PM: Well this is a great day for Canberra Hospital and it is a great day of partnership between ourselves and the ACT Government and ACT health. Because this is where the rubber hits the road. This is about making a practical difference in emergency departments like this at this hospital.
This is a really busy hospital and the number of presentations here each year in the emergency department, I am advised is about 53,000. That is a lot of people. Therefore, what is the practical challenge we face?
How do you make it better for the folk who present here who have concerns with their kids in the middle of the night or late in the evening. How do you make it better also for the people who work here to get the best possible results from the good people who work at the emergency department?
Here today at Canberra hospital, I have just met stacks of nurses, stacks of wards men, stacks of doctors, who actually are here to make a difference, and they do. Because when you come here with uncertainty about your little one, late at night, you want to know that you are getting the best possible treatment.
What we have done most recently is provide an additional agreement with state and territory governments to improve the overall efficiency of emergency departments and in the case of Canberra hospital, what I am announcing today is $10 million to help take the pressure off this busy emergency department.
It will result in the construction of a new walk in centre here at Canberra Hospital, to be operational from June 2010. What does that mean in practice, it means that when you present here, at accident and emergency, there will an option for those less serious cases to be handled by the walk in centre.
If, having presented at the walk in centre, it is discovered that you actually need more serious treatment, then of course you are nearby and close by to this fully operational emergency centre as well.
The walk in centre though, I am advised will be operational 16 hours a day, seven days a week, and estimated to provide up to 30,000 services a year.
So what is the logic? To separate out those who need less serious attention, from those who need more serious attention. And this is part and parcel of a $750 million agreement that we made at the Council of Australian Governments at the end of last year - to take the pressure off emergency departments, not just here at Canberra Hospital but right across the public hospitals in Australia.
There is a performance benchmark attached and that is a performance benchmark of 80 per cent of emergency department presentations to be seen within clinically recommended triage times as recommended by the Australian College of Emergency Medicine by 2012, 2013.
This is part and parcel of making a difference with public health in Australia. It is part and parcel of making a difference for patients who present at emergency departments like this to get the best possible treatment. And what is happening here today at Canberra Hospital, we will see rolled out at public hospitals across Australia.
This is the right way to go. I might ask the Health Minister to add and then her counterpart from the ACT, I will say one other thing and then we will try to open to questions.
ROXON: Thank you very much Prime Minister and the Prime Minister has highlighted the importance of the announcement we are making today and I am pleased to be here with my friend and colleague Katy Gallagher because this is just an example of what is happening across the country. $64 billion, the most that has gone into a health care agreement in the history of Australia, a fifty per cent increase on the previous Government's health care agreement.
But those figures are almost so big that for most people it is hard to get your head around that 50 per cent increase. But for some of the fantastic nurses standing behind us today and other staff at the hospital, I think they understand that it turns into projects that can be supported on the ground in our hospitals. This is a $10 million project, it is going to be a nurse led walk in centre, something that the ACT has been pioneering by recognising our very highly skilled nurses.
And it comes on top of investments, that I think Katy is going to talk to you about, through our elective surgery funding, where three new elective surgery theatres are being built in Canberra.
The first across the whole country was opened at Calvary several months ago, another two are due to be opened here. This is our Commonwealth money, working in partnership, co -investing with the states and territories to make a difference in our hospital system.
And of course it complements our other workforce reforms like those for nurse practitioners with MBS and PBS prescribing, which is all about using our workforce strategically, and we know in hospitals - we have just had a cup of tea with some nurses and doctors - we know in hospitals, people understand the different skills and recognise and acknowledge the skills that nurses have, that doctors have, that specialists have, and this is a way of making sure we recognise those skills across the system, but we invest in the infrastructure that is needed so that those teams can work together at their optimum.
So I might ask Katy to say a few words and I think the Prime Minister wanted me to give you a quick swine flu update which I might do after this and then we will have some questions.
GALLAGHER: Thanks Nicola, well this is a pretty exciting time for the Canberra Hospital, it is the major tertiary referral hospital, not just for Canberra but for the region surrounding New South Wales. And over the past 18 months we have been working very closely with the Commonwealth over areas of pressure for us.
There is no doubt the emergency department, the amount of presentations that we get, we have had to look at different ways of doing things and one of those ways is through our nurse led walk in centres which we have been doing a lot of work over, and it is just fantastic that we have got support from the Commonwealth to actually fund that and get it up and running in this hospital.
But we have also got our new operating theatres too which are being built on the side of Canberra Hospital here, that will increase our operating theatres by 20 per cent and that is really important when you look at the numbers of emergency surgery that we do here, again being a major referral point for the region.
And just in last week's budget or two weeks ago in the federal budget, we were also lucky enough to get about $28 million for our regional cancer centre, to be built here at Canberra Hospital again.
So, fantastic for the region, it will service a population of about 600,000 and it really builds into the whole rebuild we are doing of our health system here. So you know these are real tangible projects that are going to make a real difference to people in the ACT and the region and it is through I think working with the Commonwealth, with them listening to us about our areas of pressure, that we have been able to get these significant wins for our community.
PM: Thanks Katy. Nicola, just on swine flu update.
ROXON: Look just very briefly on swine flu, can I give people a quick update. We now have 17 cases of swine flu confirmed in Australia, 11 in Victoria, two in South Australia, two in New South Wales and two in Queensland.
We currently have four schools that are closed, two in Adelaide, and two in Melbourne.
I do need to confirm for the public that all of the cases in Australia to date have all exhibited mild symptoms; we don't have anyone who has been severely ill yet in Australia from this disease. There have been some important developments over the weekend.
We do know that we have human to human transmission here in Australia. We do have a growing number of cases with no known contact to those who have travelled overseas. We do have another 40 people that are currently being tested today but these numbers are going to keep growing.
Obviously there are now 43 countries across the world who have swine flu and more than 12,000 cases worldwide.
You will have seen that most jurisdictions have made a decision that they are going to ask for the cooperation of parents if they have been travelling with their children, even if they are well, to ask them to stay home for seven days upon their return. We have had very cooperative response from the travelling public to date and from parents. I know that this will cause an inconvenience to many people but we do believe it is one of the most effective ways of trying to reduce the spread of this disease.
And we would ask for as much cooperation as people can provide in trying to limit exposure to those who might be carrying this disease, particularly who might be carrying the disease, before they are showing any symptoms. So I am happy to take questions on that later.
I understand that a number of my state and territory colleagues will be making some further announcements later today. As you would expect in this situation there are regular updates and my state colleagues obviously are the ones that would like to make announcements about particular cases, if and when they become confirmed in their jurisdictions.
And you will need to expect that throughout the course of today.
PM: Thanks very much Nicola. Over to you.
JOURNALIST: Are you worried that your Labor backbencher Yvette D'Ath (inaudible)
PM: Not at all. I mean, backbenchers will work their way through the numbers in the budget over a period of time. This is normal and part and parcel of the public debate which will now occur in relation to debt and deficit as a means of supporting Australia in the midst of the worst global recession that the world has seen in three quarters of a century.
That is a debate which will continue. It is a debate which we welcome, because our strategy is this, that when the private sector is in retreat, the Government must step in to make a difference.
You make a difference by investing in stimulus, and 70 per cent of our stimulus of course goes to the investment in public infrastructure around the country, infrastructure which helps set Australia up for the future.
JOURNALIST: (inaudible)
ROXON: Well I think you would not be surprised to know that there are different views amongst the medical profession. I think if you talk to a lot of people working in hospitals, there is an appreciation, mostly that is where nurse practitioners currently work, of the highly skilled, or of the high level of skills that they bring to their jobs.
We need to make decisions as a government that are going to be best for patients. We are not going to make decisions that are just focussed on the needs of a particular profession. And we believe in Australia we have highly skilled nurses, as we have highly skilled doctors and specialists, and they too should be able to use their skills to their maximum ability.
Now that is not what today's' announcement is about but clearly they do complement the budget measures that we are taking. And in a country where we have growing health needs, an ageing population, more people with chronic disease, we have to use our workforce in a way that is smart. And this is aimed to help the profession work together, to deliver better services for the community.
That will be my benchmark and the Government's benchmark, whether we are making changes that will deliver better services to the community, and we intend to work closely with the profession.
The introduction of the new MBS and PBS items are November next year. We need to write the descriptors for the Medicare benefits schedule, we need to provide new provider numbers. We will be working closely with doctors and nurses to ensure we get those descriptors right and encourage the collaborative care that you see provided through hospitals where people are used to working very closely in teams.
JOURNALIST: Prime Minister, do you think -
PM: I'll just take the question in one sec. Can I just add to what the Minister just said. I think it is fantastic that we have a greater role for nurses. It is great to see nurses out there delivering a whole series of services which are going to be great for the Australian public, great for the nursing profession and as the son of a nurse, as the brother of a nurse and my, and I have got so many nurses in my family that I lose track of them, this I think is a great step forward for the profession.
I think it's good that everyone embraces this as a necessary long term reform and it's going to be good here in this Emergency Department in Canberra. It's going to be good in emergency departments across the country. Sorry for interrupting you.
JOURNALIST: Do you think public hospitals in Australia generally have improved since Labor (inaudible)
PM: You mean since the federal Labor Government was elected? What I can say is that our investment in public hospitals has improved by the order of magnitude which the Minister referred to. Let's put this into a very stark context. The previous federal Government withdrew a billion dollars in Commonwealth payments to public hospitals in the states. We have stepped up to the plate through the Australian Health Care Agreement and made a significant additional investment for the future.
On top of that through the recurrent agreements that we have also reached, and we're just talking about one here today, the $750 million partnership with the states and territories to increase the efficiency of emergency departments, this is a practical step forward. Let me give you one example though and I'm sure the Minister can flesh out the numbers for me. On elective surgery waiting lists, one of the first things we did as an incoming government was say, rather than just blame the states and territories for problems with elective surgery waiting lists, why not do something practical about it?
Now what Katy has just referred to is the practical on the ground results of that investment here which is one additional elective surgery theatre already opened here, two more about to open and the throughput of patients, I think you've got some figures on them?
ROXON: The point the Prime Minister is making is when we reached this agreement on elective surgery we got the states and territories to agree to providing 25,000 additional elective surgeries, in fact they delivered 41,000 extra elective surgery procedures. What it showed was when there was investment from the Commonwealth and cooperation from the states and territories we could deliver more.
And you're seeing the capital investments being made in elective surgery, the capital investments being made in emergency departments, you see the recurrent expenditure being committed to through the healthcare agreement, a 50 per cent increase from the previous government. But we acknowledge it takes time to turn things around if you spend a decade neglecting your public hospitals. Now that's what we saw the previous Government do and now we see them out on a flight of fancy that they don't want people with private health insurance to be able to use public hospital facilities. So this is an outrageous change on their part.
JOURNALIST: (inaudible)
ROXON: I think it's very clear from the history of what was done by the previous Government in government, pulling money out of public hospitals, what they are doing now to defend rebates for millionaires rather than supporting investments in our public hospitals. You had Joe Hockey as the health spokesperson saying he would not have put this extra money into our hospitals. I think these are all a theme that is quite legitimate for us to highlight because we know the Liberal Party has no love for public hospitals and unfortunately we're seeing that in the comments that they've been making over the weekend.
JOURNALIST: (inaudible)
ROXON: Well I think that is absolutely what Mr Dutton has been saying. He has been all over the place on this, he has been all over the place on alcopops. I admit that the media as well as the public might have trouble following what particular position they have on any one day but I think it is quite clear that they have no love for public hospitals when we've been trying to invest in them.
JOURNALIST: (inaudible)
PM: Just before we go on to that, I'll just quote you directly what Mr Turnbull had to say Matthew. I'm just going to read you the exact quote. “In an ideal world” - this is on a related matter in public health debate - “every Australian would have private health insurance, that would be the best, that would be the best outcome”. That is a direct quote about the statement of the Liberal Party which says that they believe that in an ideal world everyone, everyone in Australia should have private health insurance.
Based on our numbers 12 million individuals or members of families currently either choose not to or cannot afford to have private health insurance. Mr Turnbull and the Liberals' solution for those individuals is go and get yourself privately health insured. That's his solution for the future, why are we engaging - I've directly quoted from his statement there - why are we engaged in this debate? We are engaged in this debate because there is a fundamental divide between us. We are passionate defenders of Medicare, we are passionate defenders of the public hospital system. That is why we are co-investing with the states and territories in a public hospital system, in terms of the services we're referring to today and what you have from the Liberal leader is a clear ideological statement about where the Liberal Party would like to land, that is everyone having private health insurance. If you want a clear divide between them and us on this, that's it, we have a different view. That's why we're here.
JOURNALIST: You're not going to get the CPRS legislation through in the next month, why not delay the legislation, you've already delayed the start of the CPRS, why not delay the legislation? And a second question, did you personally block a senior diplomat being sent to Berlin and why?
PM: On the question of the carbon pollution reduction scheme, business needs certainty. You have the Australian Industry Group, you have the Business Council of Australia saying that for the future they need clear guidelines, clear rules for the future for business certainty. What we have done through excellent work by the Climate Change Minister Penny Wong is negotiate an arrangement with the leading conservation groups, the WWF, the ACF and the Climate Institute and two leading business groups on a way forward.
Why is the time critical? One is business certainty and the second is we need to have as a national position, the position Australia will put on the table at the Copenhagen Conference at the end of the year. This is really important, it is important for Australia, it is important for climate change, it's important for the future of the reef, it's important for jobs. That's why we're doing it, that's why we've negotiated this way and if you're going to have opportunistic politics being played by others on this I think frankly the national interest is not served by this.
I understand that earlier today we had also a statement by the National Party, I think from memory Senator Boswell. You can always rely upon Ron to come out on these questions. And Ron has said that the Nats have effectively said to the Government you can all go jump in the lake when it comes to the carbon pollution reduction scheme. Well thanks Ron, thanks for spelling it out so clearly. What do we say about the Liberal Party who say they are still negotiating with us? Are they speaking on behalf of the Coalition? The Liberals? The Nationals? Half the Nationals, half the Liberals?
Our job is to run the country. Our job is to get the best possible solution for what is a huge environmental challenge, a huge economic challenge. We have come up with a formula - I will come to you in one sec mate - we have come up with a formula which directly addresses the question of, directly addresses how to get the balance absolutely right between jobs, business certainty and doing something concrete about the environment.
JOURNALIST: And on the diplomat?
PM: On the question of the Berlin Embassy. My recollection of conversations which we had with senior officers of the Prime Minister's Department was that we preferred to have people in positions who spoke the language well. How that applied in this particular case I do not know but I am just saying it is general philosophy and I think you know me well that when it comes to foreign diplomatic appointments I do place priority on languages, as does the Minister and last time I looked at Germany they speak German.
JOURNALIST: Prime Minister what do you say to those workers (inaudible) particularly in (inaudible) labour intensive industries, who think that working till 67 before getting the pension is too much of an ask?
PM: I think these are tough decisions Mark and you're right to raise this question. It is a controversial matter out there in the community and I accept that. It's a tough decision which is why we believe it's necessary to do two things. Long term pension reform, the single biggest increase in the single age pension that we have seen, by $32.50 a week, we have to pay for that over time by making pensions in the pension system financially sustainable. Also to return the budget to surplus in time as well. This is one of the reforms necessary to do that.
Therefore it is a necessary and tough long term decision. The second though is this, I noticed the Liberals have said it should be brought in very soon, much more, much sooner than we have said. That's what Tony Abbott has said, unless Matthew Franklin is about to correct me for a misrepresentation of what Tony Abbott may have said, I think that is accurate. The Australian concurs it is accurate.
The, therefore, can I say, they say bring it in ASAP, we say that is not fair. The Liberals say bring in the upping the age pension entitlement age really quick. What we say is we need to allow people to at least have a long slice of time to make arrangements for their future. This doesn't start to come in until 2017, it doesn't become fully operational until 2023, we're currently in 2009. Our judgement is that provides people with sufficiently long period of time to make adjustments for their planning for age, for age pension entitlement arrangements for the future.
Also most other governments around the world are heading in exactly this direction. Why? Ageing the population, huge impact on budget burden long term, therefore you need to act and take some tough decisions. There is a question up the back.
JOURNALIST: (inaudible)
PM: Well I think there is a general principle, my attitude to significant foreign appointments is that language is an important criteria. It may not be possible in all cases. It may not be possible. But it is an important criteria. And that is certainly something I have reflected to the Department of Foreign Affairs and the Prime Ministers' department more broadly.
And you know why? A huge slice of Australia's national wealth is generated through exports. I take seriously our ability to communicate with the major export markets in the world. And our major trading and economic partners. Therefore I believe language also helps for that.
On the first part of your question, this is as I said before Chris, a very difficult and a very tough decision. Governments around the world have found these tough decisions. These do involve difficult choices for people in the future, I accept that. But my responsibility as Prime Minister is, if you are going to increase the age pension, and we have significantly in terms of the single age pension, no one disputes that, we are required in parallel circumstances to give people fair warning, around about a decade, that we are moving towards a higher age pension qualification age. We think that is right for the future. It is necessary for the future because we have to return the budget to surplus. We also have to be very mindful of the implications of the intergenerational report on the ageing of population.
I will add one footnote. Mr Costello, Captain Courageous when he was Treasurer, produced a couple of intergenerational reports saying, ‘gee we have got a huge problem here, ageing of the population, huge problem here, how is the budget going to pay for it and what are we going to do about it, umm I'm sorry, forgotten about that'.
Well we have actually decided to act. You know why, it is the right thing to do. It is tough and it is hard.
JOURNALIST: (inaudible) training packages for such people so that they could transition to a new career for that last 10 years?
PM: It is going to be important for us to, as a nation, if we are serious about the implications of the intergenerational report, which at its heart is this, a smaller number of people, working, supporting a larger number of people in retirement, that is the essence of it, how do we make that work.
What we have been discussing this morning, in this legitimate public debate about the age pension, is how do you get that right for the future. The other part of it is to make sure we have much more, as you correctly ask, targeted, flexible training arrangements so that in anyone's working career, there are in fact multiple work options.
We have to be more intelligent about this. It is, many people doing one job are going to reach a stage where they are no longer going to feel able to do it.
Our job as government is to step in and try and make that transition to a different form of employment easier. And having said that, we have got to zip.