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Wednesday, 25 March 1998
Page: 1589


Mr FORREST (6:34 PM) —I suppose, in taking the lead of the member for Cunningham (Mr Martin), I need to declare an interest as well. The lady that has been married to me for 25 years is also a nurse. Rather than that creating any conflict, however, I think that that means I am well informed about the health care system.

I have not heard all the contributions to the debate this evening, but I was interested to hear the member for Cunningham because he spoke glowingly about the health care system that is delivered in his part of the world. I think it is very sad that in the last few months we have seen outrageous comments about the health care system; that it is in tatters; that it is a mess. In fact, I think I heard the member for Lyons (Mr Adams) in his contribution earlier say it is a mess.

The reality is, Australians should look around them, beyond our own borders to other nations. I think they would come to appreciate that the health care system we have is second to none. Sure, there are some immense challenges involved, and to have a good Medicare system and a good health care system requires funding. That is where the debate is focused. It is the debate that the member for Cunningham made reference to, how to fund the best health care system that we can deliver. Many of those Australians he made reference to live in my part of the world. They have been so committed to their health care system that they have done more than the member for Cunningham's communities; they have dug into their own pockets and built in the last 50 years their own community hospitals, bush nursing hospitals, funded entirely by the communities themselves.

The sad reality for them over the last 15 years is that their access to funding must come via the health insurance system. With a declining participation in that system, hospitals, particularly those bush nursing hospitals in my part of the world, are struggling. What it means is that the electorate of Mallee has the largest number of private hospitals of any electorate in Australia but it comes because of the commitment of the communities themselves.

So there are a great number of challenges, but I just want to debunk this fear that has been created about our health care system being in tatters. If I might just have some indulgence to give you an example. The young charter pilot who flies me around my electorate is the chief pilot for the Mid-Murray Flying Club—I am pretty fussy about my pilots. He tends to fly me pretty well everywhere. He rang early last week and said he had to go into hospital and could not fly me to this particular destination. He asked, `Would a substitute pilot be okay?' I said, `That's fine.'

Later on in the week this pilot did fly me around. He shared with me his misgivings about going into hospital for this particular treatment he had to have. His misgivings were driven by this public debate that has occurred over the last few months. He said, `I don't want to go to this terrible place that is such a mess.'

I would like to appeal to members of parliament who sit on the opposition benches. They should understand that every time they stand up and speak on a public platform condemning our excellent health care system, that has an impact on other people. He shared his experience with me, saying that his two days in hospital was a delightful experience, which is a strange way to describe a stay in hospital. The quality of care that was provided to him refreshed his view. It was a great credit to the staff and professional people at the Swan Hill and District Hospital that they left this patient with a favourable impression about the quality of health care they deliver.

I am very pleased to support the Health Legislation Amendment (Health Care Agreements) Bill 1998 . It is timely. It provides once and for all a framework that the parliament can sign off on so that we do not have this regular public bunfight with the states when signing the agreements. I was interested in the member for Cunningham's remarks and his reference to the current negotiation. He has been around this place a lot longer than I have. He would be aware that this negotiation happens every time, and that there have been some equally unfavourable public comments about agreements in the past. He should be mindful of that when he describes the events of last week's premiers conference.

This legislation will provide a platform with some tangible commitments to the future and a transparent process so that all of those players out there in the state arena have some predictable future on which to base their commitments to their own health care systems in their states.

As chairman of the Standing Committee on Family and Community Affairs, I have been refreshed. In the last 12 months we have had the privilege of tabling some very significant reports in this parliament. The evidence we have collected reinforces the capacity of our health care system to deliver to every Australian, no matter where they are located. Significantly, recently, which demonstrates the innovative character of the professions involved in health care delivery right around Australia, our report on health information was tabled last year and we are currently awaiting a response from the government.

When looking at our nation's history, we should remember the Royal Flying Doctor Service and the air ambulance. I have already mentioned the bush nursing hospitals, a particular feature of Victoria's rural health care service delivery. While many challenges and issues still exist, including attracting doctors to rural regions, I would like to place my comments on the public record. Please stop debunking our health care system. This legislation ought to put an end to the constant remarks that I hear from members of the opposition about the current government's commitment to Medicare. We are putting our commitment into legislation. Let us have an end to that debunking. Let us have an end to the history lessons. This legislation confirms the government's commitment, and I am very pleased to be able to support it.

The member for Cunningham's comments about the current negotiations with the premiers fails to acknowledge the fact that there are some real concerns from a Commonwealth perspective on the condition of the state based health care system. Cost shifting does occur. The Commonwealth does not want to be caught in the dilemma of funding all of what are state based constitutional responsibilities.

There is limited flexibility. If we are going to be embracing the new century and the concepts of telemedicine and health on-line, which is a real opportunity for us as a nation to deliver health care right out there to the rural and remote communities, we need flexibility in the committed arrangements. From my understanding and reading of this particular bill, it allows the minister some flexibility to deliver that very necessary innovation. There are some exciting things happening in that area.

The issues revolve around the lack of flexibility and also the lack of patient accountability in terms of where they go. One of the things that our standing committee observed is not so much the lack of information but the lack of a process to coordinate it. So if the Commonwealth or the states fund a particular program with an objective to deliver an outcome, it can be measured. Constantly our committee receives evidence that this does not occur. Sometimes it can be many years later before we receive information which is relevant to making decisions—decisions made with some haste—about what are good programs and what are not and what are therefore worth funding and what are not.

The concept of a health information coordinator has to be a good thing. I would like to see members of the opposition support in full the complete and comprehensive aspects that are addressed in this bill. I hope they will. Let us have an end to this political nonsense that goes on about the current government's commitment to Medicare and its failure to deliver a health care system.

Members of the opposition should sometimes go home at night, sit back calmly and listen to their remarks. They lack so much credibility, whether it is to do with health care or aged care. I make this appeal to the member for Jagajaga (Ms Macklin), who is present in the chamber. Whilst she is a new member to the parliament, she is not new to the process.

The remarks I often hear from members of the opposition lack credibility. The opposition represents a government that was sitting on the left-hand side of the Speaker in this chamber for 13 years, presiding over all of the difficulties that this government is now trying to address, including the difficulty of attracting doctors to rural regions.

This government has demonstrated its commitment to tackling this issue and to tackle it seriously. It is tabling, here in the parliament, its commitment to Medicare. It is bold and it is fraught with difficult politics but it is being tabled so that the government's approach to this whole concept is transparent for everybody to see. So let us be rid of the innuendo. I challenge members of the opposition to listen to what you say because the people that sit in the galleries here in this chamber and the people that watch—and many of them do, particularly question time—and see those remarks made from this place on this side of the chamber here just do not see any credibility. I would think that members of the opposition would be more interested in apologising to the Australian people and saying, `We are really sorry. We did not understand the nature of the difficulties you faced, especially those in the rural regions, and we want to support the new government in making up for it.'

The offer that has been made by the Commonwealth to the states is generous—$30 billion over five years. It is generous. It is disappointing to see premiers adopting the stance they have, no matter what state they come from. I have always worked cooperatively with my state colleagues. I do not want to brawl with them but I would say to them that this is an extremely generous offer. The government not only has the problem of delivering this high level of expectation that people have out there—they want a Rolls Royce health care system—but it also has to balance the books nationally.

We have demonstrated this commitment by making some very difficult political decisions and I think the Australian people understand that. That is the kind of government they want to see. They want to see a government that is prepared to make the hard decisions, to reduce our debt, to reduce our commitment to interest to service that debt and to protect us from the firestorm that is currently gripping those other near neighbours of ours who have not shown a responsible policy of fiscal management. Health care has to fit under that umbrella. What this legislation does is set up a framework under which we can manage the system with the objective of delivering the best. It may not be a Rolls Royce but it will be the jolly best Holden Berlina that we can provide because those Australian people out there deserve it.

There are a lot of other things I would like to have the time to say here but I am in deference to a long list of speakers who wish to speak on this bill. I will leave my remarks there by reinforcing the appeal I made to members of the opposition. I commend the bill to all members of the House.