Health Performance Authority



I spoke in parliament this week about health reform.
National Health Reform Amendment (National Health Performance Authority) Bill 2011
17 August 2011


On 2 August I was pleased to visit the Canberra Hospital in the company of the Prime Minister, the Minister for Health and Ageing, the member for Canberra, and Katy Gallagher, the Chief Minister of the ACT. We were generously shown around the Canberra Hospital by our ACT Health hosts, Lee Martin, Rosemary Kennedy, Kate Jackson and Sarah Majeed. It was a real eye-opening visit to see hospital reform in action; to see what is already occurring in Australia's hospitals as a result of having a federal government that is committed to improving health. Our party met with 16-year-old Jake Floro and his mother Kerrie-Anne Floro. Jake had a hip operation on 15 April and he is recovering really well.

This visit through the Canberra Hospital, one of the great hospitals in Australia, reinforced the positive experiences that I and my family have had at both the Calvary Hospital and the Canberra Hospital over recent years. I learned a lot from those personal experiences. As the dad of a couple of young boys who seem to always be falling off things, I have spent my fair share of time in emergency wards. But I have also learnt a lot about the ACT hospital system through speaking with my friends, Caroline Fahey, Mary-Ann Kulh and Mike Hall. At the outset I will speak generally about the bill, but I want to return to some ACT specifics of this bill at the end of my speech. The National Health Reform Amendment (National Health Performance Authority) Bill 2011 will deliver another $20 million in extra funding for public hospitals. In practical terms, that means more beds, more local control, more transparency; it means less bureaucracy, less waste and less waiting. Under the new health agreement that was struck with all the Australian states and territories on 13 February this year, the Commonwealth will permanently pay for 50 per cent of the growth in hospital costs. Initially, from 2014-15, the Commonwealth will pay 45 per cent and then from 2017-18 it will be 50 per cent. There will be a national funding pool, so hospitals will all be paid the same way regardless of whether they are in Bourke or Ballarat. That will deliver unprecedented transparency in hospital funding arrangements.

Across a whole range of public sector management issues, transparency drives reform. We see this in early childhood, in schools, in universities and in hospitals. The states and territories, under this historic agreement, have agreed to deliver substantial reforms. They will provide greater local control of hospitals. There will be a national price for activity based funding. As a former economics professor, and I would like to think a current economist, I regard this as a great way of driving efficiency and reducing waste. We will have new national standards and new targets to cut those waiting times in emergency departments and in elective surgery waiting lists. As someone who has spent a fair number of hours sitting in emergency departments, I know the stress that can build up while waiting for service. It is really important we do what we can to cut those emergency waiting times to make sure that those families that do not need to be in emergency rooms are not there and those who need to be in emergency rooms are seen quickly.

As a result of this legislation, there will be a new National Health Performance Authority. It is a key element of the government's health reform agenda and the COAG agreements. Its role will be to monitor and report on local hospital networks, public and private hospitals, Medicare Locals and other healthcare service providers. It will deliver clear, transparent performance reporting. There will be a new framework that will provide Australians with information about the performance of their health and hospital service in a relevant way and which is nationally consistent. As with the MySchool website, where parents can now compare schools right across the country, patients will have more information on their local healthcare services and those patients will spur reform. The authority will produce clear reporting. It will produce Healthy Communities reports for every Medicare Locals geographic area. You will be able to see, for example, how your local healthcare services are performing, preventive risk factors and access to GP services.

I moved a private member's motion earlier this year about the importance of transparency across the board and about the reforms that are driven by having a MyChild website, a My School website and a MyHospitals website. The MyHospitals website, which went live in December last year, compares the emergency department and elective surgery performance of public hospitals around Australia for the first time. The MyHospitals website is a critical element in ensuring that Australian health services are as good as they can be.

I move on to speaking from an ACT perspective about what this means. The ACT government—as a strong reforming Labor government—has already taken action to make sure the ACT health system can respond to growing health service demand. For the ACT, one of the big challenges is that many of the patients who are served in Canberra's hospitals come in from New South Wales. That is particularly true in the ski season when many people who find themselves injured on the slopes will eventually end up in a Canberra hospital. There is a lot of pressure placed on Canberra's hospitals, which they respond to well.

A part of the reforms the ACT government has put in place is a program called Your Health-Our Priority. It is a major infrastructure program which is facilitating investments such as a new cancer centre at the Canberra Hospital. There are also important investments that the ACT government is making in e-health. I note that this is an area of major difference between the two parties in this place. Those opposite would be quite happy to do away with e-health. They would be quite happy to stick with the old paper records, the errors and the inefficiencies that are inherent in using a paper based system. But the ACT government, as with the Gillard government, is committed to moving towards e-health and recognises that faster broadband will offer new opportunities in the future. And right now we can start getting those e-health records to ensure that, if you turn up to a different GP from the one you usually see, your new GP will be able to see your entire health record. That new investment is going to be absolutely critical to reducing error rates and ensuring patients do not have to repeat their health history every time they go to see a new doctor. These big investments will ensure the ACT health system is greatly improved. The Independent Hospital Pricing Authority will be a key part of this.

The ACT Legislative Assembly has established an ACT Local Hospital Network as part of this new reform. That will be a network system that holds service contracts with ACT Health. It will comprise the Canberra Hospital, Calvary Public Hospital, Clare Holland House and the Queen Elizabeth II Family Centre. The ACT government will continue to manage the system-wide public hospital service planning and performance, including the purchasing of public hospital services, and it will be responsible for the management of the performance of the ACT Local Hospital Network.

That Local Hospital Network, as I mentioned, will be overseen by a high-powered board. That board includes Michael Peedom, who is the Director of Legal Services of the ACT Regional Office of the Australian Government Solicitor's Office; Professor Nicholas Glasgow, the Dean of the ANU Medical School; Lynette Brown, a member of the ACT Health Council; Mary Montgomery, a member of the Calvary Health Care ACT Community Advisory Board; Colleen Duff, the Secretary of the ACT Branch of the Australian Nursing Federation; Dr Rashmi Sharma, a director of the ACT Division Of General Practice; Michael Moore, a former ACT health minister and a long-time campaigner for better health services in Canberra; John Runko, CEO of the property industry; Darlene Cox, a member of the Health Care Consumers Association; and Megan Cahill, and Associate Director in the Health and Human Services Practice of KPMG. These dedicated Canberrans will be an important part of ensuring that the Local Hospital Network serves all Canberrans.

Another exciting health reform for Canberra, which I know many of my constituents are looking forward to, is the establishment of a GP superclinic in the ACT, a GP superclinic that will ensure that we bring together many of the skills we have here in Canberra, joining together strong medical research teams, medical training teams and their expertise in delivering primary health care.

I want to use this opportunity too to pay tribute to the West Belconnen Health Co-op. My friend Michael Pilbrow has been heavily involved in this. The West Belconnen Health Co-op has done a great deal to boost bulk-billing rates in the ACT and to bring new doctors into Canberra. They are servicing one of the more disadvantaged parts of the ACT and they have expanded from their Charnwood site to open a new site in Belconnen. As part of that, they are really serving a great mission of community medicine, ensuring that doctors are there for those who need them and bringing specialists in to the West Belconnen Health Co-op so that patients do not have to travel all around Canberra to see an expert. Once a month, say, a specialist will come in and see people with particular issues.

Winnunga Nimityjah is another health centre in the ACT, an Aboriginal health service operating out of Narrabundah but servicing many people on the north side of Canberra. Winnunga Nimityjah often drives its clients down to the health service. They go above and beyond to provide a level of health care to Indigenous Canberrans. And of course, if we are to close the gap, it will be through initiatives such as Winnunga Nimityjah. I would like to use this opportunity to pay tribute to those workers there.

All of these are mainstream reforms. You would expect them to be supported by both sides of parliament. But what we have seen is the coalition opposing efficient pricing and opposing transparency. It is of a piece with much of what we have seen from the current Leader of the Opposition. The current Leader of the Opposition only has one word in his vocabulary and that word only has two letters. The Liberal Party has become the party of 'no': the party of opposition to everything. In the case of private health insurance, the current Liberal Party says that Australians without private health insurance who earn the minimum wage should be subsidising the private health insurance of millionaires. They are unwilling to means-test the private healthcare rebate for millionaires. This is what we might expect given that the Leader of the Opposition is the man who ripped a billion dollars out of our healthcare system. It is a sad thing to see that those opposite are so committed to an ideological oppositionist agenda. The reforms that we are putting forward are sensible reforms, reforms that will deliver more beds, more transparency, more efficiency to our healthcare system. But those opposite seem only able to learn from the scare campaigns of the US Republicans and their Tea Party friends. They seem to have decided that whatever issue comes up, they have to oppose it. Maybe the next time we start talking about efficiency here, we are going to hear those opposite start to raise spectres of death panels, as the US Republicans have done.

It is sad that the modern conservative parties have now become fringe oppositionist parties. It is very different from the mainstream parties of small 'l' liberalism that the Liberal and National parties once were. They have now become the party of 'no', the party of rallies, the party of radicalism. The modern Liberal and National parties have lost touch with what ordinary Australians want. When I hold my community forums and mobile offices, Canberrans tell me that what they want is quicker access to doctors. They want access to GPs and they want to make sure that when they go to hospitals they get seen as quickly as possible. They want to know about the performance of their local hospitals and they want to be able compare those local hospitals. They want to be sure that at all times their healthcare system is operating as efficiently as possible.

My constituents know, as, sadly, those opposite appear not to know, that a more efficient system means that we can spend more dollars on high-priority areas. We can invest in cutting waiting times, we can invest in closing the gaps and we can invest in e-health, ensuring that the technology of the future is available in Australian hospitals today. I commend the bill to the House.
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8/1 Torrens Street, Braddon ACT 2612 | 02 6247 4396 | Andrew.Leigh.MP@aph.gov.au