JENKINS: Just from the outset as the local member I'd like to indicate the importance of having a Prime Minister in his first term to come to an area like Epping, in the middle of the electorate of Scullin.
The fact is that throughout the term of this Government, it has not been delivering services on the base of perceived political need but on the basis of real need, and in a number of the things that have happened at this hospital have only occurred by the fact that the Government has had that in mind. The involvement in the research and teaching facility at this hospital came as a response to what was not only a good proposal, but the fact here, in the north of Melbourne, four federal members, in what I'd describe as safe Labor seat, joined together to do the lobbying, and I welcome the further interest of both the Prime Minister and Minister Roxon in things that are happening here in the northern suburbs, and acknowledging the growth here, acknowledging the needs, and acknowledging there is a good story here that can be shared and can be involved in the way in which we develop a health system for Australia over the next 20 or 30 years.
So I invite the Prime Minister to say his bit.
PM: Thanks very much, Harry. I'm just going to move the Lego blocks here.
The Health Minister and I are pleased to be here at the Northern Hospital today to continue our road testing of the reform agenda which has been laid out by the Health Reform Commission which delivered its report to the Government not all that long ago. Part of our responsibility is not just to road test this with major inner-city hospitals across the country. We'll be doing that. Part of our responsibility is to road-test this also with major points of delivery of health services in outer metropolitan Australia, where you have such an explosion of population growth, and also regional hospitals as we've done recently in Townsville and Cairns in north and far north Queensland.
So today, listening carefully to what the health care professionals working at the Northern Hospital had to say to us and the questions that they have raised help refine our views in terms of what position we ultimately bring to the States and Territories for long-term reform. Part of the consultation that we're engaged in, and part of the discussion today here at the Northern Hospital, about how we do primary health care better, and how we enhance GP-related services more into the future.
The reasons for that are pretty obvious. One is people actually like to be able to access their GP-related services more flexibly than is currently the case, and secondly it takes the pressure off Accident and Emergencies if it's more flexibly provided around the country as well.
That's why the Government committed, prior to the last election, to rolling out some 34 GP Super Clinics across Australia, and we've now contracted for 24 of those and we now have some 8 under construction. What we've announced today is that three of those GP Super Clinics for Victoria - $4.9 million investment at the Portland GP Super Clinic, which will focus on reducing avoidable hospital admissions, with an emphasis on diabetes-related allied health services, dietetics, diabetes education, podiatry and drug and alcohol services.
$6.65 million for the Wodonga GP Super Clinic, which will focus on chronic disease self-management, with a strong emphasis on training and education, to provide clinical training places to medical and allied health, pharmacy and nursing students from a number of universities, and $3.7 million for South Morang GP Super Clinic will be a newly constructed facility to meet the needs of the rapidly expanding community in the City of Whittlesea.
These are practical building blocks to the future, and need to be integrated with wider, comprehensive health and hospitals reform across the nation for the future.
As has been mentioned before by Harry, the local member, also the investment of $14 million from the Commonwealth Government into the proper facilities necessary for the training of local health professionals in this area is another building block for the future. We need better planning for our workforce, health workforce, for the future - doctors, nurses, allied health professionals - and that needs to be done not just in the largest, inner-city campuses across the country but also in areas where that need is acute itself.
So, we're here to listen to this community. We've had a good hour and a half or so listening to questions from those who are at the coalface here. Quite apart from listening personally to the stories of oncology patients here at the Northern Hospital, and we're pleased to have indicated a further building block for long-term reform in terms of the announcement of these GP Super Clinics for the future, but this is one step on a long-term process of reform, and that's going to take some time, as I've said around the country, but the nation wants and needs long-term health and hospital reform.
It will not come for free. It will cost and it's important that we're upfront about that as we work our way around the country.
Over to you, folks.
JOURNALIST: Prime Minister, you've done a few of these in various states as you've mentioned. What is the one thing that is standing out?
PM: One thing that hits us, I think, between the eyeballs wherever we go, is the fact that there is almost a universal chorus for better planning for the training of doctors and nurses and allied health professionals, because you step back from it all, whether it's pressures in the emergency department, pressures in oncology or pressures in the primary care areas, it's all about the proper training and the proper distribution of our health workforce.
And you know something? It's one of the areas of huge failure in the past, and we've got to lift our game on this, hugely.
So in all the disparate circumstances, in far north Queensland, in north Queensland, Adelaide, Royal North Shore in Sydney and here, if there's one continuing theme it's ‘let's plan for our health workforce needs better for the future' and that's why the Minister has already embarked in part upon that with the establishment of this health workforce training agency for the future.
JOURNALIST: (inaudible)
PM: Well, I think Victoria, together with other states, have all had to deal with one huge set of external challenges, and that is, for times past, a decade or so past, they've had to wrestle with burgeoning demand for hospital and health services on the one hand and a shrinking federal health dollar at the same time. That's a real problem, and they've wrestled really well with that, given the circumstances that they've been faced.
Since we have been elected, we've tried to step up to the plate and form a new partnership with them. We've done that through the Australian Health Care Agreement which the Minister negotiated with her counterparts at the end of last year, which represents some $60 billion plus, a 50 percent real increase on the previous healthcare agreement.
On the specific delivery systems and management systems for the healthcare system in Victoria, we are quite open to working with our Victorian friends on the shape of that for the future, depending on the type and content of the long-term reform agenda that we take to the states and territories in the first part of next year.
JOURNALIST: Prime Minister, a lot of the - almost all of the questions here today were from the heads lobby groups that are pushing a well-established line. Did you hear anything here today that was actually new or actually interesting to you?
PM: I did, and very much so, but let me just highlight one of them, and that was the very illustration I referred to in my opening remarks about the need, in oncology services, for a patient care coordinator who can help shepherd people through a very complex and challenging system.
And part of the reason for coming is that you always learn something new. If you don't learn anything new when you come to a new hospital, you're not trying and you're mind is closed and your eyes are closed, but a very practical illustration here of two things - how do you enable our medical staff and nursing staff dealing with people in obviously very challenging circumstances in oncology to dedicate the most of their time to the needs of patients on the one hand while supporting those patients in their navigation of the system at the same time.
So what was their particular recommendation? Give us a patient care coordinator. That is a practical illustration of a wider principle outlined in the Health Reform Commission's report about the need for us as a nation to have a patient-centred system, as opposed to a system which answers first and foremostly to itself.
So you ask me what I've learnt today? That struck me as something pretty practical, and it's always good to have those practical examples in mind.
JOURNALIST: (inaudible)
PM: Here and there. We'll go on to other stuff after we've done a bit more on hospitals, if that's OK. Are you on hospitals, mate?
JOURNALIST: Premier John Brumby's obviously not keen on the partial takeover, particularly not keen on a full takeover of the -
PM: A quarter takeover?
JOURNALIST: So how are you going to get the states, particularly Victoria, across the line on this?
PM: Well, you know something, we, the Australian Government, haven't landed on a final position ourselves. That why we're, we try to methodical and systematic about long-term health care reform. One, as those in this room I think confirmed today in their engagement with us, this is the first time since, effectively the introduction of Medicare, a long time ago, that we, as the Government, have embarked upon a system-wide analysis of what we need in the health and hospital system for Australia for the next quarter of a century, with a real future focus. Two, the reason we are road testing it in communities like this is to fine-tune which of those recommendations we can fly with and which we can't, and what amendments may be necessary.
That's why the timetable we've put out places those final propositions to be put to the states into the first part of next year.
We'll be refining our thinking during the way through. I'm sure states and territories will be at the same time, and as always, we will have a productive and friendly exchange with our counterparts at the state and territory level and arrive at a good solution in the national interest.
But, I always say, at the end of the day, if we form a view that a particular direction of national reform is necessary, and we can't get there cooperatively, as I said prior to the election, then we reserve the right to seek a mandate from the people on that.
JOURNALIST: Prime Minister, can we read anything into it that the Premier's not here today and his Health Minister is not here today. Is there anything in that end? Should we be reading anything into it?
PM: No, not at all. I think when we've addressed forums in north Queensland we've had no Health Minister or, so, we're out here consulting in our own right. The key thing for us is to make sure that the representatives of the local health region and health community are here, because the experiences, of let's call it this wider region in northern Melbourne, are going to be qualitatively different to those that we find in other parts of the country.
ROXON: (inaudible)
PM: Yeah, and I'm sure they'll attend other consultations that we have, as is appropriate and I think in South Australia the Premier wasn't with us, was he? No, so, I mean, it's just, everyone's busy.
JOURNALIST: Minister, can I ask you some specifics about the South Morang Super Clinic.
ROXON: Sure.
JOURNALIST: Where it's going to be, how many doctors, why South Morang?
ROXON: Yeah, thank you. Look, this is a really important announcement for South Morang, and the location and other details have been agreed, unlike the other Super Clinics where we've been going through a consultation process and a tender process, because these were not announced pre-election, we've had communities across the country coming forward and saying ‘we've got a great idea - these are our partners, this is where we'd like to do it, and would you support us?' and this was one of the very convincing proposals.
It's going to be located near the municipal precinct on McDonald's Road. It's a new construction. It's a mix of GP services, community health services, particularly for early childhood, speech, parenting and neuropsychology, drug and alcohol services, chronic disease management and dental and mental health services.
It's going to be run by a consortium led by the Northern Division of GPs, but it includes in the consortium, of course, Northern Hospital, where we are now, Whittlesea Council and Plenty Valley Community Health, so this is a really important facility.
We were convinced by the argument put forward about the need in this community, but also the very professional proposal with those consortium members, and we believe it meets some of our reform targets by having those partners integrated with the hospital, with the primary care services, and we're pleased to be able to announce those three extra facilities today.
JOURNALIST: How many extra doctors and given what the Prime Minister has just said, where are you going to get the doctors from?
ROXON: As I'm advised, it's going to employ about 12 GPs, that's part of the proposal. We do have a new number of doctors coming on line in this next, actually currently but also in the next two years.
Part of our challenge is to make sure that we have good settings where they can be trained and facilities where doctors can move in and out. What we've heard constantly from young doctors is they don't necessarily, as in the past, want to spend hundreds of thousands of dollars to set up a GP practice, which in the past they might have then worked in for 50 or 60 years before they retired. They want to come, they want to work in multidisciplinary teams, they might want to do it for five years and then move out, and need to be owned, therefore, by other organisations, and this is something, because of the council's involvement, that will stay in community ownership through the consortium, and I think actually is a way of ensuring that you've almost got a honey pot in South Morang where GPs who want to be in general practice can say ‘that is exactly the type of best-practice facility I want to work in' and I don't foresee that there'll be a challenge finding those doctors.
JOURNALIST: What happens with doctors with their own practice now? Will they move into the new Super Clinics?
PM: Well, as is the case across the country with the Super Clinics, of course existing GPs can be part of those proposals as they are in some cases. Some will want to move in. We've had elderly GPs saying they're really ready to retire but they'd like to do sessions to train new doctors. There is a mix across the country. I couldn't hope to give you an exact answer for each one of them, but the Government's role is in saying ‘we think primary care is important, we think general practice is a specialty, we think communities where there are high needs need to have the best practice options available to them' and this investment from the Commonwealth enables that to happen in South Morang.
JOURNALIST: (inaudible)
PM: The reason why we have linked the Renewable Energy Target with the Carbon Pollution Reduction Scheme is because we don't want an additional compliance burden for Australian business.
What do we need to do on climate change? We need to have a Carbon Pollution Reduction Scheme so that we know the price of carbon in the future. We also need to boost renewable energy generation in the future as well.
These are two things we committed to prior to the last election, these are the two pieces of legislation we introduced in the Parliament, and the reason why they are linked is because we don't want business having to deal with both these pieces of legislation, to have different industry schemes attached to them. It just adds to the compliance burden.
Second point I'd make is this - I notice Mr Turnbull seems to be saying that they'll actually vote definitively on the future of the Carbon Pollution Reduction Scheme in November. That is, with, for the first time - hold the phone - substantive amendments. Well, I look forward to that. The operation of the Renewable Energy Target is not scheduled to occur anyway until the beginning of next year.
I therefore look forward to the way in which the Liberals and the Nationals decide to vote, finally, in an informed way, with considered amendments on the table, on the Carbon Pollution Reduction Scheme come November, because that might shed some light on the future for the Renewable Energy Target as well.
As I said also, as I also said in my interview with Neil Mitchell this morning, we'll continue to keep open to negotiations with the Liberals and Nationals, but it would be very useful if, for the first time in the history of this debate in the 20 months that we've been in Government, that we had a substantive position a) on what amendments they are proposing for the Carbon Pollution Reduction Scheme, and whether they are acceptable to us or not, it's all a mystery so far, and b) in terms of Renewable Energy Target, what specific separate industry scheme within it that they are proposing. We do not know the content of either of those positions.
JOURNALIST: (inaudible)
PM: We believe that given the scheduled introduction time for the Renewable Energy Target, which is January next year, that we are very mindful of the fact that the Liberals now seem to be saying that they might actually bring themselves to a considered position on the CPRS come November. As I said more broadly than that, we remain open to discussion with the Liberals on the basis of reasoned and considered amendments, not simply huffing and puffing into the atmosphere, and producing no definitive position on paper.
JOURNALIST: (inaudible)
PM: We, the Australian Government, are pleased today to confirm the appointment of Tony Negus as the Commissioner of the Australian Federal Police. Tony Negus is a first-class Australian police officer. He has been with the Australian Federal Police most recently as the Deputy Commissioner responsible for operations. We are therefore pleased and delighted with his appointment. He brings to this position a vast experience, and in recent times has been Acting Commissioner. We therefore as a Government have worked with him closely.
I'll come back to your immediate question in one tick, after I've just made one other point about the person he replaces, which is Mick Keelty.
Mick Keelty has been a first-class Commissioner of the Australian Federal Police. He has served the nation with absolute distinction. His role in response to the Bali bombing, the Jakarta Embassy bombings, the tsunami, his rolling engagement which he has overseen with the Indonesian national police in very complex counter-terrorism operations in Indonesia, frankly, the country owes him a debt of gratitude. And just as Mick Keelty has served Australia with distinction as Australian Federal Police Commissioner and with honour, we are fully confident the same will be the case with Tony Negus.
In terms of the recent public controversy about the raids here in Melbourne a little while ago, I think it's first and foremost important that we establish all the facts concerning that, and we will deal with those as appropriate, but let me say, unequivocally, the Government has absolute confidence in Tony Negus. He is a first-class police officer. He has discharged his responsibilities in relation to those raids impeccably, and in close coordination with the Victorian police, and I acknowledge publicly again my appreciation for their efforts, and we as a Government look forward to working with him closely in the future.
JOURNALIST: (inaudible)
PM: I read it.
JOURNALIST: But what was your response to it, your reaction to it?
PM: I got up, I had a cup of tea, opened my Herald Sun and saw the letter, and I thought it was a useful contribution to the debate. That particular letter, as I recall it, dealt specifically with the challenges in Accident and Emergency, particularly with the problems of having sufficient staff and sufficient beds. In answer to, I think, an earlier question about common themes which emerge across all our consultations, I referred before to the training, systematically, of our health workforce over time, because that affects everything, but specifically, in many, many parts of the country, we're also getting a clear representation about the stressed nature of Accident and Emergency.
Part of the response, part of the response, I say, lies in how do we actually boost primary health care, take some of the pressure off A&E presentations. Part of the response lies, of course, in the sorts of investments the Minister has already initiated with State governments through the $750 million special purpose payment, for the first time, the Commonwealth engaging in with the States and Territories to enhance A&E services across the country.
So, in answer to your question - good letter, don't know the bloke, if it is a bloke, from a bar of soap, but all this I regard as just a useful contribution to the debate and particularly when it comes to the challenges which confront most Australians most when it comes to the health and hospital system, with ‘what happens when I go the emergency department if my kid's sick? How's it going? How can I get access to treatment quickly?' That's the legitimate anxiety of parents and again, I'd publicly commend the professionalism of all of our doctors and nurses and others who staff emergency departments across the country at a time of burgeoning demand for the healthcare system, at a time when the Federal Government, at least in the past, has not been actually doing its bit.
Having said that, I've got to zip.