Tuesday 19th April, 2005

Health on the Sick List

by Christian Kerr

A treasurer resigned — and resigned from Parliament — because of promises trashed after an election just over a decade ago. Labor won the March 1993 election on the back of Paul Keating’s attack on the GST. Treasurer John Dawkins walked less than 12 months later, in February 1994, after the 1993 budget increased taxes. Perhaps a few wannabe leaders — Peter Costello and Tony Abbott — should be having a think while the ink isn’t quite dry on this year’s Budget papers. Perhaps.

Kim Beazley showed a reluctant realism his comments on the Medicare backflip on PM on Friday: “And even in our system, which has been remarkably lax over the years of ministers accepting responsibility, to have said so emphatically to the Australian people that there are rolled-gold guarantees as related to the rates of the operation of the safety-net and then to breach it months later, even in our jaded system, a resignation follows such a performance.”

Health Minister Tony Abbott, hauled back from leave, was big enough to admit to Laurie Oakes yesterday that the thought of resignation had “gone through his head”. What was more interesting, however, was Oakes probing over the scheme itself:

LAURIE OAKES: Could I read you a letter from yesterday’s Australian? It said ‘Actions of corporate dishonesty and custodial sentencing. Pity the same rules don’t apply to politicians.’ What’s your response?

TONY ABBOTT: Well, I can understand why people feel unhappy about the Government’s decision to raise the safety net thresholds. But we took a decision that in the end it was more important to be economically responsible, and more important to maintain the safety net in the long term than it was to avoid embarrassing the Health Minister.

LAURIE OAKES: So honesty comes a distant second in this?

TONY ABBOTT: Well, Laurie, when I made that statement, in the election campaign, I had not the slightest inkling that there would ever be any intention to change this. But obviously when circumstances change, governments do change their opinions, and that is actually the responsible course of action.

LAURIE OAKES: You say you had no inkling it was likely to change, but Treasury knew that there’d been a blow-out, didn’t it?

TONY ABBOTT: Yes. We certainly were aware the costs were increasing, and there was no secrecy about this, Laurie. The, the pre-election financial outlook statement revealed that there had been a substantial increase in the cost of the safety net, and obviously since the election the Government has had the opportunity to consider this blow-out — to look not just at the current quadrennium, but to look at the long term — and has made the decision that the thresholds had to be lifted.

LAURIE OAKES: So it didn’t bother to look at the long term before the election?

TONY ABBOTT: Well, we, we were looking at the long term before the election. But obviously in a budget context you can focus even more directly on the long term, and that’s what we’ve done.

LAURIE OAKES: It sounds as though you can’t believe anything anyone says in an election if they follow those rules… The lies are still being told, aren’t they? We now find out that Treasury, when it costed Labor’s policies under the charter of budget honesty, said that to abolish the safety net would cost $1.3 billion. In other words, they knew that was the cost of this scheme. That was known before the election. Yet John Howard claimed the other day that it’s only recently they’ve become aware of the extent of the blow-out. So we’re still getting lies.

TONY ABBOTT: Well, no. The Government was aware of a significant blow-out…

LAURIE OAKES: Well, that’s…

TONY ABBOTT: …before…

LAURIE OAKES: …that’s a trebling.

TONY ABBOTT: …before the election.

LAURIE OAKES: It had trebled before the election, and you claim you still didn’t think there was any need to do anything about it.

TONY ABBOTT: Well, Laurie, again let me say that I can understand why people are dismayed by this decision. But in the end governments have to balance a whole lot of objectives. And sometimes you have to choose between a range of difficult, even unpalatable, alternatives. And we could stick with the pre-election position. And further blow out the cost of the safety net. Or we could make a change. And we thought on balance it was best to take the economically responsible position now.

LAURIE OAKES: On balance wouldn’t it have been better to be honest before the election? Acknowledge it had blown out to $1.3 billion and make the changes then?

Nice one, Laurie. Why did the Government make the commitment in the first place?
State governments run hospitals while the Commonwealth is responsible for doctor numbers, health insurance and aged care beds. Jeff Kennett called for an inquiry into the health system 12 months ago. He repeated that call last week. Bob Carr says that Nick Greiner and Wayne Goss should look at ways of reforming these overlaps. The South Australian health Minister, Lea Stevens, prosaically says on the front page of today’s Adelaide Advertiser “To put it quite bluntly, the current health system is stuffed”.

Rather than indulging in its usual who knew what when hair-splitting, the Commonwealth should be taking a lead so we can see through the grey areas on who does what on health – particularly with Senate control looming and in the wake of the Prime Minister’s speech last week on Federalism.

Then, he called for a national approach in water management, industrial relations — and more work on health. But hadn’t the Productivity Commission health services as a key reform area 12 months ago – one that needs even swifter examination, along with human services, in the wake of the Commission’s report last week on the impact of our aging population.

The Commonwealth doesn’t need to take over hospitals. There are very strong arguments for the states — who know the local nuances — to keep their on the ground health responsibilities. What needs to be fixed is the buck-passing – and the poor coordination. State bureaucracies are top heavy, while their hospitals need to be more efficient.

How can the Commonwealth centrally provide the support these separate sets of state health administrators now deliver, chop duplication, and pass the savings onto services? If he’s so interested in figures, Tony Abbott might like to look at that. No Catholic joke intended, but if he comes up with something good it might redeem him.