Deborah O'Neill (NSW, Australian Labor Party) Share this | Hansard source

I rise with some pleasure and also with some incredible sadness as an Australian to have to speak to the bill that this government has the temerity to put before this place today, the Health Workforce Australia (Abolition) Bill 2014. Australia's health workforce is vital to the wellbeing of this nation. It is not just about individuals feeling well; being well and having the people who are skilled enough to help you stay well and to return you to good health are a vital part of the work of governments.

We know that the health workforce in Australia is under tremendous pressure, partly because of our ageing population and rises in chronic diseases and also because of the reality of increasing community expectations about living a healthy life. The health workforce is rich and diverse. It totals 1.3 million people, made up of 550,000 registered health professionals and 750,000 workers from other health occupations. This is no small entity. The work that it does is no small thing for this country, because a healthy Australia is vital to our national productivity as well. At the last census 6.7 per cent of all employed people in Australia were engaged in a health occupation. This number rose by 22.5 per cent up to 2011 and continues to do so. We know that health and planning for the workforce that will support Australians' health is one of the great works of all levels of government.

One comment I want to make before going to my prepared remarks relates to what we have just heard from Senator Smith: gilding the lily, pretending that what they are delivering here is in line with their promise prior to the election that there would be no cuts to health, when what we are seeing here is a massive cut and no clear indication of where this cut is going, and at the same time an abrogation of the responsibility of the federal government to work systematically and carefully with the states to make sure that we have the doctors, the nurses, the podiatrists, the dieticians, the healthcare workers in all their form that Australia needs. But Senator Smith revealed what might be lying ahead in terms of the white paper that this government is threatening, and that really, really frightens me. We heard him say that the burden of service delivery is placed on the states, and the responsibility of federal government in that mix is something that they are trying to walk away from with this bill. Claiming a duplication of service is a very cheap and very low-level way of thinking about the importance of the workforce that we need to prepare for Australians.

States are certainly responsible for service delivery. That is correct. That is one factual, correct thing that we heard from the senator. But the reality is that something called the GST, instituted by the great hero of the Liberal Party, changed the way in which those states that make up the federation are actually able to acquire money to provide the services that people in the states need. And the reality is that that has changed forever the nature of state-federation relationships. What we see here is a government so fixated on cutting and destroying and lacking a vision for the future that this failure to actually plan for working people to be available to help Australians when they need health care. That is an indictment of this government.

I want to make some comments about this notion of duplication that we are hearing about. 'Duplication' is just a cover word that this government is attempting to use to cut down the communication that the federal government needs to have with the states. In the old days that Senator Smith might hark back to, we did not have transport of the kind we have now. People did not fly. People did not move from state to state. People did not shift around the way they do now. But, thankfully, we now have that capacity, and Australians exercise that capacity all the time. The notion that there is no national need to look at workforce is a very false argument, and it belongs to another time. It is not a forward-looking vision that this government has; it is a backward, miserly vision. It is an absolute abrogation of responsibility in the modern Australia that we live in.

But it is just another expression of this government's backward-looking reality. They are constantly looking in the rear-vision mirror: 'Let's go back to when Federation commenced.' Well, as a woman, I can tell you that I am very glad I am not going back to the days of bearing 10 children and doing the washing by myself out in the bush, completely unconnected to the rest of the world. I like Facebook. I like the future. I like the opportunities of education for my children. I like the thought that Labor was planning for a health workforce that was going to be there to meet my needs, the needs of my family and friends, the needs of people in the community who I represent, the needs of the people of the great state of New South Wales. Labor understood, in our health reform, that it was the federal government that had to step up to take financial responsibility alongside the states. Yet here, within just a few months of coming to government, this backward-looking lot decided that they could completely rewrite the impact of the GST on Australia's economic reality and simply absolve themselves of the responsibility for funding and for planning a national workforce for Australia, the nation.

I am proud to be a New South Welshwoman, but I am prouder to be an Australian. And this government is attacking all of the institutions that support us as Australians in its negative, miserly way. What we are facing with this government—and those listening should make no mistake about it—is the end of Australia's health system as we know it. For 40 years, since the inception of Medicare, Australians have really understood and appreciated the fairness of Labor's vision for health. We believe as Australians that it is not how much money you have in your pocket that should determine whether you can go to a doctor or not. We think you should be able to show up with your Medicare card and get the services you need. We believe that that creates a fair Australia. That is what Labor believes. But every single time those opposite have come into government they have attempted to tear down that very essential part of Australia's fabric. They have had a go at Medicare every single time they have come into government. And I thought it was pretty bad before, but it was nothing on what we are seeing this ideologically driven government doing now: tearing apart our universal healthcare system. They want to abolish so many parts of it, attacking it on every level. But how can you possibly stand in this place as a government for Australia and say: 'It's not my responsibility to look after the health workforce for the people of Australia. Sorry: not interested today; let's just hand it over to the states'?

Australians can stand here today while we fight this legislation and every other bit of disgraceful health legislation that those opposite are bringing into this place this week, proud that we have one of the best health systems in the world. And this ideological war is being waged by those opposite. But Australians are awake to it. They know about that essential, quintessential fairness. People know that the budget that this government brought down absolutely stinks. It is rotten to the core. It is taking away very simple rights from Australians with a lot of gobbledegook talk, but you just cannot fool all the people all the time. They got away with their lies before the election—'no cuts to education, no cuts to health, no changes to the pension'. But look at what we have. In the budget that reveals the truth—cuts to education, cuts to health and changes to the pension. It tears at the very fabric of our country.

Prior to the establishment of Health Workforce Australia, when we were coming off the back of the Howard government, we were faced with a piecemeal approach—that means this state doing a little bit and that state doing a little bit. It resulted in this boom-bust cycle of ad hoc systems—sometimes there were doctors, sometimes there were not; sometimes there were nurses, sometimes there were not; sometimes there were podiatrists, and many times there were not—because nobody was actually doing the work to figure out what was going on. You have to have a look to see what is happening across the nation, not just in one state. The distribution of workers within the health sector before Health Workforce Australia came was absolutely unequal and unfair, and it was worst in the regions and in rural Australia. I see Senator Nash sitting there with major responsibilities in the field of health and with carriage of this piece of legislation—otherwise she probably would not be sitting there. She is a woman from the bush, like the National Party members she sits with—one who should have a big, loud voice seeking equity for that community. And I see my two colleagues here from Tasmania—Senator Polley and Senator Urquhart—who fought for the establishment of Health Workforce Australia and who understand that, in Tasmania, the people are incredibly disadvantaged in terms of the access they have to health workers.

But that was significantly ameliorated by Labor's investment in delivering a health workforce. We went about improving the training of health professionals nationwide by funding a $1.1 billion national partnership agreement on hospital and health workforce reform. This led to Health Workforce Australia, which was gathered together to create a national body to counter those pressures within the health system and to provide long-term, sustainable solutions. We invested in that for the people of Australia with the money collected under the GST that comes to the federal parliament. We invested $344 million to make sure we were planning the workforce and enabling the universities to be part of that planning; enabling the community to be part of that planning and enabling all of the peak bodies to be part of that planning across the nation. Not within the states, because this is Australia. It is no longer the great state of New South Wales all around the country—this is a federation of states that sends tax to the federal government and has a responsibility for national workforce planning in this critical area.

If we are going to dismantle this national authority that this miserly, short-sighted government wants to do, we will see a dramatic decline in health care, particularly in those areas that Senator Nash and the other Nationals are representing—particularly in rural and remote communities. And the impact will be felt first amongst the elderly, amongst the disabled and amongst the chronically ill. What we are going to see if this is not managed properly is an incredible impact on our workforce of 1.3 million people and fragmentation of the system—breaking it apart so states fight with one another to bring nurses backwards and forwards. It will do nothing to enhance health outcomes for Australia, and that is at the heart of what is wrong with this government—they have forgotten that politics is about people. They have forgotten that Australia is a country about fairness. They have lost that sense of responsibility to people, and their language reveals it every day. We have had ministers here speaking about education, but you would never know because all they talk about is business, business, business. When they talk about childcare, there is not a mention of children. And what we are seeing here in the health sector is the same thing: 'health dollars'; 'state responsibilities'; the old one-two shuffle—'let's hide that pea under the thimble and see if we can find where it is, because if we bamboozle them enough, they will never notice.' But the reality is that Australians are too smart for this lot. They have figured them out. There is no capacity for Australians to be conned any more by this government that wants to take away the things that build the nation and enhance people's lives. Those opposite have forgotten about people, but I can tell you that we on this side of the chamber have not. That is why, as bad as it is to have to come in and speak about this matter, I am so proud to be here for Labor and to be fighting for fairness for Australian workers and for those Australians who use the health system. And let's face it—that is every single one of us.

The reality of this government is that they are planning to pull apart a structure. They are going to cut clinical-training funding; they are going to stop talking to the universities; they are going to stop enabling people to plan for the sorts of needs we have right across this country. In my time in the House of Representatives on the standing committee on health, and now as the chair of the Senate's Health Committee, I have been able to see firsthand what is going on with this government, and the kind of impact this government is determined to inflict on the Australian people. The last time Tony Abbott was in charge of health he took a billion dollars out of health. He was responsible for a complete shortfall of doctors and nurses, and a system of overseas-trained doctors was his solution to that workforce shortage. In the last parliament we undertook an extensive inquiry into the overseas-trained doctors scheme, which the AMA themselves said had failed. It was extremely complex: we described the way that many wonderful doctors, who have come to us from all parts around the world, in trying to negotiate that system as being 'lost in the labyrinth'. So convoluted and so ridiculous was the scheme they had set up that it simply did not serve Australians' needs.

When Labor came to power, we invested and invested and invested in massively expanding the number of training places for doctors, nurses and other health professionals. Only last week in the Riverina, in Wagga, I met graduates who are coming out of a program where they have been able to engage rural and regional students and be very successful with them. In Townsville in particular, just last week regional students were brought in to study at a regional university and they are doing their placements in regional hospitals. This increases their capacity to become general specialists. These are things that Labor did to enhance the workforce. We have a proud record to stand on. We did the hard work. We cleaned up the mess that saw Australian people compromised, that saw Australians who could have had medical service denied that service, with the likely consequence of ill-health and, potentially, death from not having a person trained to do the job that needs to be done.

Today, 25 Labor senators will make it clear to the Australian people that there is one party that stands for the health of all Australians, not just some Australians. There is one party that will invest in making sure that we have the health workforce required to attend to the needs of Australians if they get sick. You can look around here today and think about people in your family. You might say, 'I'm pretty healthy,' but, let me tell you, ill-health might only be an hour away. It could be an accident, it could be a stroke, it could be that you find out that you have a chronic illness, it could be that your grandchild is born tomorrow with a disability, or it could be that you get diabetes, you need help with your foot care and you need a podiatrist. What we are debating here is no esoteric thing about states, the Federation and 1901; we are talking about real Australians who live now and want to live into the future. We need to keep Health Workforce Australia. This government should have known better, but they have revealed their true colours. They have shown themselves as the miserly, backward-looking lot they are.