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Speech to the National Health Summit, Canberra



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THE HON. BILL SHORTEN MP LEADER OF THE OPPOSITION

SHADOW MINISTER FOR INDIGENOUS AFFAIRS AND ABORIGINAL AND TORRES STRAIT ISLANDERS MEMBER FOR MARIBYRNONG

NATIONAL HEALTH SUMMIT

FRIDAY, 3 MARCH 2017

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Good morning everybody.

When I look at all the people in this room with so many views to contribute, so much

experience, I guess like a lot of good ideas, it makes me wonder why we haven't done

this before now. But we're here and I'm really looking forward to today's proceedings.

I would like to thank Aunty Agnes for her welcome to country.

I acknowledge the traditional owners of the land on which we meet and I pay my respect

to their elders both past and present.

And - in the spirit of today’s gathering - let us pledge to help close the gap in health

outcomes and life expectancy, between our First Australians and all other Australians.

I want to join our Shadow Minister for Health, Catherine King, our Shadow Minister for

Ageing and Mental Health, Julie Collins, the Assistant Shadows, Deb O'Neill and Helen

Polley - and all of my Labor colleagues including Jenny Macklin, but not just Jenny - to

say thank you for joining us.

You're busy people. You have scarce time and the fact that you choose to give up some

of that scarce time to help contribute to the political debate about the future of health

care in this country, we are very grateful for.

But perhaps before I get into the health part of my address, I'd just like, for a moment,

talk about politics - it's an occupational hazard in this building.

There is, and I think you all see it, a degree of disenchantment and cynicism about

politics as usual in this country.

Whilst we don't necessarily see some of the electoral outcomes in Australia that they've

seen other parts of the world, there is a definite disenchantment with the mainstream

parties.

That doesn't mean that the people who are disenchanted automatically agree with all

those on the fringes and what they say, but they want to say mainstream politics lift up

its socks so to speak. And I think part of that is reconnecting with people.

We have a Westminster system of politics that's adversarial - you test ideas.

But too often now, in our political system, the adversarial system becomes a game of

destruction.

And at that point the policy seems to cease being the main issue.

Question Time turns people off to be honest. It seems like a whole heap of schoolyard

antics, for want of a better metaphor.

And in the meantime, people say why don't they talk about the issues which affect us?

Why don't they just get on and do something for us, the people.

Today is part of Labor's approach in this term of Parliament to demonstrate our

commitment to be doing things for people and with people and talking to people, not at

people.

I think there's a sense that parliamentarians, in some measure, have sold part of their

status for the 8-second grab on the nightly news. That is part of how people consume

politics, but there is a hunger, I believe, for a deeper political discourse.

There is a desire to see people talk, not just about the next opinion poll, or the next

election, but the next decade, the next generation.

I think there is an almost measurable anxiety: will we be the first generation of

Australians to hand on a lesser standard of living, a lesser quality of life to the next

generation?

And I think all of these matters, all of these matters circulate when people view the

deliberations in politics.

That is why, we're gathering here today.

That is why we want to talk about healthcare.

My team and I are here to listen to the experts. We are here to listen to people on the

frontline - to the researchers, the policy makers, to the people who see how the system

works.

We want to hear what the problems are - and we want to hear what your solutions are.

I have tremendous respect for Australia’s healthcare system - and I have tremendous

respect for everyone who works in our healthcare system.

On so many measures, Australians enjoy a world class healthcare system.

We have one of the best-trained and most-dedicated health workforces in the world.

The standards of treatment we receive for emergencies and serious illness are among

best in the world.

Our major hospitals employ the latest technology.

Australia leads the world and has led the world in advancing new treatments, such as

kidney transplants - and there could be many other examples.

Universal Medicare ensures these benefits are accessible for all Australians, regardless

of their income.

But none of us would claim our system is perfect.

And the challenges we face in healthcare can’t be dismissed by complaining about

scare campaigns.

Just as the future of Medicare won’t be resolved by whinging about text messages.

I’m not going to talk about the Turnbull Government today - that will be my last

reference to them. Because we're here to talk about the future of healthcare.

We want to be a part of a new conversation about the long-term future of Australia’s

health system.

We wanted to win that last election but we didn't. We came close, we surprised but we

didn't win - I understand that.

What we want to do in this term of Opposition is prepare.

Prepare to offer the people of Australia a platform in healthcare that people can have

confidence in.

Prepare a platform on healthcare which answers the demand and the hunger for a long-

term vision.

We want to move beyond the boom and bust in healthcare policy in the recent past, the

uncertainty created by deep cuts or sudden swerves in policy or funding.

Today, I want all of us to look beyond the next Budget, or the next election and focus

instead on the next generation.

At the most basic level, this is the reality I see.

The majority of our resources and your time are spent treating Australians who are

already very sick. We need a system that’s better at keeping Australians healthy.

‘Prevention is better than cure’ is the oldest medical aphorism in the world.

Yet less than 2 cents in every dollar Australia spends on health goes to prevention.

We have a proud record of creating and delivering outstanding preventive health

campaigns - you can think of them if you give them a moment's thought: Life, Be In it,

Slip Slop Slap, the HIV/AIDS prevention campaign and a series of very successful anti-

smoking initiatives which have dramatically reduced smoking rates, particularly among

young people.

But we’re falling behind on that score now.

Hospitals are filled with people suffering from diseases that could have been treated

earlier and managed better.

And too much time and effort goes into obtaining patient information already known to

one doctor, but not to another.

Reducing fragmentation in the system and improving continuity of care are two of the

best improvements the Australian Government can make.

Investing more resources in integrated primary care, in prevention, helping keep

Australians stay healthy - not just managing illness.

Because if the last three and a half years of health policy have taught us at all, it’s that

the tired old mindset that views every dollar of health funding as a burden to the budget,

or a cost to be cut, is totally unsuited to the challenges facing 21st Century Australia.

I’m proud Labor takes a different view.

We know that a properly-funded healthcare is an investment.

An investment in healthier people, an investment in a more productive society.

And an investment in a more efficient, more cost-effective system.

I think it's one of the most powerful, most simple economic arguments for protecting

Medicare.

Accessible, affordable healthcare means that people are treated sooner and get better

sooner - at a lower cost: to families, taxpayers and employers.

It means that less Australians end up in our already-overworked emergency

departments.

I think the contrast with the United States is always the most instructive. We spend

nearly half as much, as a percentage of GDP, compared to the United States - yet we

get far better results across the population.

Labor remains steadfast and resolute in our commitment to affordable, accessible,

universal Medicare.

It’s why we have resolutely opposed the GP tax, the Medicare freeze, the imposition of

new upfront fees and charges and of course the medicine price hikes.

GPs, nurses, emergency services personnel and healthcare workers -they are the

frontline in terms of helping Australians.

There's a great piece written by Dr Elizabeth Oliver last month.

She wrote about what she does for $37.05 - the amount her practice receives from

Medicare for a standard consultation - it was an extraordinary insight into the diverse

demands on a GP’s time, skill and emotional energy.

It isn't satisfactory for dedicated healthcare professionals to be told by government

policy to tighten their belts and do more with less.

In the months ahead, I want Labor to broaden the focus that we brought to Medicare,

onto preventative health.

And I understand with the Medicare freeze, whilst it’s a payment to the doctor, the true

debate is that it’s a patient rebate refund.

And in some ways the doctors have even been made to sort of be pitting an argument

that they're seeking something as opposed to the government.

It's the money which goes back to the patient and I think it’s another argument we will

surely be pursuing about lifting the freeze.

Let's talk about preventative health.

I’m a parent.

And, as a parent, I’ve become a lot more conscious of the food and drink my kids are

consuming.

I've also noted the unacceptable democratic practice that everyone else feels they can

give your kids rubbish food - we need a law on that…no.

But when you see what’s advertised on television or on social media and you see what's

advertised in the ‘screen time’ that is part of an Australian child’s life.

We have to get serious about fighting obesity. We are one of the most overweight

countries on earth - it's always a comment which makes me breathe in.

Two out of three adults - and one in four children are overweight or obese.

Obesity even outranks tobacco and alcohol as a cause of chronic disease.

It’s responsible for 25 per cent of type 2 diabetes and osteoarthritis.

And it's responsible for about 20 per cent of heart disease and some cancers.

The total cost of obesity has been put at more than $58 billion a year, including direct

health care costs, lost productivity, reduced quality of life.

So it isn’t actually just a preventative health issue - it’s a question of promoting physical

activity too.

Encouraging more Australians to put down the phone, or the IPad, switch off the TV and

take the dog for a walk or go for a jog.

We want your help, we want your advice on the best set of policies to achieve this

important change in our national lifestyle.

One of the privileges I have as a Member of Parliament and certainly as a Labor one, is

to go out and hold public meetings.

I do town hall meetings, I did one last night with 1,000 people in Canberra.

It's interesting, wherever you travel in Australia, and I've done 40 or 45 of them in the

last year and a bit, there are always a couple of issues no matter where you are: up in

Townsville, or in Western Australia, Tassie or indeed, Canberra last night.

People can put ask any question they like.

Some of them are unusual - one lady asked me what to do about gum trees in the

schools here - I passed that one.

But much more seriously, two questions which I get everywhere.

One is about families trying to deal with a member of their family who has fallen into ice

addiction - it is a universal question - I know there are other drugs of addiction.

But that certainly is something which we're interested to hear from you about. We

understand it’s not just improving security at emergency departments, it's that sub-acute

care, it's the families who want to help.

In my introductions I said we weren't going to cover all issues but I'm very keen for

people here to give us a view of how we help the system and how we stop people falling

through the cracks.

Obviously if you talk about ice and support for families, the other topic which is raised

everywhere is mental health.

Young and not so young. The challenge of veterans, the challenge of how you help

people in families when one of their family members has had real episodic illness. And

of course, suicide prevention.

I haven't done a meeting where when I've asked people do they have a family member

or one degree of separation, do they know a family who's had a family member who has

taken their own life, when I ask that 60 to 70 per cent of every room in Australia put their

hand up.

Suicide prevention and support for people with mental health - as much as there's been

good work done - remains on the list of unfinished business for the nation.

Of course there's the growing challenge of dementia amongst older Australians and

more broadly the future of aged care.

These are anxieties and issues, which regardless of a person's postcode, regardless of

a person's ethnicity or gender or wealth or income or education - are very real.

And it goes to what I think was that earlier point, we need to be as a nation talking about

the issues which Australia wants us to talk about.

But of course, when you talk about the sources of genuine concern for our fellow

Australians, there is another unifying sense of frustration. It is people who feel let down

by their private health insurer.

I’m sure you’ve heard the story:

A patient who took out a policy in good faith, who always makes the payments - no

matter what difficulty it is, they know that on that day they've got to have the money

ready in the account to pay the insurance bill.

When the day comes to get the procedure that they need, all too often they find that it is

excluded.

A decade ago, about 8 per cent of private health insurance policies had some form of

exclusion. Today, it’s over 38 per cent.

It means more and more Australians find themselves being hit with thousands of dollars

in out-of-pocket costs, even after they’ve spent thousands of dollars over the years in

premiums.

It is no wonder that complaints are high.

Some people might remember this but I think a lot of people forget it and take it for

granted. Before Medicare, the number one cause of personal bankruptcy in this country

was medical expenses.

It feels like a different country now.

Getting sick once meant going broke. We do not want to go back down that road again.

We do not want a system that puts profits ahead of patients.

This is one of the challenges with our private health insurance - you know the dangers

and the consequences of this, far better than me.

I want to conclude by just observing, there are many issues that I haven't touched on in

my very initial remarks, many equally important propositions and trends. We'll hopefully

discuss that in the dialogues today.

I have many members of my parliamentary team here because we regard healthcare as

among the most important issues that a national government can help influence the

direction of.

And I also said at the beginning, we don't think our health system is perfect - we don't

think it's all a disaster either.

And we do see there's opportunities for cooperation with the government and we will

pursue them where we can.

We don't think our political system is perfect.

But one thing is for sure, you cannot achieve improvements to our health system by

ambush.

We cannot lift the standard of healthcare by simply announcing cuts in budgets.

And no political party, us included, can ever hope to help administer and navigate the

future healthcare without directly involving the people who work in the system and the

consumers.

I think that when governments just simply try and impose radical new solutions they get

predictable old answers.

If we are to form a government, we don't do so on the basis that everything this current

government is doing is wrong.

We don't seek to just simply rip up and change things for the sake of some political

point-scoring.

We don't come here today with a set of answers awaiting your stamp of approval.

What we want to do is reflect the experiences and the understanding of a wide range of

people.

The government like to make a thing or two of my union background. But one of the

things I learned as a union representative is that when you sit down between employers

and workers, what you've got to try and do is extract the best from both points of view.

Consensus does not mean lowest common denominator. Consensus means

understanding a direction and involving all people in how you would achieve that.

Consensus means listening to people and making a decision and using the process to

create an irresistible coalition for reform and change in this country.

As I said at the start, when I see everyone here, I wonder why we take so long

sometimes just to gather people together to distil the ideas and to set a direction.

We do not believe automatically we will win this next election, but one thing is for sure,

we intend to present to the people of Australia at the next election all of our hard work of

opposition.

We do not intend to squander the next year or year and a half just sitting and watching

the government.

We intend to prepare positive policies and it is no accident that the first of the positive

policies which we are working on in this format is health care.

We appreciate your time. We appreciate your commitment.

We are interested in your ideas and your solutions.

Not just about what we should be doing - not just what the future should look like - but

how we should get there.

That’s the task ahead of us, so I look forward to starting that process this morning.

Thank you very much.

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