Press conference with Minister for Health and Aged Care

Transcript
24 Aug 2016
Bella Vista, NSW
Prime Minister
E&OE

PRIME MINISTER:

Walid and Madeline and all of your team here, thank you so much for welcoming us and thank you to our patients, Sandra and Duncan in particular with whom we spoke earlier.

It is often said that it takes a village to raise a child, but you know it also takes a team to look after a person's health. A team - doctors, pharmacists, psychologists, specialists, endocrinologists we were speaking with earlier is a good example. And it does take a team and what Walid and Madeline have been able to do here is bring together a team of professionals, each of whom is focused on the health of their patients and that's what, of course, Sussan and I and Alex are focused on.

The goal of all of our policies is Australians living more healthily, longer, happily. We want the health and happiness of Australians is the objective of our health care policies. Now, what you are seeing here is an integrated holistic approach to health care. The Medicare system, the medical Medicare Benefits Schedule, as you know, pays doctors on the basis of consultations, of one episode after another. And care is actually more complex than that, it is more integrated than that. And so what Sussan has developed, with Stephen Hambleton, with the AMA is a new approach which we have called Health Care Homes, and we are launching - Sussan will describe it in more detail in a moment - 10 of these as trial sites, trial areas today and one of them is in the Western Sydney Primary Health Care Network, which is where we are now. And this approach will allow doctors when they're treating chronic patients with chronic conditions who of course naturally have the most consultations and consequently have the most charges through the Medicare system, naturally, because they need more support and more health care, but these chronic patients will be able to be treated on the basis of a more holistic basis and the practices will be rewarded or paid on a quarterly basis.

So it is ensuring that the Medicare Benefits System, the payment system is better supportive of the type of practice that Walid and his team with Madeline here have here at this practice.

So we believe it is a very important reform. It will ensure a more integrated approach to health care. It will ensure that patients like Sandra and Duncan continue to get the type of integrated care they have to date. It will ensure that fewer patients present with acute conditions to hospitals, and of course that is by far the most expensive part of our health care system - so that is an important consideration, but it is also under pressure. So the more we can get done at the primary level, the better.

So this is a very important reform. It is focused on ensuring better health outcomes for Australians. That's the objective, and we believe it will, if this trial succeeds and Sussan hopes to have this underway in the first half of next year. We believe this will infect a very significant element of support for the type of practices, the type of integrated care we've seen here and that has been so successful here and in many other parts of Australia, too. So I will now introduce the Health Minister to speak in more detail about the Health Care Homes policy.

MINISTER FOR HEALTH AND AGED CARE:

Thank you Prime Minister, thank you Alex. Thank you Walid and Madeline for having us here and thank you to your patients for allowing all of us in. It's often said that - well, I'm often asked what makes a world class health system and we want our health system to be the envy of the world. It is of course the clinicians, the doctors, the nurses, the allied health professionals, the people who patients sit and talk to, the people who deliver the care.

What we want to do in Government is to enable the system to deliver the best care possible for the patient, the best clinical care, the best wrapped-around consultation, ability for every individual to get what they need at the right time, and in the right place. So by having a Health Care Home, think of it as your GP family doctor - when I first met you Dr Jamal, you said: "I know all my patients and my patients know me." That stuck in my mind because that symbolises what we do want to achieve here.

As the Prime Minister said we are in the Western Sydney Primary Health Network. Ten Primary Health Networks across Australia will be the trial sites for our Health Care Homes model. 65,000 patients will be enrolled in about 200 practices. They will be part of the top 20 per cent of patients in Australia with chronic and complex conditions. They will be the first ones to deliver, to help us build the model with the doctors, with the practitioners, with the practices, build the model of care that works well, and I'm really keen for this to happen quickly. I've got my department and my staff and everyone I talk to really engaged with this because the sooner we can get there, the better off patients will be. This is part of us making the health dollar work as hard as it possibly can with one thing in mind, patient-centred care. So thank you again for having us here today.

JOURNALIST:

Prime Minister, just on what has been announced today, how does that differ in terms of what’s previously available for the care for patients?

PRIME MINSITER:

Well, it is a very significant reform and I will ask Sussan to describe that.

MINISTER FOR HEALTH AND AGED CARE:

As the PM said, we've got a Medicare system that is based on fee-for-service. That's not going anywhere, we will still have that. But as well, side-by-side we will have Health Care Homes delivering quarterly bundled payments to doctors to provide the level of care that we expect and that they actually want to do. So the system that we see here is quite close to what a Health Care Home will look like, but as the doctors and nurses will tell you, it's very clunky – it is practice incentive payments, there is Medicare payments, there is team care arrangements - there’s an awful lot of forms to fill in. There’s lots of work to do that actually isn’t spending time with the patient. We want to simplify that. We want to say here is one quarterly payment bundled up for all of the patients’ needs and allow the doctors the flexibility to do what they want. That might be outside hours. You might be receiving a newly diagnosed diabetic patient's blood glucose levels on your computer at home, you might spend half an hour in the same way many of us do of an evening doing something on your computer or iPad that involves patient care. At the moment doctors are not remunerated for that. It’s very much 9 to 5, consultation-based. This is building on what we have and making it better.

JOURNALIST:

Just considering that obviously Medicare is essentially Labor's baby, so to speak...

PRIME MINISTER:  

Oh, big premise there.

JOURNALIST:

Was there any consultation or input from Labor on this plan?

PRIME MINISTER:

Again, Sussan can say a little more about this but I know that this was developed with the AMA, with Steve Hambleton in particular from the AMA. We are working very collaboratively with doctors. What Sussan has described is and what we are seeking to do is to ensure that the payment system and the administrative system keeps up with and supports best practice at the primary health care level. So that's what we are basically - we are ensuring that the type of health care that Sandra has received - we met earlier - is that practice, that culture, that professional culture is one that is supported by the system as opposed to being a culture that has to sort of battle its way through the red tape and clunkiness of the system as it stands. 

MINISTER FOR HEALTH AND AGED CARE:

But in answer to your question about Labor - the answer is no. They have not endorsed this, they were advised by their experts in 2009 to go down the Health Care Homes model path and it is another one of their failures so we are bringing it to patients and we are doing it quickly.

JOURNALIST:

And the press release mentions that this is something that doctors have campaigned for a long time. Can you just comment a bit on that?

MINISTER FOR HEALTH AND AGED CARE:

The College of GPs, the AMA have all talked about the medical home model. It is known as international best practice and it is different in different countries but we what we are going to do here is bring the best of what we've seen internationally to Australian patients. It hasn't come from the bureaucracy. It hasn’t come from Government. It has actually come from clinicians. Steve Hambleton led an advisory group that worked through most of last year and the recommendations are on the department's website, they make really interesting reading because they do tell us where we are, where we need to be and how to get there.

JOURNALIST:

Do you mind if I move onto another topic in terms of the AFP raids today? Were yourself or anyone else in the Government given early warning about the raids today?

PRIME MINISTER:

The Justice Minister normally is advised prior to raids occurring. He sent me a message very late last night. I have to say that I had an early night because I had an early start, so I learnt about it early this morning. Can I just say that it's very important to remember that the Australian Federal Police act independently of government. I've been very disappointed not for the first time to hear Senator Conroy this morning attack the integrity of the Australian Federal Police. He has accused the Australian Federal Police of acting under political direction which is an outrageous suggestion, he knows that is untrue, and he even went so far as to say that they were acting illegally. Really, Mr Shorten has to step up and pull Senator Conroy into line.

Senator Conroy is a member of his frontbench. We've seen him in the past, you've seen him, too - we've all seen him - disrespect senior military officers in the Senate, we've seen him attack the integrity of the Australian Federal Police before and now he is doing it again. Now, he really - he knows - he knows absolutely as well as we do that the AFP are thoroughly independent of the Government. There is no political direction at all. A complaint was made by the NBN Co and the Federal Police made a decision - their decision as to investigate it, which is what they are doing, but really, Senator Conroy should know better, and he should be supporting our law enforcement agencies. These are the men and women that keep us safe. And I can tell you, speaking on behalf of my Government and I believe the overwhelming majority of Australians, we support our police and security forces because they know, we know they stand between us and danger, and as for him trying to use political influence to stop an investigation - well, really, again, he should know better. The course of justice, the administration of justice takes its course and it's not for politicians to try to meddle in it or bully the police or any other security service into one action or another.

JOURNALIST:

You mentioned that the Communications Minister was notified last night?

PRIME MINISTER:  

Well, I believe the Justice Minister was notified last night, yes.

JOURNALIST:

So when did he receive the notification?

PRIME MINISTER:  

Oh, you would have to ask him. You would have to ask him.

JOURNALIST:

The reason for my question is that the President of the Senate and the Speaker of the lower House have to be notified under law before the police can come in. Is that your understanding that that’s happened?

PRIME MINISTER:  

Well, I don't know whether the police notified - I'm sure that the police are very familiar with these practices and requirements, but again you would have to address those questions to them or to the Minister.

JOURNALIST:

Is it your understanding that...

PRIME MINISTER:

No, you would have to address your questions to them or the Minister.

JOURNALIST:

And you've spoken about the Opposition's position on this, they are maintaining this is the Government pressure on the NBN to fight this. Has there been any contact at all between you and the Communications Minister with the board of the NBN on this matter?

PRIME MINISTER:

Well, the investigation as I understand it, began last year. That's what I've read about. But the board of the NBN or the NBN management made that decision independently. It is a very highly qualified board of directors with a very experienced chairman, a very experienced chief executive and they've done an amazing job.

Again, Senator Conroy this morning was showing yet again that he operates in a parallel universe. I used to describe it as ‘Conrovia’, another sphere, another universe. He claimed that the NBN project was being mismanaged.

Let me set a few facts straight for you. When we took Government, when we came into Government in 2013, about 50,000 people had been connected to the NBN in 6 years of the Labor Government. The project had come to a grinding halt in four out of six states, and indeed in two of those states - SA and WA - virtually no progress had been made at all. Work had stopped in South Australia. As well, work had stopped in the Northern Territory. It was a completely and utterly failed project.

Now, we changed the management, we changed the board, we put competent people in charge, we gave them the ability to build the project in the manner that would deliver a completed NBN as quickly and at as least cost as possible. Now, the approach they are taking will see the project completed by 2020, 2019/20. They have met every target the new management has set, they have met every target so far. It is available at over 3 million premises. There is well over 1.1 million people who have been connected. If you look on the NBN Co's website, they put all of these figures up every week. See when I inherited the project as Communications Minister, Senator Conroy had a practice of releasing statistics and numbers irregularly and often they were quite done in a misleading way.

Since I became the Minister, the NBN Co puts up the roll-out figures and connection figures every single week. Every week they are updated, you can look it up yourself. Google ‘NBN Co weekly report’ and you will see the report and you can

see the growth, on my account, about  80,000 premises have been activated in the last month or so. So you can see the rollout is moving quickly. There’s well over a quarter of Australian premises have now got a connection. By 2018, the company expects that to be three-quarters. So it is moving on well at much greater pace and at much lower cost than if the Labor government’s approach had been taken. So this is a big turnaround story, the NBN it’s something the Government is  very proud of, the management should be very proud of. I'm very proud of it, as the first Coalition Communications Minister to be responsible for the NBN, and Senator Fifield is doing a very good job in his stewardship of it too.

JOURNALIST:

Prime Minister, today Labor is going to be proposing an $8 billion saving budget, have you had a chance to look at this list and if so what do you think of the proposals.

PRIME MINISTER:

No I haven't seen the list, but what I understand is that Mr Shorten is - so far, at any rate - not agreeing to support savings measures of ours which he had during the campaign supported, and indeed built into his own costings.

So all we are asking him to do is to support measures that during the campaign he said he would support, and indeed he assumed he would support, because he built them into his costings. So he has basically said to the Australian people: "here is my alternative Budget and I'm going to adopt these $6 billion and more measures of the Coalition Government” and if he was elected he was committing to implement them. So all we are asking him to do is to be true to his word.

What I understand he is asking us to do is to support tax increases that we have always opposed. You can you see there is a very big difference. We are asking him to support things he has previously supported. He is asking us to support things that we have always opposed. Now the reason we have opposed those tax increases, the reason we oppose  them, is because they are additional taxes on investment and if you increase the taxes on investment, you will get less investment. You know what happens when you get less investment? You get less economic growth. You know what happens when you get less economic growth? You get fewer jobs.

What Australia needs is more investment, more growth, more jobs.

Business growth remains relatively high. Economic growth remains relatively high, compared to other developed economies, but we cannot be complacent about that. There are plenty of headwinds and risks in the economy. So we need the strong economic leadership, the clear economic plan that we took to the election, every element of which -  from Budget repair to innovation, to ensuring we have the funds to guarantee support for Medicare and our health care services, for investment, for our business tax cuts, right across the board - everything we are doing is designed to ensure we have more investment, more growth and more jobs because everything depends on that. What Labor took to the election, as we know and they seem to want to prosecute now in Opposition, is a plan that had higher deficits, higher debt, higher taxes which meant less investment and fewer jobs.

That's a recipe for disaster, it’s not a recipe to secure our future, our prosperity in the years ahead.

Thanks very much.

[Ends]