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Health Minister Tony Abbott: Man of Inaction: speech to the Victorian Committee of Management for Women in Superannuation, Windsor Hotel, Melbourne.

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Health Minister Tony Abbott - Man of Inaction

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Windsor Hotel, Melbourne Tuesday 20 April 2004


Jamie Snashall 0407 438 746 Julia Gillard 0417 361 637


It’s a pleasure to be here today and I thank Maria Wilton for extending the invitation to me.

Last July I was appointed Labor’s Shadow Minister for Health. The Prime Minister John Howard then surprised me on my birthday by giving me Tony Abbott as my appointment. It is not a gift I had requested.

Last December when Mark Latham became Labor Leader I stepped into his shoes as Manager of Opposition Business. This move makes me Tony Abbott’s complete equivalent on the Opposition side as he is Leader of the House, attending to parliamentary tactics for the Howard Government.

Mark made the following remarks on my appointment two days after making it:

We have an unusual circumstance now with the member for Lalor and the member for Warringah facing each other in those important roles. I think it is the first time we have had a numbers man and a numbers woman — the first time we have had two genders pitted against each other in the role — and I think it is a

step forward for women in the parliament to play a role outside of some of the stereotypes and expectations that we have heard in the past.

From much of the feedback I get as I travel around Australia, those obsessed enough with politics to watch question time are enjoying the contest. I suspect I have disappointed some who expected women in politics to bring a kinder, gentler touch to the role.

But I have always believed that what you believe in passionately you should advocate strongly. It is the approach I have brought to my role as Shadow Minister for Health and to my parliamentary role as Manager of Opposition Business.

And passion is required because we are in a fight to the death about the future of Medicare. The next election will decide - once and for all - whether we have a universal health system in this country or whether we go down the American road of a two tier health system - one for those with resources and a residual under-funded welfare system for everyone else.

Medicare Minus

The Howard Government thinks it has ‘done health’ because it has secured a deal to get its Medicare Minus package through the Senate. This is a package rooted in the politics of spin and is all about destroying Medicare, our universal health system.

Now we have a new definition of universality.

One that says that bulk billing is only for those with concession cards and children under 16, ignoring the needs of struggling working families and those with chronic illness.

A definition of universality which says that where your doctor practises will govern the rebate he or she receives for a bulk billed service - regardless of the inequities in that.

The Minister who will no longer release bulk billing figures by electorates because he says it takes precious resources away from health will spend those resources advertising Medicare Minus.

What Tony Should Have Been Doing

Meanwhile, nothing has been done to drive forward the health reform agenda - the one that was promised would be addressed after the States and Territories were blackmailed into signing Health Care Agreements that were minus $1 billion. That’s another huge issue entirely and one I will address tomorrow at the National Press Club in Canberra.

Today I want to outline all the other health issues that are lying untouched on the Minister’s desk. They might not get as much publicity as Medicare Minus, but they are all important - especially the ones with an impact on women’s access to health services. Tony Abbott shows little desire or ability to address these issues - both large and small.

These issues include:

The report of the Red Tape Task Force

There is growing recognition that current programs meant to improve patient outcomes and doctors’ incomes have swallowed up precious time in administration and precious dollars in administration costs. Despite this, the new Allied Health services benefits that were part of the Medicare Minus bribe to get the sham safety net enacted have been piggybacked on the Enhanced Primary Care program, which the Red Tape Task Force has considered abolishing.

This report was announced in May 2002 in response to the Productivity Commission’s report on General Practice Administrative and Compliance Costs. Work was completed late last year and this February the Senate Estimates committee was told that the report was “under consideration.”

If Tony Abbott really cared about helping GPs to lighten their administrative burden so they can have more time to help their patients, he would be acting on this report and its recommendation right now. What’s Tony Abbott done? The answer is nothing.

The Review of the Divisions of General Practice and funding for the Divisions for the next triennium

If actions (and inaction) speak louder than words, then here is a great example of Tony Abbott’s commitment to general practice.

The Review of the Role of the Divisions of General Practice was presented to Senator Patterson in June 2003 and she released the report in July. The silence of the Government’s response is deafening.

In a paper released last year, Professor Gavin Mooney from Curtin University said that the review was constrained by its terms of reference and was clearly designed not to rock any boats. He posited some bolder thinking about General Practice and suggested that Divisions would be more efficient if they were funded more highly.

Tony Abbott clearly hasn’t read this discussion paper. Indeed, at this stage, with money set to run out in June, the Divisions of General Practice are yet to hear if any funding at all will be available beyond this date. The funding should have been announced months ago.

The Government says blithely “Go ahead with future planning based on current funding levels”, but this is creating havoc for some Divisions, who (rightly) are unwilling to sign contracts and are not expecting any funding boost when word finally does come through. Programs have ceased, staff has been let go, and new initiatives are on hold.

Report from the General Practice Partnership Advisory Council on provision of GP services to Indigenous communities

In February, Tony Abbott announced that funding for GGPAC would not be renewed, and work that the Council has undertaken is now in limbo. Specifically, a completed report on the provision of GP services to Indigenous communities that cost $120,000 to

produce and is described as offering some real solutions to the problem of retaining doctors in these areas, will not now see the light of day.

Rumour has it that the Department has expressed delight that it is not now required to release or respond to this report. Why would the waste of tax dollars and the loss of a possible solution to a major health problem engender delight?

Review of the Rural Clinical Schools Program

The 2000-01 Budget announced funding for nine new Rural Clinical Schools. With the current crisis in the rural workforce, it is very important to know how these schools are working and the contribution they are making to solving this problem.

The review was announced in the 2002-03 Budget. We know it has been completed, but the information is that there are no plans for its release.

Review of the Aboriginal and Torres Strait Islander Eye Health Program

This Program commenced in 1998 and the review was completed in December 2003. At this stage there are apparently no plans to release the report or to respond to it.

Perhaps Tony has read this report and is shocked and embarrassed by it. After all, it is shameful that Australia is the only developed country in the world where blinding trachoma still exists. The rates of trachoma in some communities are as high as they were 20 years ago, as high as they are in the poorest areas of Africa.

Yet trachoma could be wiped out in three or five years with a concerted program of surgery, antibiotics and facial cleanliness. Where is the health policy, where is the Coalition’s so-called ‘practical reconciliation’ agenda and where is the shame at the lack of action?

Treatment Grants Program to Non Government Organisations for alcohol and other drugs

The National Reference Group reviewed grant applications in September and made their recommendations to the Minister late last year. But possible recipients are still waiting to hear the results and learn if they have funding for their programs. By their very nature, NGOs do not have deep finances, so this waiting period will surely affect their viability.

Queries about the delay have led to suggestions that the Prime Minister wants input into the process. Such a possibility indicates the likelihood of political meddling rather than improvements to public health policy.

Out of Hospital, Out of Mind -- the Report from the Mental Health Council of Australia.

Unfortunately, the title of this report reflects all too accurately Tony Abbott’s approach to mental health. To be more accurate, the Minister doesn’t have any approach, given he off-loaded this responsibility on to his Parliamentary Secretary Trish Worth.

Yet this report, completed in April 2003, states clearly that Australia’s approach to mental health is lacking in leadership, planning, innovation and resources. Currently only 38 per cent of people with a mental disorder access care, and that is provided largely by GPs. The decline in bulk billing is placing further pressure on this most basic form of physical and mental health care for persons with mental disorders.

Mental health accounts for 13 per cent of deaths and disabilities and 30 per cent of the disease burden in Australia, yet Tony Abbott has yet to make a major public statement on this issue.

Public Health Outcome Funding Agreements (PHOFAs)

In the list of things remaining on the Minister’s desk, this last one is perhaps the most interesting from the perspective of women’s health.

The PHOFAs are bilateral funding agreements between the Commonwealth and each State and Territory which provide broadbanded and special purpose funding from the Commonwealth to the States and Territories for a range of public health programs. Currently eight public health program areas have been broadbanded (or pooled) into a single Agreement for each State and Territory. These programs were:

National Drug Strategy; National HIV/AIDS Strategy; National Immunisation Program; BreastScreen Australia; National Cervical Screening Program; National Women's Health Program; National Education Program on Female Genital Mutilation; and Alternative Birthing Program.

The current agreement expires in June, but negotiations for the next round have yet to commence. The reason given is that “the Commonwealth has yet to finalise its position.”

Despite the vital importance of these programs to the nation’s public health, it looks as if we are headed for a re-enactment of the last minute bullying which characterised the Australian Health Care Agreements - sign this or else.

Will there be more funds for the recommended childhood vaccines? Let’s remember that under the Howard Government for the first time the recommended list of vaccines and the vaccines the government pays for are two different things. Let’s remember that today there are mothers being told by their doctors which vaccines their new born babies should have and then dealing with the sickening realisation they can’t afford them. And let’s remember we are talking about vaccines for pneumococcal disease, which kills more Australians each year than meningococcal C.

Will the HIV/AIDS and Hepatitis C strategies be reinvigorated and better resourced as the program reviews all recommended?

Will cervical screening programs reach women from Indigenous and non-English speaking backgrounds who are most at risk?

And will women have more choice in childbirth?

What Tony Has Been Doing

But, while all these issues have been ignored and while he has apparently been bypassed in the jockeying for more money for Budget initiatives, Tony Abbott has found time to wade into the health debate.

There was the foray on his moral high horse into the area Peter Costello called an “incendiary political issue.” He managed to slam young women who terminate their pregnancies while saying nothing about the men involved and offering no solutions.

Then there was his slam at the attitudes of the young, when he blasted “depraved and corrupting” music videos. But of course no solutions were offered and we have heard nothing since on this topic.

And then, in a move guaranteed to ensure that young people will be unwilling to access their doctors as a source of good advice about unwanted pregnancies, sexually transmitted diseases and mental health problems, Tony Abbott is now pushing to deprive young people aged between 14 and 16 of the right to keep their medical records private from their parents.

Small wonder that Michelle Grattan has been moved to write that:

“You can’t go out on limbs like Abbott does without honing your skills in strategic retreat.” (Sun Herald 21/03/04)


People don’t want to see their health system used as a pawn in a political game about

party political advantage.

At the election, Australian voters will have a clear choice about who they want to run the health system and what sort of system they want. It will be a choice between the current vacuum of national leadership with a government that wants to see Medicare die and is unwilling to act unless political pressure forces it into another patch-up.

Or a health system with Medicare for the twenty-first century at its centre. A Medicare revitalised and reformed by a Latham Labor Government. A universal health system based on the Australian values of fairness and access, and of looking after each other.

The choice is clear.