Page 3467 - Week 12 - Wednesday, 18 September 1991
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While it would not be appropriate to pre-empt this process of community consultation, I think it would be useful to indicate the Government's initial thinking at this stage. The outcome of the community consultation will then be given detailed consideration as the Government develops its final position in the lead-up to the Special Premiers Conference, so that we can reach decisions on the basis of a full understanding of the needs of the community.
Against that background, the Government would, as a preliminary position in relation to SAAP, support moves to enhance the efficiency and effectiveness of the current program. This would recognise joint Commonwealth and State responsibilities, but with greater emphasis on agreed national objectives and strategic issues. Option 3 in the functional review report on SAAP sets out greater detail along these lines. The ACT would also support further work on defining program outcomes for SAAP in other than financial terms and, subject to acceptable national standards and maintenance of effort in terms of client outcomes, development of alternatives to current matching arrangements.
In relation to child-care, the ACT would, as a preliminary position, support the broadbanding of child-care programs, with minimal conditions to allow joint Commonwealth-State involvement in the development of national goals and performance outcomes, but to enable States to have a clearer responsibility for service delivery.
As for other reviews, the ACT's financial position will also be considered once related reports on tied grants and distribution of taxation powers have been considered. As I have said, Mr Temporary Deputy Speaker, we wish to hear the community's views on both the child-care and SAAP functional review reports in order to determine our final position on these reviews.
With respect to the functional reviews of health and aged care, there was general agreement at the joint meeting of Health and Social Welfare Ministers on the need for a national approach because of the significance of expenditure in this sector on macro-economic objectives and the need for global containment; the significance of these services as part of the social wage; and the problems of scale and viability for the provision of some high-level health specialties. It is also in the national interest to ensure that broadly the same levels of access to care at the same costs to the consumer are delivered in a similar way in all States and Territories, for equity reasons and to avoid inappropriate cross border flows.
The functional review on health and aged care identified between 30 and 40 separate Commonwealth and State programs, from hospital funding grants and the medical and pharmaceutical benefits programs to smaller specific purpose payment areas such as the Flying Doctor Service, aids and appliances, et cetera, amounting to something of the order of $24 billion worth of expenditure.
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