Federal Health Cuts

Ms HENNESSY (Minister for Health) — I move:

That this house condemns the Prime Minister and the federal health minister for their $17.7 billion in savage cuts to Victoria’s hospitals over the next decade, and for other measures that will disadvantage Victorians including dental, preventative health, Indigenous, medical research programs and investments.

Australians value their health care system. They value a universal health care system, and they value investment in and protection of their healthcare system.

When they see a federal government attempting to wind back investment in things like their access to GPs and their access to hospitals, they know they are dealing with a federal government that is, by stealth, attempting to attack universal health care.

In the federal budget handed down two weeks ago the Abbott government locked in a $17.7 billion cut from Victoria’s hospitals over the next 10 years. Those cuts will have a devastating effect on hospitals, on the community, on primary healthcare providers and on the very hardworking professionals who work throughout our health services to save lives every day.

But it is more than that. Those cuts will have a devastating impact on Victorians who are sick and who need health care and treatment, because you simply cannot rip $17.7 billion out of our healthcare system and expect there not to be any consequences.

That is not all the federal government did. In speaking to this motion I not only want to discuss the impact of the $17.7 billion cuts to health services right across the state, I also want to talk about the federal government’s deep cuts to other important parts of the healthcare system, such as cuts to our dental services, to preventive health and to health programs that support some of our most disadvantaged members of the community.

I have had many great privileges over recent months, but one of the greatest privileges was travelling around the state visiting health services and meeting with patients and their families. I have met families celebrating the most joyful moments of their lives — the birth of a new child, for example, or those who are deeply grateful to be recovering from an illness.

I have also met patients experiencing their most painful moments, when they are diagnosed with a very difficult disease and are in deep pain. I have met those who are experiencing great new trauma and their families who are attempting to assist them in recovering from it.

In short, our health system sees us at our best and at our worst, and the healthcare system and the people who comprise it — the wonderful doctors, nurses, allied health workers, paramedics, those who feed us and deal with the washing and everything in the health service — play an incredibly vital role in our lives. They deliver our children, they support us through illness, they relieve our pain and deal with our grief. Few other public institutions play such a critical role, and it is a matter of great honour to be the Minister for Health in this state.

Therefore I feel a tremendous sense of responsibility in this role and a sense of stewardship. We want to leave our health system in a better position than the one we found it in, so we will not let it be ruthlessly attacked by the federal government.

We will stand up for both quality and affordable health care. This matter is fundamental to the values of the Labor Party. It is fundamental to my values and it is a fundamental value that motivates and drives the Andrews Labor Government. A strong public health system is a critical element of a fair society.

If we are serious about building a fair society, one that puts people first, then we must have the best quality health system and one that is accessible to all, irrespective of how much money you earn and irrespective of any position of privilege you hold. That does not just mean treating a person when they are sick; it is about investing to keep people well and about investing in prevention.

That is not just a matter of fairness and equality; it is a matter of good economic sense. We need to get in on the ground floor when it comes to early intervention and investment in prevention, and by investing in prevention we save enormous amounts of money that would otherwise be spent at a later stage on intervention at the acute level. Therefore investing in prevention is one of the best investments governments can make.

Yet the most recent budget handed down by the Abbott federal government not only betrayed the values of equity and fairness, but it made bad economic sense. The federal government’s cuts to hospital funding and to programs for some of our most disadvantaged communities are reflective not just of a mean-spirited government, but of one that is irresponsible.

Over the past few months I have spoken about the $13.6 billion cuts to our hospitals over the next 10 years. That $13.6 billion was revealed when the midyear economic and fiscal outlook was handed down towards the end of last year.

We thought that was bad enough, and in response to that projected cut, health services, health workers and patients all exhibited their deep concern about the impact that those cuts would have. It will result in dramatic cuts to our health services.

They were telling me and they were telling the Abbott government very clearly that they were worried about how they would be able to continue to access health services. They were telling me that if we made those cuts, they would have to cut services and cutting services would compromise care.

Then we saw some great hope put out there by Mr Abbott. He started to say that the forthcoming federal budget would be a kinder, gentler budget. He started saying that he might start to address some of these issues, and perhaps we were naive to take him at his word.

What happened? On the night that Mr Abbott handed down his budget he revealed that he had not reversed any of those cuts but had in fact deepened them. He had deepened the cuts to take an extra $47 million away from Victorian hospitals compared to last year’s midyear economic and fiscal outlook. That means the cuts in previous budgets and the budget update are going deeper into the future.

If Tony Abbott remains Prime Minister — and that would be a great threat to the health and wellbeing of Victorians — $17.7 billion will be cut from Victoria’s public hospitals over the next decade.

I know that $17.7 billion is a huge number. It is often difficult to comprehend what that would mean, so let us put it into perspective. It would mean the equivalent of 2.9 million fewer elective surgeries. It would mean the equivalent of 32 million dialysis sessions. This will impact upon the ability of Victorians to access health care, and what would it mean for the services based on their current funding model? What would it mean for our hospitals?

We have done some modelling. Mr Abbott’s $17.7 billion cuts will mean that Monash Health will lose $2.2 billion over the next 10 years. It will mean that Alfred Health will lose $1.39 billion over the next 10 years. It will mean that Eastern Health will lose $1.33 billion over the next 10 years. It will mean that Melbourne Health will lose $1.32 billion over the next 10 years. It will mean that Austin Health will lose $1.11 billion over the next decade.

And our hospitals in regional Victoria are not immune; they will also be hard-hit. It will mean that Barwon Health will lose $840 million over the next decade. It will mean that Bendigo Health will lose $476 million. It will mean Ballarat Health Services will lose $455 million. It will mean Seymour Health, which is a fantastic health service that I had the opportunity to visit last week, will lose nearly $26 million over the next 10 years.

Then we have our small rural hospitals. They will be devastated by these cuts. These are health services with the least capacity to deal with such savage cuts. It will mean that rural health services like Beaufort & Skipton Health Service will lose $10.5 million. It will mean that Boort District Health will lose $5.4 million. It will mean Alpine Health will lose $26.8 million.

These cuts are not just outrageous in their magnitude, they are breathtakingly duplicitous, because we remember before the last federal election the coalition issued its health policy, and its health policy says:

A coalition government will support the transition to the commonwealth providing 50 per cent growth funding of the efficient price of hospital services as proposed.

Mr Abbott has broken that promise. Mr Abbott promised to increase funding to public hospitals, but instead he has cut funding to public hospitals. These cuts will permeate across every health service in Victoria, and they will have a devastating impact on the ability of patients to access care.

The Abbott government has also remained steadfast on its decision to walk away from key components of the national partnership agreement on improving public hospitals. Under those cuts Victoria has lost millions to support improving access to emergency care, elective surgery and subacute beds, and all of those cuts come on top of the $1 billion that was cut by the coalition state government.

They will have an incredibly detrimental impact on our hospitals. They will see Victorians wait even longer in emergency departments, they will see Victorians wait even longer for their elective surgery and they will see services reduced.

In stark contrast to the Liberal approach, this government’s approach has been to make a very passionate investment in health.

In this year’s budget we have invested a further $2.1 billion over the next four years, including $970 million extra for hospitals to meet increased patient demand. We are investing more than three times the amount that those opposite invested in health capital in their last budget. There is $560 million for new and upgraded hospitals.

We are building the Western Women’s and Children’s Hospital in Sunshine, we are expanding the Werribee Mercy Hospital and we are providing $106 million to expand Casey Hospital. In Ferntree Gully we are investing $20 million to provide an intensive care unit and a short-stay unit at Angliss Hospital. We will expand Moorabbin Hospital with $16.2 million for additional magnetic resonance imaging and computed tomography machines and 11 new outpatient specialist consulting suites. These investments will make a difference.

We have provided $10 million to expand the cardiovascular service at Ballarat Health Services to build, develop and equip a new cardiac catheterisation laboratory. We have also invested $20 million for ambulance capital works, including the rebuilding of nine existing branches, and we will build a new branch at Wendouree.

These are just some of the investments we are making — and this is our first budget. We are a Labor government, and investing in health is in our DNA. We will have more to come.

It shows Victorians that we care about their health and that we think all Victorians should have access to health, irrespective of what is in their bank account or whether they live in the suburbs, the inner city, the regions or rural Victoria. We are motivated by the values of fairness and equity.

We believe that everyone should have the right to access affordable quality health care close to their homes. There is no doubt it will be incredibly challenging to deliver health services in light of the Liberal Party’s vicious cuts. I know that Victorian health services are very worried about the future funding shortfalls that may result from these cuts.

We will do everything we can, but we simply cannot plug a $17.7 billion hole produced at the hands of Tony Abbott and the federal Liberal government. We will fight these cuts all the way.

But what have we heard from those opposite? What have we heard in terms of standing up for Victorians and their ability to access health care? The opposition has said only one thing about the federal government’s savage cuts. I quote from the Sunraysia Daily of 2 May in which the shadow health minister is quoted as saying:

… the federal government had given notice a year ago of its intention to scale back funding …

What a roar in terms of standing up for our health system from those opposite! It is simply not acceptable for them to roll over and say, ‘Okay’ to these health cuts.

I can tell you, Deputy Speaker, that we will not. We will stand up and fight as Victorians expect us to. We will not let the Abbott government get away with a cost shift to consumers that will have a negative impact on their ability to access healthcare services.

The Abbott government’s determination to walk away from its obligation to invest in health is also evident in the cuts it has made to the National Partnership Agreement on Preventive Health. It has resulted in the loss of funding to a terrific program called Healthy Together Victoria.

This program is a partnership of state and local governments, hospitals, non-government organisations, businesses and the community. It brings together a range of important programs with the aim of improving people’s health where they live, where they learn, where they work and where they play, in our schools and in our communities and in our local communities.

One of these programs, the Healthy Together Achievement program, helps organisations to create healthy environments by providing advice and resources about better health. That may include things like sun protection, mental health, physical activity and wellbeing. More than one in four Victorian children currently participate in this important program, and more than 300 000 Victorian workers currently participate in this program at over 780 workplaces. These are incredibly important programs, and the commonwealth has simply walked away from them. Last year in the federal budget the coalition government indicated that it was cutting that program.

It is not often that I doff my hat to my predecessor, the former Minister for Health, David Davis, but in this circumstance I will say that he at least got on the phone to the federal government and begged it not to cut this program. I have been advised that the then federal Minister for Health, Peter Dutton, said he would see what he could do to keep that funding going, and stakeholders were advised that everything was going to be okay.

In the dying days of the last state government a document called a request for tender was put to the Victorian government for $30 million to help to support the ongoing investment in Healthy Together Victoria. Then the government in Victoria changed, and in January this year I wrote to my federal counterpart seeking an update around this funding. I sought a meeting with the federal Minister for Health, Sussan Ley, and raised the issue with her, but we received no commitment. The only advice we were given is that they would consider it in the context of the forthcoming federal budget. But, disappointingly, on budget night there was no funding for Healthy Together Victoria, as many were led to expect.

I can only assume that this was a decision about politics and not about prevention. Sadly it will be the communities of Bendigo, Cardinia, Dandenong, Geelong, Hume, Knox, Latrobe, Mildura, Whittlesea, Wodonga, Wyndham and Central Goldfields that will suffer, because investing in prevention reduces the long-term toll of disease on our communities.

The Andrews Labor government has made, does make and will continue to make significant investments in prevention. We see that in our 2015–16 budget, and we will look at what more we can do to save parts of the programs under Healthy Together Victoria, but I cannot mislead those communities or the house.

The Abbott government’s abandonment of the National Partnership Agreement on Preventive Health has ripped vital funding away from this project and it will have a detrimental effect on the health and wellbeing of Victorians.

The Abbott government’s attack on our health system does not stop there. The dental health program that delivers publicly funded dental services to those who have the most limited access to dental care, including children, pregnant women, Indigenous people, refugees, people facing homelessness, people registered as clients of mental health services and disability services, has been ruthlessly cut by the Abbott government.

Under the partnership agreement Victoria was supposed to receive $220 million over three years. But what did we see in this year’s budget? Initially the federal government said it was going to defer it, but what we saw was $181 billion cut from our public dental services. That means that 214 000 Victorians will have to wait even longer to access public dental services — if they access those services at all.

We know that poor oral health, once ignored, leads to people who are in unbearable pain ending up in our emergency departments. The federal government has cut $181 million from our public dental services, yet we hear absolutely nothing from those opposite.

If that is not enough for them, the Abbott government then took its axe to the funding of child dental benefits as well. The child dental benefits scheme is a means-tested scheme that support’s children aged between 2 and 17 years. It covers basic dental treatment and preventive health treatment. It provides $1000 worth of basic dental care per child every two years, and since that program started it has helped hundreds and thousands of children across the country. But the commonwealth government is refusing to confirm whether or not it will continue to fund that program. Cutting public dental funding, particularly for the most vulnerable of people, is not just bad social policy and bad health policy; it is bad economic policy.

But the cuts do not end there. This year’s federal budget has also seen the cruel axing of the Healthy Kids Check. Since 2008 children between the ages of three and five have been able to go to a GP for basic health checks. These checks determine whether they have a hearing impediment, a speech impediment, language or behavioural issues or health concerns that may impede their progress as they develop. These checks mean that their families can identify potential developmental problems before the children start school and look at options for early intervention.

What did the Abbott government — the supposed champion of family values — do in this most recent federal budget? It told families right across the country, including those in this state, that they are on their own, because the Healthy Kids Check will no longer be covered by a Medicare rebate. This is just another senseless cut with absolutely no policy justification.

This week is National Reconciliation Week, and at the start of the week we heard members from all sides of this chamber talk about the importance of supporting our Indigenous populations. Here in Victoria we have an Aboriginal population of about 47 000 people, about 0.09 per cent of our population. Our Aboriginal population is young and growing, with more than 45 per cent aged 20 years or younger.

We all know — and no-one in this house requires persuasion — that the challenges involved in closing the gap, particularly when it comes to Aboriginal people, are very significant. Aboriginal people are more likely than any other people in this country to experience incredibly poor outcomes. We know that Aboriginal children are twice as likely to die in their first years as are non-Aboriginal children. The sudden infant death syndrome rate among Aboriginal infants is higher. Aboriginal maternal death rates are higher. All of the health outcomes of Aboriginal people are worse. That is why programs such as the Koori Maternity Services program are so important.

The Koori Maternity Services program, the national partnership agreement on Indigenous teenage sexual and reproductive health and the young parent support program are programs that have made a difference. All the evidence has said that those programs have fundamentally improved health outcomes for young Indigenous Victorians, including sexual and reproductive health, and have improved maternity and birthing services — and they have done it for reasonably small amounts of money. What happened in this year’s federal budget?

I am appalled to advise the house that the federal government decided to axe such an important program as the Koori Maternity Services program. This will have an untold impact on those who rely on the program, which has been incredibly important in efforts to close the gap in relation to Aboriginal health. Despite that, the Abbott government has cut the funding for it.

The Abbott government has also walked away from the funding for Indigenous teenage sexual and reproductive health. That will see funding cuts to Wulumperi, the Aboriginal sexual health unit at the Melbourne Sexual Health Centre. That unit is doing terrific things, but now its funding has been cut. It was the only dedicated program for best practice sexual health interventions for young Aboriginal people. It has been making a difference, yet the federal government has decided, in all of its wisdom, to cut it.

Since coming to government we have been lobbying the federal government about these important programs. We know that the cut in this funding will mean a significant reduction in access to culturally appropriate services. There are more and more examples of these savage cuts and of how they will make it difficult for families to get the treatment they need.

Another one — and sometimes it is the small things that really count in people’s lives — is the inborn error of metabolism food grant. This grant supports people with rare metabolic diseases. They are provided a small amount to help them buy necessary medications and supplements. The grant is received by only about 1000 people. It is a blip on the federal Treasury books, but it is an essential source of funds for people who have that condition. Mr Abbott decided he would cut that as well. What makes it worse is that those 1000 people were not even told about this and found out only by reading the budget papers.

I am continually astounded by the ability of the members of the Abbott government to so nonchalantly shrug their shoulders at the Australian people, including Victorians, and effectively say, ‘We simply don’t care about these cuts’.

After last year’s disastrous federal budget, when Mr Abbott forecast he would deliver us a kinder, gentler budget, we can understand why people were so concerned about the federal health budget. We saw the ongoing backflips and somersaults around the Medicare GP co-payment. That was quite an astounding policy development process to watch.

We thought the federal government had received the message that Australians, including Victorians, consider universal access to health care services a mainstream value, one they do not want governments to remove or make the subject of brutal cuts. That is because we do not want to live in a community, in a state or indeed in a country that reflects some of our international comparators. We do not want to live in a country where how much money you earn determines what access to health care you get.

Australians very forcefully told the Abbott government that, when it tried to mess with our Medicare system — and we thought that the government might have learnt the lesson. It seems not, however, Speaker. It seems that we are going to have to continue to tell it that.

The Andrews Labor government will continue to invest in health, but it is not going to cop a $17.7 billion cut to the health system and roll over and say it is okay. We are going to take the fight up on behalf of our community.

We are going to tell Mr Abbott we will not allow our state to become one where people do not get access to health care, where we do not invest in prevention, where children are forced to go without primary dental care and where children’s learning and speech impediments and development delays are not diagnosed at an early age, thereby denying them the opportunity to have early access to relevant sorts of programs. We are not going to enable our health system to be the subject of brutal, stealth-ridden cuts.

Before the last election, Tony Abbott stood before all Australians and promised he would not cut the health budget. He has broken that promise, and he has broken it in every single health budget since that point in time. We need partnership, however, in taking up this fight. We need people to stand up for Victoria. We need people to be Victorians first and politicians last — and the deafening silence from those on the other side of this chamber is an absolute shame.

The challenge for those who sit on the opposite side of the chamber is whether or not they too are going to stand up for the Victorian health system. Do they think it is acceptable for $17.7 billion to be cut from the Victorian health system? Do they think it is acceptable for Healthy Together Victoria to be cut and for people to lose those programs? Do they think it is acceptable for the most vulnerable Victorian people to be denied access to public dental health care? Do they think it is acceptable for Indigenous Victorians to be denied access to maternity programs and to sexual health programs?

Do they think it is acceptable for mental health funding to be cut by the feds? Do they think it is acceptable for rural, regional and metropolitan health services to cut their cloth? Do they think that Victorians should wait longer in our emergency departments? Do they think it is acceptable for Victorians to wait longer for their elective surgery?

Do they think it is acceptable when a society and a community starts to have two classes when it comes to health care — those with the financial means to buy it and those without it? Do they think there is a compelling economic argument to not invest in prevention? Do they want to take us backwards, after Australia has enjoyed access to universal health care for decades? I think all Australians and indeed all Victorians now regard that as a mainstream value, and they will punish politicians who do not support it.

We will not have our health system ripped apart by stealth. We will not allow those who sit on the other side of this chamber to remain silent and try to look busy while responsibility and partnership is required to stand up to the federal government. We will hold them to account for their behaviour, because we are a Labor government that fundamentally believes it has not only a political obligation but a moral obligation to make our health system better, and that is exactly what we intend to do.