Doorstop, Launceston - 9 April 2010

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PDF printable version of Doorstop, Launceston - 9 April 2010 (PDF 30 KB)

9 April 2010

E & OE

Subjects: Health reform, preventative health

Nicola Roxon: I'm the Federal Health Minister and I'm delighted to be here with Jodie Campbell and Helen Polley to look at one of the Government's investments, one of the announcements that was made during the last election now coming to fruition to be providing extra services to the community of Launceston and its surrounds.

The Launceston Integrated Care Centre was a $15 million commitment by the Rudd Opposition which has been delivered on by the Rudd Government. What you see here today in the satellite services is the new renal facilities servicing more patients than were able to be serviced before, and obviously in a much more comfortable and appropriate setting than in the hospital. And of course many of you will have seen the big hole in the ground which is the start of the rest of the centre being built. Construction is going according to plan for those services which will include not just the provision of extra medical care and services but also the clinical school for Launceston and an integrated proposal to involve local GPs.

So this is good news for the Launceston community. It gives me a lot of pleasure, Jodie and Helen, to come back and see that our Government commitments are turning into real services on the ground.

And of course it's important when we're considering renal patients, this type of project is vital if you need dialysis. One of the common causes of a person needing dialysis of course is diabetes. Just last week we made an announcement of nearly half a billion dollars of investment in managing people's diabetes better in the community, supporting GPs and their practices, their team of nurses and allied health professionals to provide better and more comprehensive care and, for the first time, actually giving patients an option to enrol with their practice and for the practice to receive more money and a more flexible payment to be able to provide a range of appropriate care for patients.

So this is a very big change in the way health services can be provided. I visited a practice in Ulverstone this morning with Emil Djakic and talked with his team and some diabetic patients about the flexibility and improvements it will provide for their practice. And we're very excited about the benefits that that can deliver to the patients to ensure that you can maintain the diabetes and ultimately of course improve health outcomes, reduce the number of people who will need dialysis into the future.

Question: How will these centres be affected under the Government's proposed health reforms?

Nicola Roxon: Well, the centre will be treated in the same way that our other health services will be. The Government's proposal is to put a 60 per cent funding responsibility to the Commonwealth, so the Commonwealth becoming the dominant funder of all health services, hospital services. Then of course we've committed to taking on 100 per cent policy and funding responsibility for primary care services.

These are the types of services that in the past have not been set up because we haven't had one level of Government responsible for the majority of funding, whether it's hospital or primary care settings. These sorts of services fall in the middle, and it's important for us to make sure that we actually provide incentives for these services to be able to grow and develop into the future. They are the way of the future to provide more care outside hospitals and in ambulatory settings, and that's absolutely what we're determined to provide with our new reforms.

Question: The Victorian Government's not convinced though. They've put up another plan with a 50-50 split. What do you make of that?

Nicola Roxon: Well, the Victorian Government, like any other government, are welcome to put forward their ideas. We're determined and happy to negotiate with the state premiers and leaders about their ideas. We do think Mr Brumby's proposal is unrealistic; it is requesting a $40 billion investment in the next four years. That's the entire Victorian state Budget. That's not the sort of change that any Government has lying around.

And we are not prepared to sign a blank cheque to the State and Territory Governments for things to continue as they currently are. That's what Mr Brumby's asking for, and we don't agree with that proposal. He puts forward many other constructive ideas that are we prepared to work with him on, and I think you're going to see a lot of discussions and a lot of passionate discussions between now and the COAG meeting on 19 April.

Question: But [indistinct] centre falls in the middle, who will it be funded by? Will it be 100 per cent Commonwealth or 60-40?

Nicola Roxon: Well, as it's currently structured it's part of the hospital services and it will be funded 60 per cent. What we have made clear is that we believe there should be a change to the way outpatient services and non-admitted patient services are provided which will see us progressively take over 100 per cent of funding for more services that can be provided in an ambulatory setting.

We've been quite open that there are categories of care that fall into the middle, but this will have stable funding from us, an increased share, being 60 per cent, and the opportunity in the future for that to go to 100 per cent.

Question: You're obviously meeting with Ms Giddings and Mr McKim today, how confident are you that these are going to be positive meetings?

Nicola Roxon: Well, look we are determined to meet with all relevant parties to this debate. Health reform is extremely important for the whole community. Your needs for health care are not affected by whether you vote Liberal, Labor, Green or any other way, and we are offering to meet with all the parties; Labor, Green and Liberal. I've had two of the meetings confirmed. I haven't yet had the meeting confirmed with Mr Hodgman but I'm hoping that he will take the opportunity to meet.

Obviously the situation is fluid in Tasmania, and we have been in contact with all parties over the last week. It's part of the reason that I am here in Tasmania, to be able to have those discussions and ensure that any future government is well briefed on the proposals of the Commonwealth and that Tasmania can have their views represented at that COAG meeting.

Question: What efforts have you put into - or your office put into contacting the Liberal Leader Will Hodgman?

Nicola Roxon: Well, we've been in contact with him for the last week, we actually briefed his health spokesperson during the election as was requested; we made those offers and were happy to do that. We contacted Mr Hodgman again after the election to offer to provide him with any information and, quite rightly, he was concerned not to precipitate what might result from the counting of the ballots.

We're in the position now that the meeting is not very far away and we made a decision that it's more appropriate to offer everyone the opportunity to meet with us and be fully briefed. I hope that opportunity is taken up. The Labor Party and the Greens have agreed to have that briefing, and I hope that Mr Hodgman will still do so.

Question: Are you flexible this afternoon if Mr Hodgman calls at the last minute?

Nicola Roxon: Absolutely. I've put a call into his Chief of Staff just again this morning to say, “look we really are keen.” We obviously respect it's up to individual parties to make a decision whether they want to do this or not.

But really this is a very important reform for the country and for Tasmania. We would like to make sure that Tasmanians have their views represented.

We've welcomed Premier Bartlett's support for these plans, but we also believe that they are significant enough that if any Opposition or any other minor party wants to be fully briefed that they should have the opportunity to be, and that's why I'm here today.

Question: You must be happy then that the Labor Government has got through given that Bartlett's more supportive of your plan.

Nicola Roxon: Well look, that's not a matter for me. We've made absolutely clear that we will deal with the elected representatives of any Government of any state or territory. We've been working constructively with the Liberal Government in Western Australia.

We've offered to work with Mr Abbott. Unfortunately he's hasn't shown much inclination to be involved in this health debate yet.

It's obviously been a fluid and difficult situation in Tasmania. But we are determined to give everybody the opportunity to be fully briefed about our proposals and we look forward to having those meetings this afternoon.

Question: You've got a fight on your hands though, clearly, with the Victorian Government saying that your plan is impractical. You're saying their plan is not working. You have to deal with the Western Australian Government; potentially problems here in Tasmania. Obviously this isn't going to be easy for you to…

Nicola Roxon: We never embarked on health reform thinking it was going to be easy. The reason that governments of all natures in the past have not tackled this is because it is hard. It is a big reform. It is serious change.

But we are determined to deliver on change. If we don't, no state Budget - Victorian, Tasmanian or otherwise - will be able to cope with the growth in health expenditure in the future, and the community will not get the services that they need.

So this is about making health services sustainable but also invest in more with the confidence that our money is going to be well spent.

And if we don't get governance right and we don't get financing right, we won't be able to make those additional investments. So it's going to be a very heated, difficult discussion between now and COAG, and no doubt at the COAG meeting. But there's nothing more important than us getting this right, and I think everyone is prepared to invest that time and effort in negotiations.

Question: New South Wales has indicated that they're going to back the Victorian alternative plan. Do you think that that's more likely to make the issue go to a referendum now?

Nicola Roxon: Well look, I'll let each State Leader speak for themselves. I think that Premier Keneally has been very supportive of our plan. There are questions and issues that she wants to pursue. She's obviously interested in talking with Premier Brumby.

These are big ticket items for any state government, let alone for the Commonwealth. And we shouldn't underestimate that there needs to be discussions and toing and froing between now and the final meeting, and any decision time.

But we've also made very clear that if we cannot reach an agreement, we believe this plan is too important for the future of the country, that we would put it to the people through a referendum. That's not our preferred option. Our preferred option is to reach an agreement with state and territory leaders. But we're not prepared to simply sign a blank cheque and say everyone can keep doing things the way they did before. The time for that is over. And that message needs to be clear to Mr Brumby.

Question: Given that you're trying to avoid a referendum though, how crucial is it to have an agreement by the COAG meeting, given that Mr Brumby is clearly opposed and maybe Ms Keneally as well?

Nicola Roxon: Well, I think that's asking the question the wrong way around. The question is what do we need to do to ensure our health system can be sustainable for the future, and how do we get better health and better hospital services for communities like those here in Tasmania or in Launceston where we're looking at the renal dialysis service.

The way to do that is to get the funding arrangements right. We think the 60-40 share is appropriate and that the Commonwealth should bear a greater responsibility for funding health services.

We think we need to get the governance right. We think we need to look at what additional investments can and should be made to change the way we provide services; more focus on what you can do outside hospital, better access for elective surgery and emergency departments. These sorts of investments can be made if we have confidence that the money is being well spent and properly governed. And that's why we're putting the reforms forward.

The question isn't about whether we have a referendum or not. The question is about how we get important health reform so that we can provide services securely into the future.

Question: So what I was asking was how crucial is it to have an agreement by COAG? Will you be prepared to negotiate further if you think that, say, John Brumby was prepared to be flexible but he needed a bit more time?

Nicola Roxon: Well, I think everybody has had a lot of time. The deadline is 19 April. That meeting can go for as long as the leaders decide they need it to go for. But I - you know, we are not anticipating that we will reach an agreement on one item and come back and negotiate over another 400 at a later time. It will be for the Prime Minister and Premiers to reach an agreement at this meeting, and we've made that clear to Mr Brumby and to the other Premiers.

Question: Another health issue. There's been a report from Perth on obesity which has found that obesity has now overtaken smoking as the leading cause of premature deaths in Australia. What's your response to that?

Nicola Roxon: Well, it's been no secret that there is growing concern that, not just the harmful consequences of tobacco, but also the excessive consumption of alcohol, and obesity, are the three biggest risk factors for premature death and many chronic diseases.

It's why we asked our preventative taskforce to look at those three risk factors and see what could be done differently to try to reduce the uptake or increase of these diseases. It's why we've announced our diabetes package because, of course, one of the serious consequences of obesity can be diabetes and it is a largely preventable disease.

So we're very focused on these problems. We've invested $872 million through an earlier COAG agreement into prevention.

We're running our Measure Up campaign. Those of you who haven't measured your waists, now is the time to do so to see if you're at risk and what sort of changes you can think about in your own lifestyles. So we're tackling this on lots of different fronts.

What's the message to the general public? What can we do to help parents and families in giving their children healthy choices and healthy lifestyles? What should we do at the government level? What can our health professionals do? And we're tackling that on all fronts. But I think it's a very serious growing problem that we need to keep a close eye on and keep investments in these areas.

Question: A task force on obesity has actually found that the federal government hasn't acted fast enough to tackle this obesity crisis. What more can…

Nicola Roxon: Well, I think that we have acted quickly. We've already made major investments in this area. Some of our changes are being blocked in the Senate, like the establishment of a preventative health agency, that the Liberal Party have been opposing.

We believe that the changes that are part of this health reform can make a significant difference to investing more at the front end of health care, and maintaining people's fitness and wellbeing rather than at the back-end when people are already too sick.

Of course more can always be done. We're prepared to consider further steps to be taken.

But this is a community-wide problem. It needs the community, it needs health professionals, it needs families, and it needs the government to tackle it.

Question: How high a priority will this be at COAG?

Nicola Roxon: It's been a high priority through our negotiations up until now. Like Indigenous health, it was one of the first cabs off the rank at the 2008 November COAG. So major investments have been made. They are rolling out. Announcements have been made, for example, in Cradle Coast a half million dollar prevention project was just announced last week. These are part of our prevention investments.

So, yes, it takes time for some of those projects to rollout. But I think we are doing a lot more than the previous government, and we need to engage governments and community into tackling what is a social problem, not just a government problem.