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Labor will reform Medicare to save our world-class public health system

By Julia Gillard - posted Monday, 3 May 2004


If we are ever to be serious about the prevention of illness, then ensuring a regular pattern of appropriate health checks and health advice provision is vital. But in today’s world, too many people do not have a nominated general practitioner who looks after their health.

This loss of connection between patients and primary care providers has been greatly exacerbated by the bulk-billing crisis and the shortage of general practitioners.

We could set a goal, to be achieved over time, that every person in Australia is registered with a primary health care service. Such a service could be a local private general practice or a community health centre or clinics associated with a hospital or Indigenous health services. This way, patients will receive timely reminders about attending for appropriate health checks and follow-ups.

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(b) Responding to the Real Burden of Disease – Mental Health

Increasingly, the burden of disease in modern Australia lies in chronic conditions. As part of developing quality relationships between patients and primary care providers, we must develop models of care for people with chronic illnesses.

Beyond that challenge, we need to make a far better attempt to deal with the burden of mental illness in our society.

Every year some 20 per cent of the population experiences a mental-health problem and three per cent of adults have a serious mental illness such as a psychotic disorder. Currently, only 38 per cent of those with a mental health problem access care, and that care is provided largely by GPs.

Doctors would like to see an expansion of the Better Outcomes for Mental Health Initiative. This program is really meeting a need. In the 18 months since it was initiated one in seven GPs nationally has signed up and in small country towns participation is as high as 40 per cent.

Unfortunately for those with mental illness and their families, mental health does not rate with the Howard government. Tony Abbott is so uninterested that he has relegated responsibility for mental health to his Parliamentary Secretary.

As Health Minister in a Latham Labor government, I will personally take responsibility for dealing with mental health as an important area of policy and ensuring that mental health needs are on the health reform agenda.

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(c) Unifying the Health System - Money

The debate about who is responsible for which parts of the health system is one that leaves people cold. They just want to know that when their elderly parents or children need a hospital bed or urgent attention from a GP that they can get it.

At the last federal election, Labor promised a Medicare Alliance, a system of better co-operation with the states on health, including establishing a Medicare Joint Account for each State and Territory to combine the State and Federal components of separately funded health programs.

This would effectively end destructive cost-shifting and mean that targetted programs could be introduced for individual regions. Layers of bureaucracy and cost-shifting could be deposited in the wastepaper basket of history.

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This is an edited version of a speech given to the National Press Club, Canberra on 21 April 2004. The full text is here.



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About the Author

Julia Gillard is Prime Minister of Australia.

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