Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

I too rise to speak on the report on health funding of the House of Representatives Standing Committee on Health and Ageing. I would just like to note that the committee has been very well served by its chair, the honourable member for Fairfax, and the deputy chair, the member for Shortland. The member for Shortland will shortly be stepping down due to other commitments. As it happens, I will be assuming the position of deputy chair. I look forward to continuing the good work of the honourable members for Shortland and Fairfax.

The House of Representatives Standing Committee on Health and Ageing convened its inquiry into health funding to investigate and report on how the Commonwealth government can take a leading role in improving the efficient and effective delivery of high quality health care in Australia. It is worth emphasising that the purpose of this body, consisting of federal members of parliament reporting to the federal government, is focused on what the federal government can do. The report is partially named The blame game.

It is not the purpose of this inquiry or its report to give the government reason or opportunity to say, ‘Don’t look at us—don’t tell us what needs to be done; tell it to the states,’ or, ‘We’re the good guys and the states are the bad guys,’ or, ‘The states are the good guys and the federal government are the bad guys.’ The report, which was signed off by MPs across the party divide, contains a message to the federal government which consists of actions that, in the committee membership’s view and that of the many witnesses and contributors to the report from around the country, the federal government itself needs to pursue and implement.

The report includes 32 recommendations, covering a national health agenda, the health workforce, private health and improving accountability. I am sure the content of this report will be referred to by MPs, journalists and commentators for some time to come, and that we in this place have ample opportunity to raise points on its content over the months before this government—in fact, all of us—will be held to account at the 2007 federal election.

I have only a few minutes to speak to this report today, so I will limit myself to just one or two points. The first category of recommendations focuses on the primary area of concern within the health system—the roles and responsibilities of governments and our need to elucidate and rationalise the funding, structural and service delivery arrangements to maximise health returns with a minimum of waste. It should be done, it is recommended, without turf wars or hissing matches or a preoccupation with historical arrangements and practices. The idea of a substantial reorganisation of the national health system is large—in fact, very large—but so are the costs of ignoring this path forward.

The total health expenditure in 2004-05 is estimated to have been in excess of $87 billion. The funding mix by source is relatively stable from year to year, at 46 per cent federal, 23 per cent state and local, and 31 per cent private funding. Over the 10 years to 2004-05, health expenditure rose by an average of 8.3 per cent per year, or 5.3 per cent per year after inflation. Everyone expects this to continue and to contribute towards ever-increasing budget allocations of governments and households around the nation.

Most projections envisage a doubling of government funding as a proportion of GDP over the next 40 years. I am glad that the 26,000 people over the age of 65 in my electorate of Hindmarsh are notionally benefiting from increasing health expenditure and the continuation of life which it has provided for. By the time we in this place reach our 70s and 80s, we are going to have to make some pretty challenging economies for Australia as a whole to be able to deliver world’s best practice to all who need it around the nation. We have heard, from time to time, people from all walks of life talk in favour of shaking up the mix of health funding sources and service delivery responsibilities.

The Minister for Health and Ageing has spoken in favour of the federal government taking over hospitals. The South Australian premier has offered him the keys. In fact, even the federal shadow minister for health has been speaking on similar lines for some time. This is all very encouraging, but it will take real political courage when rearranging $80 billion plus of funding and spending per year—a figure which is rising.

It could affect other financial landscapes and features that offer, I suppose, a nervousness with the consequential political risk. It would be a welcome change if all players, from the Productivity Commission through all levels of government and the very public whom the system is here to serve, could maintain a focus on the desired outcomes, which I have to say has not been the case over the last 10 years. Since the abolition of the Commonwealth dental scheme 10 years ago, the government has consistently stated that dental care is not a federal issue. From what we have been hearing, if there is gum disease or dental disease in the non-working population and teeth are falling out left, right and centre, the federal government are not going to lift a finger. It is much better in their view to play the silly little game that they think absolves them from the consequent suffering in the community. We hear constantly that it is the fault and the responsibility of the states.

What do you say to Mrs Mazzone, a constituent in my electorate of Hindmarsh, who contacted my office last month? She is a pensioner and of very limited means. Mrs Mazzone has been on the public dental waiting list for over 2½ years. She finally received a letter recently telling her that she could go to a private dental clinic and that it would be paid for by the public scheme. When she turned up to the dentist, after having to wait 2½ years, she was told that she had chronic gum disease, that he was not a gum specialist and that she would have to go and see a gum specialist. She went back to the dental clinic, only to be informed that she now has to wait at least two years to see a gum specialist. That is another two years of waiting, during which there will be further deterioration in her teeth and her gums. So how is Mrs Mazzone’s health going to be affected—not just her gums and teeth but her ability to maintain overall health? For someone to have to have rotting gums or bleeding teeth month after month I feel is totally inhumane, and no government should pass the blame on to someone else. We have all been elected here to try to do something to help people.

I am sure that, if the government are listening to this debate on this report, they will be automatically and instinctively thinking, ‘This is great: we can get a free kick against the South Australian government for not putting enough funds into dental care,’ or whatever they want to say. But, if they are thinking that, they will have proved my point that they have simply wiped their hands of health outcomes. That is evident. In seeing a woman’s pain and her suffering, as I did last month, it is just callous and ruthless to have people wiping their hands of it and saying, ‘It’s not our responsibility.’ I think we all have a moral duty to make sure that we make life better for people. If you have bad teeth and health problems with your teeth, why is it any different from when you have a broken arm and you go to a doctor to fix your broken arm? There is no difference. Pain is pain; they are both health issues.

Looking at the table of recurrent health expenditure by health area and the sources of funds in the report, you will see that dental services is an area of expenditure that is far and away like no other additional area of expenditure picked up by the individual out there in the community. Over $4 billion is being spent per year, with perhaps only $250 million coming from other sources. Again bringing the attention of the House back to health outcomes and where people on very limited means are clearly unable to cover the expense of maintaining their own health, as demonstrated by people enduring ongoing decay of teeth and gums for year after year, I think the government does have a responsibility to step in and take action. It does so in other areas of health; it should with dental health as well. I am glad that the committee agrees with me on this point, as is evident in recommendation No. 3 of the report, which states:

The Australian Government should supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups. This should be linked to the achievement of specific service outcomes.

It is idiotic not to; it is cruel and idiotic if we do not. It is immoral not to prevent suffering and it is financially idiotic to allow a person’s health to deteriorate for want of minimal care and treatment to a stage that requires much more substantial and expensive intervention.

I congratulate the members of the House of Representatives Standing Committee on Health and Ageing for recognising this and having the ability to make the recommendation that is clearly contrary to the own minister’s and Prime Minister’s irresponsible position on dental care. This brings me to another chapter of the report—promoting wellness. The hospital system is the most expensive element of the health system and obviously keeping people out of hospital through preventive health measures is the way we have to go. (Time expired)

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