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Wednesday, 28 May 2003
Page: 15189


Ms GAMBARO (1:33 PM) —I rise to support the Health Care (Appropriation) Amendment Bill 2003 and acknowledge the commitment the federal government has made to public hospitals and the thousands of people on hospital waiting lists in my home state of Queensland. The bill will amend the Health Care (Appropriation) Act 1998 to enable the Commonwealth to enter into new Australian health care agreements with the states and territories. This is necessary because the current act only covers public hospital services up to 30 June 2003. The amendments contained in the bill will enable the Commonwealth to continue to fund the states for public hospital services for another five years. In effect, the bill appropriates some $42 billion for the purposes of the act to cover the period of five years from 1 July 2003.

Under the current arrangements the Queensland government have received a total of $5.9 billion over the period 1998 to 2003. This is a significant amount. The Queensland Premier, Peter Beattie, considered it so generous that he cut $20 million from his own state budget in 2001 because, obviously, it was not required. Try explaining to the 2,309 people who were on waiting lists for elective surgery in January 2001 the rationale for the Queensland government's cut to funding to public hospitals. Progress that forward to the present day and consider the failure of the Queensland government to sign the new health care agreement, which would give them $8 billion over five years as long as they matched in percentage terms the growth rate in funding by the federal government. They will not commit to it. The Commonwealth have put their money on the table, but the Queensland state government are nowhere to be found.

We have committed an extra $10 billion—a total of $42 billion over the next five years—to the provision of free public hospitals Australia wide. How can you call that a cut, as members of the opposition and others have done? This $42 billion will provide for inflation, population increases, ageing effects and growth in service utilisation. We are committed to growing our investment in public hospitals by 17 per cent in terms of real increases over the next agreements. For Queensland that will mean $8 billion over the five-year life of this agreement—an increase of $2.1 billion over the previous five-year agreement.

A major feature of the new agreements is that the states will be expected to match in full the Commonwealth's rate of growth year by year. As such, they will receive 100 per cent of the funding available to them. States that do not match the Commonwealth's rate of growth will be eligible to receive a maximum of 96 per cent of the funding available to them. If Queensland does not publicly commit to matching the Commonwealth's growth in funding, it stands to lose up to $323 million in Commonwealth funding. It stands to lose $851 million if it does not sign up to an agreement at all. That money is for use in public hospitals to service Queenslanders who are on surgery waiting lists and enable the efficient functioning of the public hospital system.

In Queensland, however, many hospitals are struggling to meet the increasing demands for elective surgery. At Redcliffe Hospital in my own electorate there were around 1,700 people on the waiting list for category 1, category 2 and category 3 patients as at January this year. The majority of overdue cases, around 640, relate to category 3 patients. A category 3 patient could include someone needing a knee reconstruction—a condition that is encountered by more and more elderly people—or something similar. I value the work and dedication of the staff at Redcliffe Hospital but I know that, like many other hospitals in Queensland, their resources are subject to the whim of the Queensland state government.

The population of my electorate of Petrie and, indeed, of the Redcliffe Peninsula, where the Redcliffe Hospital is located, has one of the highest percentages in Australia of people over the age of 65—over 20 per cent. As our society ages, the pressure on our health care budgets becomes stronger and stronger. In the next 20 years people turning 55 will outnumber those turning 15.

If you were a state Premier and the federal government were offering you additional funding to ensure the wellbeing of your constituents and your state, you would jump at that opportunity. But, unfortunately for millions of Queensland residents who rely on the public hospital system, the Queensland government has again let politics get in the way and has turned its back on the Australian health care agreements between Queensland and the federal government. It is unfortunate that public health in Queensland has suffered so badly under this current administration. I dare say that the state budget, when it is revealed, will show an increasing deficit in the public hospital budget.

I regularly receive calls and letters from constituents who are concerned about the issue of cost shifting in the Queensland public hospital system. The number of phone calls is almost endless from people who have admitted themselves to hospital only to be turned away and told that they needed to go back to their GP for diagnostic tests; they occur each day.

A constituent recently sent me a five-page letter which sums up some of this. She had a horrific set of experiences at Prince Charles Hospital, RoyalBrisbane Hospital and Redcliffe Hospital over a four-month period which she outlines case by case. Unfortunately she had to stay in three different hospitals over a four-month period, and what happened to her during those four months is absolutely appalling. She writes:

RBH: I have no recollection of the ICU staff. Coronary care staff were, all except one, agency nurses, and therefore didn't even know where the equipment was kept.

She goes on, but I guess this really summarises it:

After four months of hospitalisation, with only a few days at home between admissions, I hope sincerely that I will never have to be admitted to either RBH or PCH again. Unfortunately, it is all too clear that nurses are at the coalface—on the wards—and are not being consulted, but administrators who know nothing about patient care are making decisions which directly affect the staff and the patients.

A manager or administrator may be excellent at business management—but not necessarily good with people—who are the patients.

She has had some terrible experiences. You would think that the Queensland government would accept this extra funding to help them with their hospital administration but, no, that is not the case.

All Australians do have access to free public health care. The Commonwealth recognises the importance of this. Not only is the government putting an extra $10 billion into public hospitals but also it is committing over $900 million in funding for out of hospital services in the A Fairer Medicare package. The Commonwealth continues to make a substantial commitment to ensuring access to affordable medical care for all Australians.

Some concerns have been expressed about the forward estimates in the budget papers. Indeed, the opposition seems to have focused on this issue very intently rather than looking at the facts in a much broader analysis of it all. The current forward estimates in the Commonwealth budget papers are merely a forward estimate of growth under the current arrangements. They make no allowance for the load being taken off public hospitals by the sharp growth in private hospital admissions or for the demographic changes that are occurring.

The budget paper shows a cut of $919 million against the Australian health care agreements. However, the Commonwealth's contribution under the next agreement increases funding to the states by an additional $10 billion, a 17 per cent real increase in the Commonwealth's commitment. The forward estimates are a prediction of future spending based on history. There is a 2.7 per cent difference between the forward estimates and what we are providing. The reason they are high for the Australian health agreements is the Commonwealth's extremely high level of growth during the existing Australian health care agreement from 1998 to 2003.

That high level of Commonwealth growth needs to be compared to the very large amounts of money the states have taken out of hospitals over that same period. According to the latest figures from the Australian Institute of Health and Welfare, the share of the states and territories in total funding has fallen from 47.2 per cent in 1997-98 to 43.4 per cent in 2001. In effect, the Commonwealth's share has risen from 45.2 per cent to 48.1 per cent over the same period.

Private hospitals are playing an ever-increasing role in this. Between 1999-2000 and 2000-01 the number of people receiving treatment in private hospitals grew by a massive 245,129. It is important to put this into context. More and more people are availing themselves of much cheaper forms of hospital care than admissions. The latest figures also indicate that only 71 per cent of public hospital costs relate to admitted patient costs. So people are having day surgery and that is resulting in costs for the public hospital system being reduced as well. These figures show that an increasing number of privately insured patients are choosing to receive treatment in private hospitals and are freeing up public hospitals for public patients.

The member for Hunter was saying before that all that has been happening is that the hospital waiting lists have been increasing. I want to give him some figures which relate to Queensland. For the first time since the history of Medicare, between 1999-2000 and 2000-01, public hospitals actually treated fewer patients—down 4,591. However in Queensland the waiting list for elective surgery in a public hospital has grown from 10,756 in January 2001 to 11,141 in January 2003. Over the same period the number of patients has actually declined from 38,797 in January 2001 to 37,607 in January 2003. So while the number of patients has been dropping, the number of people on the waiting list has grown. There are fewer people visiting Queensland public hospitals despite population increases, but the waiting list is growing. Queensland needs the funds that the Commonwealth is making available through the health care agreements, but they will not commit. Even if they commit but fail to honour the growth rate of 17 per cent, they will still receive 96 per cent of their funding. It seems a very big price to pay for the thousands on public hospital waiting lists in Queensland.

This bill before the House today honours our commitment to the wellbeing of this nation. It demonstrates our commitment as a federal government to a secure future for the 19 million plus Australians and it delivers to the thousands of Australians that have cause each year to use the public hospital system. I ask that the opposition seriously consider what they are denying the Australian public by opposing this legislation and that they explain that to the Queensland Premier and the thousands of Queenslanders who are on public hospital waiting lists. Perhaps they have not heard the anguish in their constituents when they have to wait, in considerable pain, for an operation. I have heard that anguish time and time again. I therefore ask the House to support this bill.