HOST: Julia Gillard you got your deal but you needed did you not, were you feeling that your credibility was at stake, that you needed a positive and decisive policy outcome to kick off this political year?
PM: I thought the nation needed a deal, I though the nation needed an arrangement which meant we were going to get a better health system and a lot of work had been done last year on health reform by the then Prime Minister Kevin Rudd, he was the first Prime Minister to step up and say ‘this is all going to go very badly if we let health costs eat State government financing.' So we needed health reform, clearly we weren't going to secure the reform Kevin had looked for with the GST, so I focussed on health reform rather than GST financing reform, and the nation needed to see its leaders come together yesterday and make an agreement for change and reform and that's exactly what we did.
HOST: Well we'll look at the details, some of the details of that package in moment, but are you concerned about a public perception that's emerging in opinion polls too, that this Government isn't delivering enough policy outcomes, and for example, the Australian Workers Union's released a survey showing that 27 per cent of its workers think this Government has their interests at heart; that's Labor heartland, is that good enough?
PM: The Government's got a lot of hard work in front of it, we've got to be out there delivering the changes that will make a difference in people's lives-
HOST: Do you need to lift your game?
PM: Well this is the year, as I've said, of decision and delivery, we've got a lot of hard work in front of us and that hard work is about improving the lives of Australians around the country; people's use of the health system, continuing to improve the education system, dealing with the big economic challenges facing the nation with our economy running at different speeds in different places, and of course dealing with the challenges of the future like pricing carbon and rolling out the national broadband network. We've got a lot of hard work to do, but I would say yesterday we did a very important piece of hard work for this nation's future, Australians rely on their healthcare system, and they will now be able to see more money in it, more hospital beds, more transparency, more local control and getting rid of a lot of things that really aggravate people about the health system, we're going to ensure there's less waiting time, less bureaucracy, less red tape than there has been in the past.
HOST: We've been hearing a lot today that the devil is in the detail, that this is going to take several months to work out. Now the mining tax was viewed as a deal as well and that's starting to unravel, is it possible and are you geared up for this, that the health agreement could go the same way?
PM: Well the mining tax is being progressed step by step, we had a policy transition group-
HOST: You're not there yet are you?
PM: Well we had a policy transition group, and now we're working through to produce the legislation. Yesterday we went into a room, no national health agreement, no way of delivering change and reform which was going to impact on the healthcare of every Australian. I came out holding a signed agreement, signed by every Premier and every Chief Minister for change. And of course that change is going to mean new resources, more than $16 billion of new resources, but I always said new money would not be on the table without reform, and we have secured major reforms. More transparency than people have ever had before, an efficient pricing system, we're taking our market based tools to drive new efficiencies in the healthcare system and a structural financing reform.
HOST: One of the key points is setting an efficient price for a hospital stay, how do you go about that in a way that suits all States? Are you leaving yourself open here to the blame game continuing?
PM: At the moment healthcare funding goes into a dark, black box and we don't know what happens to it next, you don't know, we don't know, the nation doesn't know. Well with our transparency measures and with our efficient pricing measures we're going to change that, and probably the easiest way to think about the efficient price is to say it's the fair price. To look at what it really costs to do a hip operation, or a knee replacement, to work on generating that price and then saying to hospitals ‘that's the efficient price, if you can do better, then you get to keep the benefits of that extra efficiency gain. If you're doing worse, then you've got an incentive for change.' The actual striking of the efficient price will be done by health experts in a pricing authority.
HOST: And what if the States don't like the efficient price that you've set?
PM: Well the States and Territories, by virtue of signing on to health reform, have signed on to the creation of efficient pricing, it's pivotal to the reforms and it is taking something that works in the market, in other marketplaces, people understand what the right price is, we are taking that kind of market methodology to health. It's not good enough for us to just send cheques to the States and say ‘whatever you can do for this is fine by us', if there are more efficient ways of doing things then we want States and hospitals, local hospital networks striving for those efficiencies. I want every dollar in health to make the biggest possible difference it can, that's why the efficient price is important and why the transparency is so important.
HOST: Now the focus here is very much on public hospital funding, other areas like community healthcare come under an umbrella that I think is called Medicare locals. Already there seems to be confusion about how that's going to work and why it doesn't all come under one umbrella.
PM: We want to make sure that primary care, first instance care, the care people get in their communities is better co-ordinated. At the moment we've got lots of people out there doing fantastic things, doctors doing great things, practice nurses doing great things, dieticians, speech therapists and the list goes on, but often people struggle to get the co-ordinated care they need with complex conditions, if you've got type 2 diabetes sure you need a doctor, but you may also need a dietician to help you improve your health, you may need a podiatrist because circulation problems means you're at risk of an amputation and so on. Medicare locals will help co-ordinate that primary care, we want to grow and strengthen the primary care system, whilst we're also developing local hospital networks so communities have more say in the running of hospitals in their area whilst the other reforms are showing benefits, the transparency, the efficient price, the more money that comes with the agreement signed yesterday.
HOST: Can you understand disappointment amongst some medical and healthcare professionals that they feel that they have been sidelined?
PM: Well the voice of medical and healthcare professionals has been well and truly heard over the last few years, we had of course Christine Bennet, a very eminent Australian, guide a reform commission to generate a reform blueprint, then former Prime Minister Rudd did a lot of work and a lot of consultation to generate reforms. But the truth is that all ended up falling victim to a political discussion about the goods and services tax, and I think many medical and health professionals would have been saying to themselves, well I'm not a tax expert, what I want to see is better healthcare. Well the national agreement that I struck yesterday is about better healthcare. I've said I wanted to get away from politicians arguing with politicians about the goods and services tax and who should hold it and have it, I wanted to focus on health reform and that's exactly what we've done.
And when you ask stakeholders in health what do you care about, transparency is a huge thing, they want to make sure that if one level of government is putting in more money, the other level of government isn't taking it out, the transparency I fought for yesterday with the national funding body, the national pool, will mean we always know where health dollars come from and what they go to pay for.
HOST: Once again mental health has been put in the too hard basket for now, what does that always happen?
PM: I can't quite agree with that Heather, yes we have agreed that COAG will hear from mental health experts at its next meeting, this was a suggestion of Premier Mike Rann and I think it was a good one, but in reforming hospitals and in reforming primary care, and part of the package yesterday is that the Federal Government is going to step up and bring out primary care reforms on stream more quickly. Doing those things makes a difference for patients with mental health problems, far too often people with mental health conditions end up in emergency departments when they shouldn't be there. If they'd be better cared for in the community they wouldn't have ever got there. Investments in primary care make a difference, and then for people with acute mental health conditions, they do need public hospital treatment, so better public hospitals is good for them.
HOST: Could you have done without media reports in recent days that your predecessor Kevin Rudd was less than happy in the Cabinet room that his policy had been dumped?
PM: Well look I saw a bit of rumour mongering-
HOST: You know what I'm talking about?
PM: Yes I do and I saw a bit of sort of rumour stuff in media reports. The reality is Australians are necessarily going to focus on what this means for them and their healthcare, it's a better deal for them and it's going to bring changes that Australians will be able to see and touch. Of course we had Cabinet discussions about this health package, we have Cabinet discussions about the full range of Government activity, you expect them to be robust but the rumour mongering I saw in the newspapers was simply not right.
HOST: Somebody in your Cabinet room is leaking, what are you going to do to restore discipline?
PM: Well of course it's very clear that Cabinet is confidential and that is an obligation of participating in the Cabinet process and I say to my colleagues at the Cabinet level and at Labor Caucus when we meet during Parliamentary sitting weeks with my Labor colleagues, that we have hard work to do, to focus on the changes Australia needs, that's what I expect the team to be doing.
HOST: You were dogged by leaks last year, are you worried that that cycle might be repeating itself?
PM: The only thing that's been on my mind in the past few days is all of the intensive work it's taken to strike a major national health reform deal. It was hard, it was many, many hours of discussion not only in the room yesterday but in the lead up to it, but it was hard for a good cause, this is a national agreement, we didn't have a national agreement until yesterday. States were going to get left behind as reform happened in some places and not others, we didn't have the agreement for the kind of transparency that we signed up to on the dotted line yesterday, that's going to be a profoundly transformative thing for our healthcare system, more information that we've ever had before, and our course more community control, efficient pricing so that there's less waste, less waiting time in emergency departments and for elective surgery, this has taken all of my time and all of my effort and I'm very pleased that my colleagues, Labor colleagues and Liberal colleagues, Premiers Barnett and Baillieu, joined me in this endeavour to get a new national healthcare system for Australians.
HOST: How would you rate your first months in office, was it the year from hell and that you needed to start afresh?
PM: Look it's not about me putting labels on things, of course 2010 as is very publically know had some moments of great difficultly for me, a very difficult election campaign and before that of course a very difficult decision about offering myself for consideration for this position. But 2010, people can write the history books, take whatever perspective they like, as Prime Minister my determination is that 2011 is a year of decision and delivery. Yesterday was about decision and delivery, deciding that the nation needed a better healthcare system and delivering it with a national agreement signed up to by all Premiers and Chief Ministers.
HOST: This morning you attended yet another funeral for an Australian soldier killed in Afghanistan. Is that getting harder and harder for you?
PM: Every funeral is very, very hard, we're talking about very brave young men, Corporal Atkinson whose funeral was today, was 22 years old, so we're talking about a family with amazing dignity in the depths of grief and I had the opportunity to speak to the family today, to speak to his fiancé Danielle. They are amazing people showing unbelievable courage in a very difficult circumstance, a tragic circumstance.
But when I go to those funerals and I've been to a number and I look family members in the eyes the way I'm looking you in the eyes now, many times they say to be that we best honour their sacrifice by seeing the mission through. These are families who are bearing unbelievable burdens and that is what they say to me.
As Prime Minister I'm saying to the nation this is a tragic, tragic cost but we need to see the mission through.
HOST: Is there a limit to how many funerals, a limit in your own mind, to how many funerals you'll attend before at least considering a review of Government policy on this issue?
PM: I've made a decision about our engagement in Afghanistan which I believe is right, and so having made that decision my message to the nation is this is going to be hard, and I frankly warned the nation last year that there would be hard days ahead, and today has been a really hard day. There'll be, I suspect, some more hard days ahead, but the mission is a vital one for our peace and national security. Afghanistan is a place where people who have been trained and those people have come and taken Australian lives using the skills that they picked up in terrorist training camps in Afghanistan.
We are there to deny terrorist trainers their ability to use Afghanistan for that deadly purpose.
HOST: Julia Gillard we'll leave it there, thank you very much for joining us.
PM: Thank you