03 August 2009
The Prime Minister attended a health forum at Townsville Hospital and held a doorstop interview afterwards
3 AUGUST 2009
Nation Building and Jobs Plan; Health and Hospitals Reform Commission; OzCar report; Donation disclosure laws


PM: First of all it’s great to back in Townsville, and great to be back in North Queensland, and to talk to this fine community who work in the Townsville Hospital.
Here in North Queensland and here in Townsville the Government has sought to be partners in the economic and social development of the region.
Just a few points - I’d like to reflect on what we’ve invested here so far.
In health, of course, we have already made an announcement of a $250 million investment in the future expansion of this hospital, including additional operating theatres and additional beds, as well as funding for a local GP Superclinic as well as funding, also, for additional sub-acute beds for rehabilitation purposes for this health region as well – some 30 of those.
Beyond health and into education, we have invested in providing some 2,200 additional computers for some 19 schools in the region. Some $73 million is being invested in 52 new building projects at 28 schools under the Building the Education Revolution program. Also, some $10.9 million for seven Science and Language Centres at various High Schools in the region, and $15.8 million for capital works nearby here and James Cook University.
Finally, on infrastructure, we are investing $95 million for the Townsville port access road, $55 million for the Bruce Highway arterial duplication, and also, in terms of what I understand has been a fantastic event here locally, we’ve supported some $10 million to stage the V8 Supercar event here in Townsville.
If you put together our various elements of economic stimulus, the Government has invested some $405 million in direct stimulus into this regional economy, and in ’08-’09, $162 million of that came through. The reason for all these investments is that we wanted to make a difference in terms of the local infrastructure in Townsville, the education infrastructure, the best facilities for schools for the future, while also making a difference with jobs.
Our Nation Building for Recovery plan is about supporting jobs, apprenticeships and small business today while investing in the infrastructure, the nation building infrastructure, we need for tomorrow.
Which brings us to hospitals, and I’ve indicated already what investments we’ve committed to this hospitals future, and that allocation of a quarter of a billion dollars for Townsville Hospital represents the single largest slice of the allocation from our capital fund for Queensland, and we look forward to seeing that investment on the ground before too much longer.
But the purpose of being here today, in particular, has been to talk about the future of the health and hospitals reform program, and I would thank all those from Townsville Hospital and the wider health and hospitals community for their participation and their feedback today. The Minister and I and Warren Snowdon spent time with those who are working at the coal face in the neonatal part of the hospital, as well as the oncology part of the hospital, and we’re hearing firsthand about some of the future needs, most particularly as reflected to us by those working in oncology.
But the purpose of these consultations is to here directly back from local practitioners about what they need from the system nationally for the future. Our health and hospitals system, nationwide, is at a tipping point. We need to provide more resources for it nationally, and we’re going to need to reform the way in which we do our business.
That means that the primary care, the preventative health care level, and the hospital stage, as well as with aged care and dental care, and mental health services as well.
The feedback we got today in so many areas, I think, has been really important, particularly reflecting on some of the real achievements which should be made here in North Queensland in workforce planning in an integrated way for this reason. So much of that occurs, of course, here at JCU, and I congratulate all those who are involved.
The final thing is today by way of a further national investment in our health and hospital system I’m also announcing a $13.1 million investment in programs to help people with chronic disease to better manage their conditions.
One of the reform areas for the future is in preventative health care – what can you do to make the system better long term by changing lifestyle habits to reduce the incidence of chronic diseases in Australia, which is currently going through the roof. For those afflicted with chronic diseases, how do you help those with them to manage those diseases better?
That’s what this investment is all about. It’s part of our overall reform thrust for the future. This $13.1 million investment will provide funding for 82 health and university and community organisations to deliver programs focussed in three major areas:
  1. Educating health professionals in chronic disease self-management;
  2. Embedding chronic disease self-management into the health professional curriculum; and
  3. Educating consumers in chronic disease self-management and lifestyle risk factor modification.
And in Queensland, there are investments at the Queensland University of Technology, the Australian Rural Health Network, as well as the National Aging Research Institute to develop and evaluate a positive aging self-management program.
This is one practical building block to the future, of which many others need to be put in place. Our challenge is to reform the health and hospital system for the needs of the 21st century. That means big regional hospitals like Townsville have to be part and parcel of that. That’s why we’re here, discussing these matters here today.
We began our consultation process last week. It’s now one week since we released this report, put together by Dr Christine Bennett and her Commission. Our first port of call was the Royal North Shore Hospital in Sydney, a very big hospital there. Second was the Flinders Medical Centre in Adelaide. The third nationwide out of the 750 hospitals in Australia is Townsville Hospital.
We’re glad to be here.
Over to you, folks.
JOURNALIST: Taking everything into account that you’ve been speaking about today, is it good enough that the swine flu (inaudible) for a bed, only to get to Townsville and found there wasn’t one here and then on to Mackay at a cost of $30,000 to the taxpayer.
PM: There’s always going to be necessary improvements in the health system. That’s why we’re here. I mean, the report which has been released by the Commission points to challenges right across the health and hospital system. Until we deal with those challenges, we’re going to continue to have problems of the type that you’ve just described.
Why are we here? We are here to work through, with this local community, how do we invest more positively and cooperatively and constructively with this group of professionals here in North Queensland to make this system better for the future.
There’s always going to be problems – You’ve just pointed to one of them
JOURNALIST: Doesn’t that point to more urgent action needed, though. When are we actually going to see something come from all these reforms?
PM: Well, can I say that, first of all, the Australian Government, last December invested $64 billion in our new Health and Hospital Agreement with all the states, including Queensland.
Secondly, that money is flowing. That represents a 50 percent increase on the previous healthcare agreement with the states and territories. That money is now flowing.
On top of that, we also have significant investments in the capital needs of the system as well, and that’s why I made emphasis here that that money, that allocation of a quarter of a billion dollars for Townsville Hospital’s future, has already been announced in the Budget in May.
These are things we have already done. What we’re talking about is how do we reform the system better for the long term, and that’s why we’re here as well.
JOURNALIST: Talking about reports, have you seen the Audit Office report yet in regards to Utegate?
PM: No, I haven’t seen that. I think, on this question of the forged email affair, Mr Turnbull has seen fit to ask many, many questions on the forged email affair. It’s time for Mr Turnbull to start providing some answers.
I think it’s important for Mr Turnbull to come out and describe in detail all of his dealings with Mr Grech, all meetings and all conversations. Mr Turnbull must also tell the Australian people if he or anyone else associated with the Liberal Party discussed the Senate inquiry with Mr Grech before Mr Grech appeared as a witness. These are some of the very basic questions which need to be answered in this forged email affair.
JOURNALIST: So you’ll be watching Australian Story closely tonight?
PM: I’ll be doing other things tonight. I’ve got some work to do.
JOURNALIST: Mr Turnbull comes out of Australian Story tonight apparently saying that often now speaks to his wife Lucy about policy matters and that she’s somewhat of an adviser to him. Is that good behaviour for a politician?
PM: Look, I would not comment at all on Mr Turnbull’s relationship with his wife. That’s a matter for them.
JOURNALIST: Will you be looking at a federal level at what Ms Bligh has done here in regards to fundraisers and taking in that sort of line?
PM: If I could just draw your attention to what we, the Australian Government, have done in 18 months in office.
One - introduced legislation into the Australian parliament to radically reform the disclosure laws for campaign donations. Mr Howard lifted the threshold for donations to more than $10,000. In other words, you could have 10 people at a dinner, raise $100,000 and no-one would know. You could have 100 people at dinner and raise $1 million and nobody would know. We don’t think that’s right, we don’t think that’s transparent.
So what did we do not long after coming into office? Introduce legislation to bring the disclosure level back down to $1,000 – lower than it was even before Mr Howard made the change – and we think that’s right in terms of transparency. Guess who’s blocking that in the Senate at the moment? The Liberal Party.
Secondly, what did we do? We introduced legislation to ban all foreign donations to Australian political parties. Guess what’s happened to that legislation? It’s blocked in the Senate.
Third thing we did was introduce for the first time at the Australian Government level a lobbyist register, a national register of lobbyists, so everyone’s got to put their name down, everyone has to indicate the firms for which they are lobbying, and that is a transparency measure which is important.
And here’s the last thing, which also goes to your question – last year we also circulated, under John Faulkner, the then Special Minister of State, a green paper for discussion in the community which goes to enhancing the disclosure of donations further, banning or capping political donations, placing limits on campaign expenditure by political parties, examining public funding rates for candidates and political parties, examining whether further regulation is required for third parties and others.
That’s all out there in a green paper for public consultation now.
That’s been done by us so far in our first 18 months in office. We’ll be looking very carefully at the responses to the green paper in shaping our future legislative response.
OK folks, we better zip because I’ve got to go places.
03 August 2009
Australia’s hospital and health care system Blog
Australia’s Hospital and Health Care System Blog
27-31 July 2009

This blog was open for comment from 27-31 July 2009. The topic was Australia's hospital and health care system.

Kevin.Rudd says...

G’day and welcome

Today I want to speak with you about Australia’s hospital and health care system and the challenges it faces in the 21st century.

The sad reality is that the problems facing health care have sat at the bottom of the too hard basket for a very long time... for far too long.

Politicians have pointed fingers at everyone other than themselves.

State and federal Governments have beaten their chests with mock indignation.

All in the hope that bluff and bluster would pass for action.

You know it as I do that this approach has not served our country well.

Because amidst the game playing:

  • Our population grew older.
  • Health care costs escalated.
  • The shortages of doctors and nurses became more and more severe.
  • Many people were forced into crowded emergency wards because ‘out of hospital care’ wasn’t available.
  • And modern epidemics like obesity, diabetes and mental illness placed even more pressure on the system.

The truth is these pressures are growing by the day yielding these conclusions:

Without fundamental change Australia’s health system will buckle under the pressure of demographic change, rising costs and modern diseases.

Under its current structure our health system cannot meet the challenges of the 21st century.

These are the reasons why we commenced and have now concluded the most detailed investigations into the health system since Federation.

Essentially they are a complete health check for Australia’s health system.

You can access these reports on this website and also on

I urge you to do this because the time has come for us all to develop the solutions.

To this end I will personally hold public community meetings across Australia in the months ahead.

We must consult the people with the greatest stake in the future of our health system... our local doctors, our local nurses,  health care workers, you and your families!

Your views will directly influence the changes we will make to improve the system.

We will afford ourselves six months to develop these plans.

Plans for changes in models of care, a greater emphasis on prevention, improved ‘out of hospital care’ and end to the chronic shortages of doctors and nurses.

Friends, the 21st Century has put our health system on notice. We have now reached the point of no return. That means action is no longer a matter of choice but a matter of necessity.

Let us all be a part of the solution.

So get involved, send me your suggestions, participate in the blog and together let’s improve the Australian Health System.

I thank you!

Read the full blog transcript

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03 August 2009
The National Health and Hospitals Reform
The National Health and Hospitals Reform

PM: We’ve got a big job ahead of us as far as National Health and Hospitals Reform is concerned. Prior to the last election we said there were real stresses in the system. And therefore, we commissioned the National Health and Hospital Reform Commission to look at it root and branch, and systemically. That is, if we are trying to prepare for the next generation of health challenges, how do we do it best? And they’ve provided us with their report and its conclusions and its recommendations about three weeks ago. We’re now putting it out to the public, and wanting the public’s response. In particular, we want the medical profession’s response, we want the nursing profession’s response, we want responses from acute hospitals like this, because you are so much of the front line of what the nation does.

PM: Now, your treatment here, is it all going okay?

PATIENT: Yeah, it’s going great. The only problem is that it takes a while to get in because of a bed shortage.

PM: No, I understand.

PATIENT: And they’ve got guys out there parked somewhere that have got problems that they need to get in.

PM: Well that’s one of the reasons we’re out this morning to see what extra resources the hospital systems need. You’ve got a span of care from, you know, here to there, from the sort of initial treatment through to surgical intervention. How do we integrate that better so that it’s best for you, in terms of the community as well. It’s easier to say than it is to do.

PATIENT: Yeah sure.

PM: But we’re setting out as a reform goal for the future, so it’s more personal, patient-focussed.

PM: The process from here is a national conversation which is primarily about us listening to you about what you think about this. Both in forums like this, but online as well.

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29 July 2009
The Prime Minister announced funding agreements for three new GP Superclinics in South Australia with the Federal and South Australian Ministers for Health


The Prime Minister today signed three funding agreements for the Noarlunga, Playford North and Modbury GP Super Clinics.
The three GP Super Clinics represent a $57.5 million investment in better health care for South Australians.
The Prime Minister signed the three contracts today while visiting Flinders Medical Centre with the Minister for Health and Ageing for a consultation on the National Health and Hospital Reform Commission Report.
Both Noarlunga and Modbury GP Super Clinics will receive $25 million each, jointly funded by the Commonwealth and South Australian Governments.  These clinics will also be GP Plus Health Care Centres under South Australia’s GP Plus Health Care Strategy.
The Noarlunga GP Super Clinic will be built within the Noarlunga Hospital and Health Village precinct and allow for virtual integration with existing local health service providers.
The Modbury GP Super Clinic will be built across two sites with a hub at Tea Tree Gully and a spoke at Gilles Plains Primary Health Care Service.
Both the Modbury and Noarlunga GP Super Clinics will provide a range of services with a particular focus on patients with chronic and complex conditions.  Services will be available from privately practising GPs, practice nurses, specialists, dentists and allied health providers.
The $7.5 million Playford North GP Super Clinic will be operated by Adelaide Unicare in partnership with the University of Adelaide and the University of South Australia. 
The clinic will operate from a new purpose-built facility within the ‘Playford Alive’ precinct, which will incorporate learning design features. 
The clinic will provide education-led, one-stop primary health care to this growing suburb in Adelaide’s north.  Allied health services will be provided in areas such as physiotherapy, psychology, exercise therapy, occupation therapy, drug and alcohol counselling, mental health and nutrition advice services.
All three clinics will have a strong focus on education and training and will support inter-professional learning by undergraduate and postgraduate medical, nursing and allied health students.
These GP Super Clinics deliver on an election commitment of the Rudd Government to provide primary health care services where they are most needed. $275 million has been allocated to establish 32 GP Super Clinics in communities right around the country.
29 JULY 2009
PRESS OFFICE (02) 6277 7744
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29 July 2009
The Prime Minister was a guest on Radio 5AA Adelaide and discussed health and hospital reform, disability policy, and the Carbon Pollution Reduction Scheme
29 JULY 2009
Health and hospital reform; Disability policy; Carbon Pollution Reduction Scheme


HOST: Prime Minister, thank you very much for joining us on the program today.

PM: Leon, that was a great introduction.

HOST: Well, these are the issues.

PM: That was a fairly long intro. But yeah, let’s go through them.

HOST: Absolutely. Let’s first of all talk about these changes. Now, one of the major recommendations of the report that you’ve embraced and put out for public consultation - and good on you for doing it - is the fact that there is a thought that we should be having hospitals specialise in elective surgery. Now, of course, Modbury, and other hospitals, used to do a lot of this, but they can’t now, because the intensive care and high-dependency beds have been taken away.
PM: Well, we’ve got to look at what the figures say to us nationwide Leon, and that’s our responsibility as an Australian Government, is to respond to what the figures are saying. One out of every three Australians who present to public hospital emergency departments are not being seen within the clinically recommended time, and one out of every six Australians on a waiting list for elective surgery are not being seen within a clinically recommended time. Now, those figures have been around for a long time, let’s not go over the fact that for 12 years our predecessors didn’t do anything on this.
We’ve actually said, upon coming to Government, we’d establish this National Health and Hospitals Reform Commission. We did that. It’s spent the last 16 months going right across the entire system and looking in every state and territory. They gave us their recommendations about three weeks ago.
You’re right to say it’s important that the public now debate it. For your listeners, if you go to, you will find that that report is fully online. We welcome comments from the public.
But you’re right to point out that how we do better elective surgery in the future is a critical area of future reform. And we need to make sure that we get the best system possible for doing that.

HOST: What do you feel about the reaction from Premiers like John Brumby who’ve almost raised the sickle at you and said ‘you’re not taking over my hospitals.’

PM: Well can I say, I saw some reported comments attributed to various Premiers today, or yesterday, about funding. At the end of last year, the Australian Government, and I’ll respond particularly to a reported comment of Premier Brumby, through the Australian Healthcare Agreement, brought about a 50% increase in Australian Government funding to the states and territories - a $64 billion deal - and for the first time, increased allocations, or allocations because there weren’t any in the past, to improve the number of elective surgery transactions which happen in hospitals, and, also, special allocations to assist with what happens in accident and emergency as well.

So we actually began the reform process with that healthcare agreement last year: increased investment in preventative healthcare; extra support for primary healthcare, 35 GP Superclinics across the country. Also, the special payments for hospitals as it relates to surgery, and accident and emergency.
On top of that, reforms also to increase the number of GPs that we train each year as well. That was phase one.
Phase two, looking out for the next 20 years, is this report which has come down, as I said, two or three weeks ago, and we want to have a seasoned debate about it all and get the system right.
Before, I think, Leon you said in the introduction, that these recommendations may not go far enough. Let me just quickly go to that.
You see, strategic option one for the Government, as put to us by the reform commission, is for the Australian Government to take over all preventative healthcare, all primary or frontline healthcare, to take over responsibility for hospital outpatient care, to take over responsibility for all dental care, to take over responsibility for all non-acute mental health care, to also take responsibility for creating a person electronic data record for every patient in the country, as well as providing 40% of the funding for acute hospital care as well. That is a massive reform program in itself.
The second strategic option that we have before us from the commission’s report, is over time to move to a full funding take over responsibility from the hospital system as well from 40% to 100%. So if you were suggesting before that the proposals before us were not ambitious, can I just say to your listeners, these are the most ambitious set of proposals, fundamental set of reforms, put to a Government since the introduction of Medicare.
HOST: Prime Minister, I think in the wish list sense, it is, but, it’s how much of that’s actually going to happen, because the states seem to be playing two bob each way on this. I don’t think the states have delivered, but you’ve given them a lot of extra money, and we don’t appear to be much better of.

PM: Well, to be fair to the states and territories, at the end of last year, the healthcare agreement that I referred to before injected, as I said, a 50% increase in Australian Government funding for the states and territories for health and hospitals - $64 billion - but that only flows as of this year.

And secondly, the states and territories, again to be fair to them, were dealing with a previous Australian Government which not only did not increase its allocation to hospitals, it hacked $1 billion out of the public hospitals, and you saw, incrementally, a philosophy on the part of the previous Australian Government of moving more and more health care to the private sector.
We are determined to reform fundamentally the system for the future. It will cost, and you’re absolutely right Leon to point to the fact that none of this is cost free. The costing implications contained within the report are there for all to see.

HOST: Does that mean higher taxes, or cutting somewhere else? Or, do you reckon you can get this through efficiency, which is very ambitious?

PM: Three sets of possible sources of funding for this, Leon. One is, if the Australian Government takes responsibility for any functions from the states, then there would obviously be a transfer of funding back from the states to the Australian Government, that’s the first point.

HOST: I can imagine them liking that.

PM: Yeah, sure, sure, but I’ve said to the states and territories repeatedly, there are no blank cheques in this business. This is hard, hard long term reform.

Secondly, I have also said is that, if you create for the first time a unified health system for the nation, particularly if you wire it properly - that is, you have transferable personal electronic data, controlled entirely by patients, of their patient records - you will avoid for example, multiple tests being conducted by different practitioners in different parts of the system, which lead to extraordinary cost blowouts. For example, take the report’s conclusions that a number of our major hospitals are operating about 20-25% below optimal efficiency levels. If we were able to assist, by making sure that all of our data was put electronically rather than on paper and it was transferrable across the system, it’d be better clinical outcomes for patients, but also better cost implications for taxpayers.
But the third source of funding is of course the revenue of the Commonwealth. I accept that. But why we want to have a seasoned, mature, national debate about this, where everyone should have their say between now and the end of the year, because these are big decisions, we want to get them right. Millions of people, all your listeners, have some contact with the health system every year. We’re not going to take any of these decisions lightly.

HOST: Prime Minister, we’ve had a very unfortunate debate that’s come around because of a court case that we really can’t talk a lot about with regards to problems in the disability sector, where people, loved ones looking after those disabled, are having a terrible time and under such pressures they do things that often are unthinkable. And this has brought on, even Monsignor David Cappo, to say on this program last Friday, that this whole thing is a social disaster, massively underfunded, and no plan by the state. What would you like to contribute on this this morning, because I know you’re very compassionate about disability issues, but it’s been a big talking point for Adelaide in the last few days.

PM: I’m not familiar with the case you refer to Leon, so I’m very reluctant to trample on what must be a process on foot. Let me say broadly though in terms of disability policy, our Parliamentary Secretary with responsibility for disabilities, Bill Shorten, is very, very active across the field on this. Last night at the Community Cabinet out in the City of Playford, in Elizabeth, for example, Bill received many, many direct questions about basic things such as the delivery of services to parents of children with autism or the spectrum of autism disorders.

This is a major, major problem in the community. What have we done about it? For example, one category of disability, which is autism services, for the first time the Australian Government has created a nationwide program of nearly $200 million to help parents with children with autism-related disorders. But, as was quite plain from the engagement with the community last night, which was a very good discussion, can I say, that doesn’t go far enough.
There are a whole lot of problems, both kids under six, preschool age with autism, as well as those over six who are of school age. We need to do better in this. The Australian Government is investing more, but can I say with disabilities, I have this feeling we’re only scratching the surface.

HOST: Look, on another issue, there is a big story today that two major electricity generators are warning that if we were to put into place the carbon trading scheme that’s currently being mooted, that we will have massive failure in the electricity grid.

PM: Well can I say that all three of the national energy market regulators assessed the proposed Carbon Pollution Reduction Scheme at the time the White Paper for the scheme was put out, and their conclusions are radically different to the ones which are carried in this morning’s Advertiser.

HOST: What if it’s right though Kevin?

PM: Well, no, can I just go to the second part of what we’re doing. We actually understand the implications of a Carbon Pollution Reduction Scheme, which is all about reducing greenhouse gas emissions, and therefore, it does have implications for coal-fired power stations.
We, through our system, are providing the allocation of free permits to the electricity system under this CPRS system in excess of $3 billion. We are not, shall I say, inattentive to the needs of the sector in adjusting to a new scheme.
And there’s one other thing as well. What is the big problem that our coal-fired power stations face for the future? It is, how do we do better with the whole problem, the whole challenge of carbon sequestration, and this is what’s called CCS technologies or clean coal technologies. This Australian Government is investing, with the industry, $2.5 billion – world-leading stuff - to bring on stream large-scale projects for the sequestration of Co2 coming out of coal fired power stations.

HOST: Now just for those people who don’t know what that is, it’s the storing of carbon by other means, whether it be in the ground or somewhere else. Just quickly, so nuclear power is not going to be on your agenda in the near future?

PM: If you look at Australia Leon, we have such a rich array of energy sources. We’ve just been speaking about coal and our strategy there, but on top of that, the renewable energy sector is huge.

We have barely begun to tap solar – again, why the Budget contains $1.5 billion for what would be the single largest solar generating plant in the world.

HOST: But you need private investors though, as much as you are encouraging this technology, private investment doesn’t seem to be there.

PM: Well, I don’t know if I agree with that, because, for example, prior to the last budget, and I think our first Budget as the Australian Government, we introduced a half billion dollar renewable energy fund. We put that out for expressions of interest to the private sector, and I reviewed only a month or so ago these submissions back from the private sector. 60 or 70 concrete projects involving solar, wind, geothermal, wave, as well as tidal power, across the entire renewable energy spectrum, but in particular solar. And we’re quite encouraged by the preparedness of the renewable energy sector to take the challenge up, nd there are huge job generation potentialities in this sector.

HOST: When do you expect this to start to happen?
PM: South Australia in particular, enormously rich in geothermal resources.

HOST: Well you see, the hot rock technology is there, but there doesn’t seem to be a plethora of huge investment to bring it on ASAP.

PM: That’s true, that’s why we need to co-invest. What you need to do is first of all get a proper price for carbon in the system.

Secondly, help carbon-dependent industries to transition to a lower carbon economy.
And third, also co-invest during this transition period with the renewable energy sector to get them up to scale.
That’s one of the reasons why we have legislation to increase the national renewable energy target to 20 percent of total electricity generation by 2020, making it possible for the renewable energy sector to occupy the gap. And then also, for the co-investment mechanisms that I was just describing before, and in the case of geothermal, that’s one of them. One of the challenges there of course is to make sure that you can provide an electricity grid which connects with what is often the isolated location of these hot rock resources. These are the things all to be worked through at the technical level.

HOST: Kevin, thanks for joining us. By the way, when you go to the Flinders Medical Centre, you might ask, I know you’re one of those people who will take on dissent head-on. You might want to ask them when was the last time in the corridors they had many patients in barouches because they didn’t have enough beds, because I bet you don’t find that this morning.

PM: Okay, well, the reason I’m going to hospitals with the Health Minister all around the country, Leon, is to see it all, warts and all. And I went to the burns unit for example at Royal North Shore in Sydney yesterday. We spent a lot of time talking to the physicians there and the nurses, asking the very basic question, ‘what do you currently need that you don’t have?’ That is what the sort of questions I’ll be asking here at Flinders Medical Research Centre as well.

HOST: Prime Minister, thank you very much for joining us today, and I wish you well.

PM: Thanks very much Leon.

29 July 2009
This week the Prime Minister started a blog focused on health and is keen to hear your views and ideas.
Prime Minister's blog update

This week the Prime Minister has started a blog focused on health and he’s keen to hear your views and ideas for the future of our health system.

The Prime Minister’s blog is an opportunity for the community to provide comments and engage with each other in relation to this important topic.

To participate or read what others have said, simply visit PM Connect.

Over 900 posts on climate change were published to the Prime Minister’s first blog – you can read it online.

For more information visit the PM's Blog page at

29 July 2009
The Prime Minister was a guest on ABC 774 Melbourne and discussed proposed reforms of the national health and hospital system as well political donation disclosure laws
29 JULY 2009
Health and Hospitals Reform Commission; Tony Fitzgerald comments; Donation disclosure laws


FAINE: Kevin Rudd, good morning.

PM: Good morning, Jon. Thanks for having me on the program.

FAINE: 123 recommendations, I yesterday said this is a bit like a trade union with an ambit claim to an employer.

PM: (laughter)

FAINE: There’s no explanation of priorities amidst the 123. Do you think you can do all of them, or are some more important than others?

PM: I think the reason why the report is first of all so long, the recommendations so comprehensive, is that the report is based on the assumption that if you’re going to reform the health and hospital system, it needs to be an integrated set of reforms. That is, the part relates to the whole. What we do in preventative health care relates to what you do in primary health care, that is, with GP and GP-related services, which in turn affects how we manage the resources for our overstretched public hospital system in the number of admissions.
What do you do for outpatient services to take further pressure off acute hospital beds? Are you properly resourcing aged care beds so that people don’t remain in acute hospital beds longer than they need and prevent other people from getting there? All these things, one relates to the other, together with, do we plan properly at present for our long-term needs for the workforce for our health and hospital system as well.
And the reason why, therefore, this report has been done in the way it’s been done by this independent commission, is that it said overall, the system is reaching a tipping point because of the ageing of the population, the increasing cost of the provision of individual healthcare services, the fact that we have such a large number of people who are not seen within clinically acceptable times in accident and emergency, who are not getting elective surgery within clinically acceptable times.


PM: But the time has come for a root and branch look, and that’s why this is the biggest set of proposed reforms since the introduction of Medicare, and we’ll work our way through it as systematically as we can.

FAINE: But my question specifically was, do you think you can implement all of them, or are some more important than others?

PM: Well Jon, what I said when I launched this with the Health Minister two days ago is that the Government will not inevitably be implementing each and every one of these recommendations. The other thing I’ve said is that fundamental root and branch reform for the long term of the health and hospital system is expensive, it costs money.

Therefore there will be a question of prioritisation in terms of how we go about it. But also, it’s time for Australia to have a mature debate about the state of our health and hospital system, where we want it to be over the next ten to twenty years, and therefore we don’t intend to be in the business of an immediate rule in or rule out of individual recommendations.
The Health Minister and I are working our way around the country, and she and I, depending on which city we’re in, will be working our way through the major public hospitals of the country, as well as other healthcare providers, as we were in Sydney at Royal North Shore yesterday, the Flinders Medical Centre here in Adelaide today, and we’ll be in Melbourne before long.

FAINE: If I can prioritise, if I can paraphrase what the Victorian Premier John Brumby said yesterday, show us the money, and then we’ll talk.

PM: Well, on the question of funding to the system, when we reached the Australian Healthcare Agreement with the States and Territories in November last year, it contained within it a 50% increase in the overall funding to the states, a record $64 billion. And for the first time, you have the Australian Government investing in emergency departments. That is, a $750 million program to take some of the pressure off emergency departments.
For the first time also, the Australian Government investing $600 million in seeking to slash elective surgery times.
So on the question of the Australian Government’s action, I think Premier Brumby would recognise that there were significant advances in our resourcing to the states and territories in that agreement at the end of last year, together with what we’ve done on health infrastructure: the MacCallum Institute, for example, in Melbourne, a huge investment by the Australian Government on cancer, as well as what we’ve done on the rollout of GP Superclinics out there in the area of community health and medicine.
So we’ve begun this process last year, but we’ve commissioned at the same time this independent group of experts under Dr. Christine Bennett to look at a root and branch reform for the system for the very long term.

PM: And that’s what we want to have a mature discussion and debate about now.

FAINE: Are you comfortable with physiotherapists or chiropractors making referrals to surgeons instead of a patient having to see a GP first?

PM: You know something Jon, fools rush in where angels fear to tread.

FAINE: Which one are you?

PM: (laughter) Well I’m not about to tell you what a chiropractor or a physio should do with an individual patient in an individual surgery. That ain’t my field of expertise. Nice try.

But what I am concerned about is do we have, for example, GPs in the community in sufficient number and sufficiently co-located with other community health services like physiotherapists, like podiatrists, etcetera, so that we can provide the best integrated care for patients outside the hospital environment. Better for the hospitals, but also better in terms of the long-term health of patients themselves.

FAINE: But if you have a relationship with a GP, the GP has overall conduct or supervision of your health, ideally people do have relationships through GPs, and if you in fact start to fragment that by allowing a physio, for instance, or a chiropractor to send someone direct to a surgeon, obviously you’re reducing the benefit of a relationship with a primary provider like a GP, a gatekeeper.

PM: Look, can I say our view about the importance of GPs is very much reflected in the way in which the report is constructed. If there is an overall strategic emphasis in this report’s recommendations, it’s this - one, boost preventative healthcare.

Apparently, two percent of the entire health budget is spent on preventative measures, whereas we know for the long term if you’re going to act on chronic diseases, that has to be lifted.
Second, boost what is called a primary or frontline care, and that’s primarily delivered by GPs, because we are having too many people presenting themselves to accident and emergency, who if we had a better-resourced system at the GP level, and with greater allied services associated with GPs, and with better possibilities for GPs to have more flexible hours, then you have a greater ability for people in fact to use that primary frontline care rather than having to go to accident and emergency.
That’s why for example Nicola Roxon, the Health Minister, has been rolling out a series of GP Superclinics to which we committed ourselves as a Government prior to the last election. This would build on that, but we’ve got to work our way through this together with all the other recommendations, in a systematic way, because they are all expensive, nothing comes cost-free.
FAINE: I could keep asking you questions about the detail of this scheme pretty much all morning Kevin Rudd, and it’s of such breadth that there are people coming up, jumping up out of the woodwork from everywhere complaining or supporting particular aspects of it. Just pick one of them if we could please - you’ve managed to upset both dentists and also advocates for change in dental care by your proposal for a Denticare scheme. Are you going to take on the dentists?
PM: Well, if you look at dental care at present, here’s a stunning fact for us all - that across the nation at present, we still have a system which is based on the last data that I’ve seen, which is admittedly a year or two ago, had 650,000 people on the public dental waiting list. Therefore, we must have a system whereby we attend to those things better.
Now, you talk about various groups being, reacting to this report, I emphasise this: we commissioned this independent commission of experts, under Dr. Christine Bennett, with 10 prominent Australians with expertise in the health field, with a set of terms of reference to look at how the system should be reformed for the long term. They’ve come up with their independent recommendations.
Inevitably, there are going to be people out there in the professions who will either love it or hate it or be lukewarm towards it, and the reason I want a mature national debate about this is that we tease all this out over the next six months or so, and rather than just having a, you know, an attitude as a nation which says rule in, rule out, yes, no, right, wrong, let’s work it through.
And that’s why we’re going through each capital city, the Health Minister, myself in most circumstances, talking to major public hospitals and health providers as we did at Royal North Shore Hospital in Sydney yesterday, which has been the subject of some controversy over the years.
FAINE: The timing though, it’s no coincidence that you’re building up to making announcements within the electoral cycle for next year’s federal election. There is a certain amount of politics no matter which way you describe the consultation process, isn’t there?
PM: Yeah but Jon, this is a massive set of reforms. This would be the biggest set of reforms since the introduction of Medicare. What we said prior to the last election was that if we were elected to Government we would commission a National Health and Hospitals Reform Commission to undertake a root and branch review of the entire system.
One of these hasn’t been done for a long, long, long time. That took 16 months. It reported as of the end of June and three weeks later we’ve put it out there, which if your listeners want to read the whole report is up on And we invite the public to respond directly to it in terms of their attitude to individual recommendations.
And we have said that once we have worked our way through the report systematically, consulted directly the community, we’d then frame a final proposal for the states and territories, and put it to them in terms of whether they would embrace that cooperatively or not, and then we would take our course of action for the future - either to implement it cooperatively, or as I’ve said repeatedly, take it to the people for a mandate for the decisions which need to be taken for the future.
FAINE: Alright, last question on health before we move to other things. You can’t do all this without increasing taxes, or introducing some levy to pay for it, can you?
PM: Well, you’re right to absolutely say this, Jon, nothing in this report comes inexpensively.
It has all got a bottom-line figure attached to it, and as a result, if you look at the numbers which are contained within the report, for example, it would result in a recurrent set of expenditures of between $2.8 billion and $5.7 billion a year, and that’s excluding the Denticare proposal.
Secondly, a capital addition to the entire system which is significant as well.
Thirdly, you have, also, the proposed additional cost for Denticare through the Medicare Levy increase of 0.75%.
How are these monies raised? Well, there are three sources of revenue for the future. If there is a transfer of any responsibilities from the states to the Commonwealth, then there will be a transfer of funding associated with that as well. Secondly, if you bring about, for the first time, an integrated health system for the nation, then efficiencies will be created.
One of which would come through creating, for the first time, a decent e-health system, whereby you have online, accessible, computerised data containing individual patient records. Thirdly, apart from those efficiencies, you’re right, there are also implications for the revenue.
Let’s work our way through it systematically, but I think you’re absolutely correct to point out that nothing by way of fundamental reform comes cost-free, and it won’t.
FAINE: Seven minutes to nine on 774 ABC Melbourne. Jon Faine with you through to twelve, and Kevin Rudd, the Prime Minister, with me, speaking from Adelaide.
Tony Fitzgerald, corruption reformer, investigator in your home state of Queensland, broke a long silence last night in a speech at a university and said that he thinks there’s still a culture of corruption in your home town and in your home state. Kevin Rudd?
PM: Well, I haven’t seen Tony’s speech. I have enormous respect for him. I have known him well over the years and I think he is a first-class Australian. I also am very familiar with the recommendations he made 20 years ago in the Fitzgerald report, so I’ll wait ‘til I’ve actually worked my way through his speech, I haven’t seen a copy of it.
FAINE: I can tell you that he blasts the ethics of current and former Labor Governments, which may include the one of Wayne Goss in which you served. He says secrecy was established by sham claims, through Freedom of Information documents being run through Cabinet for no reason other than to keep them secret, and quote: “access can now be purchased, patronage is dispensed, mates and supporters are appointed and retired politicians exploit their connections to obtain success fees for deals between business and Government.” He could also be talking about the federal level of Government, couldn’t he, not just the states.
PM: Well, as I said before Jon, I’ve not read his speech and I intend to do so, because I’ve known him over the years I’ve known him to be a considered individual, I also know him to have exercised and reflected great courage in the recommendations he made back then to bring about some fundamental reforms in Queensland, one of which was a recommendation to establish what was then the Criminal Justice Commission, now called the Crime and Misconduct Commission, and it’s that body which, of course, has made recent findings in relation to aspects of the Queensland Police Force.
Many of the institutional reforms which Tony Fitzgerald recommended back then, of course, continue to play a fundamental role in Queensland today. The Crime and Misconduct Commission is one of them, although there is legitimate debate about its current operations and powers.
More broadly on the question of, you referred there to donations reform and things like that, and the way in which political business is conducted. Can I just draw your attention to the fact that we have currently blocked in the Senate, political donation reforms of our own, which would reduce the threshold for declarable amounts of money from $10,000 – which is where the Howard Government took it to – to $1,000, because we thought that was simply right out of the ballpark. That’s been blocked by the Liberals in the Senate.
Prior to that, it used to be $1,500. Mr Howard increased it to $10,000, which would enable you to, I think, conduct fundraising activities which were largely unknown to the Australian public through the declarations process.
FAINE: Small beer, though, Prime Minister. The main issue here is that major developers, industrialists, investors, can buy access through sponsored lunches, $10,000 tables at dinners and all of these sorts of things in order to get around those rules just by signing a cheque.
PM: Can I just say one of the important reforms in response to that is to make sure that you have a threshold for campaign donations which become completely declarable to the Australian Electoral Commission. The previous Liberal Government increased that from $1,500 to $10,000, whereby you could have a fundraising function with 10 people paying $10,000 each, $100,000, and no-one would ever know about it.
We have legislation in the Senate currently blocked by the Liberals which reduces that down to $1,000.
The second thing we have is proposed ban on foreign political donations to Australian political parties. That’s also been blocked by the Liberals in the Senate -
FAINE: So you don’t think you need to do any more?
PM: The third thing we’ve introduced, which goes to the absolute core also of what you’ve just asked, is about the activities of, for example, people acting on behalf of companies, for the first time the Australian Government has introduced a lobbyist register, whereby a full list of all third-party lobbyists for Australian companies must be provided to the Department of Prime Minister and Cabinet –
FAINE: So you don’t think you need to do any more?
PM: No, I’m about to go on to what else we have in mind here. And secondly, for the first time, the Australian Government has therefore required these lobbyists to list those companies for whom they are lobbying. That is the first time that has occurred at the level of the Australian Government.
On top of that, John Faulkner, as Special Minister for State, issued a Green Paper on further areas of reform in these areas concerning caps , further caps on donations, further caps on campaign expenses, etcetera.
These things are out there, but the reason I emphasise the matters which are currently blocked in the Senate, is that we’ve been determined at the Australian Government level to get on with the business of reform.
PM: I note, however, they are being blocked by the Liberals.
FAINE: Prime Minister, my time with you is up. I’m grateful to you for taking our call and fitting it in to your busy schedule from Adelaide this morning.
PM: Thanks Jon. Thanks for having me on the program.
29 July 2009
The Prime Minister was a guest ABC 891 Adelaide and discussed proposed reforms to the nation's health and hospital system and the nation's economic recovery from the global financial crisis
29 JULY 2009
Health and Hospital Reform Commission; Economic Recovery; Same-sex Marriage


HOST: Kevin Rudd, Prime Minister, good morning to you, sir.
PM: Good morning. Thanks for having me on the program.
HOST: Thank you for coming on the program. Prime Minister, you are going to Flinders Medical Centre today?
PM: That’s right, and just to add to what you said in your introduction, what we sought to do yesterday at Royal North Shore Hospital in Sydney was actually to listen, and we sat there and listened to the observations of 100 or so medical practitioners about the implications of the report, that is, on the future reform of the health and hospital system and how it would impact the delivery of services of that major hospital in Sydney.
We’re doing the same here in Adelaide today because there’s no point proceeding with long-term, fundamental reform to the system unless you hear directly from those who are at the coal face.
HOST: You promised during the election campaign that if the states hadn’t signed up to a reform plan by the middle of this year, and that’s now, you would have either a referendum or a plebiscite to seek the approval of the people to take over the nation’s 750 hospitals. Your time is up. What are you going to do about that?
PM: Well, prior to the election we said that we’d set up this National Health and Hospital Reform Commission. It’s now worked for 16 months, and this is the biggest set of proposed reforms to the health and hospital system, which is under stress throughout the country, since Medicare, the introduction of Medicare.
We think the right way to go is now to put this out there to the Australian community for a national debate. It’s very important for the long term. Millions of Australians depend on this system each year. We’re determined to get the decisions right.
Also, reform is very expensive, and that’s one of the reasons why the Health Minister and I are working our way around the country, speaking to those at the front line of about 24 or 25 major public teaching hospitals right across the country, together with others. Then, then-
HOST: But you set the deadline, didn’t you, during the election campaign? This was a popular message to send out there, of ’09, the middle of ’09. Is that now abandoned, along with the GroceryWatch deadline and action on petrol prices?
PM: What we said was we would then put a proposal to the states and territories with a view to have them cooperatively to come on board with a national reform program for the health and hospital system. My preference has always been to do that cooperatively. We also said that if the states, however, rejected that, that we would reserve the option of taking that to the Australian people by way of plebiscite or referendum. We said that, and that is precisely what we intend to do.
When we convene the Council of Australian Governments in December this year, we will convene it explicitly to discuss health and hospital reform, then at the COAG meeting of early next year we will then obtain the response from the states and territories about whether they would support or reject the proposals we put forward.
If they reject, then consistent with what we said prior to the election, we then take it to the people.
HOST: Do you concede there’s been some slippage in the timetable that you announced before the election?
PM: Well, it’s a very complex and difficult area of reform. It’s really hard. We’ve received this report from the Health and Hospitals Reform Commission three weeks ago. We’ve now put it out three weeks later for the public to comment on, and for your listeners who are interested in providing their responses to it, it can be had on
We want to make sure that we do this calmly, methodically, comprehensively, because this is a very large set of reforms, and, taken in part or in whole, with significant implications for the future and for the cost to the system.
It will take time. I concede that, I understand that, but we’re determined to get this right for the future.
HOST: Prime Minister, in your 6,000 word essay published in The Age – give or take a few words – I think the message is we’ve had a soft recession or no recession at all.
PM: Gee I hope you read it all.
HOST: I have. I thought you’d be proud of it.
PM: I asked that to a journalist the other day and they said after my third inquiry that they’d read a précis, so I thought that was good.
HOST: No, no, I downloaded the full thing, courtesy of the internet.
PM: You need to get a life a little.
HOST: You’re not the first person to say that. But Prime Minister, I think, in a nutshell, we’ve had a soft recession, we’re going to have a hard recovery. Why will the recovery be hard if we’ve almost avoided a technical recession?
PM: It’s going to be tough, and I also note carefully the statements made by the Governor of the Reserve Bank yesterday because we’re going to still face increasing unemployment because employment is what the economists describe as a lagging indicator. That is, even when sentiment ticks up in the economy, you still have the flow-through consequences of employment, or unemployment, some time later.
Secondly, also as I’ve indicated in the essay that you referred to, there will obviously be changes in interest rates policy in the future as well, so therefore there will be real challenges and stresses for the future.
And the last thing is this – is that the challenge of responsible, conservative economic management is this: to expand the role of government when the private economy is in retreat, which is what happened with the global financial crisis of the last quarter of last year, but equally, to return the Budget to surplus as the private economy recovers.
What does that mean? It means that in the future we’ll be looking at pretty hard-line budget disciplines, which means some unpopular budget cuts, so therefore you ask the question ‘why is going to be a tough recovery?’ It’s putting those things together for the future.
HOST: Having encouraged more young people into the housing market with generous first home owners grants, are you now worried those people are going to be hit with higher interest rates?
PM: Everyone, obviously, has to make their own decisions about whether they buy a house and for how much and where, and we deliberately, in consultation with the housing industry, trebled the first home owner’s boost to enable more young people to get access, in particular, to their first home.
Secondly, you’re right to point out that there will be pressures in the future because, inevitably in the future there will be changes in interest rates policy. We accept that fact.
But you know, the challenge is a difficult balancing act – how do you provide support and stimulus to the economy when right around the world we have faced worldwide the biggest single assault on global economic growth in three-quarters of a century, and a near implosion of the global financial system, so how do you stimulate the economy to avoid that complete implosion here, and then how do you begin to adjust policies into the future as the private economy recovers. It’s a very difficult balancing act, I accept that, but that’s what we are seeking to do, and as you referred earlier to that essay I wrote over the weekend, at some considerable length, I tried to explain how.
HOST: And this is going to happen just as unemployment start to rise and, as you say, you’ll be looking to cut money from your budget. You haven’t got any more money to send out by way of cheques. That’s why the recovery could end up being tougher than the recession.
PM: Well, it will be a tough recovery for a number of reasons, as I said, unemployment continuing to rise for some time, that’s just what the lessons of economic history tells us, and that’s why we still have stimulus projects out there, for example, being unfolded in every primary school in South Australia at present, and language and science centres in a large number of secondary schools – projects like that across the country to make a difference now, also that we can look back on in a year or two’s time as then adding to the overall educational opportunities that our kids have for the future.
But let’s put it all into some context as well – across the major advanced economies of the world, where have we landed as a result of Australian economic policy? Our government economic policy, along with the support of the private sector, we have currently the fastest economic growth of the major advanced economies, the second lowest unemployment, the lowest debt, the lowest deficit, and we’re the only ones at this stage not to have gone into technical recession.
So it’s a very hard balancing act but we are doing better than most economies.
HOST: I know you must go shortly, Prime Minister Kevin Rudd. The Labor Party State Conference and the question of gay marriage – Ian Hunter, former State Secretary of the Labor Party, very respected MP in our Parliament, is gay, and he has publicly asked the Labor Party and you as Prime Minister to allow him, and other gay people to marry their partners, to have their partners fully recognised as a man and a woman would be. Yet you have ruled that out, is that right, and if so, why so?
PM: Well, Ian Hunter is a fantastic bloke, I actually know him, and I fully respect his relationships, as I’m sure would everyone in this community. We went to the last election being very clear-cut about our position on marriage, under the Marriage Act, being between a man and a woman. We’ve also said that in terms of all legal discriminations against same-sex partners, that we would act to remove them, and the Attorney-General has been hard at work, and from recollection, repealing some 90 or 100 pieces of federal legislation, I should say amending 90 or 100 pieces of federal legislation, to make sure that those discriminations are removed.
HOST: Prime Minister, that’s restating the policy. The question is, why?
PM: Well, as I said, we are consistent with the policy we took to the last election.
HOST: Yes, but why have that policy? Why say to two men in a committed, long-term relationship, ‘you cannot be married’.
PM: Well, we have said from the beginning, that our attitude to marriage as prescribed under the Marriage Act, between a man and a woman. I fully respect the integrity of other same-sex relationships, and I have complete respect for Ian Hunter, to whom you’ve just referred, but in terms of the policy, it’s a matter to which we have been committed for some time. I fully accept it’s a matter of controversy, and there’ll be debate, and there should be. This is an open society where we can debate and discuss these matters. We’ve simply reflected our view, and my view, as to what the proper arrangements are under the Marriage Act, but in terms of other discriminations, we have acted rapidly to remove those under various items of federal legislation, and I think the Attorney-General has done a great job of doing so.

HOST: Prime Minister thanks for talking to us here on 891 Mornings.

PM: Thanks for having me on the program.

28 July 2009
The Prime Minister and the Minister for Health held a doorstop interview to discuss their consultations on the future of Australia's health system at the Royal North Shore Hospital
28 JULY 2009
National Health and Hospitals Reform Commission; Newspoll


PM:                             What the Government is working on, based on the recommendations of the National Health Reform Commission is the biggest set of reforms to the health and hospital system since Medicare. This, therefore, requires the Government to work through the recommendations in a calm and methodical way, because we need to make sure that the decisions which are taken by Government on this are right.
We are determined, because of the importance of the system to every working Australian, that we get these decisions right.
That’s why it’s been important for us to be here today at Royal North Shore Hospital in Sydney to hear first hand from those who work in the field, from specialists, from doctors, from general practitioners, from nurses and from others in the community care sector, about their experiences here, their initial response to the Commission’s recommendations. And, I’ve got to say, I have learnt a number of things from being here this morning.
This will be the first of many all around the country. You’ve seen on our list of scheduled visits, that the Government proposes to engage with 20 or 25 of the major public hospitals directly around the country. I’ll be doing a lot of that myself, and we’ll also be engaging other health professional associations as well as those in the community health sector.
Big reform, the biggest set of health and hospital reforms since Medicare. That’s why the Government’s got to consult the community to get it absolutely right.
Over to you, folks.
JOURNALIST:          How about regional and rural hospitals? Do you plan on having forums there as well?
PM:                             Yeah, as you would have seen, or may not have seen, in the speech I gave yesterday, the major public hospitals, obviously, we will be consulting directly with them, a representative group of regional and rural hospitals, and private hospitals as well, together with the health professional associations. There are 750 public hospitals across the country. Therefore we have got to make sure we are engaging properly with the big ones, but also a representative group of the smaller ones, particularly given the findings of the Commission’s report about the fact that health outcomes are often worse in regional and rural Australia than they are in the big cities.
JOURNALIST:          Prime Minister, how much do you feel that Royal North Shore Hospital encapsulates what needs to be done in Australia’s health system?
PM:                             The beginning of wisdom is to know what you don’t know. And the reason we are consulting across 20 or 25 of the large public hospitals across the country is to begin testing the report’s recommendations with those who are practitioners in the field. A good and informed set of responses to us here at Royal North Shore today. Tomorrow I’ll be in Adelaide and I’ll be talking with a different group down there.
Ask me that question at the end of the process and I’ll probably give you a more considered response.
JOURNALIST:          (inaudible)
PM:                             Well, I’m in Sydney, and I had to be in Sydney last night, so we thought it was useful to come here because obviously there are challenges right across the hospital system in the country, but we want to be upfront in tackling problems where they exist and where the public has concluded they exist, and then engage in a very practical way about how we can improve it in the future.
We are not faintly interested in perpetuating the politics of the blame game. The country has had a gutful of that. What they want us to do is get on with the job of saying ‘how can we take this health system across the nation and improve it from here to here, and how much will that cost, and how can we go about implementing it rationally over time?’
JOURNALIST:          Prime Minister, you don’t see the hospital system as broken?
PM:                             What the report of the National Health Reform Commission tells us is that the hospital system and the health system across Australia is reaching a tipping point. That’s the term they use. You put together all the pressure factors: ageing population, the increase in the cost of medical interventions, the increasing cost of pharmaceuticals, the explosion in chronic diseases in all the categories. All that happening at one end of the spectrum.
Challenges with workforce and proper national long-term planning for nurses, doctors and bringing people through the system and a proper geographical spread of them.
And thirdly, using the taxpayer dollar better across prevention, primary care and acute care and post-acute care to make sure that it works.
Now, what the Commission has concluded is: ‘look, the time for fiddling around the edges is rapidly drawing to a close. There is a tipping point being reached here.’ That’s why they put forward the largest set of proposed reforms for the health and hospital system since Medicare. So our job is to grab this with both hands and have a go, and we intend to.
JOURNALIST:          You wanted to engage Australians on this health conversation and discussion and go forward from here, but it seems that the cost and costings need to be more upfront than they are now. At the moment you’re saying that the Henry Review of Taxation will give us all a better picture about where revenue is going to come from, but don’t Australians, at this point in the conversation need to know more about what it will cost us in the future?
PM:                             Well, actually the Commission’s report itself has two to three sets of conclusions about cost to the additions to the system which are proposed.
One is the additional annual recurrent cost which, depending on where you land, is between $2.8 billion and $5.4 billion, or thereabouts, recurrent per annum. Secondly, an additional set of one-up capital costs. And thirdly, specific costs in terms of Denticare, if the Government proceeds in that direction.
They are outlined in the report.
Secondly, what we’ve got to do, and I canvassed this, I think, yesterday in my remarks in Canberra, is now test all of those assumptions with Treasury data as well.
Third thing we need to do is mesh that with the upcoming data we’re going to get  from the next version of the intergeneration report on the ageing of the population and where that is going in terms of long-term demand, particularly in terms of age care.
It’s not easy. It’s complex. But let me tell you, I’ll be seeking to emphasize throughout is here are the reforms which are being recommended to us, and for the country at large to know that none of these come for free. Way of funding them I referred to in my remarks earlier today. Transfers between the states and the Commonwealth, one. Two, efficiencies in the system, particularly off the back of the health reforms. And three, from the revenue.
All these things related to each other.
I just want to be frank about the fact that the system has reached a tipping point. We need some fundamental, long-term reforms, and it’s going to cost.
JOURNALIST:          The American Chuck Feeney has made one of the biggest medical donations here in history in Queensland. How much do we need to rely on philanthropy from the corporate world to help fund our medical research and hospitals in the future?
PM:                             Well, can I just publicly congratulate Chuck Feeney for his philanthropy, not just in Queensland but in other parts of Australia as well. One of the first things I did as Prime Minister was invite Chuck to lunch at Kirribilli, just down the road here, to thank him for his extraordinary acts of generosity to the Australian health system, and as I’m advised here, it’s $102 million to be allocated across the following projects:
  • $50 million towards the $354 million Translational Research Institute at the PA Hospital in Brisbane;
  • $27.5 million towards QIMR; and
  • $25 million towards QUT’s hub for Sustainable and Secure Infrastructure.
These are great acts of generosity on his part and his foundation’s part, and we’ve sought, as the other state governments have done, to be co-investors with it.
Your question goes to what is the proper role of government in laying out, let’s call it health and medical research infrastructure for the future, as opposed to relying upon acts of private philanthropy. Can I say, what you’ve seen in the last Commonwealth budget with a $3.2 billion proposed investment from the Minister in 32 capital projects across the health and medical research system of Australia demonstrates where we are moving ourselves, putting our money where our mouth is.
We welcome Chuck Feeney’s philanthropy. The Australian Government is an active co-investor in the nation’s health and medical research infrastructure as well.
JOURNALIST:          At the last state election, the State Government promised new hospital projects – Northern Beach Hospital, Wagga, Parkes, (inaudible) etc – and the Federal Government didn’t fund them and therefore they’re not going ahead for the time being. Does that call into question the Federal Government’s ability to work with the states in terms of providing hospital projects?
PM:                             Look, as I said before, we’re not into the business of rolling out the blame game, and various levels of government will make their commitments in terms of various hospitals off their own bat. It’s a matter for them. This Government has been meticulous in honouring our pre-election commitments to the Australian people, one of which was the establishment of this Commission, one of which was to then get on with the business of comprehensive health and hospital care reform. I’ve got to say, complicating and compounded by the fact that in our 18 months or so in office we’ve had the worst global economic crisis in three quarters of a century but we’re still going to get on with the job. On the specifics of that, Nicola, did you want to add?
ROXON:                    Thank you. Just to say, of course, that, to state the obvious, that the state governments, of course, do continue to be the primary funders of capital infrastructure in health. We made quite clear that we were very excited about our health and hospitals infrastructure fund being able to be used to drive reform, to enhance and provide additional funding for states and territories but also for research institutes and others, so there was no intention for that to replace state funding.
Of course, the NSW people did receive benefits from that funding. A large number of projects in NSW, including the cancer care centre and the Nepean Hospital as two of the big projects but really, if the question is about the time line for infrastructure development of state hospitals, those questions need to be put to our state colleagues.
JOURNALIST:          So what you’re saying is that if the people of NSW don’t get their hospitals, blame the State Government, not the Federal Government.
PM:                             No, what we’re saying is – nice try. Can I say I think the Australian people are absolutely fed up with people playing the blame game. We want to get up, get on with the business of doing the best job possible of fixing the health and hospital system for the long term. It is not easy, it is one of the hardest areas for reform in government.
Everyone, all of you here today as journalists, have had some direct contact with the health and hospital system, directly or through your family, and all the folk who’ll be reading your newspaper or listening to your radio programs or watching your television news tonight. Therefore, every Australian has a huge interest in us getting these reforms right for the long term.
We’ve put our money where our mouth is in two respects so far prior to any consideration of the implementation of the recommendations contained in this report: One, $3.2 billion capital injection from us at a federal level which historically has not existed from the Commonwealth Government, and the Minister just referred to two specific projects in this part of NSW. Second,the Australian health care agreement. This was framed last year, a $64 billion investment, co-investment with the states and territories, a 50% increase on the previous Australian Healthcare Agreement.
The previous Liberal Government actually pulled money out of the system. They took $1 billion out of the public hospital system. We’re in the business of putting investment back in to the public hospital system, and I’ll just draw people’s attention to the fact that when there are tensions in funding concerning various projects around Australia, bear in mind this is coming off an historical base of a Federal Government which said ‘let’s blame the states and territories and let’s pull money out of their bottom draw, which is what they did.
One further point I’d just make on this as well is that, on the question of investments, Mr Dutton today, the health spokesman for the Liberal Party, is proposing a freeze on health funding. Look carefully at what he has said.
I notice also, earlier Mr Turnbull has said that in his ideal world every Australian should take out private health insurance, and the Liberals in government ripped a billion out of the public hospital system of the states.
Where is Liberal policy now standing? The Liberals, through their health spokesman today are saying that health funding should be frozen from the Australian Government. We don’t think that’s the right way to go. And their leader has said that in his ideal world, everyone should have private health insurance. There is a very clear difference here between the two approaches.
There’s another thing which has emerged on dental care as well.
ROXON:        Yeah, Mr Dutton seems to be having a spectacular day today, because he also has indicated opposition to a universal dental scheme, apparently on the basis that this idea would hurt pensioners. Quite an extraordinary allegation I think from the Liberal Party, when everyone in the community is acutely aware of the gaps in our dental services, and where the....

PM:                             The national broadcasters fallen over. (laughter).... Read the Budget (laughter)

ROXON:                    The Liberal Party is making clear that they oppose fixing problems in our dental system, yet we all know people who cannot afford or cannot access dental services. The Health Reform Commission has proposed a new, universal dental care system but in the interim, the Government has been trying to deliver extra resources to the Commonwealth Dental Health Program, particularly targeted at pensioners, that the Liberal Party has repeatedly blocked in the Senate. So I don’t think we can take the Liberal Party seriously when they say that they are opposed to ideas when they would actually help pensioners, help those who are disadvantaged. And to suggest that we put a freeze on health spending until the system is fixed, when they have no ideas themselves of how to fix this system, I think is pretty extraordinary.

JOURNALIST:          Prime Minister, Newspoll seem to be suggesting that people aren’t listening to the (inaudible).

PM: Look, I don’t comment on opinion polls, I was asked about this morning. Whether for the Government they’re up or down, our job is to get on with the job, and I’ve said that constantly in the period that I’ve been Prime Minister. A couple of things though emerge in terms of their implications for the Liberal Party. I notice that Tony Abbott’s out of the blocks, and Tony Abbott is now saying that the Liberals, come the next election, will be bringing back WorkChoices. Pretty interesting.

His comments last night along the lines that what he describes as workplace relations reform is not dead yet, we’re back again come the next election, for the Liberals. So the Liberals can’t give up their WorkChoices addiction. I think that’s something the Australian public would pay attention to. But just to finish the Peter Dutton trifecta before, we mentioned what he’d had to say about freezing hospitals funding. Then there’s this extraordinary position of opposition to Denticare as an idea. And then thirdly, what you need actually from the Liberal Party is some consistency of policy. Last month, the Liberal Party health spokesman called on the Government to take public hospitals over.
Today, the same spokesman, Mr Dutton, says they’re in the process of putting their policy together. Can I just say, you either have a policy or you don’t. Last month there policy was ‘take over the hospitals’. This policy is, today’s policy is they don’t have a policy. So, whether it’s on climate change, where the Liberals are divided right down the middle, on health policy we now have about five different positions from five different spokesmen on health policy, they are also divided. I think people would expect better of them, particularly given this debate is so important.

JOURNALIST:          Prime Minister, Peter Dutton also said this morning that today is the second anniversary of the speech that you made about a two year deadline for the national reform of healthcare. What’s your response to that? He says the delay....

PM:                             I’d say twelve years of total inaction by the Liberal Party on health and hospital reform speaks for itself. Secondly, I would say that during those twelve years, not just inaction on reform, but the physical withdrawing of funding from the public hospital system, a billion dollars worth speaks for itself. Thirdly, we said the building block of our long term reform of the health and hospital system of Australia would be based on this report, which we’ve been here discussing today.
And that is the report delivered by Christine Bennett’s National Health Reform Commission. This affects so many Australians. They therefore expect us to get it right. It’s important, therefore, that there is an informed national debate, now that there are concrete proposals out from the Commission. And that’s what we’re here to do today. And the second is, we also are obviously going to be mindful of the conclusions of the Henry commission on tax, an intergenerational report in terms of the future demand on the system for aged care and aged care related services. Thirdly though, I think what the people of Australia want is a mature and informed debate about the biggest set of reforms which have been put on the table since Medicare. That’s what the Government intends to get on and do.

And I’ve got to zip, because I’ve got to be on a plane to Adelaide. Bye bye.

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27 July 2009
The Prime Minister spoke at the John Curtin School of Medical Research to launch the National Health and Hospitals Reform Commission's report into the future of the Australain health and hospital system
27 JULY 2009


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