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Tuesday, 16 August 2011
Page: 8203


Ms HALL (ShortlandGovernment Whip) (18:46): It is no surprise that I follow a member of the opposition who, once again, has made his contribution to this debate by attacking the legislation and opposing it. He talks about how a patient asks how they will access a GP when they need it. He made a commitment to rationalise health services and he talks about Medicare Locals, and when he does that it shows that he has very little understanding of what a Medicare Local is and very little understanding about how it will operate. He also has no historic knowledge of what has brought us to the point we are at today.

The first step that brought us to where we are today came about in November 2006—or before that, when the Health and Ageing Committee tabled a report, the Blame game.The inquiry took place over the period from when the Howard government was elected in 2004 and it was conducted because the now Leader of the Opposition, the then health minister, thought that our health system needed reform.

The first recommendation of the Blame game was that the Australian state and territory governments develop and adopt a national health agenda—exactly what both the Rudd and Gillard governments have done. The national health agenda was to identify policies and funding principles to initiate and rationalise the roles and responsibility of government including their funding responsibilities. They were to improve long-term sustainability of the whole of the health system, support the best and most appropriate clinical care, support affordable access to best practice, rectify the structural and locative inefficiencies in the whole health system, give a clear articulation of the standard of service that the community could expect, redress inequities in the service quality and access, and provide a reporting framework on the performance of health services, providers and government. That is recommendation 1. The National Health Reform Amendment (National Health Performance Authority) Bill 2011 we have before us today does exactly what the last dot point says. It provides a reporting framework on the performance of health service providers and government.

I will just take us back to that Howard government of 2004 when the Leader of the Opposition believed that we should have health reform. He could see that there were inequities within the health system. He saw that the blame game existed where state and federal governments tended to shift the blame if something went wrong instead of taking responsibility. The whole package looks to deal with that, and this particular piece of legislation looks at the reporting framework.

I will also add for the benefit of the House, that this piece of legislation was referred to the Committee on Health and Ageing. We conducted a hearing into the legislation and we supported the legislation. We supported the establishment of a national health performance audit authority and we could see that this was about: making sure that we had national transparency and accountability; the identification of high-performing parts of the health system; the identification of those parts of the health system that needed to undergo some improvement; and improving the health choices of Australians in making decisions about their own healthcare needs. When this particular piece of legislation was referred to the committee—and it is part of the whole tranche of legislation that is being considered in relation to health reform—we decided that the legislation was good legislation. But we also recommended an improvement in the legislation, that an additional requirement be incorporated into clause 60(1)(b) of the bill to require that an annual report on the performance of local hospital networks, public hospitals, private hospitals, primary healthcare organisations and other organisations that provide healthcare services be compiled by the performance authority and presented to the Minister for Health and Ageing for presentation to the parliament. That was included in the recommendations of the committee. That was the only change that was made. That was made to improve the transparency and accountability and to bring together this health reform agenda.

The member for Bowman was not at all supportive of Medicare Locals in the region I come from, which is the Hunter and the Central Coast. The Hunter has its Medicare local appointed. It is GP access. The Hunter Division of GPs, who have extensive knowledge of the needs of the area, have been involved in providing after-hours service for a very long period of time and truly understand the needs of that area. The Medicare local has not been appointed yet on the Central Coast. It is important to note that, prior to the Medicare Local areas being identified, the Central Coast was part of northern Sydney. The North Shore of Sydney and the Central Coast were lumped together. You cannot tell me or any member of parliament from the Central Coast that those areas have the same needs. They are very diverse areas. The people who live in those areas know that what they need is different to what the people living on the North Shore of Sydney need. They know they do not have the same access to services as the people living on the North Shore of Sydney. This legislation delivers local solutions to local areas. This legislation looks at the transparency and the accountability that is expected from the government.

I cannot talk on this legislation without congratulating the Prime Minister on the agreement that was reached on 8 October. The Gillard government has delivered national health reform with an agreement now in place between every state in this country—something that was never achieved by the now opposition when the Leader of the Opposition was the Minister for Health and Ageing. Rather than division we have a positive outcome. We have something to move forward on. People are working together. We have reforms in place that guarantee more money, more beds, less wait and less waste. They also deliver better GP, primary and aged-care services—something that the previous Howard government could not do. Most importantly, it will end the blame game and the cost-shifting that marked the Howard government years. Why do I say that is the most important thing? Because that blame game and cost-shifting saw thousands of Australians go without their health needs being met. This is about delivering to Australians who had been marginalised by the Howard government during its time in power.

The reforms will, as I have already mentioned, deliver more money. There will be an extra $19.8 billion for public hospitals, covering 2.9 million more emergency cases. My daughter-in-law works as an accident and emergency nurse. I know how busy she gets. I know the constraints that are put upon them. This extra money will mean they will be able to deliver services to those patients who visit the accident and emergency department. It will cut the time that they have to wait in accident and emergency. The staff working in accident and emergency will have the support to do the things that they know need to be done. There will be two million more in-patient services, like major surgery, and 19 million more outpatient services, like minor operations and physiotherapy. People have had to wait not for weeks or even months sometimes but years to obtain those services in the public system.

As I have said, this is about delivering services to Australians in their community when they need it, in a timely fashion. It will mean more doctors. There will be 5,500 more GPs and 680 specialists trained—something the previous government failed to do. Instead of addressing the chronic shortage of doctors, specialists, allied health service providers and nurses, they exacerbated the shortages. There will be more local decisions. That is the Medicare Locals. The decisions will be made by the clinicians, the hospital staff and the community who know the needs of the community they live in.

These reforms also deliver less waste. Hospitals will be funded for what they actually deliver. There will be shorter waiting times in emergency departments and for elective surgery. Instead of people going on a waiting list and having to wait years—and I mean 'years'—to have surgery, it will happen a lot quicker. The reforms will also deliver better GP, primary and aged care. There will be more after-hours services, new GP training places, new GP superclinics and direct Commonwealth responsibility in most states for basic community care for the over-65s.

I want to commend one program that saw four GP practices within the Shortland electorate receive money. Under the health infrastructure program Jewells Medical Centre received $500,000. The facilities they are building there are fantastic. Not only will they be able to have more doctors working out of there, provide training for doctors and work very closely with Valley to Coast but they will also have room there for allied health professionals, like dieticians and psychologists. Even occupational therapists will be able to come in and work out those rooms providing, once again, local services to local communities where there is a need identified. The Labor Party is the only party that really cares about hospitals and ensuring that people can get services when they need them. We care about making sure that services are not determined on your ability to pay or where you live but on your needs. We are about fixing the blame game—something that the previous government did not do—and we are delivering the hospitals and community care to Australians when they need it.

As I mentioned earlier this particular piece of legislation was looked at in great detail by the Standing Committee on Health and Ageing. The bill stipulates that the performance authority also has the role of formulating performance indicators, collecting, analysing and interpreting performance information, and promoting, supporting, encouraging, conducting and evaluating research. This is vital information. We can have all the extra services, we can have Medicare Locals operating and we can stop the blame game, but if we do not have in place the proper accountability, the proper reporting requirements, then we cannot guarantee that our health system will operate as effectively and efficiently as it should. This is good legislation. It is about the Gillard government stopping the blame game and delivering health services to all Australians.