Australian Health Ministers Conference
Minister for Health and Ageing, Tony Abbott, along with Tasmanian Health Minister, David LLewellyn, holds a press conference about the outcomes from the Australian Health Ministers Conference.
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Previous Ministers23 April 2004
Australian Health Ministers Conference
Well look, can I say as chair of the ministerial conference that it has been a very productive meeting today. There have been, over the last couple of years, some frustration about us dealing with reform issues.
Earlier on, we had some nine clinical groups that brought forward recommendations which hadn't, and hasn't, been addressed right to this particular point in time but today's meeting, I think, was very productive. We've looked at a number of issues in today's meeting. The organ transplants, quality and safety issues, national medical registration matters, workforce issues, issues associated with the ACCC and the obvious problem that we have in registering overseas doctors and other issues like that and the use of IT in a more productive way in the health system.
So, all of those matters have been discussed and I think it has been quite a productive meeting in dealing with those issues, but I'm sure other ministers would want to make individual comments.
Reporter:
Did the ministers agree to appoint a taskforce to look at the Health Reform Alliance's proposal?
Llewellyn:
The Health Reform Alliance made a presentation very early in the meeting and what we are doing as a council is seeking advice from officers, and they'll be reporting back at the July meeting regarding the presentation that was made.
Reporter:
Is this advice on the taskforce, is it? The advice of whether to have a taskforce?
Llewellyn:
This is advice about the presentation that was made today, it's not about a taskforce. It's advice on the presentation as to those issues that were raised. Many of them, can I say, are already matters that are being addressed by the reform process within the conference itself.
Reporter:
Mr Abbott, can we ask what your views are on this proposal?
Tony Abbott - Federal Health Minister:
Well, I was, like David, I thought it was a very constructive meeting we've had today. Yes, obviously, there are some issues which always divides the states and the Commonwealth. Yes, there are some issues which often divide ministers of different political persuasions, but nevertheless I think today has been an extremely constructive discussion, a demonstration of the ability of the different jurisdictions to work together for the national interest, notwithstanding the kind of political argy-bargy that you sometimes see.
As for the John Dwyer presentation, I think it was an interesting presentation. I think that it would be fair to say that different ministers would have different views about the substance of the presentation. And I'm obviously happy enough to say what my view is at the appropriate time but what the council has decided is to set up … is to refer the presentation itself to officials and they'll come back to us in July.
Reporter:
But Mr Abbott, do you think it's realistic, could it ever happen in your lifetime?
Abbott:
Well, and I stress now I'm speaking as the Federal Health Minister, I'm not speaking on behalf of the council. My own view is that the problem with the Dwyer proposal is that it seems to remove political accountability from the system. Obviously, there are problems in the way our public hospital systems work at the moment.
They're part-funded by the Commonwealth but they're administered by the states and this leads to all sorts of issues, and typically a fair bit of a blame game, but I'm not sure that we're going to solve that by setting up a new entity which doesn't appear to be accountable through the political process at all. So that's my question about the Dwyer proposal.
[reporters talk over each other]
Reporter:
But wouldn't it have been better to have total federal government (indistinct)?
Abbott:
Well look, this is a proposition which a lot of people are, I guess, mulling over. But so far, none of the states or territories are putting their hands up to give the Commonwealth responsibility for public hospitals and until such …
Reporter:
Bob Carr said he'd like to give it to you.
Abbott:
Well, I'm not sure that he has in any considered way and certainly if the federal government were ever to take over responsibility for public hospitals, there'd have to be adjustment … an adjustment to the financial arrangements. So it's not just going to be a question, if it ever happens, of the federal government taking them over but the states continuing to get the same amount of money that they currently (indistinct).
[reporters talk over each other]
Reporter:
But wouldn't the (indistinct) health corporations be answerable to you as federal minister?
Abbott:
That's not the way it's appeared on the basis of the presentation this morning. What appeared to be in mind on the basis of the presentation this morning is the establishment of a new entity that would have as shareholders the states and the Commonwealth. But exactly who would have the majority shareholding, exactly who would be responsible if things didn't work out, exactly where the funding was supposed to come from - in other words clear lines of responsibility and political accountability and control - none of that was clear, to me at least, and I think that's the difficulty.
I mean at the end of the day, someone has got to be in charge. Voters have got to feel that they have someone to blame, if you like, if things don't go right, and I'm just not sure that that was clear in the proposal that was put up this morning.
Reporter:
(indistinct) proposal's been on the operating table.
Abbott:
Well look, no, no, no, no, no, no, not at all. You know, ministers are happy to consider proposals for reform of the health system. Professor Dwyer is a person of great standing and substance in our system. He and his colleagues have done an enormous amount of work. That's why the presentation is now going to be considered by officials for further discussion at the July meeting. But certainly, I as the Commonwealth Minister had some problems with it, and obviously other ministers would have their own views, and I think I'd encourage people to talk to other ministers about their views.
[reporters talk over each other]
Reporter:
On national registration, what concessions did you make to doctors?
Abbott:
I think the AMA had a fair point about the appropriate privacy concerns of doctors as well as the appropriate information access of the public, and so we have endorsed a strong reform agenda for medical registration, so that we should have a situation where doctors who are registered in one state can move freely to practise in other states where you only have to be registered once, where there is a commitment by all registered doctors to ongoing professional education.
So, I think we've got a strong reform agenda agreed to today. The one thing that we're going to reconsider in July after further discussions with the AMA is precisely what sort of information ought to be generally available to the public on this national doctor database. Now, that's something that we'll discuss with them and there'll be more to say about that in July.
[reporters talk over each other]
Reporter:
Do doctors know if there's been a negligence claim made against them (indistinct)?
Abbott:
Well, the question is, how do you do justice to the doctor without putting so much on the database that it becomes completely unmanageable? There are all sorts of, for want of a better word, disciplinary matters that sometimes come up in people's professional life. Some of them are very, very serious, and they go to people's professional competence. Others are less serious and certainly don't affect the ability of doctors to work well in the surgery or in the hospital or anywhere else.
And so, these are the sorts of things that we ought to discuss with the AMA before we finalise, and I think that's perfectly reasonable.
Reporter:
What about smart cards?
Abbott:
There was a very good paper presented to us by the Boston Consulting Group, and I think a very good resolution has come out of the meeting which will be the subject of a communiqué that you'll get shortly. The most important item to come out of today's meeting in my judgement is the in-principle commitment to establish, under the authority of the Ministerial Council, a new body which will be adequately staffed and resourced and focused to specifically drive the HealthConnect agenda.
The problem at the moment is that a lot of people have been looking at this in a somewhat piecemeal way for a long time. There have been a lot of different projects, there have been a lot of different committees. Everyone agrees on what needs to be done. What we now need to do is to make sure that that forward agenda is being consistently and strongly pushed. And so, we have agreed in principle to establish a new body with the full authority of the council to take it forward, and I think that's very (indistinct).
[reporters talk over each other]
Reporter:
(indistinct) the health reforms?
Abbott:
I'm sorry?
Reporter:
(indistinct) the health reform … you don't want another layer of bureaucracy, that everyone wants to move it forward. Why wouldn't you take exactly the same approach with the HealthConnect and apply that to reform?
Abbott:
Because what we're talking about in respect of HealthConnect is something which is completely agreed across all jurisdictions. I think the kind of measures that we're dealing with that were the subject of the presentation by Professor Dwyer this morning are just much more controversial. And in the end, one is substantially about process. It's substantially about the kind of adjuncts to service delivery. The other is about service delivery itself.
And if, for argument's sake, we are … we witness a real problem in our health system, wherever that might be, whether it be in a public hospital, a private hospital or a surgery, people need to know who is responsible and they need to know eventually which political system and which politician is going to be accountable, if it's appropriate for there to be political accountability. And that's the difficulty as I see it with the Dwyer proposal.
[reporters talk over each other]
Reporter:
What do you believe are the benefits of overseas-trained doctors?
Abbott:
Well, I think it would be fair to … it would be right to say that the focus today was on national medical registration but that obviously has implications for overseas-trained doctors. I think … and again, I don't want to put words into my ministerial colleagues' mouths, but I think it would be fair to say that there is a strong … that there's a strong sense anyway from all jurisdictions that what we really need to do is get our own workforce house in order.
We have got to train Australian doctors and Australian health professionals to treat the Australian community and that while overseas doctors … overseas-trained doctors are currently playing an important part in various components of our health system, in the end we aren't going to meet this problem through imports. We're going to meet this problem through homegrown products.
[reporters talk over each other]
Reporter:
So, what do you believe the specific benefits of the national register are, specific benefits for patients and health care?
Abbott:
Okay. Well, the specific benefits for doctors are … the specific benefit for doctors is that registration in one state will cover them in all states, and they'll only have to pay one lot of registration fees. The specific benefits for patients is that they will be confident that any Australian registered doctor meets certain uniform standards and is engaged in agreed, ongoing, professional training. So over time, there will be even more confidence in the quality of the Australian medical profession than there currently is.
Reporter:
(indistinct) also saying that a register would allow them to know how many of their trained doctors are actually performing services in their state, and therefore sort of move them around and that sort of thing - lobby harder and so on.
Abbott:
Well there's, if you like, the … there's the public register, so to speak, of doctors and then there's information which is collected by way of preparing the register. And certainly over time, we will get more and more information on specifically who's doing what, on how many doctors are working what sorts of hours, so we're able to say with more precision … precisely where our workforce needs are and so on. I mean I … this will be a very good planning tool for governments as well as being a very good, if you like, source of advice and information for the general public.
[reporters talk over each other]
Reporter:
What did you decide on new safety standards?
Abbott:
Look, it was a very good paper that was ultimately presented to the conference. In the end, it was a composite of work done by various jurisdictions. There are three essential points, first of all, every public hospital will have a system of incident management. Second, all public hospitals will be involved in a national reporting system for sentinel incidents. And third, all public hospitals will put in place a set of protocols to try to minimise the risk of serious accidents taking place in our hospitals. So we've got incident management, we've got sentinel reporting and we've got risk minimisation protocols going in.
Reporter:
(indistinct) reporting?
Abbott:
Oh yes, public reporting. Absolutely.
Reporter:
So you'll be able to look up your public hospital and see how many mistakes it's made?
Abbott:
If some disaster takes place, we will know about it and we will know about it in the ordinary course of reporting. We won't know about it because someone's asked a question on notice or because some investigative reporter has come up with it. It will be there as a matter of course because these are the events that (indistinct) be reported upon by a well-functioning public health system.
Reporter:
Do you liken Mark Latham's plagiarism case yesterday to Joseph Biden in the US? Are there enough similarities between those two instances? And if so, should Latham withdraw from the election race?
Abbott:
(Laughs) Look, I think I posed a question, what penalty would be imposed upon the Leader of the Opposition for doing something which he has previously condemned in the most vitriolic terms and which caused Joseph Biden to have to withdraw from the Democratic presidential race back in 1988? Now, I mean I leave that judgement to the Australian public, but certainly what I thought we saw this week was an Opposition Leader who was guilty, not just of plagiarism but of serious hypocrisy.
Reporter:
Isn't the Prime Minister also guilty of plagiarism?
Abbott:
Well no, because there's a world of difference between adopting … stealing someone's rhetoric and simply stating facts. I can say Australia has twenty million people, and because Geoffrey Blainey might once have said, Australia has twenty million people, I'm not plagiarising Blainey, we are just simply stating the same facts. But if I was to pluck a phrase out of the air, you know, we shall fight them on the beaches, we shall fight them on the landing grounds, it would be wrong of me to pass that off as my rhetoric without attributing it to Winston Churchill who was the (indistinct) author.
[reporters talk over each other]
Reporter:
One final question (indistinct).
Abbott:
Yeah?
Reporter:
The Prime Minister passed off Kenneth Pollack's rhetoric as his own, (indistinct) as his own.
Abbott:
Well, that's not the way I understand it. My understanding is that there were some facts that happened to be referred to in that particular book, and the Prime Minister referred to the same facts in a speech he gave.
[reporters talk over each other]
Reporter:
But it was word for word.
[reporters talk over each other]
Abbott:
Well, if you … I mean, if you say, you know, Australia has twenty million people, Australia has one major river system, Australia has a coral reef located off the coast of Queensland …
Reporter:
But the only (indistinct) that were used were exactly the same, if it's going to get down to that sort of thing.
Abbott:
Well … but we're talking here about the difference between facts, which are agreed upon, and rhetoric, which is used to embody what are thought to be our deepest aspirations and values. And the oddity of the Opposition Leader's position this week is that he was making a speech about Australia's national identity and he lifted whole phrases and concepts from a presidential address.
And Mark Latham isn't exactly a fan of the United States.
Okay? Thanks.
[unrelated discussion]
Reporter:
[inaudible comment]
Abbott:
And this of course is organ donation. Now, we had a … there was a very interesting discussion amongst ministers. Before the main meeting started, there was a strong general agreement that we needed to do more to get our organ donation rate up. There is, I think, a very good and sensitive resolution passed by the meeting, which you'll all have copies of shortly. The essential point is this - once people go on the organ donor register, there will be a strong presumption of availability for donation.
Now, I think this will get our organ donation rates up very significantly and I think this offers great new hope to the two thousand people currently on the organ donation waiting list. And it should ensure over time that we don't have anything like the tragedy of the present time, whereby some hundred and fifty people a year die on organ donor waiting lists.
So, this is a very good example of how ministers of different jurisdictions and different political persuasions can work together to make progress towards what is clearly in the national interest.
Reporter:
And will the families still be able to overturn a decision?
Abbott:
It will be a right of veto rather than the necessity to get explicit permission. And there's a world of difference between giving people a right under certain circumstances to say no, and having to get their explicit formal permission to do anything at all.
Reporter:
[inaudible question]
Abbott:
The family will certainly be informed but there will be a strong presumption that once people are on the organ donor register there is an availability for donation.
Okay? Thanks a lot.