Dick Adams (Lyons, Australian Labor Party) Share this | Hansard source

What a lot of codswallop that was from the Leader of the Nationals, the member for Wide Bay, basically trying to make an argument that the Rudd government is not facing up to inflation pressures which his government left to the incoming government. And then he decided to argue about expenditure cuts that the present government is trying to make to get control of inflation and to keep interest rates under control. That was a very poor effort from the Leader of the Nationals.

I want to take this opportunity, in the second reading debate on the Appropriation Bill (No. 3) 2007-2008, which will ask for money from the parliament for more expenditure on different needs of the country, to speak about health and the challenges facing the nation with regard to health. The new Rudd Labor government has inherited a health scheme that has suffered from 11 years of total neglect. We have had the blame game. It has been detrimental to health services and thus detrimental to the health of communities. It says something when, as a new government, we have had to commit to spending over $2.5 billion to improve hospital waiting lists, increase nurse training positions and develop new infrastructure through GP superclinics, and yet this will barely scratch some of the surfaces. We know that more will need to be done. This is just a start. We are playing catch-up because the previous government had no understanding of health. It had no vision for the future and no plan. We do have a plan—a plan to restore services such as dental health and a plan to build services such as GP superclinics. We have a plan and a vision for the future, to improve health outcomes for everyday Australians, particularly in primary health care and the prevention and management of chronic diseases.

But we need to be careful how we spend the money, we need to make sure we get value for money and we need to bring the people of Australia with us on this journey. We know that it will be a rough journey at times. The previous government did not spend a lot on health in my electorate—and they did not spend much on roads either. So there will be a few rough roads that we have to ride on this journey of reform. Any reforms that we make, any changes that need to occur, must be made in consultation with communities and not forced upon them. Labor has some good policies on health, which like all our policies have been developed through extensive consultation with stakeholders. This needs to continue.

Rural and regional communities feel vulnerable. They have limited services, limited health services and limited opportunities for training and employment. We need to look after regional communities. It is when there is change that regional communities feel most vulnerable. Some communities in my electorate have recently seen health services removed—hospital beds and aged care beds—and 24-hour emergency outpatient services have changed from face-to-face care to a phone call centre service. The state government was forced to make changes after years of neglect in funding by those in the previous federal government.

Those opposite may disagree all they like with this assumption, but I remember the last healthcare agreements, when the states were bludgeoned into signing an all-or-nothing proposal. We all remember the previous health minister’s remarks when he was asked to commence the current round of negotiations. He was not concerned. He was only concerned about the election. He was much more concerned about the election than doing his job. That is the truth and I think everybody in Australia knows it.

It has been upsetting to see how people have played politics with the communities of my electorate that have been affected by the changes. The state government announced the changes in May last year. In September, some three months later, the federal government announced up to $1 million each for the Ouse and Rosebery hospitals to restore services. Why then? Why wait three months? We got the answer on Monday night courtesy of Four Corners, didn’t we? There was a particularly bad poll—that is, bad for the government of the day—in early September, at the time of APEC. So the former health minister scrambled in desperation and threw $1 million to the local councils to use. They did not see the colour of the money. They only got weasel words that built up an expectation in a community desperate to keep services they had become familiar with. It was a hoax. No money came. It was never handed over. This was bad policy, bad politics and bad use of taxpayers’ money. There was no plan, no vision and no outcome because there was no follow-through. It was also thoughtless and thoroughly disturbing for communities who had had their hopes built up by a few feral politicians and then dashed because they were not told the truth.

I am continuing to help people to develop a proposal for Rosebery, just as I have lobbied for and helped the people of Ouse, who have developed a proposal for an MPS. Both the state government and the new federal government have agreed to consider the feasibility of this. We are moving forward at Ouse, working with people to develop their ideas and then seeing if they can work. We will do the same for Rosebery. But there is not a quick fix for either community—certainly not the quick fix that the previous government tried to make out that there was. Care must be taken. We cannot afford to waste money but we cannot afford to neglect the health of rural and regional communities.

One of the keys to good health is access to services—and quality services at that. A report on rural health by the Institute of Medicine in the United States acknowledges the obvious: it is harder to deliver quality services in rural and regional areas. Of course it is. It is also important that we provide those services, but it may mean bringing much more innovation to the service delivery.

The government’s National Health and Hospitals Reform Commission will be asked to explicitly identify a long-term plan for improving rural health services. The government’s other commitments include funding for new clinics, services and health infrastructure in individual rural centres and a new program to improve the health of Indigenous children. Specific rural workforce commitments include $2.5 million to double the number of John Flynn scholarships available to undergraduate medical students to undertake placements in rural and remote medical practices, $6 million to support the Specialist Obstetrician Locum Scheme and expand it to provide support for GP proceduralists, $2.5 million to establish a rural and remote clinical placement scheme for allied health students and $9 million to support specialists delivering outreach services to rural and remote areas through additional funding of the Medical Specialist Outreach Assistance Program. So Labor has promised extra funding for rural placements for medical students, extra university training places for nurses, including some reserved for regional universities, and a $50 million commitment to my state to help repair the neglect.

We must take care now in spending health funds, and regional communities must be the beneficiaries of this funding as well as those in the cities. The future health of communities in my electorate, in my state, in my country depends on responsible planning and administration and not on knee-jerk reactions to bad polls just before an election. It is going to take time, and we are only just beginning, but the plan is there and the will is there, and I think the understanding of the Australian people is there. There are many ways of developing our health care, and now is the time to start exploring those options. What our system tends to do is deal with sick people, and usually when somebody’s illness reaches a critical point we want to relieve symptoms. This is always the expensive end of things. What if health care was more involved with keeping people healthy or, when they have been sick, helping them to recover their health and keep healthy? Where do we go for advice? There is nothing under our current system that allows an individual to go to a one-stop shop to help them set up a health program to remain healthy or become healthy. It is time to deal with current lifestyles, to start looking at those at risk and to try and move the time when they seek help so that they have the opportunity to deal with a problem before it becomes a medical issue. For example, a lifestyle disease such as type 2 diabetes, seen as a major problem across Western nations, could be dealt with earlier.

There are many other potential problems for which, with intervention at an earlier time, critical medical treatment could be circumvented. We have become so reliant on medical expertise and machinery that we seem to have lost the ability to take some responsibility ourselves. We need to be retaught and, in seeking that tuition, to take responsibility for our lives and our health. There needs to be some assistance. It should be part of the overall health care and, therefore, attract Medicare assistance. The National Health Act, which came into being just after the Second World War, has remained geared to deal with communicable diseases, or those that deal with bacteria and viruses, and environmentally based diseases stemming from war deprivation and primitive hygiene conditions.

Today perhaps we should be looking at lifestyle diseases and all those troubles that we in our affluent society bring on ourselves: heart problems, diabetes, stroke, cancer from smoking, alcohol and drug related sicknesses, obesity et cetera. There will still be some traditional medical problems, but even some of those can be caught earlier and dealt with if people know where to go when they have some idea that something is wrong.

Tasmanians have always been innovators. There are some interesting developments there in dealing with lifestyle health issues. I believe this will lead to major changes in the way we view health, and the community will want to learn how to prevent getting sick rather than having to go through treatment because of illness. Hopefully, this will lead to valuing our doctors more and allowing them to delegate some of their less medical activities to other professionals to let them get on with their own crucial task of helping those who are sick.

Lifestyle health is linked to the ability to afford healthy foods and a reasonable roof over one’s head. As we all know, rents and grocery prices are rising and those on fixed incomes will suffer most. Labor has promised to try to help here and understands the link between good health and good fresh food and food preparation. The fast food syndrome has helped busy people both looking after families and in the workforce, but it has more undesirable side effects. We must act smarter and we must involve the community more in dealing with the problems that come from our current lifestyles. They are so different to those of 50 years ago, and we need new ideas to deal with them.

I am really glad to be in a new, fresh government that is forward thinking and is considering the difficulties that all Australians face today. We can work smarter and we can have alternatives to the way things have traditionally been done, whether in health, housing, cost of living, education or any of the major expenses that we face in our lifestyles today.

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