Louise Markus (Macquarie, Liberal Party) Share this | Hansard source

The National Health and Hospitals Network Bill 2010 was claimed by the Minister for Health and Ageing to be:

… a key step forward in the government’s health reform agenda.

This seems such high praise for a reform that, on the bill before us, will only deliver more bureaucracy, more cost, less accountability, no new hospitals, no new beds, no salary increases for nurses and no plans to increase doctor numbers. In its current form this bill does not address the crisis in our public hospitals and health support services. But that is typical of Labor. Just look at the BER, the home insulation scheme, the failure to rein in the banks and the failure to keep the cost of living to manageable levels for families, pensioners and small businesses.

The bill establishes the Australian Commission on Safety and Quality in Health Care as a permanent independent statutory authority and will move it out of the Department of Health and Ageing to become a standalone authority. Since 2006, when the commission was established under the previous coalition government, it has played an important role in the Australian health system: by leading and coordinating improvements in safety and quality in health care in Australia through identifying issues and policy directions and recommending priorities for action; by disseminating knowledge and advocating for safety and quality; by reporting publicly on the state of safety and quality including performance against national standards; by recommending national datasets for safety and quality and working within multilateral government arrangements for data development, standards, collection and reporting; by providing strategic advice to health ministers on best-practice thinking to drive quality improvement including implementation strategies; and by recommending nationally agreed standards for safety and quality improvement.

There have been advances made in areas such as clinical handover and infection control as a result of the work of the commission. The coalition does support an ongoing role for the commission within existing resources, but we hold serious concerns about this government’s capacity to efficiently and effectively implement its supposed health reform agenda. We are concerned that the government also intends to create an independent hospital pricing authority at a cost of $91.8 million and a national performance authority costing $109.5 million. Other bodies proposed to be established in the bill include Medicare Locals, at $416.8 million; state based funding authorities, with the cost unspecified; local hospital networks, again with the cost unspecified; and a national funding authority with the cost unspecified and, since, questionable. That is the Labor government’s answer to the crisis in health and hospitals—more red tape, more jobs for the boys and more cost.

The coalition opposes this bill in its current form. We oppose it for a variety of reasons. It is claimed that the reform is a national reform, yet it still does not have national agreement, with Western Australia the most notable omission from the signatories. The solid support of the Labor states in the heady days of the former Prime Minister, ‘the buck stops with me’ Mr Rudd, is starting to unravel as the states look seriously at the funding arrangements and the absence of guarantees that infrastructure, resources and services will or can be delivered. Some of the states must feel sicker than the health system, for, instead of 30 per cent of states’ GST being quarantined by the Commonwealth, as first proposed, the 2011-12 budget estimates show that for some jurisdictions it will be up to 49 per cent of their GST income stream. That is serious money, and I am sure that there are major doubts about having the money go into bureaucracy instead of into other family and community based services which would benefit from extra funding.

The partnership agreement shows that clinicians on the governing councils will not be working within the local hospital network. This means they will not be able to participate in the governance of local hospital networks, and it is not clear what role they will have on decision making and resource allocation.

The bill is short on the detail of how it will deliver services to people forced to wait for operations, the people who spend 10 hours in emergency departments waiting for a broken leg to be put in plaster or women forced to have their babies on the side of the road. These are all examples of challenges for people in the electorate of Macquarie. But it does say in section 10(2) that the commission must consult with clinicians, department heads of all states, the ACT and the Northern Territory, people deemed to be stakeholders and members of the public. That is to be commended. An added qualifier in section 10(3) says:

If the Commission is of the opinion that:

(a)           there is an urgent need to formulate particular standards, guidelines or indicators … the Commission is not required to comply with subsection (2) …

In other words, if the commission cannot find a reason not to consult it does not have to—independent indeed, but not in the way the taxpayers of Australia would want.

Another source of concern is that under the health reform proposals GP surgeries will lose $58 million in practice incentive payments for after-hours patient care. Even a casual observer would see that this has the potential to impact on the viability of general practices to deliver services outside normal opening hours, critical to areas like the Blue Mountains and the Hawkesbury. In Macquarie many health and hospital services have already been reduced. Where will people go when they have a medical or health emergency or need treatment out of hours?

But isn’t this the same bill that the health minister lauded as a ‘key step forward in providing better health and better hospitals’? Isn’t this the same bill that the former Prime Minister, Mr Rudd, was referring to when he declared that when it came to fixing the health system of this country the buck stopped with him? By any reasonable analysis of the bill in its current form, the bucks do not stop with him or this government but keep flowing into a black hole called Labor government health reform.

The coalition has a plan to stop the flow of wasted money. The coalition has already announced that it would not proceed with funding for an independent and expanded commission. Instead, the money would be used to offset the costs of the coalition’s plan for real action on hospitals and nursing policy. In addition the coalition has announced that the funding for the Independent Hospital Pricing Authority and the National Performance Authority would be used to offset a real action plan for better mental health. That is better value for taxpayers’ money. That is a better use of funding and it will deliver services where they are really needed.

The coalition is much better at handling taxpayers’ money than the wasteful, reckless Labor government, who embarked on a spending spree unseen in this country before. This is a government that has turned a $20 billion surplus into a $41 billion deficit and is paying around $4.2 million in interest on net debt this year. We have massive debt and deficit under this Labor government, yet they have put up this bill, a bill that will increase public debt with no detail or guarantees that it will deliver real services and support for health and hospitals. This government is addicted to spending and is not delivering what the Australian public want, need and deserve.

I am certain the Australian people can ill afford another three years of reckless spending and failed policies. The coalition’s plan for action on hospitals and nursing would have taken pressure off the public system and made a real difference by directly tying increased funding to delivery of increased services. We support a community controlled public hospital system by transferring managerial decision making from centralised bureaucracies to community boards. We believe in transparent and accountable governance and have proposed arrangements that give rural and small hospitals appropriate loadings and block grants to ensure their ongoing viability. Teaching and research hospitals will also receive loads to reflect the added responsibilities of their staff and infrastructure needs.

We committed 2,800 new public hospital beds compared to Labor’s 1,300. We also have plans for professional development for nurses, scholarships for rural and regional nurses and annual bonuses for nurses who choose to practice in remote regional towns that have no resident medical practitioner. We have also developed policies that would address investment in health and medical research, and information and compliance programs, to improve rates of informed financial consent. The coalition’s plans are real reforms that would have begun to address the practical needs of the Australian’s health system.

If the minister is genuinely concerned about introducing genuine, effective reforms, perhaps she would like to adopt some of the coalition’s policy. I urge the minister, if she is serious about reform, to adopt the amendments that the coalition put forward to improve this reform.

I support the amendment put forward by my coalition colleague, the Hon. Peter Dutton, the member for Dickson.

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