HOST: Prime Minister, despite promises of millions of dollars here and there, it seems that your health plan is not that popular with all the states. Are you starting to panic?
PM: Well, you know something, if you're trying to bring about the biggest change to the health and hospital system since the introduction of Medicare there's going to be a few people who will argue against it.
We've still got another week to go before the meeting of the Council of Australian Governments, but I think what people have concluded right across Australia, this is working families, pensioners, carers, that the current system's at tipping point. We need some fundamental surgery to fix it. That's why we're putting forward this new National Health and Hospitals Network - funded nationally, run locally, for the first time the Australian Government being the dominant funder of the public hospital system across the country, but also deliver more hospital beds, more doctors, more nurses, and to fix the system for the future, and it will take some time to negotiate. Of course, if the states don't agree, I've said that we would then seek a further mandate from the Australian people.
HOST: You've promised an extra $739 million to boost aged care services. How does that actually translate into beds and facilities?
PM: Well, this investment will support around 5,000 aged care places or beds and help to end the blame game between hospitals and aged care services. You see, it's very important that we do so in a practical way. If you don't have enough aged care beds in the regions and right across Australia what happens is that people get stuck in hospital beds, and that's bad for, shall I say, the hospital, also bad for the patient, so that's why we've put forward this package, and I'll be talking about it further today here in Brisbane.
We'll also be supporting the development of 2,500 new aged care places through zero real interest rate loans, providing an estimated $280 million to the states and territories to fund older Australians who are stuck in hospital waiting for an aged care place, so it's these range of practical measures, including expanding the capacity of what's called multi-purpose services which provide aged care and step-down services in small, rural communities by providing extra support there. It's a practical measure to deal with so many people who need, shall I say, flexible aged care services today.
HOST: There's a lot of money being thrown around right now. Is it the case that you'll just keep throwing money at it until the state governments accept it?
PM: Absolutely, well our view is simply this - and the answer to your earlier question, is that that is not our approach at all. The approach is this: many of the premiers have said 'just give us a blank cheque and we will deal with this problem.' My problem is this - so much money is now being wasted by the duplication, overlap and waste of the current health and hospital system that it is simply going to be a case of adding funding to a system which currently is not working.
Therefore, what's our approach? Fix the system now. That's why we're bringing in a new National Health and Hospitals Network to get rid of duplication, overlap and waste, and then second, fund the growth that the system needs - more doctors, more nurses, and more hospital beds.
None of the latter come for free. They all cost. They cost at Bundaberg Base Hospital, where I was the other day, but if we're going to make critical investments in Bundaberg and Hervey Bay and across the wider region, we've got make sure that the underpinning system right across the country, right across Queensland, is efficient and effective. The current one is not. That's why we need to reform it first and then fund its growth second.
HOST: New South Wales and Victoria are totally against this. How can you get it over the line from here?
PM: Well, the Victorian Premier has raised some reservations about funding, but if I look carefully at what the Victorian Premier has said, he's basically saying 'hand over an extra' $40 billion or an extra $150 billion over the decade, and it'll all be fine and dandy.' Frankly, we don't think that's financially responsible at all - not at all.
The key thing you must do is reform the system now by getting rid of duplication, overlap and waste. That's what our new National Health and Hospitals Network is about - funded nationally, run locally through local hospital networks rather than simply providing a further blank cheque to the states and then secondly funding the future growth in the system. That's what we're going to do.
There's a surprising amount of agreement from many of the states, but, obviously, there are others who are continuing to raise reservations. As I said, all this will be sorted out once we get to Canberra for the Council of Australian Governments meeting next week, but if the states don't agree, then we'd seek, of course, a further mandate from the people.
HOST: So, a referendum on whether the Commonwealth takes over hospitals will indeed go ahead if the states continue to refuse this?
PM: Well, I said this prior to the last election, I've said it since the election, I've said it since we released this policy on the NHHN, the new National Health and Hospitals Network, and I say it again today - my preference is to of cause get everyone to agree around the table, but if you can't get agreement, then of course you have to seek a mandate from the people, and the way to do that, of course, is through a referendum.
HOST: The Reserve Bank board member, Roger Corbett, has labelled your health reforms bizarre and also a formula for disaster. How to do you respond to those criticisms?
PM: I haven't seen those comments. People are always entitled to their own point of view, but can I say that if you ask anyone of your listeners in Bundaberg right now, and the wider region, whether they think there are hospital beds, whether they think there are enough doctors, enough nurses, or whether the current system is efficient or inefficient, I think they've already reached a conclusion that fundamental change is necessary.
So, there are those people out there who are going to have criticisms to make of one type or another. That's their entitlement - it's a democracy, but if you're just going to sit around and be negative and not come up with a positive plan for the reform of the system and a credible funding plan to fund the system for the future, then you're not really trying, and that's what we are seeking to do. Others will be negative about it. That's fine. We intend to get on with the job.
HOST: He believes it will lead to more public servants, a bigger bureaucracy as well. Can you rule that out?
PM: We've been absolutely clear cut about this since the day I released the new National Health and Hospitals Network, and that is that there will be no single net addition to the bureaucracy, health bureaucracy, of this country. That's the first point, but the second is this - when I talk about a new Health and Hospitals Network for regions like Bundaberg, Hervey Bay, can I say that we will fund it nationally, but we will run it locally through local hospital networks. In other words, the Australian Government will be paying money direct to frontline services rather than back-channelling it via state governments.
We have great fears that when that happens that not all the money reaches frontline delivery. That is why we are proposing the direct payment from the Australian Government to local hospital networks, to those who will be running immediate, practical local health and hospital services in important regional centres like Bundaberg and Hervey Bay. That, I think, is what the Australian people want.
HOST: So, no extra bureaucracy?
PM: That's correct. If you look at the statement that I made when I released this policy at the National Press Club a month or so ago, I was absolutely clear cut about that, but in terms of giving effect to it, I couldn't be clearer than to say we are paying money directly from Canberra to the local hospital networks.
You cannot have local hospital networks run by bureaucrats effectively, whether they are in state capitals or whether they are in the national capital. They should be run by local hospital networks, so what we are doing effectively through our payment system is making those payments direct, rather than funnelling it through state bureaucracy. That, I think, has seen too much money wasted before, and as I said before, we intend to fix the system in two ways - one, eliminating duplication, waste and overlap by creating, for the first time, a National Health and Hospitals Network, and two, then the Australian Government being the dominant funder for the future growth of the system, and every hospital I've been to, through Queensland and through most of the other states of Australia, the response has been significantly positive about the need for this to happen, because state governments, rolling the clock forward 10, 20, 30 years, finding it harder and harder and eventually impossible to fund the future growth of the system.
HOST: Just finally, Prime Minister, Hervey Bay's local state member, Ted Sorenson, is demanding a stroke unit at the local hospital. Will you help with that?
PM: Well, look, in terms of the specific needs of Bundaberg Hospital, that is of course part of their clinical plan, which they need to sort out with the local health professionals. The thing is, and I don't comment directly on what Mr Sorenson has said, is that for the future, for the first time, once the clinical priorities of that hospital are set for the 3, 5, 7 years down the track, or starting from the beginning of the implementation of these reforms, what you have is a system where the Australian Government, for the first time, will be the dominant funder. In the past, that has not been the case.
In the past, for the expansion of any hospital services at Bundaberg, at best the Australian Government would be responsible for one third of the running costs of the hospital, none of the capital costs, none of the equipment costs, none of the teaching costs, none of the training costs. What changes under our system is that we become the dominant funders for the future, and that is why this reform is relevant to whether it's the expansion of services at the hospital to deal with victims of stroke, to deal with cancer services, or to deal with the range of other services that we are funding as well.
Remember, when I was in Bundaberg last Friday, together with Belinda McNeven, our candidate for Hinkler, I announced $8.3 million for new and enhanced regional cancer services for Bundaberg as part and parcel of providing an additional 14 chemotherapy chairs. That's really important, but also expanding the delivery of regional cancer care services for important regions like Bundaberg and Hervey Bay, but more broadly across regional Queensland and regional Australia, but it all becomes more possible if the Australian Government for the future is the dominant funder of the system. That's the big change here, and we're just applying band aids if we think anything short of that is going to work.
HOST: It will be an interesting next couple of weeks. Prime Minister, thanks very much.
PM: Thanks very much, and it was great to be in Bundaberg.