Craig Thomson (Dobell, Australian Labor Party) Share this | Hansard source

I rise to support the bill in its original form and to oppose the amendment. It is the height of hypocrisy for those opposite to come to this place to talk about health care and say that they are taking a principled position when we saw over 12 years a decline in relation to the contributions that the then federal government made in relation to our health and hospitals system around Australia. It is the height of hypocrisy to stand and lecture us in relation to taking a principled position when they did everything in their power to try and kill off Medicare. This National Health and Hospitals Network Bill 2010 is an important and historic bill and represents a step forward in providing better health and better hospitals for all Australians. It establishes the Australian Commission on Safety and Quality in Health Care, thus delivering one of the major components of the government’s health reform agenda.

Through the government’s health reforms Australia is in the process of experiencing the most significant changes to our health and hospitals system since the introduction of Medicare. The only thing that stands in the way is those opposite. We are creating a National Health and Hospitals Network that is funded nationally and run locally. On the Central Coast of New South Wales they have already started to put in place a number of the reforms that are needed. In only the past few weeks the New South Wales government announced that one of the new local hospital networks will be that of the Central Coast. This will be a truly locally run network—in effect, a local area health service—which up until now has been part of a much larger area health service based in northern Sydney. My constituents have told me consistently that they want a local health network and not one that is part of Sydney or the Hunter. I have made very strong representations on this and I am very glad to see that it is now planned that we will have our own local hospital network. It is great news that the Central Coast will again have its own area health service as it did in the past. I am happy to say that the New South Wales government has listened to the wishes of those in our region and to the representations that I have made.

The reasons for the change were quite simple. Having an area health service attached to Sydney was not practical or effective for Central Coast people. Over the next year there will be a transition from the existing northern Sydney-Central Coast area health service to the new local hospital network based in and run entirely from the local region but maintaining key links and networks with other health services in the state. The new local hospital network will include clinicians, healthcare management experts and community representatives. Our own local hospital network will mean better services for Central Coast residents and will also allow Central Coast health professionals, including doctors, nurses and other health professionals, to have a greater say in how local health services are delivered in our community. The federal government will have a major investment in the new local hospital network, and I personally have a major interest in ensuring that the new arrangements work well for Central Coast residents.

We continue to witness ongoing challenges of supply and demand in our public health and hospitals system, with Wyong Hospital being the fourth busiest emergency department in the state and Gosford Hospital being the fifth busiest. I will do my utmost to see that with the support of this government we rise to meet these challenges. One of the key issues is ensuring our hospital emergency departments are able to see patients effectively and efficiently. Part of the streamlining of emergency departments involves having enough GPs in the community so Central Coast people can see a doctor when they need to and are not forced to go to the hospital emergency department instead. The GP superclinic at Warnervale will help alleviate area doctor shortages, as will the new GP superclinic closer to Gosford—for which a location has not yet been decided.

We have heard many and varied comments and analyses about the government’s GP superclinics, but I would like to say that the GP superclinic model in my electorate is shaping up to be a great example for other areas across the country. The government’s investment in the Warnervale GP superclinic is quite humble compared to the money put in by the operators, who will be putting in $16.5 million worth of state-of-the-art medical services for the fast-growing suburbs around Warnervale. The federal government is putting in only $2.5 million to ensure that that investment is made. More than 100 health professionals will be employed there across a broad range of medical services. The new clinic already has strong ties to the University of Newcastle and will provide a vital training ground for young professionals. The operators of the Warnervale superclinic already have vast experience from running a major medical centre in Toukley and are planning yet another multifaceted medical establishment as part of the overall redevelopment plan for the Mariners Football Club at Tuggerah in my electorate—a proposal that this government promised a further $10 million to in the last election. As part of the government’s health reforms, that is the sort of positive result that we have already started to see on the Central Coast.

Let us go over exactly what this bill will achieve. The government is implementing major reforms to the funding and governance of the Australian healthcare system, which will place it on sustainable foundations for the future. Under the National Health and Hospitals Network, which was agreed by COAG on 20 April 2010, with the exception of Western Australia, the Commonwealth will become the major funder of Australian public hospital services. These major reforms build on the strengths of the current system and will ensure that these remain sustainable into the future.

The new governance arrangements will consist of establishing three agencies: the Independent Hospital Pricing Authority, the National Performance Authority and the Australian Commission on Safety and Quality in Health Care. Arrangements for the IHPA and NPA are being finalised. It is intended that this bill will be amended to include provisions to establish the Independent Hospital Pricing Authority and the National Performance Authority. It is imperative that there be a strong focus on improving the safety and quality of health care that is delivered throughout Australia. To ensure that this is achieved, this bill will establish the Australian Commission on Safety and Quality in Health Care as a permanent, independent body under the Commonwealth Authorities and Companies Act 1997. This will ensure the independence of the commission, which is important to ensure its standing as an authoritative source of knowledge on healthcare safety and quality matters. The commission will continue in its important role in helping to reduce harm caused by preventable errors, which will continue to have a positive impact on community trust.

An important part of the commission’s expanded role will be to set new national clinical standards and strengthen clinical governance to lead the drive towards continuous improvement in quality and to safeguard high standards of care. The commission’s expanded remit also extends to ensuring the appropriateness of care in all healthcare settings, including primary care and mental health. Accreditation of health service providers is currently undertaken by a multiplicity of accreditation bodies and some high-risk services are not yet subject to accreditation, leading to a nationally inconsistent assessment of safety and quality standards. The commission will therefore continue its work in developing a national accreditation system and will develop a national model accreditation scheme. The development of national clinical standards, guidelines and indicators, together with its work on a national accreditation model, will support the take-up of the commission’s work.

The states and territories have been consulted on the bill and are generally supportive. The government is implementing major reforms to the funding and governance of our health system to place it on sustainable long-term foundations. We are changing the way that health services are delivered through better access to services designed around patients’ needs and a greater focus on preventive health and the provision of care outside of hospitals. We are also investing in our health system and our health workforce to deliver better care and better access to services for patients, now and into the future. The bill I am speaking on today is a key component of this overall health reform agenda, some of the key areas of which are the capacity of our health system, better connecting care, access to services, preventive health, sustainability and quality.

To ease the pressures on our health system, we need to increase its capacity and the services available. This means more doctors, more nurses and more beds. The Gillard Labor government is investing $1.2 billion as part of the National Health and Hospitals Network in doctors, nurses and allied health professionals. This will deliver 5,500 new or training GPs and 680 medical specialists over the coming decade. It will improve support for more than 4,600 full-time equivalent nurses working in general practice and help train and retain our valuable aged-care nurses. And we will support 800 allied health professionals working and training in rural areas over the next four years. We will also invest more than $1.6 billion for more than 1,300 new subacute beds, to reduce bottlenecks and capacity constraints in our system. These beds will be delivered in areas like rehabilitation, palliative care and, importantly, mental health services, so that people can get the right care for their needs.

As part of the National Health and Hospitals Network, the government will ensure that services are better connected and coordinated, reducing fragmentation and the blame game. Local hospital networks will be established, like the one on the Central Coast. They will be more responsive to local communities, and new funding arrangements, such as the introduction of activity based funding, will provide strong incentives for better performance and reduced waste.

The Commonwealth will also take funding responsibility for 100 per cent of primary care, ending duplication and divided responsibilities. The government will establish Medicare Locals, which will work with local GPs, allied health and community health providers to drive local integration and coordination of services and improve access to care. And, to bring the health system properly into the 21st century, the government will invest $466 million to establish personally controlled electronic health records, reducing mistakes and duplication and ensuring that, with patients’ consent, doctors have the information they need, when they need it.

The National Health and Hospitals Network will also deliver better, more timely access to health services in local communities across Australia. The government will establish a national after-hours GP and primary care service. This will enable anybody calling their GP out of hours to be referred to a nurse or a GP on the phone, and if necessary be referred to a local after-hours GP service, coordinated by their Medicare local. The government will also invest $355 million in more GP superclinics and expanded GP clinics in about 450 locations across Australia. These will bring together in a single location services such as GPs, allied health professionals and practice nurses so that patients can more easily get the full range of care they need. The National Health and Hospitals Network will also provide strong guarantees and targets to improve access to public hospital services—reversing the neglect from the Howard government ripping $1 billion from hospitals.

The Gillard government will invest $750 million so that emergency department patients will have a guarantee that they will be treated, admitted or referred within four hours, where clinically appropriate. An investment of $800 million for elective surgery will help back a target that 95 per cent of elective surgeries be delivered within the clinically recommended time, and a guarantee that patients facing excessive waits should have their elective surgery fast-tracked.

Keeping people well and out of hospital is a critical component of the Gillard Labor government’s health reform agenda: while we are improving our hospitals, we also need to reduce pressure on them and keep people out of hospital in the first place. To achieve this, the government will take world-leading action to combat tobacco, which contributes to the death of over 15,000 Australians a year. The government will introduce plain packaging for all tobacco products—a world first—in addition to raising tobacco excise, which is expected to result in 87,000 fewer smokers. The government will also invest $449 million to improve care for people with diabetes, which is fast on the way to becoming one of the major burdens of diseases in this country.

To ensure our health system is to be sustainable into the future, the Commonwealth will take, for the first time, funding responsibility for all GP and primary care services and all aged-care services. The Commonwealth will also become the dominant funder of Australia’s public hospitals, paying for 60 per cent of hospital activity and capital, as well as 60 per cent of training and research costs in public hospitals. These changes will mean that one government will have dominant funding responsibility for all parts of the health system, ending the blame game and the perverse incentives for buck passing and cost shifting.

The government has already begun delivering on its reform agenda in six key areas: our hospital projects, including expanding hospital capacity as part of the National Health and Hospitals Network, and landmark Health and Hospitals Fund projects and regional cancer centres; investing in our workforce, with new GP training places online from next year along with nursing and allied health scholarships and locum places; primary care infrastructure, through more GP superclinics announced recently, and funding rounds to upgrade general practices currently underway; e-health and telehealth, with Medicare rebates for telehealth from mid-2011 and electronic health records from July 2012; system reform, with local hospital networks and our first Medicare Locals being established from the middle of next year; and prevention, with investments being rolled out from mid next year for children and workplaces to prevent disease.

If we are to have a truly National Health and Hospitals Network spanning Australia, it is essential to have strong safety and quality standards so that all Australians can be confident that they will receive consistently high-quality care, wherever they live. This bill provides for framework legislation to establish the Australian Commission on Safety and Quality in Health Care. It is imperative that the government’s health reforms ensure that the Australian public receives safe, high-quality health care. The Australian Commission on Safety and Quality in Health Care will be established as a permanent body with an expanded remit to drive safe, high-quality care and ensure the appropriateness of services delivered in particular healthcare settings, including primary care and mental health.

This is an important piece of legislation and is part of an important reform process that this government is committed to. This bill should be passed without amendment. I commend the bill to the House.

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