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

This budget's prime purpose is about spreading the benefits of the boom to all corners of our country by delivering much-needed new financial relief to families and businesses under pressure. It will return to surplus to provide a buffer in uncertain global times and to give the Reserve Bank room to cut interest rates further if it needs to. It will protect low- and middle-income Australians and our community's most vulnerable with reforms like the historical first steps towards the National Disability Insurance Scheme, aged care reform and a blitz on dental waiting lists. Our interest, and my interest as the member for Lyons, is how this budget can help get better health and aged care, whilst still ensuring that there are jobs to go around to all.

Many people in rural and regional Australia have poorer access to health services than other Australians. Unfortunately, this results in poorer health outcomes. The Gillard government will seek to address this by building on our record investments in health facilities and buildings. Those living in rural and regional areas will benefit from 76 new projects under the Health and Hospitals Fund, including hospital redevelopments, community health centres, multipurpose services and dental facilities. To attract, train and retain permanent health professionals in the bush, accommodation for students and health professionals, including locums, will also be built and improved. If we are to attack the problem of ever-increasing costs in health care, then the key is to make our primary health more efficient and more accessible, giving the local communities opportunities to help themselves and their families. If we can keep all the minor problems dealt with at a local level, the hospitals will then be able to deal with the emergencies and chronic illness problems.

I have been working to ensure that my areas have benefited under these programs. I have already helped Sheffield Medical Centre set up a very efficient service, and two others are underway in the north, with Deloraine and Longford also developing expanded services. The funding of these communities will improve access to GPs and it is expected that the facilities will include general practice nurses and allied health specialists and have an emphasis on chronic disease care. Three other areas currently under negotiation are Sorell, Brighton and Bridgewater-Green Point. Greenpoint Medical Services will expand within the existing practice building, while the Sorell and Brighton councils will be working with local health service providers to deliver new health services and to attract new additional health professionals to the region. I am pleased that these later projects are shortly to be started; I have been seeking their establishment for the last few years.

I know that there will always be debate about savings measures, but we need to look at the broader perspective and how carefully targeted savings enable us to make some important, evidence based investments to improve the health system. A key example of the Gillard government's commitment to evidence based policy is the expansion of the National Bowel Cancer Screening Program. The program will extend to provide regular five-yearly screenings for people between 50 and 70 years of age. Consistent with the National Health and Medical Research Council guidelines, the program will further extend in 2017-18, when a phased implementation of biannual screening will commence. Bowel screening saves lives. Screening at regular intervals will pick up around 12,000 positive tests and save between 300 and 500 lives annually. This program does not have to take place in a main hospital; both this and the breast screening program can be delivered in a separate area using specialty trained staff—bringing it back to the local community.

Then there is dental health. It is a fact, sad but true, that around 400,000 people on public waiting lists, together with a range of people with limited means, have poorer dental health than their fellow Australians. Not only does this affect their health; poor dental health can also affect people in many other ways, including their confidence and ability to get a job or engage in many community activities the rest of us take for granted. In the budget, the Gillard government is investing $515 million in foundation measures to support reform in dental care. An estimated 400,000 adults will benefit from a blitz on public dental waiting lists. This initiative is clearly focused on Australia's most in need: lower income Australians who have waited months, possibly years, for dental treatment, unlike Mr Abbott's poorly targeted chronic disease dental scheme—a complete failure. The dental workforce will also get a boost with 50 extra voluntary dental graduate placements and 50 new oral health therapist graduate placements. A new grant program will encourage and help dentists to relocate to regional and rural and remote areas. This is very good for Tasmania.

In addition, the Gillard government has allocated $10.5 million for national oral health promotion activities—such as 'Clean your teeth' campaigns. The government will also invest $8.2 million through the Health and Hospitals Fund for projects that will support new dental chairs and mobile dental clinics in regional areas. This is another plus for regions like mine. Another innovation which I believe is vital for modernising the delivery of health care is the introduction of e-health. I have already spoken on this earlier this year and pointed out that the introduction of the Personally Controlled Electronic Health Records Bill is to enable the establishment and operation of a voluntary national system for the provision of access to health information relating to consumers of health care. It will, firstly, help to overcome the fragmentation of health information, and we know what that is like. I heard the other day that the AMA is still holding out for something, saying that they do not understand the software. I would just like them to get on board and give it full support. In hospitals in Tasmania we still see orderlies rolling files on big carts around the aisles. It is 1950s stuff, but it is still going on. The fact that we have not been able to upgrade to an electronic system is a real issue and people ought to be looking at why it has not happened earlier. Secondly, it will improve the availability and quality of health information. When something is electronic much more information is available. How much could that help health care in this country? Enormously.

Thirdly, it will reduce the occurrence of adverse medical events and the duplication of treatment. When someone goes to a doctor and has tests but then a few days later sees another doctor elsewhere, the tests may have to be done again because no record can be transferred from the first treating doctor. It is known that in any one week, one in three Australian GPs sees a patient for whom they have no current information. More than one in five GPs faces this situation every day. To allow it to get to that point today is, I believe, an indictment on some of the professionals as well. We know that about two to three per cent of all Australian hospital admissions are medication related. This represents about 190,000 hospital admissions each year—costing $660 million—of which about 15,000 are due to inadequate patient information. I heard today that 46 per cent of Australians have literacy and reading difficulties.

The practical benefits of e-health are obvious. But the e-health journey is not one that will be completed overnight. It is not just a matter of, 'Flick on a switch and away you go.' During the last two years, the government have been building the foundations for the national e-health records system. And progress has been strong. We have been working hard to build the essential digital infrastructure—the virtual poles and wires—for the national e-health records system, ensuring a common language that will allow the different parts of our health system to talk to each other, connecting up our medical records, and connecting the computers of our hospitals, GPs, specialists and allied health professionals to each other.

Over the last two years, the government has also provided more than $160 million to general practices across Australia—up to $50,000 per practice—to upgrade their computer systems for e-health. Government support has helped more than 96 per cent of Australian practices to get the IT they need for e-health—a percentage more than two times better than that of practices in the United States. That makes our GP workforce the fifth most computerised in the world. Now that many practices have most of the IT in place, we want to make sure government focuses its investment on the rollout and take up of e-health records. In the budget, the Gillard government is investing $233.7 million to continue the rollout of a national, secure e-health system.

Once the digital infrastructure is in place, patients will be able to register for their own e-health record through Medicare shopfronts and over the phone. Mums and dads will be able to register for their kids. When they are registered, patients will be able to go online to view their records and add a range of basic health information. This will include things like emergency contact details, the location of advanced care directives, allergies and medication. This will be a gradual process, carefully managed. As more patients and doctors register, more detailed features will be available as part of the record. Eventually things like immunisation records, Medicare and pharmaceutical benefits information, organ donation details, and hospital discharge papers will be able to be added. The budget should not be seen in isolation but rather as the next instalment in our investment in health reform. Health reform has been strongly focused on delivering a more evidence based, well-targeted health system. As many of you know, the Commonwealth is investing about $20 billion up until 2019-20 to improve public health services.

Significant funding will be paid to states where they have met targets for elective surgery and emergency department performance. These targets were developed with close consultation with medical experts, chaired by the Chief Medical Officer. We are also introducing activity based funding from 1 July this year, to ensure that all hospitals are paid in the same way, based on the services they actually deliver. The Minister for Health, Minister Plibersek, has been keen to increase transparency and accountability of those funding arrangements. The new arrangements will provide unprecedented transparency of Commonwealth and state contributions to our health and hospital system. All Commonwealth funds for public hospital services will flow through a new funding pool, enabling us to track where the funds go and how they are spent—more information for decision making. State and territory activity based funding for public hospital services will also flow through the funding pool. We will therefore know the relative contributions of the Commonwealth and state governments. No more shifting the buck.

Improved transparency of the performance of services at the local level is another critical element of the reforms. As you know, the National Health Performance Authority will use the measures and the standards identified in the performance and accountability framework to assess the performance of health and hospital services. This is real reform. As well as ensuring that innovative and effective practices are shared between local hospital networks and between Medicare Locals, the reports produced by the authority will help identify those that are underperforming to enable efficient performance management.

The final plank of the national reforms is safety and quality. The newly formed Australian Commission on Safety and Quality in Healthcare is already developing, implementing and monitoring national clinical safety and quality standards. These standards cover safety, quality and appropriateness of clinical care. These structural reforms will provide the opportunity for greater clinical engagement in our health and hospital system through new devolved governance structures in local hospital networks and Medicare Locals.

The main areas of funding by the Commonwealth are around health and education. This government has delivered on this front very well. I am still getting thanks from many country schools in my electorate that benefited from the BER scheme, with upgrades that they have been seeking for decades. Health is the next area that really needs to be addressed and this government has the runs on the board and I know that it will happen. This budget delivers the promises Labor has made to look after those on low incomes, working families, veterans, pensions and seniors. I congratulate the government on achieving what they have set out, still having a surplus. A lot has been achieved, especially for those on low incomes.

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