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PM: It's good to be here with David Bradbury, our local Member- and to talk about the particular
challenges facing the health and hospital needs in western Sydney, and here at the Nepean Hospital.
Together with the Government of New South Wales, we're seeking to improve hospital services here.
And as evidence of that, across the road you will see work commencing in about a month on what will
be called East Wing, different to the West Wing I suppose, East Wing- which is a total investment
on our part of nearly $100 million to add additional surgical beds, add additional mental health
beds, add additional services to this hospital more broadly.

This is part and parcel of helping to build more health and hospital services here in western
Sydney, which is a huge growth zone not just for greater Sydney, but for the nation. And that's why
we've got to keep pace with that. Secondly, it's also evidence of the sort of work we'll now be
doing together to improve health and hospital services under a new health and hospitals network for
the nation. Last week in Canberra, together with Kristina Keneally, we agreed on a new NHHN for
Australia-wide, a new National Health and Hospitals Network to be funded nationally, and run

More autonomy for local clinicians and health experts in this part of western Sydney, and for the
first time, the Australian Government becoming the dominant funder of the future needs of the
health and hospital network, including of the public hospital system. That's a big reform. But the
rubber hits the road in how we now implement this in improving the accident and emergency services
here at Nepean, improving elective surgery rate here at Nepean, improving the number of services we
can provide for rehabilitation beds, as well as the overall pressures on the health workforce here
as well.

On the rehabilitation beds, it's probably best to describe it in these terms- we're going to have
problems with accident and emergency and elective surgery, at the front end of the hospital, if
you're not at the same time expanding your capacity at the back end of the hospital through
rehabilitation beds. That is, where people need to go after surgery, or after particularly acute
medical experiences, in order to transition them back to the community, or in some cases, to aged

That's why, again, in Canberra last week, we the Australian Government agreed to invest in an
additional 1300 acute, sub-acute beds across the nation. Here at Nepean, I'm advised there are 18
such rehabilitation beds at this hospital. They're under pressure. We're going to need to see more
investment in beds like that across western Sydney and New South Wales more broadly. That's why
we've invested there. That's why we're investing specifically enhancing A&E services as well.
That's why we're investing, also separately, in improving elective surgery capacity, and in the
overall workforce.

None of this works unless we're adding extra doctors to the system. That's why we're investing in
more than 6000 additional training places across Australia, a large slice of which of course will
come here to New South Wales. So, work on the ground now, the building of the East Wing here at
Nepean, a $100 million investment from the Australian Government. A new national agreement which
helps to underpin the future needs for accident and emergency, for elective surgery, and for
rehabilitation beds at this hospital, all part of a new partnership to deliver better health and
better hospital services to the good people of Sydney, and wider New South Wales.

One last point on health. To fund this, we actually need to ensure that we are getting proper
resources from those programs which should be yielding savings to the budget process. And here I
refer of course to our proposal over a long period of time now to bring about fundamental reforms
to the private health insurance rebate. Right now, what Mr Abbott and the Liberal party are doing
is refusing to allow these changes to occur. The present system provides massive taxpayer-funded
subsidies for my private health insurance and for Mr Abbott's. We're both on salaries of $2-300,000
plus a year. The system's just wrong. It shouldn't be that way.

What we are doing is proposing changes in order to bring about those savings, some $2 billion over
the forward estimates, to instead invest into basic hospital services for working families,
pensioners and carers right across the system. So, this is a very basic bottom line thing. Because
by Mr Abbott denying the reform to richer Australians getting taxpayer-funded subsidies for their
private health insurance, by refusing to embrace those changes, he is denying funding flowing
through to the basic needs of working people in hospitals like Nepean. To fund these reforms for
the future of the health and hospital system, we need every dollar available.

And that means the $2 billion plus that is currently being held up and blocked in the Senate by Mr
Abbott and the position the Liberal party has adopted. It's reckless, and it's irresponsible. It's
opposition for opposition's sake. And this measure should be passed, should be allowed to pass, in
order to deliver more hospital beds, more doctors, more nurses, for working families, pensioners
and carers everywhere.

Over to you folks.

JOURNALIST: Prime Minister (inaudible) have things started to (inaudible)

PM: The challenge of climate change hasn't gone away. Climate change requires continued domestic
and international action. The Australian Government believes that a Carbon Pollution Reduction
Scheme is the most effective and least expensive way of acting on climate change. And remember, the
Government- together with the Opposition- remains committed to bipartisan greenhouse gas emissions
targets. The Opposition decided to backflip on its historical commitment to bringing in a Carbon
Pollution Reduction Scheme, and there's been slow progress in the realisation of global action on
climate change. These two factors together inevitably mean that the implementation of a Carbon
Pollution Reduction Scheme in Australia will be delayed.

The implementation of a Carbon Pollution Reduction Scheme in Australia will therefore be extended
until after the conclusion of the current Kyoto commitment period, which finishes at the end of
2012. By the end of that period, the Governments around the world will be required to make clear
their commitments for the post-2012 period. And that will provide therefore the Australian
Government at that time, at the end of 2012, with a better position to assess the level of global
action on climate change prior to the implementation of a CPRS in Australia.

The Government's targets for the reduction of greenhouse gas emissions remain unchanged. The
alternative, of course, is Mr Abbott's policy, which costs more, does less, has not been funded,
and doesn't deliver a single dollar worth of compensation to working families. And remember, Mr
Abbott at the end of the day says, quote "climate change is absolute crap", unquote. That's not our

JOURNALIST: A little while back you said that climate change is the greatest moral, economic and
social challenge of our time. With this now being delayed, do you still believe that to be the

PM: Climate change remains a fundamental economic and environmental and moral challenge for all
Australians, and for all peoples of the world. That just doesn't go away for the simple reason that
it's not in the headlines. Therefore, the practical question is this. Our current actions delivered
through until the end of the current Kyoto commitment period which finishes at the end of 2012- the
critical question then is what actions postdate 2012, and the decision that we've taken as a
Government is that that provides the best opportunity to judge the actions by the rest of the
international community before taking our decision about the implementation of a Carbon Pollution
Reduction Scheme from that time on.

JOURNALIST: What about Australia being a world leader though? So we're now waiting for the rest of
the world? What happened to the idea of us leading the way?

PM: The question of acting on climate change is a responsibility facing all Australians. The
question of acting on climate change is a responsibility facing all peoples of the world.
Australian action, combined with international action, is effective. That is why we've got to work
together with our friends and partners in the world. The truth is, of course, that progress
internationally has been slower. The truth also is that the Liberal party have executed a complete
backflip on that historical position in support of an emissions trading scheme.

And therefore, therefore the appropriate course of action is to, as I said, to extend the
implementation time for the introduction of a Carbon Pollution Reduction Scheme until the end of
the current commitment period, which is 2012. And then, based on the commitments, which are then
entered into by the rest of the international community, for the Australian Government to then make
its assessment on the implementation of a CPRS following that time.

JOURNALIST: Isn't that a backflip on your position though? Because you were always for leading the
way, and not waiting, necessarily, for the rest of the world.

PM: The Government's commitment to the targets I referred to before remain unchanged. And that is,
we remain committed, together with the Opposition, to a unilateral target of 5% greenhouse gas
reduction. We remain also committed to the possibility of doing more, consistent with global
action. Nothing has changed there. What we are simply talking about is making a proper assessment
at the end of 2012, at the end of the current commitment period, on parallel action around the rest
of the world, and a judgment, therefore, based on that, on the implementation of a Carbon Pollution
Reduction Scheme. The Government's commitment-

JOURNALIST: (inaudible) this delay? Are you disappointed by this delay?

PM: Well, a couple of factors are real. Let's just be bottom-line about it - the Liberal Party have
backflipped on their historical position in support of an emissions trading scheme. The rest of the
world has been slow to act, or slower to act on appropriate action on international climate change.
The real deadline facing us is the expiration of the current Kyoto commitment period, which
concludes at the end of 2012.

We think this is a responsible course of action. As I said before, our commitment to the greenhouse
gas reduction targets that I've outlined before remains unchanged. Secondly, our commitment to the
introduction of a Carbon Pollution Reduction Scheme as the most effective and least expensive way
of proceeding in action on climate change remains unchanged.

However, given that international action has been slower than was originally anticipated and given
the fact that the Liberal Party has now backflipped completely on this position and therefore the
legislation has not been passed, given those two factors, it's very plain that the correct course
of action is to extend the implementation date and to assess the action by other states at the end
of 2012, at the end of this current Kyoto commitment period.

JOURNALIST: Why not negotiate again with the Greens?

PM: Well, our doors have always remained open to negotiating with people from all sides of
politics, but when you have one side of politics saying that you cannot act on climate change
effectively through an emissions trading scheme, and another side of politics who would happily
close the economy down tomorrow, it makes life a bit of a challenge. Therefore, we remain open to
the possibility of discussions with all sides of politics. Our commitment to acting on climate
change through a Carbon Pollution Reduction Scheme remains unchanged. Our commitment to the targets
that we have announced before remain unchanged. What we are doing is extending the implementation
period for a Carbon Pollution Reduction Scheme, and one which is linked, therefore, to the
conclusion of the current Kyoto commitment period, which ends at the end of 2012.

Our actions in place right now as a country remain consistent with our obligations through until
2012. What we need to make a judgement of is what happens post-2012 and what the rest of the world
is doing, because the rest of the world and what they do is pretty important in terms of
Australia's future actions as well.

JOURNALIST: Speaking of the economy, how can businesses make investment decisions if they don't
know when the scheme will start or what form it will take?

PM: I think the question of business certainty is best addressed by dealing with 1) the
international realities on climate change and the actions by other states, 2) making a considered
assessment of the actions taken abroad and at home, and 3) ensuring that therefore the future
course of action is explained clearly to business and a timetable for its implementation. I've
today indicated what the extension of that timetable would be and the reasons for it.

JOURNALIST: But there's no indication of when it would it would start. They've said that they're,
you know, they're playing a waiting game.

PM: What I've indicated, well, on the question of delay, I think that's a question you could
appropriately put to the Leader of the Opposition. Remember, the Government actually negotiated an
arrangement with the Liberal Party, which was adopted by the Liberal Party, accepted by their Party
room, and then they removed their leader. That's the reason why this legislation was not introduced
at the end of last year. Let's be very clear about that.

Secondly, on the question of the timetable for the extension I've just spoken of, it's very clear -
that is, the conclusion of the assessment period would be at the end of 2012, which is the end of
the Kyoto commitment period.

JOURNALIST: Home insulation - were jobs considered more important than safety?

PM: For the Government, the importance of safety has always been paramount. Obviously, the
Government has said before there have been real problems with the implementation of this scheme and
let's just call a spade a spade. That's why we commissioned the Hawke Review, that's why various
other reviews are underway as well, and we will of course respond to their recommendations.

There have been a range of recommendations contained in Hawke. I'm sure various other bodies which
report on this will make other recommendations as well.

Our job, now, is to deal with the problems on the ground as they exist within individual households
across the country. That's what Minister Combet is doing, and to deal with that effectively through
the inspection program which he's unfolding. But plainly, plainly problems were made in the
implementation of this program.

JOURNALIST: But was the aims of this, in terms of the urgency given to job creation and safety, of
the two, which was the more important?

PM: For the Government, safety has always been the number one priority, but I've said also there
have been problems with the implementation of this and let's be very clear about that. I think
everyone would accept that, and the challenge now is to deal with the practical problems on the
ground. That's what the Government is seeking to do with the inspection program, and that is also
why the Government will be attending to any other recommendations which come forth in terms of
future action as well.

JOURNALIST: You've been called a creep for not responding to the Fullers, for not apologising,
rather, to the Fullers. Do you regret that?

PM: Can I say that any family that has lost a member of its family through accidents of this
nature, any human being must feel regret and sorrow for what has occurred. Certainly, when it comes
to the Fuller family, I, together with other ministers of the Government, are deeply sorry for what
has occurred as it affects their loved ones and nothing, no action, actually brings those loved
ones back.

JOURNALIST: Did you forget who Kevin Fuller was?

PM: I beg your pardon?

JOURNALIST: Did you forget who Kevin Fuller was?

PM: The discussion that I had with the Fuller family was a good and long discussion, a very
difficult discussion, a very personal discussion, and the Government and ministers, and myself, are
deeply sorry for the loss of life which has occurred, and that goes to the loss in the Fuller
family and in other families as well.

JOURNALIST: Did you forget who he was though, when you saw him?

PM: I'd rather not go to the detail of a very long conversation, and what I've said today is
consistent with the thoughts and the feelings I sought to bring to bear in a very difficult
conversation with a deeply bereaved family.

JOURNALIST: Just getting back to the beginning, you mentioned that we have 18 (inaudible) present.
When will we have a specific idea about how many resources Nepean will see (inaudible) be

PM: I'd rather not give you a specific timetable on that because I think it's very important that
we get the planning right and the delivery right so that people's expectations are met and not
disappointed. Therefore, when it comes to this expansion of services here at the Nepean Hospital,
what we have done at a national level is make sure that the investment in the number of sub-acute
beds is significant. It's 1,300.

If you look at the Bennett Commission of report and their analysis of the shortfall in the
investment in sub-acute beds nationwide it is described by Commissioner Bennett as the missing link
in the entire system. She was previously, I believe, a CEO of Westmead. She has familiarity with
what happens in Western Sydney, so, therefore, mindful of what she has said, there's a big national
investment in this. Now it's a question of making sure the distribution of these is right across
each state and within each state and working closely with the state planning authorities and, as
they emerge, the local hospital networks to make sure that is right, but once we have an
implementation schedule for that, then of course we'll make that public. I just don't want to, as
it were, shoot from the hip and get it wrong. I think it's far better-

JOURNALIST: (inaudible)

PM: Sorry?

JOURNALIST: Do you have an idea yet of how small they'll be? Is there an idea that they can be

PM: Having spoken this morning with the clinical leaders here at Nepean, what they are concerned
about, of course, is to make sure that they have a bigger say in the future. What they're concerned
about is how local doctors and local nurses and local allied health professionals have a real say
in how the health dollar is distributed in a community like this.

At present, I think it's fair to say that here in New South Wales the health areas of the states
are too large. I think that's recognised also, now, by the State Government as well, so-

JOURNALIST: I just want to ask one quick question about the ETS, sorry, if you wanted to finish.

PM: Thank you. It's a pretty important question for the local communities about how these things

So, therefore, the key thing is to make sure that your local hospital networks are properly tied
into the local communities of interest and how they are properly linked, functionally, to the big
tertiary hospitals as well.

Therefore, I'm not in the business, from Canberra, of saying where a particular line should lie.
For example, if there's going to be a local hospital network out here, and I assume there will be,
where should it start and where should it stop. What we need is some ground-up consultation from
the community to make sure we get that as right as possible.

There's one other factor which locals may be interested in as well. To make sure that those lines
remain as closely allied as possible to where we have any local divisions of delivery for primary
healthcare and we've got to make sure that the primary health care is better organised and better
delivered and better integrated with what happens in the hospitals, and frankly what happens within
aged care.

Where I'd like to move to over time is to ally the local hospital networks and their geographical
footprint, the geographical footprint, also, of the primary healthcare organisations and those of
the aged care networks so that we have systems which properly talk to each other so the patient
actually becomes first.

I'll take yours. I better off. I'm late inside.

JOURNALIST: Just back to the ETS, who made the decision to delay?

PM: These have been deliberated upon through our Cabinet processes over a period of time, as you
would expect, and the decisions that we take on the future of climate change are never taken
lightly. Climate change remains a core concern of the Government. It is a core concern of the
community. It is a problem which will not go away.

That is why we take these decisions carefully and deliberately and after much deliberation about
action at home, action abroad, action both through emissions trading, actions when it comes to the
role of renewable energy, actions when it comes to energy efficiency, actions when it comes to the
application of the new and increased Renewable Energy Targets.

All these things together at home, together with action abroad, add up to a real difference for the
planet. That's why we're carefully calibrating this as an integrated strategy for the future,
because this, as much as others may wish, will not simply go away. It requires real action for the

Thanks folks.