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Coalition neglect left system to fail

By Nicola Roxon - posted Monday, 15 October 2007

Last week, the Howard Government finally bowed to political pressure and floated a health idea: to create local boards at every hospital in the country. After 11 years, their only answer to a shortage of beds, a shortage of doctors and nurses, strained emergency departments and overworked hospital staff is to create a new level of bureaucracy. Instead of ending the blame game and cost shifting, the Prime Minister has opted to add a further level of bureaucracy to an already overly complicated system.

It is clear that this is a last-minute idea. Health Minister Tony Abbott has spent two months telling the world he would only embark on hospital reform once he had had sufficient time to decide if the Mersey model had worked. With the Mersey takeover not due until November, it is clear they simply want to look like they're doing something.

The problem, of course, is that they're not. After ripping a billion dollars out of the public hospital system last time around, there is no new money on the table for public hospitals or staff, just a likely $300 million of taxpayer money being spent on 7,500 new bureaucrats to sit on new boards. In addition to the state bureaucrats and the federal bureaucrats, John Howard wants another layer as well.


The Government has failed to embark on significant reforms in health for the past 11 years, with the result that the only focus of their scant agenda in health is constantly patching up their own failures. These include their self-confessed failure to plan ahead and train sufficient doctors and health professionals to meet demand, and neglecting chronic disease and preventative health. The result is spiralling healthcare costs and patchy access to health services.

Underlying all of this is the Howard Government's love-hate relationship with Medicare. Howard spent so long trying to dismantle Medicare early on that the past few years have been spent begrudgingly patching things up, simply to get back to where we were a decade ago.

Abbott's hysterical reaction to Labor's announcement that it will keep the Medicare safety net was also instructive. He seemed furious at being denied the chance to run a favourite scare campaign against Labor, but was also oddly proud of the number of people who are forced to use his safety net. The fact that about one million people use the safety net because of soaring healthcare costs in fact marks a failure of his Government's policy to keep healthcare costs within the reach of Australian families.

Labor understands there are inequities in distribution of safety net benefits. But there are also inequities in distribution of Medicare benefits more generally. Both these things are the result of poor access to health services in many parts of the country.

The real story in health policy is what lies behind the safety net: the failure of the Government to tackle workforce challenges, health costs and structural reform. Abbott finally admitted as much this week, confessing his Government had failed to increase medical school places early enough to meet demand, that when they did finally act it was long overdue and that he had no explanation for this failure.

Opportunities to plan and invest and design a better health system have been lost during the Howard era. The PM has left Australia treading water in health care. He won't work with the states, he won't plan ahead and the community is left suffering. Recognising all the work to be done, federal Labor has put its energy into a $2 billion national health and hospital reform plan.


Federal Labor will invest in primary care and hospitals to ensure better delivery of services, and work with the states within a clear timeframe to drive much-needed reform and end the blame game that the Government has been so eager to exploit. Federal Labor will invest $220 million in general practice super clinics to attract young graduates to areas of need and ensure areas that have been missing out on vital health services can finally get the health care they deserve. And federal Labor will deliver the solutions the Howard Government has given up on.

It will take leadership and commitment to drive the change that is needed. Kevin Rudd has promised the buck will stop with him in order to get the health system reforms that are needed for the community, a promise the Prime Minister refuses to make. Only a government that had lost its interest in governing would shy away from this enormous and important challenge.

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First published in The Australian on October 5, 2007.

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About the Author

Nicola Roxon is the Shadow Minister for Health and Federal Labor Member for Gellibrand.

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