Mr OAKESHOTT (2:42 PM) —My question is to the Prime Minister. With the target now set for population increases in Australia, with the well-known ageing population challenges we have right now, with debt at both the Commonwealth and state levels meaning tighter fiscal settings for forward budgets and with state governments consistently and frustratingly not following their own funding formulas within their own health departments—and, Prime Minister, this is at least as important as asylum seekers and at least as important as climate change—when can we expect real structural reform in health and hospital services in Australia for a network of services already struggling despite the obvious pressures on the near horizon.

Mr RUDD (Prime Minister) —I thank the member for Lyne for his question. I recall very clearly my visit to Port Macquarie and the time I spent with him and others speaking to the staff at Port Macquarie Base Hospital about their particular needs. The fact is that in Port Macquarie, as I was advised, you have a hospital which was essentially designed around what was estimated to be the needs for that region in the early nineties, and here we are at the end of the first decade of this century and its physical capacity has not been substantially increased.

Mr Hockey —It should’ve stayed a private hospital.

Mr RUDD —The interjection from the member for North Sydney is ‘It should’ve remained a private hospital.’ I will not go into the details of the evolution of this one but can I say to the member for North Sydney, who has suddenly become an expert on these matters, and to the member for Lyne, who legitimately represents the interests of his constituents, that the entire saga which has gone before with this hospital, namely the evolution between private ownership and state ownership, has not been a happy one for the local constituents. That is what should drive all our concerns here.

The member for Lyne raises a concern about when we will take structural action in relation to the reform of the health and hospital system and whether it will be substantial action—if I got his question correctly. As I said prior to the last election, the Australian people are sick and tired of a blame game between the Australian government and state governments on the future reform of the health and hospital system. Some basic facts need to be put before the parliament, the first of which is the ageing of our population. Secondly, there is the growth of our population. You have seen the projections referred to by the member for Lyne in his question: up to some 35 million people by mid-century. Thirdly, there is the exponential increase in the cost of pharmaceuticals for treating those within our health and hospital system. Fourthly, there is the woeful job that has been done in times past in properly planning for our health workforce requirements—our doctors, our nurses and our allied health professionals.

All these things are bearing down on a health and hospital system which, in the advice of Christine Bennett, who delivered the National Health and Hospitals Reform Commission report not long ago, is a system now at tipping point. There are 750 public hospitals across the country. The figures when it comes to elective surgery and to treatment within clinically acceptable waiting times at accident and emergency have not seen any significant improvement over a long period of time. These are the facts.

The question is: what proposals do we have before us and how can we change that for the future? What we have got before the Australian people and of course before the health and hospital community at the moment is two sets of strategic options. One, of course, involves a partial takeover of the system by the Australian government. The second is a two-stage full Australian government takeover of the entire system. They are the strategic options we are presented with. Each of the elements of primary healthcare reform—GPs, acute hospital care, post-acute care, aged care, dental care and mental health needs—are canvassed exhaustively within that report.

Our process for making these decisions is as follows. We are going to have a meeting with the Council of Australian Governments next month and we will then, with the states and territories, discuss in detail the options that we have been presented with through that report and seek their direct response to what is canvassed in that report in addition to their statement of the strengths and weaknesses within their own systems. Secondly, we have also indicated that in the first part of 2010 we will then convene a further meeting of the Council of Australian Governments in order to bring forward our recommendations for future long-term policy reform.

My view very simply—and I put this to the member for Lyne in terms of his question—is that the days for simply frittering around the edges on this debate have gone. What we actually need is a government prepared to step up to the plate with the states and territories and embark upon a long-term policy reform.

Mr Pyne —When are you going to do it?

Mr RUDD —Right on cue, the member for Pyne interjects: when are we going to act!

Ms Gillard —Member for Pyne?

Mr RUDD —Member for Pyne, member for Sturt, the pining member for Pyne, the pining member for Sturt.

For 12 years—I asked this question the other day—where was their healthcare reform plan? Where was their hospital reform plan?

Mr Pyne —Well, what are you doing about your promise?

Mr RUDD —Was he the minister for health at some stage?

Mr Albanese —No. He never made it that far.

Mr RUDD —He never made it that far? I lost count of what he was responsible for, but can I say: for 12 years they did two things. Firstly, they pulled out a billion dollars from the public hospital system in Australia and, secondly, they put forward no reform plan at all for the future of our hospitals, for the future of Australia—not one. All they did was play the old game: blame the states, make sure that you can whip it up into a frenzy prior to an election, get through, make sure that you did not cop any responsibility yourself and get home free. That was their approach. Ours is different. You have seen it in the Bennett commission report. That is the blueprint we have put out there. We are consulting with hospitals around the country at the moment and we will adhere to the timetable that we have foreshadowed, which is in close consultation with the states and territories, because the nation wants long-term hospital reform. We intend to deliver that in partnership with the states and territories.