MINISTER ROXON: Thank you very much for coming here bright and early this morning. It's a very great pleasure to be here, Dr Lim has hosted us in her General Practice. She's a GP of more than 20 years standing and very much loved by her patients as we've just seen. So thank you for letting us come to your practice.
I'm delighted to be here with the Prime Minister, the Minister for Mental Health and Ageing and Gai Brodtmann, the Member for Canberra. We're here to release the guidelines for the establishment of Medicare Locals, to call for applications for Medicare Locals, the first of which will start on the 1st July this year, another 15 on the 1st of January next year and the remaining number by the 1st July 2012.So I'm delighted that the Prime Minister's here to bring a bigger focus onto primary care and I will hand over to her and of course we will distribute these guidelines, the application process for them and I'm sure that you'll have questions to ask and a very proud general practitioner who no doubt will want to tell you about her practice as well so over to the Prime Minister.
PM: Thank you very much to Nicola and thank you very much to Dr Lim for having us here and to my colleagues for joining me. We of course talk a lot about health and when we talk about health, politicians on TV screens, people often think it's all about hospitals and hospitals are really important, what happens in our public hospital system is so important to community members. And that's why when we struck the health reform agreement we were very focussed on making sure that our hospitals could be better for the future, that they were properly funded with more than $16 billion of new resources, that there was a change in the funding system, so that the Federal Government would be an equal partner in growth and that there were changes which would empower local communities, which would mean less waste and less red tape and less waiting time.
So hospitals are important, but often we don't talk enough about primary care, the care than happens in our community and can keep people out of hospitals. From the point of view of individuals, if the primary care system is working for them they get the care they need from the practitioner they need it from at the right time. They don't have to worry about who to go and see, because when they see their local doctor, when they go to their local health care service, they can get a coordinated package of care which meets their needs.
And in the modern age so many Australians struggle with chronic and complex conditions and whilst they need a great general practitioner, they often need so much more - access to a dietician, access to a podiatrist, access to other health services that'll make a difference to their needs. We know from the point of view of the health care system, if we can keep Australians out of hospital by keeping them then that is better for the system. By international standards Australia has very high hospitalisation rates and we want to change that by having great care in the community, so I'm very proud to be here today to announce the guidelines for our first section of Medicare Locals.
When I announced our health reform agenda, coming out of the Council of Australian Governments meeting, I said I wanted to see a national health reform agreement for hospitals, but I also wanted to put a greater focus on primary care. Medicare Locals are the bodies that will coordinate primary care in the community, today we announce the guidelines and we want to get the first 15 Medicare Locals up and going from the middle of this year and the second 15 Medicare Locals up and going from the 1st January next year. I've determined we should have more Medicare Locals and we should have the come on stream more quickly.
What Medicare Locals will do is they'll be able to bring together our primary care system so that patients can get the coordinated care that they need. I've also sought to invest in our primary care system by making sure we bring on stream two years early, access to after-hours consultations and that will happen from 1st January next year, with our new after-hours hotline coming on stream on the 1st July this year.
And I want to make sure that there's transparency in primary care, so people know how their local primary care is going, so they know how health care is going in their local community. I also want to make sure that Medicare Locals over time become fund holding organisations, so they've got the ability to get service gaps in the local community filled, so if there isn't enough of a particular service available Medicare Locals can make a difference to that.
We've had the opportunity today to talk to Dr Lim and what she's stressed to us is in her clinic here she's got access to a range of services, she said it was on more than one occasion that as a general practitioner she can't do everything and that meeting patients needs is about team work, that's what Medicare Locals are about, bringing that team work to local communities.
Now if it works well from the point of view of the patient, they'll get the care they need, they mightn't see this big engine behind that is driving that coordinated care, that will be work that happens between practitioners, but it means a patient will be able to get the coordinated care that they need.
So I think today is an exciting development as we continue to make sure that patients get a better deal with health care. I'm very happy to take any questions.
JOURNALIST: So Prime Minister are you saying that a patient will never actually see anybody working in these Medicare Locals?
PM: Of course, they'll see their primary care practitioners and the primary care practitioners will be working together through the Medicare Locals. What I want is not for the patient to worry about ‘who should I go and see next, how do I get my care coordinated, how many times to I have to give my records to people, how many times do I have to tell my story about my health care problem'. From the point of view of the patient I want them to get access to the services that they need, because the practitioners are collaborating through the Medicare Locals, that's what I mean by the engine being there, bringing the practitioners together. I don't want patients to have to worry about that machinery; I want patients to get the care they need.
JOURNALIST: Who will pay for the allied health care that they might need, that the GP would want to refer them to, which isn't covered by Medicare at the moment?
PM: Well we have various programs which assist people to get allied care, particularly when they have chronic and complex diseases which mean that they need access to a coordinated package of care and ultimately I want Medicare Locals to strengthen our primary care system by becoming fund holding. But with Medicare Locals coming on stream this year and with more of them next year, what we will see is a development where there is more coordination and more focus on primary care. I believe that's what our health care system needs, we don't want people ending up in hospital if they could have got the care they needed in the community and that they could have been kept well in the community rather than ending up in a hospital.
JOURNALIST: More coordination ain't going to work if the patient can't afford the physio or podiatrist.
PM: Certainly we have programs to support access to a broader range of services and that's important, but the coordination is important too. Patients, many of them these days present with conditions that require access to a range of services. You take Type II diabetes, yes you need to see your general practitioner, you may also need to see dietician, or go to an education class to help you manage your diet, you may need to see a podiatrist because of circulation problems, if you can get that package of care coordinated for you that's what Medicare Locals are about.
JOURNALIST: These after-hours services that will be offered, will they be bulk billed, because if they're not, won't they still be an incentive for people to roll up at the hospital emergency department?
PM: Our aim with after-hours is to make sure people can get access to assistance over a telephone line, often people need reassurance and need some help, they need a sense of whether or not they need immediate assistance or they have something that they can go and see a doctor about in coming days. And then we want people to be able to access consultations after hours, we will be making appropriate arrangements for that and there are parts of the country where after hours services work well now and meet people's needs. Often for people it's just that they don't know where to go, don't know how to get help, the hotline will help with that and then after-hours access will help with that.
JOURNALIST: So there's no guarantee they'll be bulk billing?
PM: We will be working to bring services on stream that will meet people's needs, but for many Australians they simply don't know how to access an after-hours consultation and in their local community at the moment there's no mechanism to enable them to do that. The hotline will make a difference and then bringing on stream two years early our access to face to face consultations will make a difference too.
JOURNALIST: But the co-payment issue is becoming bigger all the time, it seems you've got radiology patients storming the battlements today over the claims that the gap is becoming too big for people to access diagnostic care, what do you say about that?
PM: Given the dramatic wind up to the question, I'll ask the Minister for Health to answer.
ROXON: I'm please that you have asked that because despite the storming of the battlements that I think you say, actually the bulk billing rate for diagnostic imaging is at an all time high. That's because our government introduced a bulk billing incentive 18 months ago or so. That is working well. There are still people that do have to pay co-payments and we obviously do all we can to make sure that we reduce that number but we do have a system where there is some balance provided by making sure there is good access to bulk billing services. We have an all time high for bulk billing services for GPs. That is good news for the community and as the Prime Minister has made clear of course people won't pay for the telephone service, a service that ultimately will also be an online service that will be free of charge to the public and our new after-hours incentives are going to mean that it's possible to coordinate better across an area, so if its Dr Lim's practice or another practice there's an opportunity to work with other neighbouring GPs to provide services after hours, hopefully in a way that makes it more cost effective for them and hopefully more able to be bulk billed or at a lower charge to the patient
JOURNALIST: Pathology rebates haven't been increased or indexed for 13 years, why is that?
ROXON: Well as you would know Sue that's because for ten of those years there were two memorandums of understanding with the diagnostic imaging which is a price and volume agreement struck by the Howard Government. At the request of the industry that agreement was not renewed at the end of the second five year period. We've been in discussions with them, there's been a review for both pathology and diagnostic imaging that is close to completion and of course what you're seeing now is a campaign, one where you wouldn't expect people in an industry to ask for less money for their industry but we have to temper those with the needs of the community. Our consideration for investments that are made will be putting patients first and making sure that we have a strong and viable health sector.
JOURNALIST: Prime Minister, why do you think Labor's done so well in the latest poll, or why is the Coalition doing so poorly?
PM: I said a few weeks ago that we had a lot of hard work to do and there's nothing about anything today that has changed my view. We've got a lot of hard work to do and we'll get about doing it.
JOURNALIST: Prime Minister has the Australian Government has any update on what's happened in Libya overnight and do you think it's time for Western intervention?
PM: Thank you for that question and I'm sure many Australians have been very shocked at the images they've seen on their TV screens of such widespread violence in Libya and also deaths in Libya. Firstly can I just address the circumstances for Australians, our travel advisory says do not travel, so I'd say to Australians who may have been contemplating travel to Libya for any reason, our travel advisory says do not travel.
For Australians who are in Libya and on our advice in terms of registered members of Australians, there are relatively limited numbers, we are talking around about 80 Australians. Our advice to them is to travel out of Libya if it is safe for them to do so, we are starting to canvas evacuation options should that be necessary.
On the general circumstances in Libya, we condemn in the strongest possible terms the violence that people have seen on their TV screens, we condemn in the strongest possible terms the use of the military against peaceful protesters. There is no excuse and no tolerance from the Australian Government for violence being wreaked against peaceful protestors. So our message to the government of Libya, to Colonel Gaddafi, is that they must respect peaceful protest.
JOURNALIST: And can governments like Australia and the US (inaudible) say that to Libya (inaudible)?
PM: I think what we can do is put pressure on Libya to respect the wish of the Libyan people to engage in peaceful protest. We will be making that point very strongly to the Libyan Ambassador here and the world will be joining in condemning the scenes that we've seen and the use of the military and security services against peaceful protestors. We condemn it outright and absolutely.
Across the Middle East and in Libya we are seeing an outpouring of people's pent up demands for more freedom, for democracy, for a say in the running of their societies, that's what we're seeing in Libya now and the peaceful protest that people are engaged in should be respected and not met with this kind of gross violence.
JOURNALIST: (inaudible) plan to abolish exit fees despite receiving advice back in October that it could actually costs customers more?
PM: The government believes that our moves to increase banking competition, including getting rid of bank exit fees, will get a better deal ultimately for customers, that more competition is good. If the banks go in competing hard for people's business, then consumers will get better deals and in fact over recent weeks people will have seen major advertising campaigns from the banks out there, offering deals to consumers going in to get consumer business offering better deals as a result.
So that's what our competition package and banking reforms have been all about, making sure that the customer has choices, the customer can take their business from bank to bank and the customer therefore can require their banks to give them a better deal, that's why we didn't want to see exit fees that lock people in into one product and prevent them saying to their bank, I'm going down the road for a better deal.
JOURNALIST: Did you get that advice and did it worry you at all?
PM: You've got to strike a package here and government has to make the decisions that it believes are in the national interest and we certainly believe it's in the national interest to not have people handcuffed to banking products they no longer want and not able to use their ability to say to their bank I want a better deal or I'm taking my business elsewhere.
JOURNALIST: Prime Minister, Kevin Rudd has asked that that the ALP review, the Labor Party eliminate the power of the factions, factional leaders. He's also asked for the report to be released publicly, will you release the full report?
PM: The report is in the hands of the National Executive and it will make the arrangements about this. For me I'm focused on the future, focussed on governing in the best interests of the Australian people, that's what we're doing today and that's what Nicola Roxon and I have been working on with our health reform plans including these plans for Medicare Locals.
JOURNALIST: You don't support releasing that review?
PM: This is a matter for the National Executive; we're a party of government and a party of ideas. I'm happy to see ideas debated by the Labor Party, we're a party of government, we're getting on with the job of governing in the interests of the Australian people. Health, the health care system is very important to Australians, but they want to know the public hospital is going to be there if they need it, they want to know they can get the care in the community that they need. That's what we're talking about today and making progress in with Medicare Locals coming into existence on the 1st July.
JOURNALIST: What's your response though to claims that that review actually points the finger at yourself for some of the campaign bungles?
PM: I'll let other people chew over history, we'll get on with the job of making a difference to Australians.
JOURNALIST: Prime Minister what do you make of Scott Morrison's motion to the House last night to cut the number of asylum seekers coming by boat and then Judy Moylan's reaction speaking out against it in the House?
PM: I made my views about the conduct of the opposition very clear in the House yesterday; we are a country that's got a proud bipartisan history of having a non-discriminatory immigration policy. It's been something that's been treasured and prized by Labor governments and Liberal governments and as I said in the House yesterday there are a number of Liberal Prime Ministers who should be applauded for the stance that they took in favour of our non-discriminatory immigration policy. We are not a nation that believes in discriminating on the basis of religion.
I believe the Leader of the Opposition has to show some leadership on this matter, we have now a very very dreadful spectre haunting the Parliament and the nation of discriminating in our immigration policy on the basis of religion. The Leader of the Opposition has to confirm that he stands for a non-discriminatory immigration policy, they will hollow words unless he moves to replace his Immigration Spokesperson and his Parliamentary Secretary.
JOURNALIST: Prime Minister on that matter, I wonder what you make of the radio station that conducted a quiz asking callers to (inaudible) the number of asylum seeker deaths, did you hear about that one?
PM: I saw a report of it in today's newspapers and it's absolutely revolting.