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Wednesday, 24 November 2010
Page: 3575


Mr SIDEBOTTOM (11:02 AM) —If you listened to the previous speaker, the member for North Sydney, you would not know what this debate was about but you would know what the opposition are about because, apart from the blowhard performance, which he traditionally puts on and has replicated before this, he talked obstruction, deferral and delay over and over again. Every comment made about legislation in this place by those opposite is for obstruction, deferral and delay. They are Her Majesty’s opposition and it is their role to avail themselves of and critically appraise legislation, but that is not what I heard from the shadow Treasurer in dealing with this financial bill. All I heard was waffle, waffle, waffle and no detailed discussion of the bill.

Australia’s health system has suffered from inadequate funding arrangements and unclear accountability for too long. Everybody in Australia knows this. We have many good things in our health system and we have terrific health providers, but funding has been inadequate and/or inefficiently accounted for and used. The Federal Financial Relations Amendment (National Health and Hospitals Network) Bill 2010 is about trying to fix this. The new funding arrangements for Australia’s health and hospitals system—for the record, because you did not hear it from the opposition Treasury spokesperson—will ensure for the first time that federal governments properly fund Australia’s public hospitals, reversing the Commonwealth’s declining share of hospital funding, which occurred in particular under the regime of John Howard and now opposition leader Tony Abbott’s time as health minister. Indeed, the decline has gone from a 45 per cent federal government contribution to 38 per cent. This legislation is intended to fix that.

Secondly, the bill will ensure that for the first time the Commonwealth will fund hospitals for each service they provide rather than through block grants—that is, meeting increases in demand and helping to take pressure of hospital waiting lists. The third intention of the bill is to allow the Commonwealth, as the dominant funder, to introduce new national standards for public hospital services, ensuring all patients receive timely and high-quality services. Fourthly, it will drive improvements in primary care and prevention, because the Commonwealth, as the dominant funder of the hospital system, will have an incentive to provide better primary care and prevention services to take pressure off our hospital system.

As I mentioned earlier, the Commonwealth’s share of funding for hospital services has dropped from 45 per cent to 38 per cent, so the legislation represents the first time that we will be guaranteeing a fixed share of hospital funding into the future. That is the historic element of this legislation not discussed by those opposite, merely obstructed.

It is also important to note that this legislation builds upon significant investments in the health system initiated by this government. For instance there was a 50 per cent increase in hospital funding negotiated at the end of 2008, when we came into government, and there is the $7.4 billion health reform package which sits on top of that record investment in hospital services. This includes the delivery of 1,300 more hospital beds; training for more than 5,500 GPs over the next decade; more nurses, more practice nurses and hundreds of extra specialists going to rural and regional areas; expanding primary care facilities with small infrastructure grants for more than 400 GP clinics and an additional 28 new GP clinics across the country; and our world-leading preventative health measures such as the introduction of plain packaging for tobacco, which is aimed at reducing smoking levels, to take pressure off our hospitals over the longer term. That is at the essence of this legislation.

Under the agreement proposed by this legislation the Commonwealth government will relieve the states and territories of $15.6 billion in growth of health costs from 2014-15 to 2019-20, allowing them to invest in other essential services. That is at the core of this financial arrangement. In turn, the efficient pricing arrangements will mean that Australia will get value for money from our health dollars to deliver services as effectively and efficiently as possible. We are asking those opposite to support this historic legislation.

The member for North Sydney has already indicated a number of amendments to this legislation, merely delaying this legislation into the future. If they have any concern for health in this country and understand the economics and the projected growth of health services, they will know that what we are proposing is the most sensible, efficient, effective and transparent method to deal with increasing costs—that is, for the Commonwealth to take on that responsibility. Taking on that responsibility would give us the ability, through our funding arrangements, to leverage better standards of services provided by state and private practitioners. That is at the heart of this legislation.

There are many other aspects of health reform which will be affected by this legislation. When I look at our record of only three years on health, I think it is remarkable. There is a lot more to do and that is why this legislation is coming in as part of a tranche of health reforms. We have increased the capacity of our health system to deal with the needs and demands placed on it, particularly with training more doctors and nurses and providing more beds. The government is investing $1.2 billion as part of our National Health and Hospitals Network—in doctors, nurses and allied health professionals. We will also be investing more than $1.6 billion for more than 1,300 new subacute beds, to reduce bottlenecks and capacity constraints in our systems. These beds will be delivered in areas like rehabilitation, palliative care and, importantly, mental health services so that people can get the care they need.

We are also investing heavily in connecting care services. I look forward to a local hospital network system developing in my state where I see essentially the need for three hospital networks reflecting the three subregional parts of my state—the north, north-west and the south. I look forward to working with the Minister for Health and Ageing and with my federal and state colleagues to bring about an efficient, effective local hospital network system in Tasmania based on the three regions. The soon to be established Medicare Locals program, which will work with local GPs and allied health and community health providers, will drive local integration and coordination of primary health services and improved access to care. On top of this, we are investing $466 million to establish a commonsense, integrated health record system by establishing personally controlled electronic health records, hopefully not only making it more efficient and effective but also reducing mistakes and duplication, ensuring that, with patients’ consent, doctors have information when they need it—a very important reform.

We also want to make it easier for people to have better access to services. That is why we are establishing a national after-hours GP and primary care service. Anybody calling their GP out of hours will be referred to a nurse or a GP on the phone and, if necessary, will then referred to local after-hours GP services coordinated by the Medical Locals program—that is, the Medicare area networks set up to assist people to integrate GP, primary and preventative services in our regions.

The government will also invest $355 million in more GP superclinics and expanded GP clinics in about 450 locations across Australia. I have two GP superclinics in my region of Braddon in North-West Tasmania, one of which is completed and the other is well on the way to completion. This has added greater capacity in my region for people to access integrated healthcare services. I cannot think of any more commonsense approach than to connect the health providers that provide health services in my region to each other. It will lead to better health care and better management of health services for individuals. That is part and parcel of our policy. That has been opposed by those opposite but I should not be surprised, because they have opposed everything of note that we have put up for health services and communications for this country.

Our government will invest $750 million so that emergency department patients will have, hopefully, the guarantee that they will be treated, admitted or referred within four hours where clinically appropriate. That is a very tall order and to get that consistently across the nation will be difficult, but we are investing in that and we are seeking to make that happen. The government will also invest an additional $800 million for elective surgery to help back a target of 95 per cent of elective surgeries being delivered within the clinically recommended time, with a guarantee that patients facing excessive waits should have their elective surgery fast-tracked. Again, this is a difficult target and one which we must strive to achieve.

This government is determined to tackle preventative health. We have tried to do this by taking world-leading action to combat tobacco, which contributes to the death of 15,000 Australians a year. The government will introduce plain packaging for all tobacco products—a world first, again—in addition to raising tobacco excise, which we hope will result in 87,000 fewer smokers. The government will also invest $449 million to improve care for people with diabetes, which is fast on the way to becoming one of our major disease burdens.

On sustainability, this government is seeking through this legislation to be the dominant funder of Australia’s public hospitals, funding 60 per cent of hospital activity and capital, plus 60 per cent of training and research costs in public hospitals. These changes will mean that one government will have dominant funding responsibility for all parts of the health system, ending the blame game and the perverse incentives for buckpassing and cost shifting. This legislation will play a historic part in achieving these aims.