Stephen Parry (Tasmania, Liberal Party) Share this | Link to this | Hansard source

I inform the Senate that, at 8.30 am today, Senators Birmingham, Fierravanti-Wells, Ronaldson, Siewert and Williams each submitted a letter in accordance with standing order 75 proposing a matter of public importance for discussion. The question of which proposal would be submitted to the Senate was determined by lot. As a result, I inform the Senate that the following letter has been received from Senator Fierravanti-Wells:

Pursuant to standing order 75, I propose that the following matter of public importance be submitted to the Senate for discussion:

Labor's waste and mismanagement and the chaos caused in the health sector, especially through retrospective funding cuts.

Is the proposal supported?

More than the number of senators required by the standing orders having risen in their places—

I understand that informal arrangements have been made to allocate specific times to each of the speakers in today’s debate. With the concurrence of the Senate, I shall ask the clerks to set the clock accordingly.

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

This latest funding debacle had its origins in the various versions of the so-called health reform proposal. The funding authority was included in the April 2010 version of the National Health and Hospital Networks Agreement but, with the ink barely dry, it was scrapped by Minister Roxon, who stated that we did not need to increase the size of the bureaucracy; it was appropriate for us to establish an authority without the need to do so. This was supposed to be the centrepiece of transparency for the so-called health reforms—and it was dumped with the ink barely dry. Then it was reinstated in the 2011 version and it actually became nine pool accounts in the August 2011 version, which eventually was enacted as the National Health Funding Body in 2012 to supposedly introduce unparalleled transparency into public hospital funding. In going out of her way to say that she is going to fund the hospitals directly, the Prime Minister is now acting contrary to her own legislation in funding the Victorian hospitals directly.

All of this chaos is in addition to all the other cuts that we have seen by Labor over the years: the $1.6 billion ripped out of public hospitals, the $4 billion ripped out of private health insurance, the $1 billion ripped out of dental health through the closure of the Medicare Chronic Disease Dental Scheme, the seven GP super clinics that were promised but were never even opened, and the list goes on.

I would like to remind those opposite of this document—which of course they want to forget: New directions for Australian health: taking responsibility: Labor's plan for ending the blame game on health and hospital care, by Kevin Rudd. And there is a picture of Kevin Rudd smiling.

Stephen Parry (Tasmania, Liberal Party) Share this | Link to this | Hansard source

Order! Senator Fierravanti-Wells, refer to Mr Rudd as Mr Kevin Rudd.

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

There he is smiling—Mr Kevin Rudd. This document is co-authored by Mr Rudd and Ms Roxon. Of course, we know what Ms Roxon really thinks about Mr Rudd, and she was very vocal in telling us so. Goodness only knows what they told each other in those hundred photo shoots that they did together. Let us look at what has happened with this debacle about the funding cuts midstream. We know that Labor has established dozens of new bureaucracies since coming to office, at a cost of $1 billion. So when we look at this latest issue with the states, the health minister will not explain the Commonwealth cuts. All she is doing is making accusations about the states and targeting Victoria and Queensland.

Labor's excuse about the variation in population growth has been debunked by the hapless Treasurer himself.

In the health funding determination, the Treasurer used a population growth figure for Australia of just 0.03 per cent. However, for an earlier determination for local government funding, he used a growth figure of 1.4 per cent, which is consistent with publically available ABS data.

The minister needs to stop playing the blame game, quickly review the Treasurer's determination and negotiate a resolution with the states. The matter needs to be resolved quickly, before even more damage is done. As a consequence of the funding cuts which have been made part way through the financial year, people were sent letters telling them that their elective surgery was going to be cancelled; nurses and doctors were put off; beds were closed. And, despite the reversal, enormous damage has been done. This latest fiasco in health just demonstrates that this is a Prime Minister who cannot keep her promises. In this space of health they have absolutely no credibility. (Time expired)

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

This debate has been a very frustrating one. Full of huff and bluster, lots of hand wringing, lots of finger pointing: 'It's your fault'; 'No, it's your fault'; 'It's the states'; It's the Commonwealth's responsibility'; 'It's Labor's fault'; 'It's the Liberal's fault'. I think what is forgotten in all of this is what this means for patients.

Let's get back to what this actually means. It means the closure of the emergency department in Colac overnight. It means that in the Peter James Centre in Burwood people who are waiting to get a bed so they can have rehabilitation for their stroke cannot get one. It means that a hospital like the Austin Hospital, which does such great work, originally budgets a $2 million surplus then suddenly finds itself with a $4 million deficit. Spokespeople report that that means 800 fewer operations at that hospital in order to make those savings. For Barwon Health it means the closure of a number of beds at Geelong Hospital. It means potentially the closure of more emergency departments. At Peter MacCallum, it means the closure of 16 beds—announced in February. At Royal Melbourne, it effectively means cuts to 700 operations. At the Royal Children's Hospital and at the Northern Hospital a series of planned expansions are being cut.

What this whole debacle means is that people who are waiting for urgent treatment are no longer going to get it. When you strip away all of the huff and the bluster, the finger pointing, the hand wringing, the 'It's your fault,' 'No, it's your fault', what you get is an issue that affects people's lives. We have to fix it. How are we going to fix it?

Firstly, let's work out what has actually happened. It can be summarised in a few short sentences. We have seen state governments underinvest in our public hospital system, particularly in the states of Queensland and Victoria. That is, I think, not in dispute. But we have also seen the sudden withdrawal of funding by the Commonwealth government from the public hospital system.

It is a very simple proposition. A number of state governments are underinvesting in health care, and then in December this year we see the Commonwealth government pull out $1.5 billion over the forward estimates. When you have a simple proposition like that, how is it that we hear arguments that allow both the state and federal governments to escape responsibility for their share of the problem? The lesson is: if you muddy the waters enough, you can get away with saying or doing anything.

Let's strip this back. In question time today we heard Senator Conroy say that the Commonwealth share of hospital funding is increasing. He is absolutely right. But that is not the relevant point. The relevant point is that the states are now confronted with the proposition that they are going to get a reduction in funding compared to what they were promised. So, sure, the Commonwealth share of funding is increasing, but it has increased by less than what was promised to the states. That is effectively a cut. Let's say I negotiate a pay increase with my employer. I take out a mortgage based on that new pay increase. Then, a year later, I find out that I cannot pay the mortgage, because the employer says: 'Well, I am not going to give you as much as I said I was going to give you. I gave you a little bit more, but you are not going to get quite as much as I promised you.' That is a cut. That is what has happened here.

Why have they done it? Why has the Commonwealth cut back on funding to hospitals? The answer is a little complicated but not very complicated. The Commonwealth has based its reasoning on a change in population. The government's argument is: population has not changed much and therefore we are not going to increase the funding as was promised. It is able to get away with that claim because it has compared two different population datasets. In 2011 the census changed the way it would ultimately establish population number. So there was a change between 2006 and 2011 in the way we estimate population.

What the government has done is, instead of comparing like with like, essentially compare population changes using the old approach for one and the new approach for another. That is a maths 101 error. It is a straightforward mistake and it is despite the recommendations from the ABS, the Australian Statistician, that we should be comparing like with like, that we should be using the new population estimates and comparing those using the same dataset. By doing that, the government has been able to strip away $1.5 billion worth of funding that was promised to the states over four years. Sure, it is going to increase its commitment, but it is still a reduction on what was promised.

The other part of this equation is this thing known as the health price index or health inflation. Health inflation is another measure that determines how much money is being paid by the states.

Unfortunately, we have a health price index, or an inflation measure, that does not actually reflect the cost of running a hospital. The health price index brings in all these other costs that have absolutely nothing to do with running a hospital. That is why, for example, private health premiums are going up by five per cent based on health inflation and yet, when it comes to public hospitals, we have a health inflation figure of 0.9 per cent, despite the fact that wages—by far the biggest cost of running a public hospital system—have gone up by in the order of three per cent. So we have got two important factors here. We have got the population data, which is wrong, and we have got the health inflation index, which does not reflect the cost of running a hospital.

On the back of those two things, the Commonwealth has pulled out the money that was promised to the states. But, worst of all, if that were not bad enough, halfway through the financial year, after hospitals planned their budget, worked out how many operations they were going to do, got staff employed and got everything lined up—being good corporate citizens—the government says, 'Guess what? We are going to pull away some of your funding; you need to find savings. And not just that—we are not going to pull away just this year's funding; we are going to go back to the year before and in Victoria take out $40 million from the previous year.' Again, to take the analogy of the pay cut: you negotiate a pay increase with your employer and he comes back a year later and says, 'Guess what? I am not going to pay you as much as I said I was going to pay you—but, even worse than that, I am going to deduct pay from the year before.' That is what has happened here, and it is not acceptable.

What is welcome is that the government in Victoria decided to restore $107 million worth of funding. That is absolutely welcomed. But the government has continued to play politics here. Rather than doing what it should do and give the money through its own agreed National Health Reform Agreement, which is a central funding pool jointly owned by the states and the Commonwealth, it has decided to bypass the states, undermining its own agreement, and fund the hospitals directly so that it can continue playing this ridiculous blame game—'It's your fault'; 'No, it's your fault.' It is not good enough.

What we have is a situation now where we do not know how the money is going to be paid to these hospitals. Who is going to oversee it? Are they going to get it in a block? Is it going to be paid out in dribs and drabs? How is that money going to be paid? We have doubts over the constitutional validity of how that money should be paid. We know that some of the money is not coming from additional Commonwealth spend and that we are in fact rearranging the deck chairs on the Titanic and some of the money that was originally allocated to Victoria for national occupational health and safety reforms is going to go to plug the shortfall.

So what we are seeing is an effort to continue the blame game, rather than a genuine effort to resolve the issue. The responsible approach would have been, 'Look; we misinterpreted the ABS data. We have a health inflation index that does not reflect the cost of running a hospital. We are going to fix it. We are not going to fix it by this short-term political fix in Victoria; what we are going to do is restore funding to all states and not just for this year but over the forward estimates.' That is the right thing to do.

In the end it is the people who miss out. It means that somebody who was going to get their hip done next week might not be able to get it done for another six months. It means that the kid with asthma who is in an emergency department might not be seen immediately but might have to wait two, three or four hours.

The only little ray of light in all of this is that we are going to move to a new way of funding our hospital system. We are going to get an independent umpire. It is two years away. It cannot come soon enough, because this spectacle has been particularly unedifying.

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

Sue Boyce (Queensland, Liberal Party) Share this | Link to this | Hansard source

I would like to commend Senator Di Natale for his well-reasoned and well-thought-out slamming of this government's current handling of the—

Senator Wong interjecting—

I think I should take that interjection from Senator Wong: 'A unity ticket between the Greens and the coalition.' They cannot cop criticism over there. They are very upset with the trial separation that they are currently undergoing with their friends from the Greens. But it is good to have someone with Senator Di Natale's background and analytical skills looking at this area—the contribution that we just had from Senator Polley was just nonsense—as the current funding situation has developed.

We are here talking about Labor's waste and mismanagement, and the chaos caused in the health sector. None of that should come as a surprise to anybody dealing with this government. Waste and mismanagement is their middle name. But the thing about this particular little effort that really stunned all the state health ministers was the fact that the funding cuts were in part retrospective. As the Queensland Minister for Health, Mr Lawrence Springborg, has pointed out, they were going back to grab money off procedures that had happened 18 months earlier. It is just inconceivable that Ms Plibersek, as Minister for Health, thought that she could drivel her way out of this by talking about 'over the next four years' without mentioning what had happened.

Let us look at the much-vaunted National Health and Hospital Reform package. Let us look at the national partnership agreement. One would have thought, as Senator Di Natale said, if you were going to backdate a wage decrease to someone you had a national partnership agreement with, you would have told them. But it was in the detail of the MYEFO late last year where the health ministers found out what they had lost. If you look at those figures, it is just startling to think about how much money has been ripped off.

Victoria has had $107 million restored. Well, Queensland would like its $103 million restored, although that is only a part of the $382 million that has been taken out of our health budget over the next four years. If you look at the results of that, it is shocking. The Cairns and Hinterland Hospital and Health Service in Queensland has lost $6½ million. In Brisbane, Metro North has lost $22½ million and Metro South has lost $18.8 million. Did we get any comments at all from the Queensland Leader of the Opposition about the fact that this money has been pulled out of Metro South? You would have thought the member for Inala cared about the fact that the federal government has taken almost $19 million out of the hospital and health services in her area—but no, nothing. Townsville has lost $7.8 million. Probably even more disturbing, the Torres Strait northern peninsular, which of course everyone knows is such a well serviced area, and I am being sarcastic in saying that, have lost $1 million out of their budget.

I suppose, as I said, there is no surprise in the waste and mismanagement aspect of this problem. This government have set up 12 new health bureaucracies over the past five years, but they promised 16 early psychosis prevention and intervention centres. Guess how many of those they have delivered? They have delivered none, none at all. There has been nothing delivered there, just more bureaucracy. They seem to think they can get away with using the state health budgets and talking drivel, as I said earlier, about the effects without anyone objecting. And there is the blame game. When Mr Lawrence Springborg in Queensland was talking about the half-cocked approach that Ms Plibersek was taking to this, he said: 'Just give us the $103 million. I don't care if you break the COAG agreement, just somehow put it back into our health budget.' What a disaster.

Anne Urquhart (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I rise to participate in this MPI debate on Australia's health system and to comment on the great leadership displayed by federal Labor health ministers Plibersek and previously Roxon, particularly in my home state of Tasmania—leadership that stands in stark contrast to that of the Leader of the Opposition, when he was health minister of our country for the years leading up to the 2007 election. This was a time when over $1 billion was ripped out of Australia's health system by the Howard coalition government. During a time when the mining boom was delivering them more cash than they knew what to do with, their priorities are laid bare in that fact. Contrast this mismanagement and spin with Labor's firm priority to deliver better results for patients and their families. I want to read for the Senate a letter to the editor in today's Advocate from my local area, concerning the quality of health care in Tasmania. It states:

Last Friday week at 3 am, I suffered a major heart attack at Penguin.

My wife drove me to the Burnie hospital where I was assessed and given first-line treatment and when I was stable, it was decided to evacuate me to the Hobart hospital for specialist treatment.

Unfortunately there were no beds available so I was sent by the Royal Flying Doctor Service to Launceston, where I was seen by specialist staff and by 8am had had a stent placed in my heart.

After a few days of wonderful treatment, I was discharged to enjoy the remainder of my holiday in your state.

This guy's letter continues:

All I can say as a visitor from Queensland, thank you very much to the health services of Tasmania and the professional staff.

I want to thank Mr Baltokiewicz for writing this letter and to wish him well in his recovery. I hope that he travels with his wife again to Tasmania soon.

I, too, want to thank the wonderful staff at the Burnie and Launceston hospitals who treated this patient within five hours. This is hardly a health system in disarray. This letter highlights that in this instance Tasmania's health system delivered satisfactorily. Everyone on both sides accepts that there are ongoing stresses to the health system across Australia. We Australians want and need a federal government that makes the tough decisions and steps in where required.

In Tasmania, the federal Labor government acted last year to provide a $325 million assistance package to boost access to health care. The package will boost the healthcare outcomes for all Tasmanians. This is a state that has the oldest population and whose population demographic is ageing the fastest. Just yesterday the preliminary report on improving the delivery of health services for Tasmanian patients was released. Developed by the Commission on Delivery of Health Services in Tasmania, the report addresses the key stresses in my state's health system, highlights community suggestions and sets the direction for 2013.

The commission was set up through the assistance package and is tasked with advising the state and federal governments on how best to redesign the state's health services to help better manage current and future pressures.

Labor is committed to making plans for the future and delivering quality services for all Australians. Health has definitely been a major topic in the Advocate this week, with Tuesday's front page dedicated to the start of physical works at the North West Regional Cancer Centre. This cancer centre, a 2010 Labor election commitment, will provide a treatment facility closer to home for the 600 north-west Tasmanians who are diagnosed with cancer every year. It has taken around 18 months to prepare the site and construction is scheduled for completion by the end of 2014. The centre will be operational in 2016 after the linear accelerator goes live.

Other Labor election commitments delivered for north-west Tasmanians are the GP superclinics at Burnie and Devonport and the revitalisation of the Mersey Community Hospital. These superclinics, which would be scrapped by the opposition, provide a fantastic level of care across a range of front-line services, taking some of the burden off our region's emergency departments. In Latrobe, Labor has invested over $200 million on upgrading and running the Mersey Community Hospital. The upgrades, completed over the past few years, have delivered a state-of-the-art emergency department and outpatients unit as well as a new high-dependency unit. The evidence from Tasmania highlights that, as all Australians know, the only party who can be trusted to deliver a quality public healthcare system is Labor.

Dean Smith (WA, Liberal Party) Share this | Link to this | Hansard source

I rise to speak in support of this matter of public importance and to condemn Labor's waste and mismanagement and the chaos caused in the health sector, especially through retrospective funding cuts. Labor should be ashamed of its lack of care and lack of concern for the health and wellbeing of Australians using the public health system. Let us be clear, Labor is undermining our health system on a number of fronts. Let me name just three. Firstly, Labor is contravening the National Health Reform Agreement by rebasing funding under the agreement and then moving to fund hospitals directly instead of through the states. Secondly, Labor is increasing uncertainty about whether it plans to expand and improve health and hospital services and whether these plans can actually be funded—we know you cannot have a health plan without funding certainty. Finally, Labor is constantly undermining the 30 per cent private health insurance rebate, meaning increased costs for Australian families.

The federal Labor government's failure to honour the National Health Reform Agreement by reducing the funding and beginning direct funding of hospitals is bad policy. For Western Australia this is seriously bad policy, and I understand that the negative impact could be in the order of almost $100 million over the period to 2015-16—funding that is much needed to support a growing WA population with unique challenges of providing health services over a vast geographic area. The WA government has given effect to the National Health Reform Agreement, which Western Australia agreed to in August 2011 along with other states and territories and the Commonwealth.

Some background is necessary to understand the complexity of health funding in Australia. In the Western Australian context, for 2012-13 and 2013-14 this arrangement will not result in any different funding outcome for the state, other than under the current national healthcare agreement. However, from 2014-15 the Commonwealth's funding for public hospital services in Western Australia will vary on the quantum of activity delivered. From 2014-15 the Commonwealth will fund 45 per cent of the efficient cost of the growth in public hospital services over the preceding year. From 2017-18 this proportion will increase to 50 per cent. But this is the critical point: it is important to understand that this does not mean that the Commonwealth will become an equal partner with the state in the funding of public hospital services. This point has been made particularly clear by our state health minister. This is the case for two reasons. Firstly, the arrangement commencing in 2014-15 does nothing to address the current gross inequity in state and Commonwealth funding shares for public hospital services in Western Australia; it only applies to activity growth from that point forward. Secondly, the Commonwealth's funding of the growth in public hospital activity will be determined by the relevant proportion of a national efficient price to be determined by the Independent Hospital Pricing Authority. If the pricing authority's modelling fails to take into account the significant and legitimate cost of disabilities involved in the delivery of services in a state the size of Western Australia, the state will again be left to meet the shortfall in funding.

The improvements that we may have expected to see as a result of the introduction of activity based funding are now at risk of being lost. If you do not want to believe the coalition, that might be okay. If you do not want to believe the Greens and you do not want to believe Labor, that might be okay. But you might just want to read an editorial from the Financial Review earlier this week. It said:

However, these incremental improvements—

referring specifically to the benefits of activity based funding—

now look likely to fall victim to Labor's poor economic management. Desperate for budget savings in this year's Mid-Year Economic and Fiscal Outlook, the Gillard government used revised population estimates to cut $1.6 billion in hospital funding.

So the issue is serious and detrimental to our state.

There is much that I can say in regard to this, but let me just make one final comment. Less than two weeks ago, in Perth, the Leader of the Opposition, the member for Warringah, made an important statement. He said: 'The Barnett government has become a model for all the governments we run, or hope to run, right around the country.' Importantly, he said how much he would like to model himself on the WA Premier. 'In the area of delivering quality health services Labor has failed Australians. Only the coalition can deliver us a better health system. Only the coalition can properly meet the challenging needs of Australia, especially in health and ageing. There is much to learn from Colin Barnett and the WA Liberals.'

Matt Thistlethwaite (NSW, Australian Labor Party) Share this | Link to this | Hansard source

We have hit a new low in this place with the notion that we are debating today; and it is ironic, it is Orwellian and it is downright offensive to the people of New South Wales, the constituents I represent in this place, because it is actually the complete opposite of what is occurring in reality. One need only look at today's Sydney newspaper headlines to see exactly what is going on in the New South Wales health system. I refer to an article by Alicia Wood in today's Daily Telegraph with the headline 'Ward and bed cuts at Prince of Wales Hospital'. The article reads:

The state government plans to close a ward and slash 26 beds at Randwick's Prince of Wales Hospital despite assurances that frontline health services would remain intact.

The article goes on:

Staff were advised by an email from Patrick Bolton, the director of clinical services, who said hospital management was "required" to cut bed numbers, close a ward and reduce staffing costs.

That is from today's newspaper. That is what is occurring in New South Wales. Another article from today's newspaper, this time in the Australianwith the headline, 'Prince of Wales loses 26 beds.' It reads:

The NSW health department says it's "consolidating" beds at a leading Sydney hospital but if refusing to comment on claims that 26 beds have been lost.

This follows up from an article in the Sydney Morning Herald by Shaun Nichols of 14 September last year. The headline is, 'Health budget slashed by $3 billion.' It reads:

Thousands of jobs may be axed from the NSW health service as part of deep budget cuts confirmed by the NSW Health Minister, Jillian Skinner.

Just days after the Education Minister, Adrian Piccoli, announced a $1.7 billion funding cut in his department, Mrs Skinner confirmed this morning that $3 billion would be cut from NSW health over the next four years.

They are the facts. This is exactly what is happening in my state of New South Wales. They come in here and seek to blame these health cuts on the federal government when the government is actually increasing funding to the states. In New South Wales, they have increased funding over the next four years to the tune of $1.1 billion—an extra 23 per cent of the base funding for New South Wales. But despite that, the New South Wales government is taking that money and cutting services in particular areas. If you think that the public is unaware of this, those opposite, then you are kidding yourself.

I was alerted to a Facebook page which has been set up in the wake of the health cuts in New South Wales. The Facebook page goes under the name of 'Save Prince of Wales Hospital from Budget Cuts'. I encourage members of the public who are concerned about health cuts in the Randwick and eastern suburbs area of Sydney to visit this particular website and post their opposition. I want to read some of the comments that have been posted on this website by members of the public who understand what these cuts to health services that have been undertaken by the New South Wales government will mean for them.

Belinda Mahony posted on 23 February, 'We actually need more hospitals. Too many people now. Not closure. It is a disgrace what these pen pushers are doing'. Another person posted on 23 February, 'Heard on the radio this morning that Deputy Premier Andrew Stoner got a $50,000 pay rise, and our local hospital, Prince of Wales, is having bed closures and job cuts. Hope our pollies realise this is not the way to go and get their priorities right in serving the people of our great state New South Wales.' They are some of the some of the comments of members of the public. Another one on 22 February, 'And it has started. Bed closures at Prince of Wales Hospital. Prince of Wales Hospital services patients from all over New South Wales. Emergency will be backlogged, elective surgery list will increase.' And it continues with a post from Lyn Williams on 21 February. Lyn Williams is a woman I have much regard for, and who has made representations to me about the concern that she has. She is in a wheelchair and relies heavily on the hydrotherapy pool at Prince of Wales Hospital. That is now under threat because of the cuts to health services in New South Wales. She posts, 'Every day, I hope and pray that sanity prevails and that Minister Skinner reconsiders any planned privatisation of the hydrotherapy pool which I need for my physical and mental wellbeing. Being in a wheelchair is a steep learning and it turns your life on its head. The things I once took for granted came to a crashing halt. I would ask Minister Skinner and the Prince of Wales Hospital board to wheel a mile in my shoes.' Again, another post this time from 20 February: 'Please Minister Skinner, reconsider these cutbacks as, unfortunately, I need my local Prince of Wales Hospital and outpatient hydrotherapy pool.'

They are the facts. This is the voice of the people of New South Wales. These are the people who are facing service cuts to health provisions within their community. Yet, those opposite seek to come in here and waste this parliament's time and move this particular motion. I have had representations from people in my community—from the elderly, from the disabled—who rely on these health services on a daily basis, and they are really concerned. I find it disrespectful that these people, who are facing cuts to their health services and who are distraught, have this motion moved as an insult to the work that they are doing in my community in trying to ensure that health services are not cut. This motion is lazy, it is tardy and it is not factual. In New South Wales, because of federal government outlays the budget in health has increased by $1.1 billion—a 23 per cent increase. When we look at all the other initiatives that this Labor government has undertaken in the area of health to improve services, people see that the arguments put forward by those opposite simply do not stack up.

Federal Labor has increased funding for national health in New South Wales under the Health Reform Agreement. I mentioned the $1.1 billion over four years. We have a commitment to better health care. We have, of course, undertaken the plain packaging reforms and pushed those through—despite opposition from a number of large corporations and despite a High Court challenge—which will result in a healthier society over the longer term. We have invested $4.6 billion in a new public dental health scheme that will provide better services, particularly for children and those from disadvantaged backgrounds who cannot afford to access adequate dental care.

We have reduced the cost of more than a thousand generic drugs, through the Pharmaceutical Benefits Scheme. Those drugs include cholesterol, blood pressure and diabetes drugs. We have established an after-hours health help line to ensure that people, particularly in rural and regional areas, who get sick after hours and do not have the wherewithal to travel long distances to hospitals can ring a help line and get the security and assurance that they need to make sure that their health is being looked after.

We have established 60 GP superclinics throughout the country to ensure that we are taking some of the pressure off our hospital waiting rooms and our hospital emergency departments. We have made a big investment in training more doctors and nurses to ensure that we have the adequate resources to look after our population. In that respect, this year alone we have provided the funding for the training of an extra 1,000 general practitioners throughout this country. When Mr Tony Abbott was the health minister he capped that number at 600. An extra 400 positions have been funded and paid for by this federal government to ensure that we have adequate doctors in the system. An extra $500 million is available for training nurses, particularly nurses who are working in aged care and in rural locum services where there are shortages. And, of course, we have means-tested the private health insurance rebate to make sure that that system is much fairer.

That is Labor's commitment to better healthcare services in this country, in stark contrast to what is occurring in my state of New South Wales, where the Liberals are doing what Liberal governments always do. When they come to office they commission these audits and then they cut services. They use the audits as an excuse to cut services, and that is what they are doing in New South Wales.

David Fawcett (SA, Liberal Party) Share this | Link to this | Hansard source

I rise to address this matter of public importance on Labor's waste and mismanagement and the chaos caused in the health sector, especially through retrospective funding cuts. I would firstly like to rebut a couple of the comments that many of the government members have made. They have been trying desperately to paint the Howard government as a government that did not care about health and did not fund it. It is interesting that the Museum of Australian Democracy has fact sheets on different prime ministers, where they highlight just half a dozen of their key achievements. Guess what one of those half-dozen key achievements was for Prime Minister John Winston Howard AC: record health funding of $47.6 billion in 2006-07. And just in case you think this might be some kind of conservative think tank, there are four ex-members of parliament on their advisory council, two of whom are Labor, one of whom is a Democrat and only one of whom is Liberal. So it is hardly a partisan body that would be favouring the conservative party. But they put down as one of the key achievements of the Howard government record health funding.

The government members have been saying today, particularly during question time and during this MPI: 'Who, us? Would we cut health funding? Never!' But if you look at the analysis of the health provisions in the 2012-13 MYEFO—conducted not by the Liberal Party but by the Australian Primary Health Care Research Institute at the Australian National University—you see that in their introduction they bell the cat on this. They say:

The hidden disaster in the 2012-13 MYEFO is the hit (unacknowledged by anyone in the Government) taken by preventive and public health. We know that $1.5 billion over four years … has been cut from the National Health Reform (NHR) funding.

So do not come and talk to the coalition and say that we are saying things that are unfounded. Go and look at independent experts who have studied this in detail, look at their pronouncements, and you will see that they have indicated that the government has made these cuts.

This matter of public importance that was raised by Senator Fierravanti-Wells talks about waste, mismanagement and chaos. In South Australia we know too well about Labor waste in the health area. There were 64 GP superclinics promised at a cost of $650 million around the country. In Modbury in South Australia a clinic opened right next door to areas that were well served by existing private practices: no GPs. President of the AMA Steve Hambleton hit the nail on the head when he said that this is a big waste of government money.

I come to mismanagement. People in South Australia, particularly those in rural areas, know only too well that Ms Roxon, in 2009, got rid of the Rural, Remote and Metropolitan Area way of allocating funding and brought in the Australian Standard Geographical Classification that saw places like Hobart considered more rural and remote than parts of South Australia. Large parts of our population lost out on funding to provide accident, emergency and after-hours health.

In terms of chaos, which is the point of this MPI, retrospective funding cuts hurt. We have seen in Victoria that the state Liberal government has taken this government to task and challenged them about their $107 million. The problem for people in South Australia is that we get a double hit of Labor's waste, mismanagement and chaos because not only do we have a federal government that has cut funding to the tune of $31 million from South Australia's health budget, but we have a Premier, Mr Weatherill in South Australia, who does not stand up for the state. In fact, when questioned in state parliament about this, rather than say, 'You're right; perhaps I should go and challenge the federal government,' he tried to indicate that perhaps the Victorians were not doing what everyone knew they were doing.

Now that New South Wales and Queensland are also challenging, he still has not taken his federal counterparts to task. So Mr Weatherill must step up to the plate and fight for South Australia to reclaim that $31 million, as opposed to just rolling over, because the consequences for the South Australian public are extreme. The long-promised outpatient facility at the Lyell McEwin Hospital has been scrapped to save money. There have been other delays at Modbury, and at Flinders there were six ambulances left waiting on a ramp, just last week, on a day when temperatures peaked at 40 degrees. The health outcomes for the people in South Australia are suffering as a result of Labor waste, mismanagement and chaos. They get a double hit. They get a hit from this Gillard government and, as I have just shown, independent external commentators are highlighting the cuts to the health budget but the Labor state Premier, Mr Weatherill is not fighting for the people of South Australia.

Bridget McKenzie (Victoria, National Party) Share this | Link to this | Hansard source

I, too, seek to speak in the debate on the matter of public importance on Labor's waste and mismanagement and the chaos caused in the health sector, especially through retrospective funding cuts. Midway through the financial year we have had yet another dysfunctional decision by the Gillard Labor government when they announced $1.6 billion-worth of cuts to public hospitals from the hospital national pool, causing chaos right through the hospital system all over the country, playing havoc with people's lives.

These funding cuts have been directly linked to bed closures, operating theatre closures and delays in elective surgeries right across the country, and you have heard this from senators from Queensland to South Australia to WA and beyond.

The fact is, hospital patients are paying the price for Labor's economic mismanagement in search for the elusive, yet now abandoned, budget surplus. Labor cannot manage health—$403 million has been cut halfway through this financial year alone for funding that has already been spent and allocated in the 2011-12 and 2012-13 financial years. Labor does not understand how the business end of our hospital system works. Contracts need to be signed, staff hired and surgery lists set. How many times have we heard repeatedly from Labor benches that the buck stops with them on hospitals. For the hospitals in Victoria, we thought the lack of federal bucks for a time would stop their operation. Failed and hollow promises were made yet again that they would end the blame game and fix public hospitals. The public hospital cuts are in addition to the $4 billion slashed from private health insurance and the $1 billion slashed from dental health. The Prime Minister needs to stop the blame game and stop using it as a way to pick a fight with premiers and to target my own home state of Victoria.

In the face of the Victorian hospitals budget reductions in the 2012-13 financial year by $107 million, the Victorian government stated that it would have a major negative consequence for the Victorian community, including the cancellation of Victorian hospital services and the retention of staff. The state government has further stated that this clawing back of health funding from the 2010-11 financial year, after patients have been treated, was based on incorrect application of population growth data. Across all aspects of this particular government, they just cannot get the numbers right. When we look at numerous levels right across this nation, we need to send some of the ministers back to the maths classroom—particularly Minister Plibersek so that she can use an appropriate dataset on which to base her financial predictions.

What did these funding cuts mean on the ground in Victoria? What did they mean for a city like Bendigo, with 100,000 people in the middle of building a world-class hospital right in the heart of regional Victoria? It meant that the budget of the Bendigo Health Care Group was $2 million out of pocket. What did that mean? It meant reducing elective surgery by 600 cases, the closure of 24 beds, $100,000 worth of savings in the mental health area by not filling positions, and reducing after-hours services. These are all services that a regional city like Bendigo needs. The Bendigo Hospital CEO, John Mulder, said that this was an unprecedented move by federal government to remove funding at this point in their cycle. This is the case being felt by hospital administrators right across our state, because they have had to manage in an economically responsible way. They have had to balance their budgets. It meant that services had to be cut. Other hospitals, right across Victoria, suffered, and I notice Mr Trewin, from Benalla, in the gallery today. Benalla and District Memorial Hospital is set to lose $202,000 out of its budget.

The health minister needs to stop the blame game, targeting the states, particularly my home state of Victoria. The truth is the Victorian government are reducing bureaucracy, re-investing administration savings and efficiencies over the next six years in the health portfolio and delivering back into front-line health services, which is exactly what the Gillard Labor government need to get serious about, instead of wasting more health dollars by advertising their backflip in our local papers over the weekend. It does not matter which way you look at it, and how much they squirm, Labor cannot be trusted on health. The public expect more from us. They have to stop shifting the blame and, basically, grow up.

Sue Boyce (Queensland, Liberal Party) Share this | Link to this | Hansard source

Order! The time for the discussion has expired.