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Legislative Assembly for the ACT: 1996 Week 4 Hansard (16 April) . . Page.. 959 ..

MRS CARNELL (continuing):

I will also mention the negotiations currently under way between the ACT and the New South Wales Government about cross-border payments for the treatment of patients. Probably no area highlights the cost problems we face better than this. As you are all aware, the ACT is a net provider of services to New South Wales, with some 25 per cent of our hospital activity attributable to New South Wales patients. Under the Medicare agreement, we are negotiating with New South Wales this year for an increased payment to the ACT in recognition of our above average costs for treating patients. It would hardly surprise you to learn that New South Wales is resisting such a push and is, in fact, suggesting ways that it can reduce the flow of New South Wales patients to our services to avoid our higher costs.

Mr Whitecross: They choose to pay the VMOs more and New South Wales should have to pay for it.

MRS CARNELL: This may be good for us in budget terms, but it is hardly likely to lead to the best clinical practice. Mr Speaker, obviously those opposite do not care about best clinical practice. Again it demonstrates the need to push on with the reform program we have identified for health and community care to make our own system competitive on a national basis and to bring our costs down to appropriate national benchmarks.

In conclusion, Mr Speaker, in introducing this second Appropriation Bill, the Government is making an open and accountable statement to the community about the costs of health care and the changes that are needed. Certainly, it can be argued that we were elected with a clear mandate to tackle waste and inefficiency, duplication and overstaffing within the health portfolio. To date, support from some other members of the Assembly to enable the Government to come to grips with many of these challenges has been less than forthcoming, Mr Speaker. Yet it is imperative that we reduce our costs by becoming more efficient, while always ensuring that our services strive for the highest possible standards. We have developed strategies that will deliver efficiencies, that will address the health goals and targets that we have identified, and that will improve the financial performance of the department.

This current projected overrun is unacceptable to you, to this Government and to the Canberra community; but, as I have clearly outlined, the health budget is under extreme and serious pressure. Given our unique size and location, we have the potential in the ACT to deliver a model of care which is envied by other States and Territories, that is a model of health and community services for the rest of Australia; but to do that we must ensure, first, competent financial management and, second, that we are cost competitive with the rest of the nation. I leave the Opposition and the members of the crossbenches with this thought. For the cost to the ACT of treating two patients in our public hospital system, on average three people are treated in other States and Territories in similar sized hospitals. This has to change.

Mr Speaker, as I said earlier, this appropriation will not require the Government to undertake additional borrowings to cover the expenditure of $14.2m. However, I believe that the approach we have taken in seeking this second appropriation, and the strategies we are putting in place for the future, demonstrate the Government's openness and decisiveness in tackling this important subject. Mr Speaker, health budgets have overrun

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