House debates

Thursday, 18 March 2010

Health

Suspension of Standing Orders

2:09 pm

Photo of Anthony AlbaneseAnthony Albanese (Grayndler, Australian Labor Party, Leader of the House) Share this | | Hansard source

I move:

That so much of the standing and sessional orders be suspended as would prevent the Member for Warringah speaking for 10 minutes on hospital and health policy and for the Prime Minister to reply for an equal amount of time.

Question agreed to.

2:10 pm

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

I am delighted to talk about health and hospital policy in this parliament. The first thing I will say about it is that members opposite—members of this government—should stop telling lies about the record of the Howard government. Every single year—

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order! The Leader of the House will resume his seat. The Leader of the Opposition will withdraw.

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

I withdraw, and I say they should stop telling grotesque untruths about the record of the Howard government. In every single year between 1996 and 2007—

Government Members:

Government members interjecting

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order! The members for Braddon, Forde, Dobell and Longman are warned.

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

health and hospital funding in this country from the federal government went up, and went up massively. I do not claim to have been necessarily the world’s greatest health minister, because I am not that conceited. I just say that I was a better health minister than anyone on the other side of this parliament at this time. I say we got bulk-billing up to 80 per cent, we introduced the Medicare safety net, we brought allied health professionals into the Medicare net for the first time—

Honourable Members:

Honourable members interjecting

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

The next person that displays a sign, even if it was within the guidelines that I set earlier in the parliament, will be marched.

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

The Prime Minister comes into this parliament today, puts his hand on his heart and boasts about the opening of the new cancer centre in Darwin. I provided that money in 2007. It ought to be called the Tony Abbott Cancer Centre in Darwin. The Prime Minister comes into this parliament, puts his hand on his heart and boasts about the PET scanner at Royal North Shore Hospital. I promised that money. It ought to be called the Tony Abbott PET Scanner at Royal North Shore Hospital.

Government Members:

Government members interjecting

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order, those on my right!

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

The more they squeal, the more their embarrassment shows. The Prime Minister comes in and talks about insulin pumps. I provided the funding for insulin pumps. What a fraud! What a phoney! What a complete fake this Prime Minister is! What a disgrace to the great office of the prime ministership of this country this man is!

I suppose we cannot expect anything remotely approaching magnanimity or graciousness from this Prime Minister, but let us, if we may, look at his health and hospital policies. He asks what my response is. My response is the same response as that of the state Labor premiers. Some of them question it; some of them oppose it. I question all of the policy and I oppose much of the policy because, just as his climate change policy is a great big new tax on everything, his hospitals policy is a great big new bureaucracy. That is what his health and hospital policy is.

He says that what he wants to do is to have a hospitals system which is nationally funded and locally run. He is wrong on both counts. It will not be nationally funded because the states will still have to provide 40 per cent of the funding. Believe me, a Prime Minister trying to make the states put up that money is a Prime Minister who has never had the kind of experience that any Prime Minister who is really going to bring about public hospital reform needs. He says that it is locally run. The only way it will be locally run is if he can persuade the state Labor governments to provide genuine local control of public hospitals.

This is the test of his local hospital networks. Will each significant public hospital have its own board? Will each of those boards comprise people who are genuinely experts in the fields of health management and governance? Will those people be genuinely independent of government and not just the sort of union hacks which this government typically appoints to boards? Will they have real management authority and real autonomy over the public hospitals? Will they be able to make decisions about the public hospital’s budget without reference to head office? And if they are able to raise money locally, can the Prime Minister guarantee that there will not be any compensating adjustment to the funding that they get from the states and the Commonwealth?

He cannot answer any of those questions. How do we know he cannot answer any of those questions? Because the state premiers have put those questions to him and they have told us that he has not been able to provide any detail. They have told the world that there is no detail. The trouble with the Prime Minister’s health and hospitals plan is that it will not end the blame game because the states still have to provide 40 per cent of the funding. It will not produce any extra money until 2014. What it will do is provide just another bureaucracy as the only people who currently know anything about casemix funding transfer from the states to the Commonwealth. Casemix funding does make some sense in principle, at least for our larger public hospitals, but the only people who know anything about casemix funding in this country are the people running the Victorian public hospital system, and the one person who is most ferociously opposing the Prime Minister’s plans is the Premier of Victoria. To the great credit of the Victorian Labor government, they have left the hospital system put in place by the former Premier Jeff Kennett largely in place.

Victoria is the large eastern state with by far the best public hospital system, and it does not want its public hospital system wrecked by this Prime Minister. It does not want its public hospital system wrecked by someone who is engaging in amateur hour experimentation. It does not want its public hospital system wrecked by someone who made such a mess of the nation’s roofs through his failed and disastrous Home Insulation Program.

Why would Premier Brumby want to put in charge of his public hospital system the same man who, when he tried to take charge of the nation’s homes, created up to 50,000 electrified roofs and 240,000 dodgy and dangerous roofs and who is responsible for the greatest public administration disaster in this country’s history? Why would you trust this Prime Minister with something as serious as public hospitals when he could not be trusted with something as simple as insulating the nation’s homes? He could not be trusted with fixing schools, he could not be trusted with fixing roofs and he should not be trusted with the nation’s public hospital system.

This Prime Minister has form when it comes to public hospitals. Not for nothing was he known as Dr Death when he was in Queensland. Not for nothing did they call him Dr Death, because the first thing he did when he was the Director-General in Queensland was close—

Photo of Anthony AlbaneseAnthony Albanese (Grayndler, Australian Labor Party, Leader of the House) Share this | | Hansard source

Mr Speaker, on a point of order: I ask that that be withdrawn.

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order! The Leader of the Opposition will refer to members by their parliamentary titles, but seeing that it has been raised—

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

I accept that admonition (Extension of time granted). I will happily stand here and talk and ride out question time. I am happy to talk throughout question time.

Photo of Mike SymonMike Symon (Deakin, Australian Labor Party) Share this | | Hansard source

Mr Symon interjecting

Photo of Harry JenkinsHarry Jenkins (Speaker) Share this | | Hansard source

Order! The member for Deakin is warned!

Photo of Tony AbbottTony Abbott (Warringah, Liberal Party, Leader of the Opposition) Share this | | Hansard source

While members opposite are terribly embarrassed—understandably embarrassed—by the Prime Minister’s record in health, in public hospitals when he was Director-General of the Queensland Public Service, let me make these important points: what do our public hospitals right around Australia need right now? First, they need more beds and, second, they need local control. What did the Prime Minister do when he was the top public servant in Queensland? The first thing he did was to cut 2,200 beds out of public hospitals—a great record! Some hero, some Mr Fixit he was in Queensland. The second thing he did in Queensland was to abolish the local boards. This is typical of this hypocrite and phoney whom we have in the highest elected office in this country. He stands up, puts his hand on his heart and says, ‘I’ve always supported local control of public hospitals.’ Wrong. He abolished the public hospital boards, which had done a substantially good job in Queensland for many decades. That was almost the first thing he did when he became Queensland’s top public servant.

Because this Prime Minister is a man who is slippery with the truth, he tries to avoid the legitimate questions that are put to him by not just members on this side of the parliament but even the state Labor Premiers. I put the questions to him that he needs to address in the 10-minute speech that he is about to make. Who will administer the casemix funding system that he says is the salvation of the public hospital system? Don’t yawn, Prime Minister; answer the question. Don’t stare at your notes; listen. Make some notes and you might actually be able to answer this question. Who will administer the casemix system? What is going to happen to the public servants currently with the Victorian government who understand it? Will they march en masse to Canberra? How are the local hospital networks going to be established? Who will run them? Will they be determined by federal law and federal regulation or will it be entirely a matter for the states? If the states do not actually meet the requirements to put in 40 per cent of funding, what penalties will be imposed on them? Does he give a guarantee that no country hospital will close as a result of his casemix funding? That is the question on the lips of just about every person in rural Australia right now. Will their public hospital be safe under the amateur hour experimentation that they will get from this Prime Minister, who could not even organise to give pink batts away almost for free? These are the questions that this Prime Minister has to answer. Above all else, what is going to happen to the funding now we know that he is going to confiscate 30 per cent of the state’s GST funding? How can we be confident that this Prime Minister will be any better using GST money on health than he was using tax funding on home insulation or Building the Education Revolution?

The Premiers know that they cannot trust this man. That is why they are not prepared to sign up to his hospital plan until they have seen the details. They know they cannot trust this man. That is why they are not prepared to sign up until they have seen the Henry review. They do not think they can trust this Prime Minister and, if his own Labor Premiers do not trust him, why should I trust him and why should the Australian people trust him?

2:26 pm

Photo of Kevin RuddKevin Rudd (Griffith, Australian Labor Party, Prime Minister) Share this | | Hansard source

It is good to have Mark Latham back—not in the pages of the Financial Review today but here at the dispatch box opposite! On the substance of health policy, what we have had finally after an entire week in this place is an intervention by the Leader of the Opposition on health and hospitals policy. Day by day we have waited for a question but we have waited in vain, because it took today and the challenge to the Leader of the Opposition to come to the dispatch box and just say something, however little, however small, however insignificant, about health and hospitals.

I posed the Leader of the Opposition a question before, which was: does he support or does he oppose the government’s health policy? I thought that was a pretty reasonable question—not to ask him on day one after the policy came out, not even on day two, but you would think that, two weeks later, he might have formed a view. So his definitive position on the health and hospitals policy of the government of the Commonwealth of Australia is: I question all of it and I oppose most of it. That is the definitive conclusion on the part of the Leader of the Opposition. In other words, ‘Give me a fence to sit on for a few more weeks, a few more months; I’ll wait to see where the weathervane turns and then make a decision.’ The Leader of the Opposition knows a lot about weathervanes. He knows that the weathervane actually constitutes his moral compass—that is, whichever way it blows, so then will he take the politics of his position.

On the way through, he made an extraordinary claim about the cancer centre up there in Darwin. He said it should be called the Tony Abbott Cancer Centre. Did I hear that correctly? The minister for Health and Ageing reminds me that in fact I got it wrong. I said earlier today that they had promised it prior to the last election. I got it wrong; they promised it prior to the last two elections. Pardon me for understating their level of commitment. They were so committed that they committed to it twice! As of when we went to the election at the end of last year, did we see a brick or any mortar? Did we see any evidence of anything on the ground? No, we did not.

We actually delivered the funding. We actually delivered the construction. We actually delivered a comprehensive cancer centre for the good people of Darwin so that in the future they do not have to travel all the way to Adelaide to receive their cancer services. That is what making a difference is all about. It is not just making a speech prior to the previous election when he was health minister and hoping that people will just forget about it once he captured the headlines—because that is the overall important thing in life for the Leader of the Opposition—and that someone else picks up the detail.

He also made reference to that PET scanner at Royal North Shore Hospital. We were advised by the local doctors that, in fact, they started making representations in 1997. The local doctors could not get the member for North Sydney to even organise a visit to the hospital by the Minister for Health and Ageing—1997, 1998, 1999 went by. When did they finally visit the Royal North Shore Hospital? I am told it was in that magical year of 2007. I am told it was pretty late in the year of 2007 because a particular event was looming: an election. We have funded that PET scanner and we are proud to have done so. Again, it makes a difference on the ground.

The Leader of the Opposition has raised questions about the National Health and Hospitals Network put forward by the government. Our plan is very straightforward: it is for a new National Health and Hospitals Network. For the first time, hospitals will be funded nationally and run locally. The Leader of the Opposition said: ‘How dare you consider such a plan? How dare you consider such a possibility?’ Yet I remember him saying, in the four or five years that he was the minister for health, that the Commonwealth government should take over the system. Did I get that right or did I get it wrong?

The former minister for health, now the Leader of the Opposition, had nearly five years as health minister to act on this matter of deep conviction . We all know that Tony is a straight-talking politician. We all know that he is a politician with conviction. When he said that the Commonwealth should take over the system the health system, you knew for sure he was going to be a man of action and do it. But five years later and nothing happened. The position he now occupies is that this government is doing the wrong thing by becoming the dominant funder of the system—a system that is funded nationally and run locally through local hospital networks across the country, so that clinicians, doctors, nurses and others can have a major role in the management of the system.

On top of that, the other day we made an announcement to deal with the massive shortfall in the delivery of doctors, specialists and GPs across the nation. We made an investment in 6,000 more doctors. That is action. When the Leader of the Opposition was minister for health, do we know how many times he received warnings about the workforce shortage in health? Not once, not twice, not three, not five, not seven times, but altogether some 23-plus warnings when he was health minister about the looming crisis in the workforce in the Australian public hospital system. A National Health and Hospitals Network will be funded nationally and run locally, and for the first time the Australian government is becoming the dominant funder of the system.

The Leader of the Opposition, regrettably, welched on his commitment to bring about fundamental reform, and we all remember what he said about the public hospitals. He said that come November 2007, having been health minister for five years, he was going to do something about it. The credibility of the Leader of the Opposition on health is in tatters. He gouged $1 billion out of the public hospital system of Australia. He put a cap on the GP training places for Australia. The Leader of the Opposition sat there as health minister while they abolished and continued the removal of the dental health scheme for Australia’s seniors, leaving 650,000 seniors without a Commonwealth dental health program.

Then we had that promise of all promises, that rock solid, ironclad guarantee about the Medicare Safety Net. Where did that one go? Leader of the Opposition, where did that promise go? Leader of the Opposition, where did that core commitment on your part to go—that principled position you put to the Australian people? Or was that one of those ones where Peter Costello was saying quietly to himself: ‘Tony, Tony, Tony. Whatever you do, if you go out there and promise all that, mate, I am not going to be funding it after the election.’ Guess what happened? He did not. So a rock solid, ironclad guarantee evaporated into a pool of water. Nothing happened.

We come to this question of the billion dollars. This is a really interesting point. We say he gouged a billion dollars out of the system. Who did we cite as our evidence? We cite that noted purveyor of untruths, Peter Costello and Peter Costello’s budgets of 2003-04, 2004-05, 2005-06, 2006-07 and the forward estimates for 2007-08. We have one figure after another of money being gouged out of the system. What is his defence on this? It goes to the question of indexation. Under the previous healthcare agreement, his predecessor had an indexation clause of 6.3 per cent. That was based on a calculation about the costs in the system. In the subsequent healthcare agreement, which this minister for health presided over—the now Leader of the Opposition—he reduced it to 5.3 per cent. He gouged a billion dollars out of the system. He pretends that that is not a gouge out of the system.

I say to the Leader of the Opposition: is he seriously arguing that the costs of the hospital system went down? The Leader of the Opposition, are you suggesting in that five-year period that the costs of the hospital system went down? It is a bit like saying that if you are an age pensioner and you are depending on 25 per cent of MTAWE as the basis for indexing your pension in the future, and then suddenly you have a government which reduces that to 24 per cent, that not a gouge on pensioners. This is a one billion dollar gouge out of the health and hospital system of Australia.

This is the system that the Leader of the Opposition, the then minister for health, left this government with. That is why we have acted to invest with a 50 per cent increase in the health and hospital’s budget. That is why we have acted to deal with the shortage of doctors and nurses. The Leader of the Opposition said, ‘I do not claim to have been necessarily the world’s greatest health minister.’ He may make that claim. I can say this to him: he will go down in history as Australia’s worst health minister. (Time expired)