Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

Order! The original question was that this bill be now read a second time. To this the member for Dickson has moved as an amendment that all words after ‘That’ be omitted with a view to substituting other words. The question now is that the words proposed to be omitted stand part of the question. I call the member for Bowman in continuation.

Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Link to this | Hansard source

The mountain is climbed—you are up the top, Mr Roy; enjoy the sunshine. To the many people who would have said why it would not happen, why it could not happen, why it was unlikely to happen: one man who happens to be young set about proving why it would happen—and it did. You are freed, in order to be bound again in public service. But let us also remember that anything that can happen once can surely happen a second time, although it may not be for a very long time.

The National Health and Hospitals Network Bill 2010 is not about safety and quality in health care, as I have already explained. This is about another enormous statutory authority that further represents a slew of bureaucratic legislation coming from this Labor government. There were fast-moving, streamlined, safety and quality boards and commissions before. We did not need a multimillion-dollar solution to further slow down the work of this place. But this is not a single piece of legislation on its own. We see other pieces of legislation introducing even more statutory authorities into health care in this country, while the conditions in remote and rural Australia continue to decline.

We know the words ‘Closing the Gap’. But the one single intervention, the Northern Territory Emergency Response, has been utterly ignored and the back has been turned by this government on outcomes since 2007 and the election of the Rudd government. Because, while their lips move and suggest that the intervention is supported, the safety of children and the quality of health care continues to struggle for the simple reason that there is no commitment to improving this intervention.

Last week the Bath report delivered to the Territory government found not a single element of personal responsibility involved in the disgraceful area of child abuse, but instead they set about making 147 bureaucratic recommendations to the Territory government. No wonder that jurisdiction has lost its way. The recommendations from the Bath inquiry suggested that we needed more process, framework, agencies, peak bodies, principles, consultation, planning processes, preventions, complaint processes, education strategies, more advisors, planning units, more KPIs, workforce mediation, more outsourcing, clarity, administration, more training, more data collection, partnerships, more frameworks to be adopted, more skills to be evaluated, more consulting, more initiatives, more strategies and, yes, more guidelines. You would think that the Bath inquiry only came to an end when they ran out of bureaucratic nouns! They got to 147 of them. But was there a single mention of personal responsibility? Was there a single mention that parenting is something that needs to be the first and foremost role of every parent?

In the NT intervention, where for the first time in Indigenous history a systematic move was made against alcohol abuse for the sake of the children, towards school attendance for the sake of the children, towards health checks for the sake of the children, we see not a single modification or reform being made. And what do we know as a result? From 2008 to 2009 enrolments in school have declined. Attendance at school has declined. The reporting of domestic violence and alcohol related infringements have fallen away. What we are saying is there have been no improvements; the lips are moving but the warmth of the embrace is not there for that intervention—and with it goes the future of an entire generation of children who are seeking safety and quality in their health care.

Another report passed my desk this week: the Better hospital care for Aboriginal and Torres Strait Islanders people experiencing heart attack. Again, it has been three years now—the time is ticking. But there has been no improvement in Indigenous liaison, no improvement in cultural familiarity for staff, no improvement in introducing Indigenous people to the governance of our hospitals, no improvement in making mainstream services better for Indigenous people. We have a 20-times rate of early discharge by Indigenous Australians, who check out and walk out of the best health care in the world for the simple reason that it is not one with which they are familiar, not one to which they have been introduced to or are able to feel safe and comfortably culturally. That is a priority of the National Heart Foundation; it must be a priority of this government. It should not sit for weeks and months without response. It is of the essence of safety and quality. It is one thing to be getting the drugs or the infusion wrong, or to have adverse reactions in the First World health system that we all enjoy; but quite another when you look through the reams and reams of bureaucratic legislation we are faced with on this side of the House. As I said: the lips are moving, but nothing is changing in remote, regional and Indigenous Australia.

Darren Cheeseman (Corangamite, Australian Labor Party) Share this | Link to this | Hansard source

I congratulate the member for Longman for a terrific first speech. It was certainly a speech that I listened to very closely, and a lot of things he had to say are also things that I very much personally believe in.

Mr Deputy Speaker Georganas, I think this is the first time I have had the opportunity to formally congratulate you on being returned to your seat, and of course to offer congratulations to you on becoming a deputy speaker. Today I rise to speak on the National Health and Hospitals Network Bill 2010. It is with great pride and pleasure that I do so. I would certainly like to commend the Prime Minister and the Minister for Health and Ageing for introducing these very significant bills to this parliament. I look forward to the hopefully safe passage of this legislation through both chambers so that we can get on with the business of delivering Labor’s comprehensive plan to reform our national health and hospital system. This bill is about the implementation of the National Health and Hospitals Network, by establishing the Australian Commission on Safety and Quality in Health Care. I will refer to this body as ‘the commission’ through the course of this contribution.

The commission will create better health and better hospitals for all Australians, and certainly we on this side of the chamber, the Gillard government, very much believe in that. The commission will be important in improving the safety and quality of health care into the future. The commission will be one of three governing agencies that will oversee our health and hospital reform, and I look forward to contributing further on that in future. The other two will be the Independent Hospital Pricing Authority and the National Performance Authority, two instruments of government that will be very important for our healthcare system.

These will be the most significant health reforms since the introduction of Medicare a couple of decades ago by the former Hawke-Keating Labor government. These reforms are important because they are the most substantial reforms we have seen in this place for many years. This government will be creating the National Health and Hospitals Network that is funded nationally and will be, very importantly, run locally, enabling local clinicians and communities to oversee the running of our health and hospital system. These reforms have been through consultation. In fact, there have been hundreds of meetings held across the nation in consulting with communities in developing this model. That is something I believe in strongly, the need for consultation. Indeed, consultation took place in my community and my clinicians, my doctors and my hospitals were able to feed in directly to government to ensure that we got these mechanisms correct.

This bill will help change the way in which health services are delivered, with patients having better access to services. I know that most people in this chamber, certainly those on this side, believe in delivering quality health care for all of our communities. This bill will also help with preventive health and health care outside our hospitals. It will also be significant in helping regional electorates like my electorate of Corangamite. As you no doubt know, Mr Deputy Speaker, many regional people find it generally difficult to be able to access medical help when they need it because of the tyranny of distance and the challenges of getting clinicians, doctors and nurses employed in our regions. I believe this will help in that regard. That is one of the reasons why I am so supportive of the bill, because it is in the regions where I believe the most significant reform will take place as we deploy the National Health and Hospitals Network through the course of the next few years. This will make the federal government the majority funder of Australia’s public hospital services. We have had report after report that show that our health system had been on an unsustainable downward curve for quite some time and it is only the financial clout of the Commonwealth that can bring sustainability back to our health and hospital system.

The Commonwealth government will provide $35.2 million over the next four years to jointly fund, with the states and territories, the commission. This Labor government is implementing major reforms to funding the Australian healthcare system. This funding will help our healthcare system to have a sustainable future. That is very important. If you have a look at any of the significant work that has been undertaken by any of the reputable health economists, you can see that expenses are growing, and we know that the contribution that needs to be made by the public purse will need to grow to ensure that Australians get access to sustainable world-class health care. That is a part of the need for the significant investment that we will be making to the national health and hospital system. Things like sustainability and quality, the capacity of our health system and better connecting care for people right across the country, particularly in electorates like Corangamite, are significant parts of the important work that we need to undertake.

Today I would like to touch on a few things that we are doing in my electorate to benefit my community in the broader Geelong area. I particularly want to touch on the importance of preventive health and better access to services. These two areas of health will greatly help some of the most vulnerable people in my electorate but also right across Australia. This government will provide better access to services across the country in health. The National Health and Hospitals Network will deliver to local communities in my electorate better access to health services.

The Gillard government will also continue to establish the national after-hours GP and primary care services, which are critically important for providing people with the opportunity to access information when they need it. People in my electorate speak to me regularly about the difficulty they often have in accessing GPs and nurses. Again the Gillard government is investing substantially to help address these challenges. Through this bill and the National Health and Hospitals Network, the government will invest $355 million to create more GP superclinics and to expand GP clinics as well. This will take place in about 450 locations around the country.

I am a fortunate MP who does actually have a GP superclinic within my electorate, in the suburb of Belmont; it opened just a few months ago. It provides health care to the communities in Grovedale, Belmont, Highton and Waurn Ponds. It is pleasing to see that people are voting with their feet, because the car park is regularly filled with people accessing services from there. Most pleasing about that particular superclinic is that we are working in partnership with Deakin University. In fact they are training many of their graduates at this superclinic, providing opportunities for medical students to gain practical first-hand medical experience under the supervision of qualified doctors. I certainly look forward to seeing the graduates from the Deakin University medical school gaining that practical experience at that location and then gaining employment in many parts of regional Victoria where there are GP shortages. I look forward to seeing that over the years to come.

The National Health and Hospitals Network will also strengthen guarantees and targets to improve access to public hospital services. The government needs to do this after the previous decade in which more than $1 billion was ripped out of our health and hospital system creating bottlenecks, skills shortages and a blow-out in access for many people to high-quality medical services that can only be provided by hospitals, when people most need them.

This government will also invest $750 million in emergency departments across the nation. This will guarantee that patients will be either treated or admitted within a reasonable time. That is something I look forward to. The government will also overhaul the health system to ensure that there is a better deal for those on elective surgery waiting lists. As a member of parliament I realise, as I am sure most members do, that often we are dealing with patients that do find it difficult to access elective surgery, particularly if they are in pain. My staff and I spend a significant amount of time working with constituents in addressing those issues. The reality is that we need more money to address this issue. The $800 million for elective surgery will result in some 95 per cent of elective surgeries being delivered within the clinically recommended time frame. That is certainly a dramatic improvement from the circumstances that we found ourselves in when we went into government in 2007. This is a major difference between the Gillard government and those on the other side, who sat by for years and watched our health and hospital system groan under the strains that had been created as a consequence of a lot of resources being ripped out of the health and hospital system.

We believe in putting money into health to provide better access to services for regional people of this country. My electorate is a significant one in which people do find it difficult to access a modern health and hospital system because of the tyranny of distance.

In the short amount of time that I have left there are a couple of major points that I wish to touch on. Geelong and the surrounding towns have a population near 200,000. The current Geelong hospital is getting to the point at which it cannot develop and grow any longer on its existing site. The state government is working through the planning processes to establish a second Geelong hospital, which will be called the Southern Geelong Hospital. It will be located within my electorate and I certainly look forward to working with the state government in the years to come to secure funding for that project under the health and hospital reform process. I have been campaigning hard on this issue for some time now.

I also wish to very briefly mention that Deakin University, which has a new medical school, will be partnering with the Epworth health network to build a new private hospital for the Geelong community. It will be located on Deakin University’s Waurn Ponds site. Again, this is a much needed investment providing choice for the Geelong community. I look forward to working with Deakin University and the Epworth health group to see that investment within our community.

There is no doubt that a public health system working in partnership with a private health provider can very much deliver sustained improvements for our communities across the nation. I commend the bill to the House. (Time expired)

Teresa Gambaro (Brisbane, Liberal Party, Shadow Parliamentary Secretary for Citizenship and Settlement) Share this | Link to this | Hansard source

The National Health and Hospitals Network Bill 2010 is the first step to enact the flawed Rudd health reforms. It establishes the Australian Commission on Safety and Quality in Health Care, currently part of the health department, as a permanent independent statutory authority.

It was intended that this act would be amended in the future to include provisions to establish the Independent Hospital Pricing Authority; however the flexibility that was to be built in for future changes that may be needed was scrapped just shortly after it was announced. This highlights that this important reform was driven by political agenda and not good policy outcome.

Any plan that increases bureaucracies and ties up hospitals even further with complicated processes in the delivery of health care to Australians is fundamentally flawed. Let me put on the record that I speak from experience having seen the atrocious mistakes of the Queensland Labor government in this particular area of health. To implement a health plan that does not give a guarantee that more dollars will arrive at the bedside for the benefit of patients and healthcare workers is bad public policy.

The coalition does support an ongoing role for the commission within existing arrangements, but we hold serious concerns about this government’s and the previous government’s desire to rearrange the bureaucratic structures of departments. These changes will not be efficient and Labor’s record shows that its supposed health reform agenda will not even be effectively implemented.

The aims of this commission are very broad, long of ideals but short on specifics. It is very interesting when reading the bill that more pages are concerned with how the structure will be set up and the role of members than the processes under which it will work. The commission’s aim to reduce harm caused by preventable errors, to reduce health care costs and to ensure the appropriateness of services is quite grand, but it is also impractical given the pending changes. With the proposed changes it will be all things to all departments and will prove not to be the most effective means to ensure positive and effective outcomes for patients. Well-staffed, well-resourced and well-supported bed-side care providers will be the best way forward in providing safe and quality care, not a faceless bureaucracy in Canberra that sits outside the Department of Health and Ageing.

Just as the medical fraternity assesses efficacy by measuring patient outcomes, this plan offers no efficacy measures. The coalition’s beds and boards policy would make a real difference by directly tying increased funding to the delivery of increased services. This policy is in step with the medical fraternity’s measures of efficiency through patient outcomes. In contrast, this plan increases the bureaucratic processes and has done little to demonstrate that it will achieve better care for patients and more support for our healthcare workers. Under this plan we will see a return of Labor’s wasteful spending and inefficient program delivery. Simply shifting funding by dubious means as a dominant funder will only result in unnecessary duplication of processes and structures.

Brisbane does not have a superclinic. I speak to many of the medical practitioners who tell me that they can build 10 GP superclinics for what it costs to build one superclinic. Brisbane does have, however, one of the world’s leading hospitals in the Royal Brisbane and Women’s Hospital. The doctors and nurses in Brisbane that I have spoken to speak very highly of this hospital and they tell me the fundamental reason why it remains a world class hospital is that it is self-managed. This hospital makes local decisions in the interests of its patients, not decisions by some accountants and officials that run from head office in Canberra some 1,000 kilometres away. To expand on the success of the Royal Brisbane and Women’s Hospital, each major referral hospital and its associated hospitals should have its own management board.

On a side note, when the former Prime Minister and member for Griffith was the Director General of Queensland—the chief bureaucrat to which the title is still quite fitting—he removed local hospital boards and reduced the number of beds. The two things this National Health and Hospitals Network Bill tries to do is to implement local boards and increase the number of beds. This is not reform; this is simply Labor covering up Labor’s own mess.

The coalition has a plan to establish a $150 million fund to assist nurses pursuing important professional development opportunities. This underlines the coalition’s support of clinical best practice in our health and hospitals systems. Nurses tell me such a funding proposal would go a very long way to help provide them with up-to-date quality and respectful care at the bedside.

I have recently seen what a fantastic job nurses do in various hospitals in Brisbane and I congratulate and thank them for their patient care. One need only look at the nurses’ payroll debacle in Queensland Health to see how badly a Labor government delivers for nurses and how little support they give nurses. Labor has failed hospital based nurses. It got so bad in my home state of Queensland that the current ALP National President and Labor Premier, Anna Bligh, basically told nurses to turn to charity when they were not being paid by Queensland Health. The debacle is still going on due to the severity of the Queensland Labor government’s failure. It is a disgrace.

The coalition’s plan to establish 20 early psychosis intervention centres and 800 beds for acute and subacute care is aimed at providing targeted health care and early prevention and intervention. Our proposal to provide an additional 60 headspace sites, providing a one-stop shop for Australians and young people with information and services relating to general health and wellbeing, and mental health and drug and alcohol services was very well received in Brisbane. At a recent AGM of the Mental Illness Fellowship of Queensland in New Farm it was put to the meeting by Professor Mendoza that the coalition’s mental health policy was the most significant advance in mental health planning. In the electorate of Brisbane this was one of the most widely acclaimed policies of the coalition at the last election. I had GPs and nurses alike tell me the great importance of this policy. This is real health care reform and this is a real plan.

A current plan afoot in Brisbane to close down the Royal Children’s Hospital is evidence of the reckless and wasteful approach to health care. The member for Port Adelaide, when he was Parliamentary Secretary for Health to the Minister for Health and Ageing, Ms Roxon, reaffirmed the Commonwealth’s commitment to a policy of non-closure of existing hospitals and support for state decisions. The Commonwealth has always assumed that these decisions are based on a process of state-wide consultation, but in true Labor style we have not seen state-wide transparent consultation over the decision to close the Royal Children’s Hospital. In recent polling on the issue, 84 per cent of respondents were unaware of the closure and 90 per cent were opposed to it. Maintaining the Royal Children’s Hospital and the strength of a well-functioning Herston teaching hospital within the medical school complex is very important to the people of Brisbane.

Reckless spending and the proven inability to deliver programs under Labor means more reckless spending and its economic failures mean that funding for essential services is under threat from this plan. The coalition supports the work that is being done, and can continue to be done, by the Commission on Safety and Quality in Health Care but we hold serious concerns about this government’s desire to establish a new standalone, self-serving bureaucracy that will move even further away from the patients they were designed to protect.

Sharon Grierson (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

As a nation it is fair to say that we stand at a crossroads. The decisions that we make here in parliament will be critical if we are to build the sophisticated world-class health system necessary to meet the present and future needs of our ageing population.

The National Health and Hospitals Network Bill 2010, which I rise to support, forms part of the most extensive and far-reaching reform of the health sector since the introduction of Medicare in 1984. It will deliver a health network for all Australians, funded nationally and run locally. We will become the dominant funder of hospital services, with full policy and funding responsibility for GP, primary health and aged care. We will also pay for 60 per cent of hospital activity and capital costs, as well as 60 per cent of teaching, training and research costs—costs which are ever-escalating.

We will use this increased funding responsibility to leverage greater coordination, control and accountability at a local level. There are savings and synergies to be found. That is our goal: to find those savings and synergies and make the health dollar go as far as it can. Combined with a new national performance framework, we will transform the health system, making it more transparent, to provide all Australians with improved access to high-quality health care—the one thing I think all Australians collectively strive for.

This bill establishes the framework for the Australian Commission on Safety and Quality in Health Care as part of the National Health and Hospitals Network. As a permanent, independent body under the Commonwealth Authorities and Companies Act 1997, the commission will set national clinical standards, guidelines and indicators and strengthen clinical governance. It will foster safe and high-quality care, particularly in the areas of primary care and mental health. By reducing the occurrence of preventable errors, and healthcare costs stemming from unnecessary or ineffective treatments, the commission can go a long way to restoring the community’s waning trust in the health system.

Australian Labor governments have a strong and proud history of investment in health and public hospitals. Almost three decades ago, under the Hawke Labor government, this nation stood up for the right of all Australians to protection against the crippling financial consequences of hospital and medical treatment. Now we are standing up again for the right of all Australians to better hospitals and better health care. Whether they live in regional or metropolitan Australia, this will be a health system for all Australians.

From 1 July this year we, as a government, began to deliver $7.3 billion for the Australian health system over five years to ease the pressure on our hospitals and GPs. This is an increase in funding of over 50 per cent. It is designed to build the capacity of the Australian health system. We are working to better integrate hospitals with community health providers and general practitioners. That is one thing that my region excels in—integration and collaboration has proven a great driver for innovation and best practice in the Hunter New England Area Health Service. Nationally we have delivered more beds, more training and more GP services. But according to the member for Dickson, this Labor government ‘is all talk and no action’. Make no mistake, those opposite believe in a very different Australia. It would not be an Australia for all Australians, with a health and hospital network for the 21st century.

When he was the Minister for Health and Ageing under the previous government, the now Leader of the Opposition cut $1 billion from public hospitals. Then in the lead-up to the recent election, he pledged to again cut funding for GP services, to cut the GP Super Clinics Program, to cut the e-health system and to cut the 24-hour, after-hours GP helpline. Under an Abbott-led government, we would have seen fewer doctors, fewer nurses, and fewer beds.

What it really comes down to is the question: who will put the health and wellbeing of Australians first? Who will support a national hospital network so that all Australians can enjoy affordable and universally accessible health care? Who will cut emergency department waiting times and who will fund more hospital beds? These are the questions that the Australian people are asking of us, asking this new parliament.

The question that those opposite face is whether they will support this reform package and help deliver a higher quality health and hospital system, or whether they will vote against this legislation, just as they have voted against our broader reform agenda. When they vote against more hospital beds and a national after-hours GP service, they do so not because they do not care but because, it seems, they just do not understand.

Almost a year ago, on 7 October 2009, with the then Minister for Indigenous Health, Rural and Regional Health and Regional Services Delivery, the Hon. Warren Snowdon, we conducted a consultation with the people of my electorate of Newcastle and the surrounding electorates of Charlton, Hunter, Shortland and Paterson. We asked the people of Newcastle and the Hunter for their views, their experiences and their ideas, and we listened. It is some of those ideas that we are now attempting to implement through this legislation.

Since then a significant number of residents in my electorate have written to me about the state of the public health system and of the hospital system particularly. In my experience as a member of parliament, I never receive as many responses to surveys as I do when the survey is about health. Health care is something that is critical to every member of my electorate. Jean from New Lambton asked us to fix the lengthy delays in waiting lists. At the John Hunter Hospital, the waiting list for a gastroscopy and colonoscopy for diagnosis of, say, coeliac’s disease with diabetes is one year. ‘Imagine what could happen during a whole year’, Jean said, ‘waiting for the investigation and diagnosis of a potentially dangerous medical condition.’ In December last year, cancer patients at the Calvary Mater Newcastle Hospital were having to wait for six to eight weeks to see an oncologist and a further 12 weeks before they could begin chemotherapy.

Our hospitals are getting busier each year and demand for quality health care is increasing as our population ages. The 2010 Intergenerational Report has warned that an ageing population will strain the healthcare system and increase both healthcare needs and expenditure. The proportion of our population aged over 65 is forecast to increase from 14 per cent this year to 23 per cent by 2050 and we need to ensure that our health and hospital system is able to meet this increasing demand.

These reforms to our health and hospital system are long overdue. The Australian people have expressed their concerns, in my electorate and in electorates around Australia. We are committed to rectifying the $1 billion shortfall in public hospital funding under the previous government, just as we are committed to training doctors and nurses for the future through reinstating the training positions that were cut by the previous Liberal led government. As a government, and as a party, we are committed to providing more beds, more training and more GP services. We will invest in better health and better hospitals for all Australians.

Vital to these reforms is the $64 billion agreement with state and territory governments reached in November 2008. This is a 50 per cent increase on previous Australian government funding for public hospitals. The agreement included a $1.1 billion health workforce package, $750 million to take pressure off emergency departments and $500 million for subacute care facilities. The government also invested $872 million nationally in preventative health programs for schools, workplaces and local communities with a high incidence of chronic disease. Sadly, there are too many such communities. Chronic disease is rising, and last year in my electorate of Newcastle we provided almost $200,000 to fund extra support for local patients with chronic diseases. If we are to have a truly national health and hospitals network, it is vital that we have strong safety and quality standards so that all Australians can be confident in the quality of the care that they are receiving, whether they are at the John Hunter Hospital in Newcastle or the Broken Hill hospital in far western NSW.

This has been the hallmark of the current government. We are a government for all Australians, and we will invest in the public health system in six key areas: by expanding the capacity of our hospitals through the National Health and Hospitals Network; by investing in our doctors and nurses with more training places and allied health scholarships; by building primary care infrastructure with more GP superclinics and upgrades to existing general practices; by taking health records online through investments in e-health; by developing local hospital networks; and by funding health prevention in schools and in workplaces around the country.

Over the coming five years we will deliver 1,300 new subacute hospital beds. We will cap emergency department waiting times at four hours. Not so long ago I sat with my father in an emergency ward, having got back from Canberra at 6 pm to find he had been at the hospital since 10 o’clock in the morning. That is a long time to be waiting on a bed in an emergency ward. We will ensure that elective surgery is delivered in clinically recommended times for 95 per cent of Australians. We have already seen this government’s commitment to reducing elective surgery waiting periods at the John Hunter Hospital, which services the residents of my electorate. Last year, the federal Labor government provided almost $400,000 for new equipment in my electorate to improve elective surgery performance, as part of the Elective Surgery Waiting List Reduction Plan. Nationally, we have already delivered more than 62,000 additional elective procedures.

We also provided $2.2 million to upgrade the PET scanner and services at the Calvary Mater hospital in Newcastle. I am pleased to say that the state government has this year installed an MRI machine at the Mater hospital, and I am working closely with the Minister for Health and Ageing, Nicola Roxon, knowing that they will require some support for the operation of that MRI. The Calvary Mater hospital is the largest oncology service deliver in New South Wales.

We also funded 50 new Commonwealth supported nursing places at the University of Newcastle to the value of $564,000, as part of our commitment to reducing emergency room waiting periods and improving the quality of health care. We have provided $466.7 million over two years to establish the key components of a personally-controlled electronic health records system in Newcastle, to give back to patients ownership of their health records.

I am very pleased that Newcastle, through Hunter GP Access, is one of the regions to be part of that initial project. They have a great history of providing support for GP services and in Newcastle, where we have seen Primary Health Care close down an important medical practice at less than one day’s notice, we have seen patients struggle to find or get access to their records. It has been very distressing for people who have been at a practice for a long time, so I know the value to patients of knowing that they can control their records and retain access to them. I am pleased that our region will be a part of that, and I have met with Mark Foster, the head of GP Access, and he has made a commitment that best practice will be followed. We have also allocated almost $250,000 to the Hunter Dementia and Memory Resource Centre and funded after-hours GP access to the sum of $6.7 million. I praise GP Access—we are using their model for after-hours service, which they have had for many years. It provides for a call centre and triage services. We have also provided more than $2.6 million for Indigenous mental health programs in my electorate alone.

We are already delivering a health and hospitals network for the 21st century, and we will continue to deliver on our commitment to improving access to health services for all Australians. Supplemented by strong safety and quality standards, this bill will encourage confidence among the Australian people in the high-quality care that they should receive and deserve to receive. I commend this bill to the House, and I thank the Prime Minister and Minister Roxon for their ongoing interest in the health concerns of the people of Newcastle over many years.

Patrick Secker (Barker, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy Speaker Sidebottom, may I add at this first opportunity my congratulations on your reappointment to the Speaker’s panel. I am sure you will continue to do a great job, as you did during the last parliament. I rise tonight to speak on the National Health and Hospitals Network Bill 2010. This bill is part of the Labor government’s so-called answer to health reform announced by the former Rudd government as a distraction from things like the insulation debate. Like much of the legislation announced around that time, it lacks detail and common sense.

I am fully supportive of measures that improve frontline health services. There would not be a member in this House who would not want that improvement, especially if it is directed towards regional areas. My electorate of Barker is basically all rural and regional, and my constituents are always asking for improved health services—I am sure many other members of parliament would say the same. The problem here is that the legislation will not improve frontline health services in regional Australia. In fact, it would not even improve frontline health services in the city or anywhere else, and that is why I oppose this legislation.

When the Minister for Health and Ageing spoke about this bill recently in the House she said there was a need to increase capacity and to better connect care—what an interesting phrase that was. I would take that to mean that my constituents could see a doctor quicker, that local hospitals would not close down and that mental health would not be forgotten—but not so. I receive correspondence in my office all the time about health services, such as the long waiting times to see a doctor and especially the shortage of services in country towns.

Health is such an important issue for most people and they want to trust the government of the day when it comes to health. I know there are people who bought into the Labor government’s promise of health reform hook, line and sinker. I feel sorry for those people because they will be bitterly disappointed as this bill seeks only to increase bureaucracy—it will not improve frontline health services, it will not give us better hospital services and it will not benefit my electorate.

This bill seeks to expand the Australian Commission on Safety and Quality in Health Care and to create the Independent Hospital Pricing Authority. They are great bureaucracies but they do not deliver one health service. What is concerning is that the detail on expanding these authorities is not included in this bill. How can the Gillard government expect the coalition to stand in this place and pass legislation that has no detail? When the constituents of Barker call on me as their member I would rather tell them that I opposed this bill because I did not believe it delivered anything for them and that it lacked any detail on decent reform, than tell them I supported legislation that did not fully explain the intention of the bill.

I think it is quite amazing how health services in this country have actually gone in the last couple of decades. I am a great believer that nurses, for example, often did a great job when learning on the job, but that does not seem to happen now. They now have to get their university degrees and many of those people do not actually then deliver health services—they become health bureaucrats.

I think it is very interesting to look at the situation in Queensland. I am sure it is very similar all around the country but I know that in Queensland there are 19,000 doctors and nurses delivering health services. You would think that was pretty good, but there are actually 45,000 bureaucrats who are not delivering health services. I think one of the big problems in the health system in Australia is that we have become too bureaucratised and we are not actually delivering services.

The coalition cannot support this bill because it is wasted funding that could be better spent elsewhere. The coalition announced it would not proceed with funding for an independent and expanded commission, and that the funding would be used to offset the costs of the coalition’s plan for real action on hospitals and nursing policy. The funding the Labor government announced for the Independent Hospital Pricing Authority and the National Performance Authority just makes the problem worse by adding more bureaucrats and not enough health deliverers.

Our plan, for which we were congratulated by the experts, was $1.5 billion for mental health, in contrast to something like $270 million from the Labor government. You cannot always judge a policy by the number of dollars expended, although that tends to be the way that the Labor government talks about these issues—it is spending this much on this and this much on that—but there is no doubt that we ticked all the boxes when it came to mental health policy.

I had health workers contact me and tell me they were very pleased that the opposition was serious about mental health. It is a huge and growing problem in rural areas, as you would know, Mr Deputy Speaker Sidebottom. They applauded our plan because it provided the services they needed—not more bureaucrats. This was what the people who work in the industry were telling me they needed. When the Gillard government decided to cut pivotal funding for mental health workers earlier this year I was stunned that a government could be so ruthless. Headspace is another vital service for youth and the Headspace sites in Barker were worried that they would become obsolete. Again, we see a government not concerned with real effects and not giving us the details.

I would have thought that after those opposite saw the backlash to their cuts to mental health they would have learnt from that, but here we are in this place yet again debating more legislation that promises the world and delivers very little. If the Gillard government took time out to consult industry professionals and those workers in the system that see what happens on the ground, this would be a very different debate indeed. If you ask any hospital what they need they would not ask for more red tape or more bureaucrats; they would ask for better frontline services and better management. If I went to my constituents in Barker and asked if they would prefer to see the number of bureaucrats increased, I can guarantee you that that is not what they want.

I believe that better management of hospitals lies in community-run hospitals, not in the added bureaucracy and red tape that this bill would carry with it. The coalition supports better frontline services and better general practices. Community-run hospitals are run by the people that know best, not by bureaucrats that have no idea what the communities actually need. I spent four years on a hospital board and I know a bit about what works and what does not, and bureaucracy does not always work. We all know we need a certain amount of it, but I think we have gone too far in that direction.

Labor’s reforms will not provide better services, and the delivery of services is the way we can actually judge what is happening in the sector. I have serious concerns about what these so-called reforms will mean and I ask the Gillard government to come forward and be honest about the detail of the legislation. I do not think the Minister for Health and Ageing has any idea what the detail is. I think she is in the dark just as we are on this side when it comes to Labor’s health reform. These reforms were promised by Kevin Rudd, the former Prime Minister, and were driven by a political agenda. He did not even both consulting the health minister. She was completely excluded from discussions. This is a totally compromised proposal.

While the Labor government are busy expanding their bureaucracy, hospitals are closing and patients are missing out on key health services. I draw the House’s attention to an issue in my electorate of Barker where I think that funding could be better directed. I am sure people across South Australia, and possibly even interstate, are starting to hear about Keith and their hospital. Even though it is a small town, the residents are certainly making a lot of noise, as they should because their hospital is not only being ignored by Labor but being given a death sentence.

The problem is that the Labor state government have cut Keith’s funding by 60 per cent. Could you imagine any hospital being able to continue to exist following a 60 per cent funding cut? On the basis of that cut this hospital will have to rely on their reserves and will only last another nine months. Residents are understandably upset and angry because after nine months they will have to travel 140 kilometres away to the nearest hospital when they have a perfectly good one in Keith already.

The hospital will be forced to close following the 60 per cent cut to their funding that was announced in the state budget. This is devastating news for the hospital and for the township. These cuts will be the end of the Keith hospital. It just cannot continue without funding. The state government unfortunately have been commenting in the media recently that the Keith hospital is a private hospital, as if it is a profit-making hospital. This is totally incorrect. It was built in 1954 by the community for the community, not by the state government or the federal government. It was built by the community and it has remained outside the state government bureaucracy. I note with interest that in a state Labor government seat, the McLaren Vale hospital, another so-called private hospital under the same criteria that the minister has been talking about, receives 10 fully funded beds. Keith hospital is only asking that their three beds continue to be funded in the same way they have been for many years.

The other fallacy that the minister has been putting out there is that the Keith hospital pays more for its nurses—as if somehow the management of Keith hospital are not very good at managing their hospital. In actual fact that is not the case. The nurses get eight per cent less than nurses in the state hospital bureaucracy because the Keith nurses love their community hospital and they want it to keep going.

I believe the federal Labor government should take notice of this issue because the federal government have invested quite heavily in this hospital. Labor and Liberal governments have contributed $1.3 million in total towards the Keith hospital, so it is in everyone’s interests if the hospital stays open. I actually congratulated the Labor government for funding the Keith hospital again, like I did when it achieved some funding when the coalition were in government. Keith hospital are just about to open the wing after investing about $800,000 in it. Guess what? It is going to have to close in nine months. How stupid is that? I would have thought that the federal minister would be very interested to know that all that federal taxpayers’ money has been spent and yet, because of a state government decision, the hospital will have to close. It does not make sense for the government to invest in a hospital that benefits the community and then let the hospital close while under their watch.

The Gillard government should display their interest in this hospital and ensure it does not meet an unfortunate end because of careless decisions. But I will give Minister Roxon credit because her department have met with me and on Thursday I will also be meeting with the Minister for Mental Health and Ageing, Mark Butler. I hope they are taking notice, because if the Keith hospital closes—and it will close within nine months if this funding is not at least kept at parity—there will not be a hospital for the 200 kilometres between Bordertown and Murray Bridge. I think the locals are talking about erecting signs as you leave Bordertown or Murray Bridge that will read, ‘Please, don’t get sick because there will not be another hospital for 200 kilometres.’ This will be on the main highway from Adelaide to Melbourne, the Dukes Highway. There have been several deaths on that road, so it is just ludicrous to make a decision which will close this hospital. The Keith Hospital is the furthest hospital from which the rescue helicopter can retrieve patients without having to refuel on its way back to the Royal Adelaide Hospital. With the Dukes Highway running right past Keith this is very worrying.

I have listed the many concerns I have over the possible closure of Keith hospital, and I am not alone in my concerns. Twelve hundred people live in Keith and 1,200 came out to a public meeting last week, and they are demonstrating on the steps of the state parliament tomorrow. I wish them luck because this state government obviously does not understand the issue and it is about time that Labor started listening to the concerns of the local community.

Deborah O'Neill (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

I am delighted to speak today to this important bill, which puts in place the first piece of Labor’s historic health reform agenda, our National Health and Hospitals Network, and of course I oppose the amendment moved last night by the member for Dickson.

The National Health and Hospitals Network Bill 2010 gives the Australian Commission on Safety and Quality in Health Care the role of setting national clinical standards and strengthening clinical governance. Later amendments will include provisions to establish the Independent Hospital Pricing Authority and the National Performance Authority, other elements of the National Health and Hospitals Network.

Through his amendment, the member for Dickson seeks to create a legislative logjam. As we all know, all states and territories bar Western Australia have signed up to Labor’s National Health and Hospitals Network Agreement. As the Prime Minister said in her recent press conference, we are going to keep talking to Western Australia. Notwithstanding that state’s continued absence and the obstructionist behaviour of the member for Dickson, this week is a historic week in this parliament for Australia’s healthcare system. As the Prime Minister, the Minister for Health and Ageing and the Treasurer announced yesterday, the government will be introducing legislation this week to allow the Commonwealth, for the first time, to take majority funding responsibility for public hospitals and full responsibility for primary care. This legislation, should it win the backing of the parliament and clear the roadblocks put up by the likes of the member for Dickson, will ensure that, for the first time, the federal government fairly and transparently funds Australia’s public hospitals, and that is a good thing.

For the first time, the Commonwealth will fund hospitals for each service they provide rather than through block grants. This will allow us as a nation to address the burgeoning demand in regions like mine and help ease the pressure on our hospital waiting lists. I hope the opposition will support this historic legislation when it comes before this place. Hope springs eternal. Delay will only hurt those who need the boost to health services most—those who face longer waiting times in emergency departments and further elective surgery delays.

As the minister for health pointed out in her second reading speech, the bill in question today establishes, in the Australian Commission on Safety and Quality in Health Care, a permanent, independent safety and quality body. This government is determined to drive improvements in quality and to safeguard high standards of care for all Australians. This is a key part of Labor’s health reform agenda. We appreciate that Australians have a right to demand the consistent, high-quality care they deserve, wherever they live. That is true whether you are in Woy Woy or Wagga Wagga, Gosford or Goondiwindi.

I can bear witness personally to the expectations of the people in Woy Woy and Gosford because of the thousands of people I have spoken to over the last nine months on the Central Coast. Equity of access to health care is the biggest health issue for the people of my electorate. One Sunday afternoon, as I was out meeting people in Terrigal, I met a woman who had been blessed with good health. In fact, she had been so well that she had not been to the doctor for eight years. It sounded like a good news story to me, but she went on to tell me that in the previous week she had become unwell. When she returned to her former doctor—whom her husband and her daughter were seeing—she was told that the books were full and she was no longer eligible to be a patient. This was a story I heard over and over, particularly from new residents in the area.

While meeting people in Umina I met a lady who disclosed to me, in the most frank and generous way—which is something many of us find when we meet people in the community—that she had a urinary tract infection but could not get in to see her doctor for two weeks. The result was that she ended up as a triage level 5 patient at the emergency centre at Gosford Hospital. These are issues that only a Labor government is committed to addressing, which is part of the reason the support for Labor on the Central Coast was so strong. People understand that we have a plan that will increase equity and access.

Another GP superclinic for our region will certainly help meet the needs I have just articulated. There is already a GP superclinic underway in Warnervale and another one due to be built in Robertson. Last night we heard a lot of nonsense on GP superclinics from the opposition. This is a superior model of care. We acknowledge the work of local GPs and their efforts in their practices, but the GP superclinic model really does have the health consumer at the centre of it, and I urge GPs to embrace the model.

Over time, Labor’s commitment to training more doctors and nurses will make a difference too: 1,000 extra nurses every year nationally and an additional 5½ thousand GPs and 680 specialist doctors over the next decade. Earlier this month the Prime Minister and the minister for health expanded on that announcement by allocating funding for clinical training for up to 12,000 more medical, nursing and allied health students. We are investing in the health system of the future for the future of all Australians.

My impressions of the overwhelming demand for health services on the Central Coast were forged by my extensive doorknocking across the region. Those impressions have been further reinforced in the meetings I have had over the past few weeks with many Central Coast health providers: the area health service, the Central Coast Division of General Practice and a number of others. On the Central Coast, Labor is meeting that demand through the funding of a number of initiatives, such as the $38.6 million regional cancer centre at Gosford Hospital. I was proud to be there on 14 April this year when the former Prime Minister announced the funding, $28.6 million of which is being contributed by the Commonwealth.

There is much more. Earlier this month I had the pleasure of being at Gosford Hospital with New South Wales Premier Kristina Keneally for the announcement of $1.6 million in funding to replace Gosford Hospital’s cardiac catheterisation lab. The patient I spoke to was very pleased at the prospect of undergoing his procedure close to home.

I was also with the minister for health at Gosford Hospital back in August when she announced $5 million in new beds and equipment. That means 16 new acute care beds and new emergency department equipment. I also obtained an insight into the future planning focus for Gosford Hospital, our region’s main teaching hospital. Management there are looking at enhancing surgical capacity, including theatres, acute surgical models and day-only capacity; enhancing the capacity of the emergency department, including the paediatric area and an emergency medical unit; enhancing acute medical and surgical beds; enhancing intensive care capacity; and creating in-patient rehabilitation beds. These are ambitious plans to meet the pressing needs of the community, which has every right to expect the highest possible standards.

Labor is the only party that is addressing the real health needs of the Central Coast community. We are recognising particular needs in particular places. We are liberating local voices by responding to what is actually needed on the ground. In contrast, during the previous election campaign the Liberals were shameless. They presented an uncosted, sham proposal to rebuild Woy Woy Hospital. What they proposed would barely have paid for a refit of the building. Like the entire coalition election campaign, this was nothing short of a confidence trick. I am pleased to say that the public on the Central Coast were not taken in. They know that they deserve better than that.

Our growing region deserves the best quality health care it can get. That is where the Australian Commission on Safety and Quality in Health Care comes in. It will be the body that develops the standards that make up the new National Health and Hospital Network’s performance and accountability framework. Having our own local health network—a key part of Labor’s reforms—cannot come soon enough for the people of the Central Coast. There is a sense of pride and relief among those of us on the coast that this has finally come to pass.

I feel that the Central Coast is emerging from the shadow of its larger metropolitan neighbours to the north and to the south to cement its regional identity. It is something the member for Dobell and I talk about often. We have a population the size of Canberra. We have our own football team, the Central Coast Mariners, and we might even have a rugby league team, the Bears, in the near future. Soon we shall be unchained from the health bureaucrats of northern Sydney and we will have our own Central Coast area health service. If I may borrow from the words of Martin Luther King, I know there are many health providers and consumers on the Central Coast who are relishing the day that they can say, ‘Free at last, free at last—thank God Almighty, we’re free at last.’

I know the provision of health services across our collection of villages in Robertson will present a challenge to whichever body is charged with that duty, but being able to exercise some local control and having the case mix funding model working in our favour are two things I know the local health providers are also looking forward to. I am sure our local clinicians on the Central Coast will work constructively and cooperatively with the Australian Commission on Safety and Quality in Health Care when it becomes operational to establish and ensure continuity of best practice clinical care. The commission is due to begin operations as a permanent independent body on 1 July next year. This legislation will formulate the commission as a permanent statutory authority under the Commonwealth Authorities and Companies Act. It will have a board of directors with a chair and seven to nine other members with substantial experience or knowledge and significant standing in public administration in relation to health care. A chief executive officer will be responsible for the day-to-day administration of the commission.

I note that our parliamentary colleagues in the other place have already referred this bill to their Community Affairs Legislation Committee for scrutiny, with a report due on 18 November. I hope that health consumers across the country will have some certainty after that date. I note that funding of $35.2 million has been set aside by the Commonwealth over the next four years for the commission to do its work. That funding will be augmented by funding from states and territories who are part of the National Health and Hospital Networks agreement. I commend the bill to the House and oppose the second reading amendment, which will simply create another unnecessary delay.

Ken Wyatt (Hasluck, Liberal Party) Share this | Link to this | Hansard source

I rise to speak against the National Health and Hospitals Network Bill 2010 and to support the second reading amendment. I also want to congratulate you, Mr Deputy Speaker Sidebottom, on your appointment to your position as well. It is intriguing standing talking about this issue, given that recently I was a public servant heavily involved in the many facets of the national partnership agreements that were led by the Commonwealth and through the COAG processes that were to streamline both reporting, financial arrangements and the commitments to significant reforms across the continuum of health care provided to Australians. That included reforms around hospitals and the funding that would be required and the targets that were established in respect of elective surgery lists.

Some of those processes were negotiated through jurisdictions led by Commonwealth bureaucrats or, in many instances, by ministers supported through the Australian Health Ministers Advisory Council. They included the National Healthcare Agreement. It includes Indigenous health, aged care, workforce, preventative health and the findings of the National Preventative Health Taskforce and, ultimately, the National Health and Hospitals Reform Commission. All of those documents and the work that led to the finalisation of the agreement meant that there was considered thinking around the types of services where the gaps were existing within all jurisdictions and the ways in which health care was provided to all Australians.

I saw great opportunity through both of these significant mechanisms of AHMAC, the Australian Health Ministers Advisory Council, and the reform process that would mean that all Australians would enjoy a healthcare service that would meet their needs. Whilst I was campaigning there was a constant concern raised by Hasluck constituents about the evolving changes being proposed by the Gillard government and the translation of changes impacting on their families. Hasluck has two public hospitals—the Kalamunda District Community Hospital and the Swan District Hospital. The new Midland Health campus will replace the old Swan District Hospital, which has served the community for some considerable time and will be a critical hub of healthcare access for people within its area. It is long overdue. Its model will provide a range of services not available to my constituents in that area. At the southern end of Hasluck, the closest hospital is Armadale Kelmscottt Memorial Hospital in the seat of Canning. As with all Australians, constituents want better health care and access to primary healthcare services.

In this new model of the way health is to be addressed, the GP superclinics were announced. A GP superclinic is to be built at Midland, adjacent to the new Midland hospital at the cost of $10 million. It will provide a range of services and is co-funded by the state government and the Commonwealth government. There already exists within Midland, not far from the proposed site, a general practice that provides a good comprehensive service to the people of Midland. These local GPs are well supported by the local area because the service they provide is of a high standard. The GP superclinic in Midland was not awarded to the local GPs even though they had an established practice which provided a range of services. In another part of my electorate, people living in the suburb of Gosnells have limited access to local GPs who bulk bill, which means that they can wait for up to a week in order to access a GP that will see them. This matter was raised regularly by constituents who I met whilst campaigning and to me it would have been the better place for a GP superclinic because it would have been much more accessible.

The current bill does not satisfy the needs of my constituents. In Hasluck there is a lack of specialised services such as pathology and radiology and, more importantly, mental health services, given the circumstances that young people find themselves placed in and the pressures that are brought to bear on families. I am in agreement that the Australian health system is in need of the reform that was foreshadowed within the national report, which states:

Australia’s health system is in need of reform to meet a range of long-term challenges, including access to services, the growing burden of chronic disease, population ageing, costs and inefficiencies generated by blame and cost shifting, and the escalating costs of new health technologies.

Hasluck needs to benefit from these reforms. It continues:

By April 2008, the Commission will provide advice on the framework for the next Australian Health Care Agreements (AHCAs), including robust performance benchmarks in areas such as (but not restricted to) elective surgery, aged and transition care, and quality of health care—

so the collection of data and the rigour around that had commenced—

3. By June 2009, the Commission will report on a long-term health reform plan to provide sustainable improvements in the performance of the health system addressing the need to:

a. reduce inefficiencies generated by cost-shifting, blame-shifting and buck-passing;

b. better integrate and coordinate care across all aspects of the health sector, particularly between primary care and hospital services around key measurable outputs for health;

c. bring a greater focus on prevention to the health system—

so that prevention was to become a hallmark in the way in which the health of Australians would go upstream to the front-end as opposed to relying on the care provided through tertiary hospitals—

d. better integrate acute services and aged care services, and improve the transition between hospital and aged care—

Certainly, within the dynamics of the electorate of Hasluck, that modelling and provision of service would meet the needs of the constituents. Further, it states:

e. improve frontline care to better promote healthy lifestyles and prevent and intervene early in chronic illness;

f. improve the provision of health services in rural areas;

g. improve Indigenous health outcomes; and

h. provide a well qualified and sustainable health workforce into the future

I would say with a high degree of confidence that not many of the constituents in Hasluck would have contributed to the consultation process for the national health reform agenda. However, all of those elements were encapsulated in the COAG reform process, led by Minister Roxon, the Australian Health Ministers Advisory Council and senior officers within both Commonwealth and state and territory jurisdictions. So the outcomes will lead us to the reforms that are being sought in this legislation without the legislation being required.

The National Health and Hospitals Reform Commission was established by the Rudd government in 2008 to assist the government in addressing a range of health related challenges. In that process consultation with the public sector was extensive. One of the elements is that:

The Government will introduce Local Hospital Networks to run small groups of hospitals, so that hospitals better respond to the needs of their local community. Local Hospital Networks will collaborate to provide patient care, manage their own budgets, and be held directly accountable for their performance.

This would mean that many Hasluck constituents will have limited involvement in shaping the services they need because they do not have a hospital in the southern region, but those in the Midland area would have access to being involved in the establishment and in framing what is purported to be the direction we will take.

The other element that I want to have a look at is that the hospital networks will perform a function, but there already exists in many sections of every state and territory jurisdiction the types of governance frameworks that allow for community and consumer advice into the provision and shaping of services. There are models of clinical care that go to clinical governance that already exist. I find it unfathomable that we have to re-establish or duplicate another set of governing frameworks when states and territories have for some period of time been reforming, under the guidance of the national partnership agreements, the directions in which health should be taken. In the government’s consultations many clinicians and local communities made it clear they do not feel they have the opportunity to be involved in decisions about the delivery of health services in their community, and they certainly wanted to have a greater say.

Let me say that the constituents that I represent feel strongly about what they need but do not get the opportunity to customise services within the electorate, and this legislation does not provide them with that opportunity to shape the types of services. The result is that services are not likely to be responsive to local needs and opportunities to improve clinical safety and quality will be lost through a national framework. I had the opportunity of contributing to the consultations of the reform agenda and I see this as a watershed of opportunity to shape and develop an approach in health that is far reaching, but I would like to see that led at the state and territory level. The Commonwealth have demonstrated in a number of initiatives that the implementation process cannot be done by Canberra; it has to be done at the local level.

Tinkering at the edges will not deliver the healthcare reforms proposed. It will become another failure for Labor but, more importantly, it will fail to deliver the reform that has been promoted by the Gillard government. How the commission will make a difference to a person living in Hasluck who wants access to good-quality health care across the continuant need still escapes me, particularly the person who is on a waiting list. I suspect the impact would be very little.

When I looked through section 9 and I looked at the functions of the act, I saw that many of those functions that are promoting both accountability and reporting are already being done by the Department of Health and Ageing, a highly competent organisation that has been established for a long period of time. The analysis of reports is undertaken by other institutions. The Australian Institute of Health and Welfare provides annual reports on the activities within the health arena. To establish another body or set of bodies requires funding to be directed away from frontline services. I see that it will add another layer to the way in which health is administered and the way in which negotiations will occur.

The principles of the partnership agreements go to primary responsibility for health service delivery and the legislation gives the responsibility alignment between the states and territories and Commonwealth. It focuses on improving the health and wellbeing of Australians. It focuses on coordinated federal action, accountability, financial support and greater incentives for economic and social reform. So the act does not require undertaking that role when we already have mechanisms in place.

The provision of the act proposes to ensure Australians will enjoy the benefits of a nationally unified and locally controlled healthcare system which guarantees that Australians enjoy world-class health care and universal access to health care that has merit. This would be supported with enthusiasm by the constituents of my electorate of Hasluck. What I do not want to see is the three bodies established and the funding being directed at the establishment of those to the exclusion of the provision of frontline services. I think some of the challenges that we have with this legislation is that there are already existing structures, that there are already existing mechanisms and that those functions and the constitutional related requirements referred to in the bill are in place now and do have the opportunity of having the level of impact.

Western Australia certainly has not signed up to the agreement, because it does not wish to relinquish its GST and to have the Commonwealth manage and control that money and that allocation. It does not want to see a reduction in its share of the GST. To reach a state of complete mental and social wellbeing as an individual group we must be able to realise the aspirations to satisfy needs to change or cope with the health environment. That is a choice that people need to make within the context of the choices that they will want to establish in conjunction with their state and territory governments. In conclusion I want to finish by using these words from Rethinking the Future by Peter Senge:

Those that succeed will, I believe, have unique advantages in the twenty-first century, because they will harness the imagination, spirit and intelligence of people in ways that no traditional authoritarian organisation ever can—

or authoritarian legislation ever can.

Geoff Lyons (Bass, Australian Labor Party) Share this | Link to this | Hansard source

The National Health and Hospitals Network Bill 2010 is a historic bill providing an opportunity for the removal of cost shifting and the blame game, with the focus to be clearly aimed at service delivery. I would like to have it placed on the public record that I am a strong supporter of the Gillard Labor government’s health reforms; that is, the implementation of local health and hospital networks—the most significant reforms to Australia’s health and hospital system since the introduction of Medicare. For the first time in our nation’s history, our hospitals will be funded nationally and run locally, with decision making at the local level.

Local health and hospital networks are a perfect model for Tasmania’s three regions, with one network in each of those three regions. Some of you may not be aware of or familiar with the idea that, although Tasmania is relatively small in size geographically, there are three distinct regions—the South, the North and the North-West, including the West Coast—all three regions having different needs and requirements for health services and delivery.

There has been much discussion in Tasmania, including my electorate of Bass, about the best model for health reform and service delivery in the state. It is vital that Tasmania has three local health and hospital networks that are run at the local level. I cannot emphasise enough how important it is for hospitals and health to be run at the local level. I worked at the Launceston General Hospital for 17 years and can see how far reaching the benefits this model of management will be for the delivery of health services in Bass. I worked as a manager of a small country hospital until the Tasmanian Liberals sacked the boards. I then worked under a regional structure until, again, the Liberals sacked the regional boards. I then worked under a state model which disempowered the local providers, divided service delivery and created silos of power, which increased costs and created greater queues. At that time the Liberals subscribed to the theory ‘if you cannot manage restructure and some people will think you are doing something’. The statewide plan isolated services and governments, in their ignorance, even split services to different ministers. It is possible for some primary or community services to close their books as they run out of budget. It is impossible for emergency departments to close their doors.

In Northern Tasmania services are gradually moving back to a regional model. In my opinion, all services should be in the one funding model, a single funder, so that the best care is the overriding aim. The only way to save money in health and community services is to do it right and to do it early. The regional model is the best fit for Tasmania. It is the model that works. It is the model that the community wants and it is the model that best suits Tasmania’s population and culture. The management structure for the health and hospital networks needs to be flat, with medicolegal, accounting and management expertise mostly available from within the system at present.

The reporting system needs to be one which provides the same information to the federal government as to the state government so that duplication and reporting is not the focus of activity but is merely a method of reporting outcomes. The state governments and the Australian government must agree on activity and contract the local network to complete that activity. That way the focus will be on activity with smart reporting not lengthy reporting.

In the past a funding model I call bucket funding has prevailed. This is where a bucket of funding is provided to the health and hospital providers, and then they are required to meet the activity demand from that bucket. The new hospital and health funding will link activity to the true cost and focus on services not on who will pay. The cost-shifting will be at an end as a result of these changes. Politicians have not been good at saying that a condition which will not get worse in four years will never be undertaken in our public hospital system. We should be honest. Some people with those conditions have waited in the false hope of a procedure when it is known that more urgent procedures will bump the less urgent. The funding through the National Health and Hospitals Network should eliminate cost-shifting with the budget activities agreed by the Australian government and the states. The funding should then follow that activity.

After a visit to Victoria in the early nineties I learned that Victorian hospitals were creating private clinics so they could bulk-bill the Commonwealth for services formerly provided by the states. Tasmania, soon after my return, commenced private clinics in our public hospitals so that patients could be bulk-billed, which was a cost-shift to the Commonwealth. I have been around long enough to remember that Professor Rob Fassett was told by the then head of the state health department that no renal dialysis would be done outside of Hobart. Professor Bernie Einoder AM, who is to be congratulated for his recent elevation to life membership of the Australian Orthopaedic Association, after completing the first arthroscopic procedure in a public hospital in Australia was told by the Hobart bureaucracy that arthroscopic procedures would never catch on. These are just some blatant examples of where local input is vital to the delivery of health services.

The local health and hospital networks will receive funds and will be responsible for making decisions on the day-to-day management of hospitals and health within their networks. That means local services will be more responsive to local needs and that local health and hospital networks will be directly accountable for their own performance. The health and hospital reforms will mean that doctors and nurses who work locally will have a greater say in how the local health and hospital systems are run, which is vital input to the delivery of effective health services. Governance and management of local health and hospital services will be run at the local level, increasing local autonomy and flexibility, which will mean that services will be more responsive to local needs.

The Labor government is committed to ending the blame game and to ending the cost-shifting that has plagued our health system for decades. Under this bill better access to services through GP superclinics, expanded GP services including after-hours service and assistance with infrastructure, which will develop training positions for the full range of primary care, will all be integrated into the local area networks. The government will also establish personally controlled electronic health records. This will mean that patients will have their full and accurate medical history, thus making it easier for patients travelling interstate. This will also reduce mistakes and ensure that doctors have all the information they need and with the patient’s consent. The system will also be more transparent, and it will mean that strong performance can be identified and replicated in other areas.

The Gillard Labor government is committed to health reform and to the development of a nationally consistent approach for the delivery of healthcare services in Australia. The National Health and Hospitals Network is the model that best suits the community and its needs. Better health and hospitals means better health for all Australians. I commend the bill to the House.

Louise Markus (Macquarie, Liberal Party) Share this | Link to 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.

John Murphy (Reid, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to take this opportunity to speak on the National Health and Hospitals Network Bill 2010 this evening. As the Labor government has made clear since being elected in 2007, health is a national priority. I am astounded by the contribution of some of the opposition members, none of whom mentioned the fact that it was the Howard government that ripped out a billion dollars from our hospitals during its time in government. Of course, they are silent on that fact in a monumental triumph for hypocrisy and double standards. Further, I am extremely disappointed with the notion that Australians should not expect improvements in the health system such as a national standard of quality. Why? Australians should be confident when they attend any public hospital around the country that they will receive high-quality care. Moreover, the improvements proposed by the historic health and hospital reforms build on many other measures already introduced by the Gillard government.

It might be useful to remind the opposition about particular measures that the government has already implemented or announced for the improvement of our health system. This is not an exhaustive list, but I will just point out a few for the edification of opposition members. There is nothing more important than the health of our family and friends, and that is why the government is undertaking the most significant health reforms since the introduction of Medicare.

Under the National Health and Hospitals Network reform, in a historic move, the federal government will take majority funding responsibility for our public hospitals, ending a decade-long blame game. The Gillard government recognises that Australians expect affordable, accessible and quality health care. For too long, the responsibility and accountability for health care have been used as a political football at the expense of certainty for our communities. The Gillard government is introducing legislation and reforms for our health system to secure better health and hospital services across Australia. In addition to providing 100 per cent of funding for GP and primary healthcare services, our government will fund 60 per cent of every public hospital service provided to public patients as well as fund 60 per cent of recurrent expenditure on research, training costs and capital expenditure for our public hospitals. This funding shift will end the blame game and provide financial sustainability for our health system and the hospitals. The NHHN will be funded nationally but run locally, and this will mean that the care provided will reflect the type of care needed in our local areas.

We are enhancing capacity and integrating healthcare services. We seek to improve access to services, promote preventative health measures and ensure the sustainability and quality of health care. The bill we are debating tonight is a key part of our health and hospitals reform and relates more specifically to the government’s intent to improve the quality of health care in Australia—

Sid Sidebottom (Braddon, Australian Labor Party) Share this | Link to this | Hansard source

Mr Sidebottom interjecting

John Murphy (Reid, Australian Labor Party) Share this | Link to this | Hansard source

and the member for Braddon understands that clearly. The National Health and Hospitals Network Agreement between the Commonwealth and the states—except Western Australia—and territories provides that the National Health and Hospitals Network will have a new performance and accountability framework. The standards developed by the Australian Commission on Safety and Quality in Health Care will form part of this new framework.

Contained in this bill is the framework to establish the Australian Commission on Safety and Quality in Health Care as an independent statutory authority under the Commonwealth Authorities and Companies Act 1997. The commission has been operating within the Department of Health and Ageing, but the bill will ensure that the commission will be established as a permanent and independent agency and expand its role. It is expected that the continuation of the commission and the expansion in its role as an independent national safety and quality body will help identify and reduce preventable errors and unnecessary and ineffective treatments and improve the quality and safety in our health system.

Through consultation with clinicians and relevant parties, including the consumers, the commission will formulate and monitor quality and safety standards. The commission will also provide advice to the Commonwealth, state and territory health ministers concerning national clinical standards. However, it will be the local hospital networks that will implement relevant national clinical standards once the standards are agreed to. Through its work, the commission will help improve community trust in the quality and safety of our health system.

The bill also outlines the establishment and role of the board of the commission. The commission will consist of a board of directors, a chief executive officer, expert committees and consultants and the commission staff. The functions of the commission as prescribed in the bill include the promotion, support and encouragement of the arrangements, programs and initiatives relating to healthcare safety and quality matters; collecting, analysing, interpreting and disseminating information relating to healthcare safety and quality matters; formulating standards, guidelines and indicators; advising and reporting on safety and quality across health settings; monitoring the implementation and impact of standards and guidelines for healthcare safety and quality; formulating model national accreditation schemes that provide for accreditation of organisations that provide healthcare services; and promoting, supporting, encouraging, conducting and evaluating training and research for purposes in connection with the commission’s other functions.

I have been listening to the debate this evening, and I note that some of the members of the opposition have raised concerns that compliance with the national standards and guidelines formulated by the commission is voluntary. However, it is also important to record that the guidelines or standards may be made a term or condition of a grant or under a contract, and it may also be the case that the standards may be applied or adopted by a state or territory law or even a Commonwealth law.

20:59:32

The establishment of the Australian Safety and Quality Commission in Health Care is a major component of the Gillard government’s health reform agenda which will ensure we provide the Australian public with safe, high-quality health care irrespective of where they live. The commission will set safety and quality standards, guidelines and indicators, consulting with medical professionals and consumers to deliver improvements in health care.

The federal government is already making significant improvements to our health system, particularly in my electorate of Reid. I am very pleased to note that the electorate of Reid has many wonderful health facilities, not least of all two of the busiest hospitals in Sydney—Concord Repatriation General Hospital and Auburn Hospital. I know that these hospitals have already received federal funding of more than $8 million this year. Only last Friday $2 million in funding was announced for health services in Auburn. Both Auburn Hospital and St Joseph’s Hospital in my electorate received funding under the historic Commonwealth-state health reforms, delivering better resources for doctors and patients in my community.

Auburn Hospital has received $330,000 for new medical equipment including a defibrillator, a slit machine to help diagnose eye problems, and an ECG machine for recording patients’ heart activity. The hospital will also purchase bariatric lifting equipment as well as anaesthetic monitors and equipment, specialised ear, nose and throat equipment, an ultrasound machine and a Neuro monitoring system.

The New South Wales Deputy Premier and Minister for Health, the Hon. Carmel Tebbutt, stated last Friday that Auburn Hospital carries out 5,000 surgical procedures a year and is known for providing emergency, maternity, paediatric, radiology and outpatient services. The ultrasound and ECG equipment has already been put to good use. I have no doubt that the other medical and surgical equipment will serve the hospital well and is welcomed by my electorate. On top of that, the Deputy Premier also announced on Friday that federal funding under the health agreement would provide $1.8 million for six subacute neuropsychiatric beds at St Joseph’s Hospital, also located in Auburn.

St Joseph’s Hospital is known for its care of around 950 patients a year, serving the public with medical rehabilitation, aged care rehabilitation, palliative care and aged care psychiatry. The funding will provide specialist care for patients with functional, cognitive, behavioural or physical conditions, and facilities are expected to be operational by mid next year. I welcome this funding especially in light of calls from my constituents to boost funding for mental health services. I know that this announcement is also warmly welcomed by those constituents.

The funding announcement last Friday for health services in Auburn builds on the improvements to my local hospitals already announced in July this year at Concord Repatriation General Hospital. Concord hospital received $6.3 million for 16 new beds and medical equipment under the historic COAG health agreement. Mr Deputy Speaker Scott, I know you are familiar with Concord Repatriation General Hospital, being a former Minister for Veterans’ Affairs. Concord is one of the busiest hospitals in the Sydney region with over 30,000 people treated in its emergency department every year. It conducts more than 11,900 surgical procedures and also provides more than 290,000 outpatient services. What a record!

I have a long history of supporting the services and research centres at Concord hospital. I know how important the work done at that hospital is for my community and it is appreciated. Of the $6.3 million, $5.9 million will provide nine subacute beds for the rehabilitation ward, six subacute beds for palliative care and one intensive care bed. Almost $500,000 was provided to the hospital for new medical equipment including an electrocardiogram machine, cardiac monitoring equipment, ventilators, burns surgery equipment, sterilising equipment and a duress alarm system for the emergency department. The funding means many local families can receive these important health services close to home. It is important funding that provides real and lasting benefits for the people in my electorate of Reid.

This is yet another example of how the Gillard government is working with the states and territories to end the blame game and make a real difference. The new beds and equipment make a positive difference to the delivery of health services provided to my local community and the working environment of our health care professionals. The work of our doctors and nurses is so important and the new equipment and extra beds provided by the federal funding will aid them in their very important roles, and help the delivery of health services in my area.

There is no doubt that the federal government recognises the call from Australians to improve the capacity and quality of our health system. I feel it is extremely important to note that the health reforms that the Labor government is working hard to implement are long-term reforms. We are not trying to introduce Band-Aid solutions to a vital public need. We on this side of the House are trying to provide a nationally unified and locally controlled health system that is accessible, sustainable and of the highest quality. Australians deserve nothing less.

The Minister for Health and Ageing, the Hon. Nicola Roxon, has had the very big task of implementing these reforms and she has repeatedly reminded the opposition that we are planning and preparing for the future. These reforms are a long-term investment in better care and better access for Australians now and in the future. This bill is one of the key components of the National Health and Hospitals Network reform, establishing the permanent and expanded role of the Australian Commission for Safety and Quality in Health Care. The introduction of new national standards for our public hospital services will ensure patients receive timely and high-quality services.

This is an opportunity for the opposition to support historic health reform for the benefit of all Australians. It is an opportunity for the opposition members to show that they too are supportive of more efficient, sustainable, high-quality health care and hospital system. They, like we, are interested in reducing waiting times in emergency department and elective surgery lists. I hope that the opposition will not agitate to block or delay these reforms for the sake of political mileage. I know in my electorate of Reid we have welcomed recent funding announcements about our public hospitals and, indeed, previous federal funding for research facilities too. However, my constituents have also continued to call for further improvements and investments in our health and hospital system in light of the inadequate funding arrangements that they have suffered in the past. The Gillard government is working in the honest pursuit of better health and hospital care and I commend the Minister for Health and Ageing for her efforts. (Time expired)

Nola Marino (Forrest, Liberal Party) Share this | Link to 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.

Shayne Neumann (Blair, Australian Labor Party) Share this | Link to this | Hansard source

E-health, primary infrastructure, GP superclinics, telehealth, national prevention policies—all were on the hit list of those opposite. Let them not come into this place with their sanctimonious sentiment—every single one of those things is a policy they would not support. The honourable member for Forrest did not mention that. She knows very well, as do those opposite, that when the Howard coalition was in government—and the Institute of Health and Welfare belled the cat in October 2007—the proportion of health and hospital funding in this country declined. Their record in health and hospital funding is appalling. They are the ones who capped the GP training places—Michael Wooldridge did that when he was the health minister back in 2004.

It behoved us when we came to government to put a huge amount of money into emergency service relief across the whole country. We have massively increased funding to the health and hospital system, and the National Health and Hospitals Network Bill is part of our overall strategy to alleviate the problems we inherited from the Howard coalition government. This is about putting the money back into the system; this is about a national approach. This is not about anachronistic hospital boards; this is about making sure we have health networks, it is about Medicare Locals and it is about injecting real money into regional and rural health services across the country. It is not about some phoney policies that the coalition came up with just before the election which would have ripped hundreds of millions of dollars out of health and hospital funding across the country. They made phoney promises to spend the phoney money allocated through the phoney commitments they made based on the big black hole that they had in their costings. I did not believe, and I do not think people in the electorate of Blair believed, the commitments made by those opposite in health and hospital funding.

We know that as part of the National Health and Hospitals Network we will see Medicare Locals. I have had meetings with the Ipswich and West Moreton Division of General Practice to talk about the future. They are very enthusiastic about the Medicare Locals in our area. I have had meetings with rural hospitals, doctors and allied health professionals in my area to discuss the hospital networks that we are bringing in. Again they are supportive of what we are doing. I have written dozens of letters in support of applications for funding sought by GP practices across the Ipswich and West Moreton area in support of our primary infrastructure funding—$300,00 for one lot; a possible $500,00 for other important infrastructure such as medical clinics across the area. The people of the Ipswich and West Moreton region also support the idea of a GP superclinic like the one currently operating at the University of Queensland, run by UQ Health Services.

This legislation is important because it is part of the overall framework for the health and hospital system that we are bringing in. It is important legislation because it establishes the Australian Commission on Safety and Quality in Health Care. It is important legislation because this commission will set national clinical standards and strengthen clinical governance. The agreement provides real accountability and transparency. A performance and accountability framework will be established, and we think also, because the commission is established in a very sensible way with a board of directors, a CEO, expert committees and consultants and commission staff, the commission will have the capacity to monitor national standards and work with clinicians to identify what is best for clinical care for the Australian public, including what services should be delivered in which particular areas. We also want to make sure that the networks have local people involved as well. That is why the legislation is important.

This bill legislates not just for the establishment of the Australian Commission for Safety and Quality in Health Care as a new independent statutory body; it forms part of a framework for our overall strategy on health and hospitals. The legislation was talked about in detail by the Minister for Health and Ageing in her second reading speech on 29 September 2010. She made the point that the federal Labor government’s health reforms, which she is responsible for in her ministerial capacity, are the most significant changes to Australia’s health and hospital system since the introduction of Medicare. I concur.

My electorate is the fastest growing region in South-East Queensland and has long suffered by not having enough doctors and allied health professionals. This particular region warmly welcomes things like the GP superclinic. Why would the local newspaper, the Queensland Times, editorialise about how important that GP superclinic is to the people of the Ipswich and West Moreton region? That particular clinic provides services such as urgent care and it deals with people who cannot get in to see the after-hours clinic at the Ipswich General Hospital, which receives federal funding of $100,000. I commend the Ipswich and West Moreton Division of General Practice for their assistance in running that clinic.

The urgent care clinic has two GPs and a nurse. It provides concession card holders with the kind of assistance they need by simply bulkbilling them. Children under 16 and patients over 65 will also get access to bulkbilling. The clinic is open from 8 am to 6 pm Monday to Friday. The second stage will open in 2011 and will focus on diabetes, respiratory and mental health services, and paediatric and cardiovascular care. These are important issues in my region and the GP superclinics are absolutely vital.

Maintaining wonderful clinics like the Kambu Medical Centre in Ipswich is also important. I commend Ms Stella Taylor-Johnson, the CEO, who was recently elected as chair of the Aboriginal and Torres Strait Islander Community Health Service in Brisbane for the work that she has done. I have been to that centre on many occasions and I have also taken Minister Snowdon with me to that particular clinic. The funding for that comes from the budgetary provisions for health clinics across the country. Kambu is located in the Ipswich City Council area, which is home to 4,729 Indigenous people or 3.4 per cent of the area’s population, according to the ABS census data collected in 2006. It receives considerable funding from the Department of Health and Ageing.

This is important for my local area because while this particular legislation is part of a national framework the people at the coalface—the doctors, nurses and allied health professionals—deal with patients everyday and there are capacity constraints that we see locally in the fast-growing region of the Ipswich and West Moreton area. The provision of funding for 1,300 new subacute beds is also particularly important. We are more than doubling the funding for mental health services. We are investing $1.6 billion for those new subacute beds, many of which will be able to be used by people suffering from mental disability. This is particularly important for my region because for a long time the Challinor Centre housed people with mental disability. Now many of these people are living in the community and looking after themselves with the support of wonderful local organisations like Focal Extended, ALARA, Blue Care and Lifeline.

While this is a bill that affects us nationally, I want to talk about how it affects my electorate in particular. I look forward to the Medicare Locals, with the emphasis on Ipswich being the hub and the spokes going out into the rural areas. The Ipswich General Hospital has received considerable assistance from us over the years. Since we have been elected, there has been additional assistance for elective surgery as well as for the infrastructure needed for those surgeries. This was to assist not just the waiting lists but also the hospital to become better able to cope with the growing areas of Springfield, the Ripley Valley and the areas west of Ipswich. I look forward to working with the local GPs in my area because I think they will make a big difference. Allied health and community health providers will also offer great assistance and I looking forward working with them to make sure that our region has the kind of health services that we need.

This legislation is important. As Tip O’Neill, the former Democrat House of Representatives spokesperson, said, ‘All politics is local.’ I wanted to talk tonight about how this national legislation and the establishment of this particular commission, as part of a whole framework, will affect my seat of Blair. I wanted to make sure that those of my constituents who listen to this speech and follow what happens in the House of Representatives understood how important the National Health and Hospitals Network is not only for my electorate and the whole of the Ipswich and West Moreton region but also for the Lockyer Valley and the Scenic Rim.

Debate (on motion by Ms Ley) adjourned.