Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

Sure, you can select a couple of exceptions and also some areas requiring further focus, such as obesity. In this regard, Australia has not moved significantly, and that does remain a key challenge.

I will now move from AIHW and inject some more fact, this time from the OECD. As I have already indicated, men in Australia rank No. 2 in the world and females No. 3 in the world. We come in behind Japan and France. Our death rates are the lowest in the world, following only Japan’s. There is no mention in that top group of Canada; nor is there any mention of Canada in the top group for life expectancy. For ischemic heart disease, Canada just sneaks into the top five; but it is Australia that sits behind only Denmark and Sweden in the OECD ranking for mortality rates.

Moving to the rate of death from accidental falls—I have lost two grandparents to accidental falls—I note that Australia leads the world in having the lowest rate. Again, there is no mention in the top group of Canada. Rates of Indigenous low birth weight and circulatory diseases are included in a whole area where there are a series of benchmarks which we are watching closely to see improvements in Aboriginal Australia. In looking at the frequency of dental caries in children aged 12, Australia leads the way in having the lowest rates, in front of the UK and Switzerland. Again, there is no mention of Canada in that top three.

This selective reporting of figures that we have seen from the opposition is a little reminiscent of the global warming debate, where everyone was harking to the promises made by Canada, only to find them eventually falling far short of their Kyoto targets. Perhaps, once again, grasping for Canada has not proven to be a terribly wise strategy. I can really only comment on Australia. The OECD comparisons can sometimes be brutal and the differences between economies often relatively small, but Australia has performed exceptionally well in those fairly external and objective comparisons made internationally.

Health is immensely complex. I would not be the first person to say that it is much more than the absence of disease. But the great challenge in this debate, as we have heard for the last half-hour, is that happiness becomes little more than good health and a very bad memory. You do not have to think too hard to remember the state of Australia’s health and the degree of investment in health under the previous government in the early nineties, and the complete lack of alternatives that have been presented by the other side in the 11 years in which we have followed their progress.

Nothing is more marked than the failure that was Medicare Gold, the proposition that came from the other side of the House—one of the first original thoughts we had seen from them—for in-hospital care for everyone over the age of 75. It was poorly costed, it was poorly thought-out and it triaged not on clinical need but purely on age, down to the day. It left partners of those who were over 75 in the lurch. It completely uprooted the whole notion of private care and private health as we know it and, in the end, it fell foul of nearly every commentator except the most biased Labor commentator available. We saw a range of references being made by everyone from Michael Costello to Peter Botsman and of course Barry Jones, who in those few words said that Medicare Gold ‘proved to be a turkey’.

We on this side of the chamber know well that a strong economy that allows families, youth and seniors to plan for the future also allows us to invest in a health system that provides what Australians need. I do not want to be guilty, as a previous speaker on our side has been accused, of not mentioning every sector of the health system, but we have seen consistent increases in investment. We have seen that in the COAG arrangements. That has been witnessed through $42 billion in the healthcare agreements and an increase of $10 billion over the previous agreement. That is only possible with a well-run economy. Of course the other side will say that this was purely by accident—fortuitous externalities that see Australia’s economy moving ahead at the expense of other OECD nations that simply have not achieved such consecutive budget surpluses, and I hope we witness another surplus tonight. It is with that surplus that the great programs that can preserve and promote health can be funded.

One of the traps that the opposition falls into is to say that the division of responsibility between jurisdictions effectively becomes an abrogation of responsibility by the federal government. Of course we leave public health, except for what are called the public health outcome funding agreements, predominantly to the states, just as dental care has rested entirely with the states, except for a short moment of Keating madness as the economy collapsed, with a small injection of funding into dentistry that did nothing for the waiting lists and left states like Queensland no better off. That is the legacy of moments of Keating economics, and since then there have been no policies that have shone any light on alternatives to what the Howard government has done.

Let us look at that aspect. We have seen increases in bulk-billing rates, with rates now at 77.1 per cent. We have seen the return of private health insurance using a range of incentives—Lifetime Health Cover and the Medicare levy surcharge. There have been three strategies that have built the rate of private cover to 43 per cent. I can walk down streets in my community and know that families are protected, many choosing the benefits of private cover and in so doing reducing the burden on hospitals, which was recognised by a former health minister, Graham Richardson, under the Labor government. In my own area, in the Redlands, in the last 18 months alone, there have been 3,000 visits by after-hours mobile GP services—again, taking the strain off the hospital system and preventing individuals and families from having to sit and wait for hours in public hospitals, who now instead have a visit to their door.

I am not about to say that everything one government has done is good and everything that the state governments have done is bad. That is a simplistic argument that has been put to us by the other side. Of course the state governments do what they can, but from my experience in Queensland state governments are very much focused on cost minimisation. It is very much about how they reduce the throughput in public surgery and how they reduce the amount of time spent by VMOs in our hospitals. Sure, they are not firing VMOs; they are just spending a whole lot less time in the hospital seeing patients. What a frightening notion that VMOs would actually be spending time with patients in our state hospitals, to the point that medical students and surgical trainees cannot find work in the public system from which to hone their skills towards graduation and completing their specialty training.

Many of us, both in government and as doctors, recall the indemnity crisis of 2001. It was the premium support provided by this government that actually solved the unsolvable—the problem that Labor had ignored right through the nineties, despite plenty of warning. These were the same warnings about the workforce crisis that they were hearing while they were in government. Of course, it was Graham Richardson himself who said that this country had too many doctors. It has been the Howard government that has turned those workforce issues around with a real focus on rural issues. The government has been looking after both the nursing numbers and the training of doctors and has been ensuring that bulk-billing rates increase right across the country.

I have sat with doctors in their consulting rooms and talked to them about the enhanced primary care initiatives. They are working. The health checks for those over 75 and the health checks for those aged 45 to 49 are working and are addressing the preventative needs that the opposition has spoken about but conveniently ignored. We have invested in HIV as well as in public health. Many of the programs like Healthy Schools and the tuckshop program in state schools which are funded by the federal government have been completely ignored. That is a loss to this debate and I hope that some injection of information makes it clear that, as international comparisons go, Australia leads the world in public health. Any suggestion otherwise is completely deceitful.

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