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

On 7 March, the Senate Finance and Public Administration References Committee released its report Implementation of the National Health Reform Agreement. The focus of the inquiry, which featured 59 submissions and a public hearing in Melbourne, was on adjustments in Commonwealth funding for state hospital services under the Health Reform Agreement. The dissenting report from Labor senators, including me, clarifies the reasons behind this adjustment in Commonwealth funding to the states, which was announced by the Commonwealth Treasury on 3 November 2012.

The National Health Reform Agreement, announced in partnership with the states and Territories, in August 2011, ensures that more transparent funding of public health is based on services delivered and significantly increases access to care, to drive improved efficiencies. In the coming years Commonwealth funding will be directly linked to the actual level of services delivered by public hospitals, with funding being provided directly to local hospital networks. No longer will the states receive lump sums of cash from the Commonwealth. Instead, funding will rise as health service levels rise. It is a more efficient method of health funding and one that this government can be proud of.

Regardless of what you hear from those opposite in the chamber, the Commonwealth funding adjustment was undertaken in accordance with the terms of the Health Reform Agreement. All jurisdictions knew the agreed funding formula set out in the Intergovernmental Agreement on Federal Financial Relations. They knew that this formula was calculated with reference to population estimates, a health price index and a technology factor. It was no secret they signed up to it. It is a straightforward formula which reflects the costs of delivering public health services.

Prior to the release of the report, the committee held public hearings in Melbourne, as I said, and committee members heard detailed accounts of some of the false allegations that have been thrown at this government. One particularly revealing insight was provided by the Victorian branch of the Australian Nurses Federation. The committee heard from the branch's representative, Mr Paul Gilbert, that the Victorian government may have acted to ensure that the funding adjustment was implemented in a way that maximised service cuts to Victorians. Mr Gilbert stated:

It has been put to me that there was one example where a health service proposed to deal with the cuts by way of not closing any beds or reducing theatre sessions and that that proposal was rejected in favour of one that closed beds and reduced theatre sessions.

He went on:

I think [Victorian Health] Minister Davis … ensured that the impact was as severe as it could be in order to generate the positive outcome.

I must obviously put on the record, although I am sure everyone here is aware of this—I know Senator Ryan over there is—that Mr Baillieu is no longer the Premier. But the former Premier Baillieu's government strategy was to blame the Commonwealth and not own up to the decision it made to cut $616 million from the Victorian health system.

The dissenting report also noted that the Victorian Liberals departed from the normal process and refused to issue quarterly reports of elective surgery lists and emergency department waiting times. They did not enter into the statement of priorities with the state's Department of Health. They also failed to provide the independent Health Reform Agreement administrator with details on how they allocated Commonwealth funding. It was not like these were discretionary tasks that depended on the mood of the Baillieu government at the time; they were standard process. This information was not provided because the cuts to Victorian services were already intended. The Health Reform Agreement funding adjustment presented the Victorian Liberals with the perfect opportunity to attribute blame to the Gillard government. It was for this reason that the health minister decided to step around the dishonest Baillieu government and provide an emergency $107 million health rescue package to the state's Local Hospital Networks.

It was an extraordinary measure, but one that was absolutely necessary because the Gillard government was not going to let the Victorian Liberal government harm the health prospects of all of Victorian citizens. You should never play politics with your state's health priorities, but that is exactly what the Victorian Liberal state government was doing. We will have to wait and see how the Napthine government approaches the funding of the state's health services. We can only hope that he approaches this task with a greater sense of responsibility than his predecessor did.

The dissenting report also points out that the Health Reform Agreement actually features a dispute resolution clause that could have been employed to handle these health funding matters. It has not been triggered by any government, including the Baillieu government. If the Victorian government were genuinely concerned that the Commonwealth's actions were unjust, they could have used it at any time. But of course they did not do so, and we know why they did not do it: because, instead, all they wanted to do was play politics; instead, as I said, the Victorian government preferred to rely on the Commonwealth funding adjustment as a misleading rationalisation of their own funding shortfalls. The Health Reform Agreement ensures that all states will receive additional Commonwealth funding for public hospitals compared to the previous arrangements. Some states have refused to meet the requirements of the agreement and properly perform their role as assistant managers, and this has had disastrous results for the service delivery in these states.

The Gillard government—that is, our government—is 100 per cent committed to reforming Australia's health system, and I would like to again encourage all states to transparently reveal how Commonwealth funding to the health system is being spent. All state governments, including the Victorian government, need to take responsibility for cuts in funding that occurred independently from the adjustments in Commonwealth funding announcements last year. We know very well on this side what Tony Abbott, when he was minister for health, did. He gutted health by $1 billion—

Opposition Senators:

Opposition senators interjecting—

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Order!

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

and those opposite know that if they ever are to sit on this side of the chamber they will do exactly the same thing again!

Opposition senators interjecting—

They will attack the most vulnerable in our community, like they—

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Senator Polley, just resume your seat for a moment. I would appreciate that when I call the Senate to order that people do not simply ignore that call from the chair, but rather that people come to order.

Senator Bushby interjecting—

Well the noise was coming from you, Senator Bushby, primarily, so if people would accept the rulings of the chair we will get through this in a much more civilised manner.

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

I note from their interjections that those opposite do not like the Australian community to know the real facts. I look at the senators over there and they are all smirking. They know what Tony Abbott, if he ever becomes Prime Minister—

David Bushby (Tasmania, Liberal Party) Share this | Link to this | Hansard source

Point of order—

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Yes—

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

of this country, they know what Mr Abbott will do.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Senator Polley, you need to refer to Mr Abbott by his correct title.

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

I was getting a bit excited. I am concerned for the Australian community. The most vulnerable in our community depend on governments to be honest with them. We have to deliver the best health system that we possibly can. Having state Liberal governments trying to shift the blame onto the Commonwealth is going back to the past. What we are about is moving the health system forward. We know, and the Australian community knows, and I intend to keep reminding them at every opportunity, what Mr Abbott did when he was health minister. That is why the Australian community is so concerned about the threat of having Mr Abbott—

Opposition senators interjecting—

Don Farrell (SA, Australian Labor Party, Parliamentary Secretary for Sustainability and Urban Water) Share this | Link to this | Hansard source

He ripped $1 billion out of the health budget—

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Order! Senator Polley, please resume your seat again.

Bill Heffernan (NSW, Liberal Party) Share this | Link to this | Hansard source

You're going to rip the heart out of the Prime Minister on Monday!

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Thank you, Senator Heffernan! The Senate will come to order—again.

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

Thank you, Mr Acting Deputy President. It is nice to know that those opposite are listening to my contribution because this is really important. In Tasmania, we know what the Howard government did when interfering with the state health system. We know what they did to the north-west coast hospital. We know what that cost the Australian taxpayers. We know that, and I have to say, through you, Mr Acting Deputy President, Senator Bushby—you were not here in this place during the Howard government's time—we know what happened in Tasmania. Now, under the Local Hospital Networks, we will see over the coming period of time how things will improve for the delivery of health services to our Tasmanian community.

But it is not just having the Liberals back in government at a federal level that we have grave concerns about. What will they do in health? We know they have a track record. We know Mr Abbott's track record. We know what former Prime Minister Howard's track record was. If it was only health, maybe the community could come to terms with that. But we know, when it comes to aged care, when it comes to industrial relations, what those opposite will do to the Australian community. So we on this side will always work to ensure that the most vulnerable in our communities have good access to good health care, that they have access to good dental care. That is going to be our priority. We will continue to do that. We on this side will do all we can to ensure—

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

Your negativity.

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

That is right: no matter how negative you are, no matter how many times you come in and vote down good legislation, we know, as the Australian public know, the Australian community's priorities. They know that they can rely on the Gillard Labor government to deliver good outcomes as far as health is concerned. They know we will deliver good outcomes when it comes to aged care. They know we will deliver good outcomes as far as education is concerned. We also will do everything that we can to ensure as many Australians as possible who want to be in full-time work and have work opportunities are supported by this government. That is what the figures demonstrate here today.

Scott Ryan (Victoria, Liberal Party, Shadow Parliamentary Secretary for Small Business and Fair Competition) Share this | Link to this | Hansard source

I had to check my phone to see what the date was. It is still 17 days until the Melbourne Comedy Festival starts. That is pretty much the sort of performance we will see at the Melbourne Comedy Festival—if only it were not such a tragic comedy. I had the privilege of chairing the Senate Finance and Public Administration References Committee inquiry into the implementation of National Health Reform Agreement. Let us go back and address the facts of what happened.

In the profoundly misleading and untrue ads that every taxpayer in Australia is paying for in the Herald Sun and the Sunday Age on a weekly basis the government's own officials admitted that they ripped $107 million out of the Victorian health system for the years 2011-12 and 2012-13. I want to highlight the absurdity of what this involves. In December last year the Commonwealth sought $36 million from the Victorian health system for health care that was delivered between 1 July 2011 and 30 June 2012. I do not know if letters went out to patients who had been in the health system in Victoria for hip replacements asking them to come back so they could take their new hip out. Health care is not like returning a video recorder. You cannot get a refund for health care.

Why was this the case? Because the ABS undertook a massive revision of the population numbers. As the ABS outlined, this was not a small intercensal error, which is when they recast population numbers over the last few years; this was three times larger than the largest intercensal error on record. They are backdating population figures for 20 years. When you compare the basis that they assume that they gave funding to Victorian hospitals for with the basis that they now want to fund Victorian hospitals for you see that they are assuming that in the last 12 months Victoria's population grew by only 11,000 people. That is farcical. In Casey or the city of Wyndham that many people move in in six months. To say that Victoria's population grew by only 11,000 people in 12 months is nothing short of ridiculous.

Here we have the key element of this. This was a political decision. It was a decision in order to reach the mythical surplus, the pot of gold at the end of the rainbow that this Treasurer can never quite catch, and to come up with some sort of accounting trick. The people who were going to pay for that were Victorian patients. What is worse is that they were seeking to make patients on waiting lists today pay for mistakes the Commonwealth made two years ago. They are reducing funding today for health care delivered 18 months earlier. How is that fair or reasonable? The underlying logic of that is that the waiting lists were not long enough in July 2011, in January 2012 and in July last year so they are going to lengthen them now in order to try to achieve a surplus.

The Secretary to the Department of Health and Ageing claiming that the Commonwealth had no option but to implement these cuts—no capacity whatsoever; it all had to be followed to the letter of the agreement—leads me to two conclusions. If the ABS changed its population numbers by even more—let us say it was five times greater than the previous greatest error; it was only three times greater than the previous greatest error in the history of the census—the logic of this government is that no matter what that number is it will not apply the common-sense test; it will simply strip that amount of money from Victorian patients. I suppose a lack of common sense is not a new accusation about this government.

Victorian patients know that that is not true. Under questioning, the secretary to the department, Ms Jane Halton, claimed that this was the letter of the law and the government could not avoid implementing these cuts, seeking refunds for treatment provided a year and a half earlier. Why on earth then the night before the hearing did the Minister for Health decide to throw a bit of money back in? If it was legal the night before the hearing to return this money to Victorian hospitals then it was legal to do it in December and not implement the cuts in the first place. You are caught by your own words, just like you were caught by your own words on the National Health Funding Pool.

What used to happen when funding payments were made direct to treasuries was you might lose a bit on health funding but gain a bit on education funding and you might lose a bit on disability services funding but gain a bit on aged-care funding. That meant the states had flexibility to actually mix and match. But, no. According to the former Prime Minister and the current Prime Minister—maybe the current Prime Minister and the former Prime Minister, we are never quite sure which way around when we see people madly SMSing in this place during question time—the wisdom comes out of Canberra. The four towers of people in Woden—none of whom treat a single patient—have all the wisdom of our public health system, not the states who own the hospitals and not Catholic Health Australia that runs some hospitals. The wisdom comes from Woden. The great fallacy and conceit of this Labor government is that Canberra knows best.

What we have under the National Health Funding Pool is transparency. It is what Kevin Rudd wanted for so long. It is what the current Prime Minister, Ms Gillard, wanted for so long. It is the National Health Funding Pool that caught this government's hands in the till. This Health Funding Pool shows that they pulled out the money, so they cannot claim that they were state funding cuts.

You know the Labor Party are desperate when they resort to a quote from the ANF. Under sustained questioning the ANF would not criticise the Labor Party—surprise, surprise to everyone who works in the health system! Well, knock me down with a feather. We know the ANF just runs the Labor Party line. We do not know which of them are going to end up in parliament. We will probably find some of them in the Senate after the next election. They would not criticise the Labor Party, yet every other stakeholder who came before us said that you cannot seek refunds for health treatment delivered 18 months ago, which is what they were doing.

You have the flexibility to implement changes to ABS population statistics in a different way, which they proved themselves the night before when the minister for health made the desperate announcement that $107 million was going to be tipped back in. Then of course we saw the asterisk. There is always a footnote with this government; there is always a catch; there is always the fine print. The fine print is that they are going to punish Victorians in another way. The fine print is that, despite the fact that they are cutting funding for operations that hospitals performed 18 months ago, they are going to strip Victorian taxpayers of other funds that could very well support the Victorian health system, whether that be through hospitals, aged care or preventative health, and support Victorian schools. We are going to strip Victorians of other funds and make them pay, and that yet again demonstrates what is at the heart of the Labor Party. We saw it earlier today in the debate on free speech: a glaring authoritarianism. Do what the unions want in the workplace or the thugs will do a run-through as they did in eastern Melbourne a decade ago. Remove any restrictions on illegality or unions running amok in the building industry. Now it is about punishing Victorian taxpayers for the Victorian government doing nothing less than saying, 'The Commonwealth has taken $107 million off us, so we don't have $107 million to spend on our health system this year.'

But there is also another catch. The government have said that we will get this money back in. This is the problem: when the government did cut funding in December and those changes were made with the statements of priorities and the health networks in Victoria, people lost their jobs, operating theatres were mothballed, staff were told to go and find other work and priorities were rearranged. Despite the money coming back—by the way, not a single dollar has arrived in a Victorian hospital since this announcement three weeks ago—it is absolutely impossible for most of our health systems to do a catch-up of three months in three months. They would have to do almost double the work planned in the coming three months in order to fill the gap that the Labor Party caused by stripping.

So we have recommended in this report that the Commonwealth never again cut funding on the basis of services already delivered. The Commonwealth is the financial gorilla in this federation, to one of its great flaws. If the Commonwealth gets its population statistics wrong then the Commonwealth, not patients, should bear the cost. It is not like returning a particular good that you purchased. That cannot be done in health care. The committee has also recommended that the Commonwealth immediately desist from its threat to punish Victorian taxpayers for the funding cuts it undertook. We also recommend that the Commonwealth should not seek to create more red tape and bureaucracy despite their absolute love for it. It seems like it is a job plan for this government to create more people filling out forms. By going to the hospitals and health networks directly, they are just going to force more compliance costs. I fear to see what these MOUs are going to contain in terms of reporting and compliance.

We have also recommended that consideration be given to a further inquiry into the total health price index formula because it clearly is not capturing some data, but this government stands condemned for its behaviour in this matter.

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

I too rise to make some comments in relation to what has been another debacle by this government in the health space. As Senator Ryan has justly said, they were forced to back down in relation to Victoria. Then they had to take out full-page advertisements in the Herald Sun and the Age to try to spin their way out of another health debacle. It was more expensive political spin that could not hide the fact that this government promised a certain amount of funding, cut that funding mid-year while trying to cobble together their surplus and now has to restore that funding for one state.

And what were the consequences of this bungle? As Senator Ryan correctly said, services had to be cut. Victorian patients, their families and hospital staff had to endure enormous stress and uncertainty because of these cuts. But what about New South Wales, Queensland and elsewhere? In particular, in the palliative health space the government has failed to provide any certainty for palliative-care patients, with the imminent cessation of funding for a whole range of services which were due in June 2012. Palliative patients around the country are set to miss out on services as a consequence of this latest health debacle. There was federal funding for palliative care, including community palliative care. The Senate did an inquiry last year into palliative care and, given the recommendations of that Senate inquiry, to now have this sort of consequence in this space is really quite sad. Federal funding for palliative care, including community palliative care under the National Partnership Agreement on Hospital and Health Workforce Reform will cease on 30 June this year. This is a double blow for the palliative-care patients and their staff following the $1.6 billion which was withdrawn from public hospital services, including these notorious mid-year cuts that we have just spoken about. Palliative Care Australia understandably are very concerned about these hospital cuts. They are 'deeply concerned that the use of retrospective adjustment to funding levels announced through the national health reform agreement is creating immediate funding crises'.

I also want to use this opportunity to correct the record yet again. Here is Senator Polley touting misleading, wrong information from those opposite, who continue to parrot this misrepresentation about the time when Tony Abbott was the Minister for Health and Ageing. Let me once again say for the record that this claim that funding for public hospitals decreased by $1 billion under the coalition government is false, misleading, wrong—a lie. Australian government funding for health, including public hospitals, increased significantly under the coalition government. According to the Australian Institute of Health and Welfare, Australian government expenditure on public hospitals increased every year from approximately $5.2 billion in 1995-96 to over $12 billion in 2007-08. Annual spending on health and aged care by the Australian government more than doubled from $19.5 billion in 1995-96 to $51.8 billion in 2007-08.

Australian government funding to the states under the Australian healthcare agreements was $42 billion between 2003 and 2008 compared to $31.7 billion between 1998 and 2003 and $23.4 billion between 1993 and 1998. The 2003 to 2008 Australian healthcare agreements provided a 17 per cent real increase in funding compared to the previous agreement. The government's claims are untrue. In 2003 the coalition government provided an extra $10 billion for public hospitals in the Australian healthcare agreements. Funding for public hospitals from 2003 was 83 per cent higher than under the previous Keating Labor government.

A change in the growth rate of the Australian healthcare agreements due to higher private health insurance coverage and other demographic changes was reflected in the forward estimates in 2003. However, public hospital expenditure continued to increase by 17 per cent in real terms in the 2003 to 2008 Australian healthcare agreements, contrary to the false, misleading, wrong assertions that those opposite continue to make in this place. It is a lie what you keep saying in relation to the time when Tony Abbott was health minister. These are the facts that are on the public record. They are figures from the Australian Institute of Health and Welfare. They have been provided to me in estimates by your government. So do not come in here and continually—

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Senator Fierravanti-Wells, I would like you to address your remarks through the chair, please.

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

Those opposite should not come into this place continuously and peddle this lie when you have continuously provided this information to me in estimates. It has come from your own officials, it has come from your own government, it has come from your own health department. So don't come in here as Senator Polley and others continually do and lie about the facts that are on the record.

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

Mr Acting Deputy President—

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Senator Fierravanti-Wells—

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

I withdraw that.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

You will withdraw it. Thank you.

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

I have withdrawn it, Senator Brown, so you can sit down.

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

You are not in charge, so sit down yourself.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Resume your seat, Senator Fierravanti-Wells. I remind everybody I am supposed to be in charge and I would appreciate everyone having that view as well. Senator Brown on a point of order.

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

My point of order was to ask the senator to withdraw properly and not just as an aside.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

There is no point of order. Senator Fierravanti-Wells has withdrawn.

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

My, my, my, the quota girls are touchy this afternoon. I come to another point and I would really like to say—

Jan McLucas (Queensland, Australian Labor Party, Parliamentary Secretary for Disabilities and Carers) Share this | Link to this | Hansard source

Mr Acting Deputy President, I raise a point of order. Senators in this place should refer to each other in a respectful way and Senator Fierravanti-Wells is obviously very well aware that that comment had to be withdrawn this time last week. I think it is disrespectful to the Senate, when somebody actually knows that a comment was deemed to be out of order a week ago, that she would intentionally use it, and I request her to withdraw it.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

I think you should withdraw that, Senator Fierravanti-Wells.

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

Since I have used it on a number of occasions and some chairs have asked me to withdraw and others have not, perhaps we might have some consistency in ruling. If it offends those opposite, yes, I will withdraw it.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Let us be very clear: I will be very consistent, so I hope you will not use it again.

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

I will be very careful, Mr Acting Deputy President.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Have you withdrawn?

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

I do withdraw it. I might move to the hypocrisy of the HSU in regard to the Gillard government's $1.6 billion hospital cuts. Here we have federal Labor and the Gillard government cutting $1.6 billion in hospital funding, which is causing closures of hospital beds, the shutdown of operating theatres and the reduction in capacity of emergency departments. And the Health Services Union—surprise, surprise—remains silent on this point. It can only be such a hypocritical move. Instead of running a campaign against the New South Wales government, including stop-work protests about possible privatisation of one hydrotherapy pool, perhaps they could address their minds to looking after their workers in the health sector and complaining about this government's cuts of $1.6 billion.

We know the history of the Health Services Union, particularly when one looks at Mr Thomson's and Mr Williamson's activities in relation to that union. So one would have thought that, having been so criticised in this place and in the other place and generally through the media for their conduct in relation to dues of their aged care workers and health workers, that in this situation, given what was happening in their own area, they would have got off their backsides and actually done something constructive in relation to what is going on in the health sector by this government. But no, instead of fighting these reckless retrospective cuts which are having such an impact in the health sector and which of course are affecting its members, the HSU is engaging in phoney political battles in an election year in New South Wales. I say to the Health Services Union: after all your antics, it is about time you actually return to work and do something constructive for your members.

Question agreed to.