PM: It's great to be back at the Royal North Shore, and I'd to thank our colleagues here, including Paul Roach, for taking us around, Maxine McKew, the local member. I've heard a lot about what's been going on here, and I think it's been a good story.
I began my consultations on the future of the national health and hospital system here at Royal North Shore Hospital about eight months ago. Since then, we have been around 103 hospitals around Australia. I've visited 21 of them, including the Royal North Shore. I've listened very carefully to what doctors, nurses, clinicians and others, and patients, have been saying about their expectations for the future of our health and hospital system.
I'll just talk briefly about what's happened here first. I understand from Paul that they began lobbying for a PET scanner here back in 1997. Is that right? That was 13 years ago. I'm very pleased that this PET scanner is now up and functioning, and I think we saw Gordon this morning and we understand how this piece of new technology will actually make things better for him - in the analysis and the diagnosis and how he is treated.
This is a good story, but you know something? Thirteen years is too long. And you know something? The undersupply of PET scanners across the country is something we need now to deal with.
How does that relate to what we're talking about with the reform of the national health and hospitals network?
We are planning to introduce a National Health and Hospitals Network which is funded nationally and which is run locally. Funded nationally, whereby for the first time the Australian Government becomes the dominant funder of the recurrent costs of our public hospital system, of their capital costs for the first time, of their equipment costs - which means PET scanners. Of course, also, the teaching, training and research costs as well.
This is a very big reform, but the time has come for this reform in Australia.
Earlier today I met with the Premier of New South Wales, Kristina Keneally, and we had a long, positive, productive discussion about future directions for this National Health and Hospital Network.
In the days ahead I'm going to be burning the shoe leather. I'll be keeping the engines running and the planes on alert as I travel from Sydney to Brisbane tomorrow to the Queensland Premier, Sunday, I understand, with the Victorian Premier, with one objective in mind - how do we land this fundamental reform for the health and hospital system for the future?
There'll be a lot of argy-bargy on the way through, but you know something? What I want as Prime Minister of Australia is to see this fundamental reform for better health and better hospitals done.
So there'll be a lot of action in the days ahead as I go to each state capital, starting with Sydney here, Brisbane, Melbourne, talking to each of the Premiers and Chief Ministers to make sure that we can land this agreement.
Of course, if the Premiers and Chief Ministers don't agree, we've also said that we'll be then seeking a further mandate from the people, but I want to make sure we land this agreement for the future.
And having said that, folks, I'm happy to take your questions.
JOURNALIST: Prime Minister, how did your meeting with the Premier go? Did you manage to answer all of her questions?
PM: Well, that's a question you should put to the Premier, whether I answered them effectively. It was a good and it was a positive conversation. And we are dealing with practical matters like the future operation of local hospital networks, the future funding of the capital needs of hospitals like this one, the future funding of their equipment needs, questions such as that. It was a positive, constructive conversation. It'll be one of many, not just with the Premier of New South Wales, but with other Premiers as well.
As I said before, I intend to be wearing out the shoe leather, keeping the car engine running, the plane on high alert, running around the country talking to Premiers to get health and hospitals improved for the future.
JOURNALIST: (inaudible)
PM: The Premier raised some very specific questions about elements of the reforms, part of which goes to the operation of local hospital networks, part of which goes to long-term funding for the system.
As I said earlier today on radio, some Premiers around the country have said they want to know what happens in the Government's response to the independent review of taxation.
What I have said very plainly is that whatever decisions the Government takes on that in the future, there will be no net negative impact on the states and territories, so let's get back to health and hospitals reform. That's the important thing, and that's what we're focussed on here.
JOURNALIST: Prime Minister, did the Premier raise the issue of GST, and whether the New South Wales slice of the pie will increase to accommodate this system?
PM: On the question, our proposal is for a National Health and Hospitals Network, funded nationally, run locally, with the Australian Government for the first time becoming the dominant funder of the public hospital system.
Secondly, one of the ways that will be funded is by taking approximately one third of the GST from the states and putting it into a National Hospitals Fund for the future - the Australian Government then taking on its shoulders the dominant funding burden for the future growth of the system as well.
Now, on the details of the allocation and distribution of the GST, that is currently being worked through by Treasury officials, between the Commonwealth and all the states and territories. That work will continue right through until COAG meets in April.
JOURNALIST: Prime Minister, there are estimates that up to 20,000 health bureaucrats will lose their jobs as part of your reforms. Do you think that's a reasonable estimate? Have you got any idea about how many jobs will go?
PM: Can I say, there will be a fear campaign every other Thursday about why we shouldn't get on with the business of fundamental reforms to the health and hospital system, and you've just raised a new one.
Last week it was about closure of country hospitals. That's absolute nonsense.
As for this fear campaign, I'd simply describe it in the same sort of terms.
Wherever you go across the country, people are going to come up with one excuse after another as to why health and hospital reform should not happen.
What I'm saying, loud and clear, is that health and hospital reform will happen. We are determined that it happens. Mums and dads right across the country want to see better health and better hospital services. We've put forward a very clear cut plan for doing so. We intend to get on with it.
JOURNALIST: Beyond COAG, what's your timetable, Prime Minister, for the delivery of this new network?
PM: We would begin the implementation of this new network from 1 July next year. And then we have outlined a clear timetable for transitional arrangements to the full operationalisation of the system through 2012-2013.
But the first changes would occur from 1 July next year.
We have spent too many decades, too many decades, delaying reform of the health and hospital system; too many decades delaying how to put it on a better funding basis for the future; too many decades pushing it to one side, hoping that a band-aid would do when in fact, much more radical surgery is needed.
That is what we are proposing. We intend to get on with the job.
JOURNALIST: 13 years is too long to wait. What's an acceptable period? How quickly would it be delivered under your (inaudible)?
PM: Well, in terms of the PET scanner here, 13 years is a hang of a long time to wait given, I'm told, across greater Sydney, there are only six such machines in operation.
As for the system itself, I won't go to the past and say what happened during the 12 years in office of our predecessors.
We've been in power now for two years. We said that we would put forward a properly costed, properly funded plan for the future of the national health and hospital system. We have done so.
We have now said that we are about to engage the states and territories on whether they will come in behind it or not. And further, we have said that if they don't, we're going to seek a further mandate from the people.
Also, the timetable for implementation is there for all to see. That's our plan. We think it's the right way for the country and I would urge all premiers and chief ministers to get behind it, and as I said before I will be burning the shoe leather across the country in the days and weeks ahead to try and bring that about.
JOURNALIST: Can you guarantee that no managers of hospitals like this one and the ones you'll visit in the coming days will lose their job as the result of your reform?
PM: You know what we are seeking to do through the establishment of local hospital networks is to make sure that you have a community of interest which is served by one or a number of local hospitals, large and small.
The individual management arrangements within them - we would like to see clinicians such as these gentlemen, nurses, health professionals, take a much bigger role in the delivery of these local hospital networks in the future.
Of course, you're going to need finance experts, you're going to need management experts as well, but precise organisation will be left to others. What I have said is that in establishing local hospital networks there will be no net addition to bureaucracy anywhere in the country, and we stand by that.
JOURNALIST: But you've also been to, apart from more than 20 hospitals, a lot of schools. (inaudible) bureaucratic inefficiencies are confined to the health system? And if not, why stop at health? (inaudible) heavily involved just in terms of stimulus packages with schools across the country, can you see this as a blueprint for other big bureaucracies and greater efficiencies nationwide?
PM: One of the reasons why we have decided to tackle head on the question of health and hospitals reform is because over the next couple of decades, it will chew up the lion's share and then all of the budgets of the states and territories.
Therefore, if we do not act now, the states' and territories' ability to deliver proper school services in the future, to deliver proper transport services in the future, to deliver proper law and order services in future will be undermined.
I listened carefully to what the New South Wales Premier said back in January in a speech which she gave where she said that within 20 years or so, the state budget of New South Wales would be overwhelmed by health and hospitals alone.
So, to go to your question, unless we deal with this and put the system on the right funding basis for the future, and secondly cut out the duplication, waste and overlap between the two levels of Government, then we are not serving the needs of the people of Australia or the people of New South Wales.
They want better health, better hospitals. Our plan for this National Health and Hospitals Network, one funded nationally but run locally, and for the first time in the country's history the Australian Government being the dominant funder of the system.
JOURNALIST: You talk of the mandate that you may seek, but the Premier will soon be seeking, effectively, her first mandate as well. Will it be in her political interests to accept the sort of proposal (inaudible)
PM: Premier Keneally will make her own judgments. She has engaged constructively in these discussions today. There's quite a ways to go between now and the COAG, Council of Australian Governments meeting in April, and I have a lot of discussions to undertake with a whole bunch of other Premiers.
What decisions she takes is a matter for her. I am encouraging all Premiers and all Chief Ministers to get behind this important reform.
The time for this change in our health and hospital system has come. It has well and truly come. There is no more time for delay and for excuses for delay. Let's bite the bullet, get on with it, and make sure we are actually building a system that can meet the demands that will be placed on it for the 21st Century.
JOURNALIST: Prime Minister, an Australian has been lost at sea in Chile after the earthquake. What assistance has been given to his family or even efforts to help find him?
PM: On the details of this, I would prefer that the Foreign Minister answer your question directly. I know that our diplomatic and consular officials in Santiago de Chile have been working closely with Australian families concerned about family members. But on the details of it I would much prefer that the Foreign Minister answers your question direct, and I'm sure that will be forthcoming later today.
Thanks, folks. Better run.