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TRANSCRIPT OF INTERVIEW WITH DAVID KOCH, SUNRISE, 24 JULY 2009

Subject: Hospital beds, health reform, support for mothers with post and antenatal depression

DAVID KOCH: Well, this week we launched our boost our beds campaign on the show, that's after we
found out there are fewer hospital beds per 1000 Aussies than there were in 1981. Over a third have
gone.

Now, we mentioned how we've been following this issue for years and years. Well, here's a quick
Sunrise history lesson.

In December 2003, we broadcast a show from a hospital emergency room. I spoke with AMA president at
the time, Bill Glasson. Even then, he said bed block was preventing proper care.

[File footage played]

BILL GLASSON: A bit like a freeway, people think they can't get on the freeway because they can't
get off it. And the reality is that there's a huge problem in the aged care sector, in the sense
that we can't get - we haven't got enough beds to actually get patients out of hospitals.

[End of file footage]

DAVID KOCH: Then in early 2004, we held the Sunrise health ministers forum. We had state health
ministers together with then federal Health Minister, Tony Abbott. Among the issues raised were
performance benchmarks for state health departments. We thought the health system was pretty sick,
but Mr Abbott wasn't quite as worried.

[File footage played]

TONY ABBOTT: I think that if you're unfortunate enough to be sick, Australia is still the best
country in the world to be sick in. Our system is not sick. Our system has some problems, and our
job is to try to fix those problems, make them better.

[End of file footage]

DAVID KOCH: Fix the problems. But were those problems ever actually fixed? As you can see, this is
an issue that's been around much longer than the Rudd Government. In fact, you could argue, they
really inherited a cot case in terms of our hospitals. But we did promise to ask the current
federal Health Minister Nicola Roxon about boosting our beds, and she joins us now. Thanks for your
time, good to see you.

NICOLA ROXON: Good morning.

DAVID KOCH: Is it a concern that we have so many fewer hospital beds per thousand Australians than
we did, say, way back in 1981?

NICOLA ROXON: Look, of course, because the population's growing, we have less proportionally; we
have more actual beds. But we also do things differently. Probably not enough things differently.

Now, for example, you're not usually an admitted patient if you have chemotherapy treatment, you do
it in a day process mostly. We are, with medical technology, changing the reliance on what we do in
hospitals and what we don't. But it's obvious to me we don't have that balance right because there
still are access problems for people who need to be in hospital getting into hospital, and that's
what we're trying to work on.

DAVID KOCH: Particularly at a time like this. Like, I reckon you guys are doing a great job in
terms of handling the swine flu issue. But it's just highlighting the fact that our hospitals can't
cope with anything out of the ordinary. That's got to be a concern.

NICOLA ROXON: Look, I think our hospitals are doing a great job with this surge of cases, because -
particularly our intensive care units are under pressure.

I think we've got a problem. I don't pretend there's not a problem. It's why, even in just 18
months, we've been trying to invest a lot more money. I don't want to list for your viewers every
single thing...

DAVID KOCH: No.

NICOLA ROXON: ... because we know it's not yet enough. And that's why we are talking about quite
ambitious reforms. We believe we need to invest more and we need to do some things differently. And
there has been a bit of resistance, because it's hard. Change is hard for people and we really are
trying to drive that.

Even some of the things in your introduction, those outcome measures and reporting, we've changed
that already. People might not see the results already - we've only been there for 18 months - but
I am really confident we're on the right track.

DAVID KOCH: Okay.

NICOLA ROXON: But we need some serious reform. Beds is part of the answer, but I don't think...

DAVID KOCH: Sure.

NICOLA ROXON: ... the whole answer.

DAVID KOCH: Because you need the staff to man the beds as well. A lot of people have been emailing
in saying, oh, you know, you've got to have the nurses and the doctors there with the beds.

NICOLA ROXON: Sure.

DAVID KOCH: We've got beds there just lying idle, but we don't have the staff to service...

NICOLA ROXON: Well we - I mean, we have come to government with there being a legacy that we've
inherited...

DAVID KOCH: Yeah.

NICOLA ROXON: ... where bed shortage is part of it. But workforce shortages are a severe part. But
also being prepared to do things differently: transition care, sub-acute care, the sorts of things
that Bill Glasson was talking about. We also have to get hospital beds outside hospitals so the
flow can work, and that means we need to do a lot of things at the same time.

I'm confident they're all under way. I don't think they've delivered all of their results yet.

DAVID KOCH: Okay. When will we see them deliver those results?

NICOLA ROXON: Well, I think we need to see it changing fast. I think the community is telling us
that...

DAVID KOCH: Yeah.

NICOLA ROXON: ... they don't want the promise of change. They do want to actually see it change.

DAVID KOCH: Okay.

NICOLA ROXON: And, federally, that's quite hard to deliver. We've got a historic deal from last
November, the money and investment's going in. We see construction around the country, but that
doesn't mean we don't still have people turning up at our hospitals...

DAVID KOCH: The states are mucking it up though aren't they? They're the one not willing to change.
They're not willing to come to the party.

NICOLA ROXON: Look, I think it varies across the country. I think there's some quite innovative
things being done in some places and some types of care are done really well in one state and not
another, and that confuses people even more. How come I can't get the same thing in one state
compared to another? That's what we're trying to do, to get...

DAVID KOCH: Okay.

NICOLA ROXON: ... a unified system.

DAVID KOCH: All right. Give me a benchmark. When we talk to you in six months time, tell us what we
can expect to have this situation eased?

NICOLA ROXON: Well, in six months time, the sort of commitments we've made about transition beds,
people being able to get out of hospital quickly, particularly the elderly getting into aged
care...

DAVID KOCH: Right.

NICOLA ROXON: ... you should be able to see changes for those. They're already coming on line. Our
elective surgery targets, we're going to be paying for performance. So if states don't meet the
guidelines, they won't get the payments. Those payments start from the middle of next year, but the
system is starting soon. I think there's a range of different measures...

DAVID KOCH: Okay.

NICOLA ROXON: ... you can use. We've set some of them with COAG emergency department waiting times.
There's a whole range. And we need to make sure we do it across the system, because if you just
measure one thing, everyone puts their effort into that, and might drop the ball elsewhere.

DAVID KOCH: And you're going to be tough on the states.

NICOLA ROXON: We...

DAVID KOCH: Deliver or you're out.

NICOLA ROXON: We have been absolutely clear, we don't mind putting in more money. We've done that.
We think the Howard Government did the wrong thing pulling money out, but we want results for it.

DAVID KOCH: Okay.

NICOLA ROXON: And we want to work - we will push. We're not here to apologise for the states, but I
think they are doing a lot of good things. They need more of a push...

DAVID KOCH: All right.

NICOLA ROXON: ... and we all need to be able to change. That's the professions, it's the states,
it's us...

DAVID KOCH: Yeah.

NICOLA ROXON: ... and do things a bit differently.

DAVID KOCH: Okay. Let's end on a positive note. Five million dollars in funding to counsel women
with post and antenatal depression. Up to 16 per cent of mums suffer from this. This is a good
initiative.

NICOLA ROXON: Look, this really is, I think, a good initiative. It's part of our whole investment
in maternity services where we're looking to give women more choice and more support. It's
staggering, I think, to most of the community that such a large proportion of people do suffer from
depression. But also, we have not a large number but a devastating impact when children are
stillborn, or when they die in a very early age, and these peer support groups need funding, and
they are now going to be linked with our national telephone line, so that families are not isolated
in these very difficult situations.

DAVID KOCH: That's terrific. That's a really good idea.

See you in six months.

NICOLA ROXON: Certainly.

DAVID KOCH: Can you come back?

NICOLA ROXON: I will.

DAVID KOCH: And also, get your people to keep feeding us information on where beds are opening.

NICOLA ROXON: Sure.

DAVID KOCH: Where the increases are there, because it's something - it's just gone on too long.

NICOLA ROXON: Okay, we'll do that.

DAVID KOCH: Good to see you.

NICOLA ROXON: Thanks.