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Transcript of doorstop interview: 21 May 2003: Kallangur Medical Practice, Brisbane: \nMedicare; superannuation; private health insurance rebate; troop ceremonies; terrorism; Woomera; Dr Hollingworth; cannabis trials.\n

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Subjects: Medicare; Superannuation; Private Health Insurance Rebate; Troop Ceremonies; Terrorism; Woomera; Dr Hollingworth; Cannabis Trials

CREAN: This is the third visit I’ve made to this area in as many months, and when I was here in February I indicated that bulk billing had declined faster in this area than anywhere in the country. That decline in bulk billing has continued since my first visit.

Of course, that is a reflection of the current Government policies. But just to indicate, bulk billing in the Pine Rivers area has declined 35% in just the last two years. That’s the profile in the area in which we stand today but, of course, it’s a profile that’s replicated all around the country. This is the dramatic decline in bulk billing across Australia because the Government has allowed bulk billing to decline. And, of course, if bulk billing goes that’s the end of Medicare.

When I came here I said that we needed to do something to restore bulk billing and to save Medicare. I’ve had a number of discussions around the country with the medical profession, with health economists, with many people, looking for solutions as to how this problem can be addressed.

I met with Dr Trappett. He asked to meet with us when I was here last February, and we had that meeting. Information that he gave us, together with other information, helped inform our response.

I’ve put forward an initiative that will restore bulk billing by lifting the patient rebate across the board to everyone by $5 - but then going further to recognise that in areas in which there have been dramatic declines in bulk billing - and that varies from region to region - additional incentives whereby if bulk billers meet targets of restored bulk billing they will get additional payments.


This combination of the lifting the patient rebate and looking to incentives to target particular areas of need will see the restoration of bulk billing and will save Medicare.

There is now a stark choice in terms of health policy in this country. John Howard’s plan will destroy Medicare. Simon Crean’s plan will save Medicare. And I’m delighted that Dr Trappett’s input has helped us form the position. It’s policy that’s funded. It’s policy that’s costed. It’s policy that will work, and it will work to reverse this trend and bring it back to this.

The fall in bulk billing is an important blow for Australian health in this country. Restoring a circumstance in which people can afford their health care, turning away from the Americanisation of the Australian health system, where it’s your credit card, not your Medicare Card that counts. And doing for this country what they’re entitled to, what they’ve earned, what they’ve paid for. They’ve paid through their taxes, paid through their Medicare levy, an entitlement to a doctor that bulk bills. I’m going to restore that; John Howard would only destroy it.

JOURNALIST: It’s a lot of money, Mr Crean. How are you going to fund it?

CREAN: Well, the cost in terms of the announcement I made the other night is $2 billion, but $1 billion of it is offset in the Government’s own package - a package that, if implemented, would actually destroy Medicare. That’s the irony. But the truth is, what they are prepared to spend, we can build on - and build on to the tune of $1 billion more.

Half of that component will be paid for by not proceeding with the tax concessions for large multinational foreign companies. The other half will come off the surplus, but that’s affordable over four years. This is fully costed, fully funded, and do-able. And the papers that I put out on Thursday night demonstrate that.

JOURNALIST: Do you think your warnings about Medicare are biting with the Australian public?

CREAN: I’ve got no doubt about that. You only have to walk around the country, in terms of public response. And I must say, since Thursday night, I’ve been from Melbourne to Perth, to Sydney, to Brisbane and, tomorrow, to Townsville.

Everywhere I go people are saying, `Thank God someone’s actually biting the bullet on Medicare. I’m sick to death of circumstances in which we can’t find a doctor that bulk bills. Medicare has to be saved. It’s a good health system. We want it saved.’ So I’ve got no doubt that there is lift


out there but, more importantly, there’s recognition not just of the problem but of the fact that I’ve got a solution.

JOURNALIST: Why is this area particularly bad compared to any others around the country?

CREAN: I think that there’s a combination of factors. One goes to the supply of doctors - and that’s another important part of the package that we’ve announced. But, quite frankly, it goes to the cost structure that doctors are expected to operate under. I mean, these are not opulent premises. These are not wealthy people. They are not ripping off the system. These are people who want to provide a public service, but they don’t expect to have to do it on a pittance.

Now, we all know that costs increase. The technology improves, and they have to keep themselves updated with the latest training. These are factors that have to be taken into account in any contract between a public health system and its provision through private providers. And you’ve just got to keep that updated and it hasn’t been updated.

And what I’ve announced on Thursday night demonstrates not only how far the system has fallen behind, but what a decent down payment will do. This is a down payment on improving the system, restoring bulk billing and saving Medicare.

JOURNALIST: You say there’s a greater recognition that you’re the man to save Medicare. Is that enough to satisfy the ‘nervous nellies’, as you describe them, in your Caucus?

CREAN: It’s enough to satisfy a belief that the Labor Party is committed and has a plan to save Medicare. That’s what it’s enough to do. That’s what the leadership issue is about - showing that there is another way, showing that there can be a better deal for Australian families. And I’m confident as we continue to pump out the message and get people to understand the clear differentiation.

And what I think the interesting thing is now, every radio interview you go on, people introduce it by saying there’s a clear differentiation between the Liberal Party and the Labor Party on health. And it is about a commitment on the part of the Labor Party to offer a better package to restore bulk billing and to save Medicare. I’m delighted with that.

JOURNALIST: Well, Doctor, is Simon Crean the man to save Medicare?

TRAPPETT: He is the first man in 20 years to offer a reasonable package to any doctor in Australia - from either political persuasion,


Liberal or Labor - the first man to offer a reasonable increase. You’ve got to back him.

JOURNALIST: How bad is the situation with Medicare and bulk billing at the moment, in your view?

TRAPPETT: I walked around a conference floor down in Sydney over the weekend. Everybody is against the idea of bulk billing because it’s just not enough for our labours. You won’t get doctors to go into the country if you offer them a pittance.

JOURNALIST: Do you still offer bulk billing here for your regular clients?


JOURNALIST: How long will that last?

TRAPPETT: As long as I can.

JOURNALIST: On the horizon, can you see you might have to drop it if, say, Labor’s plans aren’t implemented?

TRAPPETT: It may happen, it may happen indeed. But I’m the age that I am. I ultimately want to retire. One half of me wants to retire, the other half doesn’t want to retire because I do enjoy working. But I have a lot of poor patients in the area. On the other hand, I don’t like the idea of giving concession cards to retired bank managers with large superannuation packages. I have them amongst my patients.

CREAN: I might say, we’ve also got a good deal for superannuation for those people looking to retirement, because the other thing that was announced on Thursday night was another tax cut, another tax cut under Labor’s new deal - a tax cut on the contributions into superannuation funds from 15% to 13%, for everyone.

In contrast, the Government’s proposal would only see those tax cuts go to the top 4% of income earners. Superannuation has only ever been extended to all of the workforce under Labor Governments. We’re the only ones that will continue to extend the adequacy of superannuation to the whole of the workforce. And just as Labor’s become, traditionally, the Party of the pensioner, it is now the Party of the superannuant, ensuring superannuation entitlements and adequacy for everyone, not just the privileged few.

JOURNALIST: Another issue is the Private Health Insurance and the rebate there. When will you make clear your plans for the Private Health Insurance rebate?


CREAN: Well, again I said when we came out in February - and I’ve repeated this point on a number of occasions - I think we do have to look seriously at the $31 billion that’s currently being spent by the Federal Government on health. We have to constantly look at how best that money can be spent to improve the public health system.

We recognise that there’s a dual system, that there is private provision and we rely upon it. There needs to be incentive in there for that, and people have factored in the Private Health Insurance rebate into their disposable incomes.

So we are not going to do anything stupid, and I’ve said repeatedly that I’m not going to abolish the Private Health Insurance rebate. But I am constantly looking at ways in which we can improve the spend. And, just as I showed on Thursday night how reallocation of monies can be used to save bulk billing, restore it and save Medicare, I’ll continue to be on the lookout. I made the point that Thursday night, insofar as health is concerned, was a down payment - but it was a serious down payment. And I’m serious about continuing that agenda.

JOURNALIST: On another issue, there was to be a homecoming at Amberley tomorrow. That’s been now moved up to Townsville. Some people are angry that it’s been moved there, saying it’s a Government ploy to put it in a marginal seat. But the Government is saying: no, the troops actually wanted it and the families wanted it. What have you heard about that?

CREAN: I’ve heard nothing about it. In fact, I’ve had very little advance notice as to what the details of any of these homecomings have involved. I still haven’t got the details, the running sheet, of tomorrow’s events in Townsville.

Nevertheless, I’ve attended every one, bar the first. The first, of course, was the one that the Prime Minister ensured I couldn’t get to. But all of the others I have, in fact, attended. And I’ve been delighted to attend, because I think it’s terribly important that we say to those people - who followed orders, served their country, discharged their duties and did it honourably - I’m delighted that every one of them was returned safely. And I want to reinforce the message that Australia stands united in thanking them and welcoming them home. And I think it would be pretty silly if the Government of the day sought to play politics and politicise the troops. I haven’t.

JOURNALIST: Are you concerned that these homecomings are becoming much more a public-relations exercise on the part of the Government?


CREAN: I think they’re important, because I’ve seen the faces of the families. And they are delighted, they’re happy. It’s an emotion, it’s a happy emotion - which is just fantastic to see - I think made happier by two facts. One, that everyone has returned. And, two, that the nation as one has stood and welcomed them home. I hope and pray that those that are still over there all return safely. That’s my fervent wish, and I hope they return as quickly as possible. The best way for that to happen is to get the UN involved in the mandate to reconstruct and build the humanitarian relief in Iraq. But, of course, it’s important to have media present at these things to demonstrate the appreciation on behalf of the nation. I just hope that there hasn’t been politicisation of them. I’ve seen no evidence of that to date.

JOURNALIST: On terrorism, are the Government’s policies on terrorism becoming a bit ad hoc?

CREAN: Too ad hoc - and I’ve made comment about this. I think that the Government has to own up to the fact that our involvement in the war on Iraq has made us a greater threat to terrorist attack - whether it be here or overseas. We have seen evidence of the Government acknowledging that by certain decisions: armour-plating the Prime Minister’s personal vehicle; building barricades around Parliament House; putting tighter security on Defence facilities; heightening security at embassies - all in Australia.

Overseas, of course, we’ve seen 12 new travel alerts issued within the just the last week. And, still, the Government is trying to pretend we’re not at greater threat. Tony Abbott had the courage to admit we were at greater threat because of our involvement in Iraq. The Prime Minister, as much as he is entitled to be proud of the fact that the engagement in Iraq was over quickly, has got to also acknowledge what everyone knows - by involving ourselves in that, we’ve made ourselves a bigger target.

And he should come clean and he should announce a comprehensive package to deal with it. I suggested on Thursday night some initiatives that we as a nation could embrace: a Department of Homeland Security, for example, to coordinate the intelligence-gathering; a Director of National Security, a supremo to coordinate and report directly to Government; a regional summit of the leadership in the area, to work together.

We’ve seen the benefit of working together, with the Australian Federal Police involvement in Bali, in bringing the perpetrators of the Bali bombing to justice. We need more of that. And that’s what I would like to see happen. Stop the ‘ad hoc-ery’ and bring forward a comprehensive plan. They’ll have my full support in doing that.


JOURNALIST: In the short term, the United States has increased their alert level. Should we be doing the same?

CREAN: In relation to the Saudi Embassy?

JOURNALIST: Yes. And also they’ve gone, I think, from Orange to Red.

CREAN: Yes, well, in relation to the Saudi Embassy, I’m surprised that if, in fact, the United States and the United Kingdom have taken that step, I’m surprised as to why the Australian Government hasn’t. I’ve sought a briefing as to why, and I’ll hold comment until later.

But would have seemed to me to be another indication of why the involvement in the unilateral nature of the attack on Iraq, as distinct from a United Nations approach, has exposed the participants to greater threat from terrorist attack.

JOURNALIST: Mr Crean, is the Federal Government burying its head in the sand over the allegations that have been made about the Woomera Detention Unit?

CREAN: It’s trying to, and it shouldn’t be allowed to get away with that. It’s got to come forward with all of the details in response to the allegations made in the 4 Corners program. If they don’t, we can only conclude that the Government has got something to hide.

JOURNALIST: Philip Ruddock has called in the Auditor-General to have a look at Woomera, and not an independent investigator. Shouldn’t an independent investigator be called in?

CREAN: Well, let’s see what the Auditor-General has to say. But let’s also hope that what the Auditor-General has to say becomes public, because what also has to become public is the Government’s response to the allegations, all of the allegations - one of which involves allegations of child sexual abuse. Now, Philip Ruddock’s first response to that was to call it scuttlebutt.

Well, we’ve seen too much of this Government trying to wish away and sweep under the carpet the allegations of child sexual abuse. This is a huge blight in our community. We’ve got to front it, deal with, and come forward with constructive solutions.

And, again, I’ve put forward some initiatives in that regard: a Children’s Commissioner to coordinate the activities of the State authorities; a requirement for organisations in receipt of Commonwealth funding - and this would have included ACM, in the case of Woomera - to sign up to a Code of Conduct that, if allegations are made of child sexual abuse, they


have to be referred to the authorities. If my code had have been in place and those allegations existed, they would have had to been passed on, otherwise ACM couldn’t have got the money.

And the other thing that I want to see is a check on people working with children - a tick given so that parents can be satisfied that the people that are tending their children are appropriately cleared and that they’re safe.

These are constructive initiatives that the Government should embrace, rather than try and sweep the issues under the carpet.

JOURNALIST: There’s another poll out today showing that support for the Governor-General, Peter Hollingworth, has collapsed. Should he now go?

CREAN: You don’t need the polls to tell you that. I’ve been consistent since February of last year that the Governor-General should go. I’m confirmed in that conviction, not by any polls, but by the fact that the Anglican Church, which was asked to do an inquiry into the way in which Archbishop Hollingworth dealt with allegations of child sexual abuse while he was Archbishop of Brisbane conducted himself.

What that report found was that Archbishop Hollingworth covered up for a known paedophile in the Church. The Church said that was untenable. That’s what makes the Governor-General’s position untenable, and that’s why he should resign. It’s got nothing to do with public opinion polls.

JOURNALIST: What’s your opinion about the proposal to trial medicinal cannabis?

CREAN: I listened to Bob Carr with great interest last night, and I thought what he said made sense. He was talking about a limited capacity to use it in circumstances where medical advice demonstrated that the nausea associated with certain treatments could only be alleviated by this form of treatment.

Now, I think that if people are suffering like that, they are entitled on medical advice to have that pain eased. And if this is the only solution, I’d back it. To me, it makes sense. And I think that people should properly understand what has been put forward by Bob Carr, see it as a constructive initiative to actually help people who are suffering. And, in that context, I think it makes eminent sense.

JOURNALIST: Would you use it, Mr Crean?

CREAN: No, I don’t suffer nausea.



JOURNALIST: Have you ever used cannabis?

CREAN: No, I haven’t. I’m an asthmatic. I’ve always had an aversion, and still do, to any form of smoke.

JOURNALIST: Would you decriminalise it if you were Prime Minister?

CREAN: No, I wouldn’t. I wouldn’t go that far at all. But I think this issue needs to be addressed sensibly, and I think the initiative announced yesterday by Bob Carr makes sense.