Jill Hall (Shortland, Australian Labor Party) Share this | Hansard source

I made an initial contribution to the debate on the report of the House of Representatives Standing Committee on Health and Ageing entitled The blame game in the House earlier today. I believe that it is such an important report that I have a need to expand on my earlier contribution. The report is aptly named The blame game because it examines issues that impinge on our health service—our services to Australian people.

I am in a unique position. I have stood in a state parliament and blamed the Commonwealth for problems that exist within our health system and I have been in this House and listened to the states being blamed for problems within our health system. The truth of the matter is that both levels of government must bear responsibility in one way or another for the problems that have existed. It is a very easy out for all levels of government to say that the problems have been caused by the Commonwealth or that the problems have been caused by the states. The issue is: how do we get the best value for our health dollars? How do the Australian people get the best outcome as far as health is concerned? Is it through each level of government?

Local government get in there and do their bit too, blaming both the state and the Commonwealth for problems. Usually their complaints are directed towards the states, but they do blame the Commonwealth as well. I note that local government, particularly in Western Australia, have some very innovative approaches and have worked to get around the health professional shortage in their areas by digging into their own funds, which are quite often limited, to ensure that there are health professionals in their area. I think that the first commitment that governments at all levels need to make is to ensure that the blame game stops. I think every member of the committee feels equally as strongly about that as I do.

There are a number of models that we can look at to end this blame game. We can look at a model where the states take full responsibility for health. We can look at a model where the Commonwealth takes full responsibility for health. I might just mention that last year the Prime Minister set up a task force, headed up by Andrew Podger, to look at this very issue. It is my understanding, from evidence that he gave to the committee, that he supports a Commonwealth-led model. Unfortunately, his report was never made public. Another model is Commonwealth-state pooled funding of the health system. There is the Scotton managed competition model. Each of these has benefits and each of them has some drawbacks. What the committee did was put the models on the drawing board so that people could look at them and then have further discussion of those issues.

One area that does lead to the blame game and arguments for cost-shifting is outlined in recommendation 16 of the report. Recommendation 13 looked at the way the health system is funded and at varying funding arrangements. Recommendation 13 talks about the utilisation of growth factors that can rise or fall in response to the actual level of services provided on the basis of clinical need and the formula that is used when funding health services. Recommendation 16 is about the GST and the impact that it has on ‘specific purpose payments’. For those members who are not so familiar with that, specific purpose payments are impacted on by the amount of funds that are in the GST pool. Basically, it has the effect of reducing the funds that can be allocated to the funding of hospitals and health. I think that that unanimous recommendation of the committee in the report will go some way towards dealing with that issue.

This morning I mentioned that there should be a national health agenda, which is recommendation 11 of the committee report. I think that too would lead to a diminution of the blame game. If all levels of government and all players in the health system can commit to a national health agenda then the health system and the people who utilise it—that is, all Australians—will benefit.

Recommendation 3, dealing with dental services, is very important, one that I believe we all felt very strongly about. As I said earlier today, the issue of dental services is one that each and every member of the public is confronted with on a daily basis. So I think it is important that we are brave and that we do address that issue.

The skills shortage in the healthcare workforce has an impact on all regions and all electorates within Australia, but it has a greater impact the further you are from the Sydney Harbour Bridge. In my area we have a chronic shortage of doctors. Although the government has put in place some initiatives to address that, I have to say a lot more needs to be done in that area. It is very important that the skills shortage is addressed. I do not think that bringing in doctors from overseas is the answer; there are some ethical issues associated with that. It is very important that the government look at the relevant recommendation in this report and strongly commit to the training of health professionals. It is important for Australia’s future. I refer people to recommendation 5, a very good recommendation, and to recommendation 4, which recommends:

The Department of Health and Ageing take a lead role to better coordinate the existing jurisdiction-based recruitment of overseas trained health professionals …

I definitely think we would benefit from the Commonwealth taking that lead role, along with ensuring that adequate numbers of health professionals are trained. That is of vital importance to the Australian people, because not having the health professionals on the ground has an enormous impact on the Australian people.

I could talk for hours on this report. It is one of the best reports that I have seen in this parliament. It is a report that offers solutions, it is a report that identifies problems and it is a report that can show us the way forward, and the government should get behind the recommendations. It is a unanimous report, which was hard to get to because of the different perspectives that we all have on health. But the bottom line is that it is a document that governments of all persuasions can work with and that can deliver better health outcomes to the Australian people.

I thank Ian Bigg, and I thank the secretariat yet again. They did a fantastic job and, without their assistance and the participation of the chair, Alex Somlyay, we would not have the report that we have before us today. (Time expired)

See this speech in context