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Campaign capers

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It has taken three weeks, but we have finally witnessed the first big bids in the health policy auction of the 2013 election campaign.

The major parties last week both played their big cards – and they were targeted at opposite ends of the health system spectrum.

Labor came out firing first and, in keeping with Kevin Rudd’s style in his first stint as PM, the focus was very much on public hospitals.

The Labor package for the week comprised a $357 million fund for hospital and medical treatment facilities, with Sydney’s Westmead Hospital topping the charts with $100 million towards its major redevelopment (the hospital needs at least $800 million); a $250 million Medical Research Innovation Fund ($125 million Government money); a Family Payment incentive to boost vaccination rates; $50 million for Medicare Locals to provide stroke care; a $15 million cancer care package for rural Australia; and changes to pharmaceutical pricing policy that will ultimately save $125 million on the price of medicines.

While the package appears big and bold, a lot of the funding and announcements have been released before or funding already existed in the Budget.

Nevertheless, it is a bold pitch.  But the missing link is primary care – more specifically general practice.

And that is where the Coalition policy presents a stark contrast.  The priority is primary care and general practice.  Hospitals hardly rate a mention.

By Tony Abbott’s own admission it is modest on spending, but it is all about better targeting of health spending.  The Opposition Leader said the Coalition would maintain the current system of health funding but the theme would be ‘maximising health services, minimising health bureaucracy’.

The Coalition policy responds directly to AMA lobbying in key areas.  The AMA has welcomed funding for GP infrastructure grants, 100 new intern places a year, a doubling of the practice incentive payment for teaching in general practice, and a welcome review of Medicare Locals.  There is also funding for bowel cancer screening and a diabetes strategy.

The Coalition policy ticked quite a few boxes in the AMA’s Key Health Issues document.

Meanwhile, the AMA has welcomed policy from The Greens to ban alcohol advertising in children’s television viewing times, restore MBS indexation, and the earlier pledge to establish an independent health panel to monitor asylum seeker health.

Given the enormous expectation in the electorate about health policy, we expect more health policy from all sides in the final two weeks of the campaign.  It would be wise for the major parties to fill the obvious gaps in their policies.

Here is a summary of the Labor announcements:

  • $100 million for the first stage of a comprehensive redevelopment of Westmead Hospital, the major hospital servicing Sydney’s western suburbs.
  • $12 million for construction of a medical research and education facility for the Westmead Millennium Institute which focuses on conditions including cancer, diabetes, cardiovascular disease, major infectious and immune diseases and liver, eye, kidney and psychiatric diseases.
  • $10 million for the Children’s Medical Research Institute (CMRI) Westmead redevelopment project, one of Australia’s leading medical research institutions. This will allow CMRI to expand its work, including a project to identify molecular components of an enzyme that 85 per cent of cancers depend on for their growth.
  • $6 million for a full Medicare license for the MRI machine at Mt Druitt Hospital giving patients in Sydney’s west faster diagnosis of medical conditions.
  •  $10 million for a new linear accelerator and mammogram machine at Nepean Hospital.
  • $22 million announced last week to build another stage of the vitally needed St George Hospital redevelopment that will provide an additional floor on top of the emergency department and a rebuilt vascular surgery unit.
  • $15 million to develop a new neonatal care unit and hospice facilities at the Flinders Medical Centre in South Australia.
  • $10 million for a new statewide multidisciplinary cancer care team in Western Australia, including oncologists and radiotherapists, which will be expected to provide patient care in regional centres such as Kalgoorlie and Geraldton.
  • $10 million for critical cancer treatment infrastructure at Royal Princess Alexandra, Royal Brisbane and Prince Charles Hospitals in Queensland, delivering a significant number of chemotherapy chairs.
  • $890,000 for a cancer care nurse coordinator and a dedicated Aboriginal and Torres Strait Island nurse coordinator for the Alan Walker Centre in Darwin.
  • $49 million for Tasmanian private, non-government and public health sectors which will support better access to palliative care services across the state.
  • $100 million announced last week towards a significant redevelopment project to modernise the Victorian Eye and Ear Hospital, which will allow it to better meet the need for surgery and to reduce outpatient waiting times.
  • $12 million announced last week towards the development of a new complex care unit at the Epworth Geelong Hospital, which will allow residents of Geelong and Western Victoria to receive first class health care close to their homes.
  • The $250 million McKeon research package.
  • Vaccination incentives.
  • $50 million Medicare Locals stroke care.
  • $15 million Rural cancer care package.

The Coalition promises that its Policy to Support Australia’s Health System will:

  • Deliver greater community involvement in the management and responsibility of local hospitals.
  • Restore the independence of the Pharmaceutical Benefits Advisory Committee (PBAC) and restore integrity to the Pharmaceutical Benefits Scheme listing process so that medicines can get to patients faster.
  • Provide the Health Minister with authority to list medicines recommended by the PBAC that do not cost more than $20 million in any of the first four years of its listing.
  • Bring forward the proposed roll-out of the National Bowel Cancer Screening Program.
  • Develop a new National Diabetes Strategy as well as provide $35 million to find a cure for Type One Diabetes.
  • Restore the Private Health Insurance Rebate as soon as we responsibly can.
  • Deliver a more efficient funding model for hospitals through activity-based funding.
  • Strengthen primary care by providing $52.5 million to expand existing general practices for teaching and supervision and invest $119 million to double the practice incentive payment for teaching in general practice.
  • Provide 500 additional nursing and allied health scholarships for students and health professionals in areas of need as well as $40 million for 400 medical internships.
  • Review the Medicare Locals structure to ensure that funding is being spent to support frontline services.

John Flannery