Tony Zappia (Makin, Australian Labor Party, Shadow Parliamentary Secretary for Manufacturing) Share this | Hansard source

If this was good legislation, coalition members would be tripping over themselves to come into this chamber and speak in support of it. Instead we have seen only a handful of them bother to do so—probably because they know they can defend neither this legislation nor the $50 billion of cuts in health spending that the Abbott government brought in in its first budget. This is one of only several cuts made by the Abbott government in that budget. Having gone to the 2013 election promising not to cut health spending—in addition to a range of other promises—the Abbott government has now managed through this budget to unite people from across Australia. Regardless of political leanings, regardless of whether we are talking about community groups or even political groups such as the premiers of the various states, people from across Australia are united in condemnation of this government's $50 billion of cuts to health spending across the country.

But the criticisms are not confined to politicians and other levels of government. The Rural Doctors Association has issued press statements critical of the health program cuts. The AMA has issued similar critiques. Yesterday I received the May 2014 bulletin of the Australian Dental Association. I will quote the last two sentences of the bulletin:

All in all, funding the dental care has been less impacted than other areas of health. Nonetheless, the losses outweigh the gains.

I repeat the words 'less impacted than other areas of health' and 'the losses outweigh the gains'. This is a non-political and independent analysis of spending in respect to the dental areas.

The South Australian Health Alliance—an alliance of South Australia's leading health unions, health consumer groups, community groups and service providers—have come out strongly with their concerns about the Abbott government's cuts to health programs. I can understand that; particularly coming from South Australia, I am aware that the federal government has cut funding to South Australia by $655 million over the four-year budget forecasts. This is made up of $444 million in cuts to specific purpose payments, $120 million of cuts to national partnership agreement funding for public hospitals, $42 million of cuts to national partnership agreements funding for financial assistance for longstay patients and $50 million of cuts in other health initiatives.

This legislation seeks to repeal the Health Workforce Australia Bill 2009 and transfer Health Workforce Australia's functions into the Department of Health. It has already been stated by the member the Kingston that most of those losses will occur in South Australia, and so it is not at all surprising to hear the concerns of the South Australian Health Alliance. Transferring a program to an existing department may sound like a reasonable thing to do—particularly if it really is going to save public funding; under those circumstances, it could be defended. However, a close analysis of this decision to axe Health Workforce Australia will show that it is short-sighted. It is a decision that will ultimately result in more costs being incurred and no national coordination of planning and training Australia's future health workforce. That in turn will reduce Australia's ability to deliver the very high standard of health services across the country that we would all expect.

The effect of this legislation will be that the responsibility for planning and training Australia's health professionals will fall onto the individual states, as it was prior to the legislation coming into effect. It will result in an uncoordinated, piecemeal approach, rather than a coordinated national approach. The approach we currently have and the legislation that currently covers Health Workforce Australia resulted from a Productivity Commission report of 2006—a report initiated by the Howard government, but not implemented by it. When Labor came to office, we implemented it because we needed a national approach to preparing and planning the medical and health workforce for this country. With the implementation of Health Workforce Australia we have for the first time reliable statistics and reliable projections of the numbers of doctors, nurses and midwives that we need into the future. That in turn enables us to plan for the training of the health professionals that are required to take the place of those who retire or otherwise get out of the industry.

Yesterday the Rural Doctors Association issued a media release, warning that the Abbott government's decision to shut down that general practice education and training will erode the high quality GP training that new medical graduates currently receive. According to the release:

We have very high standards in Australia for the selection and training of GPs, and this been developed over many years. In many respects, Australia's GP training system is the envy of many other countries. It is crucial that these standards are maintained and not destroyed overnight simply because the current government wants to get the budget back into surplus in the shortest possible time frame. This would be a false economy.

The Rural Doctors Association, I believe, reflects the views of people in country areas broadly and certainly reflects the views of those doctors who are working in country areas.

It has been one of the challenges of state governments in this country for a long time to try to ensure that we get enough health professionals in country areas. It has never been easy; it has been very difficult. We have tried to provide incentives for health professionals to do so, but I am aware of many country towns that are still struggling to get the health professionals they need. Just when it appears that we are making some progress through programs that are currently in place, the government comes along and says, 'We are going to cut those programs.'

It is not surprising that the Rural Doctors Association is very concerned about the cuts and is raising concerns. These are the people that you would expect to know most about health services in their communities, and yet the government clearly is not listening to what they are saying. I would have thought that any good minister and any good government would take advice from the very bodies that know most about the issues they are dealing with. But that is simply not the case here, because the government is prepared to put budget cuts ahead of the needs of communities.

This policy comes on top of a series of other cuts to health services made by the Abbott government. Only yesterday we learnt that $9.9 million has also been cut from the training of nursing and allied health students in Tasmania: nursing scholarships will cease from 1 July of this year and allied health scholarships from 1 July 2015. Yesterday in this House we also saw the abolition of the Australian National Preventive Health Agency—another short-sighted decision by the Abbott government. Health preventive programs inevitably have a substantial cost saving for our health system and for the nation. It is much more cost-effective to prevent illness than to treat it. That should be understood by all. It is a common theme and a common message from all health professionals: prevention is better than cure. We have a process and a system in place that the government, again, has chosen to disband or move to another department. It is incredibly short-sighted, and it is not surprising that so many health organisations across the country have come out in condemnation of it.

With these decisions that the government are claiming will save money now, inevitably health costs will be compounded and transferred into the future. The government are transferring those additional costs to future governments and future generations. Of course, the government, and the Minister for Health, who I see is in the chamber, will not be around to wear those future health costs; they will be someone else's problem. That is not responsible government. Responsible government is about doing the right thing for today's generation and for future generations.

There are 1.3 million Australians working in the health sector. It is a major employment sector. It needs good management to make sure that it is balanced and well supported. When Labor was elected in 2007 the health workforce was in total disarray. There was no national strategy or planning for future needs. We had a shortage of health professionals across several health professions. We had a great deal of difficulty in getting GPs and other health professionals to work in country areas. We had a frustrating process in place for international medical graduates to have their qualifications recognised in Australia and then be cleared to work as health professionals in the country. I can recall raising this matter on several occasions and I can recall meeting with several health professionals in my own office. All of them expressed their frustration at having their qualifications properly recognised so that they could take up the job they had been offered but which they were not able to do until they had been cleared. We had the Howard government even threatening to take over hospitals, starting with the Mersey hospital in Tasmania. There was also a limitation on the number of medical places that were made available to students within our universities. This highlights just how chaotic the health system was when we came to office.

The Labor Party set about reforming the process and the system. Many of the reforms we introduced have made the system better. It is only a relatively short period of time that those reforms have been in place, but they are already making a difference. After the Abbott government was elected the first thing it is doing is dismantle everything that has been put in place and cut $50 billion in health funding on top of that.

I have heard the denials from the Prime Minister and the Minister for Health about cuts to health funding by the federal government. Their problem is that nobody believes their denials. Their problem is that all of those who have studied the budget and who need to know exactly what is in it for them have come out in condemnation of the government. The government's problem is that none of the premiers believe their spin that there are no cuts to health spending in this country. None of the professionals around the country that work in the health sector believe their spin that there has not been $50 billion of cuts to the country. And none of the people that I speak to in my community as I get around believe their spin that there has not been $50 billion of cuts to health spending in this budget over the forward estimates. The government's problem is that they know that they have made cuts that are going to deeply hurt the Australian community and deeply hurt the health profession more broadly. It knows those decisions are not popular. No amount of spin, no amount of weasel words and no amount of denials by the minister when he comes into this place will change the fact that health spending in this budget has been cut by $50 billion and that that will have devastating effects for people right around the country.

See this speech in context