himself to those equivocations by the Minister by tabling in the House last night a letter from the Minister for Health in Tasmania to me dated 16 August. The important thing about that is that it was six weeks after the Premiers Conference. It is well worth that letter being incorporated because it shows clearly what the Minister was up to. First of all, he made the claim that the Tasmanian Government had never acknowledged that it would replace its cost sharing agreement with a block grant compensation arrangement under Medicare. The reason he tried to produce that story was revealed in the latter part of the letter where he sought to secure from the Commonwealth Government moneys and compensation on health issues which have nothing to do with Medicare and nothing to do with the cost sharing agreement. The letter-honourable members may read it -was simply a shabby effort to blackmail the Federal Government. Let us get the facts clear about what the Tasmanian Government agreed to. At the Premiers Conference in Canberra on 30 June the following statement was made by the Treasurer:

I emphasise that the Commonwealth's attitude towards the amount of any additional borrowing programs it is prepared to support will also be heavily contingent on the States agreeing to the proposals for compensating the States for new health arrangements under Medicare on the basis put forward by the Minister for Health on 15 June 1983, subject to changes which we will later be proposing in Premiers Conference.

It was clear that the whole arrangement was based on the States agreeing to those proposals. What were those proposals? A document was circulated to all the Premiers. It was also circulated to all the officials for their consideration. It was headed 'Medicare program financial proposals by the Commonwealth Government, 30 June 1983'. I table that document so that honourable members can make their clear judgments of its proposals. That document states, in part:

The proposals accepted at the Health Ministers' Conference as a basis for agreement, as amended after consideration by submissions by the States . . .

Clause 10 of that statement includes the following:

South Australia and Tasmania to be reimbursed for both in-patient and out- patient revenue losses on the basis of existing cost-sharing agreements being terminated, and their replacement by identified health grants equal in value to the cost-sharing grants applicable at 1 February 1984; plus revenue loss adjustment as above.

That document was presented. What did the Premiers decide to do? Let me quote from the Premiers Conference and Loan Council communique:

The heads of Government agreed on the revised proposals for Medicare as outlined by the Minister for Health in Premiers Conference, including the basis for compensation payments to each of the States as outlined by the Minister . . .

Those proposals which I referred to a moment ago were agreed to in that communique by which all the arrangements were made between the States. I table that document for honourable members to make their own judgment.

We do not simply have to leave it to those documents. On 14 July the Health Ministers met to consider those arrangements. At that conference Mr Cleary clearly said that he had advised his Premier at the Premiers Conference, that he agreed with the broad concept of the Medicare funding details for all States, that he acknowledged that the agreement at the Premiers Conference was on the broad principles of Medicare and that this Health Ministers Conference would simply finalise the details. On 14 July Mr Cleary was quite clear that the broad principles, including those cost-sharing arrangements and their substitution by other arrangements, had been agreed on; it was simply a matter of settling on the details.

The final point I want to make is that, on the evidence now before the House, the kinds of statements made in the letter from the Minister of 16 May are simply, as I said originally, an effort to blackmail the Commonwealth Government around this agreement, because his Premier agreed quite clearly that the cost- sharing agreement would be replaced by the block grant compensation. On all the evidence, Tasmania has received a very fair deal out of those compensation arrangements.