HOST: Prime Minister, thank you very much for joining us on the program today. PM: Leon, that was a great introduction. HOST: Well, these are the issues.
PM: That was a fairly long intro. But yeah, let's go through them.
HOST: Absolutely. Let's first of all talk about these changes. Now, one of the major recommendations of the report that you've embraced and put out for public consultation - and good on you for doing it - is the fact that there is a thought that we should be having hospitals specialise in elective surgery. Now, of course, Modbury, and other hospitals, used to do a lot of this, but they can't now, because the intensive care and high-dependency beds have been taken away.
PM: Well, we've got to look at what the figures say to us nationwide Leon, and that's our responsibility as an Australian Government, is to respond to what the figures are saying. One out of every three Australians who present to public hospital emergency departments are not being seen within the clinically recommended time, and one out of every six Australians on a waiting list for elective surgery are not being seen within a clinically recommended time. Now, those figures have been around for a long time, let's not go over the fact that for 12 years our predecessors didn't do anything on this.
We've actually said, upon coming to Government, we'd establish this National Health and Hospitals Reform Commission. We did that. It's spent the last 16 months going right across the entire system and looking in every state and territory. They gave us their recommendations about three weeks ago.
You're right to say it's important that the public now debate it. For your listeners, if you go to www.yourhealth.gov.au, you will find that that report is fully online. We welcome comments from the public. But you're right to point out that how we do better elective surgery in the future is a critical area of future reform. And we need to make sure that we get the best system possible for doing that. HOST: What do you feel about the reaction from Premiers like John Brumby who've almost raised the sickle at you and said ‘you're not taking over my hospitals.' PM: Well can I say, I saw some reported comments attributed to various Premiers today, or yesterday, about funding. At the end of last year, the Australian Government, and I'll respond particularly to a reported comment of Premier Brumby, through the Australian Healthcare Agreement, brought about a 50% increase in Australian Government funding to the states and territories - a $64 billion deal - and for the first time, increased allocations, or allocations because there weren't any in the past, to improve the number of elective surgery transactions which happen in hospitals, and, also, special allocations to assist with what happens in accident and emergency as well. So we actually began the reform process with that healthcare agreement last year: increased investment in preventative healthcare; extra support for primary healthcare, 35 GP Superclinics across the country. Also, the special payments for hospitals as it relates to surgery, and accident and emergency. On top of that, reforms also to increase the number of GPs that we train each year as well. That was phase one. Phase two, looking out for the next 20 years, is this report which has come down, as I said, two or three weeks ago, and we want to have a seasoned debate about it all and get the system right. Before, I think, Leon you said in the introduction, that these recommendations may not go far enough. Let me just quickly go to that. You see, strategic option one for the Government, as put to us by the reform commission, is for the Australian Government to take over all preventative healthcare, all primary or frontline healthcare, to take over responsibility for hospital outpatient care, to take over responsibility for all dental care, to take over responsibility for all non-acute mental health care, to also take responsibility for creating a person electronic data record for every patient in the country, as well as providing 40% of the funding for acute hospital care as well. That is a massive reform program in itself. The second strategic option that we have before us from the commission's report, is over time to move to a full funding take over responsibility from the hospital system as well from 40% to 100%. So if you were suggesting before that the proposals before us were not ambitious, can I just say to your listeners, these are the most ambitious set of proposals, fundamental set of reforms, put to a Government since the introduction of Medicare. HOST: Prime Minister, I think in the wish list sense, it is, but, it's how much of that's actually going to happen, because the states seem to be playing two bob each way on this. I don't think the states have delivered, but you've given them a lot of extra money, and we don't appear to be much better of. PM: Well, to be fair to the states and territories, at the end of last year, the healthcare agreement that I referred to before injected, as I said, a 50% increase in Australian Government funding for the states and territories for health and hospitals - $64 billion - but that only flows as of this year. And secondly, the states and territories, again to be fair to them, were dealing with a previous Australian Government which not only did not increase its allocation to hospitals, it hacked $1 billion out of the public hospitals, and you saw, incrementally, a philosophy on the part of the previous Australian Government of moving more and more health care to the private sector. We are determined to reform fundamentally the system for the future. It will cost, and you're absolutely right Leon to point to the fact that none of this is cost free. The costing implications contained within the report are there for all to see. HOST: Does that mean higher taxes, or cutting somewhere else? Or, do you reckon you can get this through efficiency, which is very ambitious? PM: Three sets of possible sources of funding for this, Leon. One is, if the Australian Government takes responsibility for any functions from the states, then there would obviously be a transfer of funding back from the states to the Australian Government, that's the first point. HOST: I can imagine them liking that. PM: Yeah, sure, sure, but I've said to the states and territories repeatedly, there are no blank cheques in this business. This is hard, hard long term reform. Secondly, I have also said is that, if you create for the first time a unified health system for the nation, particularly if you wire it properly - that is, you have transferable personal electronic data, controlled entirely by patients, of their patient records - you will avoid for example, multiple tests being conducted by different practitioners in different parts of the system, which lead to extraordinary cost blowouts. For example, take the report's conclusions that a number of our major hospitals are operating about 20-25% below optimal efficiency levels. If we were able to assist, by making sure that all of our data was put electronically rather than on paper and it was transferrable across the system, it'd be better clinical outcomes for patients, but also better cost implications for taxpayers. But the third source of funding is of course the revenue of the Commonwealth. I accept that. But why we want to have a seasoned, mature, national debate about this, where everyone should have their say between now and the end of the year, because these are big decisions, we want to get them right. Millions of people, all your listeners, have some contact with the health system every year. We're not going to take any of these decisions lightly. HOST: Prime Minister, we've had a very unfortunate debate that's come around because of a court case that we really can't talk a lot about with regards to problems in the disability sector, where people, loved ones looking after those disabled, are having a terrible time and under such pressures they do things that often are unthinkable. And this has brought on, even Monsignor David Cappo, to say on this program last Friday, that this whole thing is a social disaster, massively underfunded, and no plan by the state. What would you like to contribute on this this morning, because I know you're very compassionate about disability issues, but it's been a big talking point for Adelaide in the last few days. PM: I'm not familiar with the case you refer to Leon, so I'm very reluctant to trample on what must be a process on foot. Let me say broadly though in terms of disability policy, our Parliamentary Secretary with responsibility for disabilities, Bill Shorten, is very, very active across the field on this. Last night at the Community Cabinet out in the City of Playford, in Elizabeth, for example, Bill received many, many direct questions about basic things such as the delivery of services to parents of children with autism or the spectrum of autism disorders. This is a major, major problem in the community. What have we done about it? For example, one category of disability, which is autism services, for the first time the Australian Government has created a nationwide program of nearly $200 million to help parents with children with autism-related disorders. But, as was quite plain from the engagement with the community last night, which was a very good discussion, can I say, that doesn't go far enough. There are a whole lot of problems, both kids under six, preschool age with autism, as well as those over six who are of school age. We need to do better in this. The Australian Government is investing more, but can I say with disabilities, I have this feeling we're only scratching the surface. HOST: Look, on another issue, there is a big story today that two major electricity generators are warning that if we were to put into place the carbon trading scheme that's currently being mooted, that we will have massive failure in the electricity grid. PM: Well can I say that all three of the national energy market regulators assessed the proposed Carbon Pollution Reduction Scheme at the time the White Paper for the scheme was put out, and their conclusions are radically different to the ones which are carried in this morning's Advertiser. HOST: What if it's right though Kevin? PM: Well, no, can I just go to the second part of what we're doing. We actually understand the implications of a Carbon Pollution Reduction Scheme, which is all about reducing greenhouse gas emissions, and therefore, it does have implications for coal-fired power stations. We, through our system, are providing the allocation of free permits to the electricity system under this CPRS system in excess of $3 billion. We are not, shall I say, inattentive to the needs of the sector in adjusting to a new scheme. And there's one other thing as well. What is the big problem that our coal-fired power stations face for the future? It is, how do we do better with the whole problem, the whole challenge of carbon sequestration, and this is what's called CCS technologies or clean coal technologies. This Australian Government is investing, with the industry, $2.5 billion - world-leading stuff - to bring on stream large-scale projects for the sequestration of Co2 coming out of coal fired power stations. HOST: Now just for those people who don't know what that is, it's the storing of carbon by other means, whether it be in the ground or somewhere else. Just quickly, so nuclear power is not going to be on your agenda in the near future? PM: If you look at Australia Leon, we have such a rich array of energy sources. We've just been speaking about coal and our strategy there, but on top of that, the renewable energy sector is huge. We have barely begun to tap solar - again, why the Budget contains $1.5 billion for what would be the single largest solar generating plant in the world. HOST: But you need private investors though, as much as you are encouraging this technology, private investment doesn't seem to be there. PM: Well, I don't know if I agree with that, because, for example, prior to the last budget, and I think our first Budget as the Australian Government, we introduced a half billion dollar renewable energy fund. We put that out for expressions of interest to the private sector, and I reviewed only a month or so ago these submissions back from the private sector. 60 or 70 concrete projects involving solar, wind, geothermal, wave, as well as tidal power, across the entire renewable energy spectrum, but in particular solar. And we're quite encouraged by the preparedness of the renewable energy sector to take the challenge up, nd there are huge job generation potentialities in this sector. HOST: When do you expect this to start to happen? PM: South Australia in particular, enormously rich in geothermal resources. HOST: Well you see, the hot rock technology is there, but there doesn't seem to be a plethora of huge investment to bring it on ASAP. PM: That's true, that's why we need to co-invest. What you need to do is first of all get a proper price for carbon in the system. Secondly, help carbon-dependent industries to transition to a lower carbon economy. And third, also co-invest during this transition period with the renewable energy sector to get them up to scale. That's one of the reasons why we have legislation to increase the national renewable energy target to 20 percent of total electricity generation by 2020, making it possible for the renewable energy sector to occupy the gap. And then also, for the co-investment mechanisms that I was just describing before, and in the case of geothermal, that's one of them. One of the challenges there of course is to make sure that you can provide an electricity grid which connects with what is often the isolated location of these hot rock resources. These are the things all to be worked through at the technical level. HOST: Kevin, thanks for joining us. By the way, when you go to the Flinders Medical Centre, you might ask, I know you're one of those people who will take on dissent head-on. You might want to ask them when was the last time in the corridors they had many patients in barouches because they didn't have enough beds, because I bet you don't find that this morning. PM: Okay, well, the reason I'm going to hospitals with the Health Minister all around the country, Leon, is to see it all, warts and all. And I went to the burns unit for example at Royal North Shore in Sydney yesterday. We spent a lot of time talking to the physicians there and the nurses, asking the very basic question, ‘what do you currently need that you don't have?' That is what the sort of questions I'll be asking here at Flinders Medical Research Centre as well. HOST: Prime Minister, thank you very much for joining us today, and I wish you well. PM: Thanks very much Leon. (ends)