PM: Good morning. I understand a number of you have probably got questions about Egypt and I'll be happy to take those questions at the appropriate time but I'm actually here to make a major statement about health.
Can I start by saying we know that our hospitals face an enormous funding challenge. When we look at hospital costs and health expenditure the rate of increase in hospital costs is faster than the rate of increase in the revenues available to state governments. If nothing is done to fix that it means over time state governments will find it harder and harder to properly fund hospitals and that means patients will find it harder and harder to get the care that they need. Indeed if you look at the projections of the growth of hospital costs as compared to state revenues, if nothing is done states will face a situation where hospital costs overwhelm their state revenues. That is, they would not have money left to fund other essential services like police and like education.
This is an unsustainable position and it requires genuine reform. Last year Kevin Rudd as Prime Minister sought to tackle this major challenge for the nation. He was the first Australian Prime Minister to step up to the plate and to seek to deal with this major challenge for Australians and the future of their health care system.
On Sunday the Council of Australian Governments will meet and if we emerge from that meeting with a new health agreement, then it will stand on the shoulders of the reform work undertaken by Prime Minister Rudd. But it is now clear that the agreement that Prime Minister Rudd negotiated will not become a national agreement, it is clear that different states are pulling in different directions. Now what we need is national reform and a national determination to deliver better services through a national agreement.
The country needs that national reform, that genuine health reform and that's got to be about a better deal for patients with a focus on health reform, not about accounting transactions. I want a better deal for patients, that's my bottom line as Prime Minister. I do not want to let a political argument about financing arrangements stop me securing that better deal for patients. I do not want to let politics stand in the way of the cause of genuine health reform. When I talk to patients, when I talk to Australians around the country they don't talk to me about the GST, they don't talk to me about financing transactions, they talk to me about their health care needs and the services they want to see available in their community for them and their families and that's what we have to do deliver - health care that will deliver concrete benefits to patients in communities, we've got to deliver genuine health reform that will stand the test of time. That means we've got to tackle the structural funding challenge that I've just outlined as we deliver a better deal for patients.
Now that requires five key reform elements - more transparency, less waste, strict national standards, including shorter waiting times, activity based funding and more local control.
So to round it all up, what is the aim here? It's better hospitals and better frontline health services right around the nation, whether a patient is in Melbourne or Perth or Brisbane or in one of our great regional centres or in rural Australia, we want them to have the health care that they need. That's my focus, not financing transactions and achieving the better deal for patients is my bottom line, anything else is a distraction.
As a result of taking this approach, when COAG meets on Sunday I will put the following proposal to Premiers and Chief Ministers: first I will deal with the question of funding and properly funding hospitals into the future to deal with the structural financing problems that I've outlined. I announced today that I will at the meeting on Sunday say to Premiers and Chief Ministers that the Federal Government is prepared to contribute half of the costs of growth in public hospitals. That is we will contribute 50 cents for every new dollar that is needed for public hospitals, that will come from the Federal Government.
That means with us contributing 50 cents in every new dollars that is needed, that there is an equal partnership between the Federal Government and State and Territory Governments in meeting the growing costs of health care.
This will overcome the challenge of dealing with rising hospital costs, which I've outlined. As a result that funding will be there to overcome the problems that a lack of funding has caused including a lack of beds, a lack of equipment, a lack of staff. We need this kind of structural reform and we need the Federal Government to share the fair burden of growth and the fair burden is for the Federal Government to pay for half the growth.
The financial benefit of this arrangement for States and Territories to the end of the decade is $16.4 billion, which is roughly equivalent to the current estimate of what they would have received through the COAG discussions and agreement last year. So there are very serious benefits here for States and Territories.
The second element of the proposal I will put is in return for providing more funding for hospitals into the future, I will ask States and Territories to commit to transparent new arrangements for the funding of public hospital services. I will propose that the Federal Government, States and Territories contribute their share of hospital funding and growth funding into a single national pool. That national body will transparently report on the number of services paid for by the single national pool. You will be able to see very clearly money in, money out, from the Federal Government and from State and Territory Governments.
Third, I will propose to the State Premiers and Chief Ministers that we drive structural reform in the health system through using very familiar market based tools. One of those market based tools will be activity funding, that is funding flowing on the basis of an efficient price for services. That efficient price will be set by an independent body, a bit like the Reserve Bank, independent of the Federal Government, independent of State Governments.
That pricing of hospital services will help us identify underperforming hospitals, it will help us identify best performing hospitals, underperformance can be remedied and best practice can be shared.
Then we will be, I will also at the meeting on Sunday, be saying we must agree to standards about how hospitals treat patients. This is the same reform style approach I brought to education, where we were very focussed on quality and increasing standards. I will be insisting on transparency, once again a very familiar approach, just as I insisted on school reform being one that included the transparency we now have from My School, we will have transparency in health reform.
And once again a familiar old friend from education reform, local empowerment and local autonomy, a key element of this will be local hospital networks, making decisions at a level closer to communities. Clearly in this package that I've outlined today there is a very key focus on hospitals and that is to be expected, given the concerns of States and Territories about rising hospital costs and the health care problem this poses for the nation, but we need to remember if this country is going to have quality health care into the future we need to do better in front line services.
We are a nation that has high hospitalisation rates compared with countries that are similar to us. We can only address that through better front line services, better for patients to get their care from the right person, in the right place, at the right time and avoid a trip to hospital, better for the finances of the nation, for a person to get that care and not ending up being in an acute hospital bed which is the most costly part of our health care system.
So today as an improvement in primary care I want to outline the following reforms to Medicare Locals. We will of course be committed to establishing Medicare Locals, primary healthcare organisations, the job of which is to better co-ordinate front line services that care for people. I want to build on and improve the Medicare Local system, which the Government has already announced.
So today I announce that we will ensure that Medicare Locals are more representative of their local communities. That means there will be more Medicare Locals, I have been concerned some of the Medicare Locals are too large in size, we will be creating more Medicare Locals. We will fast track the delivery of Medicare Locals, I am going to double the number of Medicare Locals that start in the next 12 months from 15 to 30. I will also be providing to these Medicare Locals funding to enable them to deal with afterhours services, it's a big problem that people end up in hospital emergency departments because they can't find care after normal business hours when they need it and people don't time their illnesses or their children's illnesses for office hours, people often need after hours care. So I intend to start two years earlier with the funding to be provided to Medicare Locals for after hours services.
I also want to empower Medicare Locals so that they are able to respond to particular health care needs, in their community and plug service gaps. That means that my vision for Medicare Locals is that they will be fund holding over time, they will have funds to plug service gaps. I will also be insisting on transparency as to the performance of primary health care within Medicare Locals, I want local communities and regions to be able to see transparently how primary health care is going in their community, in their Medicare Local, in the same way that I have enabled Australians to see how their local school is going.
Medicare Locals will work with local hospital networks to improve patient care and the quality of health and hospital services in local communities.
All in all as we move to COAG on Sunday, my focus is on a better deal for patients, on achieving structural reform, a financing of health care so it is sustainable and properly funded over time, of using market based tools to reform health care, of using transparency, quality standards and local autonomy to improve health care and as Prime Minister I will have a keen focus on front line services. I am very, very persuaded of the fact that unless we improve frontline services and keep more people out of hospital when they don't truly need to end up there, we won't as a nation have that health care service that we need for the future.
I'm very happy to take questions.
JOURNALIST: Prime Minister wasn't the whole thrust of this reform agenda to effect at least majority Federal control of the hospital system because the states had bungled it so badly, the administration of hospitals and in some cases dangerously, and isn't this now an embarrassing admission of defeat for you and your Government?
PM: My focus here is a better deal for patients and what your question is asking me about is will patients get a better deal, and under this package yes they will. Patients don't end up worrying themselves about whose name is on that pile of money, does the little plaque say ‘state' or does the little plaque say ‘federal', what they worry about is does my hospital have the money in needs, when I go there will I get the treatment I require, will I get it in a timely way, will I understand what's happening, will I be able to see how my local hospital is performing, and across those range of questions, the answer out of this package is yes, yes, and yes.
Yes there will be proper funding, us stepping up to 50 per cent of the new money.
Yes there will be standards, including times for treatment.
Yes there will be clear transparency so people will know what is going on.
Yes there will be efficiency because there will be a price, an efficient price, and people will be able to see transparently whether it's being secured or not.
These are the things that matter to people and they're delivered by this package.
JOURNALIST: Prime Minister-
PM: Matthew Franklin.
JOURNALIST: Would it be fair to say, just as you compare the previously proposed package and this one, that in having given away the idea of a change of the funding structure that had been proposed, and you've just explained that and why, your new, you make up for that by imposing more transparency in the style that your brought to the education sector, is that your response and your way to get more control and better efficiency?
PM: What I believe will drive improvement in healthcare - so the broad answer to your question is yes - what I believe will drive improvement in healthcare is everyone being able to see what is going on, there being clear standards that people will be held against and standards are part of this package, and there will be proper funding. The reality here is we've been in an endless blame game between Federal and state governments about health, because if patients get poor services, then the state governments have said ‘well it's because the Federal Government doesn't fairly fund us', and the Federal Government has frequently said ‘it's because the states don't administer health well.' Well we're busting out of all of that, it will be beyond question for the future that the Federal Government and state governments are partnering together to pay for growth: 50 per cent from us, 50 per cent from them, and this is against a backdrop where we've seen in the past the percentage that Federal governments are putting into hospitals going down over time, so an equal partnership for the future. And then there will be the transparency and standards and accountability and local control that I've referred to.
Laura.
JOURNALIST: So you're saying that this will end the blame game, what's the cost to the budget of this because you're bringing forward spending, what's the new money that's going to be spent over the forward estimates and does the reduction from 60 per cent to 50 per cent partially fund this acceleration of the primary health measures?
PM: The amounts involved in the primary healthcare measures are modest and they are bring forwards predominately, they will be accounted for in the budget. In terms of the big quantum, the big quantum of money, the amount of money, new money, flowing into health through these arrangements is basically the same as what would have happened under the old arrangements: we're talking about $16.4 billion. What of course you don't have is the merry-go-round of GST money.
Michelle.
JOURNALIST: Could you tell us in what figure the federal funding will represent, what proportion - it's now 38 per cent I think - by 2020, what will be Commonwealth proportion and do you agree that this is the second best model that has been essentially forced on you by political changes in the states, or do you think this is a better model than the one Kevin Rudd put forward last year?
PM: I think this is the best deal for patients, so we're getting away from an argument about financing, so if you actually think what has happened since COAG last year, people have blued about financing, they have blued about the GST, well my analysis is people sitting in hospital emergency departments, or queued at their local doctor waiting for an appointment, aren't there wondering to themselves about the mysteries of Commonwealth/state financial relations, they're actually looking desperately at the clock and at their watch and looking at the queue and wondering when they're going to get in to be seen.
JOURNALIST: Well why did you have it in the first place?
PM: Well obviously there was a vision pursued last year and I'd make it very clear, this vision of healthcare is standing on the shoulders of what has gone before, but the essential public policy problem that Kevin Rudd was grappling with last year is if you looked into the future you could see a time where state governments could no longer afford to fund healthcare, that it just wasn't going to work over the long-term and so he grappled with that sustainability issue. This package solves that sustainability issue as well as focusing on key reform elements to get a better deal for patients.
JOURNALIST: (inaudible)
PM: Yes I do I'll come to other questions but you asked me Michelle, just remind me because I could bore you silly with, how long have you got?
JOURNALIST: By 2020 what will be the Commonwealth proportion of hospital funding which is now about 38 per cent?
PM: Ok, within the decade our, this is the total, so the growth 50/50, within the decade we will reach over 40 per cent and that will keep growing, so if you go to the end of the decade it will exceed 44 per cent, so inevitably with stepping up to 50 per cent of growth you are dragging the base up behind you and that's-
JOURNALIST: 44 per cent in 20 years?
PM: That's right, and that's showing you how the base is being dragged up.
JOURNALIST: How will the national funding pool work, who will control it and how will, how can you be sure that the arguments between the state and Federal governments won't be sort of transferred onto whatever the mechanism for the national funding pool?
PM: Well the proposal I will take to COAG is that there be a single national funding pool, that it have an independent board, so in line with the general principles of COAG reform and you would have seen some talk about those this week from the COAG Reform Council, that there would be a board that is not the Federal Government, and not the state government that runs the pool. There would be state accounts within the pool, clearly we cannot have a circumstance where money for health for Western Australia ends up paying needs in the ACT, no one is suggesting that, so state money goes to state needs and there's absolutely clear and transparent accounting, Federal Government money in, state government money in, activity based payments out.
JOURNALIST: So it's more about accounting and transparency that body?
PM: That's right-
JOURNALIST: More than distribution?
PM: Correct. The distributional tool is the activity based price, which would be set by an independent pricing authority.
Phil Coorey.
JOURNALIST: Excuse me if I sound a bit thick, could you explain how you've restructured the growth funding because as I understand it the Commonwealth was to take over 100 per cent of growth funding under the original deal, and now you're saying you'll pay 50 per cent of it, is that right, it's still the same.
PM: I can explain that to you and I want to assure you that question is not thick, I think you're talking yourself down there Phil and you've got all of your colleagues here to do that for you. So the maths of this is, that the Federal Government under the old proposal, was going to fund 60 per cent of healthcare costs, 60 per cent of growth. Now that required a take back of GST revenues and you've seen all of the public debate about that take back. Under the model that I am laying out before you, the GST would be with the states as the GST has been with the states in the past, there would be no take back. What that means of course is that the states have available to them the benefit of those revenues for health and for other purposes, but clearly the single biggest expenditure item that comes on any state government's account is health expenditure. Therefore you've then got to work out how are you going to fund growth into the future, so the GST is out of the picture, states have got the GST, we are not using the GST for healthcare purposes, how are you going to fund growth? The right way of funding growth I believe is an equal partnership, 50 cents in every new dollar coming from the Federal Government, 50 cents in every new dollar coming from state governments.
JOURNALIST: Where do the states get that money from?
PM: Well the states have available to them all of their GST, which they didn't under the old model, and their ordinary revenue sources. So that's the percentages, what matters in the world is the dollars, so when you go to Aussies for a cup of coffee after this you'll be required to pay in dollars not in percentages, what matters is the dollars. The new dollars flowing to states and territories under the proposal I've put to you today is basically the same as the new dollars that would have flowed under the agreement struck last year.
JOURNLAIST: Prime Minister what legislation will be required at a federal and a state level for this?
PM: We will need legislation, they'll need to be legislation in relation to, and you would have seen some of this legislation has already started to be talked about and worked on; pricing authority requires legislation, the creation of the funding pool requires legislation, however we do not need to pursue the GST legislation which has been in the Parliament and the subject of discussion.
JOURNALIST: Will the states need mirroring legislation as well?
PM: Look we'll need to work through, depends on some conclusions about structures and governance of some parts of these arrangements.
Katherine.
JOURNALIST: Prime Minister notwithstanding health reform is obviously urgent and important, why are you seeking to wrap this up this weekend, given that we've got an election coming up in New South Wales that almost inevitably is going to deliver a change of government, aren't you exposing yourself to a situation where Kevin Rudd was in last year where he had the Barnett hold-out? Why this weekend rather than letting it go on for a couple more months?
PM: Because the task is urgent, it is important, and we need to get sustainable arrangements over time. I accept, as I indicated in my opening remarks, that the arrangement that was struck last year is not going to become and never going to be a national arrangement. We would not get Western Australia to agree, and clearly as the cycle of politics changes and it has changed in Victoria, I'm not going to predict state election outcomes, but it may at some time change in other places, as the cycle of politics changes then less and less agreement and buy-in was going to be had for that deal. But the most controversial bit of it was the GST take back and my view is we could all grow old and tired talking about state/federal financing arrangements, or we could get on with the job and deliver a better deal for patients. My bottom line is a better deal for patients. I also believe if I can go into COAG on Sunday and walk out with a national agreement with the political consent of Premiers who are now Liberal and Labor Premiers, that that would give me and the nation assurance about the sustainability of these arrangements over time.
Mark Metherill. I'll come to the back, go to Mark first, no I'll go to Mark first and then come to the back, we've got to give the old bloke a go.
JOURNALIST: Prime Minister will the funding pool cover all health spending and secondly when do think the activity based funding will actually be fully implemented?
PM: The pool will be the financing pool for hospitals, so there'll be the activity based funding, there will be the need for some block funding because you would be aware in terms of the activity base that there are some rural and regional hospitals, some special circumstances where activity based funding doesn't meet the needs, we will be staying on track to get activity based funding up from the middle of 2012.
At the back.
JOURNALIST: What indications have the states given you so far to this new plan?
PM: We're in negotiations, COAG negotiations are always, you know, got their twists and turns and we may see a few more between now and Sunday, but this is the proposal that I will take on Sunday, I have been very clear at every point with states and territories and let me be very clear here, there will be no new money without reform, quite a simple equation, just got an equal sign in it, no new money if there's no reform. So there will on be, there will only be additional money available for states and territories, the growth money they seek, if they reform. There are no blank cheques here.
We'll go to the back.
JOURNALIST: If you don't get an agreement on Sunday is a referendum back on the table for a Commonwealth takeover of the health system?
PM: Well the model I've just outlined in the model I think is appropriate, it's an equal partnership in growth between states and territories and the Federal Government, my eyes are on Sunday going into the room and coming out with a health reform agreement that will stand the test of time.
JOURNALIST: But if you don't get one?
PM: Well, you know, eyes on Sunday and on succeeding and that's what I am focussed on, walking into that room on Sunday and coming out with a health reform agreement that stands the test of time, a health reform agreement that's a better deal for patients, that properly funds hospitals into the future, that gives us more transparency, less waste, more local control, market based tools like activity based funding, that's what my eyes are on.
We'll go back, because Phil's already had one, we had to explain the maths to him, so we'll go up the back and come along. Yes?
JOURNALIST: Originally there was a 1 July start date for the new financing arrangements, the GST handover. Now, what is the deadline you're setting yourself for getting a lot of these quite new arrangements up and running? When does this pact start?
PM: well, the new funding would flow from 2014. Of course, we have provided a great deal of new funding to States and Territories in the meantime. As a Government, when we entered the healthcare agreements that hospitals are working on now, we upped funding by around 50 per cent.
And since then, for the time that was going to be in between discussions and when the reform were really going to start - remember, of course, the reform package talked about last year had an operation date in 2014 as well - for the time in between we've already agreed with the states and territories that around $3.5 billion of extra funding would be available. That's for elective surgery and emergency departments and the like, as well as financing improvements in primary care and health workforce.
So, all of those will continue to flow, but the step through to these new arrangements, moving to 50 per cent of growth, would start on 1 July 2014.
Yes?
JOURNALIST: The actual, tangible outcomes for patients, or expectations, the new hospitals, how quickly they can get surgery and so on, are they expected to be the same under this arrangement or better or worse?
PM: Well, put simply, there is effectively the same amount of new money on the table. Money matters. Money makes a difference, but it matters the most if you are getting the efficiencies you need in providing services, so a key part of this package is no more waste. That's what the efficient pricing mechanism was about. That's what the transparency's about.
Waste will stand out like, well, I won't use that expression, but waste will stand out very clearly, and as a result of it standing out underperformance will be able to be remedied and good performance, and this is something I very much brought with me from my days in education, with more transparency, more accountability, clear standards, proper funding, you identify what's going wrong, you get in and fix it, but you identify and celebrate what's going well and you get in, work out why it's going well, and you share it.
So, with the efficiency-based pricing we will see hospitals going really well. We'll learn something from them for the rest of the nation. We'll see some hospitals falling behind and that will have to be addressed to lift them up to the right standards.
Dennis?
JOURNALIST: Prime Minister, Mr Rudd described the deal last year as securing the future of federation, based on 60 per cent dominant funding from the Feds and GST rake-back from the states. You've mentioned the test of time, and given figures for the next 20 years, are you confident, particularly as far as capital funding is concerned-
PM: -Particularly as far as?
JOURNALIST: -As far as capital funding, as capital works, is concerned, that this will continue to secure the future of Federation and health, or is there actually going to be a shortfall that the States are going to have to make up in 15, 20 years time?
PM: No, I believe these are the durable arrangements we need over time.
If we look at the architecture of Commonwealth-State financing, the States got access to a growth tax with the GST, and we remember all of those debates from way back when.
As it turns out, the rate of increase in that growth tax does not match the rate of increase in health care costs, they rise more rapidly, so it's an unsustainable proposition to say ‘GST growth tax, Federal share in health care costs going down over time, that equalling a good health care system and good hospital system'. It doesn't add up.
Now what we will have, State's GST growth tax over time, Federal and State government's stepping up to an equal partnership in new money.
We are an area of government, the level of government, with the best revenue-raising capacity. Now, it's always hard to get revenue in, as we've seen from some other debates, but we have our revenue raising capabilities. We can step up to that 50 per cent of growth.
The old system, of course, has been to go into COAG, shove a pile of money on the table, walk back out, the States and Territories take the pile of money and it means the share of the Commonwealth funding of hospitals go down and the States and Territories just end up wearing that.
We are busting out of that by the equal partnership in growth.
Yes?
JOURNALIST: Prime Minister, the principle at the heart of the Rudd plan was that the only way to guarantee the outcomes was for the Commonwealth to be the majority funder. Do you not accept that principle, and if not, how to do you guarantee the outcomes will actually flow?
PM: The way you guarantee outcomes is you set up a package that means the delivery of those outcomes is spelt out in it. So, you've got to get the mechanisms right.
What's the mechanisms in this package that get it right? Well, we'll have money in a single, transparent pool - no hiding, no hole in the bottom of the bucket as we're tipping money in at the top. A single, transparent pool: dollars in, dollars out. Everybody will know who put them in and where they went.
So, that's fundamentally important.
Then, what do you pay for? Do you just send a blank cheque with a post-it note on the top of it saying ‘do your best'? No. Those days are gone.
We pay for activity, and we pay at the efficient price. So, if you are inefficient, you bear that burden. That will be a powerful incentive to States, hospital administrators, to everyone involved in health care, to step up and deliver efficient price.
Now, if the financial burden of not delivering the efficient price is not enough, everyone will know that you are not delivering the efficient price. That's what the transparency is about, and everyone will know if you are not treating patients properly because there will be clear standards, including waiting times, and clear transparency about whether or not they've been reached.
The Australian public's got a role here. The Australian public, in my view, should always have a role in improving government services. That's why I was so passionate about My School, and controversially, at one point said - at least it was controversial in the media, I don't think it was controversial in the community - controversially said if you get on My School and you're not happy about the performance of your child's school, walk down the road and go and have a chat to the Principal. You, as a parent, are a partner in this. You've got the tools. You've got the information. Insist on the performance. We will be mirroring that in health.
We'll come back to Phil. I'm feeling sorry for him.
JOURNALIST: The money you were going to take from the States in GST, will the States have to sign, to commit to that level to health, so they can't, sort of, fritter it away on other stuff like transport or other areas. Will they be duty bound to put that equivalent percentage on health under the agreement?
PM: States spend a lot of money on health. It's their single biggest expenditure item. Where the discipline comes in this is I'm not putting in new money if they don't. My 50 cents only goes on the table if their 50 cents has gone on the table. That's the partnership.
JOURNALIST: So, just a second half to that question, Barry O'Farrell has said he's not going to bound by anything Kristina Keneally signs up to unless he assess it himself.
If you, in anticipation, you get a national deal this weekend, what would be your message to Barry O'Farrell should he be Premier after March 26?
PM: Well, I've already declared on these questions I am very old-fashioned, so I think-
JOURNALIST: -As a hypothetical.
PM: Well, I think before people should conduct themselves as a Premier then people should get the opportunity of a vote. Call me old-fashioned, a traditionalist, but I do believe that that's the case.
So, should Mr O'Farrell or indeed anybody else emerge as a new Premier or a Chief Minister anywhere, what I would be saying to them if we go into the room on Sunday and come out with a deal, what I'd be saying to them is these are arrangements that are sustainable over time which would have had political consent from conservative and Labor premiers and I think that makes them sustainable.
What we have now, of course, is a situation where, you know, there was a lot of work done, a lot of focus on the reform need. Kevin, as Prime Minister, did do a lot of great work in this area, but we do not have a national agreement and we do not have people pulling in the same direction. I want to remedy that.
Go to Karen at the back.
JOURNALIST: Can I just change the subject, maybe briefly, to yesterday and the Senate's passage of the Coalition Bill on youth allowance. The Government's calling that a Money Bill. Can you tell us what you propose to do about that legislation? Will you allow it to go forward in the House or not?
PM: I've seen all of the media reporting about this and I obviously saw the events in the Senate yesterday. This is all blindingly simple at the end of the day.
Number one, it's not constitutional. Money Bills can only become law in the country if the Government agrees to them. That's why they call it the Treasury benches when you sit on the Government side. So: unconstitutional.
Number two, on the merits of the proposition, let me say as follows - it seems very, very easy for Mr Abbott to find ways to spend money. What he's not so good at is finding ways to save money and offset that spending. So, it is grossly irresponsible of Mr Abbott, to allow his political Party or his Coalition to bring to the parliament a Bill with unfunded savings.
What does he say I should to fund that Bill? Cut health? Cut education? Cut Defence? Cut flood recovery? What is it that he says I should do to fund that Bill? Question is unanswered.
Now, I no Mr Abbott will probably shrug his shoulders and say ‘finding budget savings are easy.' To that I would say if they were so easy to find it's hard to explain why his endeavour to find budget savings has led to the implosion of political Party.
Finally, can I just say this, on the question of student income support, I have read claims that this is Coalition pushback against Federal Government cuts in student income support. That is entirely untrue.
Anybody who says this Government has cut student income support is wrong. What this Government did is take a system of student income support with clear inequities in it, where the participation rates of country kids were going down, and strike a better and fairer package that was revenue-neutral over the forward estimates, but beyond the forward estimates, as participation in university grows because of our targets to get more kids university education, as participation grows funding on student income support grows.
So, let's not have any of this hypocrisy that this is somehow a pushback against cuts. That is completely untrue.
JOURNALIST: Does that mean you won't allow the Bill to go forward?
PM: No, we won't.
Yes?
JOURNALIST: Prime Minister, for the second time in a week you've announced measures to increase accountability, efficiency and to sort of head of waste in big-spending Government programs. You almost sound like you're singing from Tony Abbott's election play book.
How concerned are you about perceptions in the community that your Government was wasteful in the first term?
PM: I must admit I never saw that play book. Tony Abbott's play book was, what, the $11 billion black hole? I'm certainly not taking any lessons from that play book.
Every time we announce something we properly account for it and properly fund it. Mr Abbott has a few three-word slogans that he wandered around with during the election campaign and we're not intending to adopt any of them.
JOURNALIST: Can you answer his question about waste, though?
PM: I am very focussed, as Prime Minister, on making sure that Government money is spent efficiently, and I've had that discussion before with self-same press gallery, and we will do what we need to to make sure, whether it's in flood recovery or other areas, that we get the maximum value for Government dollars.
JOURNALIST: (inaudible) impact of the health reforms today that you've talked about today, can you say whether there's a net increase or decrease in the budget bottom line over the forward estimates, and if so, will that be outlined in the next days or would you make the adjustments in the May budget?
PM: From the hospitals package that I've outlined, we're on the same path as the forward estimates.
I'll go to the back.
JOURNALIST: Prime Minister, a question on Egypt - what are the dangers of President Mubarak staying on, and do you think he should step down before September?
PM: I know the Foreign Minister has had something to say about this today, and can I say, too, we are very concerned about events in Egypt. We are monitoring the situation very, very closely.
We want to see an orderly transition, but we want to see peace. We're obviously all very concerned that circumstances as they are unfolding in Egypt may occasion further violence, and we would be calling for calm and restraint on all sides. I don't think anybody wants to see violence happening, and clearly there is a real risk of that.
To summarise my position, the Government's position, we do believe that there needs to be fundamental reform. We do believe that change has to come. We understand the status quo is not a tenable position, but we do want to see peace in the transition.
JOURNALIST: What's the latest advice on Australians still in Egypt?
PM: Look, the advice to me remains the same. Obviously the circumstances in Egypt, we've seen developments which now would cause us to have concerns about violence as demonstrations are likely to swell in reaction to current events, but the circumstances for Australians remain the same.
We evacuated, made available evacuation opportunities for people. A range of Australians chose to stay. A range of Australians, obviously, made their own arrangements on commercial flights to get out. We have beefed up consular assistance, so the numbers of people who are available to assist.
We've expressed our condemnation for attacks, violent attacks, and threats and menacing of journalists, including some Australian journalists who were caught up in some very frightening and difficult situations.
JOURNALIST: Just on the health reforms again, I think in the former package the Federal Government was going to pick up 60 per cent of capital funding. Is that all now the States' responsibility, and are they willing to accept that?
PM: Under this package, the money and resources for the task are the same. We need to remember that.
Under this package, capital planning would remain the responsibility of the States, and I'm certainly very keen that we see transparency in capital planning, and that we see capital planning calibrated against the information we will have about activity levels that comes through activity-based pricing, and we will continue to provide assistance over time to health care capital. We've done that in the past through the Health and Hospitals Fund. We're in the process of doing that now for regional and rural hospitals.
The package is still being negotiated, so this is what I've outlined to you today - the proposal I will take to COAG.
JOURNALIST: (inaudible) capital planning issue, call it, sounds a rather tighter approach than was proposed under the previous agreement.
PM: Well, we're looking for transparency here. We will be able to map activity-growth pressures because of the activity-based funding. You'd expect to see those growth pressures in growing communities, for example, or communities that for whatever reason become home to populations with high health needs. So, you know, we will have a way of assessing where activity is growing and we want to see transparency.
But I do want to be clear, just in case anybody's under any misapprehension: what I've outlined today is my proposals for COAG on Sunday. Clearly, we've got some work to do and we'll have the meeting on Sunday.
JOURNALIST: Prime Minister, just on the national anthem, what did you think of former Victorian premier Jeff Kennett's idea of changing the anthem to ‘I am, you are, we are Australian'?
PM: I can understand the emotional resonance of that song. I most recently heard it sung on Sunday in Victoria at a bushfire memorial event, and it did bring tears to many people's eyes as there was a slight change in the words to reflect the bushfire situation.
So, that is a song of great emotional warmth and attachment for Australians, but I can't agree with Jeff that is should substitute for the national anthem.
I am at least relieved that he hasn't suggested the Hawthorn club song.
Thank you.