THE HON SUSSAN LEY MP
Minister for Health
Minister for Aged Care
Minister for Sport

TRANSCRIPT

Interview on 936 ABC Hobart with Leon Compton
06 September 2016

Interview on 936 ABC Hobart with Leon ComptonLeon Compton:

The Federal Health Minister and the Minister for Ageing is in Tasmania at the moment for her visit since the federal election. She’s in town for, amongst other things, an enormous aged care conference that’s on tomorrow that we’ll be broadcasting from live. If you’re heading down there it will be good to see you there. She joined us in the studio a little earlier this morning. I started by asking if she was planning to go and visit the political gravestones of Brett Whiteley, Andrew Nikolic, and Eric Hitchinson, who lost their seats in Bass and Braddon and Lyons at the last election because many say that their epitaph reads, didn’t address Tasmanians concerns about health. Okay, that wasn’t my first question to her, my first question was this, if the consensus in Tasmania is that your treatment of health, as a government, played a significant role in the wipe out of seats here, do you now accept that as fact? Have a listen.

[Excerpt]

Sussan Ley: I’m not sure whether every Tasmanian would agree that health was the number one issue, but I know that every Tasmanian is concerned about health and the contact that I’ve had with this state over the last few years has given me an understanding of the needs here and a determination, as we move into this term of government, to make sure that our substantial Medicare funding, mental health funding, funding to address ice, drugs, and alcohol, all lands in the best place for consumers and patients. I thinks that’s important.

Lots of people talk about the election and you, Leon, have talked about the reasons why we may have done well or badly, I’ve listened to feedback. I understand that health is vital. But I do want to reassure Tasmanians that under this government, $40 million more in Medicare funding will be provided every year than under Labor. And I think that underscores the fact that we’re investing, not retreating.

Leon Compton: The reality though, is the feeling in the last election was, that you just weren’t addressing people’s concerns about health. Do you acknowledge that reality? Are you saying now that you’ve got, you’ve marked yourselves with need to do better?

Sussan Ley: Well as I said to Bill Shorten the other day in Parliament, he was not able to put his hand on his heart, on The 7:30 Report and say that this government was privatising or had plans to privatise Medicare. Now, what that tells me is that he knows it was an evil scare campaign. I know it was, and all of my colleagues in Northern Tasmania who have lost their seats know it was. Nevertheless, they face that fight every day at the pre-poll leading up to elections. So I’m sorry that the people of Tasmania were misled by Bill Shorten and I can reassure them that we have the interests of Medicare and, most importantly, their own health interests very much at heart.

Leon Compton: What happened during the election campaign? I mean it’s a battle that you chose not to fight. Your opponents were raising what you’d call a Mediscare campaign and yet you were largely invisible, certainly in Tasmania through the course of the campaign. Eric Abetz says he was calling Canberra and saying, this is a massive issue here, and yet the government chose to fight on other battle fields. What happened?

Sussan Ley: Well I don’t want to unpick what happened during the campaign. In fact, it seems quite some time ago to me because that official review and recommendations will come and we know we are setting that up as a Liberal Party to make sure that we did everything that we needed to do, and if there were lessons to be learnt then we learnt them. Now I’m not suggesting that any campaign is perfect or that there weren’t things that we could have done …

Leon Compton: [Interrupts] Were you side lined on health minister during the election campaign?

Sussan Ley: No I wasn’t and if anyone would care, look at my Twitter feed, they’ll see where I was. I was very much out, on the ground – appreciate that it wasn’t necessarily in Tasmania – but I was very much out on the ground, talking grass roots health with people wherever I went and the lessons of the campaign will be learned and I accept that also.

Leon Compton: But you would have been hearing on the ground, during the campaign, that health was a problem in Tasmania as an issue. Did you hear that?

Sussan Ley: Well I heard that lots of things were issues in Tasmania. Actually, I also heard that jobs were an issue in Tasmania, as they are across the country. And as Minister for Health concerned about the ice epidemic, I heard a lot about that, and that’s one of the reasons and one of things that I’m going to look at today, to make sure that we have the best possible drug and alcohol and ice treatment for those who’ve lost their way, particularly young people. I know that the proportion of young people that doesn’t – that don’t have a job, particularly in Northern Tasmania, is high and we want to make sure that our policies around growth, economic development, and of course tourism, which is a great industry for Tasmania, work well. So I’ll be taking a lot of these soundings back to the next cabinet meeting, but number one, I’m here today to talk about – with the community and those who are coming here for an important aged care conference about the future of health and the future of aged care.

Leon Compton: The Australian newspaper is quoting a report that you have commissioned into the operation of the Medicare Benefits Schedule this morning. It talks about the cost and waste of doctors being paid to offer repeat scripts to people, paid to provide sick certificates for people and other matters. How do you save money in the Medicare Benefit Schedule and also preserve the integrity of the system, what’s your approach?

Sussan Ley: We’re doing that already with what is a landmark reform, Healthcare Homes. It’s been underway for over a year, it’s been developed by doctors, we’ve got an implementation group. Our Medicare system at the moment is built almost entirely on volume. So Medicare gets charged every time a transaction or an episode of care happens and while not wanting to take that away, what we need to recognise is that for those people with chronic and complex conditions, they need integrated care, wrap around care – the Healthcare Homes model will, in fact, pay doctors quarterly in bundled, blended payments, to look after those patients with chronic and complex conditions, to give them everything they need. Not just transactions, appointments between 9 and 5, but the dietician, the podiatrist, the psychologist, everyone there, everyone ready to look after them. And the purpose of this is to keep people out of hospital and, really, the purpose is to make them happier and healthier and out of hospital. So, we’re developing that. It’s really exciting, ’m doing it with doctors at the table, conveniently Leon, the RSCGP, the Royal Australian College of General Practitioners from Tasmania is in this building, I’m meeting them next and I’m consulting closely with them all the way through this reform.

Leon Compton: But [indistinct] just the raw numbers, the Medicare Benefit Schedule cost $21 billion a year, how much do you think you can save if you attack the low-hanging fruit if you like, things like people turning up at the doctor to get a sick certificate, how much saving do you think there is to be fair?

Sussan Ley: I’m not doing this exercise to make savings, I’m doing this exercise to reform the Medicare Benefit Schedule – that’s one reform, and to have better outcomes for patients, that’s the Health Care Homes. So I don’t want to see inefficiency in the health system and part of my job as Health Minister is to make sure that where we see inefficiency we reinvest it for the benefit of patients. So you’re quite right, if the Government is paying effectively too much for small appointments that aren’t necessarily adding to a person’s overall health, particularly if they have chronic conditions, then that money does need to be reinvested and it will be in Health Care Homes where- the main reason for, you know, the purpose here is to keep people out of hospital and to get their care better managed earlier on and to get them engaged in their care. They’ll still be able to see the doctor for sick certificates by the way, I mean we’re not suggesting that you won’t do that for your flu jab or your sick certificate. But if you’re in that group of people who are really quite unwell we need to take this different approach.

Leon Compton: On ABC local radio around Tasmania the Federal Health Minister is our guest this morning. Minister, in talking about doctors managing people’s care, last week on Mornings we learnt that when a GP identifies a category one problem with somebody that demands a bowel screening, a colonoscopy, in Tasmania that can take more than 12 months. We are told that doctors are terrified of the exaggerating but are really scared seeing a patient that has waited more than 12 months to get a colonoscopy with a category one level rating, how is that acceptable in 2016.

Sussan Ley: Leon, that’s not acceptable. I’m going to meet with doctors today. I’m catching up with Michael Ferguson, your Health Minister who’s a good mate of mine and I do want to say to Tasmanians we work closely and well together. So this is the first time I’ve heard what you’re saying. I’m not going to give you an off the cuff answer. What I am going to undertake to do is find out what is going on and how services can be improved to meet the needs of patients in that position.

Leon Compton: Let’s talk about the Mersey Hospital…

Sussan Ley: And just- before we get to that. I mean it may be an issue of the service itself being under resourced, not necessarily because of money but because of the ability to attract and retain specialists. So workforce is vital wherever you go in health and often I hear of gaps in services but when I trace them back there is a vacancy that can’t be filled, there are positions that don’t have occupants in them and so on, so we need to get the workforce right. I could spend another hour talking to you about that and I won’t, but it is vital because we can’t always get doctors to move to areas of need in Australia and we have to find ways to do that better.

Leon Compton: It’s a good Segway for my next question is which is about the Mersey Hospital in Northern Tasmania based just outside of Devonport. I’m sure the issues around certainly funding of it you would know well. It limps along on a two yearly funding cycle for a piece of infrastructure that is dearly loved by locals. The funding envelope for it runs out in less than a year from now. Will you commit to refunding the Mersey Hospital past June of next year?

Sussan Ley: We are going to make decisions about what happens with the Mersey post June 2017 and I will do that in consultation with Michael Ferguson and the people who use the Mersey Hospital. So the re-profiling of services for health in Tasmania has seen changes at Mersey. They’ve been I believe I would absolutely agree with Michael in the interests of Tasmanians in that region, we do need to work together to make sure that they have access to the services they need while recognising that the provision of public hospital services is core business for the Tasmanian Government.

Leon Compton: So what does that mean in terms of a hospital that is currently operating on a two year funding package of $148 million, I mean will you commit to that amount of money for the hospital for next year?

Sussan Ley: Leon, it means exactly what I said and it means that I can’t give you an answer for precisely what will take place in terms of the arrangement post that time because there are discussions to be had which I’m not going to pre-empt. There are discussions that I need to have with my colleagues in Canberra. There are discussions that Michael needs to have with his colleagues in Hobart and there are conclusions that we need to draw. So I always focus on the consumer. I always focus on the patient. Sometimes it’s easier to look at the provider and the provision of services and of course they are very close and very relevant, but my concern as is Michael’s will be the best possible services for the people of Tasmania. In this case Northern Tasmania.

Leon Compton: The existence of the service though is contingent on federal funding, you know how tight the health budget is and how great the level of need in Tasmania. If it doesn’t get funded by you it’s hard to imagine the state being able to find the money.

Sussan Ley: We have to have some discussions and as I said I’m not going to pre-empt what the conclusions might be. But I’m sure that while I’m here people will make passionate observations to me about their health services and I look forward to that. You know I’m not doing this job from my desk in Canberra, I’m making sure that I hear first-hand and while I’m not in Northern Tasmania at the moment I need to hear what Tasmanian’s think and what their needs are and I’m really looking forward to doing that today.

Leon Compton: One of the issues that you had in the federal election was that GPs were effectively campaigning against you in their surgeries Minister around Tasmania, particularly over the continued Medicare rebate freeze. The story in The Australian newspaper today seems to suggest that you might be amenable to lifting that freeze if money can be found in other places. Can you explain your thinking on that?

Sussan Ley: Well that’s a comment that was made in The Australian newspaper this morning…

Leon Compton: And straight out of your office.

Sussan Ley: …but the point- I need people to understand that the budget is the budget. The economic circumstances we face are what they are and savings that may be found in one area of the health system certainly can offset expenses in another area of the health system and vice versa, so we will have all of that in front of us as we make new health policy into the future. And I do understand that GPs are the centre of patient care and that’s why this morning I’m visiting a GP surgery. I’m spending time with GPs. But number one I’m talking to them about our Health Care Homes model because it is a new model of care and it is absolutely in the best interest of patients and I do want every step of the way to bring this back to patients. Interestingly that story in The Australian told us one thing Leon and that is that by the leader of the Opposition in Labor saying don’t touch Medicare, they’re actually out of step with public opinion, because what we know absolutely is that the public wants our Medicare system to adapt, to be flexible in order that it does exactly what you and I have been discussing; look after patients.

Now, Labor seems to think you set and forget and you add more money on the credit card, you are irresponsible about that spending and you don’t actually put patients at the centre because you don’t do one single reform and Labor in all the time I’ve been Health Minister, sure they’ve announced more money, they’ve thrown- that’s an easy thing to do in opposition especially when you can’t say where it’s coming from. Remember what you can’t pay for you can’t deliver…

Leon Compton: Minister…

Sussan Ley: They haven’t announced a single reform in health. We are a reforming government.

Leon Compton: Minister, I’m particularly interested in the short time we have left to understand what your view might be then to the Medicare rebate because doctors were telling us that it could threaten the existence of surgeries in poorer parts of Tasmania if the amount they receive for bulk billing continued to be frozen. Are you amenable to lifting that freeze?

Sussan Ley: I don’t make decisions that have to go through [indistinct] review committees and cabinet committees here on the ground, but I do take away the feedback I receive and I’m certainly happy to- and willing and want to talk to doctors, to visit their surgeries and to see what they’re experiencing. Yes I took the feedback during the campaign and I’m sure I’ll take plenty more today. My point is I’m listening, I’m understanding and I’m willing to fight for a health system that looks after patients and that’s what I do every day.

Leon Compton: One of the interesting features of talkback on this station is raising continued rises in health care premiums. You and I have spoken about that a number of times. This year they went up 5.6 per cent on average. For someone on a pension or a low income who feels like they desperately need their private health, it can’t continue to rise at double inflation on into the future as it has been over the past number of years. So whet’s going to happen in 2017 with private health insurance cost?

Sussan Ley: I found the same thing Leon, that’s why I did a survey, 40,000 people answered my online survey and they all said exactly what you’ve told me. That’s why before the election we put a group together which will continue now which is broad across the sector includes the device manufacturers, the private health insurers, the private hospitals, consumers, doctors to work out how we can take pressures off the system. During the campaign I announced more transparent products and less regulation. That takes cost out. A gold, silver, bronze standard product. Because believe it or not next to cost and affordability and concerns about visibility, what does my policy give me, how do I know what I’m covered for, where are these gaps going to come up and bite me? So we’ve started well and truly down the road to that, and we also know that we have to do reform in the area of prosthesis. These are the devices that- for example hips and joints that you have inserted during operation. The private hospital system pays sometimes 40 per cent more, in fact some times a lot more than that for these devices than the public system, so we have to work out how to be again as efficient as possible for the consumer.

Leon Compton: Minister, can that lead to insurance premium rises that mirror inflation or less over time?

Sussan Ley: Well it needs to lead to lower premium increases and while the cost of health continues to go up at faster than the rate of inflation, this will be a challenge. And the reason why health costs are going up at the rate they are, isn’t just the ageing population, it’s technology, it’s consumers demanding better technological solutions to health which is terrific but it’s also expensive.

Leon Compton: So there we are. Thank you for coming in. Health Minister Sussan Ley on 936 ABC Hobart, ABC Northern Tasmania.