Closing address to the 4th Rural and Remote Health Scientific Symposium

Thank you for your contribution

Thank you for the role that each of you play in improving the health of rural and remote Australians.

Whether you are a frontline healthcare provider, a researcher, data analyst or a public servant.

Together, you help provide us with one of the best, most efficient health systems in the world.

Australians are rightly proud of their health system. You can be proud of your contribution to it – and to our nation.

It’s fair and efficient.

World class health systems don’t just build themselves.

They take events like this, with the sharing of ideas. They require the primacy of evidence and science to underpin decision making and imagination.

The current budget climate

The policy shifts before the Federal Parliament ensure health will be at the forefront of the election in 2016 and every day between now and then.

Health in Australia is going through some pretty radical changes.

Labor is deeply concerned about the attack on universal health care, and the prospect of a two-tiered health system.

I find these changes alarming because they ignore the needs of remote and rural Australia. More fundamentally they fail the fairness test.

There is no evidence underpinning the changes to health outlines in the Federal Budget.

They make the health system more complex, harder to navigate and more costly.

Evidence and imagination is what is needed when formulating quality health policy – policy that will serve rural and regional Australia.

The original architects of Australia’s universal healthcare, John Deeble and Richard Scotton, with lawmakers Gough Whitlam and Bill Hayden were faced with a problem in the 1970s.

Massive inequality and inefficiencies in health outcomes.

One million Australians without insurance.

Huge and unpredictable costs on family budgets.

Together, they crafted an imaginative policy approach.

A new model for universal health insurance.

A model that had never been tried around the world.

One that gave individuals choice of doctor, provided certainty in costs for patients – in most cases zero cost.

It was a system that covered everyone, including the one million Australians that, at the time had absolutely no health coverage.

Imagination and evidence made good policy – and it will again today.


Today’s problem

A lot has changed in the past 40 years since the introduction of Australia’s first universal healthcare system.

We face a different set of problems.

But before I outline what I see as problems in rural and regional health, I have to clear up one very big mistruth that we hear in the political discourse. It’s repeated often. It’s misleading.

We have been told by the Minister for Health that ten years ago, we were spending $8 billion on Medicare and today we are spending around $20 billion.

In that time, spending on the Pharmaceutical Benefits Scheme has jumped from $5 billion to $9 billion.

The raw numbers are correct. But just as the housing, food, wages has inflated in that time, the far more honest figure to use is the proportion of government spending.

Ten years ago, the cost of Medicare was 4.8 per cent, and today it is about 4.6 per cent – almost identical, if not slightly less.

The PBS cost 3.2 per cent ten years ago, but today costs only 2.3 per cent – less as a proportion of government spending.

The health budget is a sign of a country and community that has its priorities right. It is about spending choices. A wealthy country should be choosing to spend on its health.


Medicare is the Solution – not the problem

While we argue about the threat of a two-tier system, people in regional and rural Australia can rightly argue  that we already have one - the gap between the city and the country.

Life expectancy is lower.

Diet and nutrition is poorer.

Chronic disease rates are higher.

Rates of accident and substance abuse are higher.

Access to care is more expensive and distances more vast.

Education and disease prevention is harder and more expensive.

Practices, clinics and programs are also more expensive to run and logistically harder to attract clinicians.

There is an urgency here that I, as the Shadow Assistant Minister responsible for Rural and Regional health, feely acutely.

We’ve got to get this right.

So today I do not come armed with a new policy or a wiz-bang promise of new money and spending should Labor be returned to government.

I come instead, with a message and an offer.


The Solution

My message should be no surprise to you: evidence, science, imaginative responses to our problems will be the basis for our decision making.

We’ll be working to a fair and efficient policy on regional health.

My offer is this: My door is open. It’s open to constructive criticism, to ideas, to evidence.

It’s open to you.

Policy takes years of development but Labor has already begun the process of consulting on the shape of our policies.

Labor is the party created Medicare, the PBS and put hospital funding on a sustainable footing.

You already know that Labor will always fight to ensure that people in rural and regional Australia get the healthcare they need, not the healthcare they can afford.

We are doing it right now.

We are doing it every day.

Labor MPs are united in defending Medicare and ensuring all Australians, no matter where they live or their financial circumstances, receive decent, affordable health care.

We will be paying close attention to the social determinants of health, including regional and remoteness as a factor in this.

We’ll look closely at the recommendations of the Mason Inquiry in developing our response.

Underpinning all our policy will be the principles of fairness and efficiency.


Thank you

Nothing could happen without you.

Our local health groups, community organisations, medical researchers, data agencies and service funders.

You are the critical link between rural and remote health outcomes and the shaping of our national health policies.