HOST: Good morning, Mr Rudd.
PM: Good morning. Thanks for having me on the program.
HOST: Has the President called you yet?
PM: Yeah, I got off the phone from him about an hour or so ago, and we had a good chat. He's sad and sorry that he won't be here in Australia in the coming week or so, but he's looking forward to a more relaxed visit a little later on in the year.
HOST: So a little longer, obviously?
PM: A little longer, because he would like to be here with Michelle and the kids, and he's visiting both here and Indonesia, so there's scheduling there as well, but as it was turning out last time the visit was just going to be too tight and too short, so he's looking forward to something longer later on.
HOST: Who's got the tougher battle to get their health plan up? Him or you?
PM: I think the President and myself face some common challenges. Number one is we're both trying to get health and hospital reform done, and number two is we both face Senates who want to block everything. So, I had a chat with him about how it was all shaping up in the United States.
For your listeners, remember in America there's no Medicare. In America, frankly, the public hospital system doesn't work properly, so if you're a poorer person on lower income there's just nowhere much to go. So, he's trying to fix that, and full marks to him for doing it.
Here in Australia, we've got our own challenges, which is the proper funding, long term, of our public hospital system and health system more generally. So, we have a challenge to make sure we get the states and territories on side with that, but if we don't, as I said, we'll seek a mandate from the people to obtain the powers necessary to bring about these reforms anyway.
HOST: Because it's going to be even tougher after this weekend with Labor tipped to lose both in Tasmania and South Australia.
PM: Well, these will be tough elections for both the state governments in South Australia and in Tasmania. They've been there for some years, but this'll be a tight election campaign, it has been a tight election campaign, and the voters will decide.
But for health and hospital reform, my own view is it should go, frankly, beyond party politics. This is just crying out for change. People want more hospital beds, more doctors, more nurses, but they want to make sure that the system doesn't just keep up this cost-shift, blame-shift, pass-the-parcel exercise we've had for decades now. That's why we've put forward the national health and hospital network, funded nationally, run locally, with the Australian Government for the first time being the dominant funders of the system.
HOST: When we last spoke, you talked about New South Wales health bureaucrats trying to undermine this process. You might notice in the paper this morning there are stories from New South Wales Health talking about big western suburbs hospitals like Westmead which will suffer under your plan. Now, is that true, and is this continuing this battle you're having with New South Wales?
PM: I think these state health bureaucrats should stop running fear campaigns because they are frightened of fundamental changes for the future. What we want is more frontline services, more doctors, more nurses, more hospital beds. That's one of the reasons why the Health Minister and I released earlier this week a plan to invest $600 million-plus for 6,000 new, additional doctors, medical specialists, GPs, because there's a crying shortage around the country. So, I think it's time people got with the program.
HOST: Yeah, but New South Wales is the state that'll, it seems is going to be the biggest stumbling block, has to make the most changes. That meeting you had with Kristina Keneally last week, were you rude to her? Were you deliberately rude to her?
PM: We had a very good meeting, and it was substantive, it was positive, it was constructive-
HOST: -But that image of you looking away and being, you know, ignoring her.
PM: It was substantive, positive - seriously, it was a very good meeting.
HOST: But was it just, were-
PM: -I think both of us were surprised by some of the subsequent media coverage.
HOST: Was it the visual version of verballing, was it?
PM: I think we had a really good meeting. I think we're both surprised. It's Carmel as well, Carmel Tebbutt, we were both surprised by some of the media coverage later.
HOST: Do you like her? Do you like Kristina Keneally?
PM: We get on very well, as do I with the Deputy Premier and Minister for Health, Carmel. I've known both of them for quite some years. It was a really good meeting, as was the one in Queensland with Anna, as was the one in Victoria with John Brumby.
I think people are serious about getting on with the business of health and hospital reform, but you know something? I'm not really interested in atmospherics. I'm interested in substance. I'm interested in getting on with the business of changing the hospital system.
For your listeners this morning, have they got a problem with being able to find a GP on time? Have they got a problem in terms of a waiting list for elective surgery? Did they have a problem last night at accident and emergency at one of the hospitals around here? These are the problems I want to deal with, and that means cutting out waste and inefficiency from the system, because of the Commonwealth-State brawl. It means properly funding the system for the future, hence why, for the first time in Australia's history, the Australian Government would be the dominant funder of the running costs of our hospitals, the capital costs of our hospitals, the equipment for our hospitals.
Just last week I went out to Royal North Shore here, and we had funded a new PET scanner. There's only six of those in Sydney, and we've just opened the sixth, and we've paid for it.
We should have a better system than that, whereby the folk who use the Royal North Shore hospital or who depend on it for cancer services - it goes right through to the New South Wales central coast - shouldn't have to wait for a decade or so for a PET scanner to come on-stream. You need a more rational planning system than that. That's what we want to bring about.
HOST: You talk about atmospherics and how you don't like them - a lot of atmospherics in Parliament yesterday. You and Tony Abbott, it seemed to get almost personal. Do you like Tony Abbott?
PM: I've known Tony for a long, long time, so obviously he has a different set of political views to myself, and a different set of policy views. This was a big debate over health and hospital reform and all I was making a point was that Mr Abbott had four or five years as Health Minister, right up until the last election, to fix the system. He said four or five years ago, the Commonwealth should take over the system - well, he didn't.
During that period of time as Health Minister he took a billion dollars out of the public hospital system. He capped the number of GP training places. And then, hand on heart, said that he'd never, ever change the Medicare safety net, a promise he subsequently breached. So, his record on health is bad.
But you know what I'm more concerned about? What's his plans to fix up health for the future. Our plan's clear: a new national hospital and health network for the nation, funded nationally, run locally, with 6,000 new doctors, medical specialists and GPs. That's what we want to do. We don't have the alternative plan yet.
HOST: In this debate you'll have with Mr Abbott to discuss all this, will it be a freewheeling debate, or is it going to have set times that you can both speak? What will be the format?
PM: The format, I'm sure, will be sorted out in the days ahead. I'm pretty relaxed about that.
HOST: Can we have as few rules as possible, just where you can go at each other?
PM: Oh look, I'm pretty relaxed about all that. The key thing is to make sure that the people listening to the debate and who really care about the future of their local hospitals and enough beds, enough doctors, enough nurses, that my plans are clear in people's minds as to what I propose to do, but so are his.
HOST: Well hang on - because in relation to that, the suggestion is that small, local hospitals that have relied on block funding under your plan will not be able to survive under this casemix funding system that you want to introduce, and that you're going to deal with that down the track aren't you, with some of these other funding announcements? So, will you have those on the table next Tuesday so people can see what the future of that hospital will be?
PM: You mentioned before a fear campaign or the possibility of it from various state health bureaucrats. That's one of them.
Let me say very plainly on your program this morning under our proposals for this new national health and hospital network, there will be nothing in that plan at all which would cause any hospital, large or small, to close - quite the reverse. We see, for example, in western Sydney, where you've got a vastly growing population, the need to expand all those hospital services, and if you're servicing a big and growing community, our funding system would actually support that to grow those services.
At present, what happens is people are given a fixed budget once a year - that's it, goodbye. Now, that shouldn't be the case. We want a new system for the future and I think those who are arguing against it seem to be saying almost by implication that the current system is just fine and dandy, we'll defend it how it is. I don't believe that's the case, nor do I believe that's what working families want in Australia either.
HOST: Because the detail is important in this, and some of the, even in Victoria, where they've got the system operating, they've had to return to that block funding for smaller hospitals to avoid them closing, so would you do that in New South Wales, extra funding for some of those smaller, regional hospitals?
PM: To support the needs in rural and regional areas - remember, I grew up in a small country town, we had a visiting doctor once a month for half a day and the nearest hospital had about 12 beds and it was a while away, so I actually understand this from the point of view of growing up in that area-
HOST: -So would you have that extra funding?-
PM: -Therefore, going on to your point about making sure those services continue, we would absolutely make sure that those services continue and the formula that we are proposing for what's called activity-based funding is entirely tailored to the local circumstances of how far away are you, how difficult is it to deliver those services there, how more expensive it is to get a visiting specialist there, for example - on top of the particular, shall I say, concentrations of health problems in particular parts of the country as well.
So for us, and you go to the question of additional funding grants, we'll be very mindful of particular needs in the system.
HOST: So there could be block funding for some of those hospitals.
PM: We'll be very mindful of particular needs in the system because, as I've said before, there is nothing in what we are proposing which would cause any hospital anywhere to close down. That is, in essence, the fear campaign being run by the state bureaucrats who want to see no change occur.
HOST: But you understand, people criticise you for being verbose. It's a simple question. Are you going to put in block grants to deal with that, and the answer would be either yes, you will, or no, our system will deal with it. So you're saying no.
PM: What I said to you before, John, is there's nothing in our funding system which would cause any of those hospitals to close. That's your direct question, that's my direct answer, and I believe that's the assurance which I've been giving to folk as I've been asked this since the debate on this was first kicked off by state health bureaucrats putting stuff out in the papers a couple of weeks ago, and I've been pretty consistent about that.
HOST: Prime Minister, can I ask you about the school building program which has had so much debate over the past week, and Julia Gillard has been in parliament defending the program and the way it's been implemented. A simple question about the school that's almost become the focus of the program, Hasting Public School at Port Macquarie - how is it that that covered outdoor learning area that was budgeted for, I think, $400,000 or so can suddenly blow out to $900,000? It's a simple question that I don't think anyone's adequately explained yet.
PM: Well, I think from my last conversation with Julia the audit on that one hasn't been concluded yet, so let's just look at the facts once it's through. You ask me about one school. We're currently engaged in building programs for 10,000 schools across the country, 7,500 primary schools, larger scale, as well as science centres, new science centres and language centres in the secondary schools, as well, so I looked at the figures on this the other day in terms of where problems have arisen - across those 10,000 schools, complaints have been raised in terms of 0.73% of them.
Can we just put this into some context? This was done deliberately to keep the Australian economy going at a time when economies around the world were falling into recession - falling into recession. We, Australia, did not go into recession, and one of the core reasons that didn't happen is we decided to use a national infrastructure stimulus strategy, but not just that, to provide state-of-the-art libraries, state-of-the-art science centres, state-of-the-art language centres, multipurpose halls, new classrooms for kids right across Australia.
We're proud of what we've done. There's going to be problems, always, in the implementation of large scale programs. You just deal with them one by one.
So, when the audit's through in the school that you're referring to, I'm sure Julia will come to your program and go through the detail of it.
HOST: We'll remind her of that. We will, thank you.
HOST: Just, finally, Newspoll this week, I think your approval rating's gone down more than 20 percent from its high. What do you say to the more than 20 percent, a quarter of the people in the poll now don't approve of you, who used to approve of you. Why is that?
PM: Well, you know, my job is to take some hard decisions for the nation. Some of those will be popular and others will not be. One of the hardest decisions we took a year and a half ago was decisions to step into the breach with the Australian economy so it wouldn't fall into recession. Now, some of the programs that we've put in have resulted in criticism. You just referred to one of them now.
So, when it comes to election time, people will make their judgement, and my experience of the Australian people is that they are hard judges but they are fair judges, both on your record of what you've done, which is keeping this economy out of recession, protecting the jobs of hundreds of thousands of working families compare with the rest of the world, and then plans for the future - how we intend to deal with the health and hospital system.
It's going to be a huge debate about all these things. I understand that.
HOST: Mightn't it be that they just agree with you that you could have done better? You spent a week telling us that you really thought you could have done better. Do they just agree with you?
PM: Well, the point is that they will mark the Government, they'll mark me, on the basis of what we achieved and our plans for the future, and what I'm saying on that is that in terms of what we've achieved, keeping the economy strong, protecting hundreds of thousands of jobs of working families at a time when the rest of the world crashed into recession, that's not a bad achievement.
And, secondly, not just starting the reform of the health system now - we've increased our investment in the public hospitals of the country by 50 percent already, but this big plan for the future is about how do you deal with the deep surgery it needs for the long-term future? How they judge us in the end, John, that's a matter for the people - as it should be.
HOST: Do you agree that we're in a pseudo-election campaign already?
PM: You know, I presume people were in that frame of mind from the day after the last one. I don't know. My job in these limited, 3-year terms that we have here is to make use of every day to try and make a difference to working families' lives, and I am concerned - as we began this conversation today - about what's happening at the accident and emergency last night, what's happening for elective surgery today, have you got enough GPs in your area, are there enough medical specialists? And, last week, here at the Royal North Shore, to be there to see the opening of a PET scanner, I think the sixth in Sydney, which we funded directly, the Australian Government, which affects so many people-
HOST: -Didn't Tony Abbott approve that, though?
PM: Well, this is a really interesting story. What the locals have said to me is-
HOST: -He claimed to parliament he approved it.
PM: Yeah, well the Royal North Shore started making representations to them, that's the previous government, in 1997. I'm advised by the locals that Mr Abbott supported this on the eve of the last election in 2007. We actually funded it. We actually built it. We've installed it. We've opened it and it has been in operation now for one week. I think the locals are more concerned that it's there.
HOST: OK. So, you don't think you're rattled, because there are commentators lining up to say you're rattled.
HOST: Not only you, but let me say it, the party - panicked and irrational nervousness in the ranks about the next election.
PM: You know something? Political commentators will roll out there, say a whole bunch of things, and guess what? A lot of them may not like us, a lot of them may like us from time to time, a lot of them may loathe us for all the time - that's one of the great things about the democratic system which we are.
Our job is to get on with the business of governing, and on the question of having a debate health and hospitals reform, you know something? I welcome that with open arms. We have a plan for the future, it's clear cut, it's there, it's an extensive document. My opponent doesn't have a plan, and he has a record, and the record on health and hospitals is pretty damn awful.
HOST: Prime Minister, thank you for your time this morning.