Speech: Julia Gillard, "Moving forward to a better health system", Brisbane
Julia Gillard
posted Tuesday, 27 July 2010
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I’m delighted to be addressing a forum of the Committee for Economic Development of Australia, once again, in its 50th anniversary year.
For five decades CEDA has continued to shape Australian economic and political debate.
I have come today to speak about the future of the Australian health care system. And to explain what I mean when I speak of moving Australia forward.
A nation’s health system is a measure of the nation itself.
The quality of its health services is a test of a nation’s prosperity.
The accessibility of those health services is a test of its fairness.
For political parties, health policy is a test of values.
Friends, there is no Australian for whom decent health care is not essential at some point in their lives.
A first class health system means dignity and peace of mind.
For parents of young kids.
For kids of aged parents.
For relatives and friends of those who are gravely ill.
And for all us in the event of an emergency.
Health care is something that families rely on when things go wrong ...
... and so it is something governments must get right.
That is why I regard health care as one of the greatest responsibilities of any government.
I believe that if Australians are to have the world-class health services they expect, the Australian Government must play a key role in providing for those services, through ensuring they are properly resourced, with the capital, technology and the health workforce needed to deliver quality services around the nation.
That is why the Government I lead has been so determined to address the gaps in our health system.
That’s why we’re investing in:
- The gaps between hospital services available to families in our cities and families in our outer suburbs.
- The gaps between cancer services in our cities and our regions.
- the gaps in after hours and GP services for children or the elderly – who often most need these services outside ordinary working hours. .
Left unaddressed, gaps in our health workforce can shut down parts of hospital wards because doctors and nurses can’t be found to staff them, while patients linger in emergency departments and wait longer on elective surgery waiting lists.
Friends, three years ago, Labor inherited a health system suffering from years of neglect and underinvestment.
As shadow Health Minister, I watched as Mr Abbott and the Howard Government left the system struggling under the weight of increasing demand and rising costs.
Year after year, they neglected the big challenges.
A shortage of doctors and nurses across the country – yet Mr Abbott maintained a cap on GP training places.
Hospital budgets stretched to breaking point – yet Mr Abbott saw a billion dollars pulled out of the system.
Patients getting lost between primary, acute and aged care – yet no investment was made in e-health or reforming the system to make it easier to navigate.
Instead of better services, we saw funding cuts.
For three years we’ve been toiling to fill those gaps and respond to that legacy. We’ve been making headway – but there is so much more to be done.
Now, ahead of an election on August 21, I am offering the Australian people a clear choice.
A choice to move forward to a 21st century health system with new investments and new services in a better run health system, not going backwards with cuts to public hospital funding and a return to the neglect of years gone by.
Just as Medicare secured the future of our health system for a generation past, so our challenge is to secure the future of our health system for a generation ahead.
There can be no going back to the long years in which Mr Abbott was Health Minister, where he invested his energy into shifting blame to state health systems instead of investing more resources in improving health services themselves.
I lead a government that is determined to tackle the long-term challenge of providing better health services for the future.
Already we have delivered record funding – a 50 per cent increase in funding for public hospital services since we came to government.
Those resources are meeting immediate and urgent needs for more hospital beds, more staff, new medicines and new medical technologies.
But I recognise that a modern healthcare system starts with strong GP and primary care services that Australians rely on every day.
That’s why Labor is proud to be investing in health services for families that are more easily accessible, closer to home and open after hours.
We are establishing a national 24 hour GP helpline to support families when things go wrong.
From 1 July next year, thousands of families will get support from a GP or nurse at the other end of the phone, and from 1 July 2013, this phone service will also be able to link Australians to after hours services in communities across the country.
Any parent who has faced the scare of a very ill child in the middle of the night knows – a service like this is long, long overdue.
On top of 36 GP Super Clinics that we are already rolling out across the country, we have committed to a further 23 new GP Super Clinics that open long hours – because as parents know only too well, kids don’t only get sick during office hours.
The clinics are staffed by teams of health professionals, including doctors, nurses and allied health professionals.
They bring a range of health services under the one roof, so families are saved the run-around across the suburbs from the waiting room to the pathology centre to the specialist and the physiotherapist.
We will also deliver another foundation of modern health care, a system of personally controlled electronic health records.
That means patients won’t need to go from surgery to clinic to visiting room to hospital ward, re-telling the same information to one person after another.
We live in an era when you can read a book on an iPad, upload photos from across the world and do your banking online.
Yet we still have separate, thick paper files on each patient in half a dozen different locations…
It’s as if while most Australians are watching youtube, our health professionals are stuck with an old black and white TV.
E-health is fundamental to better health care.
It means patient information and records can be accessed by an appropriate health professional, where patients agree to participate.
It will allow the effective sharing of patient information such as test results, referrals and discharge summaries, helping reduce adverse drug events, medication errors and poor transitions as patients move from one health care setting to another.
Electronic health records are long overdue, and it is deeply disappointing that the Coalition has chosen to oppose this vital reform, just as it is deeply disappointing they are determined to cut our GP Super Clinics and after hours services.
Because in pledging to cut these essential health services, Mr Abbott is again turning the clock backwards on our health system.
When Australians find themselves in the difficult circumstances of needing to go to hospital, they want to know that they will receive treatment on time, in hospitals that are modern and well-resourced.
That is why from July 1 next year we will start rolling out a four hour national target for patients to be admitted, referred or discharged at emergency departments – this will be introduced gradually, so that our hospitals and their staff can expand services and change practices to meet this target.
It is why we are progressively implementing a national target that will see 95 per cent of Australians receive their elective surgery within clinically recommended times.
None of this can be achieved without greater investments in the health workforce.
We are tackling the doctor shortage, with an extra 1,300 GPs trained over the next three years.
In nursing, we are funding 3,000 new nurse training places over the next three years.
On top of this, yesterday I announced a commitment to support training for up to 270 more specialist emergency doctors and 2000 new emergency nurses over the next decade – training places which will commence from January 2011.
Friends, money can buy services, but to make lasting change, we need to undertake real reform.
The improvements in services I have discussed are being supported by a larger program of reform to the governance and financing of our hospitals.
The only way we can ensure that support for a public hospital system remains sustainable into the future is by the Commonwealth taking more funding responsibility.
That is why our reforms will make the Commonwealth the major funder of hospitals into the future, by providing 60 per cent of operational and infrastructure costs, and assuming 100 per cent funding of primary care and aged care.
With its stronger financial position, the Commonwealth is taking on a significantly greater responsibility for the future of our health system, but we are not prepared to continue to underwrite a broken system.
If my government is returned to office on August 21, I will pursue our national reforms until the job is done.
These changes can only be achieved through dialogue and negotiation and, yes, sometimes hard bargaining.
Achieving real change and providing better services will come down to the hard work of implementation.
Implementation will require cooperation with States and Territories and engaging and empowering tens of thousands of clinicians working in our health and hospital services.
It is through cooperation that I will ensure that the Government’s historic agreement to reform are honoured and undertaken faithfully:
- that Local Hospital Networks are genuinely local.
- that professionals are giving genuine autonomy to run their local hospitals – as we break from the centralised control of large area health services.
- that the Commonwealth sets standards on the quality and accessibility of services that Australians should expect to be able to receive.
- and that States have a legitimate role in planning to help ensure the delivery of our new national standards.
When States and Territories submit their implementation plans to the Commonwealth, the Health Minister and I will be seeking that Australians get real reform that will deliver better services.
Friends, another area of growing demand in our health system is mental health and so today I would also like to discuss how we can move Australia forward in improving mental health services.
I grew up in a household with a father who was a psychiatric nurse.
I learnt from him that illness of the mind is as debilitating as illness of the heart, the lungs or the bones and no less important or deserving of our understanding and care.
I remember visiting Orygen Youth Health well before Governments – state or federal, Liberal or Labor – supported any expansion of Headspace.
What I have learnt from these experiences is that mental health issues can be complex and intractable – so often linked to other problems such as employment, education, housing, relationships, drug and alcohol use.
The solutions are as complex and multi-faced as these problems.
But I have also learnt that mental illness is a place where quality services can make a difference in people’s lives.
Indeed, better mental health services can save lives.
With this in mind, I have cast a fresh eye over the agreement reached at COAG and our government’s record, to explore how these reforms can help deliver better mental health services into the future.
And I have concluded that our reforms will make an important difference.
By ensuring that our frontline services – our GP clinics, after hours care are strong - we build the foundations for better mental health care.
By establishing Medicare Locals we will be able to better coordinate services and stop Australians suffering from mental illness from falling through the gaps.
Already, our investment in 1,300 new sub acute beds is being used to expand mental health services.
Just last week, Minister Roxon announced a 20 bed mental health unit at Liverpool Hospital in Sydney funded through this investment.
And we’ve grown and strengthened Headspace services to double the number of sites across the country – with the first 10 new locations announced last weekend – to ensure every capital city has at least one service.
At the same time we are supporting the Early Psychosis Prevention and Intervention Centre [EPPIC] model – which will provide treatment and support for up to 3,500 young people aged between 16 and 25 years.
All this is vital work. But I know it is not enough.
But I do believe we can and should do more.
This is why I am dedicated to pursuing health reform, because it holds the prospect of significant improvements in how we go about delivering all health services – those of the mind and those of the body.
To build on these major reforms, today I would like to set out Labor’s plan to redouble our efforts for tackling suicide.
Friends, every suicide is a tragedy.
Few of us have not been touched by suicide – whether in our family, among our friends, in our workplace or our local community.
Every year we lose 2,000 Australians to suicide, that means six more people today, tomorrow and each day after.
Of course many, many more attempt suicide or consider it – and it is only through the efforts of community organisations like Lifeline that many do not go ahead.
Today I announce a comprehensive package of measures to tackle suicide and promote better mental health in our community.
A re-elected Gillard Labor Government will invest $277 million to support our communities, our schools, our health services and our carers to do more to identify and prevent suicide.
Our comprehensive package will target four key areas – (1) frontline services for those most at risk (2) direct prevention and crisis intervention (3) services targeted to men and (4) looking after kids, both those at risk and generally building their resilience.
We will boost frontline services in communities for people at greatest risk of suicide in our community, by providing:
- psychological counselling services for around 12,500 people each year who have attempted or are at risk of suicide.
- up to 20,000 specialist psychiatry sessions in the community each year.
- support for the severely mentally ill – like assistance with managing day to day activities and respite for carers of people with severe mental illness.
- Secondly, the Government will invest in direct suicide prevention and crisis intervention services, including:
- expanding Lifeline Australia’s support hotlines to be able to take more calls – so that calls to Lifeline from mobiles can be toll-free and Lifeline can establish dedicated helplines at suicide hotspots.
- improving safety at suicide ‘hotspots’, such as the Gap in Sydney;
- training frontline community workers such as financial, legal and relationship counsellors so they can better identify and respond to the needs of people at risk of suicide or who have attempted suicide
- establishing outreach teams to schools affected by suicide - to reduce the chances of ‘copycat’ suicides
- providing support to Medicare Locals around the country to improve community led suicide prevention services, targeted at groups and communities which are high risk of suicide.
- Third, we will give priority to men - who we know are often at greater risk and less likely to seek help – a priority.
- This includes funding for programs to identify and support workers with depression in 350 workplaces through Beyondblue.
- Fourth, we will promote resilience and good mental health for both our young children and our young people, by:
- expanding services to improve children’s resilience by teacher and parent training to a further 1,700 primary schools.
- training frontline health and community workers to better identify and support children with serious mental health, developmental and behavioural issues
- giving young people who are reluctant or unable to access face-to-face mental health services an online alternative through which to seek help
Making progress in preventing suicide and improving mental health will not just take investment, but it will also take reform.
If re-elected, a Gillard Labor Government will move forward, with a different perspective, a Labor perspective grounded in our view that comprehensive health reform is the starting point for better mental health services.
I want to be absolutely clear – mental health will be a second term priority for this Government.
In particular, the Government recognises that better youth mental health services is an area where further investment is needed – and that our existing network of services will need to be scaled up over time.
The mental health sector has been calling for a five and ten year plan – the Government would like to pursue this to ensure we can deliver services for those who are suffering unnecessarily.
Our reforms will be pursued constructively and cooperatively – in close consultation with experts in the mental health sector.
But we will also work with parents and school teachers, doctors and nurses, and carers and, most importantly, those who live with mental illness.
Friends, Labor’s record of health reform is a legitimate source of pride to members of my party. Labor has fought for better hospitals and health care, from the earliest Labor administrations a century ago, to the Chifley Government in the 1940s with the PBS, to the Whitlam Government that built Medibank in the 1970s and the Hawke Government that introduced today’s Medicare system more than a quarter of a century ago.
Today it falls to my Government, another Labor government to build on this tradition, with the biggest reforms to the health system since Medicare, and new plans for better primary care, better hospitals, and more resources for mental health and aged care.
But August 21 stands between us and these goals, and there is a stark choice between moving forward under Labor and going backwards under the Coalition.
I will not cut public hospital funding, as Mr Abbott did in the past.
And I will not cut investments in GP, primary care services and the 21st century care permitted by e-health records, as Mr Abbott promises to do in the future.
As Shadow Health Minister I learnt that a strong primary health care system – the first point of contact for most Australians – is the foundation for a strong health system.
Removing those foundations will not build a stronger health care system – it will undermine it.
As one of the longest serving Health Ministers in Australian history, Mr Abbott never took charge of the problems in the health system.
By his own admission, Mr Abbott spent his time as Health Minister saying health reform was “over-rated”.
Rather than reforming the health system, he took a scalpel to funding for public hospitals.
And while the Government has been laying out a comprehensive plan for health reform over the past year, Mr Abbott has again made no considered contribution to this national debate.
Mr Abbott has not told us his plan for better hospitals, his plan for improving access to GPs, or his plan to train more doctors and nurses.
All we know from what he has said is that Mr Abbott would revert to his record – cutting services.
For families this would mean no GP Super Clinics giving patients the joined-up care that they need.
It will mean no after hours phone line to help families when things go wrong late at night.
And it means cancelling the electronic health record project which stands to make health care so much safer and more efficient.
Friends, it is being said that this election campaign is bland – that it poses few real choices.
But there is a choice in this election and it is a stark and clear choice:
a choice between cutting services and improving services.
Behind that choice there lies an even deeper and more significant distinction:
Between a negative Coalition that can only oppose and condemn, and that would take us backward.
And a Labor government willing to build for our nation’s future, to take the nation forward.
We’ve done great things as a nation, like creating Medicare.
And I believe we can do great things again if we move forward together unafraid of the future, and confident that together we can deliver the highest standard of health care to the Australian people.
Tags: Gillard, Health, Health Reform, Mental Health, Roxon