Transcript - Interview with Adam Spencer on ABC 702 Sydney - 12 April 2011
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Adam Spencer: Nicola Roxon, the federal Health Minister, has been a regular guest on this program and it's a pleasure to welcome her again to the show. Good morning, Ms Roxon, how are you?Nicola Roxon: Good, thanks, how about you?
Adam Spencer: I'm well, thanks. An exciting day because electronic health reform has been a big part of your agenda. What's happening today with - in the area of electronic patient records?
Nicola Roxon: Well, the delivery of an electronic record for every Australian who wants one got a step closer today because we've released the concept of operations which is a quite detailed document but it explains to consumers, to the health professions, to the technology industry and software developers how all the different pieces are going to fit together, what they will be able to - excuse me… .
Obviously too early in the morning. I'm sorry, I'm croaky.
Adam Spencer: No trouble at all.
Nicola Roxon: We'll be explaining to consumers what they will be able to access and the benefits to them but also the design of the system so that all of our wonderful industry players can get out and design parts of the system so that they'll all be able to speak with each other when we want to make this system available to the whole community from 1 July next year.
Adam Spencer: And the idea of a system like this is - how will it affect my day to day dealings with my doctor and my health system?
Nicola Roxon: Well, the main benefit for consumers is that, particularly if you use the health system a lot, is that you'll be able to have all the information about your health, your latest tests, the medications you're on, your allergies, in one place.
So your GP will have it if you give permission to the GP but if you go travelling, if you're on holidays, if you're retiring and you're travelling around Australia for six months, you'll be able to access those records anywhere in Australia and you'll be able to give permission to any other health professional that you choose to see those records as well and, of course, in cases of emergency or ending up in hospital, you'll be able to make sure that all the information is stored in one place, not kept separately by, you know, the doctor you see in the emergency department who may or may not send records to your GP, you know, back at home.
So it's really about improving the level of information people have, making it more convenient for patients and also providing that all important protection if there's an emergency where that information's needed quickly.
Adam Spencer: Minister, under the headline Draft plan for e-health disappoints, Karen Dearne writes in The Australian newspaper's IT section today that the system will not provide real time medical information, instead it will serve copies of some clinical documents uploaded from doctors' systems in a voluntary program and I get the impression criticising that the system doesn't go far enough and isn't real time and sufficiently interactive. Are you familiar with those criticisms? What would you say?
Nicola Roxon: Yeah, I don't think that those criticisms are fair. I think actually when the system is up and running people will be able to access a lot of information.
What it does rely on is, of course, the health professionals entering information as it becomes relevant so if you've had a test which shows that you've got a particular blood condition or shows that you need particular medication, that'll be on your electronic health record, accessible to you and to any health professional you choose as soon as that gets entered on. And mostly people would be familiar that most GPs do that now while you're in their appointment.
What we need to do is make sure that that information is able to be connected with other information about you and your health when you give permission for that to happen.
Adam Spencer: If this system does come online, so to speak, when will it be up and running, Minister?
Nicola Roxon: Well, 1 July next year is the switch-on date. We do plan to have about half a million Australians in different parts of the country on the system before then because we've funded what are called lead sites for health professionals and regions that are early adopters and early adapters who are testing out how the system can best work so that health professionals can use it easily and consumers can have control over their own information.
Adam Spencer: Can I ask you, whilst I've got you there, Minister, of course, one of the most important aspects of a country's health performance and health industry is the research that goes into medical breakthroughs and employs some of our best minds to make our medical system and the treatments available to us better. It seems to be a poorly kept secret that the Budget is planning a significant cut to the NHMRC grants regime, a figure of anything up to $400 million is being quoted. Would you be concerned if $400 million was going to be taken out the NHMRC?
Nicola Roxon: I think that this has got a bit of a life of its own, as you see happen usually before the Budget. You know, lots of things that are written before the Budget are not accurate.
What is accurate and I've been public about is that every single dollar that we put into the health system has to be constantly assessed to see if it's being spent in the most efficient and effective way.
Adam Spencer: But you'd agree with NHMRC it's something like only 23 per cent of all claims are funded anyway, when anything up to 70 per cent of the claims that are put into the NHMRC are deemed worthy of funding. So is anyone seriously suggesting there's fat in the NHMRC budget?
Nicola Roxon: No, what people are suggesting is that we always need to make choices as a government and those choices are going to be difficult ones in this Budget but it does seem to, as I say, have had a bit of a life of its own without any information being provided from us.
What is clear is that in this Budget across the health portfolio and across all portfolios, we will have some difficult choices to make, to ensure that we can continue to invest in important areas that are pressing also.
I mean, we need to invest more money in mental health. We need to make sure that our hospitals continue to be sustainable and that we have enough GPs across the country.
These are all issues which need to be carefully considered and of course we would be carefully considering any impact, if you needed to make any cuts or changes in areas of research or elsewhere in the health portfolio.
Adam Spencer: Is it true that with the nature of grants being allocated for years to come when they're given out that if there was a significant budget cut to NHMRC now it would disproportionately skew towards new researchers, new labs, start-up projects because a lot of money has already been allocated, if there was to be an impact that's where it would disproportionately be felt?
Nicola Roxon: Well, I think it's true when you look at any programs that have a long lead time, grants that are allocated with the NHMRC can often be for, you know, five, 10 and 20 years, so of course you don't ever look at options which might cut into projects in the middle of their funding but I really think this is getting ahead of ourselves and I absolutely respect that the media's going to keep asking us about this but the Budget is several weeks away, we don't make announcements about the Budget ahead of time and there are difficult choices that we have to look at.
We need to make sure the health system is sustainable as our population ages and has more chronic diseases so we do need to invest strategically to make sure that our system is strong and that we can provide the best health outcomes to the community.
Adam Spencer: But in terms of strategy, as a long term thing rather than a year-by-year thing, submissions that have been made on this show suggest that for every dollar spent in medical health research five dollars is made down the line. Is that sort of analysis accurate in which case isn't a small amount of funding to be maintained at the moment a wise investment?
Nicola Roxon: Look, I think that it is clear that our government has acknowledged that value because what you've seen since we've been in government is the rates of investment in research, in medical research, increasing. It's continued to increase by many, many times since we have been in government so we understand that but it, as well as other expenditure, whether it's in pathology where we've just announced yesterday a save of over half a billion dollars which we've negotiated with the industry, we need to look at growth and we need to look at any way that we can keep that growth in expenditure under control.
Because similarly you can look at other parts of the budget I'm responsible for, like screening tests which also you spend a very small amount of money upfront and you save a very large amount of money by detecting disease earlier and of course you save many, many lives. So in health there are only choices between good and worthy projects. There's not very much money that goes into things that people don't think are important. So we just need to deal with those priorities and that's what the budget process that we're currently going through will do.
Adam Spencer: One thing that a lot of organisations and individuals are trying to communicate to the Government is they feel that given that we are in - blessed with one of the strongest economies in the world at the moment, you're talking a $14 trillion budget deficit in the United States, where they still are increasing investment in health and medical research, as far as I understand, billions of dollars deficit in the UK, a lot of people are concerned that this government is too obsessed with getting us back into budget surplus as quickly as possible when by any international standards at the moment we're doing remarkably well. Are you hearing that message from people, those concerns that short-term cuts to make the budget into deficit [sic] a matter of months earlier than it might otherwise be, could have long-term detrimental effects?
That's what the experts are trying to communicate, I get the impression.
Nicola Roxon: I absolutely understand that people can have that view and of course we hear that. As politicians we obviously are attuned to listening to lots of advice and ideas and recommendations that people give us but this is not a budget where we're looking at the short term. This is a budget where we have to look at the short term and the long term and in health more than in many, many other areas we do need to look at how we can continue to have the system be sustainable.
Now, I'm in a portfolio where we have requests for new expenditure that are billions and billions of dollars each and every time.
We have the, you know, Medical Association saying that there should be five billion extra dollars in mental health and a similar amount of money in Indigenous health and that we should never find savings in particular areas that might affect their membership. Now, we just don't have a magic pudding of money to be able to meet each and every one of those demands and our job as a government is to weigh those requests, to look very carefully at any impact and to make the best decisions about balancing both the short and long term interests and, in Health, in making sure that we're going to give all Australians the best possible chance at getting the best possible health care well into the future and that's what we'll be doing in this Budget.
Adam Spencer: Minister, as always, a pleasure to speak with you.
Nicola Roxon: Thank you, Adam.
Adam Spencer: Nicola Roxon there, is the federal Health Minister.
Ends
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