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Wednesday, 13 August 2003
Page: 18393


Ms GILLARD (2:05 PM) —My question is to the Prime Minister. Is the Prime Minister aware that in April 2002 the states and the Commonwealth agreed to establish nine reference groups which were to work through key health reform issues in the lead-up to the new Australian health care agreements? Is the Prime Minister aware that the executive summary to the report of the nine reference groups states:

The current fragmentation of the health system has been identified by all Groups to be the most significant barrier to realising optimal health outcomes for Australians.

... ... ...

The overwhelming message from the Groups is that this lack of integration is unsustainable, expensive—


Mrs Bronwyn Bishop —Mr Speaker, I rise on a point of order. The standing orders are quite clear that question time is meant to have short questions, not speeches. Indeed, the text from which the honourable member was reading sounded very much like a speech, not a question. She should be ruled out of order or told to get to the point forthwith.


The SPEAKER —I would remind the member for Mackellar that I am not aware of any standing order that dictates the length of questions. It has been a custom that questions are relatively brief, and that custom has not so far been transgressed. I have not heard the member for Lalor advancing the argument. I have listened closely to her question. Clearly, any quote should be limited. I recognise the member for Lalor.


Ms GILLARD —I will conclude the question as quickly as I can. The quote from the executive summary of the nine reference groups—an agreed Commonwealth-state process—concludes as follows:

The overwhelming message from the Groups is that this lack of integration is unsustainable, expensive and detrimental to health outcomes.

Prime Minister, despite these findings, isn't it a fact that the Commonwealth has abandoned this vitally needed health reform process and has walked away from any opportunity to incorporate the recommendations of these reference groups into the new health care agreements?


Mr HOWARD (Prime Minister) —In answer to the honourable member's question, I have not read that document, so I cannot tell her whether what she asserts to be a fact is a fact. But what I can tell her from my certain knowledge is a fact is that the Commonwealth has offered to increase health funding to public hospitals by 17 per cent in real terms over the next five years. That represents an increase of $10 billion. I can also tell her as a fact that, because of the introduction of our 30 per cent tax rebate for private health insurance, we have taken a massive load off the public hospital system of Australia. I can also tell her as a fact that neither the member who asked the question nor her leader can guarantee to the 45 per cent of Australians who have private health insurance that if Labor were to win the next election their tax rebate would be safe.


Ms Gillard —Mr Speaker, I rise on a point of order which goes to relevance. My question was about the health reform agenda. If the Prime Minister does not know anything about it—


The SPEAKER —The member for Lalor will resume her seat. The member for Lalor has been extended a good deal of licence in this question, as she is aware. The question was about health reform; the Prime Minister was responding to the matter of health reform. I do not think the matter should be widely canvassed, but his answer was entirely relevant.


Mr HOWARD —Good health policy in this country requires a contribution from both the public and the private sector. This government, in the 7½ years we have been in power, have not only increased support for public hospitals; in fact, over the last five years we have contributed more to the support of the states' public hospitals than they themselves have done. Despite the fact that the public hospital system of this country is owned and operated by state governments, we have been more generous than the states have in the funding of them. The reason why the states have not signed the health funding agreements that we have sent to them is that thus far the states of Australia have been unwilling to match the increase in funding that the Commonwealth has offered.

There is this extraordinary situation where the Commonwealth, which does not operate the hospitals, is offering to increase its money by 17 per cent in real terms to guarantee the real-terms funding that they now receive and to give the 17 per cent if the states will match the increase. But so far not one state, not one territory, has been willing to match the increase that the Commonwealth has offered, despite the fact that it does not run these hospitals. They are not Commonwealth hospitals; they are state government hospitals. Every day that Mr Beattie, Mr Carr, Mr Bracks, Mr Bacon, Dr Gallop and Mr Rann refuse to sign those agreements, they are putting at risk the availability of hundreds of thousands—indeed, millions—of dollars extra for the patients of public hospitals. So I would say to the member for Lalor that good health policy in this country depends on having a private and a public contribution. We have made a generous public contribution. We are willing to increase our money by 17 per cent. We have brought in a private health insurance rebate. I can assure the 45 per cent of Australians who have private health insurance tax relief that it is safe under a re-elected Howard government. It would be in danger under an elected Crean government.