Duncan Kerr (Denison, Australian Labor Party) Share this | Hansard source

The alpha and omega of health is birth and death, and the focus of this government is on death. ‘Howard will fight to the death’ say the headlines. He will fight to his death and that of all those that serve with him. The government are going to the next election chained to a political corpse. It is a plot worthy of Melville, and he knew a thing or two about the illusions that drive men and women to their doom against all sense. One of the things that is driving the government to their doom against all sense is their failure to recognise their own shortcomings and to appreciate the strengths of the arguments that are being advanced against them. They have become so inured to their self-rhetoric that they do not recognise that the community demands and expects more of them.

What we have got in this country now is an argument being advanced by the Minister for Health and Ageing not on health issues but on politics. He is a bit like the characters in the film Weekend at Bernie’s. There he is, dragging around a political corpse of the Prime Minister, saying that he is really alive. ‘You have got to believe it. You have got to have faith: the Prime Minister is really alive.’ That is the health policy: believe that something that is false is actually true; persuade yourself and perhaps you can fool the people. It is an extraordinary situation.

What is happening now really demands an author of the calibre of someone like Melville, with Moby Dick. We have a captain going down with his ship. Of course, in true heroic tradition, that usually happens after you have put off the paying passengers and your own shipmates—and then the captain goes down with the ship. But, no, in this instance, the passengers and crew are also to go down with the Prime Minister, with the would-be mutineers cowed to silence, the old captain, something like Captain Queeg, with the steel balls in his hand, cabin fever in his eyes, aglitter with hate for those who have told him it is time to go. That is notwithstanding that he actually asked the French-speaking first mate to inquire as to whether or not the crew were happy with his conduct. He had come back saying: ‘Not happy, Captain. Time for you to stand aside.’ But, of course, what he then does is keelhaul those who speak out, cow to silence those who stay aboard and threaten to scuttle the ship—threaten to open the seacocks if anyone speaks against him. And of course they are all cowed to silence.

What of the ship’s second-in-command? What we have is essentially a character that would better fit Flashman novels—all strut and no courage or loyalty to his own party: the Treasurer. That Flashman stands aside of his responsibilities, neither having the will to stand with the Prime Minister nor to strike him down. The Minister for Health and Ageing, who has been so beautifully characterised by the shadow minister as putting his whole focus on the political survival of this government, goes before the state ministers that he castigates about their failures in health policy and says, as to the Commonwealth health agreements with the states: ‘I will not discuss this further. I will not examine it. I am now focused entirely on politics.’ That is exactly what you can see: the ship’s doctor, the fanatical Dr Abbott, handing out rum and opium to keep alive the dull hopes and fantasies of the crew, who are still struggling with some hope to keep the rotting hulk of their government afloat for a few more weeks.

That is essentially where we are at. This is the ugly place the Howard government have got to: becalmed, going nowhere, political death stalking them by denying reality. How do they deny reality? They deny reality by trying to address with bandaids the problems that confront them. Instead of responding to the Tasmanian state government—which had put forward the bravest and most constructive plan ever for health reform in Tasmania to address a crisis of health policy in that state and to deal with parochialism and the misallocation of health resources over historical time—instead of saying, ‘We will assist you with funding if you fall short of the resources you require to make this work effectively,’ they step in and play up parochialism in a most destructive way. Of course, in the end, if you are offered something like $45 million or so to take a hospital off your hands, a state government is going to accept it. But this is the worst kind of long-term policy for Australian national health planning.

I was a member of the Royal Hobart Hospital board of management—a community run hospital in the old terms. Do you know why we stopped having community run hospitals in Tasmania? It is because each and every one of those boards ran their hospitals for their local, parochial interests. We drove the funding of those hospitals over budget each year, then put our hands out to the government and said, ‘You’ve got to fund us or we’ll close surgical units or the like.’ We had in our state a constant demand for hospitals but in places where demand was insufficient, so we would put hospitals in every small settlement. Some have been closed over time as a response to increasing demand elsewhere. To get rationality across the state, Lara Giddings put forward what was the bravest, strongest and most sensible plan ever for health allocation, to get away from that kind of parochialism. And do you know what the federal minister did? In he came and said: ‘Look, I’ll play to the lowest common denominator of partisan politics. I know this kind of parochialism works. It’s worked before. I’ll gee it up again,’ and off we go.

I know that this is the kind of outcome that, if applied consistently across Australia, would destroy our health system. It is not a solution. The federal opposition has come up with a $2 billion injection which will go across the health system to make certain that all hospitals operate effectively and provide services efficiently to those that they service. We expect the states to cooperate—this is not being done with an expectation that there will be failure. But we also have in reserve the capacity to step in ourselves if the will amongst the states fails, because we do know that this is hard politics. The easy thing to do is to just spray money around without regard to the long-term responsibilities of a national government—to keep funding the creaking door, the squeaking door, wherever it might be, and to ignore those long-term demands and drivers of the health system. What are they? The first is an ageing population. The second is the fact that the cost of the provision of health is increasing faster than the CPI. The third is the fact that the Commonwealth has reduced its commitment to hospital funding nationally so that, instead of providing 50 per cent of the balance of funding required to the states, it now, I think, provides in the order of 43 per cent. That is off the top of my head and I will be subject to correction, but I think it is 43 per cent. What that means is that there is a $70 million shortfall in my home state of Tasmania alone. That then creates further difficulties and issues that all state governments are having to confront.

What we need is a national government that responds efficiently and proactively to all these long-term demands. Instead, we have a health minister focused on the political corpse of the Prime Minister, with the stethoscope out, pretending there is a heartbeat. We have the remedies from other doctors. Dr Bolt and Dr Albrechtsen have indicated that the dead tissue has to be cut out. But, bizarrely, today, again in some kind of political knee-jerk reaction no doubt driven by the Prime Minister’s office, we have the headline: ‘Costello must go for sake of Liberals’. That is the strike back—the dead striking at the living. We have Dr Rolfe counselling that the Liberals should cut out the living tissue. Finally this morning we had Dr Hewson, the only real doctor in the business, saying: ‘Look, don’t you worry about that. Everything is going perfectly swimmingly.’ This is the denial of reality that the coalition is operating under. At the end of the day, how can they ask the people of Australia to trust them with their future when they are not going to be part of it? How can the Prime Minister ask the people of Australia to trust him with the future of health care in Australia when the Prime Minister himself is not going to be part of that future and his own colleagues have told him that they no longer want him?

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