Today's new deal on health delivers national health reform that will last, built on a genuine partnership between the Commonwealth and the States and Territories.
The Gillard Government will invest a guaranteed extra $19.8 billion in public hospitals - matched by tough national standards to make sure that money goes straight to hospitals and straight to patients.
And because this is a genuine national deal, every person in Australia will benefit, no matter where they live.
What that all adds up to is a better deal for patients.
* More money, more beds, more local control and more transparency
* Less bureaucracy, less waste and less waiting.
Under the new deal:
* The Federal Government will step up to permanently pay 50 per cent of the growth in hospital costs.
* This will be done in two stages, increasing to 45 per cent in 2014-15 and to 50 per cent in 2017-18.
* Once this kicks in, the States and the Commonwealth will share future funding growth in a 50/50 partnership.
* The States and Territories will receive $16.4 billion in extra hospital funding between 2014-15 and 2019-20 under the new structural funding arrangements and $3.4 billion for extra emergency departments, elective surgery and 1300 sub acute hospital beds in the next four years.
As part of the agreement there will be a single national funding pool, meaning hospitals will be paid the same way, delivering unprecedented transparency in hospital funding arrangements.
In return for this extra funding, States and Territories will also deliver significant reforms to the way hospitals are funded and services are delivered, including:
* Greater local control of hospitals.
* A price on hospital services through activity-based funding to drive efficiency and reduce waste.
* Strict national standards, including:
* a 4-hour target for emergency waiting times
* a 95 per cent elective surgery target, aimed at ensuring 95% of all patients waiting for elective surgery are treated within clinically recommended times.
* a National Access Guarantee to ensure that no Australian experiences extremely long waits for elective surgery.
* More transparency through strict reporting via the MyHospital website.
As part of the changes announced today, the Commonwealth will have a renewed focus on the delivery of stronger primary health care to get people the services they need in their local communities and keep people well and out of hospital.
Implementation of these reforms will include stronger clinical engagement to ensure that the voices of clinicians all over the country are heard in the process.
HEALTH FUNDING
The biggest challenge facing our health system is that it is running out of money.
There is a fundamental structural problem: hospital costs are rising faster than the States can raise money to pay for them.
Without structural financing reform, rapidly rising health costs will overwhelm State and Territory budgets within the next few decades.
The Government is committed to properly funding public hospitals to meet the rising costs of care into the future.
From 2014-15, the Commonwealth Government will increase its share of public hospital funding by funding 45 per cent of all efficient growth in public hospital services, increasing to 50 per cent in 2017-18.
That is, from 2017-18, 50 cents in every new dollar spent on efficient hospital costs will come from the Commonwealth.
This will mean a genuinely equal partnership between the Commonwealth and the States and Territories on how growth in hospital costs is paid for into the future.
The financial benefit of this arrangement to the States and Territories will be a guaranteed $16.4 billion over the remainder of the decade.
NATIONAL FUNDING POOL
The Government will improve transparency of funding flows through the establishment of a single national funding pool.
This will ensure that all hospitals are funded under the same comparable, transparent arrangements.
Commonwealth and the State and Territory Governments will pay their share of base funding and efficient growth funding into a single national pool.
This body will be administered by an independent, national body, distinct from Commonwealth and State Health Departments, to be operational from 1 July 2012.
Instead of eight bureaucracies under the previous deal, there will be just one national funding body.
MORE EFFECTIVE, MORE EFFICIENT HOSPITALS
The Government is determined to deliver health reforms to give patients a better deal.
That means cleaning up our inefficient health system in which there is too much waste, by introducing solid market-based reforms to drive greater efficiency and innovation in the public hospital system.
Efficient Price
Instead of States receiving block grants - the equivalent of blank cheques - hospitals will be funded for each activity they undertake.
This will be based on the fair and efficient price for each service, set by an Independent Hospital Pricing Authority.
This will help identify our best hospitals, as well as some of our less-effective hospitals.
Combined with indicators of quality and access, we can identify our underperforming hospitals and successful techniques used by our best hospitals can be shared.
In some instances, like payments to smaller regional hospitals and some highly specialised services, funding will continue to be paid in block grants.
Standards
The Commonwealth Government will continue to insist on tough national standards for public hospital performance to drive shorter waiting times for both elective surgery and emergency departments.
We will work with the States and Territories on safe and effective implementation to deliver:
* The four-hour National Access Target - to reduce long waiting times in public hospital emergency departments, by aiming to have patients assessed, treated and discharged or admitted within 4 hours where clinically appropriate
* The National Access Target for elective surgery, aimed at ensuring that 95% of all patients waiting for elective surgery will be treated within clinically recommended times.
* The National Access Guarantee for elective surgery, which means that extremely long waits for elective surgery will become a thing of the past.
Reporting on Performance
The Government will also publish information about how each hospital performs so the public can choose the best care.
This is another important market principle which will drive improvements in patient outcomes across the nation.
Transparency will also be increased through activity-based funding, meaning you pay for what you get, and one national funding body to ensure all hospitals are paid in the same way for services delivered.
Local Control
National health reform will also give local communities and clinicians a greater say in the delivery of their local hospital services through the establishment of Local Hospital Networks.
A GREATER FOCUS ON PRIMARY CARE
The Gillard Labor Government also understands that a strong health system requires more focus and investment in primary care services.
Our primary heath care reforms aim to shift the centre of gravity from hospitals towards primary health care.
The Government is establishing Medicare Locals to drive improvements in primary health care and ensure that primary health care services are better tailored to meet the needs of local communities.
The Government will strengthen its primary health care reforms by:
* ensuring that Medicare Locals are locally responsive, and can demonstrate how they will connect to local communities and respond to local health needs - this will mean establishing more Medicare Locals than originally planned;
* bringing forward the establishment of more Medicare Locals to ensure more communities receive the concrete benefits from Medicare Locals sooner;
* fast-tracking reforms to after-hours GP care, through which Medicare Locals will plan and support local face-to-face GP after hours services;
* ensuring that local communities have robust information about their local primary health care services - including key information on opening hours and availability of health care services, patient outcomes such as rates of preventable hospitalisations, and information on the health status of the community, such as rates of chronic disease.
Over time, the Commonwealth will empower Medicare Locals with more flexible funding to target services to their local community's specific needs.