Can I acknowledge my Ministerial colleagues Nicola Roxon and Mark Butler ... the Leader of the Opposition ... and all our federal parliamentary colleagues gathered here tonight.
Dr Steve Hambleton, AMA Federal President and Mr Francis Sullivan, AMA Secretary General
Dr Christine Bennett, who is so well known to all here and has been such a fine servant of the public good in health.
My old friend Dr Mukesh Haikerwal; Mukesh I was so pleased when I knew that we'd be seated together tonight.
And all AMA Councillors, members, supporters and friends
Welcome to Canberra and I thank the AMA for the opportunity to join you at this important time in the history of the Australian heath system.
Labor and the AMA haven't always agreed on policy - that's no state secret.
But we have always agreed on the need to give the Australian people the quality health care they rely on the care that each of you work so hard to deliver each and every day.
In this land of the ‘fair go', the provision of universal health care lies at very core of our nation's social compact.
Our system of universal health care is fundamental to the security and dignity of every Australian.
And it must be strengthened and renewed as we face the ageing of the baby boomers and a rising tide of chronic illness and disease.
That is the whole aim and purpose of the 2011 federal-state health agreement.
It is a once in a generation reform that will set our nation's health system up for decades to come.
Reform that will buttress the principle of universality with the equally important principles of sustainability, transparency, high performance and value for money.
Let's take a moment to consider the scale of this agreement, because it is truly extraordinary: an extra $19.8 billion to the states in the first six years, rising to an extra $175 billion by 2030.
Be very clear:
This is $175 billion in extra funding that the Commonwealth was not obligated to provide.
Money that the States and Territories would otherwise have had to find themselves from their budgets or else money the system would have gone without.
Remember when we came to office in 2007, the Common-wealth's share of funding had slipped under 40 per cent.
With this Agreement, we will fund 50 per cent of the growth costs of our hospital system.
For the first time in Australia's history, half of every new dollar in our public hospital system will be paid by the Commonwealth, come what may.
In so doing, we have defused the time-bomb that has ticked away inside our state finances for years and made the Commonwealth an equal partner in growth.
Not only does the Agreement underwrite the fiscal sustainability of the States and Territories.
It will make a real difference to doctors caring for patients every day.
Less time worrying about where the next dollar will come from.
Instead more staff, more beds, more services.
Between 2014 and the end of the decade alone, our new funding will deliver:
* 2.9 million extra cases in our emergency departments
* 2 million additional in-patient services for major surgery or severe conditions
* 19 million more outpatient consultations, such as minor surgery or physiotherapy.
In other words, more opportunity for you and your colleagues to do what you were trained to do: Treat and support patients.
But, friends, in creating this Agreement, we knew that more money on its own was not going to be enough.
We need the system to be accountable in ways it has never been before.
That is why state and federal funds will go into a single, transparent National Health Funding Pool.
It sounds technical - but, in fact, it addresses one of the most fundamental concerns that doctors hold: the fear that extra money will be skimmed away by revenue-hungry State and Territory treasuries.
That will not happen because the National Health Funding Poolwill act like a transparent and arms length repository for public hospital funding.
The funds for public hospitals - jointly contributed by both levels of government - will go into one centralised locked pool, overseen by an independent Administrator.
They will be tracked transparently to the last cent.
The money trail will be there for all Australians to see.
In turn, funds will flow from the National Pool directly to each Local Hospital Network - no skimming, no leakage.
That leads to the second element of this package: The creation of localised health bodies that respond to the unique circumstances of their own communities.
We've moved away from the highly centralised health bureaucracies that for too long stifled innovation and flexibility in our system.
Clinicians will take the lead in planning and delivering health services locally, as they should and must.
Importantly, those local health authorities will not be given blocks of money as they have been for decades.
The days of the blank cheque are over.
Instead funding will be distributed according to an efficient price, backed by a new performance authority to monitor results.
Poor performance will have nowhere to hide.
It will be found out.
Finally, we've put in place achievable targets for emergency department and elective surgery access, based on medical expertise.
In other words, making our reforms real for every patient who needs a hospital for emergencies or elective surgery.
They may not know the details of our health agreement.
But they will see the concrete and tangible results that matter to them:
* 90 per cent of patients across all triage categories being seen within four hours.
* And 100 per cent of patients waiting for elective surgery being treated within clinically recommended times.
Those targets have the blessing of an expert medical panel, and they have the resources and structures required to back them up.
Friends, the battle since April last year has not been about dollars.
It has been about reform.
Five key interlocking reforms that make sense only when taken together as a whole:
* more funds driven by activity, efficient pricing, performance monitoring, achievable targets and localised control;
* each addressing the weak points that had made our health system progressively more inefficient and unsustainable.
That is the true battle that has been fought by the Commonwealth - and won.
Instead of a paper fight over funding shares, we have secured fundamental reforms that reshape our health system to its very core:
* We have secured the right to expect every health service to be delivered at an efficient price.
* We have secured the right to track where every dollar, state and federal, goes via the National Health Funding Pool.
* We have secured the right to expect that health system performance shall be reported publicly by an independent umpire, without fear or favour.
* We have secured the creation of new Local Hospital Networks that break the old model of centralised control.
The significance of these measures cannot be over-stated.
They are the biggest changes to health policy in Australia since the introduction of Medicare.
In fact, they represent the saving of universal health care as we face three decades of unprecedented demographic pressure.
But, friends,
None of us in this room tonight imagine for a second that the health and longevity of our community can be solved entirely within the walls of our acute care system or without substantial parallel reforms to aged care and disability services, of which I spoke earlier this month.
Never has there been a greater need for prevention, early intervention and care based in the community.
That's why we've focused so hard on tackling smoking and alcohol abuse - and I'm grateful in that regard for the AMA's unwavering support.
We've also got a growing burden of chronic conditions like high blood pressure and diabetes, much of it manageable while patients continue to live at home.
In fact, it is a tragedy that so many Australians go to hospital when they do not need to.
It is a human and financial waste.
That's why under the National Health Reform, we want to shift the centre of gravity of the health system from hospitals to primary care.
General Practitioners will remain front-and-centre of primary care, backed by Medicare and the PBS, which remain the cornerstones of our health system.
To complement and support those cornerstones, Medicare Locals will take responsibility for the primary health care needs of each local community.
Medicare Locals will work in partnership with GPs and other professionals to ensure each community has the right mix of services to meet its health needs.
For example, by working closely with Local Hospital Networks to make sure that primary health care services and hospitals work well together.
Helping ensure GPs are supported to provide after-hours services or visits to nursing homes.
Identifying where local communities are missing out on services and coordinating services to address those gaps.
And taking advantage of the new opportunities which high speed broadband will create - to extend health services into every corner of the community and into every home.
Friends, I know the AMA and the Government don't not have a complete meeting of minds on this issue at the moment.
It was the same in the early days of Medicare.
But through dialogue and lived experience, we can give Medicare Locals a chance to prove themselves.
Our hardworking doctors in the nation's 7000 GP practices might just find they have acquired a new and valuable friend.
Because colleagues,
We haven't just gone through months and years of painful reform to achieve some aesthetically-pleasing new bureaucratic structures.
We did it to change health care in this nation for the better.
To put an end to the arguments that have distracted and debased our health system for so long.
To stop doctors and their representatives worrying about funding and structures so they can give their attention to the thing that really counts: patient care.
Every Minister since Neal Blewett has tried to address these issues.
And every Premier and State Treasurer has prayed daily that someone would.
Well, that someone is us.
The process wasn't pretty.
It wasn't fast.
But it has delivered a result of which all Australians should feel proud.
I hope, in time, the AMA and its members may come to feel proud too.
As these reforms work, and as we work together, in good faith and good will, together we will ensure our great health system remains great for the years and decades to come.
The Australian people deserve nothing less.