MITCHELL: Mr Rudd, good morning.
PM: Good morning Neil.
MITCHELL: This letter in the Herald Sun, it's a very powerful letter from an emergency doctor. He says the system's overworked and crumbling. Is he right?
PM: I can't reach that judgment nationwide, but I take seriously considered letters by someone who's obviously an expert in the field. Certainly, in the four to five hospitals across the country that the Health Minister, Nicola Roxon and I have been to so far - Royal North Shore in Sydney, Flinders Medical Centre in Adelaide, and then Townsville Hospital and Cairns Hospital last week - the stress and pressure on Accident and Emergency is huge across the country. So, that's part of the problems of the system. Of course, part of the answer to it is not just the additional investment which the doctor legitimately points to in his letter, it's also how do you take some pressure off the A&E by better investing in what's called primary healthcare. That's why we're rolling out GP super clinics across the country as well.
MITCHELL: Yeah, I wanted to get this, there's an announcement on that today as I understand. Would you like to talk to this doctor and people like him?
PM: Yeah, I got up this morning and read my Herald Sun, as you do in Melbourne. Mind you, as I do in Canberra. I thought that we could have a conversation with him. So we'll try and track him down through the Herald Sun and we'll have a conversation.
MITCHELL: Okay, Julie, go ahead please Julie.
CALLER: Oh good morning everybody. I work in an emergency department as a ward clerk, and I find it most difficult to find that the nurses are so underpaid. There's not enough nursing staff in the hospitals, if there is more nurses you could open more beds. And I think everybody should need to pay for this service, and that would stop a lot of these people with sore toes and sore throats using emergency departments for what it's not, instead of an emergency department.
MITCHELL: Prime Minister.
PM: Julie, thanks for your comments. Two parts of what you just said. One is people who present at Accident and Emergency who probably don't need to if they have access to GP-related services, particularly after hours, that's the first point. And the second is, making sure we've got enough nursing staff across the system generally, but also in A&E overnight as well. On the first point, part of the reason why we want to see an expansion of GP-related services across the country is that people have somewhere else to go after hours to get shall I say, non-urgent medical attention. Otherwise they form the queue at Accident and Emergency.
One statistic for you. I was in Adelaide recently, it's part of the virtue of going round the state, around the country - you actually find out what's working and what's not working. Over in Adelaide, where you've got a GP super clinic operating now near a hospital, I think it's Noarlunga hospital, I was told over there that since it's been operating there's been a 16% decrease in the number of presentations at the A&E.
Secondly on the nursing stuff, you're absolutely right. There hasn't been adequate, nationwide workforce planning on the number of nurses we need long term and that's one of the matters which are dealt with in this report, produced by Dr Christine Bennett. Have a look at it, it's on yourhealth.gov.au, and all those recommendations deal with the future challenges that we need to deal with on nursing staff.
MITCHELL: The other point that's raised in this letter, and he mentions a shortage of nurses, shortage of doctors, how do you keep specialists like emergency specialists, emergency physicians, how do you keep them in the public system?
PM: Fantastic question. Some of these things are raised in the Bennett Health Reform Commission report. And we have to deal with, frankly, the fact that so many of our specialists are stressed out completely because of over work. You read this carefully, this letter in the Herald Sun, and I've not met this doctor, I can only assume he's a reputable representative of his profession.
MITCHELL: I recognise some of the language. I suspect I know who it is.
PM: Okay, you can fess up off air. But, what I find across the country is extraordinary dedication by medicos, specialists, and those attending A&E who are working huge hours. What we've got to do is take some of the pressure off them by upping the number of doctors we train. Now one of the problems in the system in the past has been we actually had frozen for such a long period of time the number of GP training places for example in the system. What Nicola Roxon, the Health Minister has done is boost that now by 200. We're going to have to do more on that score, as well as deal with the nursing shortage as well.
MITCHELL: Hello Linda, go ahead Linda.
CALLER: Oh look, thanks Neil, I actually wrote you an email a couple of weeks ago, I work in the health system. Can I just congratulate Mr Rudd, because the health problem is so multi-layered. We've got a global ageing population, there's chronic disease out there, so the primary health care is where the money needs to go. It's not just the hospital system.
PM: Well Linda, thanks very much. Can I again draw your attention to this report online, yourhealth.gov.au, the Health Reform Commission recommendations for the future, there are 123 of them. It tries to look at the whole system. That's why we've taken 16 months doing it. Preventative healthcare investment - you know we only spend 2 per cent of our health budget, 2 per cent of our health investment on preventative action. And if we don't boost that for example, the explosion in chronic diseases will actually completely throttle the system longer term. And primary care, GP-related services we've just been speaking about.
MITCHELL: Steven, go ahead please.
CALLER: Ah, good morning all. Just wanted to say, look I work in, I'm a surgical registrar at a major public hospital in Victoria, and ah -
MITCHELL: Sorry, did say a surgical registrar?
CALLER: Yep.
MITCHELL: Yep, okay.
CALLER: And, so what I'm finding is that beds are being closed in the hospital at the expense of, for administrative departments and so what's happening now is that at the moment, we're actually working at 110% capacity. And in terms of the emergency department, I'm seeing 12 patients a shift, which is untenable. Really untenable.
MITCHELL: Twelve a shift, how many hours is that?
CALLER: Ten.
MITCHELL: Ten hours, okay.
PM: Well ah, Steven thank you very much for your call. The pressure on Accident and Emergency as you rightly point out across the nation is huge. Part of it we've sought to respond to in stuff I've said this morning about taking some of the pressure off by more flexible opening hours for GP super clinics, we're opening three more of those in Victoria, which is part of what we're announcing today with the Health Minister.
But the other part of it is, frankly, a greater investment in capacity in Accident and Emergency itself. One step that we have taken in our 18 months in office is this - for the first time the Federal Government has invested some $750 million in Accident and Emergency direct to State Governments across the country because we need to increase capacity now, in order to make it easier for them to cope, like we've done for elective surgery for the first time as well.
MITCHELL: Steven, if you're seeing 12 patients in a 10 hour shift as a surgical registrar, I mean that's, not just you, but that'd be potentially dangerous, that sort of workload wouldn't it?
CALLER: Well, we're rushing people out and the problem is that these patients come into emergency and they have to go somewhere. They have to be sent to another department. And the beds aren't there. It's all about beds. It's not about Accident and Emergency, Prime Minister, it's about beds. The beds aren't on the floor, the beds aren't in the building, where are we going to put these people?
PM: Steven, I take your point. Frankly, some hospital it's beds and A&E, and then on admission, it's beds in the hospital proper. You're right, and you're right on both points. And this is an emerging theme across the country. So, again, you know, have a look at this report online. We're road-testing its recommendations around the country between now and the end of the year, and please give us your considered thoughts in a note to us, I'd appreciate it.
MITCHELL: Okay Steven, hold on, we'll give you our address, you can send it through us if you like. We won't open it. Mark, hello Mark.
CALLER: Yes, good morning Prime Minister Rudd. I just wanted to explain what happened to us last week. I think I spoke to you last week Neil, where my wife was taking my four week old baby to the Western Hospital in Sunshine.
MITCHELL: Yeah.
CALLER: And rolled up at 9:50, was told she'd be admitted at 10:20am, and was left in a cubicle with a plastic chair and the baby in the pram 'til 11:40pm that night.
MITCHELL: 13 hours? What was wrong with the child, the four week old?
CALLER: He had bronchitis, he had to be put on air, had difficulty breathing and infection in the lungs.
MITCHELL: Is he okay now?
CALLER: Yep, yep, he's got through it now.
MITCHELL: Good. Prime Minister?
PM: Well that's good news in terms of your little one, Mark, but it's bad news in terms of what's actually been your experience and that's no criticism at all of the health professionals working at the coalface. What you're basically saying to us is that we need greater investment across the system to make it, I've got to say, better for people like you presenting for what I assume from what you said before was a pre-booked presentation at the hospital.
MITCHELL: It was an emergency presentation as I recall.
PM: Oh was it an emergency presentation?
MITCHELL: Yeah.
CALLER: I think the worst part about it was, like, every two hours they came up and said "you'll be admitted in half an hour, you'll be admitted in half an hour".
MITCHELL: And it was an emergency, that's why you took him, wasn't it?
CALLER: That's it, of course.
PM: Well, that's the recurring theme in so much of what Neil's said on air this morning, which is the pressure on Accident and Emergency, and frankly the professionals working there all deserve medals.
MITCHELL: I guess it's been happening for so long, I remember I was on the panel for the debate between John Howard and Mark Latham and it was an issue I raised then and we got massive response to it. Can you really fix it this time?
PM: You know, I think however long we are in Government, and that's a matter for your listeners and a matter for the country at large, I don't want to look back and say we didn't have a damn good go at this. Because, step back from what all your listeners have said to us this morning in their calls, what actually is happening to the system nationwide and frankly across most developed countries - population growth, ageing of the population, as well as the increased cost of medical treatments, plus real pressures on medical workforces, that's all pushing us into a higher cost medical environment.
And the problem is, so many of the solutions, and many of them are undertaken admirably by State Governments, have dealt with part of the system, not all of it, and part of that goes back to the fact we've got these divided responsibilities between Federal and State. And we call it cost-shift blame-shift. What are the Feds currently responsible for? Basically GP-related services. States primarily responsible for hospitals.
And so, let's go down to this Accident and Emergency thing that we've just been talking about. Why is it historically such a problem? Because the increased investment in, let's call it GP-related services in the community, is a federal cost. The States historically have been responsible for Accident and Emergency within hospitals. So, both sides have this perverse self-interest in preserving their, you know, budgetary integrity, and that's wrong. We've got to actually deal with that.
MITCHELL: And the three clinics being opened today?
PM: Ah, the three of them are at South Morang, and at Wodonga, and at Portland, totally an investment of about $14 to $15 million. But the whole idea with these things is to provide GP Super Clinics with a range of GP and other allied medicine services, you know like podiatry, and to be open flexibly, in terms of hours. This is one small investment, and we're rolling out about 25 of these across the country at the moment, 25 contracts being signed. But if we can replicate that example I gave you before, in Adelaide, whereby opening a clinic in a community of a catchment of 100,000 people which is the example given to me in Adelaide, and it can bring down the presentations at the local A&E, that's one part of the solution. The other part lies in response to the doctor who rang in before, Steven, who is actually, the actual physical availability of beds.
MITCHELL: The Prime Minister's with me, we'll get back to calls a little later in the program. There's several issues I need to touch on. We haven't got long. Prime Minister, Kokoda - what's the latest you've heard from the recovery?
PM: Neil, before coming on your program this morning I spoke with Chris Moratis, who's our High Commissioner in Port Moresby.
Firstly, on the question of the recovery of loved ones, which is very, very difficult, the weather, and we understand fully the frustration of families. This is taking a long time. The weather has been impossible yesterday.
Nonetheless, we have a second recovery team which as of about three quarters of an hour ago was winched into the site from a Black Hawk helicopter of ours. It's now on the ground. They are all applying what is a standard Interpol protocol for how you deal with crash sites of this nature.
It does take time, but we are exerting every possible effort to get this done in as quickly and as dignified a manner as possible. One other matter which I saw coverage of this morning which is the problem being encountered by some trekkers in terms of how they physically get out, particularly if they are walking from Owen's Corner, arriving at Kokoda and needing to get back to Moresby, given that the airline in question, or one of the airlines in question, Airlines PNG, has suspended services until September.
I spoke again to the High Commissioner on that this morning. At Kokoda village itself, and this might be relevant to any families listening, there will be a High Commission staff person there during the course of today to help coordinate physical exit for anyone who's been, as it were, disrupted by the withdrawal of this airline service.
Also, we've got RAAF Caribou aircraft dropping supplies in to Kokoda village, including food supplies, if there's any problem there in terms of people coming off the track, and subject to availability, then we'll also assist in getting people back to Moresby as well.
The alternative route is to travel via road another four hours to Popandeda. There's another airline service which operates out of there, so we're seeking to coordinate that in the ground.
MITCHELL: OK, now, the emission trading legislation - will you, are you prepared to use it as an election trigger?
PM: You know, Neil, I have not the slightest intention of going to an early poll. I don't think people like that. I think they want you to serve the term that you've been elected for. So I would just really like this thing to get through.
MITCHELL: So you'll negotiate it?
PM: We've said repeatedly, give us some amendments. Remember, this thing, which was voted down by the Liberals in the Senate yesterday, not one single amendment was put forward by the Liberals in terms of, 'OK, you say you want some changes. What are they?' And not one was put forward, so there's been a lot of politics in this in terms of internal divisions within the Liberal Party. We just want to get on with the job, because, partly, business certainty. The business community wants certainty for the future and they want us to finish the business.
MITCHELL: Well, are you prepared to separate it off the Renewable Energy Targets?
PM: The reason why we've had these two things together goes back to the business argument again, which is, you've got two systems here. One is called the Carbon Pollution Reduction Scheme, goes across the entire economy, it's got a series of adjustment mechanisms in it for businesses. The second is the renewable energy target, which is designed to boost the renewable energy sector. What's the mission there? To increase Australia's renewable energy generation to 20 percent of electricity supply by 2020.
Two separate systems, but we've got parallel adjustment mechanisms in them for business, which have been linked to reduced business complexity. Now, we would therefore want that to be the case for the future so that there is just absolute simplicity. The renewable energy target's not due to come into operation until January of next year. This thing is now, the Carbon Pollution Reduction Scheme is up for vote in the Senate the next time around about November. They've said, the Liberals have said, they'll then be providing a decisive vote on the future of the CPRS. We hope there's time, therefore, to still marry the two schemes.
MITCHELL: If not, though, will you negotiate that? Are you open to negotiating it?
PM: Well, I've said to the Liberals all along that if you got an amendment, bring it forward. I mean, this is a pretty basic point - if the Liberals are saying we don't like x, y or z, then we say put on the table you proposed drafting amendment. Nothing's come forward, so in the case of the renewable energy target, for example, that piece of legislation, if there is an alternative set of interim adjustment mechanisms for business, why haven't they been put on the table.
This is part of our, frankly, legitimate frustration in dealing with opposition for opposition's sake.
MITCHELL: But there's a suspicion, as you know, that you're playing politics, you're keeping the possibility of a double dissolution trigger in the back pocket.
PM: You know something, Neil? People will always say that because we're in the business of politics.
MITCHELL: So it's untrue?
PM: Absolutely. You know the reason? Because we want to just get on with the business of getting this thing through. You know, every country in the world, including the United States, is struggling with this challenge right now. It's one of the hardest the policy challenges for any Government.
It goes across 1,000 major businesses in the country, roll-on implications for households and businesses in terms of cost. This has taken a huge amount of effort to get done. Instead, because the Liberal Party leadership is crumbling, we can't get a coherent position from them, like 'here's the alternative. Here's, on black and white, on a piece of paper, what we want by way of an amendment.'
MITCHELL: The economy - the Europeans are making optimistic noises overnight, Barack Obama's made some optimistic noises. Interest rates have already moved up at the Commonwealth Bank, as you'd know. Are we know heading into an environment where interest rate increases are more likely?
PM: As I wrote, I think, in the press a few weekends ago, Neil, and I'm sure you committed to memory that 6,000-word essay I wrote in the Fairfax newspapers - why are you smiling like that?
MITCHELL: Every word.
PM: Is that the road to recovery is going to be very bumpy and on that road to recovery there's going to be two or three factors, let's just be up front about them.
One - unemployment's going to continue to go up, because economists will tell you employment is a lagging factor in the economy.
The second is, sooner or later interest rates are going to go up, and you can see that clear from the statements from the Reserve Bank Governor in recent times, because they've come off 425 basis points, four and a quarter percent in the last short period of time as a anti-recessionary measure.
And thirdly, we're going to have to return the budget to surplus. We've mapped out a strategy to do that, and that, in time, will mean budget cuts.
So these things are going to make things hard for the future, but we must embark on this road to recovery, but for anyone to assume it's all going to be a bed of roses - it won't be.
MITCHELL: I read there's still 30 percent of your stimulus package, $6.3 billion, still sitting in the bank. Do you ant people to spend it?
PM: Every Australian out there will make their own wise decisions, Neil, about whether they're going to buy an extra copy of the Herald Sun.
MITCHELL: Have you spent yours?
PM: From memory, Neil, I don't think I fit within the Family Tax Benefit A category in order to pick up the payment.
But you know something? Quickly, on the economy, the fact that this economy, still, as of now, of the major advanced economies as of the first quarter this year, was the only one to not be in recession. Secondly, was the fastest growing. Thirdly, second-lowest unemployment. Fourthly, with the lowest debt and deficit. You know, we're some things right, but let me tell you, we're not out of the woods yet.
MITCHELL: Couple of very quick things. Can you every see a situation where we have computers tracking cars and you pay for use of the roads, as proposed?
PM: Proposed by?
MITCHELL: The academics with the Henry Committee.
PM: Ah, right, okay. Look, I think that would be a matter of massive political controversy, but if the academics are putting that forward in the context of Henry, then let the debate ensue.
But like this exercise we are engaged with at the moment in terms of health and hospitals reform, if you read that report they are quite radical, many of the recommendations, but I don't believe you should just cut off the debate because it's controversial.
MITCHELL: What's your view on women's boxing? It's been admitted to the Olympics.
PM: How do I say this carefully and judiciously, Neil? I think my sentiments are a bit like yours.
MITCHELL: That is of concern to both of us Prime Minister.
PM: Now look, I don't wish to sound sexist and this sort of stuff, but anyway, I'm a bit on the conservative side of the ledger when it comes to that.
MITCHELL: And $2 million for your broadband man, Mike Quigley. That's, what, five times your salary? More!
PM: Ah, yeah, probably. But if you look across the telecommunications industry, when you've got people being paid $3 million, $5 million, $9 million, this is way below what the market demands. This guy is a very experienced man, run a very large, he's an Australian, he's run a very large American corporation, and we're pleased to have him on board.
MITCHELL: Thank you very much for your time.
PM: Thanks for having us in the studio.
(ends)