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Monday, 21 November 2011
Page: 9066


Senator FIERRAVANTI-WELLS (New South Wales) (17:58): Before question time, I was talking about the national funding body. Senators would remember that this is the body that first was in, then, when the ink was barely dry, was removed and now is back in the equation. It has gone from being out in deal mark 1 to being back in deal mark 4. Last year, on 17 June, on the ABC's AM program, it was reported that:

The Rudd Government has made a pre-emptive strike on one of its health reforms, even before the measure saw the light of day.

The Federal Government has been accused of axing a health funding watchdog, which was supposed to oversee payments to the states under its new health and hospital network.

… … …

A spokeswoman for the Minister says the decision to scrap the funding authority removes a layer of bureaucracy, and she says the Commonwealth's investments in health will be transparently reported in the Budget papers.

When questioned about this matter later, the Minister for Health and Ageing, Ms Roxon, told journalists:

… we've made it … clear we don't want to increase the size of the bureaucracy—it's not appropriate for us to establish an authority where there is not a need to do so.

In Labor's health reform mark 4—the deal of August this year—the funding body is back. It is under a different name, but it is back. All this is simply instructive as to how the Australian Labor Party has lurched from one so-called reform deal to the next: not really knowing where it was going or what it was doing, so long as it could be seen to be doing something. Mr Broadhead said at the recent Senate inquiry that 'under the agreement reached in early August there is a role for a national health fund administrator and the national health funding pool' and that these may be established by legislation later in the year. So it has worked out it does need them, but it needs them in a different iteration given that the states are back in control and it is business as usual. He further explained:

It is a very strong principle through the agreement that the aim here is to have the amount of funding, the source of funding, the destination of funding and the basis upon which the quantum was arrived at all publicly reported. This would mean that, to the extent that a state's contribution to activity-based funding for a particular local hospital network was less than or more than the national efficient price or the same as the national efficient price, it would be visible for people to see in the reporting that is required. That includes not only the reporting to parliament but also the public reporting that is required.

From a coalition's perspective, we consider that the millions of dollars to fund additions to bureaucracy would be better spent on frontline services. The Department of Health and Ageing already has 5,000 staff and former Rudd minister Lindsay Tanner said on 14 October 2009:

The indiscriminate creation of new bodies or failure to adapt old bodies as their circumstances change increases the risk of having inappropriate governance structures. This in turn jeopardises policy outcomes and poses financial risks to the taxpayer.

It is only the largest hospitals that will operate under an activity based model. Most of these so-called bureaucracies at the heart of the Australian Labor Party's health changes were due to start in July this year. Deadlines have been missed and pushed back, the health system continues to struggle and Tasmanian hospitals are broke. We have even had the Premier of Tasmania offering to the Commonwealth that it take back the hospitals in Tasmania. The Australian Workplace Ombudsman is seeking urgent court action against nurses closing hospital beds as part of their pay dispute. Yet this Australian Labor government would have us believe that it is in command of health and the efficient running of the health and hospital systems. Tell that to the parent wanting a doctor's appointment for their sick child. Tell that to the adult children of an elderly parent with dementia looking for a nursing home bed. Tell that to the people who cannot afford dental care who have to wait years for treatment. Tell that to the parents of a young adult with mental illness who cannot find treatment. Tell that to the health professionals who just want to get on and do their job of helping people.

The Minister for Health and Ageing, Ms Roxon, thinks everything will be fine by 1 July 2012 when the local hospital networks will be paid for the services they provide. Some of these local hospital networks do not even exist. But Ms Halton, the Secretary of the Department of Health and Ageing, assured us at the October estimates that they are being set up by the states and that the states are well underway with that. 'I have no reason to believe that they will not be up and moving in the time frame that was agreed,' Ms Halton said. We can only be inspired by her confidence as many health experts are dubious that the time frame can be met. With the Gillard government's track record, optimism on this reform may well be misplaced.

In the remaining time I have available to me, I will foreshadow the coalition's amendments, and I will speak in more detail in the committee stage. We are concerned about and will be moving an amendment in relation to the constitution and membership of the pricing authority. The bill provides for the formation of two committees to assist the pricing authority: first, a clinical advisory committee to advise on the formulation of casemix classifications for health care and other services provided by public hospitals; and, secondly, a jurisdictional advisory committee which will maintain a schedule of public hospitals and the services each provides and advise on funding models for hospitals and determined adjustments to the national efficient price to reflect variations in the cost of delivery of healthcare services. Our amendment goes to the fact that there is no representation or any recognition of non-government hospitals. This was one of the issues that was highlighted so vividly in the submission by Catholic Health Australia, and this is one of the major potential problems with this legislation. But, while the cost base for treatment in Catholic public hospitals is different from state public hospitals, there is no guarantee of representation for non-government hospitals on the pricing authority. I will deal more with those issues in the committee stage.