HOST:Now, before we get to health, you're looking pretty healthy in the polls this morning. Latest out show that you're in a 50-point lead over Malcolm Turnbull in the preferred Prime Minister stakes. Must be a nice way to start the day?
PM:Look, in the time I've been leader of the Labor Party, these things go up, they go down. The important thing is to keep your eyes focussed on the main game, and people expect us to deliver on our pre-election commitments. One of those is to reform the health and hospital system. So, just keep your nose to the grindstone, keep doing what you've been elected to do.
One thing, though, I just say. I notice there's some jockeying for leadership on the other side of the show and that Tony Abbott yesterday was on television saying that next election they'd be looking at bringing back further changes to industrial relations. WorkChoices, under Mr Abbott, on its way back. Have a look at what he said last night.
HOST: Well, his book launch is on today. I'm sure you'd be a very welcome guest there in the audience.
PM:I'm not so sure.
HOST:Let's have a look at that health shake up now. One of the things that the report calls for is for all Australians to automatically go to a government-operated health plan, and that would see the introduction of something called Medicare Select.
Can you explain to us exactly what that is?
PM: Look, this is one of the proposals put forward by the independent Health and Hospital Reform Commission. It's built on a foundation of Medicare, so Medicare would remain, but on top of that it's designed, according to the Commission, to provide an additional level of service to people to help them around the system.
HOST:Is that creating a two-tier health system?
PM:Well, one of the recommendations or conclusions of the independent Commission, the Health Reform Commission, is that we already moving in a direction of a two-tiered system. We don't want that to be the case. We don't want people who are living in, shall we say, poorer parts of Australia or in rural and regional Australia to have a second-rate health system. So that's why we've got these series of proposed reforms that are there.
As I said yesterday, we don't intend, as we have this big debate with the nation about what they want, and how they want to pay for these major reforms in the health system, we want to make sure we get that right, so we're not going to be in the business of ruling in or ruling out particular options which were put forward by the independent experts.
Let's work our way through that. That's one of the reasons I'm off to Royal North Shore Hospital here in Sydney later this morning, to speak to people at the coal face.
HOST: Another one of these suggestions are the introduction of new health care centres. Can you explain to us exactly what they would offer and what that would mean for the local GP? Will it spell the end of them?
PM:No, actually, it is designed entirely to build on the services operated by GPs. If you look at it in these terms - first of all, we need to be stronger on preventative health care. How do you keep people out of hospital, how do you keep them well? Two per cent of all we spend on health at the moment is spent on preventative health care. We need to lift that so that we maintain wellness, keep people out of the acute care system.
The second thing is this - what's called primary care, or front line care. And that is primarily through our GP-related services. How do we better resource them and provide additional services like physio, like OTs, like podiatrists, like all the allied services, in some sort of one-stop-shop, so that when people go to the doc, they actually find it easy to get all those allied services rather than having to front at a hospital later on.
So we've already started in this direction through Nicola Roxon's roll-out of GP Superclinics across the country, there are about 35 of them already funded. Can we extend that model more broadly so that when you're crook, you're sick, you go to the GP, and you've got three or four additional things you need to do and they are located within a common, almost community, health centre.
HOST: Despite all the talk of complete takeovers, at the moment most of the talk centres around a partial takeover of 40 per cent of the hospital funding. Could this simply be a whole new layer of bureaucracy that just clogs things up even more than is currently the case?
PM:Under no circumstances. I mean, the Australian people have the right to expect that we get to the bottom line of things like increasing access to hospitals for elective surgery, making sure you don't have unacceptably long waiting times in accident and emergency. You've had, I'm sure, all those stories on your program here.
How do we actually improve that?
Now, what we're on about is a series of reforms with the states and territories to see that we can make real changes there. How you then govern the system, your point about bureaucratic administration, is the secondary point. But what's on the table here is quite a radical set of changes. The Commonwealth Government taking full responsibility for preventative health care, full responsibility for primary health care, full responsibility for aged care. Also, when it comes to outpatient services in hospitals, full responsibility there. 40 per cent of the acute hospital treatments, as well as full responsibility for dental care through this new proposal for Denticare.
HOST: On the issue of Denticare, to fund that, that will need a Medicare Levy of 0.75 per cent. That works out to be $450 a year for people on a salary of $60,000. How can people afford another hike in the Medicare Levy?
PM:I full accept that's not cheap. I accept that. What I'm also trying to say to the Australian public is if we're going to fundamentally change our health and hospital system and prepare for the next 20 years, with an ageing of the population, with an increased cost in the provision of medical services, through the cost of drug going up, as well as a greater need for drugs as people get older, then we've got make sure it's properly funded as well.
HOST: How are you going to fund that?
PM:Dental care is a big gap in the current system, particularly less well off people constantly putting off dental care. The problem is, infections in your mouth actually spread to general infections and become a general health problem.
So on the question of cost, the proposals put forward range from additional cost to the system of somewhere between $2 billion and $5 billion and $6 billion per year, additional capital cost to build new facilities, as well as the amount that you just referred to for Denticare.
We're not going to the absolute detail of final costings yet. We're going to test all this with the Treasury. Which is why, during the next six months before we put a final proposal to the states and territory governments, that we will have all these things rounded off, but that doesn't -
HOST:But surely that means a tax hike?
PM: - come for free.
HOST: It must mean a tax hike. $5.7 billion is the number that is around this morning per year?
PM:Well, we said that explicitly in the report, and I should say the independent Commission did, and I said so in a speech yesterday. That's what their conclusions are.
I'm just being very blunt with people - if we want to reform and improve the system, it won't come inexpensively.
Three sources of how you do it.
One is if we the Commonwealth take responsibility from the states, that means a transfer of the funding back to the Commonwealth from the states.
Secondly, it means that if we've got one total health system for the country, it can become more efficient, and there are findings in the report about how you make your hospitals more efficient.
But thirdly, you want to point to revenue. And we've got a big revue coming up on the future of the Australian taxation system due by year's end called the Henry Commission Review.
Put these things together, we finalise a proposal, put it to the states by early next year, they'll accept it or reject it - and we've said what we'd do if they reject it.
HOST:Prime Minister, just quickly, at the last election you promised these sweeping health changes, the reforms would come in and take over the health care system if the states didn't get their act together. Yesterday you told us we'd have to vote you in again if we want to see any of these reforms come to fruition. Is that fair?
PM:No, what we said was that if the states didn't cooperatively come on board with us on a unified set of long-term reforms for the health and hospital system, and our preference is to do it cooperatively, what we said then is that we'd go the people, I said that prior to the last election, through a plebiscite or a referendum.
These are very big decisions. Millions of Australians, everyone watching your program today, has had some contact with the health system. You don't take these decisions likely, and the period ahead, between now and the year's end, the Health Minister and I are going to visit many of our major public hospitals right across the country, starting with Royal North Shore in Sydney today, and we're doing so in every capital city. We've got to get this decision right, it's very big for the future, and it won't be cheap.
[ends]