Helen Polley (Tasmania, Australian Labor Party) Share this | Hansard source

The opposition's criticism of the government's approach to the health sector is one of the most hypocritical and disingenuous claims that I have heard since I have been in this chamber. The National Health Reform Agreement, announced in partnership with states and territories on 2 August 2011, is a huge step towards a better health policy for this country. The agreement increases publically available information to enable a proper comparison of health service performance and ensures more transparent funding of public hospitals based on services delivered. In addition to this, it substantially enhances access to care to drive improved efficiency.

For the first time, Commonwealth funding will be directly linked to the actual level of services delivered by public hospitals, with funding flowing from the National Health Funding Pool directly to local hospital networks. From 2014-15 Commonwealth public hospital funding will be completely uncapped and based solely on activity levels. States will not simply get lump sums of cash but will be paid according to the work done by the hospitals—so that, as service levels and costs rise, Commonwealth funding will rise as well. The agreement will result in an extra $19.8 billion spent on public hospitals through to 2020 and a total of $175 billion to 2030. It is also worth remembering that the agreement carries a pledge of accelerated emergency department treatment and substantial cuts to elective surgery waiting lists, so that all Australians receive the care they need without lengthy delays.

The adjustment in Commonwealth funding to the states, announced by the Commonwealth Treasury on 3 November 2012, was undertaken in accordance with the terms of the Health Reform Agreement. In the first two transition years of the agreement, Commonwealth funding variations may occur based on the application of the agreed funding formula set out in the Intergovernmental Agreement on Federal Financial Relations. The formula is calculated with reference to growth in population estimates provided by the Australian Bureau of Statistics, a health price index provided by the Australian Institute of Health and Welfare and a fixed technology factor. When they signed the agreement, every jurisdiction approved this formula which reflects the costs of delivering public hospital services. There is no grand conspiracy; the adjustment was simply made in accordance with an agreed formula.

Last week in Melbourne the Finance and Public Administration References Committee's hearing into the implementation of the Health Reform Agreement heard that numerous false allegations have been thrown at the government. The Victorian Premier Ted Baillieu and his health minister, David Davis, in particular, have been quick to blame the woes of their inept leadership and lack of commitment to health funding on the Gillard government. Commonwealth funding to the state of Victoria is increasing by $900 million over the next few years. With such a comprehensive increase, it really is incredible that the Victorian government cannot take care of the state's health system.

Instead, the Victorian government budget papers show significant cuts to health funding by the Baillieu government in both 2011-12 and 2012-13 of some $616 million. Elective surgery waiting lists have reached a record high of 46,131. I note that this is 7,000 more than when the Premier came to office. However, they are not owning up to their mismanagement of the state's health sector. Instead, as the Victorian branch of the Australian Nursing Federation informed the committee, the Victorian government is using the recent Commonwealth funding adjustments as a smokescreen to hide their own massive cuts to the state's health sector.

It is important to bear in mind that the Victorian Liberal government has not, since June 2012, issued its quarterly reports of elective surgery waiting lists and emergency department waiting times. It has not, as is customary, entered into a statement of priorities with the state Department of Health to indicate what services they intend to provide. The Baillieu government has also failed to provide the independent Health Reform Agreement administrator and the National Health Funding Pool with details on how it is allocating the Commonwealth funding. None of this information has been forthcoming. The reason it has not been forthcoming is that cuts to services were already intended. The Health Reform Agreement funding adjustment has presented the Victorian Liberals with the opportunity to cynically blame the Gillard government for their own failures.

That is why the Victorian Premier and his health minister cannot be trusted. That is why the emergency $107 million health rescue package for Victoria's crippled health system, announced by the Minister for Health last week, will sidestep the Baillieu government and be handed directly to local hospital networks. Those funds will be an enormous relief to those who work in the Victorian health system and to all Victorians who rely on the state's health services. But it should never have come to this.

As the health minister said herself last week, the Baillieu government has proven itself to be a cruel and incompetent manager of the Victorian health system. But of course the Victorian Liberal government is not the first Liberal government to grossly mismanage health priorities and expenditure. Those opposite me in the chamber serve under a Leader of the Opposition—Mr Tony Abbott—who, as health minister during the Howard government years, saw $1 billion dollars cut out of public hospitals. That is enough to pay for 1,000 hospital beds.

If Mr Abbott was to become Prime Minister, we know the coalition would cut emergency departments, cut elective surgery improvements, cut GP superclinics, cut after-hours services, cut local control and cut the 24-hour telephone GP help line. How do we know this? Because that is their history—we saw it when John Howard and his government were in power for 12 years.

The shadow minister for health said in November last year that jobs would be slashed from the health department and portfolio agencies. Do not forget that he also announced that jobs were to be cut from Medicare Locals, which were established to coordinate primary healthcare delivery and confront crucial service gaps. Under the opposition, how many social workers would remain, how many outreach workers would remain and how many Aboriginal health workers would remain? Just who would be safe if the opposition were to make their cuts? We know that, if they get onto the government benches, that is exactly what they will do.

The opposition leader has taken several swipes at the components of the nation's health architecture which ensure transparent and effective health funding. That includes the Independent Hospital Pricing Authority, the National Health Performance Authority and local hospital networks. These bodies, which may be abolished if the opposition leader has his way, actually deliver the reforms that our health system needs. These are the health systems that our country needs.

The opposition leader has many questions to answer, but we know he has no answers. His solution to the issues confronting health services is to just cut—cut jobs and services. If you support the principle of activities based funding then why don't you provide unqualified support for an independent authority to identify the services which are being paid for? If you are committed to improving transparency and accountability in the health system and making sure Australians have access to information about health services then surely you would want to continue with an independent agency to crunch the data and publish the reports. If you agree that decisions on health should be made, where practicable, by local communities then surely you would to retain local hospital networks which achieve this purpose. I know, from my home state of Tasmania, how effectively they are working. These bodies are not examples of bloated bureaucracies; they are valuable tools in the nation's health system and they ensure that money is spent by those who know where the services need to be.

The government is committed to the National Health Reform Agreement and to making sure that every Australian receives the health services they need. When the opposition leader was health minister, bulk-billing rates were 67 per cent. Today, the rates are over 81 per cent. A record 1,100 GPs were trained this year. When the opposition leader was in charge, training places were capped at 600. We have made medicines cheaper so that Australians can afford drugs for conditions such as high cholesterol and diabetes. We have established a $4.6 billion public dental scheme to assist children and low-income earners. We have introduced plain-packaging reforms and extended the Gardasil vaccine to boys. We have means-tested the private health insurance rebate and built GP superclinics. We are ensuring that the future health needs of Australians are being met, and we are ensuring that there is less waste and increased transparency and accountability—unlike those opposite, who only oppose these reforms.