Senator BARNETT (2:06 PM) —My question is to the Minister for Health and Ageing, Senator Kay Patterson. Will the minister outline to the Senate the health reforms that are being undertaken as part of the health care agreements? Is the minister aware of any states or territories that have not fulfilled the requirements for reform agreed as part of the previous agreements?

Senator PATTERSON (Minister for Health and Ageing) —The $42 billion offer to the states—a $10 billion increase, 17 per cent over and above inflation—is a huge increase to fund and contribute to public hospitals. One of the major reforms that we are requiring in the agreements is that the states—they have not done this before—as they come up to the plate, should tell us what they are going to spend in this financial year and at least match our growth in funding. Some states have failed to tell us what they spent last year and what they spent the year before. So the public do not even know what they have spent for the past two years, let alone what they are going to spend for the next five years. Yet the states demand that the Commonwealth tell the public what we are going to spend five years in advance. So one of the reforms is about transparency and fairness. If the Commonwealth is asked to say what we are going to spend for the next five years, the states ought to tell us what they are going to spend, in order to give patients and hospitals certainty.

One of the other reforms is to ask the states to report on certain achievements under the health care agreements. Some states—for example, New South Wales— have not even achieved the number of separations that they have been paid for in the life of the last agreement. So we are saying to them that we want better reporting and more information so that the public knows how their hospitals are performing. We want to see how they have spent the money. It is very simple: come up to the plate and tell us what you are going to spend and make sure that you enable anybody who fronts up to a hospital to be treated as a public patient. Let me say that some people are being cajoled into using their private health insurance in ways that are totally unconscionable—they are being rung up and asked after they have left hospital to change their admission details in order to help with hospital funding. That is outrageous. We want the states to treat people, if they turn up to a hospital, as a public patient; we want to ensure that they report on how they have spent the money; and we want them to match our funding.

The health reform agenda has been driven by the health ministers. As I said yesterday, I have cooperated with the states—with nine groups who have given us ideas on how we can reform the relationship between the Commonwealth and the states. We spend $40 billion on health every year between the Commonwealth and the states. If we can drive those dollars further, we will get better health outcomes for people. We can actually reform and streamline cancer care, we can improve the delivery of mental health services, we can improve quality and safety and we can improve pharmaceutical benefits and the way they are used.

There is a summit going on at Old Parliament House. They will present a communiqué today saying that they want to delay the signing of the agreements for a year.

Senator Hutchins —Why aren't you there?

Senator PATTERSON —Will I be there? No, I won't be there, because I do not agree with the way they are going about it. They are saying, `Don't sign up to the agreements for a year.' We will have an argy-bargy about funding for another 12 months when we need to get on with reform. What the states need to do is to sign up and get on the reform train and drive reform to get better outcomes for patients.

The other thing that they will be asking for is a national health commission. Can you imagine having a national health commission? Would we have equal representation for the states? Would the states give up sovereignty in deciding how money is spent? What happens if the commission decides to privatise hospitals in the states? They would have no control. Having a national health commission would be a backward step. It would add another layer of bureaucracy. We have a system in place now with elected representatives. We are elected—the commission would not be elected—to deliver health, to pay for health and to ensure that we get cooperation between the states and the Commonwealth. I have worked assiduously with the state health ministers to drive the reform agenda. We do not need a national health commission.

As for Mr Carr presenting information at the health summit, I would like to have the time to tell the Senate about what he has not done rather than what he has said has been done. (Time expired)

Senator BARNETT —Mr President, I ask a supplementary question. The minister has carefully outlined some of the disturbing trends of the state and territory governments. Can the minister provide further evidence of the states' and territories' inaction or action with respect to implementing the health reform agenda?

Senator PATTERSON (Minister for Health and Ageing) —I thank Senator Barnett. Mr Carr gave a speech which I thought showed monumental ignorance, gross ineptitude or blatant misrepresentation. He went on at length about a trial in the Hunter Valley. He extolled the virtues of that trial. He never once mentioned that it was a Commonwealth-led trial; nor did he once mention in his speech the fact that the Commonwealth, as a result of that trial, gave the state $14 million to extend it to the whole of the Hunter Valley. He was saying what a wonderful thing it was but he never said it had been led by the Commonwealth. He never said that the Commonwealth paid the state to extend it to the whole of the Hunter Valley.

He then went on about the pharmacy initiative. As I said yesterday, he ought to wake up; it has been going on in three states, it has been offered to New South Wales and they have never taken it up. In addition, he has failed to run out the meningococcal vaccine program. (Time expired)