NATIONAL RURAL HEALTH CONFERENCE – HOBART
Good morning and thank you Joe for that introduction.
I’d like to start my speech today by acknowledging the traditional owners of the land on which we meet and pay my respects to their elders past, present and emerging.
Thanks very much to the National Rural Health Alliance for having me today, particularly to CEO Mark Diamond, chair Tanya Lehmann and Leanne Coleman for organising this important event.
And to all the special guests and delegates who’ve made it this year – thanks for being here.
It’s a pleasure to be with you today, less than two months out now from a very important election – one that I of course hope will bring a change in Government.
Things are always changing in Canberra politics – we saw that last year when the Liberals changed Prime Minister.
Sadly, this constant political change – in leaders and ministers and ideological direction – can breed policy inertia.
That’s certainly been true in health policy over the last six years.
And it may go some way towards explaining why there has been a distinct lack of progress on rural health.
There remains a massive – and in my view completely unacceptable – divide in health outcomes between those living in our major cities and the 7 million Australians who live outside them.
You’ll often hear me say an Australian’s health outcomes shouldn’t be determined by their credit card. Well neither should it be determined by their postcode – but all too often it is.
I know you’re all very familiar with the issues in rural health so I won’t bore you by repeating them today.
Suffice to say that when people in country Australia have a stubbornly lower life expectancy than those who live in our capital cities – 3.4 years lower for men and 2 years lower for women – it’s a clear sign something has gone wrong.
It’s no exaggeration to say that the failure to make meaningful progress on these inequalities is costing country Australians their lives. So we absolutely must do better.
Labor takes this inequality very seriously.
And I want to give you some tangible examples today of how we’re seeking tackle it.
Last year Bill Shorten announced Labor’s $2.8 billion Better Hospitals Fund. $2.8 billion is the difference between the 50 per cent of hospital efficient price growth the current Government promised to pay before they were elected in 2013; and the 45 per cent they have actually delivered.
Last week, Bill and I announced that $1 billion of that Fund will be going towards capital projects – vital upgrades to our public hospitals like new wards with more beds, better emergency departments and theatres, and new palliative care and mental health facilities.
Every state and territory will benefit from these targeted investments that will ensure patients can access modern and safe health services, and that doctors and nurses have the tools they need to deliver the best possible care.
We are already partnering with state and territory governments – Labor and Liberal – to identify and commit to projects that will make a tangible difference to the lives of Australians, whether they’re giving birth, undergoing essential surgery, waiting for emergency treatment or reaching the end of their lives.
And already, we’ve announced about $400 million worth of capital projects all over the country.
And today, I’m proud to tell you that half of those commitments have been to health services in regional and rural Australia.
That’s nearly $200 million that will go to fixing, upgrading and in some cases building entirely new health facilities.
In Queensland we’re building a new cardiac theatre in Rockhampton and a new 33-bed ward in Townsville.
We’re embarking on a major upgrade of the emergency departments in Cairns and Emerald.
We’re building an all new multi-purpose health facility in Blackwater, and a new Urgent Care Centre on Bribie Island.
Just last week I was in Western Australia with Bill, and we announced we’re establishing a dialysis facility in Halls Creek and a new health centre in Yanchep.
We’re totally rebuilding the hospital in Laverton. We’re upgrading the surgery facilities in Collie. And we’re providing more dental chairs in Albany, doubling the hospital’s capacity.
All these projects will mean that country people will be able to access more world-class health services close to home – and won’t have to travel to the nearest city for care.
And ultimately, that’s Labor’s vision for our health system – one in which every Australian can get affordable access to the care they need without having to leave their loved ones and their support network.
I expect we’ll announce many more regional investments before the May election.
I should point out too that many of these projects are located in safe conservative seats. Some of them are in seats where we don’t even have a candidate.
So this isn’t some cynical pre-election exercise.
We’re listening to the states – both Labor and Liberal – about their needs and we’re providing funding for the projects where we think we can make the most difference for patients.
And crucially, this $1 billion worth of capital investments is on top of our commitment to restore the core public hospital funding cut by the Liberals. That funding will benefit every single public hospital in the country – including across regional Australia.
Now I’ll turn to some other issues that I know are of interest to you.
As you all know, the Government appointed a National Rural Health Commissioner about 18 months ago.
That was a move Labor warmly welcomed – and we did considerable work to strengthen the role.
And we welcomed the appointment of Emeritus Professor Paul Worley in the role. We think he was an excellent choice.
But this is a role still in its infancy and it remains to be seen whether it will have the impact we all hope.
But I would say this: Labor shares your concerns that current funding for the Commissioner role is insufficient to support what should be one of Professor Worley’s top priorities: the establishment and implementation of a National Rural Generalist Training Pathway.
Labor supports this pathway, which aims get more doctors with advanced skills to rural and remote communities.
We have even made specific mention of the Pathway it the new ALP Platform, which was adopted in December.
Of course, if and when we achieve the strengthening of the rural medical workforce and expansion and retention of rural health services like surgery, that is only the beginning.
There will then be the need for more nursing staff with advanced skills including midwives, theatre nurses, nurse practitioners, mental health nurses, and child health nurses, and this will follow onto allied health professionals having diverse roles.
So it’s a big job and it’s important to get it right.
We will be watching the April 2 Budget to see if there’s money for the rural generalist pathway – and if there is, we will match it.
If there’s not, a Shorten Labor Government will find the money. And if we will ensure the Pathway is implemented in a way that it actually delivers for rural communities.
We were also pleased the Government decided last year to adopt our call for a National Rural Health Strategy.
We do have some concerns however that the Government’s strategy is not as holistic as it needs to be.
It appears to be entirely focused on workforce issues, which as we know are very important – but they’re not the only challenge.
We’d like to see a strategy that’s broader in scope. And that’s something we would strive for in Government.
The new ALP Platform also refers to the importance of telehealth – something I know you’re deeply invested in.
Labor has a proud record on telehealth – we were the ones who first introduced incentives in 2011.
This was a major change in medical service delivery. And it has helped patients access specialist care without the time and expense involved in travelling to a major city.
In 2016, a 12-month CSIRO trial of home-based telehealth services for managing chronic disease in elderly patients reported a 24 per cent reduction in MBS expenditure and, importantly, a substantial decrease in the rate of hospitalisation.
The cost reductions were directly linked to better health management through telehealth.
So we are well aware of the advantages telehealth can bring. And yes, we want to see these services expanded.
Which is why last week we announced a Shorten Labor Government will establish a National Telestroke Network.
Every year, 56,000 Australians have a stroke – that’s one every nine minutes.
People in regional and rural areas are almost 20 per cent more likely to suffer a stroke.
They’re also more likely to die or be left with serious disability because most stroke specialists and units are in the cities, denying them access to life-saving treatments.
Labor will invest $12 million to bridge this deadly gap by building a National Telestroke Network, which will link 41 regional and rural emergency departments to a roster of metropolitan stroke specialists via telehealth technology.
These specialists will provide around-the-clock support to local clinicians by examining patients, reviewing CT brain imaging and providing diagnosis and treatment advice. This will speed up access to thrombolysis – clot-dissolving medicine that will be available in all 41 hospitals and must be administered within 4.5 hours.
This initiative shows that Labor is listening to you – and we take telehealth seriously.
We know you believe this should be expanded to GPs.
And we certainly take your point that many people in rural and remote areas face difficulty accessing GPs the same way they do specialists.
But it’s important to also get the balance right.
Medicare arrangements should support the provision of face-to-face services as the gold standard – supplemented by targeted availability of telehealth, where face-to-face services are not available.
But we are keen to work with you to find a way forward on this.
In conclusion, I want to assure you that if indeed I do become Health Minister overcoming health inequality – including between city Australians and country Australians – will be a major focus for me.
I look forward to working with you to achieve that goal.
Thank you and I’m happy to take questions.