PM: It's good to be here this morning at QE2, in my home town of Brisbane, and to spend some time visiting this hospital with Nicola Roxon, the Health Minister, and of course Graham Perrett, the local Member, and to have met and spent some time with the members of the medical staff and the nursing staff and the wardsmen and many of the patients who are here as well. Before I begin addressing the question of health and hospital reform, I'd like to make some remarks in terms of developments overnight for our friends in Poland.
The tragic death of President Kaczynski of Poland is a great loss to the people of the Polish Republic, and of course to the Government of the Polish Republic. This has been an extraordinary tragedy involving the loss of nearly 100 people, including the President and his wife. It has also had a huge impact on so many people who had senior positions within the Polish Government. And so, on behalf of the Australian Government, we extend our condolences to the Polish people, to the Polish Government, and our thoughts and our prayers are with them all.
Secondly, on the question of health and hospital reform, let me make some remarks about what we are here to announce today. I think all of us who are mums and dads, at some stage or another, we've had the experience of waiting for a long, long time in emergency departments at night, for our kids to be attended to, or sometimes, not our kids, ourselves. I think I speak for so many parents about the times when you've been absolutely sick with worry about your little one and you come to an emergency department and you just get sick of waiting. It doesn't always happen that way, but it happens many times around the country.
It's a terrible experience to turn up to your local hospital's emergency department in the middle of the night, and then to wait eight hours for something to happen. The fact is, right now, almost one in three patients around Australia, about 600,000 people each year, wait longer than eight hours in an emergency department before being admitted to a hospital. Let me just underline that again. Around Australia right now, one in three people who present to emergency departments, that's 600,000 people each year, are waiting more than eight hours to be attended to at an emergency department and admitted to hospital. Almost one in three patients wait longer than a clinically acceptable time.
Our plan for better health and better hospitals for Australia aims to significantly reduce the currently unacceptably long waiting times in hospital emergency departments. It should be unacceptable- here we are in 2010- for people in Australia still to have to wait over eight hours in an emergency department before they are treated. We must do everything we physically can to reduce the waiting times in this nation's public hospitals. We can do better, and we must do better. And we intend now to do better.
That is why what we're announcing today is a new, four hour target for all public hospital emergency departments right across the nation, and we intend to deliver this first and foremost in the more than 165 emergency departments of our major hospitals across the country. Under the new four hour target, public hospitals will be expected to ensure that patients who present to an emergency department within four hours are either- one, admitted to hospital; two, referred to follow-up treatment; or three, treated and discharged.
To help public hospitals reach this new national four hour target, the Government intends to invest half a billion dollars, the equivalent of an additional 1.2 million emergency department services, across the country. Financial incentives will be attached to these targets. Where a state's public hospitals meet or beat that target, hospitals in that state will be eligible for additional health funding.
This new target, and the funding to deliver it, are contingent upon the states and territories agreeing with the establishment of a new National Health and Hospitals Network. For the Australian Government to step up to the plate and provide additional funding of this type means that we must have the states and territories and their public hospitals as part of an integrated national network, one in which the Australian Government will become the dominant funder for the first time of the public hospital system of Australia. This is a big change.
The Government will begin providing $150 million from 1 July of this year, 2010, in upfront payments to help states and territories with the costs of moving towards this four hour target. This investment will provide additional capacity, also equipment and planning in hospitals to deliver improvements in the performance of emergency departments, and lift hospitals to new and higher standards required under what we've defined as the new National Health and Hospitals Network. A further $350 million will be available in incentive funding for those hospitals which meet these targets for the future.
As I said before, this new plan to improve the treatment times for the emergency departments of our country will take effect and begin to take effect from 1 July of this year. It will be implemented over a four year period, and we will stage up from those categories of patients who are most clinically at risk when they present, before completing the implementation over that four year period. We will also focus initially, as I said before, on those 165 hospitals which currently run our nation's major emergency departments, and we'll work with clinicians on how to improve emergency department presentation times, and treatment plans for the smaller hospitals of Australia, as well.
To conclude before I ask the Health Minister to add to my remarks, can I just say this- I've been here this morning at QE2, and I've spoken to the folk in the emergency department here. These are really good people, a great team of people who are doing the absolute best in terms of the needs of this local community. But here's a fact- there are currently nine emergency bays in this QE2 emergency department. That's how many there were in 1981.
We're now nearly 30 years later and there are still nine. And they perform minor miracles here each day. I understand- I'm advised that those nine bays are designed to provide a throughput each day of 80 patients. Apparently they're treating, in the last 24 hours, about 110 patients. They're currently running at about 30% above what this unit was designed to do. My message to the good people here at QE2 and, frankly, to the major emergency departments of Australia, is this story is one across our nation. And therefore, we need to change the system.
That's why the Australian Government is for the first time in the country's history proposing to become the dominant funder of the public hospital system of Australia. And that action begins with our emergency departments. If I could ask the Health Minister to add, and then I'll say one thing about Jessica Watson, and then I'll happily take your questions.
ROXON: Thank you Prime Minister. This is another important stage, an exciting stage in our health reform plans. To be introducing a four hour target for emergency departments across the country is a big step. This is an initiative which has been agreed to and commenced implementation in Western Australia. It's something that South Australia has committed to, most recently during their last election. And we now believe that this should be implemented across the country.
It follows hot on the heels of us investing $750 million into emergency departments in the last two years that we've been in Government. That has provided funding to 37 hospitals, including here at QE2, where $19 million is going to increasing the capacity of the emergency department. And we've had a presentation today how that will provide another 11 beds for allied health treatments and others that will help speed up the process.
So I can only add to the Prime Minister's comments that we know that doctors and nurses and allied health professionals are doing their darndest across the country to see people as quickly as they can, but we are prepared to provide resources to help change the system so that the flow can work better, so that people can be treated more quickly, and most importantly so that patients don't have the anxiety of waiting for many, many hours, often to be admitted into hospital after that long wait.
I also think that here is a good example- it of course, these announcements complement our other announcements, for example in primary care. Graham Perrett has been a big advocate of the Brisbane Southside GP super clinic, a $7.5 million investment which will have a number of sites across Brisbane's south, where patients will be able to be treated more, closer to their home, and in a setting that's more appropriate for their condition, which we hope over time will help reduce the presentations that are inappropriate here at the emergency department.
Similarly, our investments last week that we announced into diabetic care, $500 million to treat diabetes patients better in the community, so that they're not repeatedly presenting with complications at emergency departments. So this is a very important part of our overall package to take pressure off our hospital system, to provide better health services for the community, and to reduce the level of worry that not only our patients feel, but the staff in our systems can feel if they can't actually redesign things to meet the modern needs of the community. I'm happy of course to answer questions as well. I think it's a very important initiative today, and I'll hand over back to the Prime Minister.
PM: Just before taking your questions, a word or two about young Jess Watson. Can I just say, all Queenslanders and all Australians are enormously proud of what she's achieved. I last spoke to her on the satellite phone when she was about to round Cape Horn. That was a while ago. And now she's back, I'm advised, in Australian waters. Here you have a young Queenslander, a young Australian who's shown great courage, great determination, and I believe is an inspiration for all Australians. Jess, it's fantastic to have you back home.
Over to you, folks.
JOURNALIST: (inaudible)
PM: Sorry, say that again?
JOURNALIST: (inaudible) part of the target?
PM: Can I say that on the staff question, one of the challenges to making emergency departments work properly is to properly invest in the number of doctors in the future. And that is why about two to three weeks ago the Australian Government announced its plans to fund an additional 6,500 medical training places over the decade ahead. 5,500 of those will be GPs. About 1000 of those will be specialists. Frankly, these reforms in emergency departments only work if we've also got flowing through an additional number of medical staff, nursing staff, the Minister has already partly acted on as well.
And the other thing I'd draw your attention to in terms of allied health professionals, those who I'm advised here will become part and parcel of a $19 million investment in increasing the throughput of the emergency department of QE2. We've also announced in the course of the last week, in fact last Tuesday in Cairns, a new package for additional training places for allied health professionals as well. Nicola, would you like to add to what I've just said? That's fine.
JOURNALIST: Mr Rudd, why (inaudible)
PM: We are first of all determined to do this- reform the funding and structure of the new National Health and Hospitals Network, because unless we get the funding and the structure right for the future, we will continue to have waste, duplication and overlap between the Australian Government and the states. We are not prepared to have that for the future; nor is the Australian taxpayer; nor are those who use the public hospitals of Australia. Therefore, I want to be absolutely clear-cut- getting the future reform of the funding of the structure of our system is fundamental to the other growth that can occur within the system.
Secondly, we've also been plain that we need to also increase our investment in the current gaps in the system. We have done that already in terms of our proposed investment in the medical workforce. We have done that also in terms of today's announcement on additional investments in accident and emergency. Can I also say we've done so already in relation to the primary healthcare system, and the treatment of major disease categories- a very large announcement during the course of the last week or so for sufferers of type 1 and type 2 diabetes, through the primary healthcare system. And a major investment of nearly $600 million in regional integrated cancer care centres across Australia.
Each of these are separate building blocks within the system. But the overall foundation stone is the policy I announced at the National Press Club in Canberra about four or five weeks ago. That is the absolute basis which we have for moving forward.
JOURNALIST: What else are you planning on revealing this week?
PM: Can I say that- I won't use the term that you have just used- we have a series of considered policy statements which we have worked on over a long period of time. The reason they are sequenced in the way in which they are sequenced is that the foundation stone for reform, is as we've described it- agreement to a new National Health and Hospitals Network, funded nationally, run locally, through local hospital networks, with the Australian Government for the first time being the dominant funders of the public hospital system of Australia.
Other growth elements of the system now, we have planned, we have worked through; in part we have collaborated with the states on; and they have been announced in proper sequence following the initial statement on underlying reform.
JOURNALIST: (inaudible)
PM: Sorry?
JOURNALIST: (inaudible)
PM: Well in terms of elective surgery, I'll turn to the Minister. Can I say that on elective surgery, what we have done in the first two years in office is invest some hundreds of millions of dollars in improving the throughput of elective surgery around the country, both in terms of what's called a blitz of elective surgery procedures which we've now funded more than 60,000 such procedures around the country. And secondly, by providing investments to a large number of hospitals, more than 30 I think, Nicola?
ROXON: More than 120.
PM: There you go, more than 120. Well that is more than 30. More than 120 around the country, for enhanced surgical and theatre capacity. On further- on elective surgery, I'll turn to the Minister.
ROXON: Yes, thank you- of course, we have an elective surgery commitment with $600 million - the Prime Minister's referred to the 62,000 procedures which were undertaken under stage one - the 125 hospitals that are receiving upgrades, many of which have already opened- for example, the two theatres at Royal Brisbane. And stage three, which is being paid right now, $300 million which is being paid as states reach their targets. We have made it clear that we think more can be done in this area.
We will be making further announcements, but we've been working with the states and territories about how we continue to invest in what is an important area of access, emergency departments, elective surgery, and other access to our hospital services are obviously some of the pressure points that families feel constantly when they're trying to get access to care, and on top of the $600 million investment which is rolling out right now as we speak, there will be further announcements in due course.
PM: Okay.
JOURNALIST: (inaudible)
PM: Our job is to work with all the Premiers and Chief Ministers, Labor and Liberal, large states and small states, between now and when there'll be a meeting of the Council of Australian Governments, tomorrow week in Canberra. I will work as constructively and positively as I can with each of them. I believe that working families, pensioners, carers, right across the country, have already reached a conclusion that the current system is not good enough. It needs to be improved.
And I would say to any Premier or Chief Minister who thinks that their system is currently good enough and doesn't need to be improved, to go and have a long, long conversation with people currently queuing for attention at the emergency departments of their hospital this morning. I think that might be, shall I say, an instructive experience for all concerned.
Certainly, the Minister and I, between us, have visited nearly 100 hospitals across the country over the last six or eight months. And the playback that we have had in every state is that this figure that I mentioned before- 600,000 Australians each year presenting to emergency departments, having to wait more than eight hours, is not good enough for 2010. That's one in three Australians presenting in emergency departments, I'm advised, who are not being seen in clinically recommended times.
I would say to any Premier and Chief Minister who thinks that that is good enough, I think it's time we embraced, instead, national reform. I'll continue to work with Premier Brumby and the other Premiers as positively and constructively as I can, and we still have a week of negotiations to go.
JOURNALIST: Is four hours still too long a wait? It's a long time to leave people waiting for.
PM: Well a lot of analysis has gone into this particular target. Remember, the Bennett Commission of inquiry into the health and hospital system, we had running for 18 months from when we were elected two years ago until about six months ago. And secondly, in the six months since then, the Minister and I, and others assisting us, have been round to about 100 hospitals around the country. Based n the advice that we have received, we believe that this is a credible target to work towards, with funding to head in that direction beginning from 1 July of this year.
Look, if we can make further improvements in the future, I'm sure- but if you're a mum and dad out there who's waited eight hours plus already, I think you'd be saying four sounds not a bad improvement. I go to this simple point- it is just not acceptable that in 2010 we should have a system where in accident and emergency, one in three Australians are not being treated within clinically acceptable times. That has to change, and our national health and hospital reform program is about changing that.
JOURNALIST: Just one about asylum seeker policy-
PM: Sure.
JOURNALIST: You're being accused-
PM: Sorry, you on health as well?
JOURNALIST: (inaudible)
PM: We'll come back. I'll take yours.
JOURNALIST: Alright. You're being accused of adopting a populist stance, taking a leaf out of Mr Howard's playbook from 2001, where he sent the SAS to the MV Tampa, and now you've used, or announced a crackdown in processing asylum seekers. One, are you- do you think the Government's in breach of any international convention or the Refugee Convention that its ratified? Are you being populist? And also, how does it work? Is it just merely a delay of three months for the Sri Lankans or the Afghans? Do you-
PM: Sorry, the answer to your question- the answer to your first question- is no. The answer to your second question is no. On the third question, which is how does it work, it is a matter of this suspension being enforced as of now. And it means it being reviewed in the case of one group at three month point, and a second group at a six month point. And the reason for that is based on information concerning the changing security circumstances in the countries of origin. Our policy is very clear-cut. Our obligations are to deal with genuine asylum seekers, and those who are not genuine asylum seekers, to send them back to their countries of origin. That is the Government's consistent position.
Over here.
JOURNALIST: Why would you expect the states to sign up to your health reform plan when they haven't had all the details to begin with?
PM: Can I say that our discussions with the states and territories have continued for a long period of time. The states and territories have a very clear idea of what is the fundamental architecture of our reform for the next 10, 20, and 30 years. We have put out a comprehensive document which outlines that, called the National Health and Hospitals Network, funded nationally, run locally, for the first time the Australian Government being the dominant funder of the public hospital system, the exclusive funder of the primary healthcare system, the exclusive funder of the aged care system. This is a fundamental reform to deliver better- more hospital beds, more doctors, more nurses.
Secondly, the growth components that we've also spoken of, have been very clear in their articulation. Therefore, I think for anyone out there to suggest that there is not enough information around, maybe those folk may be looking for an excuse not to be positive. I'm not sure. But the key thing is, I intend to be positive for the remaining week of negotiations, because I believe the Australian people want the Government to get on with the job of doing this. I was elected with a mandate to bring about a fundamental change to the health and hospital system of Australia, where we would end the age of buck-passing, of cost-shift and of blame-shift between one level of Government and the other. I intend to get on with it. I hope all the other heads of State and Territory Governments do the same.
Having said that- last one, then I'll go.
JOURNALIST: (inaudible)
PM: I'll be seeing Anna before I leave Brissy. But I'll be in Brissy for a couple of days yet. So I'm sure we'll-
JOURNALIST: But not later today?
PM: I will be meeting Anna before I- do you want the time of the event and the coffee shop in question? I'll sort that out. There's a few other things on as well. But we will, I'm sure, catch up before we go. And having said that folks, I've got to zip, I'm due at another meeting. Thanks very much.