PM: It's been good this morning, having been on the road now for nearly two weeks talking about health and hospitals reform and building better hospital services for all Australians to be back here in Canberra to talk about the detail of this plan with the Chief Minister.
The thing about Canberra is that it's not just a health service for the 360,000 people who live in the ACT - it's a health service for more than 600,000 people who live more widely across southern New South Wales. That's why it's such an important health service for people in rural and regional Australia, as well as those who live in this city.
Today, we've been going through the detail of this plan for a new National Health and Hospitals Network funded nationally, run locally, and the practical action being this - more hospital beds, more doctors, more nurses in order to deliver better health services for working families, pensioners and carers.
The Chief Minister will speak for himself, but I'm pleased to say that we've reached agreement on the content of this plan with the Chief Minister in the lead up to what will be a very important meeting on Monday.
I'd say this about Monday's meeting - on Monday, COAG has a unique opportunity to bring about real, concrete action to improve health and hospital services for Australians. COAG can deliver better hospitals by taking real, concrete action to produce better services for working people. Our plan supports 6,500 extra doctors, 95 percent of elective surgery done on time, and caps emergency department waiting times to four hours.
Let me repeat that: our plan supports 6,500 extra doctors, it ensures 95 percent of elective surgery done on time, and caps emergency department waiting times to four hours. This is a big change on the past.
To make this happen, we've got to agree on real reform at COAG, and on that basis bring about real investment for the future, real reform and real investment for the future. I won't be signing any blank cheques on Monday, because that might be good news for state treasury bureaucrats around Australia but it would be bad news for patients depending on our hospital system.
Blank cheques may be good for state bureaucrats but they are bad for delivering better health and better hospital services for working Australians. So I thank the Chief Minister for his cooperative approach. Many of the premiers are working in exactly this direction, because I think we all know that the Australian people are looking at what happens next Monday and into the future about achieving real change on the ground for people who want better health and better hospital services.
I'll turn to Jon now and then take your questions.
STANHOPE: Thanks very much, Prime Minister.
As the Prime Minister's said, the ACT has been working productively with the Commonwealth over the last four or five weeks, most particularly in relation to the detail of the Prime Minister's national health plan. We indicated early that we were very happy to work hopefully productively but certainly cooperatively with the Commonwealth to achieve a new plan for all of Australia in relation to the delivery of health care.
We accept, and I believe all Australians accept, that to do nothing was never an option, that there must be change, that change is imperative, that the Prime Minister has, through his leadership, developed a plan to take Australia forward significantly. Every state and territory will tell you, all the time, that the current arrangements for the funding of health care are simply unsustainable. That's the case for us. It's the case for every jurisdiction in Australia, so we've grasped the opportunity. We've grasped it in a positive way.
We have, of course, some local, some parochial issues, issues of significant concern to us around the detail of a national health scheme such as that proposed by the Prime Minister. We raised those in our initial meeting with the Prime Minister and sought some comfort or assurance about those special issues, most particularly issues that recognise that we only have two public hospitals here in the ACT, one of which is not owned by the ACT Government, so issues around the development of local health networks would need to be looked at in a site-specific or jurisdiction specific way so far as the ACT's concerned.
We're also unique amongst the jurisdictions that 26 percent of all occasions of service in hospitals in the ACT are provided to New South Wales residents. Indeed, 30 percent of our waiting list for elective surgery is comprised of residents of New South Wales, and we do need that unique circumstance recognised. The Prime Minister has undertaken to work productively on that very issue, and we also do have here in the Territory some inherited, some historic issues, in relation to cost structures that we would like to be assured that the independent pricing arrangements would be taken into account.
I've received today through the discussions with the Prime Minister today, continuing assurance that each of the issues of particular concern to the ACT will be dealt with, that pathways for resolving those issues have been determined and on the strength of that I'm more than happy today to commit to the national health agreement that the Prime Minister will be bringing to COAG on Monday.
The ACT will be a signatory to the agreement. It provides all Australians with certainty into the future. It brings, most importantly, the Commonwealth to the table as a significant, signed-up partner in the delivery of health care. We will have uniform, transparent systems across Australia in relation to outcomes and to cost, and the ACT's very happy to be a part of that.
As the Prime Minister said, it does need to be understood the ACT - or Canberra - is a city of 360,000, but our hospitals serve the entire southern region of New South Wales. We service through our hospitals 600,000 people. In other words, our hospitals, our health care system, provides for more people than, well for instance, the population of Tasmania. That's the significance of Canberra and the health care that we deliver. We are a major provider in Australia, providing health care not just for the 360,000 Canberrans, but for an additional, at least, 250,000 within the region, all the way from Eden to Goulburn, all the way from Gundagai to Batemans Bay.
We're very happy to sign this up. We're doing it for the people of Canberra and for this region.
PM: Thanks very much Jon, and just to emphasise that, therefore, this is an important region for not just the people in the city, but 600,000 Australians living in regional and rural areas who depend on us having a health and hospital system that can deliver for the future.
I can't say this enough, that when you have a plan on the table which offers 6,500 more doctors, 95 percent of elective surgery being done on time, and capping waiting times in accident and emergency to four hours, this is a big step forward for the future.
JOURNALIST: Do you think the agreement between these two jurisdictions will make any difference to those jurisdictions that don't support your plan?
PM: Well, that's a matter for them, and I'm sure you'll be putting those questions to them during the course of the day, but we're having great discussions with many premiers and chief ministers across the country because I think underneath it all, they all recognise the current system doesn't work. We need change. We need a new system which delivers more hospital beds, more doctors, more nurses. We've put out a plan, this plan, to underpin that. We intend to get on with the job.
JOURNALIST: Prime Minister (inaudible) GST, would you be happy for states to keep the GST and just give you a commitment that they're going to put 30 percent of it, or is that a (inaudible)?
PM: We believe that for the future we must have the GST dedicated to a national hospitals fund and that is necessary so that we keep that money out of the pockets of state treasury bureaucrats.
Let me say it again: we need to have those monies dedicated to a national hospitals fund because the alternative is leaving those monies in the hands of state treasury bureaucrats who may not use it for health and hospitals. That's the old system. We're not going to be party to the old system. We have a new system, a new system which we put forward after two years of work, and this, we believe, is the right plan for the future - as I said, a plan which offers 6,500 more doctors, which offers 95 per cent of elective surgery being done on time, which offers that accident and emergency waiting times be capped at four hours. That represents real progress on a previous system which frankly no longer works.
JOURNALIST: Prime Minister, WA, Victoria, New South Wales, all said they will not vote for the GST issue. Has the fat lady already sung before COAG has even begun?
PM: Well, I'd encourage all premiers and chief ministers to bring a positive approach to what working people and pensioners and carers right across Australia - in WA, in Victoria, in New South Wales, Queensland and all the states - are crying out for, and it's simply this: the current system doesn't work any more. We need a new system.
Others may be happy to defend a system which no longer works. We believe we need a new system which provides for long-term funding for more hospital beds, more doctors, more nurses and this plan here offers 6,500 more doctors, it offers 95 percent of elective surgery being done on time, it offers also that in accident and emergency waiting times be capped at four hours. These are the things which matter to working families.
I look at all of you here today, I'm sure all of you have presented at various times to accident and emergency departments around the country and you've had unacceptable waits. Some of you will have family members who've had to queue for elective surgery where it's gone beyond the recommended clinical time. That's got to change. Australia can do this better, and I'd ask and urge everyone to get in there and support this.
As I said before, on the GST in response to this question here, you can't just invent funding out of nothing. What you need is for these monies to be dedicated, to be allocated to a national hospitals fund so that it's kept out of the pockets of state treasuries. I don't think working people across Australia have any confidence that the state treasuries, constantly reigning in their hospital budgets is the way to go for the future.
JOURNALIST: Prime Minister, if talks fail on Monday, what's the next step?
PM: You know, I've been very consistent about that since way before the last election and that was we will take a reform plan for better health and better hospitals to the premiers and chief ministers and we would prefer to do this cooperatively, but if not then we would seek a further mandate from the Australian people. I have said this consistently for two to three years now and I haven't budged one bit and I don't intend to.
JOURNALIST: Would you consider further negotiations if (inaudible)?
PM: Oh, I think people are tired of delays. They're really tired of delays, and I've heard people bringing out more excuses for delay. This plan of ours was released six weeks ago, and we've released a further volume of it outlining the additional investments we would make in the system as well, and this is built on the Bennett reform proposal which was produced over 18 months and consulted right around the country over that long period of time.
The work has been done. The plan is clear. It's here, it's in black and white. We're up for decision - this Monday at the Council of Australian Governments. There are no more excuses for delay. Working families want us to get on with the business of improving their health care services now.
If you've been like me, starting in your last week, in Far North Queensland and ending up back here last night about two weeks later, a bit less, out there on the ground people are very clear about this - they've already concluded that the current system, in whichever state you're talking about, is not working properly. They want change, and the smallest country hospitals, the bigger regional hospitals, they very big metro hospitals - they want change, and it would be wrong for leaders to pass up this historical opportunity, this once-in-a-generation opportunity to bring about that change now.
Back to you, Chris.
JOURNALIST: (inaudible) about something what you've just said (inaudible) you're saying having a dedicated (inaudible) Now, before I thought the idea was that you'd directly pay local hospital networks through case-mix. Are you now saying that you agree with the (inaudible)?
PM: Our position on this, Chris, has not changed. You go back to the document, we have said constantly that these monies would be dedicated or allocated to a national hospitals fund and furthermore it is absolutely critical that local hospital networks be supported. That has been clear in our position all the way through. That hasn't changed.
One of the things you also pick up in regional Australia is that they are tired, very much tired, of having state treasuries and state health bureaucrats constantly, constantly telling them what to do and telling them how much money they can't have. The virtue of us introducing activity-based funding right across the country is that these hospitals are then funded for what they actually do. That is the big difference, and when I go to hospitals like I was in the last few days at Port Macquarie, speak to the locals there, they say 'for us, here at Port Macquarie, what really works is an activity-based funding model because we are currently budgeted to deliver this many services. In reality, we are delivering this many services, and that is why our system is under so much stress.'
That's why we're bringing in this reform, and you know something? It's the product of nearly two years of work, so for those who actually go out there and call for further delay, I actually don't think they are quite listening to what the people are saying.
JOURNALIST: Christine Nixon, she now appears to have given a fourth account of events about Black Saturday (inaudible)?
PM: The Government's position hasn't changed on that. I notice that Christine Nixon has already apologised for her position on the night when the fires hit and we've said then and said since then that she continues to have the Government's support.
Having said that, folks, I've got a few things to do. I've got a team of officials in there to chunk through the rest of it. Thanks, folks.