PM: Good afternoon everybody. Everyone knows we face long term challenges when it comes to Australia's health and hospital system and prior to the election we said we would establish a National Health and Hospital Reform Commission, and today, I'm implementing and honouring that pre-election commitment.
We have, of course, a challenge when it comes to all the long term challenges in our system: duplication, overlap, cost shift, blame shift, ageing population, the explosion in chronic diseases, not to mention, long term workforce planning.
This, therefore, creates not just a problem for the next week or the next month, it creates a problem and a challenge for the decade ahead. That why the system, our national health and hospital system, is in need of radical surgery.
Of course, so far, we have at work our COAG Working Group with the States and Territories dealing with the specific implementation of a range of commitments we made on hospital funding and other elements of health funding prior to the election. And that COAG Working Group is also working on the whole question of the Australian Healthcare Agreements.
But it's important that we just are not focussed those challenges, important as they are, it's important we're also dealing with the challenges in the long term. That's why it's critical that we proceed with the implementation of this National Health and Hospitals Reform Commission, and I'm pleased today to be able to confirm the appointment of Dr Christine Bennett who will be Chairperson of the National Health and Hospitals Reform Commission.
Dr Bennett is trained as a paediatrician; she has worked in the past as the CEO of Westmead Hospital in Sydney, Australia's largest teaching hospital. She's been prior to that the General Manager of the Royal Hospital for Women in Sydney. She has also been CEO of Research Australia. She has also worked as a paediatrician in the field, as I indicated before, and is currently the Chief Medical Officer for MBF.
Dr Bennett, therefore, has a wide range of experience right across the field in hospital administration, in the private health industry where she is now, also, of course, as a clinician herself and I'm very grateful Dr Bennett for you having accepted the invitation from the Health Minister, Nicola Roxon to Chair this body.
Dr Bennett will be supported by a Commission made up of the other following individuals:
Rob Knowles who is currently chair of the Mental Health Council of Australia, formerly the Victorian Liberal Health Minister.
Geoff Gallop, former Premier of Western Australia and currently Professor and Director of the Graduate School of Government at the University of Sydney
Mukesh Haikerwal who is a Melbourne GP and the immediate past President of the AMA
Stephen Duckett,a health economist and former Secretary of the Commonwealth Department of Health. Well known in the health sector as an expert in health financing. Currently Executive Director of the Reform and Development Division of Queensland Health.
Professor Ron Penny, Emeritus Professor of Medicine, University of New South Wales. Professor Penny is one of Australia's leading immunologists and is a well known expert in chronic disease management and care.
Sabina Knightis a remote area nurse, is currently Senior Lecturer at the Centre for Remote Health and remote area nursing. She's worked extensively in remote health including in Indigenous Communities
Sharon Wilcox is director of consulting firm, Health Policy Solutions. Prior to this Dr Wilcox had 20 years experience in public health policy in Victoria, New South Wales and in the Commonwealth.
Justin Beilbyis Executive Dean of the University of Adelaide's Medical School. He's worked in general practice in both urban and rural settings for 20 years.
And Mary Ann O'Loughlinis currently a Director of the Allen Consulting Group. She was a senior Social Policy Advisor to Prime Minister Keating, and has held a number of Senior executive positions in the Commonwealth Public Service
This, therefore, is a very broad based Commission that we have established and what we've sought to do is bring together the best expertise, the most representative expertise across the country, in order to deal with this nation's long term health policy challenges.
We want to design a health and hospital system capable of dealing with the challenges of the 21 st century. And these are large challenges indeed which affect working families so directly.
Therefore it's no point just tinkering with the system. We've actually got to look at this root and branch, and do it thoroughly, that's why we said before the election we would establish this National Health and Hospital Reform Commission. We've honoured that commitment by the announcement made today, and by the appointments that we've made consistent with that announcement.
If I could ask Dr Bennett if she'd like to add to my remarks, and then, the Health Minister.
DR BENNETT: Thank you Prime Minister. This is a very important opportunity for Australia. We have a very good health system in this country, but we know it's under pressure, and we know we're going to face a lot of challenges into the future.
This is an opportunity to take people who have a lot of talent and experience in the Health System away from the hurly burly of everyday and to actually stop and think about where we want to see this health system down the track so that we can take steps toward that health system. A health system that actually focuses on the needs of our community and brings together all elements and over 30 years of experience in the health system across all those elements, it's really important we start to connect the whole spectrum of health care for our community.
So I congratulate the Government for this initiative because it is very important, very timely for us to actually stop and have a stocktake of our healthcare system and plan for the future.
PM: Thanks very much.
ROXON: Thanks very much. Kevin has taken you through the number of people that have agreed along with Dr Bennett to being part of this Commission. These are ten really top quality people. Ten top quality people who are being appointed because of their individual skills and ability.
They have each been invited to come in their personal capacity, not representing anybody that they might have worked with or for. All of them are very exited about the idea that this is a new chance for us to design some of the changes that are needed so that we have a sustainable health system into the future.
And I'm very exited and pleased to be the Health Minister making these announcements today, because I think the important work of this Commission could well provide a blueprint for us long into the future. And I know that with the quality of the people that have been appointed that we will get strong and detailed advice about a range of initiatives that may need to be implemented earlier.
Many of you would be aware that we've asked the Commission to give us some early advice on our Healthcare agreement negotiations, and of course, the longer term work that they will be doing that Kevin has outlined in his introductory comments.
So this is a really important step for us in developing a health system for the future that will be sustainable and having someone of Dr Bennett's experience, particularly having worked across so many different sectors in the health arena, provides an opportunity for us to look at the health system with fresh eyes, see how we can get the public and private sectors to work better together, see how we can get preventative health care at the front of this debate not at the end, see how we can get our hospitals working better. And it's a big challenge that you've agreed to be part of Christine, we are very pleased that you have, and I think this the first day of a very exiting period in health.
PM: Over to you Folks.
JOURNALIST: What is the framework, Prime Minister, for the Commission's work (inaudible) so is it going to be commissioned by the Government to look at particular issues? Will it be able to choose its own subjects? And what is the time frame for reporting back to the Government?
PM: The timeframe for reporting back to Government, we envisage three reporting points.
Initially, sometime between now and the middle of the year, and that would provide the Government with some interim advice on its response to the deliberations of the COAG Working Group, given that that COAG working group is also looking simultaneously at the unfolding Australian Healthcare Agreement.
Secondly, we envisage an interim report by years end. And finally a final report mid 2009. That's consistent with the reporting timetable we outlined prior to the election as well.
In terms of the program of work, what we've indicated is that it's important that this body cover the field. And that's why the expertise represented on the Commission is so wide ranging.
Specifically, we have asked the Commission to examine the inefficiencies generated by cost shifting, blame shifting and buck passing between the two levels of Government. How we deliver better integrated and coordinated care across all aspects of the health sector, and that includes of course primary health care by GP's through to hospital based care and community care.
Also, critically, the need for a greater focus on prevention. And this is absolutely core business if we're looking at the explosion and the cost across the health system of out of control chronic diseases. Type 2 diabetes is one, cardiovascular another, and unless we deal with these, the impact on our community in terms of well being, in terms of cost to budget, in terms of workforce participation will be huge.
On top of that, how do we better integrate acute services with aged care services, and how do we better develop long term health services for rural areas and the overall deep and abiding problem of proper workforce planning. It is, therefore, comprehensive in its scope. We outlined that comprehensive mandate for the proposed National Health and Hospital Reform Commission prior to the election, and it's that mandate were delivering to this body now.
JOURNALIST: Prime Minister, how will this clash with your Budget priorities to look for big savings? The Business Council of Australia suggests a three year freeze on spending. Will you exempt health and hospitals from that freeze?
PM: I noticed the BCA, the Business Council of Australia, had something pretty direct to say about how the previous Liberal Government squandered the money which came from the taxpayer in investing in this country's future productive potential.
And I note also the Business Council of Australia, by virtue of that criticism, is in effect saying that the previous Government didn't deal effectively with the nation's inflationary challenge.
Turning to the future, we believe that this is the year to do the planning. We thought that when we put this proposal together last year. This is a comprehensive piece of work. It needs to be done in the first term of a Government, because you need to get all the experts around the table and look at how the part relates to the whole.
We therefore would not be looking at the recommendations for implementation until we are into calendar year 2009.
JOURNALIST: Cost cutting in the health care -
PM: Sorry, say that again.
JOURNALIST: What about cost cutting in the health area? This is a priority now, isn't it?
PM: Well, when it comes to our Budget disciplines and what the BCA is also talking about, I'd emphasise again that we're dead set serious about our proposed Budget surplus target of 1.5 per cent of GDP. The razor gang's at work and we've been having more discussions about that in Cabinet again today, more work to be done.
But, dealing responsibly with the Budget, in the current planning period, and, planning long term for the long term needs of our health and hospital system, you need to be doing these things at the same time. And that's what we're doing. That's why we are keen to have these deliberations conducted during the course of '08. We'll be looking forward very much to the recommendations when they come to fruition in '09.
JOURNALIST: Financing, in particular (inaudible) at health insurance and in particular the private health insurance rebate as part of this root and branch review?
PM: The Private Health Insurance Rebate policy remains unchanged and will remain unchanged. What we're looking at is how the structure internally operates.
JOURNALIST: After the mid-'09 report, does the Commission stay on in some sort of monitoring role or does it wind up and, it presumably would have recommendations as to whether you would take overthe hospital system, obviously?
PM: The proposal for this National Health and Hospital Reform Commission is for a finite life through until the middle of next year. It may conclude its work earlier. I'm sure Dr Bennett's very efficient and probably doesn't want to be with us for that long. But, that's the proposal there. It's a concrete piece of work which needs to be done. Then it becomes a matter for Government to deliberate on its recommendations and to decide what policy action we need for the future.
Working families are depending on us to get this right. And we intend to get it as right as possible.
On the other point you raise, Michelle, which is our pre-election statements about the future ownership of the hospital system, whether it's Commonwealth or State, our position hasn't changed.Mypreference all along has been to do this cooperatively with the States and Territories. We are currently engaged in an extensive set of negotiations with the States and Territories within that framework. This is also consistent, the operation of this Commission is also consistent, with the deliberations of COAG in Melbourne at the end of last year. But we as a Government will make a judgment by the middle of next year whether it's working or not. And that's exactly what I said prior to the election as well.
JOURNALIST: Will it make a recommendation on that?
PM: No, the Commission's making recommendations to us on the overall design of the system against these terms of reference. That is, how do we best deliver the most cost effective, integrated, health delivery system to Australian working families?
Given the enormous challenges on the system in terms of ageing the population, cost of pharmaceuticals, the explosion in chronic diseases and the (inaudible) systems management problems we have as well. Together with the undersupply of doctors and nurses.
But the decision, to go back to Michelle's point, the decision on working cooperatively or coercively with the States, as I said last year, will ultimately be a matter for Government. And our determination won't be the subject of a recommendation by the Commission.
JOURNALIST: The Australian Fair Pay Commission had a report out today. Perhaps surprisingly, it talked about lower income workers being better off in the last two years. Your response to that? And also, the Fair Pay Commission brings down a minimum wage decision in July. Given you're going ahead with the tax cuts, would it be right to assume that there is little chance of a pay rise there?
PM: Well, on the question of working families, one of the reasons we are determined to proceed with the implementation ofour tax cuts, despite a lot of public commentary to the contrary, is that we do believe that working families are under financial pressure. And that's why it'simportant they receive those tax cuts. There is a lot of mortgage stress out there, a lot of people are finding it difficult to balance the family budget, and we understand that.
The other reason for proceeding with those tax cuts, for example, is that it also enhances the overall task of workforce participation. And we therefore think that is a useful contribution to the overall challenges of labour force supply in the overall inflation equation. We've got to be acting on those things.
Remember, the Business Council of Australia today, which is not a branch of the Australian Labor Party, said that these opportunities had been squandered by the previous Government. We don't intend to squander the opportunities which we now have.
JOURNALIST: Mr Rudd, given the events in Parliament last Friday, do you think that the idea of making Parliament sit on Fridays may have been a little ill-conceived? And do you plan to be present yourself next time the Parliament sits on a Friday? And do you have any plan to change or review the idea of sitting on Friday at all?
PM: I think as the Speaker often says, I haven't yet reviewed the tapes. I gather it was a lot of fun for the fair last Friday. I saw a bit of it. But, look, I just think a lot of that behaviour was just childish. I think oneofthe other things I'd draw your attention to is the list of matters which were subject to motions by Labor backbenchers who wanted to have these things raised and debated in the house: electricity privatisation, interest rates and mortgage stress in Western Sydney, health services in Palmerston in the Northern Territory, organ donation, and the Tasmanian Tigers cricket team, among other things.
These are matters of direct relevance to backbenchers. We always intended that this be a forum for backbenchers to put forward their views. And it's a pity that some people decided to take it in a pretty childish way.
JOURNALIST: You said last week that Australia faced an epidemic of binge drinking. I'm wondering how far you are prepared to go to address it. Does it include increased taxes? Or what are some of the options?
PM: Well, what I said last week, I think it was a radio interview in Brisbane who asked me about this, is that, I don't claim any particular expertise in this area. Others around me have morethan I do. But, as a parent, and someone who has observed what has gone on in the general community over the last decade, frankly, I think it's got out of control. And, Governments at all levels have to start doing something about this.
For example, binge drinking, alcoholism, substance abuse, substance addiction, all become part of chronic disease conditions which effect the ability for people to lead a productive and happy life, their ability to be employed, and produce huge costs to the overall health system. We'll have something more to say about this very soon.
JOURNALIST: (Inaudible) Mr Knowles and Dr Gallop (inaudible) with the new Prime Ministerial code about (inaudible) reengagement?
PM: Well I think you've got, DrGallop has been out the system for a while. When was Mr Knowles out of the system?
ROXON: A long time ago.
PM: Some time in the Mesolithic period, I think. Sorry, the Kennett Government. Look, you know, no one's sent to coventry permanently, I think what you have got to be concerned about is people walking out the door one day and hopping into a related job the next.
JOURNALIST: You're reportedly planning to address NATO. What is it additional that you want to tell NATO that your Defence Minister hasn't already? And, would there perhaps be - the last Government refused an affiliation request or a closer ties arrangement with NATO. Is that something you might be re-thinking now?
PM: Travel arrangements as far as the NATO summit in Bucharest, have not been finally determined or announced, so I'll leave that to one side for a bit.
On the question of why would we talk with NATO. Well, NATO is charged, in large part, of the war in Afghanistan. Last time I looked, we were there too. It's pretty basic that if you've got NATO, largely responsible for the operations in certainly the north-western half of the country, and some NATO members in the south-eastern half of the country, in particular Canada, and I spoke with the Canadian Prime Minister about this on the phone just a little while ago and the Dutch Prime Minister on the phone about this on the phone a few days ago, it's important that we talk to each other.
Our Defence Minister Joel Fitzgibbon is absolutely right. If you're going to have Australian troops, our men and women in uniform, on the ground in a war in such a difficult and hostile operating environment as Afghanistan, then we in Australia, as the Government, have a responsibility to satisfy ourselves that there is a coherent strategy for prevailing in this war. And if NATO have most of the forces on the ground, we need to be talking to them much more comprehensively than was the case in the past. I believe that is the responsible course of action when it comes to Australian national security policy.
JOURNALIST: (Inaudible) what you are going to do about the tightening of donations (inaudible) and political parties in general?
PM: Well, consistent with our pre-election commitment, the outrageous decision to ratchet up the disclosure limit for campaign donations to I think ten grand, well, we've already indicated that we'd bring that down to $1,500, to where it was before. I wouldn't be surprised if we went better than that.
I think that's entirely - I think it was just wrong. Absolutely wrong what happened. I mean, the fact that you could have a $10,000 donation limit, just do the maths on that. There are a bunch of people in a room, $10,000 a hit, easy to raise a million dollars in one night. No one knows where it came from. I mean, I just don't think that's at all right.
JOURNALIST: Should Federal Labor, should federal parties, not accept donations from property developers? There is obviously a problem here with the way some of them are operating -
PM: What I'd like to see, David, is a general review of how we go about campaign finance. I am a big devotee of campaign finance reform. Few things that corrupt the democracy. One of them, is when this stuff goes off the rails. And the other is when you have practices like we saw here, in the last three to six years in particular, where the Government of the day dips their hand into the til and pulls out hundreds of millions of dollars in taxpayer funded advertising. These are two things which corrupt the democracy, and we've got to zip. Thank you very much.
[ends]