Health Ministers’ meeting in Canberra, health reform

Transcript - Treasury Place, Melbourne - 23 April 2004

GILLARD: Today in Canberra, Tony Abbott has let slip a historic opportunity for health reform. Today the state and federal health ministers met and had Professor John Dwyer and some of the finest minds in health give them health reform proposals.

Tony Abbott's answer is basically nothing. He wasn't properly prepared for the meeting. He's got no process to now use those ideas to drive health reform forwards.

Every Australian knows we need to end the cost and blame-shifting between the Commonwealth and the states. And we need to build the health system for the 21^st century. Tony Abbott isn't equal to this task. He has let a major opportunity for health reform slip today. And the only way of getting health reform is for a Latham Labor Government to have its health reform process driven by a national health reform commission.

And the directions of reform are clear. We need the Commonwealth and the states to put their money together in a way that stops cost-shifting. We need a second generation Medicare card. A smart card with basic patient information on it. And of course, we need better support for our general practitioners and our nurses who are out providing first instance care in the field.

None of those things were agreed to today, because Tony Abbott dropped the ball on health reform.

JOURNALIST: Didn't Mr Howard canvass this idea four or six weeks ago and was immediately shot down by all the state Labor premiers?

GILLARD: Tony Abbott joked at a conference that the Commonwealth could take over the public hospitals. John Howard shot that idea down within 48 hours. And now Tony Abbott is saying, we'll have a discussion about health reform and at some point the Commonwealth might respond. Not will respond, but might respond.

So Tony Abbott flew an irresponsible kite. But real health reform doesn't require kite flying. It requires concerted action. And Tony Abbott has let the opportunity for concerted action slip today.

JOURNALIST: In order to end the constant blame shift would you propose abolishing state and federal health departments and having an independent body?

GILLARD: What we've proposed is a Medicare Alliance where once the Commonwealth and the States have agreed how much money they're going to put into health, the Commonwealth and the State puts it into one account. And health priorities are then funded out of that one account. So there's no incentive for Commonwealth bureaucrats or State bureaucrats to spend days and days of time trying to work out how to shift costs onto the other level of government. Because the money would all be coming from the same place.

JOURNALIST: You might recall Premier Bracks in Victoria at least [indistinct] He also shot it down as a non-starter.

GILLARD: Premier Bracks would have responded to Tony Abbott's joke about the Commonwealth taking over the public hospitals and said that wasn't a starter. Well we know it wasn't a starter. Even John Howard said, within 48 hours, that the Federal Government wasn't going to do it.

But Premier Bracks and indeed all the Labor premiers have in the past indicated support for Labor's Medicare Alliance. For having a joint account from which health priorities are funded so that you don't get any game playing, cost shifting. The Medicare Alliance would mean that a whole layer of bureaucracy, which is now in our health system, could be confined to the dustbin of history.

JOURNALIST: Have you got any figure you can put on the sort of wastage that might be saved?

GILLARD: Bill Glasson, the head of the AMA, who obviously would know a bit about the health system consistently says that $1 billion could be saved if the game playing, cost shifting could be removed from the system. Now that's $1 billion that could go to patient care instead of paying bureaucrats to work out how to get a cost across to the other level of government.

JOURNALIST: So if this was to happen we wouldn't have the current nurses' ban going on at the moment would you propose.

GILLARD: Well certainly if we got all of the waste out of the system, the game playing out of the system there would be more money for better patient care.

JOURNALIST: Do you really think that's going to end [indistinct].

GILLARD: Bill Glasson uses that figure in all of his speeches. I don't know where they originally generated it but they get Access Economics to do their modelling work. So presumably it relates -

JOURNALIST: Are you suggesting the Federal Government is disinterested in that since it suits them to have this political football?

GILLARD: I think it suits Tony Abbott and John Howard to blame the Labor states for problems in health. And one of the reasons that we would have, a Latham Labor Government would have a historic opportunity to reform health is Labor governments would be dealing with Labor governments. It's really a once in a generation opportunity to shift the health reform system on, to shift the health system on.

JOURNALIST: [Indistinct] the GST but that's a separate issue.

GILLARD: You'll have to talk to Simon Crean about that.

JOURNALIST: Surely not all the States are completely happy, though, with the idea of one centralised unit and less responsibility for health in their hands.

GILLARD: The States … Labor had the Medicare Alliance idea at the last election. And all of the State Premiers signed off and supported it. And even today, Morris Iemma the Health Minister in New South Wales, Bronwyn Pike the Health Minister here, have indicated support for the Medicare Alliance proposal.

JOURNALIST: I assume pre-election all your polling shows that health is still up there as one of the two or three buzz issues.

GILLARD: Yes. Number one issue. Number one comes up in the published polling as well as our own research. Most important issue on people's minds. And I think they're actually, people's views of the health system aren't really formed by what they read in the newspaper. It's the way they experience it. They're more reliant on newspapers for foreign affairs and things like that because you can't live the experience. But people know what it's like to try and get in to see a GP, whether you can get bulk billed. What happened when they or a neighbour went to the public hospital. So it's the real world stuff that informs that.