Page 3319 - Week 09 - Wednesday, 20 August 2008
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MR SMYTH: Is there an Erindale clinic? That is the answer. They just do not keep their promises, and nobody trusts them.
MR STANHOPE (Ginninderra—Chief Minister, Treasurer, Minister for Business and Economic Development, Minister for Indigenous Affairs, Minister for the Environment, Water and Climate Change, Minister for the Arts) (11.47): I am pleased to be able to respond to this motion.
Mr Smyth: I’m sure you are.
MR STANHOPE: I am; it is remarkable. It is remarkable in the context of the way in which this particular policy proposal has been advanced and presented and it is remarkable as being what must be the quickest backflip on a policy position in the history of ACT self-government. With full fanfare yesterday morning, we had the Leader of the Opposition presenting his health policy, his vision—bulk-billing GP practices at three identified, specified places within the territory. That was on the Ross Solly program on the ABC at 9 o’clock on Tuesday morning. By the 6 o’clock WIN news, the policy had been changed completely, from a bulk-billing GP service to a fully funded ACT government service—in the space of nine hours.
Three bulk-billing—in other words, commonwealth funded—GP clinics at designated places within the ACT were to be provided and were to be the centrepiece or the latest instalment in the Liberal Party’s health policy for the purposes of this coming election. That was at 9 o’clock. That position persisted until about 12, until the Leader of the Opposition had digested advice that had been provided by the minister: “That’s not exactly consistent with the Health Insurance Act. Have you got commonwealth approval to open bulk-billing GP clinics in the ACT?” If you do not have commonwealth approval to open a bulk-billing GP clinic then to open a bulk-billing GP clinic would be inconsistent with the Health Insurance Act and you would not be able to pursue a bulk-billing health clinic. You cannot promise it if you do not have that approval. The commonwealth does not give that approval. It has never given it to a state or territory government and there is no reason to believe it will now begin to give that sort of approval to a state or territory government.
We never promised a bulk-billing GP after-hours service, because we were aware of the way in which the legislation operates and the basis on which commonwealth payments are made. State and territory governments have been representing, perhaps forever but certainly for the last seven years, for a change in the nature of commonwealth-state-territory relations in relation to responsibility for the funding of public health. It is a constant issue in the consultations between the commonwealth and the states—and always, during the years of a Liberal federal government, a case that fell on deaf ears.
It is at the heart of the issue about cost shifting and the blame game that has been a feature of commonwealth-state relations. The commonwealth has specific responsibilities in relation to the provision of health care. The constitutional positions, the agreed positions, in relation to a division of responsibility are quite clear. Under those arrangements, the states and territories are responsible for hospital care, mental health services, cancer services, aged care and rehabilitation services, early
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