Page 3292 - Week 12 - Thursday, 19 November 1992
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discussed in detail the principles of Medicare, to ensure that all States and Territories could express their views and principles. Medicare is vital if we are to avoid a United States style of health system, where two classes of hospitals exist - one poorly equipped public system for the poor; and a well-furbished system for those who can pay.
The Commonwealth has introduced a Bill proposing that the principles of Medicare - choice of services, universality of services, and equity in service provisions - be followed in public hospitals and incorporated in complementary legislation in the States and in the Commonwealth. I agree with that approach. Choice of services means that an eligible person must be given the choice of receiving public hospital services, which might include in-patient, outpatient, emergency and day services, free of charge as a public patient. That will not apply under the Liberals.
Access to public hospital services is to be on the basis of clinical need, which means that it should not be influenced by a person's financial status or place of residence or by whether that person has health insurance. Equity in service provision means that States will ensure that eligible persons, regardless of their geographic location, are able to have reasonable access to public hospital facilities. It is also proposed that States commit themselves to making information available on the public hospital services eligible persons can expect to receive as public patients, and to making improvements in the efficiency, effectiveness and quality of hospital services provision. The Commonwealth proposes to make information available by progressing a patients' charter which would clarify exactly what public hospital patients can expect under Medicare.
The ACT Government supports the Medicare principles and the notion that legislation should be introduced in the Territory to complement Commonwealth legislation. In particular, we will need to protect the Territory's position under any proposal for intergovernment charging, because of the close interaction between the ACT and the surrounding region in health services provision. There are some areas of minor difference on the details of how the funding will operate, which we will be pursuing in negotiations with the Commonwealth to ensure that the Territory is not adversely affected. The Government has already independently set in train some of the measures now sought by the Commonwealth, such as the establishment of an independent complaints mechanism, which was announced in the budget this year.
All governments have recognised the very real difficulties in waiting lists for elective surgery. The Commonwealth has recognised the need to provide additional funds to all States to address this issue. Accordingly, it has proposed to fund further action by States to shorten their waiting lists in this and the next financial year and to set in place processes which are consistent between different jurisdictions to improve management of waiting lists. We are developing an integrated proposal on waiting lists which would do two things: Firstly, we would want to ensure that this funding is used to produce real reductions in the numbers of people on waiting lists, particularly in high need specialities. Secondly, we would want to ensure that effective processes are set in place so that we can properly manage waiting lists and count those patients on waiting lists accurately.
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