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National Press Club -

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Today at the National Press Club,

the Opposition's health spokeswoman,

Julia Gillard. Ms Gillard will

discuss the ALP's proposal for

tackling the health problems of

Australian children. And

strategies for obesity and low Australian children. And prevention

Press Club. weight. Live from the National strategies for obesity and low birth

Press Club, the ALP's Julia Gillard.

(Bell gongs) Ladies and gentlemen,

welcome to the National Press Club

again for today's National

Bank Address with zbil

Bank Address with Julia Gillard. again for today's National Australia

Julia is, of course, the

Opposition's Shadow Minister for

Health and this week the Coalition

of Australian governments will meet

to discuss once again the issue of

health which will not go away for

State or Federal jurisdictions in

this country. So today's address

not only timely in a general sense, this country. So today's address is

but particularly for this week.

Please welcome Julia Gillard.

APPLAUSE Thank you very much.

Thank you for joining me here today.

Thank you very much to my Labor

colleagues who have given up the

opportunity to have a parliamentary

lunch with Helen Clark. That's for

backing the Aussie sheila. Today I

want to talk to you about

and that is the need to prevent our want to talk to you about prevention

march towards an American style

health system where 45 million

people have no health cover and

live in daily fear of getting sick people have no health cover and they

and for millions it could mean

financial ruin and the debate of

other three Ps - population, financial ruin and the debate of the

productivity. And the need for

prevention at the centre and.

Prevention can be the cure to many

of the problems we face today. It

certainly holds the key to a

successful response to demographic

change and it is the key to the

sustainability of our health budget.

However, to understand the

importance of prevention, we need

abandon the language of post-war importance of prevention, we need to

policy that puts a brick wall

between social policy and economic

policy, and we need to accept that

there is an inextricable link

between the health of our people,

the health of our health system and

the health of our economy. And

while we need to understand this

link clearly, it is especially

important for business to

it, and to get into the health important for business to understand

debate before it's too late. It's

certainly too late for General

Motors and for Walmart, two

iconic companies which are both Motors and for Walmart, two American

caught in the American health

nightmare. Recently I visited the

United States and I saw for myself

the disturbing vision of what

Australia's health system could

become if we let it. It's a

nightmare whichever way you look at

it. If you are an adult living

below the poverty line, you are not

given access to the publicly funded

Med i, cade. If you need to go to

the ER, the only thirng the

is obliged to do for you without the ER, the only thirng the hospital

cost is to stabilise you, not treat

you, to stable lies you and then

you out the door. No wonder tens you, to stable lies you and then get

millions of Americans live in fear you out the door. No wonder tens of

of being sick. And if you're in

business, well, the view is no

better. With governments not

funding universal health care and

many people not being able to

insurance, it is often business many people not being able to afford

which has to take own the burden.

Which brings me to General Motors.

General Motors, as we all know is

one of the world's largest

automotive manufacturers. It has

just announced record losses and

layoffs. What you may not know is

that GM is one of the largest

care purchasers in the United that GM is one of the largest health

States. GM finances the health

of more than 1 million current and States. GM finances the health care past employees.

past employees, and their

dependants, at the cost of $7

billion Australian per year. This

adds around $2,000 Australian to

cost of every car that rolls off adds around $2,000 Australian to the

GM production line. In a system cost of every car that rolls off the

like that, where, having health

insurance depends on the type of

you have, whether you had a job insurance depends on the type of job

GM or the like, you can understand you have, whether you had a job with

that people want to hold on to a

with health insurance benefits, no that people want to hold on to a job

matter what, even if they hate it,

even if they would prefer to move

towns or states to join family

members. And especially they are

locked in if someone in their

already has a health condition and locked in if someone in their family

they know that if they move, they

are unlikely to get health benefits

again. There is plenty of evidence

to suggest that this health

insurance necessity reduces

mobility and creates what is called insurance necessity reduces workers'

in America job lock - people being

locked into the job they have

because of the health benefits. locked into the job they have solely

the natural reaction of employers because of the health benefits. And

to try and get out of providing the natural reaction of employers is

health insurance, or at least to

provide a lesser portion of it. GM

has already negotiated lower levels

of coverage as part of their plan

stay afloat. Other companies are of coverage as part of their plan to

trying to get out of providing

health insurance to all their

employees, and the number of US

companies providing insurance

dropped 10% in the past five years.

But that isn't getting business off

the hook. Individual states of

America faced with rising health

care needs and dropping rates of

private and company-provided

insurance, are finding new ways to

put the burden on business, and

that's where Walmart comes in.

Walmart employs low-skilled and

low-paid workers, and by doing so

can exploit the low-wage medico

programs. Each new Walmart worker

is costing the average State about

$12,000 a year in Medicare benefits.

In response, the State of Maryland

has just passed legislation that

requires companies of more than 10,

10,000 employees, like Walmart, to requires companies of more than

spend at least 8% of their payroll

on workers' health or to pay the

difference into State's Medicare

fund. The legislation is obviously

targeted at Walmart, but its impact,

of course, is going to be far more

widespread. The American health

care system is a nightmare for

people and it's a nightmare for

business. It is a system in name

only. It is actually a fragmented

patchwork of financing delivery

ultimately hurts people and patchwork of financing delivery that

business. Now, you may be

about it between the comparison business. Now, you may be sceptical

between Australia and American

health services and you may be

thinking to yourself, "Surely that

couldn't happen here." But American

health services are caught in a

pinger movement with an increasing

need to go without on the one need

and increasing, indeed startling

health inequalities on the other.

And that same pinser movement

between the user paying and going

out between health equalities is

here in Australia. Australians are

paying more for health services and

getting less to meet the cost. Out

of pocket costs are growing.

Private health funds are

contributing less to non-government

health expenditure. Australians

lives in the most disadvantaged

areas are have potential

areas are have potentially

areas are have potentially premature avoidable death rates 54% higher

than those in the well-off areas.

The rates of hospitalisation is 50%

higher in the disadvantaged areas.

The fact is that the most disadvantaged people in our

community, those with the worst

health status are more and more

likely to have lower access to

health care services and this

situation is becoming entrenched

under the Howard Government. More

than nig, my visit to the United

States has reinforced in me my

strong belief that the business

community should be members of the

jury the strongest advocates for

jury the strongest advocates for our universal health insurance system.

The corporate taxes paid by

The corporate taxes paid by business help to fund the health insurance

system and that is, of course, a

cost to business, but it is a

cost to business, but it is a stable and predictable financial

contribution. A good health system

is good for business. Crisis

schemes like Maryland's can be

avoided, as can the negative

avoided, as can the negative effects of job-lock. And it's time for the

business community to join the

campaign to prevent Australia going

further down the American path. At

the moment, we know that the

the moment, we know that the private health industry is back in the ear

of the Federal Government, and it

has good access to the Federal

Government's ear, and it's calling

for new FBT arrangements to create

for new FBT arrangements to create a stronger link between employment

stronger link between employment and health insurance. Now, the Howard

Government shouldn't let them get

away with this, and the business

community shouldn't let them get

away with this either. Labor has

always been very good at harnessing

the goodwill of sections of the

community, and we need to do that

now by harnessing the goodwill of

business in this campaign, and the

campaign starts now. The Howard

Government we know will want to go

down this path, but we don't want

down this path, but we don't want an increasing Americanisation of our

health system. Both Kim Beazley

health system. Both Kim Beazley and I are both very fond of America -

I'm particularly fond, having spent

three weeks there in January - but

as Kim Beazley said here last week,

we are already losing some of the

best things about being American

best things about being American and looking more like the 51st State of

America. We can't afford another

step which takes us into the health

nightmare which is America's.

Return on investment needs to play

Return on investment needs to play a great role in driving decisions

about health. And there are big

returns to be had from investing in

prevention. For example, according

to a report from the Department of

Health, our investment in reducing

tobacco consumption from the 1970s

to the late 1990s has reaped an

enormous return. Based on year

enormous return. Based on year 2000 dollars, $1 76 million in program

costs returned a benefit of $8.4

billion. Now, those figures are

worth repeating and thinking about.

$1 76 million reaped a benefit of $8.4 billion.

$8.4 billion: Yet, despite the

evidence - and this is the clearest

evidence you could have - that

long-term returns from invest

long-term returns from investing

long-term returns from investing for prevention make a difference, the

majority of public health spending

still goes on treating existing

problems and only when they become

chronic conditions. Indeed, we

spend about $30 billion every year

on treating our top chronic

on treating our top chronic diseases such as heart disease and mental

illness. In 2002/3, we spent less

than a billion raising awareness

than a billion raising awareness and preventing disease, but spent 53

times that treating illnesses. Of

course, we know that not all

course, we know that not all disease can be prevented, houfr, it's

sphimented that 90% of Type II

diabetes, more than 50% of

cardiovascular disease and 50% of

cancers are preventable. The OECD

has estimated that 50% of premature

deeths that are preventable from

drinking, smoking and other such

behaviours, that 50% of those

behaviours, that 50% of those deaths can be avoided. Most importantly,

and if we truly seek to address

fiscal sustainability, we need to

change the mind set which currently

sees billions being spent on

managing diseases, rather than

preventing them in the first place.

Prevention is important because it

saves and it improves people's

lives. No-one wants to be sick or

to die before their time. But

prevention also pre-dueses future

budget pressures, not oenlt by

helping to contain health

expenditure, but by ensuring that

the maximum number of people

possible are in the labour force,

and that they are healthy enough to

be highly productive. A society

riddled with ill health will have

low production rates and

productivity. That's commonsense.

Work done by the Melbourne

Work done by the Melbourne Institute has similar findings to other

literature, that health has a major

impact on the

impact on the supply. For example,

as the health of older working men

fell, so did their paption in the

workforce. Coupled with evidence

from the World Health Organisation

and the OECD, it shows we can keep

people in the workforce for longer

if we improve health outcomes over

the longer term. Treasurer

the longer term. Treasurer Costello is constantly telling us about his

three Ps - participation,

productivity and population. It's

time we added the fourth P, and

time we added the fourth P, and that P is prevention. This means that

once and for all, we need to accept

that there is an inextricable link

between our health and the health

between our health and the health of our economy and that there is an

inextricable link between the

inextricable link between the health of our people and their

participation and productivity in

our workforce. The Howard

Government's lack of action on

prevention makes you wonder whether

it's a case like the Wheat Board

bribe can zal where they basically

just don't want to know, and you

would have to say you would hope

that government would work on the

basis that a minister would call

advisers in and say, "Can you give

me some more information about this.

me some more information about this?" The houflt is the first

government that we've had in our

history where the ministers

televisors, "Just stop telling me.

televisors, "Just stop telling me." They've obviously done that on the

Wheat Board scandal. Instead of

that lack of action, we should act

to move prevention from the perrive tri-

tri- -- periphery of our health

care system to the very centre. It

can be done and it's done in other

countries. The UK and Canada are

tackling prevention in bold and new

ways. In the UK, they have their

own goals, targets and budgets and

economic analysis to support them,

separate from but integrated with

the health care and treatment

system. It is interesting to note

that the reports that make the case

for this extensive reform and

investment in public health sit on

the Treasurer web site, not the

health web site, and that's

something Tony Abbott wouldn't know,

but that Peter Costello ought to be

thinking about. Wails, a country

which, -- Wales, a country has

which, -- Wales, a country has made the decision to invest in

the decision to invest in preventive health. Even though where I come

from, the Welsh people understand

that in their economic

circumstances, such an intervention

in the first instance must come at

the expenditure of health. We know

that tobacco-related diseases cost

$12 billion in costs every year and

at least $250 million of this is

just from hospital costs alone. We

know that 500 schoolchildren - 500

schoolchildren - will smoke their

first cigarette today. 500

schoolchildren, and we know that 70,

schoolchildren, and we know that 70,000 teenagers smoke regularly.

And that smoking is a risk factor

for low birth weight babies and

asthma and pneumococcal disease in

children. But with those sorts of

statistics, can you believe that we

are spending only a few million

dollars a year on anti-smoking

programs? And can you believe that

the program to help pregnant

the program to help pregnant mothers quit smoking has not yet begun 16

months - 16 months - after it was

first promised? It isn't just about

the money. It's also about

integration and incentives.

Australia desperately needs an

integrated primary health care and

prevention strategy. I talked

prevention strategy. I talked about this in a National Press Club

this in a National Press Club speech in April 2004. At that time, I

outlined how Medicare fee for

service fails to provide the right

incentives to encourage regular

check-ups and screening and the

provision of health advice. Of the

problem is at the moment the only

time a GP sees a patient is when

time a GP sees a patient is when the patient walks into the GP's surgery,

and that's normally when the

and that's normally when the patient is sick. The proposed new Medicare

payment for wellness checks will

fall into the same category. It's

reactive, not proactive. If you go

to the doctor, well, that's fine,

but there is still no incentive in

the system for the doctor to look

the system for the doctor to look at his or her patient load and to come

and find you for a wellness check.

Without a proactive component, the

so-called preventive health

so-called preventive health Medicare items of the kind put forward by

Tony Abbott are more about treating

the worried well, than they are

about reaching out to those who are

truly most in need. A health

truly most in need. A health system with prevention at its centre would

also have the health of Australian

children at its very heart.

children at its very heart, because

we all know Australians hold

Australian children very dear to

them, and because we know for the

nation, that it's the best

investment we can make, the best

investment we can make in those

children we care about so much is

children we care about so much is to put them at the centre of a health

prevention strategy. That's about

the future. It's the only way to

make sure that those Aussie kids

grow up to be Australians who fully

participate in our society and in

our economy. If we are truly to

prevent an ever-increasing burden

prevent an ever-increasing burden of chronic and complex diseases, then

we have to ward these diseases off

in childhood. A child beset with

health problems or with the

indicators for health problems like

obesity will become an adult with

chronic and complex conditions who

may face a premature death. Indeed,

when we do the maths, we can see

that the chronic and complex

illnesses that are at the overall

leading causes of disease and

leading causes of disease and health expenditure in adults are

responsible for the great weight of

disease burden in babies and

children. That's when it starts.

Last week, Kim Beazley launched

Labor's blueprint on children's

health policy. Today I'm launching

goals for Aussie kids, Labor's

discussion paper on children's

health which stretches to improve

the health and development of

Australian children from the womb

Australian children from the womb to 18 and beyond. Labor's blueprint

18 and beyond. Labor's blueprint and the accompanying policy discussion

paper is based on what has been

called Madernti's paradox, which is,

of course, the painful truth that

of course, the painful truth that in spite of medical advances and our economic prosperity, our children

are facing a growing array of

chronic illnesses and developmental

problems, so we might be getting

richer, but our kids aren't getting

more healthy. Increasing

proportions of children and youth

proportions of children and youth in Australia are subject to diseases

and disorders, and the list is a

frightening one, such as asthma,

diabetes, obesity, intellectual

disabilities, depression, suicide

and eating disorders. We've seen

dramatic increases in substance

abuse, in aggressive juvenile crime,

in child abuse and child neglect.

We should be concerned at the

increase in social disparity in

these outcomes, although they are

these outcomes, although they are at unacceptable levels right across

unacceptable levels right across the spectrum. We should acknowledge

current policies just aren't

working. We know that prevention,

screening and early intervention

screening and early intervention are cost effective. Governments must

now be prepared to set goals for

Aussie kids' health and deliver

prevention, screening and early

intervention to meet those goals.

The discussion bay per I am

releasing today has 26 goals which,

when fully implemented, will have a

real and positive impact on the

health of our children, now and

health of our children, now and into the future. They are universal

goals for every Australian child,

for every Aussie kid, no matter

whether they live in a capital city,

in a suburb, a town or in outback

Australia. Of course, we know that

our best efforts are going to be

required to match this challenge

required to match this challenge for our Indigenous children, and for

those children who often bear the

burden of geography, language or

disability and are at risk of

missing out. Some of the goals can

be delivered in their entirety

within a relatively short time.

Others will require incremental

implementation over a longer

time-frame. The most aspirational

and I think inspirational of these

goals will require long-term

commitments and may only be

commitments and may only be achieved over a generation. In putting

forward these goals, we start with

goals about maternal health,

childbirth, screening of new babies

and support for new mothers to

ensure the best start in life for

their new bub. And we think that

all kids will benefit from goals

that will ensure universal

vaccination through the national

vaccine program and access to all

recommended vaccines. No more of

the Tony Abbott/John Howard

the Tony Abbott/John Howard fiddling around with vaccines and denying

people access to vaccines. Access

to preventive care and dental

to preventive care and dental health services, improved bulk-bill

services. Support services for

parents and carers of kids with ser

veer disabilities and chronic

illnesses, and re-vitalisation of

the national health priority on

injury prevention and control. A

number of Labor's goals for Aussie

kids are spes

kids are specifically targeted at

certain age groups, however it's

important that access to services

important that access to services is defined by need, and not by age

group. We know that kids develop

differently. We will also see

parents, teachers and health

professionals as willing partner

ners to address the goals, so there

is a focus on nutrition, obesity,

dental care and child development

milestones. As children make the

transitions to plea school and

primary school and then onto high

school - all the big lifetime

school - all the big lifetime stages - regular assessment of their

- regular assessment of their health and development and then referral

onto the appropriate intervention

programs will mean that physical

mental health problems can be programs will mean that physical and

up and effectively addressed. As mental health problems can be picked

everyone knows, adolescence can be

very difficult time with its own everyone knows, adolescence can be a

particular set of health problems,

and Labor's goals for kids ladies

and gentlemen aged 13 to 18

recognise this through our

commitments to make sure that we

establish adolescent health

to provide a whole holistic establish adolescent health services

to health care needs for our to provide a whole holistic approach

teenagers, access to mental health

services. Early intervention and

acute care services for mental

illness and education and awareness

programs targeted at risky

behaviours. To achieve these goals

and make these efforts go faster

further, a Beazley/Labor government and make these efforts go faster and

will show national leadership and

drive this agenda through the

council of Australian governments

and of course, through the

Australian health Minister.

Ministers conference. This

discussion paper that I'm released

today also includes our commitment

to establishing a centre for

children's health within the

Department of Health and ageing

a specific task to implement the Department of Health and ageing with

goals for Aussie kids. This

discussion paper is owned by all of

our Labor caucus and they will be

using it in the next few months to

campaign and to seek input on these

goals, and that will help us turn

these goals into election policies.

I today many urging every parents,

every teacher, every health

professional, everyone who cares

about the future of our Aussie kids

to have input into this discussion

paper. We genuinely want to hear

from you. And I know that good

policy starts now and it starts by

involving families and business in

the making of good policy. We want

to harness them in this campaign.

We can't deny the good times that

Australia has enjoyed the, the

buoyant growth, stable inflation

increases in the incomes and assets buoyant growth, stable inflation and

of Australians. All of that is a

matter of public record. And we

can't dismiss the fact that we are

actually in the grip of a good

old-fashioned commodity xwoom.

Indeed, the good times that we now

enjoy should remind us of one major

thing, and that is that it requires

governments who are prepared to

budget for the future. We wouldn't

be enjoying today's good times if

hadn't been for the long-term be enjoying today's good times if it

of the hawk and Keating governments. hadn't been for the long-term vision

Their work is why we're enjoying

good times today. But when we're

enjoying those good times we've got

to ask ourselves one simple but I

would say profound question: What

this prosperity for? I think one of would say profound question: What is

the answers has already been given

to us by the Australian people.

research Australia public opinion to us by the Australian people. The

poll 2005 found that 75% of

Australians strongly agree that

modern health care is expensive, so

preventing disease is the best

option. These Australians are

right. Australians actually

understand the politics of the long

term. They get it even when their

elected representatives so

frequently do not, and to protect

our future prosperity and to build

our community, we should be

investing in prevention, not just

cure. And we know that all

Australians want the very best for

Aussie kids, for all of them, and

we are to meet the country's Aussie kids, for all of them, and if

long-term health needs, we must

the march towards an American-style long-term health needs, we must halt

health system, and we must invest

prevention and move it to the health system, and we must invest in

of our health system. It's good prevention and move it to the centre

our health, it will deliver great of our health system. It's good for

returns on investment, it will be

very good for business, but most of

all, it will be great for Aussie

kids. Thank you very much.

Thank you very much, Julia Gillard, kids. Thank you very much. APPLAUSE

Shadow Minister for Health. As

usual , we have our period of media

questions. The first one today is

from Stephanie Pete ling. From the

'Sydney Morning Herald', Julia. I

would ask you to consider another

health question, the approval

process for R u.

process for RU486. I'm just

wondering if you're interested or

you have any views on the extent to

which religion has played into the

debate this time. And are you

surprised that this seemingly

innocuous change in the approval

process for a drug has basically

turned into a national debate on

abortion? Gee, poor old Tone. He

used to be a tough man, now he

take it. Tony Abbott has been out used to be a tough man, now he can't

there in the public domain talking

up the abortion issue since the

Leck. He has been out there using up the abortion issue since the last

statistics that at the time he used

them, he knew them to be wrong to

cry to create evidence of an

epidemic of abortion, as he

to it. He has been out there using epidemic of abortion, as he referred

inflammatory terminology like the

pop and forget pill. His reference

to backyard abortions this week,

reference to unscrupulous doctors. to backyard abortions this week, his

Well, when you're out there in the

public domain being as inflammatory

as that, you shouldn't be startled

when you get a bit back the other

way. This RU486 debate is not a

debate about the legality or

galt about abortion. I know that debate about the legality or illegal

Tony Abbott was in the newspapers

this week referring to Clinton's

terminology that he would like to

see abortion safe, legal and rare.

Now, I can agree with that

terminology, but the difference

between Tony Abbott and me is I

it. He has been on a campaign to between Tony Abbott and me is I mean

set back abortion in Australia. He

knows it, even if he is denying it

now. The RU486 issue at base is

about whether or not experts decide

whether a medication is safe or

whether a politician does, and I

think we should be trusting the

experts that we trust to deal with think we should be trusting the same

very dangerous medication - cancer

drugs, pain-killing drugs, drugs if

Ms Used can be fatal, drugs if Ms

Used can be misused can be

addictive. If we can trust them to

make those decisions, we can trust

them to make a decision on the

safety of RU486 Josh Gordon from

'The Age'. You've called on the

business community to do more to

stop Australia going down the path

of America in terms of a fragmented

health system. I'm just wondering

if you could expand on that and

us what you mean and what the if you could expand on that and tell

business community should be doing

specifically? Well, I think the

business community needs to be in

dialogue with health policy makers

about the future of our health care

system. Some of the policies get

made well outside the Federal

Government, it gets made by people

in the health sector and who are

serious about issues, and of course

it gets made by State Labor

governments, but I think the

business community should be

business community should be engaged in the public dialogue and it

in the public dialogue and it should be saying to the Howard Government

it would be bad for business for

it would be bad for business for you to unwind Australia's universal

health care system, and we see that

business talking, we see that as a

social policy issue, sure, but more

than anything else, from the

perspective of business, it is an

economic issue, and it's about

future costs, future productivity

and the dependency ratio of this

nation as we age. These are the

things that are central to business

concerns. Whether or not they're

going to be able to get a healthy,

productive workforce, whether or

productive workforce, whether or not they're going to have to bear an

increasing proportion of costs for

health in some of the eccentric

health in some of the eccentric ways as I've described in the United

States and our dependency ratio

States and our dependency ratio will be worse if we aren't addressing

be worse if we aren't addressing the potential burden of chronic and

complex diseases which take people

outside the labour force in

childhood. Andrew Fraser, the

'Canberra Times'. Your speech

touched on prevention. I was

wanting to ask about prevention in

another area. Politicians often

dismiss our questions about

preselections as mere matters for

their party, but they can be and

their party, but they can be and are often intensely personal affairs.

often intensely personal affairs. I was wanting to ask for your

was wanting to ask for your feelings particularly on the challenge to

Simon Crean, who is with us here

today? And are you a subdescriber

today? And are you a subdescriber to the Mark Latham school of thought

the Mark Latham school of thought or are you more minded to embrace Kim Beazley's compete

Beazley's competing -- complete

indifference to his plight? I will

feel uncomfortable now talking

feel uncomfortable now talking about Simon as if he's not here and I'm

sure Simon can absolutely talk for

himself. I'm a subdescribe

himself. I'm a subdescriber to the

Julia Gillard school of thought.

And that is in respect of Simon

Crean, that not only he has history

in the party that means he deserves

the respect of the party overall,

that is of course his history as a

government minister, as a loyal

deputy leader, as an effective

shadow treasurer, as a shadow

treasurer that prosecuted an

anti-GST campaign that took us to

the closest to victory, he is

entitled to the party's respect

entitled to the party's respect from that record of service and that

respect should be shown in the

preselection process by having

preselection process by having Simon re-preselected and returned the

electors of Hotham willing, to the

Parliament at the next election.

Simon, of course, not only has that

record to stand on, but he has got

the capacity to be a very great

continuing contributor to Labor.

One doesn't wander around talking

about shadow ministry discussions

but I am prepared to say this:

but I am prepared to say this: Simon is now one of the important

custodians of our collective and

corporate memory. We would miss

corporate memory. We would miss him dreadfully if he was not here to

help advise about the long-term

issues for Labor, and he is one of

the few people, indeed Kim Beazley

is the only other, in the current

shadow ministry who can bring that

breadth of knowledge and experience,

and it would be a dreadful result

for rural and regional Australia to

not continue in the shadow ministry

he is doing so well. People in the

the bush will tell you that Simon

has a special touch with people out

there and he showed that certainly

when he was in government with

portfolios that took him out in

rural and regional Australia.

APPLAUSE Melissa Polimeni from

AAPT. Just getting back to RU486.

The committee looking at the RU486

bill handed down its findings and

failed to recommend whether the

current banned should be lifted.

Was the inquiry a waste of time?

Look, I wouldn't label any proper

inquiry process a waste of time.

We've seen of course, the Howard

Government late last year put

through some of the most dramatic

legislation this country has ever

seen without proper inquiry

processes - the Industrial

Commissions legislation, the processes - the Industrial Relations

sale, the so-called welfare-to-work Commissions legislation, the Telstra

changes were all herded through,

very, very quickly without proper

inquiry. I am a supporter of

inquiry processes I think they can

make a difference. Obviously on

RU486 issue, you are in a make a difference. Obviously on the

circumstance where people tend to

have very strong issues on these

issues. Those views have coloured

their approach to their work as

members of the committee, and I'm

certainly not surprised that the

committee would have divided on two

lines and that there would have

no uniformty if you were amongst lines and that there would have been

them. That doesn't mean to say it

was a waste of time. It has

people around the country to have a was a waste of time. It has enabled

say on this issue, the issue

properly before the committee which

was the particular regulation of RU

4al 6. Next question is from

Annabelle Stafford. From the

'Financial Review'. Peter Beattie

has suggested that public hospitals

in Queensland might encourage

patients with private health korve

to be treated as private patients,

which seems to go a little bit

against the idea of universal

cover. What do you think of that against the idea of universal health

suggestion? I don't think there is

any problem, and indeed it is

relatively common in other states

for public hospitals, who are

treating privately sured patients,

to make an inquiry of those

as to whether or not they want to to make an inquiry of those patients

use their private health insurance.

You know, if you're privately sured,

you're privately sured for the

purpose of being treatd in a public

hospital or a private hospital.

Obviously in your system you have

your citizenship right which

entitles you to free treatment in a

public hospital, and we should

undermine, but giving people the public hospital, and we should never

election to access that insurance

when they're being treatd in a

public hospital I think is a good

thing. It is a revenue source for

public hospitals. At the end of

day, private hospitals hold out to public hospitals. At the end of the

the people who will come and assist

them when they're sick. It doesn't

mean that the private insurer

necessarily avoid that obligation. mean that the private insurer should

Patricia Cacaallos From 'The

Australian'. I've got two

questions. You say that in Wales

the Welsh people have understood

that spending on prevention must

come at the expense of health care

services. Should the Australian

people expect the same thing, that

consequence of this under a Labor people expect the same thing, that a

government would mean less spending

on everyday health care and more on

prevention? The other question I

have is that you say here that

access to services is defined by

need and not by age group.

Gold, during the federal election, need and not by age group. Medicare

was very much defined by age group.

Is that a consistent policy across

the board and how do you feel about

Medicare Gold now? Sure, on the

question of the issue in Wales,

obviously the Welsh people are in a

different economic position to the

Australian people, unhappily.

is a small place, 4 million people, Australian people, unhappily. Wales

low income status, certainly by

world standards and low health

status, a lot of which is actually

the legacy of the coal-mining past

and the diseases that people got,

silocosis that people got through

coal-mining, including some of my

relatives in Wales, so they're in a

difficult position where they've

to make a choice .s Wales is a difficult position where they've had

that returns out of 40 seats, 36 to make a choice .s Wales is a place

Labor seats, so they know how to

vote in Wales, but they are in a

different economic position than we

are, as I've said. We acknowledge

that when you look at the macro

economy, we've enjoyed some good

times and we are obviously in the

midst of a commodity boom and that

gives us some different choices

about expenditure, so we're drawing

from a bigger pot. On the question

of need, this gets us to the fall

misunderstanding of the nature of

Medicare Gold and what it was

designed to achieve. Sure,

Gold was a benefits package for designed to achieve. Sure, Medicare

Australians 75 and above, but there

are other benefits we provide to

older Australians because of their

age range. The pension, being one.

I don't think we should forget, and

of course access to residential

care being another, so there are of course access to residential aged

things that relate to age and

to being older Australians, so it things that relate to age and relate

was a benefits package from the

point of view of older Australians,

but from the point of view of the

health system, it was a profound

reform package. It was going to

make sure for you and me next time

we need a hospital bed and neither

of us is anywhere near 75 - though

some days feel like it - it would

have ensured for you and me that

next time we need a hospital bed,

10% of those hospital beds weren't

being used by frail, aged people

would be better cared for in being used by frail, aged people who

setting and most particularly in would be better cared for in another

residential aged care or respite

care, so it was good for the system.

Next question is from Ben Ruse.

From the West Australian. Given

your intention to focus on pro

veention and also the increasing

costs to the PBS, can Labor commit

to maintaining the PBS in its

current form without increasing

co-contributions or limiting the

range of drugs available? Before

someone in the audience jumps up to

answer this question for me, which

suspect I'm at risk of with answer this question for me, which I

Medicines Australia being here

today, we can't sit around talking

about the huge growth rates of the

PBS. That's not true. I would

suspect, on the evidence available

to me and my office, that growth

rates are below 2%. What that

is that the co-payment increase rates are below 2%. What that means

the Howard Government put into is that the co-payment increase that

has made a difference to the the Howard Government put into place

affordability of medicines which

means that some people, and the

people we're talking about are the

people who are long-term users of

medicines, people with mental

illness, people who have

illness, people who have cholesterol issues to address, need medicine

every day. The statistics can only

be trerpted to mean that some of

those people aren't accessing their

medication anymore. That's not

medication anymore. That's not good news. That's bad news for the

health system because that's going

to turn up in our acute care system

in terms of mental illness,

in terms of mental illness, probably quite quickly. In terms of

cholesterol-lowering and other

medications in a slowerer

time-frame, but when people end up

having a major health problem they

otherwise would not have have had

because that's what the medication

is there to control and address. I

think this government has a huge

think this government has a huge and unaddressed issue with the PBS.

When I said that ministers from the

Federal Government sit in the

Federal Government sit in the office saying to their advisers q just

don't tell me that," I'm not sure

don't tell me that," I'm not sure if Tony is saying, "Don't tell me that

and he is being told and doesn't

understand it, but either way, it

understand it, but either way, it is a big problem in the health system

and we need to address it. David

spears from Sky News, Julia. Since

the Howard Government introduced

the Howard Government introduced the 30% private health insurance rebate

Labor has been fairly uncomfortable

with it. Wouldn't scrapping

thorough free up the billions of

dollars you're talking about here

and provide the bold leadership

and provide the bold leadership that you called for when Kim Beazley

returned to the leadership of the

Labor Party in a similar way that

creating one single level of

government to control all health

care - wouldn't that also provide

the sort of bold leadership on

health that no doubt is something

you would be interested in? Sure.

Look, when it comes to the priefrt

health insurance rebate, you know,

at the last election, at the

election before, Labor said that it

recognise that had the private

health insurance rebate was now

factored into family budgets.

Whilst we didn't think at the time

that tws designed, that it was the

best answer to Australia's health

care problems, we now understand

that it's relied on by families to

make the discussion around the

kitchen table about how the bills

are going to make that discussion

add up, so consequently we don't

have an agenda against the private

health insurance rebate. But in

terms of looking at reform in

health, there are some big reforms

that we need to do. You know,

that we need to do. You know, every so often the Minister for Health

Tony Abbott will wander out and say,

"Why don't I take over the whole

health system?" To which most of

health system?" To which most of the Australia rightly says q God,

Australia rightly says q God, you've got to be joking." That's is all we

ever hear about it. The Prime

Minister every time he says it says,

"You've got to be joking Tony. You

can hardly do what you've got now.

Would you find getting on with that

first?" So there is not going to be

some big-bang reform where states

give up their power over the health

system to the Federal Government.

would ask people to think about system to the Federal Government. I

this: Even if that happened

tomorrow, there is no way that the

Federal Government is going to

manage individual hospitals out of Federal Government is going to micro

Canberra. You would still end up

with funding flowing to some sort

regional geographic entity, and in with funding flowing to some sort of

lot of places in Australia, that regional geographic entity, and in a

geographical entity is going to

a fair bit like a state. We need geographical entity is going to look

understand that - Tasmania in a fair bit like a state. We need to

particular. We need to understand

that and say, "Look, there are big

things we need to do." The big

reform I've talked about today

prevention. We need big reforms on reform I've talked about today about

workforce, and we've talked about

that in the past. We need big

reforms on hospitals and

to address the fail aged we were reforms on hospitals and Corporation

talking about before - that's where

the real future agenda lies. Big

reforms on mental ill dnce -

certainly a topic that needs a lot

of political muscle to try to find

solution. They are the things we of political muscle to try to find a

should be focusing on, rather than

this circular debate about

Commonwealth/State. Glenn Milne

News Limited Sunday publications Commonwealth/State. Glenn Milne from

'The Australian'. I know you've News Limited Sunday publications and

to rush off to Question Time, but I 'The Australian'. I know you've got

can't let you get out the door

without mentions Mark Latham.

from the miracle of converting without mentions Mark Latham. Apart

photographers into objects of from the miracle of converting press

national sympathy, I think one of

the other good things that Mark

Latham did was advocate in the last

election the banning of junk food

advertising for kids. I Justin

wonder whether that policy remains

in place and where you support it,

and do you think that should be

extended to the banning of junk

vending machines in schools I am extended to the banning of junk food

certainly concerned about the

evidence that shows that how many

joung. Junk food commercials a

child sees. Our kids end up seeing

lots and lot fs of advertisements

and you don't need to be Einstein

work out that advertisers advertise and you don't need to be Einstein to to distort purchase

to distort purchases and they

wouldn't be putting that on kids'

TV, and kids have a lot of pester

power, particularly in supermarkets,

when Mum or Dad is trying to get

them up and down the aisles. We

have to look at the issue of junk

food advertising. This is

being awed titted by the relevant food advertising. This is currently

authority. We said we are content

to wait for the results of that

audit which will be at the end of

this year xwf we finally

our policy for the next election, this year xwf we finally crystallise

but, yes, we are concerned that

food advertising does make a but, yes, we are concerned that junk

difference to what kids eat. On

question of schools and what's difference to what kids eat. On the

available in school,, it's vending

machines, school tuckshop and all

those things. We need more

those things. We need than a -- machines, school tuckshop and all of

need more than that. Kids could those things. We need than a -- we

still go down the road and go to

other shops, so it is a more

profound change than just that. We

are amazed to see that the $15

million that the Howard Government

finally coughed up for some of

things hasn't been fully finally coughed up for some of these

subdescribed to, hasn't been fully

spent, a poorly designed program,

we do need to be doing more in that spent, a poorly designed program, so

area. The goals for kids

paper highlights the issue of area. The goals for kids discussion

obesity. It can be influenced with

national leadership working with

State and local government right

down to schools, kindies, community

parks, all of that we need to be

taublinging about, but it requires

leadership from the top, and we

don't have that leadership now.

Andrew Fraser: The AWB scandal has

consumed a lot of media space in

recent times. Do you believe it

yet changed a single person's vote recent times. Do you believe it has

and does Kevin Rudd's prominence in

the debate on it alter Labor's

leadership over the next 18 months?

The ance to the second question is

no it doesn't. Kevin is doing a

tremendous job with the Wheat Board

scandal, and a scandal it is, $300

million worth of scandal and Kevin

is across the detail in a truly amazing bell,

amazely r -- truly amaze

amazely r -- truly amazingly.

Guess what will be back on the

Board today at Question Time. On Guess what will be back on the Wheat

the question of whether or not it's

changed a vote, look, it's a

complicated issue which is going to

take people time to think about,

what I think people do understand take people time to think about, but

this: That the Howard Government, what I think people do understand is

through neglect or perhaps by

turning a blind eye, but through

or both of those, has basically turning a blind eye, but through one

allowed a scandal to develop where

$300 million of funds ended up with

Saddam Hussein's regime at a time

that he was preparing for war and

then we sent Aussie troops in to be

part of that war. Now, that's not

that complicated. You can't, on

one hand, be running an that complicated. You can't, on the

administration that gets $300 --

that gives $300 million to the

people you're about to go and fight

and then send troops in to go and

fight them and not wear the moral

responsibility for that, and that's

what the scandal is about ultimately, the moral

for having allowed that situation ultimately, the moral responsibility

develop. The Prime Minister all but for having allowed that situation to

defended the ministerial veto on

RU486 in his press conference with

Helen Clark earlier today. He

won't declare his hand, but he went Helen Clark earlier today. He still

on at length about the greatness of

the ministerial veto. Do you think

you have the numbers in both houses

now to pass that bill? Look, I

like to speculate on the question now to pass that bill? Look, I don't

numbers because each individual like to speculate on the question of

member of Parliament, I think, is

thinking their way seriously

the issue and try tog come to a thinking their way seriously through

position that they feel comfortable

with. I think, obviously, the

Minister making those statements with. I think, obviously, the Prime

might become a factor on the mind

senators who are to vote very soon, might become a factor on the mind of

as soon as tomorrow afternoon on

question. RU486, so we will see as soon as tomorrow afternoon on the

what emerges from that. For the

Prime Minister, though, I would say

that if you are going to be out

there spruiking the merits of

ministerial discretion, you perhaps

want to be getting another health

minister. Julia Gillard, let me ask

you the last question for today.

You touched briefly on your views

centralising the health system You touched briefly on your views on

jurisdiction, but with COAG meeting

this week and with cost-shifting

being the endless argument about

being the endless argument about the whole system, what do you see as

being the next most important step

in dealing with costs? Well, the

first most important step is the

prevention agenda I've talked about

today. The next most important

today. The next most important step after that is to get the states and

Commonwealth to sit down and to

Commonwealth to sit down and to work through the discontinuities and

through the discontinuities and gaps that are in our current Australian

health care agreements, the sort of

gap gaps that allow fail, aged

people to end up in hospital beds.

I note that Andrew Podg e, r, the

Howard Government's own health

expert, came out with something

expert, came out with something very much liek Medicare Gold, which is

interesting to see. But we need

interesting to see. But we need the government and the states to be

talking about those. In strong

defence of my State colleagues, at

the last election, they signed up

the last election, they signed up to do those things with federal Labor,

that they would have sat with

Federal Labor and worked Federal Labor and worked through

these issues. It was a new

these issues. It was a new Medicare working partnership and it would

have made a big difference. The

onus is on the Howard Government to

show whether or not it has the

political skill to broker such a

change, and we haven't seen too

change, and we haven't seen too much evidence of it yet. I think COAG

will do some things on Friday,