Just how Nicola Roxon took her seat at the head of the Health Ministers’ meeting in Hobart last week beggars belief.
Ms Roxon’s position as Federal Health Minister is now untenable.
Her strident and consistent advocacy for the Rudd health ‘reforms’ leave her now embarrassed, discredited and renders her impotent and therefore unable to remain in the health portfolio. Just as Peter Garrett had to be separated from the disastrous pink batts scandal and other wasteful green energy schemes (he should have been sacked), so too Nicola Roxon must be dispatched from health.
Spectacular policy reversals have become the hallmark of the Rudd-Gillard Government and now of Ms Gillard herself, none more so than in health where she has jettisoned the core elements of the Rudd ‘reforms’ and re-instituted elements that Rudd and Roxon herself had previously discarded.
Both the Prime Minister and Health Minister were still arguing just weeks ago that the Commonwealth must become the dominant funder of public hospitals, that a claw-back of the GST from the states was necessary to enable that and without both measures “real” health reform would not be possible.
But the Health Minister also argued against the need for a separate funding authority - or what has become the ‘funding pool’ and centrepiece of Gillard’s latest plan.
At a press conference mid last year Ms Roxon said this: “It’s not appropriate for us to - and we’ve made it very clear we don’t want to increase the size of the bureaucracy - it’s not appropriate for us to establish an authority where there is not a need to do so. There will need to be people who can process essentially the cheques that need to be paid through to local hospital networks, but it doesn’t require an authority.”
Either Minister Roxon was wrong then, or she is wrong now, but either way her credibility is now non-existent and her absence from Gillard’s side as this latest version of health ‘reform’ was rolled out was conspicuous.
Last year the Coalition argued that the Rudd ‘reforms’ were little more than a political distraction to take the focus off the pink batts problems. Little has changed. These Gillard ‘reforms’ are all about giving the impression that this Prime Minister is “delivering”, although a Heads of Agreement - an agreement to get an agreement - hardly measures up.
With Labor’s primary vote continuing to tank since Ms Gillard became Prime Minister, she desperately needed the optics of sorting out the mess of Labor’s first term, conveniently blamed entirely on Rudd.
By dumping the much-hyped GST clawback she removed the obstacle for First Ministers to another in-principle agreement and paved the way for the picture opportunities she hopes can help save her from plunging polls and the knives of those agitating on the benches behind her.
While Labor has tried to blame Western Australia as the hold-out on the Rudd reforms, the simple fact is that State Labor Premiers also refused to sign on the dotted line to hand over their GST dollars. An agreement to that, was separate to the document signed at COAG last year.
So whilst Gillard may have pulled off a much needed PR manoeuvre, there is still no actual deal and certainly no ‘historic reform’. She has merely revived ‘the promise’ to the point where the same lines were delivered in the same room as Kevin Rudd ten months ago.
On 20 April last year, Kevin Rudd boasted that “we’ve agreed to the biggest reforms to the health system since the introduction of Medicare.” A year on and Gillard has the audacity to proclaim an agreement to reach an agreement, as some major achievement. It is petty political spin, especially compared to the real reforms in an array of policy areas not only promised, but actually delivered, by the likes of Howard, Hawke and Keating.
Even with this watered down version, it looks like Gillard has again over-promised. There is still an enormous amount of detail to be sorted and contested.
‘Historic health reform’ has been central to Labor political strategy and rhetoric since 2007 and it is a big stretch to claim that they need time to devise the mechanics of their plan. Nicola Roxon has over 5,000 staff in her Department and yet Labor is still unable to provide any substantial detail on how their plan is to work in practice, let alone deliver what they have been promising for four years.
But the ‘patience of patients’ is going to have to stretch even further. The big ticket item, the supposed increase in the share of Commonwealth funding isn’t going to reach its heights, according to Ms Gillard only after being pressed, until the “end of next decade”.
Much emphasis has been given to the supposed 50/50 funding split in this proposal, but according to Ms Gillard, in 2030 the height of the funding contribution by the Commonwealth will be “44 percent”, assuming their assumptions and models are right of course. So in fact, some 23 years after Kevin Rudd and Nicola Roxon promised to fix public hospitals and hold a referendum to take financial control, Commonwealth funding may have gone from 38 percent to 44 percent.
This will be only on the ‘efficient cost’ of providing hospital services. States will be responsible for 100 percent of anything over the ‘efficient cost’ so the Commonwealth’s total contribution to all hospital costs may in fact be less than 44 percent. Gillard has again trotted out Rudd’s line that the ‘buck stops with me’, but somehow with these timelines, I don’t think she will be around to be held accountable.
To the credit of the Labor spin doctors, they have been able to hide this inconvenient truth in all the grandiose and over-hyped political rhetoric.
The Coalition proposed a strong policy which addresses issues of financial relations and governance. But importantly, we also proposed common-sense solutions to the problems plaguing our health system, not new inflexible bureaucratic structures. Our proposal for investment in mental health, aged care, longer consultations and after-hours primary care would take pressure off critical aspects of our health system and could start to be delivered now, not in 2014, 2017 or 2030.
Ultimately though a Government is not judged on what it promises, but by what it delivers. Gillard has been Deputy Prime Minister and Prime Minister in a government that has presided over massive financial waste and policy chaos.
The shots of back-slapping and hand shakes at the COAG meeting may help her with a temporary political reprieve, but the hollowness of what has been ‘achieved’ compared to what was promised and the complete lack of mechanics to deliver, may cost her in the long run.
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