Transcript: Interview with Jon Faine

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PDF printable version of Transcript: Interview with Jon Faine (PDF 27 KB)

ABC Melbourne

13 April 2010

Jon Faine: Well as you've been hearing in the news, the Prime Minister is making a so-called final final offer to the state premiers to try and stitch up some sort of a deal over a States and Federal Government agreement on the health system.

Nicola Roxon is the Minister for Health, and can explain to us the details of this final final offer. She's speaking to us from Queensland, where she's touring hospitals yesterday with the Prime Minister.

Nicola Roxon, good morning.

Nicola Roxon: Good morning.

Jon Faine: First of all, the timing of all of this - the final concession from Kevin Rudd to release supposedly all the details rather than doing it on the drip. Is there still though more to come after this final offer?

Nicola Roxon: Well look, this is the final proposal that we're taking to COAG on Monday, so what you've got is a combination of the financing and governance arrangements that were released nearly six weeks ago now, and the details of our additional $3 billion worth of investment in emergency departments, elective surgery, diabetes care, workforce investments, aged care - all that detail is put together in a comprehensive package.

It was provided to the states last night because senior officials are meeting today to work through all that sort of detail, and of course responding to the state premiers' requests to release this information so they can work through it property before Monday.

Jon Faine: Was it a mistake not to release it before?

Nicola Roxon: No, look, we made quite clear that we had a reason for doing it in this way. Unless the financing and governance changes are agreed to and we can be confident that we've got a sustainable health system into the future and that we've got improved accountability, we've made clear that we weren't interested in making additional investments where we couldn't be confident how the money would be used.

So I think it was appropriate to have that discussion first. It was a complex one. It's been a very good debate, I think both publicly and between the premiers and the Commonwealth.

And now we've released these other components, which of course deal with pressure points in the system where we know that immediate investment can help either clear the backlog or restructure some of the services where maybe capital money is required to do that.

Jon Faine: You say investment. Your critics say you're just throwing money at a problem with no plan. This is being said by everybody from nurses through to private hospital providers. Everyone's saying this is a hallmark of the Rudd Government - it's the same with school building program - you just throw money at a problem and think that fixes it, Nicola Roxon.

Nicola Roxon: Well, I don't think that hold up when you look at how this health reform has developed. This is picking up a huge chunk of the National Health and Hospital Reform Commission's recommendations.

Now, people might have had a preference to see it all together. There now are two very detailed documents that do bring it together. And I think that you can tick off a vast number of their recommendations, including things like access guarantees, which we've just over the last few days announced for emergency departments and elective surgery.

So I don't think it's right that this is, can be regarded as a throwing money at the system or piece by piece. It is part of a whole reform story that we have worked through very carefully.

Now people might have liked to see it together. We can argue about timing. But ultimately this package holds together of dealing with our main pressure points, reforming the system so that we can deliver better health and better hospital services to the community.

Jon Faine: And yet at the same time you can't guarantee that no state will be worse off, if I can paraphrase the jargon used in the debate about industrial relations. In Victoria, quite rightly - and you're speaking to Victorians now - Victoria is saying, well we're not prepared to go backwards because other states have been hopeless in reforming their own systems.

Nicola Roxon: Well we can guarantee that no states will be worse off in terms of…

Jon Faine: Well John Brumby doesn't believe you so far.

Nicola Roxon: …financial arrangements. No, and look every Premier is entitled to put their view and argue for their constituency. But I think it is dangerous to think that simply more money, without reform, would actually fix the system, and that does need to be some of what Mr Brumby is putting forward.

We've put extra investment with changes to the way services are provided attached to it, because we don't think more of the same is going to be either sustainable, and in some instances isn't good enough.

So that's really the nub of the discussion that now will be had on Monday in Canberra between the premiers and the Prime Minister, and we're very hopeful it'll be a constructive discussion and that Premier Brumby and other premiers will be convinced that together we can deliver a better outcome if we sign on to these plans.

Jon Faine: Well, everybody says, oh better outcomes, better health care and all the rest of it, but the devil is in the detail and we judge you by what you do not what you say.

And Health Minister, the issue in Victoria, for instance, you're throwing hundreds of millions of dollars at aged care, elective surgery now also - pulling rabbits out of hats - and yet people are saying well we've heard all of this before.

And why should we this time believe that it will make a real difference when minister after minister after minister in government after government after government have made similar pronouncements?

Nicola Roxon: Well, I don't think that we can bear the responsibility for, you know, previous governments for the last 20 or 30 years. We have actually been investing and doing things differently for the two years that we've been in government.

The reforms that we're putting forward haven't been done before. There hasn't been a commitment, for example, to a four-hour access target for emergency departments.

There hasn't been the significant investment in primary care coordinating how our GPs and nurses and allied health professionals work outside hospital. There's been no visiting of major change to the financial relationships - who bears what responsibility for funding into the future.

This isn't more of the same. We think it's beyond time for more of the same, and we're urging premiers to look at this proposal constructively. Of course there will be other things that premiers want us to take account of - that's what this negotiation process is about - but we believe there's a real opportunity to change things long term. And it's quite an exciting opportunity…

Jon Faine: Well it might be, but…

Nicola Roxon: …that comes with difficulties if we can't get an agreement.

Jon Faine: The aged care sector told us yesterday they've been asking for this money for - to get elderly people out of hospitals and into appropriate long term care - they've been asking for it for as long as anyone can remember. Suddenly it's available because you've got a political problem to solve - you want to get things stitched up before a federal election.

Nicola Roxon: No, it's available because we've been working step by step through the reforms of our health system that are needed, and one important part of that is getting the aged care mix right.

And what the Prime Minister has been very upfront about is this isn't a panacea for aged care; the problems run very deep. It is something, though, that we can fix step by step, and these are the first steps for us to be able to do that…

Jon Faine: But there's no aged care nurses, there's no specialist staff. If you create the extra money for extra beds, how do you operate them?

Nicola Roxon: Well, the nurses have been very active, and the ANF in particular has been very active in arguing for better standards in terms of staff and numbers. We understand those arguments.

And as the Prime Minister - he specifically addressed this yesterday - said, we've got to also make sure that the community can get access. We have to rebuild things step by step.

And these are the first important steps - over $700 million for us to be able to provide that care. And we'll keep working with the nurses on making sure that proper recognition of their skills within nursing homes is part of our long term changes.

Jon Faine: And finally Minister, what about some of the cultural change? For instance, weaning people off, right across Australia, the idea that if there's something wrong you go to the doctor, and introducing things like practice nurses and multi-disciplinary one-stop-shops and the like - again, been talked about for years, but where's the action, where's the plan?

Nicola Roxon: Well, the action, actually, our record is good on this. We have just passed through the Parliament the first ever recognition that Medicare payments and PBS script writing should be available for nurse practitioners and for midwives - the first time new professionals have been added to Medicare for many, many, many, years.

Jon Faine: When does that start?

Nicola Roxon: I beg your pardon?

Jon Faine: When will that then start?

Nicola Roxon: That will start on 1 November this year. It was a very difficult process to get it through the Senate, but I am pleased that the Government's plans have now been adopted. It's a big change.

Our GP super clinics are being established across the country. The Prime Minister and I, for example, went to the facility that's being built in Geelong.

It's going to be a great service that's co-located with Deakin University, so that we've got young health professionals being trained in primary care settings, not just in hospitals. Again, a big change to the way we think about where important investments are needed in our health system.

Jon Faine: All right.

Nicola Roxon: All these pieces of the puzzle have to fit together. We think the jigsaw puzzle is fitting together in this plan, and that's what we want to work with the states and territories to deliver.

Jon Faine: When's the election?

Nicola Roxon: Well, you'll have to ask the Prime Minister, but I suspect he won't tell you either. We've made clear that we would prefer to go our full term. That means we're due for an election at the end of this year, and we're very focused, as you wouldn't be surprised, on making sure that we get our health reform plan agreed to, and that's my priority now.

Jon Faine: Well there won't be an election in December. The state election in Victoria is in November. That rules out a bit of October as well. And then you've got the Cup week preparations, from a Victorian point of view of course, but nationally…

Nicola Roxon: You think I should start campaigning do you, Jon?

Jon Faine: Well I think you should, because then you go back to the football finals, the school holidays, that rules out September, and you could have an election in June, July or August really, couldn't you?

Nicola Roxon: Well, you certainly could. I don't know whether we will, and that's something that is up to the Prime Minister, but he's made clear that he expects us to go full term. And what I'm absolutely focused on is getting a good deal for the community in reforming our health system.

Jon Faine: Well the overall impression is the decks are being cleared in readiness for a campaign that will start in months. Thank you for your time today.

Nicola Roxon: That's a pleasure.

Jon Faine: The Federal Minister for Health, Nicola Roxon.