Subjects: health.
E&OE..................
(tape break)… I think it';s particularly relevant in the light of some of the initiatives I';m going to outline that we are releasing the Coalition';s health policy right here in an outer-metropolitan area of Melbourne because much of this policy is directed towards the needs of people living in outer-metropolitan Australia, which will build on the many initiatives that the Government has undertaken over the last five and a half years.
Can I stress at the outset that the new measures that I announce today which are worth $306 million and will build very significantly on the improvements to health policy and health provision in Australia over the last five and a half years, they are, unlike the policy proposals of our opponents, eminently affordable. We are half way through this election campaign, we have two and a half weeks to go and Labor is back to its old deficit tricks. If you look at the promises Labor has made to date they already have a budget deficit for next year if they were to win, in the red to the tune of $200 million. And we';re only half way there. Think what it';s going to be like by the 9th of November. So I stress at the outset that what I announce today is affordable and all of the policies that we will be announcing between now and the election will fall into that category.
Labor asks us to believe that they are born again believers in keeping the budget in surplus. Don';t listen to what they say, remember what they did. When they were last in Government they left us with an accumulated national debt of $96 billion. By the end of this financial year we will have repaid $58 of that $96 billion, they';ve tried to stop us doing that. If they get back into office they';ll run the budget into deficit as surely as night follows day and that will drive interest rates up as surely as night follows day. So my first message to you today is that unlike Labor';s accumulated promises, which are already projecting a deficit of $200 million in the coming financial year, our policies are affordable. Because my friends the foundation of any social policy is a growing economy with low inflation and low interest rates and the capacity to grow further into the future. If you don';t have growth you don';t have revenue, if you don';t have revenue you can';t spend more money on health and education and all the other public services our community needs.
In announcing this policy today I take very great pride in telling you that the Coalition is building a balanced health system that ensures that all Australians have access to high quality health care. We are committed to a strong and sustainable public health system, Medicare, that provides access to high quality care regardless of income. We are also committed to strengthening Australia';s private health care system to give people more choice and to help sustain Medicare by taking the load off the public hospital system. And we are committed to rebuilding health and medical services in Australia';s country towns, our regions and urban fringes so that people have access to high quality services regardless of where they live.
The initiatives that I announce today build on five and a half years of solid achievement by the Coalition Government in health policy. This financial year, the Coalition Government is spending $29 billion on health, compared with $16 billion, $16 billion in the last full financial year of the Keating Government and that was 1994-1995. We have strengthened medical services provided through Medicare. Under the Coalition, the number of services bulk-billed has increased substantially. More Australians have access to free medical services than ever before.
The 2001 Budget alone provided an extra $750 million, $750 million over four years to Medicare to improve access to GP care for all Australians. These funds will enable General Practitioners to provide better care to patients with asthma, diabetes or mental illness. We are also funding GPs to increase the number of women being screened for cervical cancer, especially women living in rural and regional areas, migrant women and indigenous women.
The Coalition has also provided record funding of about $32 billion to the states and territories for public hospitals through the Australian Health Care Agreements. This my friends represents a 28 per cent increase, 28 per cent real increase, that';s over and above the inflation rate, over the five-year lives of these agreements, compared with a real increase of only 18 per cent under the last agreements negotiated by the Keating Government. Once again I invite you to compare what they say they will do with what they did do when they were last in Government. This increase includes about $3 billion that the states had previously agreed to pay back if private health insurance membership rose to its current level. We have allowed the states to keep this money, even though their public hospitals come under less pressure when more people use the private health system. Now that is a very important consideration, we subsidised people taking out private health insurance, we lifted the number of people in private health insurance. The original health medicare or health care agreement says that if it got to a certain level then the state would have to repay a certain amount of money to us. We have forgiven that obligation and as a result the states have under our Government an additional $3 billion that they had previously agreed to pay back.
The 2000 Budget provided $562 million over four years under our Regional Health Strategy, the most ambitious initiative ever to provide more health and medical services across country Australia. That strategy will provide 200 post-graduate training places each year in the country for General Practitioners, leading to an almost immediate increase in the number of rural GPs. It will establish nine new clinical schools in the country to train medical students. And doctors trained in the country as everyone knows are more likely to stay in the country. It will also establish more health and medical services in rural communities, including 85 more of the popular Regional Health Services.
The Coalition has also revitalised Australia';s private health system and given Australians more choice in health. Our 30% rebate, worth $2.5 billion a year, which the Labor Party voted against and we only got through the Parliament with the support of Senator Brian Harradine and remember that when they go around the nation saying they';re in favour of the tax rebate, they voted against it, they voted against it after the 1998 election. And other initiatives like lifetime health cover and closing the gap have also made private health cover more attractive and improved industry performance.
These measures have led to approximately three million more Australians with private health cover. Today, 45 per cent of Australians have private health cover, compared with fewer than 34 per cent in 1996. More people using more private health services are already taking pressure off our public hospital system.
Importantly in the area of preventative medicine the Coalition has immunised Australia';s children. Today, 95 per cent of infants and 95 per cent of school-aged children are fully immunised. The 1998 Measles vaccination campaign alone immunised over 2 million children. That is a world-class achievement.
And since coming into office, the Coalition has doubled spending on indigenous health services. 44 indigenous communities, some with populations over 1,000, have gained access to basic health services for the very first time. Our ATSIC/Army Community Assistance Programme has improved the delivery of essential services, like power and water, to indigenous communities.
The 1999 Budget doubled the funds available for health and medical research, with an extra $614 million for the NHMRC over a period of six years. By doubling the money being provided to Australia';s world class medical researchers, we will maintain the reputation that this country has always had in the area of medical research of punching well above its weight.
Turning now to the future and for our third term agenda the Coalition will build on its achievements over the last five and a half years with a comprehensive plan to further strengthen Medicare, strengthen the private health sector and provide better access to health and medical services across Australia, regardless of where people live. Today I announce a $306 million package to provide more doctors in outer-metropolitan areas, better after-hours care, better treatment for cancer patients, better palliative care in the community and better care for people suffering from arthritis.
Firstly more doctors for outer-metropolitan areas. Doctor numbers in outer-metropolitan areas need to keep up with recent rapid population growth in these parts of Australia. Therefore the Coalition will increase the number of doctors who work in the outer-metropolitan areas of all six state capitals. And this initiative is directed very much at electorates like La Trobe and this initiative is all about making sure that Australians who live in the outer-metropolitan areas of our big cities have access to the same services as all other Australians. To that end we';re going to provide $80 million over four years to bring an additional 150 doctors to practice in these areas. Specialist trainees and researchers will be enabled to work in supervised general practice programmes in these areas and they will be encouraged to work after hours and on weekends. Doctors undertaking the general stream of the GP training programme will be required to train in designated outer-metropolitan areas. And GPs can complete a fast track vocational registration programme by working in a designated outer-metropolitan area and thus become eligible for higher Medicare rebates and for practice incentive payments.
The next item of new initiatives for the third term is better after hours care. The Coalition has already acted in this difficult area by increasing after-hours rebates under Medicare by 50 per cent this year but we will go further and provide $43 million over four years to establish 32 after-hours clinics across Australia, predominantly in outer-metropolitan and rural areas that do not have good access to after-hours care. These clinics will be set up in collaboration with local GPs. Once again an initiative aimed very much at the legitimate concerns and the legitimate requests of people living in outer-metropolitan areas such as the electorate of La Trobe and the area where we are now meeting.Thirdly, in the area of providing better treatment for cancer patients it is important for all of us to bear in mind that people with cancer must have access to world-class diagnosis and treatment. Therefore, we will provide $73 million over four years to improve access to radiation oncology services for people living in country Australia. At present, there are only eight of these services located outside capital cities. Up to six new services will be funded under this proposal. The location and the operation of these new services will be determined by the results of an inquiry into radiation oncology recently announced by the Government and due to report in early 2002.
We will also provide $44 million over five years for six new Positron Emission Tomography scanners around Australia. Those scanners are especially useful in diagnosing and treating cancers of the brain and of the lungs. These new scanners will provide people with cancer and their doctors with access to the latest technology.
Fourthly, the area of better palliative care. People who have terminal illnessess deserve to be treated in a dignified manner and in circumstances of their own choice. The Coalition will therefore provide $55 million over four years to equip health workers such as GPs, community nurses and other allied health professionals to improve the standard of palliative care offered in their local communities, including pain management. This measure will support people choosing to die at home and will also provide more assistance to families of those who choose palliative care. A strong emphasis will be placed on the delivery of palliative care for people in residential aged care and people living in regional and remote areas.
And finally the area of arthritis treatment. As our population ages, arthritis will become an increasingly major health issue. Three out of four Australians will develop some form of arthritis during their lifetime. The Coalition will provide $11.5 million over four years to improve access by GPs to quality treatment and prescribing information and help arthritis sufferers and their families with advice and support in managing diet and exercise. In addition, we will make managing arthritis better a National Health Priority area, in consultation with the states and territories. Disability brought about by arthritis is a common form of entry and reason for entry into residential aged care and better management of the condition can be very effective in helping people to remain at home for a longer period of time.
Now those, ladies and gentlemen, are the specific new health initiatives, totalling a $306 million package which will add to the health achievements of the Coalition Government over the last five and a half years. I';m very conscious that in the area of health that new agreements with the states and territories are due to commence in July 2003. And the Coalition will initiate negotiations with the states early in the next term, with the following major objectives. Firstly, reduction of public hospital waiting lists and waiting times. Secondly, reduction of medical mistakes in public hospitals. Thirdly, more investment in step-down care and rehabilitation services and infrastructure to allow people discharged from hospital to be treated and cared for at home wherever practical. Fourthly, improving on the strong safety and quality focus that is a feature of the current agreements. And finally ensuring that the states and territories share in overall increases in funding commitments to public hospitals. And in addition I commit the Coalition to a situation where the agreements will not contain any penalties on the states should private health insurance membership reach particular levels. In other words, if people in private health insurance continue to increase then there';ll be no clawback or no penalties despite the fact that in the process additional strain is taken off the public hospitals.
The Coalition will not allow Labor states to get away with under-funding their public hospitals or ignoring peoples'; wishes to have more post-hospital services provided in the community and at home.
Can I just before concluding say one or two things about the alternatives offered by the Labor Party in the area of health. I happen to hold the view ladies and gentlemen that although our health system is far from perfect and although it is an area where there is always room for improvement and it';s an area where more money can always be provided and used, if you look around the world, health services in Australia, particularly for the less well off are better than anywhere else in the world. If you look at the health system of the United States, if you look at the health system of the United Kingdom, if you look at the health system of other European countries and then with all its imperfections you compare it with the health system in this country you find that ours is superior. It does need improving and I';ve outlined a number of initiatives where it can be improved, but the charge being made that our health system is in crisis is inaccurate.
The charge being made that it';s all the fault of the federal government is wrong. The reality is as I have outlined, that over the last five and a half years we';ve provided massive further funds off the back of a growing economy and as a result of a growing economy rising revenue collections. And we';ve introduced a taxation system which over the years ahead will provide the states with more money each year, more money each year to spend on public hospitals and to spend on government schools and police and road services and all the other public services that state governments should provide.
The Labor Party showed after 13 years in government and five and a half years in opposition that they do not really understand what constitutes good health policy. Private health insurance coverage was 65 per cent when Bob Hawke defeated Malcolm Fraser in the 1983 election and it fell to under 34 per cent in 1996 when they were defeated in the election that year. And the reason it fell is that they don';t believe in it and it';s important to remember that when you look at their commitments during this election campaign to retain it. GPs and specialists left rural and regional Australia in large numbers and rural health services declined. Our childhood immunisation rate under Labor fell to 53 per cent, that is a third world standard, it was a disgrace that a few years ago the immunisation rate in this country for children was barely over one in two. And we have as a result of the campaign we introduced, we have lifted that with enormous ongoing benefits in the years ahead to the health of Australian children. Medical research was neglected and in their last term, Labor cut the forward estimates of the NHMRC Budget by $50 million a year.
But now in this election campaign the Labor Party is proposing what is called a Medicare Alliance with the states. With almost no detail on how this alliance will work, Labor';s policy is little more than a public relations exercise providing no real assurance of additional health and medical services. Yet it';s the core of the alternative offering of the Labor Party in this very important area. At the heart of this alliance are what are called Medicare Joint Accounts for each state that would pool Commonwealth and state funds covering hospitals, aged care, medical benefits and pharmaceuticals. This proposal raises a number of fundamental questions that the Labor Party has not answered. For example, how could Labor assign Commonwealth medical and pharmaceutical benefit funds to the joint accounts without capping them? Would the states be required to contribute to cost overruns above the funding caps? If not, how could the alliance be a panacea for cost-shifting, one of the main benefits claimed by Labor Party? Would a requirement to contribute to cost overruns entitle states to a say in medical and pharmaceutical benefits policy? This could lead to different policies between the states. Let me illustrate. An expensive pharmaceutical could be on the PBS list in New South Wales but not in Queensland. GP rebates could be higher in Victoria than in Western Australia, with consequent lower bulk billing rates in Western Australian. Labor';s Medicare Alliance would fragment or balkanise Australia';s health system.
When pressed in a question in the Western Australian Parliament yesterday on the risk-sharing arrangements to underpin Labor';s Alliance, the Western Australian Premier Dr Gallop admitted that it was only, quote, “an agreement in principle” and the details would be worked out later. Quite clearly, Mr Beazley and Dr Gallop don';t have a clue about how the centrepiece of their health policy is going to work. The Alliance is nothing more than an illusion. The only certainty in Labor';s policy is more bureaucratic, more commissions and talkfests. They can';t guarantee any reduction in public hospital waiting lists which are fundamentally the responsibility of state government administration. States run and substantially fund public hospitals, we supplement their funding with generous payments under the Medicare agreement. We don';t run the hospitals, therefore the responsibility in relation to waiting lists rests with those that do run them. They can';t guarantee any more doctors and medical services in country Australia. They can';t guarantee any progress on key public health goals for asthma, cervical cancer or anti-smoking. And they can';t really given their track record in government and their refusal to support the legislation after the 1998 election give any plausible guarantee that if they were to become the government they would retain the 30 per cent private health rebate in full.
Ladies and gentlemen the Coalition';s agenda for health involves retention and further strengthening of Medicare. It involves a retention of a very strong commitment to a balance in our health system between public and private provision. But most importantly of all what the Coalition offers for the next three years is a strong, growing economy and a strong growing economy is the foundation for the capacity of any government to provide increased funding in areas like health and education.
It';s one thing to promise you';ll spend more on health and education, it';s another thing to have the ability to run the economy at a sufficiently higher level of growth without inflation breaking out and interest rates going up to guarantee that you';ll have the funds to meet the promises that you make. Over the last five and a half years we have met our promises on Medicare. We promised in 1996 that we would retain it and strengthen it and we have. We said we';d make provision for private health insurance and we have. We said that we would strengthen medical research and we have. And we are committing ourselves to five very important initiatives worth more than $300 million which are of particular benefit to outer-metropolitan Melbourne.
Ladies and gentlemen it is a credible building for the next three years on the health policy achievements of the last five and a half years and the policy that I announce today is of particular benefit Bob to the people that you represent. And we';ve done that because the need in outer-metropolitan Melbourne as in outer-metropolitan Sydney and outer-metropolitan Brisbane is in the areas that I';ve outlined and I know those initiatives will be very warmly supported by the Australian people who live in those parts of our country.
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