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Michael Wooldridge, Federal Health Minister
August 6, 2000
Reporter : Laurie Oakes

When Kim Beazley unveiled Labor's plan to cut the queues in public hospitals by setting up after-hours clinics for late night emergencies the reaction of Federal Health Minister Michael Wooldridge was dismissive.  The same idea, he says, is already being trialled in Perth.

He was more supportive of the Prime Minister's push to bolster the traditional family by barring single women and lesbians from having babies through in vitro fertilisation.  And he went further than Howard, warning doctors not to bill Medicare for IVF treatment for fertile single women, which he considers elective surgery.

Dr Wooldridge is in our Melbourne studio with Sunday's political editor, Laurie Oakes.


LAURIE OAKES -- REPORTER:  Dr Wooldridge, welcome to Sunday.


REPORTER:  It's often said that health is a Labor Party issue.  Has Kim Beazley succeeded in getting onto his agenda now with the emphasis on health policy at last week's ALP conference?

WOOLDRIDGE:  I don't believe so, Laurie, because there's really nothing new here.  There's a lot of fanfare.  There's a lot of smoke and mirrors, but all they've done is taken some policies that are already in development.  On some issues, like information technology, they've just lifted completely what we're doing and tried to pass it off as their own.  They really haven't put in the hard work. 

And there's a lot of things that are missing - there's nothing on mental health, nothing on immunisation, nothing on rural health, nothing for country people at all, nothing on indigenous health.

REPORTER:  But they didn't pretend this is their entire policy, they said there's plenty more to come, surely?

WOOLDRIDGE:  Well, in July last year they made a commitment that they would have detailed policies on all these areas that they'd be consulting over the next nine months, and they just haven't turned up with them.  They haven't done the work.

REPORTER:  I think they said they'd have them ready, they didn't say they'd release them, did they?

WOOLDRIDGE:  Well, there's no evidence that they're ready.  If we go by the policies that have already been released, they're certainly not ready.  They're a grab bag of things put together at very short notice.

And what's really important is what's not there.  For example, on the thirty per cent rebate Labor is refusing to rule out means testing.  Now, that would be a disaster.  They never wanted the thirty per cent rebate, they didn't invent the thirty per cent rebate.  They didn't support the thirty per cent rebate, and if they roll it back it's going to seriously disadvantage the eight million Australians with private health insurance.

REPORTER:  Do you think they did leave that open?  For example, Kim Beazley said, referring to the rebate, we won't walk back from that.  He said, we've got our criticisms of it whether or not it's good public policy, but the consequences of dealing with it in any other way than just simply leaving it there would be potentially quite severe.  I mean, that seems pretty clear, doesn't it?

WOOLDRIDGE:  Just an hour and fifteen minutes ago the Labor shadow spokesperson on health was given two opportunities to rule out means testing the thirty per cent rebate.  She pointedly refused to do so on both occasions.  They never wanted it, they didn't support it, and if they do means test it, if they do fiddle with it, if they do roll it back it will be a disaster.  It's been four-and-a-half years' hard work to fix this, Labor could muck it up very quickly.

REPORTER:  Well, we saw a split between Jenny Macklin and Kim Beazley over whether Labor would block your IVF legislation in the senate.  Do you think there's another split between them on this?

WOOLDRIDGE:  Well, there are quite a few splits.  And I think it's because Kim Beazley gets pushed around by the left wing, and gets pushed around by special interest groups.  It's very hard for him to say what he actually believes.  On the thirty per cent rebate, we had the extraordinary thing of the New South Wales Labor Party ringing up Brian Harradine and asking him to support the legislation that Kim Beazley was opposing because the left had told him that's what they demanded.

REPORTER:  Now, if there was a means test imposed on this, how would that hurt the system?

WOOLDRIDGE:  Well, the sort of figures we've been talking about for a means test have been around fifty thousand dollars for a family.  It leads to great instability. When we've got lifetime health cover now, people would be moving in and out of eligibility for the rebate.  It would become very complex and very confusing.  We actually tried it ourself [sic] with the private health insurance incentives in 1997, and they didn't work.  It was only once we gave the full thirty per cent rebate to everyone, introduced lifetime health cover that we really have had the wonderful result that has fixed a problem that's been around for fifteen years.

REPORTER:  So, are you prepared to guarantee that no matter how expensive this gets the Coalition will not means test it?

WOOLDRIDGE:  I absolutely guarantee.  It's the centrepiece of what we've done in health care, and by getting more people in private health insurance we can do something to help the public hospitals.  Bob Carr knows this, Peter Beattie knows this, Graham Richardson knows this.  And I'm sure Kim Beazley does too, but the left wing of the Labor Party won't allow him to act on it.  It's like treating the symptom or treating the disease.  In health it's always better to treat the cause, and unless you do something for both public hospitals and for the private system you're never going to fix the system.

REPORTER:  Now, if you are right about the Labor Party's attitude to private health insurance, does that mean that health, in your view, is now a Coalition issue?

WOOLDRIDGE:  Well, the thirty per cent rebate is something that's enormously popular.  It's fixed a fifteen year problem.  It's been hard work and if Labor rolls back the thirty per cent rebate -- and they're refusing to rule that out as late ... as early as just an hour-and-a-half ago -- then, I think, they will be very savagely dealt with by the public.  The public does not want rollback.  They don't want rollback on the GST and they don't want rollback on health.

REPORTER:  But Mr Beazley certainly seems to be on a popular theme when he talks about the need to boost our public hospital system to boost public health, and his starting point is that John Howard has a legendary dislike, even hatred, of Medicare.  That's true, isn't it?

WOOLDRIDGE:  Well, you could take some sayings from the mid-1980s, if ...

REPORTER:  Well, a whole lot.  I mean, I'm going to ... what I'm going to do is take a scalpel to Medicare, he said last ... when he was Opposition Leader in 1987.  He said -- this is John Howard -- there'll  be many major reductions in health.  The Medicare system is a total disaster.  We will be proposing changes to Medicare that amount to its de facto dismantling. 

Now, Kim Beazley says that's already happening by stealth.

WOOLDRIDGE:  Well, that was thirteen years ago.  If you look at everything John Howard said in the last five years, he's in fact been very supportive and said we'll keep Medicare in its entirety.  And Medicare is in better shape today, Laurie, than when we came to government.  When I came to government, Kim Beazley's Medicare had allowed children to be un-immunised.  We rank sixty-eighth in the world and kids in Sydney were dying of measles. 

Kim Beazley's Medicare selled [sic] country people short.  Kim Beazley's Medicare wasn't providing services to Aboriginal Australians.  The Medicare that I look after not just funds doctors and pharmacy and hospitals, but it's also preventing illness; it's also better coordinating illness for older Australians; it's also got our immunisation rates up to one of the best of the world. 

So, Labor basks in some sort of self-congratulatory complacency.  The fact is there were a lot of problems that we inherited with Medicare and it's in a lot better shape today.

REPORTER:  Well, let's go through some of the Labor ideas.  The idea of a Medicare alliance between state and federal governments, in other words, an agreement to remove the artificial barriers that exist between federal and state programs to stop buck-passing and cost-shifting.  What's wrong with that?  It seems very sensible.

WOOLDRIDGE:  Well, if you pull funds like that, you can actually end up with six different Medicares -- one for each state.  That's the Canadian system.  I was in Ottawa just three weeks ago talking to the Canadian Health Minister, Allan Rock, and he, quite frankly, had more problems than I do.  It doesn't fix the problems where it's been tried overseas and Labor's very short on detail.  They say, for example, we're going to pull the funds, but we're going to leave existing entitlements to Medicare and pharmacy.  Well, it's in Medicare and pharmacy where the cost-shifting occurs, so their statement is internally inconsistent.

REPORTER:  But, I mean, how do you solve this problem of cost-shifting?  I've heard you complaining about it as well.  You've used it as an excuse plenty of times when the federal government's accused of not doing the right thing by public hospitals.  Surely something has to be done?

WOOLDRIDGE:  Well, we are solving it.  We're doing it slowly.  In Victoria, for example, the Commonwealth has just recently agreed to take over all out-patient and discharge pharmacy.  Now, that's been a big breakthrough.  We've got the same offer on the table to all other states and territories.  In emergency departments, we've [sic]  having discussions about what we call category four and five patients -- the ones who aren't emergency patients -- being treated in the Medicare system.  These things evolve and these things will happen. 

Labor has just picked up on an idea and hasn't put any detailed work behind.

REPORTER:  Well, there's a fair bit of work behind it, a fair bit of detail, including increasing public spending on the public health system over ten years in real terms.

WOOLDRIDGE:  Mm.  Well ...

REPORTER:  Now, will your government do that?

WOOLDRIDGE:  Well, we have.  In the last ten years ...

REPORTER:  Well, let's look at the next ten years.

WOOLDRIDGE:  No.  But, well, let's do it both ways.

REPORTER:  All right.

WOOLDRIDGE:  In the last ten years, health has gone up forty-two per cent in real terms, and in the next ten years, I believe it'll go up by a similar amount.

REPORTER:  But a large swag of your increased expenditure is on that Medicare rebate you're talking about.  It's not on public hospitals.

WOOLDRIDGE:  Oh, well, let's take public hospitals then.  In the last year of Labor -- 1995/96 -- the Commonwealth spent four-point-seven-billion on public hospitals.  This year we're spending six-point-three-billion on public hospitals.  Now, that's an increase of one-point-six-billion dollars in less than five years. 

That sort of increase never happened under Labor.  Take ...

REPORTER:  Well, I mean, it seems you can prove anything by statistics.  Kim Beazley says that your government cut eight hundred million dollars out of the public hospital system, increased patient charges under the Pharmaceutical Benefits Scheme by five hundred million dollars, and abolished the four hundred million dollar Commonwealth Dental Scheme for pensioners.

WOOLDRIDGE:  Well, let me take them one by one, and I'll go backwards. The Commonwealth Dental Scheme was a four year program that came to an end.  We never gave a commitment to keep it on beyond four years.  Labor never did, either.

REPORTER:  But pensioners didn't stop having dental problems after four years, Dr Wooldridge.

WOOLDRIDGE:  No.  In 1993, when it was announced, Paul Keating announced it as a program defined in time to help the states with their waiting lists - and this is a state wait... state responsibility.  With pharmacy, let me give you ... in 1995, the amount of money we were spending on pharmacy was two-point-three-billion.  This year it's three-point-eight-billion.  That's gone up one-third. 

Now, the so-called cut that Kim Beazley talks about is, in fact, the therapeutic group premiums, a system whereby we get better prices for the pharmaceutical companies.  So, he's being quite deceptive by pretending that better purchasing from the pharmaceutical companies is in fact a cut, when we've spent one-third more on the PBS than he did. 

And, with hospitals, this so-called eight hundred million dollar cut is similarly deceptive.  The states, in 1996, made a contribution to fix Kim Beazley's ten billion dollar black hole.  They did that from their general revenue.  Labor has taken that amount of money, said a third of it's a cut to hospitals, multiplied it by four and then rounded it up to the nearest hundred billion.  That is a complete deception and Labor will not get away with it.

REPORTER:  Labor says it will reinstate the pensioner dental scheme.  Will you?

WOOLDRIDGE:  Oh, well, they promised that in 1998.  We won't, because we think that's a state responsibility.  We think that's something that the states should take the responsibility for and some states, like Queensland, are getting on with the job and doing it well.v REPORTER:  Now, what about Medicare after hours?  The idea of twenty-four hour clinics and a helpline staffed by nurses - good ideas?

WOOLDRIDGE:  Oh, well, in some cases it can be a very good idea, but it's not quite that easy.  It's a bit more complex.  We have five trials running today - in Maitland, the Grampians in Victoria, central Sydney, Tasmania and Perth - looking at different ways of doing this, finding what's acceptable to the public and what's acceptable to the doctors. 

In the Maitland scheme, for example, which I understand the Labor Party visited and they've just copied this in their policy, we have a twenty-four hour helpline.  We have, actually, a car that will go and pick you up and take you to the hospital if you like; we've got a GP surgery operating out of the Maitland Hospital. 

This trial will be finished by the middle of next year, when it'll be properly evaluated.  We'll see how it's acceptable to the public, how it's acceptable to the doctors and then look at rolling it out further.  But Labor really hasn't done the homework here, they've picked one idea that we're already well down the track on and tried to paint it as their own.

REPORTER:  Okay.  We're almost running out of time, but let's look at the government's little game of wedge politics, as some people see it - the matter of IVF treatment for single women and lesbians.  Now, that's the sort of thing a lot of people would expect, I guess, from John Howard.  But it's damaged your small l liberal moderate image, hasn't it?

WOOLDRIDGE:  Well, it's not a game, Laurie.  The cabinet took the view - and I agree with that - that provision of fertility services is not just another good and service.  You're creating life and if you have rights of a child and rights of a mother, we felt the rights of the child should prevail.

REPORTER:  But we had the headline in The Age yesterday, the Health Minister compares IVF for lesbians to a facelift.  I mean, you're being portrayed in a pretty unfavourable way over this.

WOOLDRIDGE:  Oh, yes, some of the left-wing press wishes to do that.  That came off an AAP story.  AAP removed that story because it was inaccurate.  The Age obviously chose not to remove it.  I never did that - on the issue of funding, nothing's changed at all.  Nothing in fact's changed in the last fifteen years, it's still the same funding arrangements ...

REPORTER:  But ...

WOOLDRIDGE:  ... under the Medicare that was introduced by Neal Blewett.

REPORTER:  But you have threatened doctors who provide Medicare rebates for IVF treatment - the so-called socially infertile women.  You've threatened them with prosecution, haven't you?

WOOLDRIDGE:  I've made no threats at all.  I can't prosecute anybody.  I've got to tell you, in the last four-and-a-half years that sometimes I would have liked to.  The fact is, that's for the Health Insurance Commission and ... was anything like that to happen.  But I don't think that's the point, Laurie.  There's no change there.  That has happened under Labor, it's happened under us.

REPORTER:  Well, you ...

WOOLDRIDGE:  The real ...

REPORTER:  You say that, but the AMA vice president Trevor Mudge says that the idea of prosecuting these doctors is absurd, because the law makes no distinction about who is eligible for a rebate and who is not - that's his words.  Trevor Mudge says, so we would urge the federal government to clear up the law and introduce legislation and make sure there's no confusion.  Will you do that?

WOOLDRIDGE:  The AMA's a political body and you have to take their comments in a political vein.  The body who's responsible for professional standards in this area is the IVF Directors' Group and they have put out a public statement saying completely the opposite - that they back what the government's doing; that they don't think IVF should be available to gay and lesbian women; that it should be controlled under state law; and that what John Howard's doing is quite right and proper.

REPORTER:  But, if ... that doesn't say that Dr Mudge is wrong when he says that the law is confusing and should be cleared up.

WOOLDRIDGE:  Well, the IVF Directors' Group, the group responsible for professional standards in this area, put out a statement in May this year, and I think that clears that up perfectly.

REPORTER:  So, you ...

WOOLDRIDGE:  What you have ...

REPORTER:  So, you won't be taking the opportunity to clarify the law, when you move your amendments to the Sex Discrimination Act?

WOOLDRIDGE:  Well, I think the law's very clear and it has been clear for a long time.  What's not clear is the Federal Court has overruled the states and territories and we're putting a very simple proposition.  We think the children do have rights here, we don't think facility [sic] services are just any other service.

REPORTER:  Dr Wooldridge, we thank you.

WOOLDRIDGE:  Thanks, Laurie.


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