Nola Marino (Forrest, Liberal Party) Share this | Hansard source

Health delivery in Australia effectively means managing a $100 billion a year business. That is what it is. I was interested in listening to the comments about a ‘sustainable quality health system’. I am afraid that, given this Labor government’s history of wasted billions and billions of dollars and the mess and mismanagement of programs, ranging from their incapacity to give away pink batts, to green loans, to school buildings in Labor states, I have absolutely no confidence in their capacity to manage a national health system.

At Federation in 1901, the newly adopted Constitution gave the Commonwealth government responsibility for defence and for border protection against both human invaders and diseases. It took another eight years, however, until 1909, to actually establish a federal quarantine service, and the role of border protection appears still to be one the present government is seriously struggling with 109 years later.

In the Constitution, the states and territories sought to retain control of what they considered internal issues, including health. Prime Minister Billy Hughes appointed the first director general of the Commonwealth Health Department, a Dr J. Cumpston, who made the aim of the department that of ‘positive health, freedom from all illness and disability for every human unit in the community’. Here we are 85 years later and where do we find the health debate? We find a federal Labor government struggling with the delivery of health services to the Australian community and also struggling to deliver its election promises.

It is a government without a genuine commitment, unfortunately, to mental health outcomes. It is a government that promised to fix hospitals by mid-2009 and promised to deliver 36 so-called GP superclinics, only three, or perhaps four, of which are open at this point. It promised to recruit 7,750 hospital nurses—1,000 of them were promised in 2008 alone, yet only 617 were recruited over a two-year period. The government promised to recruit 1,000 nurses for aged care and only 139 were actually recruited. The list simply goes on and on. And of the billions and billions of dollars that were splashed around in the stimulus packages, not one cent went to our health system.

The aim of our modern health system should not have changed from the honourable target set by Dr Cumpston in 1921, that of positive health and freedom from all illness and disability for all. And the way we can deliver this has not changed: by working efficiently and effectively, with goodwill and genuine intent, with the states and territories. I am seriously concerned that a government that could not deliver, as I said, an effective pink batts program or simply deliver computers in schools is asking the Australian people to trust them to deliver a national $100 billion health program. It makes me shudder just to think about it. It is a program that will involve the development of what will undoubtedly be Labor’s latest federal bureaucracy. The minister in her second reading address on the National Health and Hospitals Network Bill 2010 said:

The Commonwealth will also become the dominant funder of Australia’s public hospitals, paying 60 per cent of hospital activity and capital costs …

Given that the actual funding is being taken straight out of state budgets, this is actually sleight of hand by the Labor Government—more smoke and mirrors and more spin—which effectively strips states of 30 per cent of their GST funding. This is why the Western Australian state government has not signed up to the agreement and shows no sign of doing so.

The WA government is very rightly concerned that a purportedly unified national system would once again leave the isolated West under-funded and under-serviced. We in WA are well aware that this government sees our state as a cash cow. We only have to look at the original version of the resources super profits tax and its current successor, the minerals resource rent tax, to see two examples. The Gillard government clearly sees the state of Western Australia as a source of additional tax and little more, so it is no wonder the Labor Party has performed so poorly in the West.

We can deliver a better health and hospital system. In my electorate of Forrest in the 1990s, local health services had local boards of management comprised of volunteers from the local communities. You would understand this, Mr Deputy Speaker—local people who volunteered their time to protect and enhance the health services in their local communities. That is how much they genuinely cared for their community’s health delivery. Unfortunately, in 2001 an incoming WA Labor government—yes, a Labor government—sacked all these boards in line with Labor’s centralist and anti-community-control agenda. The WA Labor Party followed the Labor mantra of less community input and more government and bureaucratic control. There is a bit of a pattern here.

The result of this has, in many instances, been the downgrading of services across local districts as community health services lost their local champions—the people who had fought to maintain their local services. I believe that community control is better than bureaucratic control, particularly if that bureaucracy is here in Canberra. I want to see health boards re-established—boards of community champions who once again will work overtime to strongly represent, protect and enhance health services in their areas. Will the government’s proposed local hospital networks perform these functions? The name, which seems to limit actions to hospitals only and not allow for action on other allied and primary health services, is also not encouraging. It actually suggests a breakdown of coordinated health service delivery by producing separate lines of administration.

The bill before the House identifies separate primary healthcare organisations independent of local hospital networks. We need to provide coordinated health care that crosses the boundaries of hospital, allied, primary and aged health care and regional health services, not hospitals in isolation from primary health care.

We also need to address the issue of activity based funding. This has been a relatively successful model in many areas, but rural and regional health services must be very seriously and carefully considered in the equation. As we know, it is often far more expensive to provide health services in regional and remote areas, but that does not mean that those services should not be provided in regional areas simply because it might be cheaper to deliver them in a regional or capital city. The additional costs associated with health provision to a remote site like, say, Mildura, 540 kilometres from Melbourne, cannot be equated with the additional cost of remote heath service delivery to a tiny town like Halls Creek, 2,800 kilometres from Perth.

Expenditure on health across Australia, in total cost and as a percentage of GDP, continues to expand. As I said, it is a $100 billion business and I believe that a government that cannot run a $2.45 billion home insulation scheme to give away pink batts will certainly not be able to manage a $100 billion a year health system.

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