Tuesday, 23 June 2015
Matters of Public Importance
Health and Education Funding
I could tell that the Leader of the Opposition's heart was not in it today. He kept talking about a sensible and mature conversation, and it was the theme that ran through question time, but the only people without sense and without maturity today are the Labor Party. I wonder whose benefit this is all for, because everyone inside this chamber knows, and knew throughout question time, that this was all just a mess of confected outrage. The member for Sydney was brandishing charts and shrieking about the AMA but conveniently had forgotten that when she was health minister she said, 'Those doctors earn enough. They can afford a rebate freeze.' She was not at all worried about the cost to patients. The outrageous member for Throsby harnessed the real and genuine need of the sick children of Australia to his pointless political opportunism by juxtaposing children at emergency with an options paper on the Federation, which again I come back to. Everyone in this place knows that this is not a real argument. So for whose benefit is this all being carried out?
I know that the Leader of the Opposition is in the thrall of all of the unions who elect all of the members on his front bench. We had no better reminder today than my colleague, the Minister for Social Services, talking about a subject that I was familiar with and was very interested in as the spokesperson on child care in opposition, and that is the Early Years Quality Fund. Today it is about the patients and it is about the schoolchildren. Then it was about the children in child care. That was the argument that Labor brought to this place. What did we see? What was revealed today? The real truth of the then Prime Minister Julia Gillard's Early Years Quality Fund—$300 million. It was not about the workers and not about the children. It was only ever about the union. We saw that today when the Minister for Social Services revealed that United Voice, one of the unions that elects more than one member on the front bench, gave a donation of $1½ million to the Labor Party in the year that Julia Gillard rolled out the fund. When you look at the forces at work in determining what this Labor Party says, what it does and what it pretends to believe in, you do not have to dig very deep.
But the subject matter of today is the Federation white paper. We are talking about Labor playing politics, and they are playing politics with the Federation. The Federation is, as we all know, the arrangement that the Commonwealth makes with the states, and that includes funding agreements. Today we had a scare campaign about an options paper.
Ms Chesters interjecting—
The member for Bendigo, as one of the United Voice members in this parliament, might have some concerns about her involvement in the Early Years Quality Fund.
The scare campaign that Labor jumped up and down about today was about an options paper that will appear on a website tonight—an options paper that, shock horror, many of us have actually seen—and has been the subject of conversations between the Department of the Prime Minister and Cabinet and the premiers' departments in the different states. When we start an agreement that finishes with a discussion at COAG, Council of Australian Governments, involving the Prime Minister and the premiers, those discussions are worked up through state and federal bureaucracies. People might be getting bored because you talk about what gets worked up through state and federal bureaucracies. Some of it is fantastic, some of it is interesting and some of it will never see the light of day. But we are talking about a discussion paper. We are talking about options and we are talking about ideas. While the Leader of the Opposition said in one breath that he is very, very happy to have a sensible and mature conversation about the Federation, he turned around and, in another breath, said, 'How could you possibly suggest these things?' Apart from the fact that we, the government, are not suggesting any of these things, we want to come back to the core business, which is to work on a white paper for the reform of the Federation.
If I come to my own area of health, the important point I want to make is that this is going to be a constructive piece of policy work. It really is. I have raised it twice with state and territory ministers because as we approach a new funding agreement with the states we have to work out how we can act together in the interests of patients—not how we can act in the interests of the unions who elect us and not how we can act in our own interests but how we can act in the interests of patients. We build the health system for patients and we build the school system for children and their families.
We know that over time the burden of chronic and complex disease in Australia is falling on an ever-increasing cohort of the population. Once upon a time there were episodes of care—and they might have been in primary care and might have involved hospital care—but now we see more than ever the transition from general practice to hospital, back to community care, to step-down care and often back to hospital again. Mr Deputy Speaker, as a rural member like me who is interested in these things you might be interested to know that the cost of avoidable hospital admissions in Australia has been estimated at $3 billion. That was part of the work that went into this options paper. It is a sensible statistic. It tells us—me as the Commonwealth health minister and the state minister—that there is $3 billion that between us we could save. Wouldn't it be good if we did that? It would be good for our budgets and, most of all, it would be good for patients.
It would be good for those patients who go to hospital because their blood sugar is out of control, their asthma plan has not worked, they have a cardiac arrest because of mismanaged coronary heart disease or their depression puts them in a desperate place and they come to emergency. I accept that for state governments that presentation at emergency is something they cannot turn away, but between us we can work out how we can avoid those hospital admissions, save our budgets money and look after patients.
We fund 40 per cent of the cost of the public hospital system. That is well known. Over time we and the states have shared the cost of the public hospital system. That presents its own challenges, particularly with the increasing burden of chronic disease. It presents its own challenges because where there are clear lines of funding there are clear lines of responsibility but those lines of responsibility do not map across a patient's life experience and they do not necessarily mean that the two arms of government work together in the interests of patients.
Labor have been talking about an amount of money that they seem to think we have taken away from schools and hospitals. Again today we heard $80 million. The Prime Minister very clearly asked: 'If that is what you believe the system is missing out on, what will you do? Will you put it back?' There was dead silence. In fact, there has been dead silence from Labor on every aspect of their policy in health. As the health minister I have sat here and listened and tried to understand and I have asked the odd question, gone to conferences and read transcripts but I have not heard any of the spokespeople for Labor on health talk about a policy. I have actually heard some good policies from other members of the crossbench. I have heard some interesting policies from the Greens. The leader of the Greens, being a doctor, and I have had some good conversations. So it is possible to have conversations with your political opponents, but it is not possible for the Labor Party to come up with a single policy—not one.
The Prime Minister asked the Leader of the Opposition today: 'If you think all this money has gone missing from hospitals and schools, what will you do? Will you put it back?' There was dead silence. In fact, the only thing we have ever got from Labor is a sort of tacit admission that savings need to be made—'We understand that no area will be exempt.' The opposition spokesperson said on Sky News on 22 February:
… the opposition would be kidding itself if it didn't recognise there were challenges in the budget and that savings needed to be found.
There is no area that is going to be exempt. We have to look across the board.
I get the admission, but what is the Labor Party going to do? What are your policies? We have released a budget that is absolutely full of new initiatives: reform of the MBS, reform of the PBS—the legislation passed the Senate a couple of hours ago; strategic agreements around the supply of medicine—and fixed up Labor's e-health mess—$485 million over four years to build an electronic health record that works for patients.
I come back to the Prime Minister's comments that Labor did in its term in government add more money—all of that money borrowed—but did it make a difference? Unfortunately, it made very little difference to the health of Australians. Its agreements with the states were all about free money. The responsibility on the part of the states to do something that in the interests of their emergency presentations, their elective surgery waiting lists and so on actually did not even occur. So we are here saddled with Labor's debt but nevertheless working on positive, proactive policies for the future. The whole question time was wasted with this nonsense. Again, everyone in here knew it was just a piece of confected outrage designed to score a political point and to construct more smokescreen around the Leader of the Opposition's unfortunate circumstances at the moment.