Senate debates
Tuesday, 16 August 2011
Business
Withdrawal
12:35 pm
Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Hansard source
This motion deals with the government withdrawing one of its supposed key planks: the Federal Financial Relations Amendment (National Health and Hospitals Network) Bill 2010. This legislation is now redundant, very much like the Australian Labor Party's grand hospital reforms, which began with such great fanfare. We saw Kevin Rudd and Nicola Roxon daily on our television screens all garbed up in hospital attire for the photo opportunities that found their way onto the MyHospitals website. And of course it was all to no avail because this piece of legislation, like the other pieces of legislation—this whole sad and sorry saga that was the grand hospital plan—is all falling apart. It is falling apart because we are now back to business as usual. This has been an enormous backdown by a desperate Prime Minister. This is the third time Labor has claimed that it has reached a so-called historic agreement on health reform in the past 18 months, but it has failed spectacularly to deliver in relation to health and so-called health reform. What this government talks about as 'health reform' barely resembles the supposed agreement promoted by then Prime Minister Rudd only last year and further watered down, with the revised agreement further watered down by Prime Minister Gillard earlier this year.
Then the government could not get any agreement with the states. Quite frankly, we are not actually sure now what is in and what is out—what has fallen off the back of this reform. We do not know what is going to happen with mental health, we do not know what is going to happen to primary health and we do not know what is going to happen to aged care. Key changes will not be implemented until at least 2014-15. That is seven years after Labor promised it would fix the public hospitals or else hold a referendum to take them over. Remember Kevin Rudd's famous words, 'The buck stops with me'? That is obviously another broken promise from a government that has made breaking promises an art form.
The central tenet of Labor's health reforms was the grand promise that the Commonwealth would become the dominant funder, at 60 per cent of hospital costs. Of course, that has been scrapped. Remember the supposed increase to 50 per cent funding of hospital services? That will not occur until 2017—at least two elections away—and with no explanation whatsoever as to how it is to be funded. The efficient price of hospital services has yet to be agreed to, and further negotiations may even be required on the scope of services eligible for Commonwealth funding.
As I said, we had Kevin Rudd telling us, 'The buck stops with me,' but Julia Gillard today says that the states will be in charge. This is business as usual, and it is very clear that, in the end—and this is always going to be the case—the states will end up rolling the Prime Minister, as they inevitably have done. Julia Gillard has also broken Labor's promise on elective surgery guarantees. Patients in category 1 who had waited the clinically recommended time were promised that they would have their surgery in five days, patients in category 2 in 15 days and patients in category 3 in 45 days. That is now gone. The new national elective surgery targets will not be fully implemented, if they are at all, until 2016, with 'reward'—and I put that word in inverted commas—funding now paid in advance to state governments. And of course there are absolutely no guarantees to patients. The national emergency access target for patients to be admitted or discharged within four hours has now been watered down from 95 per cent of emergency department patients to 90 per cent—and it will not be fully implemented, if it is at all, until 2015.
So what do we have here? This is not a plan that is going to help patients. It is not going to fix the hospitals as Labor promised, but it is certainly great for the bureaucrats, because we have more bureaucracy. Hundreds of millions of dollars have been spent this year establishing the National Health Performance Authority, the Independent Hospital Pricing Authority and Medicare Locals. We still do not know what Medicare Locals are actually going to do. We do know that they are going to have an office somewhere, but we do not know what they are going to do. Of course, there was the National Funding Authority. In the end, four years after Kevin Rudd first promised health reform as a priority—one of his many priorities for his Labor government—the deal that has now been signed off has been so watered down that it barely resembles what Kevin Rudd said he would do.
Is this really reform? How many new beds are we actually going to see in hospitals as a consequence of it? It is interesting to see some of the comments that have been made in relation to the latest iteration of this so-called deal. The Chairman of the Australian Healthcare Reform Alliance, Professor John Dwyer, summed it up in this way to the ABC on 2 August:
It is a reform package in a financing/accounting sense rather than in a system sense.
So instead of seeing this sweeping national reform that had been promised by the Australian Labor Party, Australians have simply ended up with some system change and more bureaucracy, forking out billions of dollars just so that this very desperate Prime Minister could look like she was actually achieving something.
While more money may flow to the states, there are of course no guarantees of better health outcomes for patients. This is what health reform should have been about. It should have been about better outcomes to patients, but there are no guarantees. All of this promised improvement in healthcare delivery is in the never-never. It is all years and years and years away. There would have to be a third election win before we would even contemplate any changes coming into effect—something that Kevin Rudd promised to do in 2009. And of course Labor will have to win a fourth election victory before any of these reforms will be fulfilled. Can anyone actually believe that this incompetent government will ever deliver on so-called health reform? Julia Gillard said that 2011 was to be the 'year of delivery'. But the latest iteration of this agreement makes it clear that this is certainly not the year of delivery in relation to any form of health reform. We will not be looking at anything happening in health before 2014 at the earliest. All we have seen of late have been reams of paperwork and millions of dollars that have been wasted in preparing all these various iterations, which have absolutely gone—the red book, the green book, the yellow book, the blue book. Then there was the $29 million that was wasted telling us that we would get health reform, but of course we are still waiting—and we are going to have to wait a long, long time.
So, in the end, as I said, guarantees on elective surgery waiting times and emergency department treating times have now become targets; promised private hospital treatment has disappeared; penalties for poor performance have been dropped; rewards have become upfront payments; and states have become the gatekeepers for the much-hyped National Performance Authority. Can we really believe this Prime Minister when she talks about more beds, more services and less waiting time? We have heard it all before. There has been no delivery, and all we are getting is more talk.
Back in 2008 Kevin Rudd claimed that increased funding in health could support an additional 3,750 hospital beds in 2009-10, growing to 7,800 additional beds by 2012. But of course the State of our public hospitalsreport last year found that there has only been an increase of—wait for it—11 beds across Australia! All those photo opportunities, all those visits to hospitals—over 100 of them—and all we got were 11 more beds.
There was the $150 million on the elective surgery waiting list 'blitz'. But, as newspaper after newspaper across Australia has reported, waiting lists have only increased in our public hospitals all over Australia. So, what is going to be different this time around? Absolutely nothing. Ms Gillard has backflipped, she has backed down, she has traded off the Kevin Rudd proposals and her agreement was absolutely, totally and utterly unrecognisable when compared to Labor's promises in relation to reform. So it is not surprising that we now see legislation has become redundant. It sort of reminds you of the Monty Pythonskit with the dead parrot—the parrot is deceased, it is dead, it is no longer. I do not want to trivialise it, but this is the reality of, quite frankly, the farce that has now become this government and so-called health reform.
Question agreed to.
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