LEON CROMPTON: Increasingly, when the state government is talking about delivery of health services in Tasmania, there's some blame being allocated to the Federal Government for lack of money. Now and over the next five years, it's money that the state government say has been promised to Tasmania but doesn't look like being delivered. The State Government say that federal Labor will underfund Tasmania by $673 million over the next five years.
AUDIO FROM THE HON BRIDGET ARCHER, MINISTER FOR HEALTH, TASMANIA: On the current projection, over the next five years, Tasmanians would face a $673 million shortfall of health funding from the Federal Government. And that is obviously short changing our health and really making it more difficult for us to deliver the services that Tasmanians rely on. And this is just not keeping up with demand. So, we're really urging the Federal Government to get on quickly with negotiating this new agreement and to ensure that states are actually receiving their fair share of that funding and that our hospital systems aren't going backwards.
CROMPTON: That's Bridget Archer talking with us a week or so ago, the state's health minister, and it seems that that the Australian Medical Association (AMA),agree with her assessment.
AUDIO FROM AMA TASMANIA PRESIDENT DR MICHAEL LUMSDEN-STEEL: Well, we know we've got a funding crisis in Tasmania and we know that from having to go back to the polls, what we don't have in Tasmania is a health service plan to meet the demand and is funded by the demand. What we've got is an historical funding model that gets a top up every year from the Treasurer that actually isn't meeting the demand.
CROMPTON: So that seems to be some consensus here in Tasmania about how things are looking out over the next five years. Rebecca White is Assistant Minister for Health and Aged Care with the Federal Government. Rebecca White, good morning to you.
REBECCA WHITE, ASSISTANT MINISTER FOR HEALTH AND AGED CARE: Good morning, Leon.
CROMPTON: You're short changing Tasmania. That's the assessment of Bridget Archer and it seems the AMA agree. Why?
WHITE: Well, we're not at all. In fact, the Federal Government provides 70 per cent of the funding for Tasmania's entire budget. And Bridget spoke about the negotiations that are currently underway and have been continuing since late 2023, in which the deal that we've put to Tasmania means they will be better off. I'm not quite sure where she's getting her figures from, and I'd encourage her to negotiate directly with the department rather than through the media because I think we can all see what's going on here. The Tasmanian Government has badly managed the budget over a number of years now. We're seeing record debt and deficit and they're just pointing the finger at Canberra because it's easier than actually dealing with the problem they've created themselves.
CROMPTON: You are currently negotiating. You talked about this as a government back at a National Cabinet meeting in late 2023 and you talked about the funding cap to Tasmania being increased and health funding would increase generally. They're obviously concerned that they are not the terms under which these negotiations are happening at the moment.
WHITE: Well, that's certainly not what advice has been provided to me either by Minister Butler's office or by the department. We are negotiating in good faith and the deal that's currently before the state to consider sees them better off. And as I said, the state government benefits from the Federal Commonwealth Government investing into Tasmania's health and hospital system. We know in Tasmania we've had challenges with our health and hospital system for a very long time. And ultimately it comes down to the priorities of the government of the day to invest in the services Tasmanians need. And the Labor Party here has long been calling on the Liberal government to better prioritise health investment, supporting our workforce and supporting patients to access the care that they need. I would continue to urge them to focus on that as their priority and negotiate with the Commonwealth as we have been doing in good faith because we want Tasmanians to benefit from better health care. It's why we've seen the Federal Government prioritise investments in our Medicare Urgent Care Clinics. We've stood up five, we're expanding that to three more. That is helping take pressure off our emergency departments. Here in Launceston, we've seen a reduction in presentations for those category four and five patients now able to access urgent care through Medicare Urgent Care Clinics. We are doing a significant amount when it comes to supporting patients to access health care in our state. I just push back on the State Government's rhetoric here. They are looking to blame somebody because of their own mismanagement of the budget.
CROMPTON:Is Dr Michael Lumsden-Steele from the AMA correct that Tasmania is funded on the numbers when in reality we have an older, sicker population, a more diverse or dispersed population, and that what we should be funded on is the level of demand in the system instead?
WHITE: What I heard him say on your programme is quite true. What he talked about the State Government doing is that year they chronically underfund health and then they rely on the Treasurer to provide a top-up because they try to make the forward estimates look good, so this is they're trying to make the budget look good, rather than trying to support patients and the health workforce to provide a better health system. Every year they chronically underfund health to make it look like they're returning the budget to some kind of pathway to surplus, which we know is not true because there are structural challenges there that they haven't addressed. And every year the Treasurer has to put more money in because they simply have not been able to fund the health system with the budget they were initially allocated. I do agree with his assessment of how the Tasmanian Government's managing the health budget. It is a problem. They aren't properly funding it at the outset. It is leading to significant challenges and constraints. It's putting stress on staff and it's restricting patients' access to care.
CROMPTON: But to be fair, these issues are not unique to Tasmania. States around the country are having problems, for example, dealing with bedblock, finding the aged care spaces, for example, for people to leave hospitals safely and return to or go to aged care for the first time or supported NDIS places that take them out of hospitals, which the states are struggling to manage. It's happening statewide. Can the Federal Government do more, Rebecca White?
WHITE: And we are doing more, Leon. And as a part of these negotiations, we're also talking about how we support better access for patients who need aged care or residential aged care settings, but also those who rely on the NDIS All of that is included in our negotiations with the states for the Commonwealth Agreement. And we've also now seen from the 1st of November, there'll be more than 60,000 more packages come online for support at home. And from a couple of weeks ago, 20,000 packages were opened up. I know that there are a lot of people waiting far too long for aged care packages here in Tassie. You've had people on programme talk about that as well. We need to do better and we are working to do better. It's a significant investment that the Federal Government's making, more than $4 billion and we are opening up more packages as we speak.
CROMPTON: On Mornings Around Tasmania, Rebecca White's our guest this morning, Assistant Minister for Health and Aged Care in the Federal Labor Government, also Assistant Minister for Women. One of the things that caught me during that story, and you would know this part of the story well, is that you can talk about delivering more care packages, but the question for regional Tasmania is where will they fall? You would know the GP in Bicheno who gives us a call and says her problem is access for her patients to these packages at all. What, if anything, will the Federal Government's increase in packages do about that, Rebecca White?
WHITE: We have talked to Dr Liz Grey before and I speak to her fairly regularly, but I also speak to our aged care providers around the state and they are telling me that they've got workforce ready to support the new packages which is part of the issue. We know that without workforce it doesn't matter how much money you throw in the system you're not able to support patients. It's why we've been investing in the workforce through an uplift in aged care workers pay of 15 per cent free TAFE places to support more workers coming through the system. It has to go hand in hand with new money. I'm very pleased through the conversations I've been having with aged care providers around certainly my electorate of Lyons to hear that they are comfortable with their staffing levels at the moment. They feel ready to support these new packages as they come online. And that's something that I hope we start to see delivered now that this new money is coming into the system.
CROMPTON: Rebecca White, let's talk about concerns about some of the other changes your government's making from the 1st of November this year. Proposed changes to how much people will pay for home care packages, for non-clinical care. Those charges could increase by 5 per cent to 50 per cent. That's things like showering and help getting medication on board. And for everyday living, so things like gardening, might be someone coming over and helping with your cleaning. Charges could increase to between 18 per cent to 80 per cent for people coming into the scheme. Is that fair?
WHITE: Well, I'd just say at the outset that we know from the Royal Commission that we were told some of the significant failings in the system. I mean, that report was titled Neglect. And there are significant reforms that are underway. You've spoken about parts of those.
CROMPTON: This is about saving money, isn't it?
WHITE: Not at all. As I said, there's more than $4 billion that's going into these aged care reforms. We will continue to fully cover the cost of all clinical care for those in residential and in-home care. You're talking about the non-clinical components. There will be lower contributions for pensioners and Commonwealth senior cardholders, and we'll make sure that anyone who's in financial hardship has the assistance that they need. But we need to also ensure that we have a robust and sustainable aged care system. As we've got an ageing population, not just here in Tassie, but right across the country to support them to access the care and additional supports they need as they age, whether that's in home or in aged care. We're going to monitor the impact of this to make sure that there is equity in the system and that's something that I'm always happy to hear about, whether they're a family member or they're somebody who's accessing care or someone who's providing care, to make sure this is working as intended. You're right, this is a big reform. There are going to be bumps along the way and there might be some things that aren't necessarily what we expected. And that's why it's important for us to hear that feedback so we can make sure we have adjustments where they're necessary. But I just remind people that this is an important reform that came on the back of the Royal Commission It is intended to address the neglect that we've seen in the system, to put more money in, support more staff and more importantly than any of that, support people who are ageing in our community to do that with dignity.
CROMPTON: Okay, final question for you. People might understand that when you get a home care package, you might start at level one, but it goes level one, two, three, and then four for the highest level of care. Your government has said it won't work retroactively, so if you're already in the system, your charges will stay your charges. Rebecca White, what if you go from a level three to a level four rate of care? So you get upgraded in terms of your care. Will these new charges start applying if that shift happens?
WHITE: To be honest with you, Leon, that's a great question. And I don't have a clear answer for you, but I'm happy to come back and see if I can share some details for your listeners about that.
CROMPTON: Appreciate you talking with us this morning. Thank you. Minister for Health and Aged Care and Assistant Minister for Women, Rebecca White. We're going to talk more about those changes in aged care charges after nine o'clock this morning. I'd love you to be part of that conversation. We've got somebody who's running one of the services that provides that care. If your package changes and you go from a level two to a level four, that happens quite commonly, then will you be caught in this new system of charges? How will it work? We'll get back to Rebecca White and get an answer on that.