Prime Minister Transcript of joint doorstop interview Royal Hobart Hospital 22 April 2010
Period of Service: 03/12/2007 to 24/06/2010
Release Date: 22/04/2010
Release Type: Interview
Transcript ID: 17236
PM: First of all it's great to be back here in Hobart, great to be at the Royal Hobart, and here at the repatriation centre and the rehabilitation unit. Because this is where the rubber hits the road when it comes to delivering better health and better hospital services to all Australians, including older Australians, including the good folk of Tasmania more broadly. It's good to be here with the Premier- I think in your first official day on the job, is that right?
BARTLETT: That's right.
PM: Good, and congratulations to you. But also here with Julie Collins, the Member for Franklin, and Jonathan Jackson, who is our new candidate for the seat of Denison. I understand you've been an accountant here in Hobart - we won't hold that against him. Born and bred here in Tassie. And also married with a couple of kids, on the steering committee of an organisation called Main Chance Farm, which helps kids at risk. So it's good to have a candidate of such high quality standing for us for the upcoming federal election due by the end of this year.
We're here to talk about health and hospitals. And together with the Premier, in Canberra over the last several days, we've forged an historic agreement for a new National Health and Hospitals Network, the NHHN - funded nationally, run locally. All for one purpose, to deliver better health and hospital services to working families, to pensioners, and to carers. And that means more hospital beds, more doctors, more nurses to make the system work better.
Here in Tasmania, the key thing is to make sure that we deliver services which make a difference on the ground. And that's why I'm pleased, with the Premier, to have been party to an agreement which will deliver over the next three years $142 million in additional investment, and over the period ahead beyond that, a further $340 million. Let's just go to the immediate period ahead. We're talking about new investments into emergency departments in order to bring about, over the three years ahead, a four hour target for ED waiting times. This is important. It's important for people who go to accident and emergency, knowing they can be treated in time.
For elective surgery, we're also investing some $15 million and a further $8 million as well to bring about a target of 95 per cent of people being seen for elective surgery within clinically acceptable times. We're also investing, nationwide, in a very large expansion in hospital beds, including sub-acute beds of the type that we've been visiting here today at the rehabilitation centre.
For Tasmania, we'll see from 1 July the beginning of a rollout of 30 more of those beds across the state, including in centres like this one. This is really important, because there's a demand for these beds. It's very important for people's dignity, for their health, that they have an opportunity to rehabilitate, to get their confidence back, to get their strength back, in order to get back home. But you can't do that if you don't have enough beds. And that's why this is a very practical measure on the ground.
They advised me, coming into the centre today, that there are I think two wards of 20 each here - so across the state, we're looking at a further 30 fully staffed beds. These, for the benefits of our friends in the media, are not those physical things that you sit on called a bed. A cost of a bed is about $6-800,000 a year per bed. And that's after you've got through the set-up costs. These are very expensive investments. But they're very important to enable people to get their lives back together, to be able to become self-sufficient again, and to make sure that they can be returned home as quickly as possible.
Of course, to make all this work, we need to have for Tasmania, and for the nation at large, more doctors, more GPs, more specialists. I spoke last night here in Tasmania, in Hobart, with the head of the AMA and senior officers of the AMA about the shortage of GPs across Tasmania. The figures they gave me, Premier, were you're currently about 24 short across the state. I have no basis whatsoever to dispute those numbers. Therefore, the practical thing is what are we going to do about it to fill that gap now.
So what we're doing is adding - starting from the year ahead - a significant increase in GP training places right across Australia. And that will roll out over the decade ahead, to bring about another 6,000 places. Here in Tasmania, what we're talking about is 111 GP training places being rolled out, 20 junior doctors positions, 14 specialist doctors, 74 allied health workers. You can train people in university, that is one thing. But unless you're also funding training places within hospitals, it doesn't work. This is a radical change, therefore, to our investment in the needs of the health workforce.
So, where the rubber actually hits the road with big announcements like the one we made in Canberra the other day, what does it mean for people here, in Hobart, in Launy, and right across the state of Tasmania? It means investments which make a difference on the ground at your accident and emergency, for your elective surgery, and available hospital beds, and at a very practical level, for folk like Bertha and Tom and Noelene who we met today, folk in their 80s and 90s, it means being able to have access to a bed like this so that the acute care beds at Royal Hobart are freed up for the people who will roll into accident and emergency tonight, some of whom will need urgent surgery.
So this is all part of an integrated reform for the system.
The second thing I'd touch on before taking your questions, and asking the Premier to comment as well, is on the economy. We can invest in better health and better hospitals because the Australian Government has kept the economy strong. We've protected this economy, during the worst global economic downturn that the world has seen since the Great Depression. We have protected Australian jobs. We've protected Tasmanian jobs. Had we seen the same unemployment levels here as we've seen around the rest of the world, you would have up to half a million more Australians out of work, with huge consequences for the economy, with huge consequences for our ability to fund the expansion of services like we're doing in health and hospitals.
I'd draw your intention to the important report brought out in the last 24 hours by the IMF, the International Monetary Fund. The International Monetary Fund provides further clear international evidence that Australia leads the world in global economic performance when it comes to the advanced economies. It indicates quite clearly how Australia has succeeded in keeping this country out of recession while practically every other advanced economy in the world sank into recession.
And the numbers released by the IMF today couldn't make that any clearer. Australia's growth outlook is stronger than for any of the other advanced economies. Let's just go to one or two of the numbers so that people are very familiar with it. For 2008, we managed to keep growth in this country running at 2.4. Across the rest of the advanced economies, it contracted to 0.5. In 2009, when the global recession was biting at its worst, we managed to keep positive economic growth in the Australian economy at 1.3 per cent while the rest of the advanced economies sank into 3.2 per cent worth of recession. That is, negative 3.2.
For 2010, the IMF's projection is 3 per cent positive growth for Australia, 2.3 for the rest of the world as they slowly recover. And for 2011, the IMF's projection is 3.5 per cent growth for Australia against 2.4 per cent, the average of the other economies. This is a very clear contrast, a very clear international contrast which underpins the Australian Government's success in keeping this economy strong. And that is what we have done. And because of that, we're able to invest in the needs of our health and hospital system.
One final point on the economy. And that is the contrast in terms of our political opponent, Mr Abbott, could not be clearer. Mr Abbott today has called for the Government to immediately cancel the implementation of the remaining parts of the Australian Government's national infrastructure stimulus strategy. That's what he's called for. Mr Abbott previously has said that the model that we should've followed is New Zealand.
New Zealand went through one and a quarter years of negative economic growth. We began this period of the global economic downturn with the same unemployment rate as New Zealand. Right now if we had the same unemployment rate as New Zealand, we'd have more than 300,000 more Australians out of work.
Can I just say, this is the starkest of all possible contrasts. This policy from Mr Abbott would cause chaos, economic chaos, and would pull the rug out from under the economy. And literally thousands of businesses, small businesses, would go to the wall.
Look at the specific projects which his policy would mean either cancelling or winding back. Here in Tasmania, the Brighton Bypass on the Midland Highway - $164 million worth of investment - gone. Ipswich Motorway, the Bruce Highway, the Pacific Highway, the Hume Highway, the Western Ring Road in and around our major cities. Regional rail express in Victoria. The Hunter Expressway in New South Wales. Rail upgrades in South Australia. Mr Abbott is saying to each of these projects, 'gone'. Let's be very clear about this.
Therefore, when I look at the implications of this reckless policy announcement on the ground, huge projects affecting roads right across the country would be affected, but here in Tasmania, and right across Australia, 4,000 schools in the middle of rolling out the biggest school modernisation program that the country's ever seen would be left in complete chaos. Absolute chaos.
So my challenge to Mr Abbott is - one, name each of these projects across the country that you would cancel. Two, name which of the school modernisation projects you would cancel. Town by town, community by community, state by state. Let's have the details, or is this just a cheap political line? On the economy, Mr Abbott represents a capital R risk. And on health and hospitals, Mr Abbott, as always, is negative with a capital N.
I just conclude by one further specific investment on health and hospitals we're making here in Tasmania today. What we'll do here in Tasmania is also have $1.5 million provided to the University of Tasmania to work with a range of health providers, including Hobart Private Hospital, to create clinical training places for around 180 students. These students will be training in areas such as psychology, pharmacy, midwifery, nursing, physiotherapy and medicine. And it builds on the health workforce reforms that we've spoken of already. But these investments in our health and hospital system would not be possible unless you're able to keep our economy strong.
We've kept our economy strong. We're the only one of the major advanced economies to have stayed out of recession. The only one to have grown positively during the worst economic downturn since the Great Depression. The second lowest unemployment. The lowest debt, the lowest deficit. And Mr Abbott's response to that is 'cancel the lot'. Well I'd say, on the economy, Mr Abbott represents a capital R risk.
Now Premier, before I take any questions, do you wish to add on the health matters that we spoke about?
BARTLETT: Well can I just say, firstly, my congratulations to the Prime Minister for bringing about, having the courage, and taking us as Premiers through the most significant reforms to health and hospitals since Medicare. The reforms that we signed up to - and I proudly signed up to on behalf of Tasmania this week - will see a generation of improvement in our hospitals, a generations-worth of improvement to our elective surgery waiting lists, to our throughput in emergency departments, and to places like this in terms of the extra sub-acute beds. So my congratulations to the Prime Minister and I offer my full support in the implementation of these reforms in Tasmania.
That implementation, while these reforms will have long-term benefit over the coming decades for our nation and for our state, that full support in implementation will also have significant short-term benefits for Tasmania. With the work we've already done together since the last COAG health arrangements were put in place in late 2008, Tasmania's elective surgery waiting lists have dropped by a full 13 percentage points. That trajectory will continue with the extra investment that the Prime Minister has committed, and we will see our waiting lists in Tasmania over the coming two and three years continue to reduce by that amount or by a similar amount over those coming years.
This is a great outcome for Tasmanian patients, a great outcome for Tasmanian health and hospitals, and with the further announcement today, that investment will continue to see Tasmanians, and indeed interstate people moving to Tasmania, to find positions of training in our hospitals, which has, of course, been the missing link.
This, together with the many hundreds of millions of dollars that we committed to over the course of the election campaign that we will start implementation on right now, one of which was of course a $14 million program to attract GPs to rural and regional areas of Tasmania, will dovetail perfectly with the reforms that the Prime Minister is talking about and we'll see rural communities get better access to GP services, further taking that pressure off our emergency departments state-wide.
So, thank you for coming down, Prime Minister, and we look forward over coming months and years to working with you on getting these reforms right and delivering for all Tasmanians.
PM: Good. Thanks very much. Over to you, folks, for some questions.
JOURNALIST: Prime Minister, this from the IMF report (inaudible) Mr Abbott this morning said that the Howard Government could take a lot of credit for that - do you accept that?
PM: What I would say is that Mr Abbott should focus on one core fact - that is, that he and his Party opposed the Government's national economic stimulus strategy. That strategy has been validated by the International Monetary Fund, the World Bank and the OECD as the basis upon which this economy stayed out of recession. That is the core fact.
Secondly, not having learnt from that, Mr Abbott now says that this strategy should be cancelled. I go round regional Australia, North-West Tasmania, Far North Queensland, those parts of Australia which are still doing it tough - and I mean really tough - what Mr Abbott would say is 'I intend to pull the rug from under those regional economies'. That is not acceptable.
Can I also say, again, that on the economy, Mr Abbott increasingly is a capital R risk.
JOURNALIST: Do you now have to, to get these changes through, you now need to go to Parliament, I understand. Have you thought about the Senate and a strategy, perhaps, to get these through in that other difficult arena that might match the premiers?
PM: Well, your question is based on a core reality. The first is we can have a plan, a National Health and Hospitals Plan, to bring about better health and better hospital services for all Australians, but unless you've got the agreement of the states and territories then it wouldn't get anywhere, and if you don't get it through the Australian Parliament then you can't get it implemented on the ground.
Now, we've passed the first of those hurdles, the big one - getting seven of the eight governments of Australia, the states and territories, to support the implementation of the biggest reform to our health and hospital system since the introduction of Medicare, remember, with the Australian Government for the first time becoming the dominant funder of the public hospital system of Australia.
That brings us to the next phase, which you point to in your question. My challenge, again, to Mr Abbott today is to provide two simple, plain-speaking guarantees.
The first is to guarantee he will not use his numbers in the Senate to block the necessary legislation to give effect to the National Health and Hospitals Network, and secondly to provide a clear-cut guarantee that if he was to win the next election that he would not overturn these reforms or change them.
That's the bottom line.
JOURNALIST: Do you have a plan B, though? Have you approached Nick Xenophon, the Greens, those sorts of people in the Senate?
PM: I've noticed already that Senator Fielding is sounding negative. The key thing here is to make sure that we have a clear statement from Mr Abbott, who prides himself, it seems, from time to time, on straight talking, to give us a straight-talking answer to this question. And the question for Mr Abbott is provide a guarantee that you won't use your numbers in the Senate to block the implementation of this health and hospitals reform package.
You know something? Mr Abbott increasingly seems to be playing to what he sees to be his short-term political advantage. I would challenge him, instead, to look to the long-term health needs of the nation. Playing short-term politics is one thing. Short-term political advantage for Mr Abbott may be one thing. Long- term health needs of the nation, frankly, is what working Australians want to see.
JOURNALIST: Would rejection in the Senate also trigger a referendum?
PM: Can I say that we believe that Mr Abbott has got a deep responsibility here to act in the national interest, not to run and hide, not to scurry away, but to be plain-speaking - plain-speaking. Our plan for a National Health and Hospitals Network has been out there for more than six weeks. It's there in two elaborate documents which detail precisely what we intend to do.
Further, there is a detailed communiqué which goes to the actual content of the agreement with the state and territories. It's there for all to see. And Mr Abbott and his Party have been following this debate for a long, long time. Mr Abbott was health minister of Australia for nearly five years just prior to this election. It's not as if he comes to this debate without any previous experience. Therefore, the challenge again to Mr Abbott, as he claims to be an exponent of plain speaking, is to say will you provide a guarantee today not to block this reform to our health and hospital system in the Senate. It's pretty plain.
JOURNALIST: Are you ignoring the crossbenchers, then? The other parties and the independents?
PM: Well, I've noted what, already, Senator Fielding has said. I'm sure discussions will occur with all senators, as it does and as would normally be the case, but let's just face some realities here about who commands the lion's share of the numbers in the Senate. It's called the Liberal and the National Party. Last time I looked their leader was Mr Abbott, and therefore the ball is very much in his court. And this question is not an academic question. It's a real question. What stand between the delivery of these reforms to our health and hospital system is Mr Abbott failing to be clear cut - does he support this in the Senate or does he oppose it?
So, rather than just running for cover, as he seems to have done in the last 24 hours on this one, I think it's time he came out and actually said what he means on this. We're coming, also, up against an Opposition which has become the most obstructionist opposition in the Senate in 30 years, if you look at the number of pieces of legislation which are being blocked by the Liberal and National parties in the Senate.
JOURNALIST: Prime Minister, a slightly different topic - you've grappled with the Greens in the Senate on things like emissions trading and had things knocked back.
BARTLETT: I think I know where this is going.
JOURNALIST: Now that Mr Bartlett effectively needs Greens support in the lower house alone to do just about anything, how can that work? How can that possibly work?
PM: Well, first of all, the Tasmanian people have spoken. The Tasmanian people have let their hopes and desires and judgments be known through the ballot box. That's what our democracy's all about.
So, what are the alternatives? You leave a state ungovernable or you form a government, and I believe what the Premier's done is a practical course of action in response to the clearly expressed will of the people.
I've also noted carefully what the Tasmanian Greens leader has had to say. He's committed himself to a constructive course of action. I believe, at this stage in the process I see expressions of goodwill all round to make this work, and certainly my attitude as Prime Minister is I work with every democratically elected government of the country - Liberal, Labor, Calathumpian, Green, whatever you like, okay? That's what the people elect, so I think -
JOURNALIST: - Does it change the dynamics in Canberra between you as a Federal Labor and Federal Greens, at all?
PM: We've always sought to maintain a constructive dialogue with the Greens. They will whack us around the head from time to time, and say nice things occasionally. That's just the nature of the argy-bargy of politics.
Can I say, though, for the good people of Tasmania, making sure that the government is properly functioning, based on goodwill from the parties concerned, I think that's what people expect. The people of Tasmania, like Australians right across our nation, they want government to get on with the practical business of delivering better services on the ground in education, in health and hospitals and law and order and transport and infrastructure, and so I wish the new Government of Tasmania well, including its newest ministers, including Minister McKim.
JOURNALIST: Does it mean (inaudible) I mean, that would be (inaudible) for a lot of Labor ministers (inaudible). How do you think (inaudible)
PM: I think with good humour, charm, general exchange of -
BARTLETT: - Like the COAG meeting.
PM: Yeah, like a COAG meeting, which occasionally has its robust moments.
Look, it depends, ultimately, whether people want to make the system of government work or not. And, for example, COAG, the Council of Australian Governments, in the two years or so that I've been Prime Minister, it has become the workhorse of the federation. We have engineered major, major changes to the nation in terms of our intergovernmental agreements on education, on health and hospitals now, on microeconomic reform across a whole range of areas including conflicting state regulation of the economy, the agreement we reached recently in Darwin on a national agreement for the first time on closing the gap with Indigenous Australians which is the most comprehensive agreement on health and education services for the first Australians, and you know something? That's all based on ministers of different governments with different emphases and from different political parties deciding through an act of political will to make the system work.
So, the challenge and the opportunity lies to these new members of David's government to do the same. I've heard very strong expressions of goodwill and intention to do that. We're pretty relaxed about all that. At the end of the day, I think people in the community are pretty practical. They'll make a judgment based on what we do, what we deliver and how far we go.
And having said that, I'm late for a conference. You've got a conference on tourism here that I've got to address.