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Transcript of doorstop: Parliament House: 17 August 2003: Australian healthcare summit, Medicare, COAG.

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Shadow Minister for Health



Subjects: Australian Healthcare Summit, Medicare, COAG

GILLARD: I’m in Canberra today to attend the healthcare summit being held at Old Parliament House. This is a meeting of more than 200 health professionals who are here because they believe our health system needs reform. It’s being attended by most of our State Health Ministers. Now, these health professionals believe that the need for reform is urgent and they are in despair because the Commonwealth Government is doing nothing on the reform agenda.

In April last year Senator Patterson agreed with her State colleagues that she would drive a reform agenda in 9 key areas. They were supposed to be looking at things like strengthening Medicare and bulk billing to take pressure off our hospital emergency departments because that’s where people go if they can’t see a bulk billing GP. And they were supposed to be looking at issues like having frail aged people who end up in acute hospital beds being accommodated in better settings. None of that work has been done. Senator Patterson has simply refused to attend a number of meetings with her State colleagues on the reform agenda and now she is refusing to attend the health summit.

I am calling on Senator Patterson again to put aside her pride, to come down to Old Parliament House and to listen to the best expert advice that is available about what should be done to reform our health system. I also note that Premier Bracks and Premier Carr have both indicated today that they share that frustration about Senator Patterson’s inability to deal with the health reform agenda. Both of the Premiers, on behalf of each State Premier and each Territory Chief Minister, have said that they are calling on John Howard to put health reform on the agenda for the next COAG meeting at the end of the month. I would agree with that call, federal Labor endorses that call, there is no more important issue for our national leaders to be talking about when they get together than health. John Howard should be putting health on the COAG agenda and he should be using the opportunity to end Senator Patterson’s war with the States and to ensure that the reform agenda, the vitally needed reform agenda in health, is brought to its conclusion.

JOURNALIST: But wasn’t it the States who didn’t want to talk about the reform agenda at the most recent meeting with the Minister?

GILLARD: It was the State Health Ministers that first raised the reform agenda, most particularly Craig Knowles when he was the Minister in New South Wales. It was the State Ministers who attended a number of meetings that Senator Patterson simply refused to attend. Since then, discussions have degenerated because Senator Patterson has put a ‘take it or leave it’ money offer on the table for the funding of healthcare over the next 5 years and most particularly for the funding of public hospitals. I’m not surprised that the States have reacted pretty adversely to being told ‘Forget


about the reform agenda, here’s the money’ when the money isn’t enough and when Senator Patterson isn’t prepared to work through the reform agenda.

JOURNALIST: Isn’t this just a squabble between a pack of academics, lobby groups and some politicians? Why should the punter be at all interested in this confrontation over this summit?

GILLARD: I think that people in our community are pretty concerned about what would happen if they, or a member of their family, got sick and needed to go to a public hospital. At the end of the day, the 5 year health care agreements between the Commonwealth and the States are about the funding of health care and most particularly the funding of public hospitals. I think people want to know that if they go to an emergency department of a public hospital, that they are going to be seen in a timely way and get quality health care. I think they want to know that if they are in a hospital bed they are in a hospital that is functioning at its optimum and is sufficiently resourced. I believe every Australian has got an interest therefore in the summit that is happening today and in what is going to happen with the 5 year healthcare agreements.

JOURNALIST: The summit is calling on the States to sign at least an interim agreement to guarantee funding for 12 months so that the deadlock can be thrashed out. Is that something you would support?

GILLARD: Absolutely. In the first instance, we would say that the question of health care should be put on the forthcoming COAG agenda; we would say that Senator Patterson should come down to the health summit today and restart the reform process. We would say that at COAG, health should be at the centre of the agenda and the reform process and if that means there needs to be a short-term interim arrangement while the reform process is brought to a conclusion, then so be it, but the main

thing is for the Federal Minister for Health, the Prime Minister to say ‘This is a priority’ and to start dealing with it.

JOURNALIST: Once the penalties kick in though, how likely is it that the States will continue to not sign the agreements when they are facing financial penalties? Isn’t this just a lot of rhetoric and they’ll come to the table eventually?

GILLARD: The problem for the States obviously is that the Commonwealth is blackmailing them. It’s saying ‘We might have started a reform agenda with you, we might have been prepared to talk about bulk billing, we might have been prepared to talk about aged care, now we’re not prepared to talk about those things anymore. Here is a sum of money, take it or leave it, and if you leave it, we will make sure that you suffer penalties.’ Now I think that people who would worry about having to go to a public hospital would be pretty concerned that public hospital services could be cut back because those penalties come into place because of the Commonwealth’s belligerence about this agenda. There are big pressures on States, that is true, but the States are saying one clear thing: ‘Let’s sort it out, let’s start sorting it out at COAG’ and I don’t see any reason why a Prime Minister who cared about health and cared about public hospitals wouldn’t agree with that.

JOURNALIST: The ACTU says today that two-thirds of Australians want an increase in the Medicare levy to pay for health care. Have you got the guts to do that?

GILLARD: Look, in terms of financing, what we do know is the biggest issue in front of us right now is the way in which our public hospitals are going to be financed through the health care agreements for the next 5 years. That’s the issue that urgently needs to be dealt with, that’s what the health summit is about, it’s what Premier Bracks and Premier Carr have talked about today. In terms of the general financing of health, what we do know of course is that the Medicare levy only funds a very small proportion of our health system. The rest is funded out of taxes. At the end of the day, budgets are about priorities and we have shown, from Labor’s point of view, that we are prepared to put a priority on health, with the construction of our $1.9 billion Medicare package where we’ve said that health care was more important than some corporate tax arrangements that the Howard Government was proposing.


JOURNALIST: (inaudible)

GILLARD: I can understand why Australians are well and truly sick of the buck-passing and cost shifting that has gone on in our health system and that is what the reform agenda is about. The reform agenda that was started by the Commonwealth and the States in April last year was supposed to address all sorts of inefficiencies in the system, all sorts of cost shifting issues, to try and get a more modern, more streamlined system. Now it is the Commonwealth that has decided it doesn’t want to be a part of those talks and I think Australians are entitled to say ‘Well, we don’t want our Federal Government walking away from as important an issue as reforming and modernising our health system.’ And I think voters will want to hold the Commonwealth to account for that.

JOURNALIST: Are you ruling out an increase in the Medicare levy under Labor?

GILLARD: In terms of financing, once again, I think this is a common misconception. It would be an error to focus on the Medicare levy. The Medicare levy, in fact, finances less than 10% of health expenditure. The vast majority of health expenditure is financed out of taxation revenue. We’ve indicated that: (1) we support the reform agenda, we believe that every dollar in the health system should be working as hard as it can to get a health outcome and with the cost shifting, with the irrationalities of the current system that doesn’t happen and it should happen. (2) We’ve said we believe budgets are about priorities and when a Labor Government is weighing up the priority for health against other priorities, we’ve already shown a preparedness to put health first and we did that in the Medicare package.

JOURNALIST: Wouldn’t increasing the levy help arrest the decline in bulk billing?

GILLARD: Once again, there isn’t an equivalence here in terms of what Medicare pays for. Medicare is a far bigger system paid for by general taxation revenue as well as the Medicare levy. We’ve got a $1.9 billion fully costed policy on the table to bring bulk billing rates back up to 80% - that is where they were when Labor last left office and when Medicare was working and everybody knew that it was working. We don’t need any increases in the Medicare levy or indeed in any other form of tax or revenue to finance that package. It is a fully costed package.


17 August 2003

For further information contact: Jamie Snashall on 0407 438 746