Russell Trood (Queensland, Liberal Party) Share this | Hansard source

This government loves to talk about reform. There is nothing it likes to talk about more than health reform. At the 2007 election, it talked about health reform; during the Rudd years, it talked about health reform; at the 2010 poll, it talked about health reform. And now it is back on the agenda. But the reality is that this government’s record on all reform and in particular health reform is appalling. It has achieved so little that it is remarkable that it is even willing to contemplate further efforts. The problem for patients Australia-wide is very simple indeed and it became evident a very long while ago. As with almost everything else that this government does, it has not got the first idea about what it is doing. We have now reached a new depressing low in relation to reform and in particular health reform. The Prime Minister has signalled that she is on the verge of scrapping last year’s much-vaunted health reform agreement, one that drew in the states.

Bearing in mind that we are on the verge of ditching yet another so-called historic reform, it is useful to recall the government’s level of achievement in this area—the successes, if you like, that might be claimed in relation to change in the health area. There is probably not one of us here and perhaps more widely who do not recall Kevin Rudd’s 2007 superclinic promise. There were to be 31 monolithic health centres dotting the landscape from one end of the country to the other. These would offer bulk-billing, GP services, diagnostics, specialist suites and pharmacies. Everything would be together. All that one would have to do was make one stop and all one’s medical and pharmaceutical needs could be met at once.

What was the result of that promise? As at last year’s election, a total of three of these facilities were up and running—not even 10 per cent of the policy was achieved. Flushed with the success of not even achieving 10 per cent of the promise, the Prime Minister then announced that she was planning the construction of 450 new clinics. As I calculate it, the implementation of this program will take in the vicinity of 600 years. That might be slightly longer than most of us are going to be here to see the success and slightly longer than any other Australian might be around to see the success.

So having achieved that policy triumph and having made this announcement, where will we go from here? It is hardly surprising that there is another set of reform proposals. They are all in the marginal—not mainstream—areas of health. Having failed to succeed at that particular reform, the government moved on to not only superclinics but also a whole series of other very minor changes. They are all on the fringe of the real health reform that is needed in Australia. They are the pet projects of the social engineers within the Preventative Health Taskforce. They are everything but what we desperately need.

Back in 2008 Minister Roxon and her health department wasted an enormous amount of time, energy and resources by waging a war against sugary alcoholic beverages. It was quite clever politics because it served a particular constituency, but it failed to address the serious elements of health reform. The reform caravan moved on but it did not move onto mental health services, aged-care places, hospital waiting lists or the things that one would regard as the absolute core of genuine health reform; instead, it moved onto the debate over the cataract rebate. Here they sank to a new low by playing the politics of envy. It was an outrageous campaign that accused the specialists of being completely self-interested and that their opposition to the policy was essentially motivated by a desire to protect their income. All of this was for nothing more than 0.2 per cent of the health budget.

Alcopops, smoking taxes and cataract rebates are hardly the foundations of genuine and serious health reform, nor were the extravagant claims that the health system could be repaired in 18 months or so. There is no doubt that Australia’s health system is complex. There is no doubt that it tries to balance the interests of the public and private sectors. We have duplication and overlap between federal and state responsibilities. We have a $30 billion hospital system and a $20 billion Medicare service which often work at odds with each other rather than complementing each other. The result is a high degree of cost shifting on a grand scale between the two levels of government.

Mr Rudd proposed a solution to this problem. It was a very bad solution, in my view, because at the very centre of his proposal was what I would call a fiscal sleight of hand with the government proposing to fund a larger proportion of the hospital system expenses of the states by seeking to take 30 per cent of their GST revenues. I cannot believe that anybody in this country seriously believes that a better health system will be achieved by adding another layer of bureaucracy to that which already exists. But it made absolutely perfect sense to a Labor government to add another layer of bureaucracy because when one of these regional health arrangements inevitably collapses they can all blame each other and the Commonwealth can escape from under.

This was an ill-conceived scheme. It remains an ill-conceived scheme and we should perhaps be praising its decline. If the Prime Minister is going to ditch it, that is well and good. This was another case of reform that had run off the rails and it was another failure to make serious changes in an area where Australians expect change, need change and where a Labor government has failed to deliver.