Page 943 - Week 04 - Tuesday, 30 March 1993
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Australian average rate. Unfortunately, the ACT daily rate could be as much as 25 per cent higher than the Australian average. So where will the balance come from? Will the Canberra taxpayer be subsidising interstate patients? Will this continuing drain on ACT funds lead to longer and longer waiting lists and fewer and fewer hospital beds?
Mr Berry has said that cross-border payment rates will be subject to agreement with New South Wales, and he rightly comments that if no agreement can be reached the Federal Government will step in. What he failed to tell us is that under those circumstances the ACT will, more than likely, get the Australian average rate per bed day, based, of course, on things like case-mix data and DRGs - information that the ACT still cannot provide. There are other areas of the new agreement that Mr Berry did not tell us about.
Mr Berry: Which other States can provide it?
MRS CARNELL: Queensland, New South Wales - do you want me to keep going?
Mr Cornwell: Do you know what she is talking about?
MRS CARNELL: No, he does not know. There are other areas of the new agreement that Mr Berry did not tell us the whole story about. Mr Berry neglected to highlight the fact that the amount of money that the ACT gets from the bonus pools will depend largely on how the other States perform. This means that, if New South Wales and Victorian public hospitals admit substantially more public patients, the amount of money available to the ACT and other States decreases.
When Mr Berry boasted that the ACT will be $21m better off in health, he also neglected to tell Canberrans that the Medicare agreement amounts to only some of the funding equation. The remaining money comes from the Commonwealth on the recommendation of the Commonwealth Grants Commission and from other sectors. Mr Berry neglected to mention that the Grants Commission has said that the ACT is $45m overfunded in health and that it will seek to reduce funding closer to the Australian averages over the next few years. So, Madam Speaker, the Minister should not be complacent on the basis of the extra money available from the Medicare agreement. There is still much to be done to address the inefficiencies in ACT Health.
I have already stressed that I am concerned that the Medicare principles and commitments do not contain a commitment to private health insurance for those - and I stress this - who choose to take it. I am also concerned about the manner in which these principles were dealt with in the Health Bill 1993. These principles and commitments under the Medicare agreement are required to be adopted by States and Territories. But this is the wording of clause 6, entitled "Legal effect":
Nothing in this Part is to be taken to create any legal rights not in existence before the enactment of this Part or to affect any legal rights in existence before that enactment or that would, but for this Part, have come into existence after that enactment.
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