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Tuesday, 3 March 1998
Page: 214


Mrs STONE (8:00 PM) —I welcome the opportunity to speak on this government's performance as it wrestles with the legacy of more than a decade of Labor's mismanagement of Australia's public health sector. The member for Dobell (Mr Lee) referred to the public's concern about the costs of private health insurance. He implied that the decline in numbers insured is a recent trend. If only Labor was in government, he seems to argue, the community would happily line up to pay their private health insurance premiums.

Let us look at the legacy of Labor. Let us consider the shape that Australia's health services were in after 13 years of Labor's efforts. Let us begin by looking at Labor's record of health care funding over the last 13 years. In the 1994-95 Labor budget, $51 million was cut from general practice programs, authority prescription changes meant a further cut of $42 million, $22 million was cut from aged care and funding to reduce hospital waiting lists was cut by some $20 million. Labor's 1995-96 budget saw a massive $540 million slashed from right across the health portfolio. This included over $132 million cut from aged care. There were across the board cuts in the administration of health schemes, crippling many. And what about rural health and the chronic shortage of doctors that anyone representing a rural seat in Australia knows is the No. 1 issue when it comes to keeping families and attracting new business? The social infrastructure is essential and the shortage of doctors, nurses, pharmacists and paramedics of every description is a chronic problem.

Apparently Labor did know of the problem. They heard about it, no doubt, on a very infrequent trip into the bush, because in 1992-93 they introduced a doctor relocation incentive scheme where some $20,000 or so was offered to help doctors remove to a regional area. The trouble with that was that they did not understand exactly what non-metropolitan Australia was all about—nor do they now. For example, you could not get the $20,000 if you shifted from Melbourne to the regional centre of Shepparton. Shepparton is indeed only two hours from Melbourne, but it has a chronic doctor shortage and it has been that way for decades.

If, however, you were in a one-doctor town in northern Victoria in another part of the electorate of Murray, say, Kerang, you could get that relocation allowance to go to an even smaller no-doctor town a few kilometres down the road. So it was a case of just shifting the deckchairs on the Titanic as it slowly sank.

Since that time, there has been, fortunately, a massive public rejection of the Labor Party and its policies. No doubt, one of the most seriously concerning parts of Labor's policies was the impact of their health budgets and their health policies. In particular, let me talk about what we have done since we inherited this very parlous situation.

We have addressed rural health issues in particular. There is a whole series of initiatives now going to the heart of the problem. Too frequently the young men and women who choose to study medicine come from metropolitan Australia. They have no consciousness or understanding of the bush. So when they do finally graduate, they choose to practise in metropolitan areas as general practitioners or, indeed, as specialists. But this government has set up five departments of rural health, and I am very fortunate in Murray to have one of those departments because, unfortunately, we have one of the most chronic shortages of health practitioners of all descriptions across Australia.

These departments of rural health are innovative. They are a strategic alliance between a university department of medicine and a local regional hospital. We are expecting to see young doctors, specialists, nurses or paramedics do some of their training in these regional centres. We hope that, while they are there, they will learn extra skills necessary to practise in the bush. But we hope they will also become enculturated, and they will not be fearful of bringing their families to live in areas beyond the tram tracks of the capital cities.

Our government has a range of such initiatives. They include scholarships for young rural students—the John Flynn scholarships—and scholarships for rural nurse practitioners. We will make sure that over the years we address the chronic health service provider imbalance.

Let us look at other initiatives that go beyond regional Australia. For example, we have tackled the immunisation rates. After 13 years or so of Labor, we had Third World levels of immunisation of our young children. We were looking at whooping cough, measles and rubella outbreaks that were a scourge of our country in the 1950s. We have had to set about educating a whole generation of young mothers about the significance and the importance of immunisation. This government is taking this very seriously and we are putting millions of dollars towards giving incentives to help general practitioners spread the word and to make sure parents understand the need for child immunisation.

We are tackling problems associated with the harm done by illicit drugs. We have put some $87.5 million into a national illicit drug strategy. We are tackling the problems associated with the differences between the bureaucracies administering health services—in the states and the Commonwealth. In particular, our national public health partnerships are designed to cut through the bureaucracy to make sure the dollars go to service provision and not to red tape. A number of these strategic partnerships have already been signed between the Commonwealth and the states and they continue to be signed. It is a major step forward.

Of course, most people here will have been celebrating the successful introduction of the therapeutic group premiums to the pharmaceutical benefits scheme. This is a very reasonable balance between what taxpayers and the individual are going to be asked to pay. We had an incredible system where the cost to taxpayers of pharmaceuticals in this country had blown out to more than $2.5 billion in 1996-97. This government is tackling the problem in a way that the previous minister for health under Labor could only dream about. She understood the problem, she attempted to address it, but all we saw was the further ballooning of the costs of pharmaceuticals.

We are tackling the mental health issues in this country. In fact we are putting $28 million over the next four years into a national mental health strategy. We are not just putting dollars towards projects; we are insisting on, `Projects with outcomes'. We are measuring those outcomes. No more will we sit back and say, `We put $28 million towards the problem. That's okay; we can walk away.' We are identifying what outcomes are needed for the people in this nation who need special mental health services. We are doing the same for our indigenous citizens who have major health issues. No more do we simply say, `There are so many millions of dollars thrown at the problems.' We are talking about identifying and monitoring improved health outcomes which we negotiate with the providers of those health care options and with the people who are suffering from the health problems in those communities.

There are a whole range of initiatives. None of them in the past was addressed in a way that was ever going to deliver a better health service in this nation. Yet all the member for Dobell, the shadow minister for health, can talk about is how come the public is concerned about the cost of private health insurance. Of course the public is concerned. It is a major issue and a major problem. It is no good simply describing the problem. I strongly recommend to the Labor Party that they watch closely and see what this government is doing in terms of funding the health needs of this nation, making sure that people can access health services no matter what their income is. I invite them to watch how we are addressing the imbalance between medical services provided in the cities and medical services provided in the country. It is not fair that, because this nation is so huge, those who live several hours from a metropolitan city can expect to see their young children suffer because they have no access to preventative health regimes or ready access to a local general practitioner.

To continue to have these issues brought up as matters of public importance which never address the real problems associated with health service in Australia, but simply try to politicise and score points over people's concerns in the public domain, is a very cynical exercise. I invite the Labor Party instead to participate in helping us form better health service provision for the nation from this day on.


Mr DEPUTY SPEAKER (Hon N.M. Dondas) —Order! The discussion has now concluded.