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Transcript of interview with Louise Saunders: ABC 936 Hobart: 16 February 2011: national health reform; GP Super Clinics

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THE HON NICOLA ROXON MP Minister for Health and Ageing


Interview with Louise Saunders - ABC 936 Hobart

16 February 2011


Topic: National Health Reform, GP Super Clinics

Louise Saunders: Let's talk health. We've been talking about it now across many issues for quite some time, and the Premier was in Canberra at the weekend for the COAG meeting at which the health funding arrangements were discussed. You've been talking about that this week.

In the state today for a couple of reasons was the Federal Minister for Health and Ageing, Nicola Roxon. One of her duties was this afternoon to take a look at a site inspection for the Clarence GP super clinic, one of four for Tasmania.

Nicola Roxon joins me. Good afternoon.

Nicola Roxon: Good afternoon.

Louise Saunders: The site inspection over at Clarence, when do you expect that might actually open?

Nicola Roxon: Well, Clarence is on track to be opening in April or May this year. So what we were able to look at is all of the construction. It's at a very advanced stage. Any of your listeners who drive past will have seen the enormous building going up around the existing community health centre. And it's going to be a very significant service for all of the Hobart community, really, because you'll be able to get GPs and allied health professionals, and it's going to be co-located with other community health services as a stage two that the Tasmanian Government is funding.

So a very good example of what partnerships, when you invest in important health reform, can actually deliver to patients, getting that access closer to home and not having to go to hospital for so many of your different services.

Louise Saunders: They haven't been universally welcomed though, have they? The Australian Medical Association retains some concerns about their presence in areas where there are GP services, and the follow-up squeezing of the services; the effect that that has.

Nicola Roxon: Yeah look, there's been a little bit of criticism from some doctors in some places. I do need to tell your listeners that often that seems to be the people who have put in a bid but not been successful. It is a competitive process.

And I think many Australians, in Tasmania but everywhere else in the country, have experienced a long waiting time for their GP, not being able to get on to or get access to a GP if they're moving suburbs. There are many parts of the country where we really just haven't had enough of those services.

So the government is trying to invest to add to, to complement the services that are already there, not to be in competition with them. But it's probably not surprising to you or your listeners that sometimes a local doctor might not like that.

We've had pretty widespread support other than occasional criticisms, and often from people who really wanted to run the super clinic themselves but maybe were not the best bidder.

Louise Saunders: Well, the AMA has spoken through its president, and I don't think he could be said, to be on behalf of the AMA though, a contender to run one of the super clinics though, could he?

Nicola Roxon: I don't know, it's different in all states and we've had very positive support in some areas. We have the federal president of the AMA and vice president saying they're very supportive of the concept. They do themselves say, look, sometimes we contest where they should be. And that's why we have local consultations.

This Super Clinic at Clarence though is, I think, very good example of being able to use Commonwealth money to get a certain number of services, and then state money to be able to really leverage that.

So the intention of being able to have extra dental services, mental health services, as well as your GP services and nursing and allied health, community nursing being based there as well, is really starting to put the bones on our philosophy of doing more in primary care, the frontline of health care, to keep people well and out of hospital for as long as we can.

Louise Saunders: Well, you're certainly right when you talk about the squeeze of GP services and the wait that some people may have to get into see a GP in Tasmania. But to improve access, I guess, includes to increase the numbers of GPs in the state. Do the super clinics or other federal policies do anything to increase the number of GPs on the ground in Tasmania?

Nicola Roxon: Absolutely. One of the key components of our GP Super Clinics strategy is that they need to be teaching facilities for the future. So partnerships with local universities are very important, and that is the case at the Clarence Super Clinic.

But also we've actually invested more than half a billion dollars to train more GPs. This was an area that Mr Abbott actually had a cap on the number of students who were graduating who could go into those GP programs which, in our view, was pretty silly when you have such a shortage across the country.

So that is the other thing I was doing here today, visiting the University of Tasmania and talking to them about their plans, how they're going to train people, the support we're giving them for the health workforce to be well trained here in Tasmania, and hopefully for them then to decide to stay and make their professional careers here as well.

Louise Saunders: What about the Sorell Super Clinic? What's happening with that?

Nicola Roxon: The Sorell Super Clinic is underway. The planning is very advanced. There have been some hold-ups in negotiating with the operators, the successful bidders. They wanted to expand even beyond the funding that was provided by the government, and that's delayed things slightly. But certainly that is going ahead. There's a $5.5 million investment at Clarence and $2.5 million at Sorell. And I am hopeful that we'll get a breakthrough in those negotiations shortly.

Louise Saunders: Sorell is certainly a booming area in terms of population, with new housing going up. I think people - and I've had a couple of texts this afternoon asking about Sorell particularly. Are you able to put any prospective dates on the start of work or even a conclusion?

Nicola Roxon: No, look, I can't do that today, and I wouldn't like to mislead your listeners. We had hoped that construction would have started a little earlier than this. There has been a hold-up with the negotiations. And that's, as I say, because the operators would like to build an even bigger facility. Now, obviously we encourage that sort of investment but the Commonwealth can't simply approve larger amounts of taxpayers' money when a certain amount was bid for.

But when you look at the four projects across the country, the super clinic in Devonport is already up and running, the one at Burnie is very advanced in its construction and an associated project - the Launceston coordinated community care centre - its construction is already well advanced.

Now, what this really is highlighting is when governments work together, you can actually make a difference for patients. And that's what the Prime Minister was trying to achieve on Sunday. And we're very pleased that Premier Giddings, a former health minister herself, agreed to these arrangements and we can work together now for the benefit of Tasmanian patients.

Louise Saunders: Well, let's talk about that because one of the issues that has been raised as a concern arising from the COAG meeting has been whether there will be a protection of infrastructure spending where it's needed in Tasmania. Because of the pool arrangements,

our smaller contribution and our smaller state, there has been some concern we may miss out.

Nicola Roxon: No look, every single dollar that was on the table in last year's deal is still on the table. What it actually means is our investments at the federal level have gone up above a billion dollars for Tasmania; a huge investment when you look at what was ripped out of the system by the previous Liberal government federally, but also when you look at the size

of the Tasmanian services and population.

This is a very big injection of funds but not as a blank cheque. The injection of funds comes with a commitment to reform and make sure that we are going to deliver the best services wrapped around the patient, responsive to the needs of the particular patient, that we can do. And I'm very optimistic that that will deliver real benefits for Tasmania.

Louise Saunders: The state government is facing some budgetary restriction and is looking at making some cutting, particularly to do with costs - on-costs and labour costs. If there should be reductions in the overall health budget for Tasmania, would that affect the federal health budget that comes our way?

Nicola Roxon: Well, one of the important parts in the agreement that was struck on the weekend is that health expenditure from the state and from the Commonwealth into the future will actually be kept separate from all these other budget considerations. So you don't want to be in the position, if the Commonwealth is investing extra money, that a state government in Tasmania or elsewhere might pull money out, or vice versa.

So this pool means that, into the future, both levels of government commit 50 cents of every dollar in growth to the system that was based on the activity that's undertaken in the system. So it's not negotiable. If that activity - if there's hip replacements or other surgeries that need to be undertaken, 50 cents of the dollar in the efficient price for doing that will be met.

So it's driving the reform but it's also making sure the security is there that health dollars will be spent on health and not moved off into other areas of expenditure.

Louise Saunders: And, Nicola Roxon, the other concern that's been expressed is that sometimes the provision of services in Tasmania is at a higher cost than in mainland states because of the need to perhaps pay a premium to attract staff to this state. Will that be

something taken into account when setting a cost for provision of health services?

Nicola Roxon: Well, it certainly will be taken into account. And what has been agreed for the first time ever in this country is that we will establish what is a proper price and a fair price for particular services in health. It won't be established by a politician, it won't be set through a budget process of any Cabinet. It will actually be carefully looking at the cost of nursing, the cost of medical care, the cost of having your bed open. And, whilst there will be a national efficient price, our independent authority will assess any differences, whether it's in rural and regional Australia or whether there are state differences that need to be taken into account.

But we certainly want to make sure that taxpayers across the whole country can be confident that the money being spent on the health system is what's needed, not some inefficient price that might be paid in any part of the country at the moment. We simply don't have that information and we need to be able to say to taxpayers, who are also the patients, your health dollar is going absolutely as far as it possibly can.

Louise Saunders: And just finally, Nicola Roxon, does anything that's been agreed to in the last few days with our Premier Lara Giddings, affect the commitment that you've given to the Member for Denison, Andrew Wilkie, for funding for the Royal Hobart Hospital?

Nicola Roxon: No, absolutely not, but they certainly do complement that agreement. Our commitment to fund the reconstruction of the hospital remains as it was, which is $100 million has been committed to $50 million already paid, so that the construction can commence. And an application has been made, which is being assessed by our Health and

Hospitals Fund board, but we've made very clear that a remaining $240 million will be provided if that application meets the eligibility criteria which we have every expectation that it will.

But on top of that, the agreement for Sunday means that our ongoing costs of the health system are now going to be able to be shared more equally between the Commonwealth and the states. And that provides security in the long-term for Tasmanian patients, that their health system will be able to continue to improve.

Louise Saunders: Minister, I'll leave it there. Thanks for your time.

Nicola Roxon: Thank you.

Louise Saunders: Thank you. The visiting Federal Minister for Health, Nicola Roxon.