Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Hansard source

I am going to come back to making sure I can answer the member for Lyne’s question first, and then the member for Boothby’s. We are happy that the member for Lyne has taken a keen interest in how the new national hospitals network will be able to make sure that his part of the country gets its fair share of services. The purpose of moving to activity based funding, of making sure that the money can follow the population, is a positive one which will be of significant benefit to the member for Lyne’s area. I think he is unnecessarily concerned about ‘the state pool’, which I think were his words. What has been agreed as a result of COAG is that the Commonwealth will pay its 60 per cent of funding to individual state funding—essentially holding pools, which is a legitimate phrase to use.

The really good addition that we were able to negotiate, through the COAG arrangements, is that states—so, in the member for Lyne’s instance, New South Wales—will put their hospital funding into that as well, and all of the money that flows to public hospitals for activity will actually come from that funding. So there will be a much more transparent process, which means that money that we are putting in cannot replace money that the state might have previously put in, and there cannot be any allegations about skimming or inappropriate moving around of money. So that is a really big step for transparency, and should give a big boost to local areas’ confidence in getting the appropriate share of money.

You are quite right to raise questions about how the different boundaries will work, and I think this comes to the member for Boothby’s questions as well. It is going to be within the remit of the states to establish the local hospital networks. But we have been very clear about our priorities. It is to be done by agreement. There are two contrasting arrangements. For the Medicare locals, we will be driving the proposed boundaries, but there will still be a negotiation process with the states and territories, and we would expect the same to apply in reverse for the local hospital networks.

So I do not think that the member for Boothby, for example, should be too unnecessarily alarmed that state ministers are expressing preferences. I think in one instance you might be verballing the minister. But in others it is legitimate for them to be standing up and saying, ‘Our preference is this.’ That will not necessarily meet the requirements of the agreement.

We have until the end of this calendar year to finalise those arrangements, and we would expect that there would be a lot of public input. I imagine that, in the member for Lyne’s area, there will be a lot of very active public input into what would be the appropriate framework to make sure that local communities do have a say and do not feel like they are being controlled by a very distant bureaucracy but, nevertheless, that there is a big enough catchment to mean that you can plan sensibly for the types of hospital services that are needed in any area.

We do not agree with the opposition’s view that you should have an individual board for every hospital. We think that that sets up competition which can often be damaging and unhealthy. But if you make sure that there is a small group of hospitals that are able to plan together, that can indeed work very well.

The member for Lyne also asked about ‘capital catch-up’. Of course, there is always a challenge in these arrangements, because in health and hospitals a lot of historic decisions have been made about where health services are—and predominantly they are in our capital cities, right in the middle of town. I do not think anyone is suggesting that we close those hospitals, and I think there is a lot of support for the specialised services that they provide.

We need to do the flipside, which is to guarantee that there will be new capital investments and enough beds in the areas where there are new populations. I think that the member is aware that the agreements reached at COAG—for extra beds in the subacute area, and for extra support for emergency departments and elective surgery—do mean that we will shortly be able to make announcements about the distribution of some of those beds. In fact, I announced today that some of those beds are being provided at Wollongong Hospital. We expect, in due course, together with our state colleagues, to be able to make more of those announcements.

I think the Minister for Ageing answered some questions about aged care and geriatric issues in particular. We have heard you loud and clear: the seat of Lyne would like a superclinic. I think the only issue that you really have is if the Liberal Party is elected; they do not believe any more money should go into these programs.

I am very interested in the ideas that you raise about the university delivery and health delivery being more integrated. Our investments in the Taree hospital are a good example of doing that, and we are looking forward to that proving to be successful and to being able to emulate that in other places.

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