Scott Ryan (Victoria, Liberal Party) Share this | Link to this | Hansard source

I present the report of the Senate Finance and Public Administration References Committee on COAG reforms relating to health and hospitals, together with the Hansard record of proceedings and documents presented to the committee.

Ordered that the report be printed.

I seek leave to move a motion in relation to the report.

Leave granted.

I move:

That the Senate take note of the report.

The evolving time limits we have have got shorter and shorter, so I will be as brief as I can. I will commence my comments by recording my thanks to the secretariat. This was a short inquiry into a very significant issue. The secretariat has worked tirelessly, and I think all members of the committee particularly appreciated their efforts over the last two weeks. This is a report into the government’s announcements regarding health reform, but they can more accurately be characterised as ‘announcements regarding hospital administration and funding’. It is in no way the most substantial reform since Medicare. It is focused entirely on hospitals—almost to the exclusion of health.

The government had numerous reports to draw on but needed to make a political announcement, and it did this rather than make a health announcement. We have heard that from a number of stakeholders, in particular, over the last two weeks. There is no better example of that than with respect to mental health and the government’s failure in that regard. This became clear at the inquiry. There is little detail available outside the intergovernmental agreement and little detail about what this will actually mean for patients in public hospitals across Australia. It is typical of Labor. This was all about inputs, processes and flow charts so beloved by our Prime Minister; it was not about patients. It was typical in its use of rhetoric to overstate the political case, but it let the detail slip. We do not know how many Local Hospital Networks will be set up, we do not know where they will be, we do not know their boundaries, we do not know the boundaries of the Medicare Locals, we do not know how these will interact with the Local Hospital Networks and we do not know the role of local clinicians and health professionals in both of these bodies.

What we do know, however, is that the Commonwealth Auditor-General does not have the power to audit the Local Hospital Networks, as these are creatures of state parliaments. Given the discoveries of the Victorian Auditor-General about the shenanigans that have been undertaken in certain Victorian public hospitals under the Victorian Labor government, this is a critical flaw in the plan, as the Commonwealth parliament will be able to exercise no oversight over these new bodies.

I have also made some personal additional comments regarding the structure of our health system. Despite the superficial nature of these alleged reforms, they still contain the potential to stifle the dynamic elements of our health system that we will depend on for future reform. The most important example of this in the past was undoubtedly the Kennett government’s introduction of casemix funding in Victoria in the 1990s. The very reform that this government is claiming as its own was pilloried by the ALP and then opposition leader Mr John Brumby when introduced. The then minister, the late Marie Tehan, was vilified by the Labor Party in Victoria and in Canberra. The hypocrisy of Premier Brumby and the Labor Party in this regard cannot go unnoticed. We have long memories, just as the Prime Minister does.

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

I would like to add my comments in relation to the heavy workload that all our committee secretariats have to deal with in this place and I would like to commend them for their work on this report by the Senate Finance and Public Administration References Committee on COAG reforms relating to health and hospitals. I would also like to thank the 37 contributors for their submissions and the witnesses who came before us.

But let us put on the record what this references committee was all about. It was a political stunt, because those opposite cannot deal with the facts. The facts are that when we came into government in 2007 the health system in this country had been neglected for over 11½ years. The now Leader of the Opposition has proven himself to be one of the worst ministers for health that this country has had to deal with. In relation to the National Health and Hospitals Reform Commission, I will quote from the former Chair when he came before the committee:

… it would be fair to say that we are all quite delighted that the vast majority of what we put forward—which represented, as I said, the thinking of thousands of people around Australia—was being acted upon.

I think the investment that has been envisaged is a very significant investment and similar to what we hoped for.

What better endorsement would you have for what the federal government has been able to negotiate with all the states and territories, with the exception of WA. I think that is really quite significant. I urge people to read this report. The government members—both Senator Cameron and myself—put in a dissenting report, because we believed that it was essential that the facts of the hearing were put on the public record.

Those opposite continually like to quote Catholic Health Australia. I would also like to quote from the evidence that was given before us. Committee witnesses such as Catholic Health Australia all reinforced the true fact and that is that the problems that we are facing in this country now with our health system have not been brought about because of any incompetence on behalf of our government. In fact, it has been a long, long road to get where we are. They said:

Why would we think that providing public elective surgery to patients within clinically recommended times is terrific? It is because we are seeking to ensure that all Australians, regardless of income level and regardless of their socioeconomic status, have equitable access to health care when they need it.

They also said, ‘after all that is part of our responsibility to provide the best possible health care for all Australians.’ There are so many elements. Whether you talk about aged care, mental health, e-health, it is there in this report. I urge you to read it to get the real facts as to where the opposition stands and why this country now is facing the dilemma and we are doing the reforms that are so badly needed.

Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Link to this | Hansard source

Australians had an expectation that Mr Rudd would fix hospitals. That was his promise in 2007. Remember, ‘The buck stops with me. I have a plan to fix hospitals by 2009.’ Of course 2009 came and went. We have no plan. When the heat and the pressure really started to be put, he decided it was time that he needed to do something—a plan that is now in disarray. Despite all the hype and all the talk and all the spin without the substance, another cobbled-together plan emerged from the Prime Minister.

After 2½ years that this government had to develop a plan to ‘end the blame game’, what do we have? We were told, ‘We did not formally start this agreement until 5 February’—the formality started on 5 February—and then there was the Prime Minister at the National Press Club on 3 June with his first blueprint, the blue book. So we went from the big promises in the blue book on to the sales pitch that the government had in the green book. Then reality set in and we had the agreement and we had the red book. Of course, the reality is very different from the hype. The wheels are starting to fall off. It is very clear that ‘local’ does not mean local. The doctors on the Local Hospital Networks will not come from the local area, they will come from outside the area.

The transparency and the accountability so touted in the red book to stop the states syphoning off monies and using dollars for bureaucracy are gone; the National Funding Authority—gone, dumped even before the ink was dry. Funded? This campaign is a false, deceptive and misleading campaign of federal funding, and run locally, is just that: $29.5 million—another hypocrisy of this government. They called government advertising a cancer on democracy and here is their independent committee approving this campaign without even looking at the ads.

We have no real reform. As people said, ‘Labor’s wasted opportunity for real health.’ No real reform, business as usual with the states and, of course, the many, many specific concerns. As the AMA said:

The AMA is concerned that the funding structure agreed to in the IGA will not end the blame game, but instead merely provide different opportunities to undermine and ‘game’ the system.

So more bureaucracy—forget ending the blame game—because that is exactly what we are going to have. The public expectation of fixing the hospitals will not be met. There is no confidence that our public hospitals will be fixed; there is more of the same. One only has to look at page 6 of the Australian today—the headline says it all: ‘Reforms to health “business as usual”’—because that is what it is. The states are more entrenched than ever and this is business as usual. This is not reform. This is not what the Australian public wanted.

Doug Cameron (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I will not try to speak as quickly as Senator Fierravanti-Wells did, and if I do not get everything in I will just have to live with that. I find it absolutely hypocritical that Senator Fierravanti-Wells would stand up here and question the Labor government’s record on health. We have to analyse the Howard government’s record on health. When the current Leader of the Opposition, Tony Abbott, was the minister for health in 2003, $108 million was cut from health. Here we have the opposition daring to argue about more money being spent on health, when they were the arch cutters of funding to health. In 2004, $172 million was cut by Tony Abbott from the health budget. In 2005, Tony Abbott cut $264 million from the health budget, and in 2006, $372 million was cut out of the health budget. If the Howard government had been re-elected, a further $497 million would have been cut from health. That was a billion dollars from the health system.

What were they spending the money on? They were spending the money on pork-barrelling and electoral bribes. That was the economic incompetence of the Howard government. They allowed working people and working families to not have access to decent health, because they were too busy pork-barrelling and trying to bribe the electorate. How dare the opposition talk about lost opportunities in health when the Howard government was responsible for 11½ years of incompetence, neglect and cost cutting. That is the record of the Howard government. Even Dr Kerryn Phelps said at the time:

The Treasurer, Peter Costello, announced in January of this year that there would be no new money for health in this budget, and it appears that that’s exactly what’s been delivered.

She went on to say:

I’d have to say it’s very unpopular. It’s not seen to address the fundamental issues, particularly in general practice, which relate to access and affordability.

I can go through the AMA’s quotes for every budget under the Howard government, where the Howard government was ripping the heart out of Australia’s health system. We are about changing that. We are about making sure that we can deliver a decent health system for every working family in this country—not just if you are rich enough to pay for it. In the public hospital system, we want to ensure that the money is there for ordinary Australian working families. (Time expired)

Question agreed to.