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Sky News On The Hour 10am -

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Subjects: National health reform; Newspoll; banking reform; Australian Labor Party; Immigration

MINISTER ROXON: Thank you very much for coming here bright and early this morning. It's a very
great pleasure to be here, Dr Lim has hosted us in her General Practice. She's a GP of more than 20
years standing and very much loved by her patients as we've just seen. So thank you for letting us
come to your practice.

I'm delighted to be here with the Prime Minister, the Minister for Mental Health and Ageing and Gai
Brodtmann, the Member for Canberra. We're here to release the guidelines for the establishment of
Medicare Locals, to call for applications for Medicare Locals, the first of which will start on the
1st July this year, another 15 on the 1st of January next year and the remaining number by the 1st
July 2012.

So I'm delighted that the Prime Minister's here to bring a bigger focus onto primary care and I
will hand over to her and of course we will distribute these guidelines, the application process
for them and I'm sure that you'll have questions to ask and a very proud general practitioner who
no doubt will want to tell you about her practice as well so over to the Prime Minister.

PM: Thank you very much to Nicola and thank you very much to Dr Lim for having us here and to my
colleagues for joining me. We of course talk a lot about health and when we talk about health,
politicians on TV screens, people often think it's all about hospitals and hospitals are really
important, what happens in our public hospital system is so important to community members. And
that's why when we struck the health reform agreement we were very focussed on making sure that our
hospitals could be better for the future, that they were properly funded with more than $16 billion
of new resources, that there was a change in the funding system, so that the Federal Government
would be an equal partner in growth and that there were changes which would empower local
communities, which would mean less waste and less red tape and less waiting time.

So hospitals are important, but often we don't talk enough about primary care, the care than
happens in our community and can keep people out of hospitals. From the point of view of
individuals, if the primary care system is working for them they get the care they need from the
practitioner they need it from at the right time. They don't have to worry about who to go and see,
because when they see their local doctor, when they go to their local health care service, they can
get a coordinated package of care which meets their needs.

And in the modern age so many Australians struggle with chronic and complex conditions and whilst
they need a great general practitioner, they often need so much more - access to a dietician,
access to a podiatrist, access to other health services that'll make a difference to their needs.
We know from the point of view of the health care system, if we can keep Australians out of
hospital by keeping them then that is better for the system. By international standards Australia
has very high hospitalisation rates and we want to change that by having great care in the
community, so I'm very proud to be here today to announce the guidelines for our first section of
Medicare Locals.

When I announced our health reform agenda, coming out of the Council of Australian Governments
meeting, I said I wanted to see a national health reform agreement for hospitals, but I also wanted
to put a greater focus on primary care. Medicare Locals are the bodies that will coordinate primary
care in the community, today we announce the guidelines and we want to get the first 15 Medicare
Locals up and going from the middle of this year and the second 15 Medicare Locals up and going
from the 1st January next year. I've determined we should have more Medicare Locals and we should
have the come on stream more quickly.

What Medicare Locals will do is they'll be able to bring together our primary care system so that
patients can get the coordinated care that they need. I've also sought to invest in our primary
care system by making sure we bring on stream two years early, access to after-hours consultations
and that will happen from 1st January next year, with our new after-hours hotline coming on stream
on the 1st July this year.

And I want to make sure that there's transparency in primary care, so people know how their local
primary care is going, so they know how health care is going in their local community. I also want
to make sure that Medicare Locals over time become fund holding organisations, so they've got the
ability to get service gaps in the local community filled, so if there isn't enough of a particular
service available Medicare Locals can make a difference to that.

We've had the opportunity today to talk to Dr Lim and what she's stressed to us is in her clinic
here she's got access to a range of services, she said it was on more than one occasion that as a
general practitioner she can't do everything and that meeting patients needs is about team work,
that's what Medicare Locals are about, bringing that team work to local communities.

Now if it works well from the point of view of the patient, they'll get the care they need, they
mightn't see this big engine behind that is driving that coordinated care, that will be work that
happens between practitioners, but it means a patient will be able to get the coordinated care that
they need.

So I think today is an exciting development as we continue to make sure that patients get a better
deal with health care. I'm very happy to take any questions.

JOURNALIST: So Prime Minister are you saying that a patient will never actually see anybody working
in these Medicare Locals?

PM: Of course, they'll see their primary care practitioners and the primary care practitioners will
be working together through the Medicare Locals. What I want is not for the patient to worry about
'who should I go and see next, how do I get my care coordinated, how many times to I have to give
my records to people, how many times do I have to tell my story about my health care problem'. From
the point of view of the patient I want them to get access to the services that they need, because
the practitioners are collaborating through the Medicare Locals, that's what I mean by the engine
being there, bringing the practitioners together. I don't want patients to have to worry about that
machinery; I want patients to get the care they need.

JOURNALIST: Who will pay for the allied health care that they might need, that the GP would want to
refer them to, which isn't covered by Medicare at the moment?

PM: Well we have various programs which assist people to get allied care, particularly when they
have chronic and complex diseases which mean that they need access to a coordinated package of care
and ultimately I want Medicare Locals to strengthen our primary care system by becoming fund
holding. But with Medicare Locals coming on stream this year and with more of them next year, what
we will see is a development where there is more coordination and more focus on primary care. I
believe that's what our health care system needs, we don't want people ending up in hospital if
they could have got the care they needed in the community and that they could have been kept well
in the community rather than ending up in a hospital.

JOURNALIST: More coordination ain't going to work if the patient can't afford the physio or
podiatrist.

PM: Certainly we have programs to support access to a broader range of services and that's
important, but the coordination is important too. Patients, many of them these days present with
conditions that require access to a range of services. You take Type II diabetes, yes you need to
see your general practitioner, you may also need to see dietician, or go to an education class to
help you manage your diet, you may need to see a podiatrist because of circulation problems, if you
can get that package of care coordinated for you that's what Medicare Locals are about.

JOURNALIST: These after-hours services that will be offered, will they be bulk billed, because if
they're not, won't they still be an incentive for people to roll up at the hospital emergency
department?

PM: Our aim with after-hours is to make sure people can get access to assistance over a telephone
line, often people need reassurance and need some help, they need a sense of whether or not they
need immediate assistance or they have something that they can go and see a doctor about in coming
days. And then we want people to be able to access consultations after hours, we will be making
appropriate arrangements for that and there are parts of the country where after hours services
work well now and meet people's needs. Often for people it's just that they don't know where to go,
don't know how to get help, the hotline will help with that and then after-hours access will help
with that.

JOURNALIST: So there's no guarantee they'll be bulk billing?

PM: We will be working to bring services on stream that will meet people's needs, but for many
Australians they simply don't know how to access an after-hours consultation and in their local
community at the moment there's no mechanism to enable them to do that. The hotline will make a
difference and then bringing on stream two years early our access to face to face consultations
will make a difference too.

JOURNALIST: But the co-payment issue is becoming bigger all the time, it seems you've got radiology
patients storming the battlements today over the claims that the gap is becoming too big for people
to access diagnostic care, what do you say about that?

PM: Given the dramatic wind up to the question, I'll ask the Minister for Health to answer.

ROXON: I'm please that you have asked that because despite the storming of the battlements that I
think you say, actually the bulk billing rate for diagnostic imaging is at an all time high. That's
because our government introduced a bulk billing incentive 18 months ago or so. That is working
well. There are still people that do have to pay co-payments and we obviously do all we can to make
sure that we reduce that number but we do have a system where there is some balance provided by
making sure there is good access to bulk billing services. We have an all time high for bulk
billing services for GPs. That is good news for the community and as the Prime Minister has made
clear of course people won't pay for the telephone service, a service that ultimately will also be
an online service that will be free of charge to the public and our new after-hours incentives are
going to mean that it's possible to coordinate better across an area, so if its Dr Lim's practice
or another practice there's an opportunity to work with other neighbouring GPs to provide services
after hours, hopefully in a way that makes it more cost effective for them and hopefully more able
to be bulk billed or at a lower charge to the patient

JOURNALIST: Pathology rebates haven't been increased or indexed for 13 years, why is that?

ROXON: Well as you would know Sue that's because for ten of those years there were two memorandums
of understanding with the diagnostic imaging which is a price and volume agreement struck by the
Howard Government. At the request of the industry that agreement was not renewed at the end of the
second five year period. We've been in discussions with them, there's been a review for both
pathology and diagnostic imaging that is close to completion and of course what you're seeing now
is a campaign, one where you wouldn't expect people in an industry to ask for less money for their
industry but we have to temper those with the needs of the community. Our consideration for
investments that are made will be putting patients first and making sure that we have a strong and
viable health sector.

JOURNALIST: Prime Minister, why do you think Labor's done so well in the latest poll, or why is the
Coalition doing so poorly?

PM: I said a few weeks ago that we had a lot of hard work to do and there's nothing about anything
today that has changed my view. We've got a lot of hard work to do and we'll get about doing it.

JOURNALIST: Prime Minister has the Australian Government has any update on what's happened in Libya
overnight and do you think it's time for Western intervention?

PM: Thank you for that question and I'm sure many Australians have been very shocked at the images
they've seen on their TV screens of such widespread violence in Libya and also deaths in Libya.
Firstly can I just address the circumstances for Australians, our travel advisory says do not
travel, so I'd say to Australians who may have been contemplating travel to Libya for any reason,
our travel advisory says do not travel.

For Australians who are in Libya and on our advice in terms of registered members of Australians,
there are relatively limited numbers, we are talking around about 80 Australians. Our advice to
them is to travel out of Libya if it is safe for them to do so, we are starting to canvas
evacuation options should that be necessary.

On the general circumstances in Libya, we condemn in the strongest possible terms the violence that
people have seen on their TV screens, we condemn in the strongest possible terms the use of the
military against peaceful protesters. There is no excuse and no tolerance from the Australian
Government for violence being wreaked against peaceful protestors. So our message to the government
of Libya, to Colonel Gaddafi, is that they must respect peaceful protest.

JOURNALIST: And can governments like Australia and the US (inaudible) say that to Libya
(inaudible)?

PM: I think what we can do is put pressure on Libya to respect the wish of the Libyan people to
engage in peaceful protest. We will be making that point very strongly to the Libyan Ambassador
here and the world will be joining in condemning the scenes that we've seen and the use of the
military and security services against peaceful protestors. We condemn it outright and absolutely.

Across the Middle East and in Libya we are seeing an outpouring of people's pent up demands for
more freedom, for democracy, for a say in the running of their societies, that's what we're seeing
in Libya now and the peaceful protest that people are engaged in should be respected and not met
with this kind of gross violence.

JOURNALIST: (inaudible) plan to abolish exit fees despite receiving advice back in October that it
could actually costs customers more?

PM: The government believes that our moves to increase banking competition, including getting rid
of bank exit fees, will get a better deal ultimately for customers, that more competition is good.
If the banks go in competing hard for people's business, then consumers will get better deals and
in fact over recent weeks people will have seen major advertising campaigns from the banks out
there, offering deals to consumers going in to get consumer business offering better deals as a
result.

So that's what our competition package and banking reforms have been all about, making sure that
the customer has choices, the customer can take their business from bank to bank and the customer
therefore can require their banks to give them a better deal, that's why we didn't want to see exit
fees that lock people in into one product and prevent them saying to their bank, I'm going down the
road for a better deal.

JOURNALIST: Did you get that advice and did it worry you at all?

PM: You've got to strike a package here and government has to make the decisions that it believes
are in the national interest and we certainly believe it's in the national interest to not have
people handcuffed to banking products they no longer want and not able to use their ability to say
to their bank I want a better deal or I'm taking my business elsewhere.

JOURNALIST: Prime Minister, Kevin Rudd has asked that that the ALP review, the Labor Party
eliminate the power of the factions, factional leaders. He's also asked for the report to be
released publicly, will you release the full report?

PM: The report is in the hands of the National Executive and it will make the arrangements about
this. For me I'm focused on the future, focussed on governing in the best interests of the
Australian people, that's what we're doing today and that's what Nicola Roxon and I have been
working on with our health reform plans including these plans for Medicare Locals.

JOURNALIST: You don't support releasing that review?

PM: This is a matter for the National Executive; we're a party of government and a party of ideas.
I'm happy to see ideas debated by the Labor Party, we're a party of government, we're getting on
with the job of governing in the interests of the Australian people. Health, the health care system
is very important to Australians, but they want to know the public hospital is going to be there if
they need it, they want to know they can get the care in the community that they need. That's what
we're talking about today and making progress in with Medicare Locals coming into existence on the
1st July.

JOURNALIST: What's your response though to claims that that review actually points the finger at
yourself for some of the campaign bungles?

PM: I'll let other people chew over history, we'll get on with the job of making a difference to
Australians.

JOURNALIST: Prime Minister what do you make of Scott Morrison's motion to the House last night to
cut the number of asylum seekers coming by boat and then Judy Moylan's reaction speaking out
against it in the House?

PM: I made my views about the conduct of the opposition very clear in the House yesterday; we are a
country that's got a proud bipartisan history of having a non-discriminatory immigration policy.
It's been something that's been treasured and prized by Labor governments and Liberal governments
and as I said in the House yesterday there are a number of Liberal Prime Ministers who should be
applauded for the stance that they took in favour of our non-discriminatory immigration policy. We
are not a nation that believes in discriminating on the basis of religion.

I believe the Leader of the Opposition has to show some leadership on this matter, we have now a
very very dreadful spectre haunting the Parliament and the nation of discriminating in our
immigration policy on the basis of religion. The Leader of the Opposition has to confirm that he
stands for a non-discriminatory immigration policy, they will hollow words unless he moves to
replace his Immigration Spokesperson and his Parliamentary Secretary.

JOURNALIST: Prime Minister on that matter, I wonder what you make of the radio station that
conducted a quiz asking callers to (inaudible) the number of asylum seeker deaths, did you hear
about that one?

PM: I saw a report of it in today's newspapers and it's absolutely revolting.