Richard Di Natale (Victoria, Australian Greens) Share this | Hansard source

I rise to speak to this critically important issue, and that is what a 21st century, modern healthcare system looks like in Australia. It's good to be having a discussion on something that matters. I'm not going to spend too long dwelling on the coalition's record on health care. It's an abysmal one. They came to office. They cut the Australian National Preventive Health Agency. They've decimated prevention. Under the Abbott budget in 2014, we saw hospital funding slashed. They've frozen Medicare indexation. They have underinvested in health care and they have put us on a path towards a US two-tier health system that will cost us more and leave Australians with much worse health outcomes. No, what I want to talk about is what a positive vision for the country looks like.

Election after election, people rate health as the most important priority when they cast their vote. It's about time they got a comprehensive plan for what we need to address the failings of our health system at the moment. The first thing to do is to acknowledge that health outcomes are not simply a function of having a good health system; they are also a function of those social determinants that contribute to good health. Having a roof over your head and access to affordable housing—that's a health issue. Being able to feed yourself because you're on an income support payment, like Newstart, at a level that doesn't commit you to living in poverty—that's a health issue. Being able to get a decent education for your children at a public school—that's a health issue. Dealing with climate change and addressing the challenge of climate damage—that is a health issue.

A decent health system is founded on some key principles. Firstly, it's universal. It doesn't matter where you come from, it doesn't matter what your background is, it doesn't matter what your postcode is and it doesn't matter what your bank balance is; you get access to world-class health care in a decent health system. A good health system puts prevention at its heart. It focuses on prevention. A decent health system has a primary care system which people can navigate, where GPs, as the gatekeepers, are supported by allied health professionals and practice nurses. It's where people are able to get access to decent health care in a coordinated fashion. It's not churning them through; it's not six-minute medicine. That is what decent primary health care looks like.

Of course, if we're going to deal with those issues and if we're going to have 21st century health care, what we need to do is make sure that our health policy is determined by evidence, not by who's got the biggest chequebook, not by the private health insurers who lobby to advance their industry, not by the junk food industry and not by the alcohol industry—that it is, indeed, informed by evidence, not by lobbyists.

When it comes to prevention, the Greens support having a national preventive health agency, because we understand that that is the most cost-effective way of delivering better health for Australians. We need to focus much more on prevention, but the government's ideology is of small government, individualism, not focusing long term and wanting to get a quick hit today in the polls rather than focusing on long-term initiatives—which is what prevention is; these initiatives have long lead times. We need to invest in prevention if we're going to keep people well.

We need to make sure that we address the issue of obesity, and, certainly, in the next few weeks, we'll be announcing the Greens-led recommendations from the Senate inquiry into obesity. But, again, you have to take on those vested interests. You have to take on the food lobby, you have to take on the alcohol industry and you have to take on the advertisers if you're going to address some of those structural problems that contribute to unhealthy weight.

When it comes to primary care, we need to have a system that moves away from throughput, where it's simply a case of GPs being driven towards shorter consultation times—basically, throughput rather than outcomes. That's why we want to see chronic disease management through a system of blended payments, as was promised in the Health Care Homes trials, which failed to deliver. We want that to be also addressed. We need greater investment in our hospital system, but we've got to take the cost shifting out of it, which is why we support an independent body to address those funding shortfalls.

Denticare, Aboriginal health and addressing the health impacts of climate change are all part of the Greens vision for health care in Australia.