Richard Di Natale (Victoria, Australian Greens) Share this | Hansard source

During the dying days of the last government, after the soap opera that was the change of leadership and so on, I remember someone saying to me, 'Can things get any worse?' At the time I wondered whether they could. You only need to look at this government's record on health policy to know that the answer to that is an emphatic: yes, they have got much, much worse. The health policy that the government has introduced through the course of the past two years is a litany of missteps, mistakes and utter chaos. Things got particularly bad under the previous minister, who has shown himself to be as inept in Immigration as he was in Health.

We had the co-payment policy, which was floated—it seemed like it was a thought bubble at the time—with no consultation. That got buried very quickly. Then we had version 2 of the co-payment policy, and for a while it looked as though that was flavour of the month where the government was concerned. Then that was ditched. The argument was that we needed to make sure that we sent a price signal, which later became a value signal, which was really code for saying, 'We've got to make it harder for someone to see a doctor because we think that people aren't that crook,' to use the words of the chair of the Commission of Audit. Then we had version 3 of the co-payment policy. That hung around for a while and eventually that was ditched. In the end, the policy went to where so much of this government's political agenda has ended up, and that is in the graveyard of bad ideas.

The one idea that did see the light of day and is having an impact right now—in fact, it is biting pretty hard—is what this government did to the funding of hospitals. It is true that reports that have been floated in the green paper are simply suggestions—if we are to believe the government—about possible reforms by a future government. You do not need to look at the green paper, because the reality of what is happening within our hospital system right now is much more frightening than what has been described in that green paper. We have half the facts out there. It is true that the government has increased funding to the states to ensure that our hospitals can continue to function. But that is only half the truth. The problem in this place is that most of the information that flies around is half fact or is opinion dressed up as fact.

The reality is that demand for hospital services is increasing. It is increasing as a function of a couple of things—improved health technology and growing population—and the funding is not meeting that demand. What that means, and it is very straightforward, is that people are going to have to wait longer in emergency departments, they are going to have to wait longer to have surgery done, it is more stress on staff, mistakes will happen and patients who need urgent care are going to miss out.

If this trajectory continues—and this is not speculation, this is the reality, which is far scarier than we have seen in the green paper—the hospital system will simply collapse. They are not my words. They are the words of the former secretary of the health department, now the head of the health program at the Grattan Institute, Stephen Duckett. In his words it is completely unthinkable that this policy could continue because the result would be a total collapse of the hospital system. There will be a change at some point or our hospitals will indeed fall over.

The simple issue is that federal governments have an important responsibility to fund our hospital sector. They cannot vacate the space as this government has done, and they cannot vacate it for a few reasons. It is all very well to have an ideological position that says, 'State governments should look after hospitals; we'll take care of Medicare and aged care.' What that position ignores and fundamentally misunderstands is how the system works. The entry points into the system are through primary care, a federal government funded responsibility. The exit points are through aged care, which, again, relies on federal government funding. You cannot have a situation where you have these divided responsibilities that create all sorts of perverse incentives to shift costs from one jurisdiction to another. It results in a very inefficient system, and that is at the heart of the problem here. We have divided responsibilities.

It must be said that the previous government, despite having extremely ambitious targets when it came to what it would do to reform our hospitals, at least made some progress. For the first time we had federal governments with some skin in the game who had an incentive not to shift costs to state governments. Likewise, state governments had an incentive not to shift costs across to federal governments. That is one of the big cancers in the system at the moment. By the federal government meeting half the costs of growth funding, what we saw was both parties finally working together to try and solve some of the issues that exist within our public hospital system and within our health system more generally. This helped the system work better.

This government is taking us in the opposite direction to where we should be heading when it comes to ensuring we have a decent system. It is a system, and the different parts of it have to work together. We cannot carve out state responsibility for hospitals in one area, federal responsibility for primary care in another area, aged care in yet another area and expect the system to somehow work properly. It makes for a patient experience that is fragmented, that leads to care being sub-adequate and that is ultimately expensive for the taxpayer. This is an ideological pursuit for no good reason. We need to start taking a much more responsible and mature approach to this situation and recognise that if we do not work in partnership with state governments right around the country we are going to return to the bad old days where a government, in the lead-up to an election, waved the chequebook around, rolled out some pork and said, 'We'll fund a hospital here or a few beds over there,' and the system continued to flounder. That is the problem that we have got right now.

It must be said that it is not just about hospitals, though, where this government has failed on health. There are so many other areas. Let us look at the flexible funds, which are funds that are given to a whole range of programs that do important work out in the community. There has been a $600 million cut in funding for the Flexible Funds program. What does it deliver? It delivers services to people with substance abuse issues. The government is running around talking about the ice epidemic, about how critical it is that we do something to address the scourge of ice, and yet they are cutting $8 million from programs that fund substance abuse. Tell me how those two messages are consistent.

The government says: 'Domestic violence is a national priority. Good on Rosie Batty for being a champion for domestic violence! But do you know what we'll do just quietly? We'll cut funding for domestic violence programs, many of them delivered in the health space. We'll cut funding for mental health. We'll cut funding for dental health.' Despite the fact that we have a huge inequity in our health system, which means many people across the country cannot get access to decent dental care, we have huge cuts in dental health as well. This is extremely short-sighted. One of the most significant causes of presentations to both general practices and emergency departments is untreated dental disease. It has a huge impact on the rest of the body—and we are cutting funding for dental health!

We have seen a funding cut for the Preventive Health Agency—'Forget that prevention stuff! It's namby-pamby stuff! Why would we care about things like obesity, smoking and alcohol? Why would we care about those things? It's really up to individuals. It's all about personal responsibility.' Well, if you are a young child being brought up in a home where alcohol is a big part of the family environment, you are already at risk of running into problems yourself later in life.

The truth is that we can afford to have decent health care in this country. Don't believe the nonsense that our health system is unsustainable. It is one of the best health systems in the world. As a proportion of GDP, we spend less than the average health spend of other OECD countries when it comes to health—and we get really good value for money. We need to start having a conversation in this country about whether our governments are investing in things that our community want, need and deserve. When it comes to health care, the Australian community speaks with one voice: 'Yes, we believe that our taxes should support a decent health system and a decent hospital system and it's the federal government's responsibility to deliver that for us because we're who they are working for.' (Time expired)