Ms ROXON (3:19 PM) —It is good to be here to be debating the challenges that we face in the health system. It seems to me that, for the Minister for Health and Ageing, it is pretty difficult to tackle the nation’s health problems if you are too busy tackling your colleagues on your internal problems. The states, stakeholders and health professionals have been asking the health minister for months to deal with the issues, the crises, the major problems and long-term decisions that need to be made in our health system—they have been pleading with him to take some action. His answer to them has been: ‘I can’t do any of that now, because there is an election in the offing. I’m going to concentrate on the things that need to be done now.’ In fact he even publicly said, when the states asked if they could now recommence negotiations with him for the healthcare agreement: ‘No, I’m not going to do it now. It doesn’t have to be done now so I’m not going to do it now.’ He was as blatant as that.

Then I was surprised to read in the paper in the last couple of days that the very same minister has been giving all of his colleagues, who were obviously dealing with other internal matters, a lecture saying:

That was even after he has been spending months and months saying all he was going to do was clock off on some sort of extended smoko because an election was in the offing—he had no more duties as the health minister; he was not going to talk to the states; he was not going to try and solve any health problems; he was not going to deal with chronic disease; and he was not even able to make up his mind what his health policy was.

The most entertaining thing this week happened in question time today, when the minister was determined to try to make a mockery of our $2 billion health and hospital reform plan. He had the nerve to ask what the criteria would be for taking over a hospital. Maybe I could ask the minister what the criteria are for taking over the Mersey. I might suggest that the only criterion the minister is going to use is the electoral pendulum: ‘Where do you all come on the pendulum?’ Whether a hospital is going to be taken over by this minister depends on the government’s electoral prospects. Those are the full criteria that he uses. To stand up and say to us, when we have released a comprehensive plan with clear targets, benchmarks that are going to be signed off on and a whole range of opportunities—much more detail than your electoral pendulum—

Mr Abbott —Table it!

Ms ROXON —You have a copy of it, Minister. You have a copy of the benchmarks. You know what they are. Can you reduce readmissions? Is that a good idea? Is it a good idea to reduce readmissions to hospitals or not? As the health minister, you should know the answer to that.

Mr Abbott —Mr Deputy Speaker, I rise on a point of order. She is putting challenges to me. I’d like her to table the documents and, if she cannot table them, explain precisely what she is talking about.

The DEPUTY SPEAKER (Mr Jenkins)—Order! There is no point of order and the Leader of the House will refer to members by their titles.

Ms ROXON —It is interesting how touchy the minister is on this, isn’t it? And do you know why he is touchy? He actually would rather be on our side of the House when it comes to hospital policy. He is the one who wanted to take over hospitals—not that long ago, was it, Minister? And you are just embarrassed that we have had the guts to do it and you haven’t!

Mr Abbott —Mr Deputy Speaker, on a point of order: if I am not allowed to refer to her as ‘she’, she is not allowed to refer to me as ‘he’.

The DEPUTY SPEAKER —All honourable members will refer to other members by their titles and all remarks will be referred through the chair. Discussions across the table are not helpful at any time, especially now.

Ms ROXON —Mr Deputy Speaker, I will always refer to the health minister as the delicate petal that he clearly is. He is obviously unable to deal with an issue where we have been prepared to make a difficult decision. The Leader of the Opposition has stood up and said: ‘The buck will stop with me.’ We would like to make sure that we can improve our health and hospital system with the states. We want to do it in cooperation with them. We are going to negotiate with them on a range of measures that are going to take pressure off our emergency departments, deal with our elderly in a more appropriate way and make sure we reduce preventable hospitalisations. This is already five times more detail than the minister has released of his criteria for taking over the Mersey hospital.

The government only has one plan for one hospital in one electorate in one state. We have a $2 billion national plan for dealing with the long-term future of the health and hospital system. This is something that, frankly, the community expects the minister to be able to take some responsibility for. He is embarrassed because he has been caught out. He is on record as having said what he would like to do. He is on the record as having said that the system between the Commonwealth and the states is a ‘dog’s breakfast’. He is on the record as having said that the states should vacate the field and let the federal government run the health system altogether from start to finish.

What does he say when Labor comes up with a clear national proposal? ‘Oh, no, I’m older and wiser and have decided that that’s not such a good idea.’ In other words, ‘The Prime Minister said no and I didn’t have the guts to follow it through.’ That is what happened with this minister, and he now is embarrassed that he finds himself with his views on health policy more in line with ours but not able to pursue them.

I can tell you, Minister, that you have left everybody very confused about your view on hospitals. It seems to change every week: you want a federal takeover; you do not want a federal takeover. Then, of course, the Prime Minister launches a takeover of one hospital; you are not sure whether that is a test case and whether it is going to happen in other hospitals. You changed your mind five different times in one week, and then, when asked in an interview if this was an election stunt, you were unable four or five times to deny that that is all it was. People have been asking the minister for his criteria. As I say, I can table the minister’s criteria if that would be of assistance, because it seems to me it is the only way that, in this House, we will know whether hospitals are going to be given any attention by the Howard government or not. If you are not close on the pendulum to the electoral interests of the Howard government, you have no hope of anybody paying any attention to your healthcare needs in the community.

Mr Ticehurst —What are you going to do with the Central Coast?

Ms ROXON —There are a lot of concerned people on this side of the House and a lot of other concerned people—the member for Dobell is one who is acutely aware of the needs of the health community in his electorate and would certainly be interested to know whether he is close enough to be within the minister’s range or not. I am not sure whether he will be or not.

Mr Wilkie interjecting—

The DEPUTY SPEAKER —Order! The honourable member for Swan is not helping.

Ms ROXON —We have arrived at a position where, when the minister goes on national television for an interview, even the interviewer, let alone the public, does not expect him to be asked a question about health. He does interview after interview; he talks about the leadership challenge; he talks about internal issues. He talks about anything other than health policy every time he does an interview. And do you know what? No-one is even surprised because, when he does talk about health in here, he never tells us anything about his policies. He probably spends a bit of time attacking us. He likes talking about Queensland politics. He tries doing everything he possibly can. He likes to belittle people—that is his main approach with me. But, Minister, the truth is that most people would like to know what you are offering them at this election. You have made a whole range of rock-solid guarantees in the past that have never been followed through.

I thought it was interesting: the minister made another rock-solid guarantee today—he said that there was ‘rock-solid support’ behind the Prime Minister and the Treasurer. I thought: ‘I’ve heard that somewhere before. What does his rock-solid guarantee actually mean?’ If I were the Prime Minister I would be worried that my most trusted lieutenant is making a rock-solid guarantee when the last one he made only lasted a number of days, or it might have been a month—certainly not very long and certainly it was not the highlight of the minister’s career. He has said as much himself. But that he actually used those words again—I wondered whether it meant that the leadership challenge was not really over.

The serious part of this whole debate is that Labor are in the business of laying out an alternative health and hospital plan for the future of the country. We have a $2 billion plan—new money on the table in addition to the money that is already there—that is going to kick-start a reform process. It is us as the Commonwealth putting our money where our mouth is and being prepared to actually take a step and say the Commonwealth needs to invest. We are going to push the states. We want them to pull up their socks in some areas too. If they do not want to play ball, then we will consider whether we take over financial control of hospitals. We have made that perfectly clear. There is nothing secret about that. Despite the minister’s posturing, we have made quite clear that our preference is to work with the states. We believe it will be the best outcome for the community if every Commonwealth health dollar and every state health dollar is used to maximum benefit in a cooperative way—get rid of duplication; get rid of all of the blame shifting and cost shifting.

We are going to this election with the clear message that, if that cannot be done, we will not let those negotiations and that inaction drag on forever. If the states will not play ball, we will go to the public and seek their approval to take over financial control of the hospitals. We will not just waltz into one hospital in one electorate in one state and say, ‘Have we got an offer for you!’ Ten weeks before an election we will not say, ‘Have we got an offer for you!’ when every other hospital and every other community in the country says: ‘What about us? What are you doing for us? What is the plan for us?’ The government has not done the work. Either the minister has not done the work or he is not prepared to argue to get it through his cabinet colleagues. Then he got caught—blindsided, I think—by the Prime Minister, who was prepared to do this in one seat and hope that it might have some electoral benefit but was not prepared to put it together as part of a comprehensive plan.

We are proud of the fact that we have a comprehensive plan which will be nationally consistent, because if it is not nationally consistent it is not going to be sustainable. That is the real risk for the community in northern Tasmania: is the government’s proposal going to be sustainable? It is fine to go in and offer it—and I am pleased that the minister was able to report today that the Tasmanian government and the Commonwealth government are having better negotiations on the outcome of this, because everyone needs that to be a successful proposal for that community—but the truth is that the work was not done first. The government just waltzed in and said they had an offer. There is absolutely no way they could make the same offer to every hospital around the country, even if there were the need, and we know that there are many people who will be left out by their proposal.

I am very concerned that the minister has just taken an extended smoko break. For someone who is so anti union I am surprised that he is prepared to make use of those sorts of award conditions, that he is prepared to just clock off when he has not got time to keep doing his work because he is more worried about saving the government’s skin. Here is Labor, delivering a plan and focusing on delivering better results for patients, when the Howard government is focusing on winning votes. We are interested in campaigning on health and providing better services to the community. We are interested in doing that in a long-term, sustainable way. We are interested in having a plan that is not just for 10 weeks, for this election period, but for the next 10 and 20 years. We are interested in really making sure that our health and hospital system is viable in future. If we do not retool and re-equip our health system for the future, we will not be able to cope with the challenges that we face.

Many members on this side of the House very much feel the ageing of the population. Many of us represent communities in which there are a large number of elderly people who need a different type of health care from what was needed when the number of elderly in the community was a much smaller proportion. We need to get it right. We need to have care that is not just hospital care but community care—appropriate care—and aged-care facilities. We need to deal with the growing burden of chronic disease. I went to a hospital in Bennelong the other day where 25 per cent of the patients were diabetic. They were not admitted particularly for diabetes related conditions—some of them were—but when the diabetes clinic that is linked to the hospital did a survey, 25 per cent were found to be diabetic. If we cannot ensure that we have systems in place where we can treat and prevent, where possible, diabetes or have better processes in our hospitals so that people with complex conditions and a range of comorbidities are able to be treated—

Mr Abbott —Tell us what they are.

Ms ROXON —The minister says, ‘Tell us what they are.’ Minister, you have been in government for 11 years and you have no idea what the solution is, have you? You have no idea whether or not you are prepared to provide more funding to that clinic. You have no idea whether or not you could fund—

Mr Abbott interjecting—

Ms ROXON —Minister, it is quite staggering. How many years has he been health minister? Is it four years or three years?

Opposition members—Too many!

Ms ROXON —We know it is too many years. When we have an idea, rather than saying, ‘That’s a good idea; I should have thought of that,’ the minister says, ‘Tell us some more detail because I’m not sure what I’m going to do about it.’ That is his approach: no solutions, no options. It is the case with a whole range of things. If the minister is serious and interested in what he can do for diabetes, why does he not look at a couple of things that have been on the table for a long time? Why does he not look at the COAG plan that everybody else has been calling for the government to sign on to?

Mr Abbott interjecting—

Ms ROXON —You have done about a quarter of it, Minister. You have not been doing all the hard stuff, all the expensive stuff.

Opposition members interjecting—

Ms ROXON —I think he has had his angry pills.

Opposition members interjecting—

Ms ROXON —I do not think the numbers were quite as clear as he was hoping for. Minister, this is a serious issue. We have a national coordinated plan for health and hospitals. We have a $2 billion plan and you are on extended smoko. (Time expired)