Monday, 4 March 2013

Griffith University School of Medicine - Grand Rounds Forum 2013

Griffith University School of Medicine - Grand Rounds Forum 2013

"A heart to heart with Kevin Rudd"

Griffith University Gold Coast Campus

Thank you for having me here today.

And hi to all those on joining us via video link.

I am a great admirer of the medical profession, going back to my work at the Canterbury Hospital as a wardsman in the 1970s.

And as someone who has had my life in the hands of your colleagues twice for aortic valve replacement surgery.

So I thank you for choosing the medical profession and the sacrifices you have made already to be admitted to medicine, the sacrifices you will continue to make, with interrupted sleep, and the intelligence and sense of professional purpose you bring to a career which benefits all Australians.

Today I wanted to talk to you about three things:

First, some of our national success stories in health and hospitals policy, especially when it comes to organ donation as this is DonateLife week.

Second, the NBN and the National eHealth Strategy.

And third, a few basic statistical facts on the government’s investment in the health system that we have made over the last five years compared to the past.

I want to take you through the facts of health funding over the last five years – not the fights, just the facts.

Then you guys make up your own minds on the politics of it all. 

This week is DonateLife week.

How many of you here have spoken to your family about organ donation?

And how many of you haven’t?

Because this is the real problem we have been trying to address for the last five years – to make it easier for you to do your jobs saving lives.

When I was elected in 2007 as Prime Minister I knew that not only did Australia have an organ tissue donation problem. But also that it wasn’t an issue that was going to excite people.

In fact for many people it just makes them feel sad.

While our rational selves may be able to say “organ donation, yep it’s important, no worries” when it comes to sitting down with your parents and saying “mum, I want to talk to you about when I die”.

It isn’t that easy.

I know for our family it is a hard discussion, and I’ve been the recipient of a donated aortic valve.

But people are having the conversation and the data from Donate Life shows that there has been a significant improvement.

Since our program was implemented in 2009 we have seen a real improvement in organ donation.

I am proud of our $151.1 million in federal funding as part of national reform agenda to establish Australia as a world leader in best practice organ and tissue donation and transplantation.

Like our overseas aid program which funds vaccination of missions of kids against preventable diseases - this is one of the areas where we have literally helped save people’s lives.

• The number of organ donors has increased by 43%.

• The number of recipients has increased by 30%.

• And the donor per million population rate has increased by 38%.

This is the highest donor rate in Australia since national records began.

And it is because we have put resources into our hospital network.

163 clinical specialists dedicated to organ and tissue donation in 77 hospitals

And 79 staff in eight specialist organ donation agencies.

And Queensland has got its share.

$9.31 million under the current two year agreement providing funding for 25 dedicated specialist hospital and agency staff at 12 hospitals in Queensland.

And to give the Queensland Government their credit they are putting in about $1.5 million to DonateLife Queensland this financial year, although we came perilously close to losing that finding last year in the midst of the State Government’s health cuts.

So on organ donation – this is what you can achieve when you listen to the profession, provide the resources you need, get the states working together, and, pardon the appalling pun, have a little bit of heart.

The NBN will do for healthcare in the 21st Century what the Flying Doctors did for the 20th.

That’s not say that NBN will render doctors obsolete – of course it won’t.

But, the NBN will take us forward in leaps in bounds in this country’s battle with the tyranny of distance.

As part of our investment in the National Digital Economy Strategy, the Government will aim support the use of individual electronic health records (though the Personally Controlled Electronic Health Record system).

Announced in the COAG reform agreement signed in 2010 and launched in July last year, the eHealth system allows patients to view their health records whenever and wherever they want.

And, in an effort to support safer and more efficient quality healthcase, the records can be securely shared with the healthcare organisations involved in a patient’s care.

It means my GP and my cardiologist will know what’s going on with my heart in a systemised, efficient manner. Now I don’t know about you, but I find that very comforting.

And critically, if I’m on the road anywhere in the country or abroad - there is a system in place to transfer all my medical records at the push of a button and all under my authorisation.

Deloitte expects that the net direct benefits of Personally Controlled Electronic Health Records (PCEHR) will reach $11.5 billion over 15 years to 2025. If you break that down, that’s $9.5 billion in net direct benefits to Australian governments and $2 billion in net direct benefits to the private sector.

There are currently 1000 healthcare provider organisations registered to participate in the eHealth record system generating upwards of 50,000 active eHealth records throughout Australia since 1 February 2013.

And the number is growing rapidly. Great for better health outcomes, great for the health budget by avoiding multiple repeat diagnostics.

And great for the health IT industry where the commercial spinoffs will be considerable.

The second element to the National eHealth strategy is the national telehealth initiative.

The Australian Government has provide over $460 million in funding for telehealth services which at the most basic level mean that folks living out the back of beyond don’t necessarily have to get in the car and drive for hours to see a doctor.

It means that specialists in Sydney, or Brisbane or on the Gold Coast can assist GPs in our regional communities.

It means that we have better healthcare access into our aged-care homes.

This is all because the NBN is allowing us to transfer voice, data, images and information electronically rather than necessarily having to physially transfer the patients.

And the benefits aren’t just for people who are sick or people who are isolated geographically – Access Economics predicts the ongoing benefits telehealth will bring to the Australian economy as somewhere between $2 billion and $4 billion a year.

The opportunities for the Australian healthcare system and NBN are almost limitless and are much more riveting than a videolink of one of my speeches (unless you are dealing with sleep disorders where I am sure they could be just as affective as a prescribed dose of Tylenol.

As you know, there are a lot of people throwing around accusations of people cutting funding from various health services.

So here are a few facts:

Fact number one – the Australian government’s health and hospitals reform agreement has delivered the Queensland health and hospital system record funding of $13.5 billion over the last 5 years.

This represents a 17 per cent real increase on the previous government. A 17 per cent increase on the funding when Mr Abbott concluded his four year term as Federal Health Minister.

Second, over the next four years from the current financial year Australian Government funding for Queensland health and hospitals will continue to increase – by a further 21% - to a record annual allocation of $3.76 billion in the 2015-16 financial year.

Third, the Australian Government’s contribution to the state hospital system had decreased to 42 per cent (leaving the states to cover 58 per cent of the costs) by the time of the 2007 election.

Since then we have signed an intergovernmental agreement to increase the Australian government’s contribution to 50 per cent by July 2017 and by July of next year it will already be at 45 per cent.

So these are the three headline figures and the three headline facts as of today under Health Minister Plibersek.

Today I also want to drill down into a bit more detail where the increases have gone and what they actually mean.

You know as health professionals that effective preventative health strategies are unlikely to kick you out of a job.

But it will help keep people alive.

And it is critical to managing the health budget for the future.

When we came to office the federal Government was spending $258 million a year on health prevention.

We have added an extra $1.1 billion in new preventative health spending measures since then. This includes:

• The creation of the Australian National Preventive Health Agency;

• The $103 million for the National Binge Drinking Strategy;

• And of course our reforms to plain packaging of tobacco which I was pleased to announce as Prime Minister which big tobacco continues to fight in the courts (while, I might add, still providing campaign donations to the federal Liberal Party in the last election).

Second, in primary care we have doubled the federal government’s annual investment from $466m in 2007 up to $900m this year.

And we have delivered the infrastructure needed to deliver this increased investment in services

• More than 60 GP super clinics;

• 429 grants for new primary care infrastructure to expand GP services;

• And $52 million for 267 regional primary care infrastructure projects.

And we have expanded the services available for primary care:

• 4600 funded practice nurses by 2014;

• The new GP after hours line to take pressure off our emergency departments;

• And investing $50 million to deliver GP after hours video conferencing.

To pull all of this together we have created 61 Medicare Locals across Australia in operation to coordinate the care and services available to each local community.

Third, we are also investing $2.1 billion for 1,731 new sub-acute beds at our hospitals.

Fourth, we come to the individual and major disease categories. Let’s look at Cancer.

We have had $2.3 billion in new spending measures on cancer treatment since being elected.

We are building or have built 25 new regional cancer centres (7 of which are in Queensland). This is to help close the gap in life expectancy for cancer sufferers in regional and rural Australia compared to the capital cities.

Fifth, on medical research we have invested $700 million for new and upgraded medical research facilities (including the massive investment in the Ian Fraser Translational Research Centre at the PA Hospital which will open next year and house 650 researchers and staff) and delivered $4.3 billion to medical researchers across the nation.

Sixth, then we get to the lifeblood of the system, the training of guys like you.

Compare these two figures:

$142 million per year


$1500 million per year.

One of those figures is the amount being invested in the health workforce and training under Mr Abbott as health minister as of 2007.

The second is the annual figure that we are investing today.

We have:
• Doubled the number of GP training places to 1200 a year;

• Funded scholarships for 1,100 nursing places and 500 rural allied health places per year.

• In Queensland alone the number of commencing training places is up to more than 200 – up from 126 in 2007.

• And a fair few of them are trained at the UQ Medical Training Centre at Greenslopes Hospital in my electorate in which we’ve invested $13 million in.

And finally on training and intern places - I spoke to the Australian Medical Students Association national conference in the middle of last year – and indeed the number one issue they raised was the “Intern Crisis”.

And at the time it was causing genuine angst for many students.

As you know – late last year we worked with Queensland and a range of other state governments to start to address the shortage of medical internship training places.

We now have the WA, the ACT, NT and Queensland governments funding an additional 32 internships in their public hospitals.

And we the federal government are funding an additional 84 intern places in 2013 – mainly in private hospitals.

All eligible Australian trained medical graduates have been offered an internship commencing in 2013. And overall the number of intern positions has increased 53 per cent since we came to office in 2007.

There is still some work to go – but we are aware of the concern and working towards a sustainable long term solution.

I am a big believer that government has a central role to play in the provision of healthcare.

I believe we have a responsibility to do so for all Australians – not just those in the city and not just those who can afford it.

I will not stand idly by and see Australia simply slip back to the level of health funding that we had in 2006.

I will not stand idly by and let Mr Abbott say that everything was fine when he was health minister – it wasn’t.

I will do what I have done with you today.

Make sure that you know the facts about what we have done for health reform.

It is not a perfect record.

But the figures demonstrate it is a record light yers ahead on our predecessors and a state Liberal National Party whose three part strategy for the future is cut, cut, cut.

Where we have invested and what we have prioritised and – as in the case of organ donation – how it is making a real difference.

Thank you for having me to speak to you today and thank you for the choice you have made to enter the medical profession.


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