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Now, if pigs would fly

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When you glance at this column this morning you may be looking for something to take your mind off the budget to be brought down this evening – a distracting word-picture about the crocuses whose delayed but recent arrival in New England this year signals the end of an especially deep and long winter.

Well, sorry, for as Nanki-poo said in The Mikado, “The flowers that bloom in the spring, / Tra la, / Have nothing to do with the case.”  The best I can do is to offer you my budget. Here it is.

“Madam Speaker, in presenting the Budget this year, I wish to begin by affirming the commitment of this Government to the support and growth of two of our central national services, health and education.

“Contrary to the accusations of our armchair critics, this Government is determined to conserve the values that have made this country great, and to manifest that commitment in the way we fund health and education.

“Recent rumours have unsettled the community, and tonight I want to reassure you and them that we understand how important both health and education are for the expression of our deepest national values – values including humane concern for the less well off, of giving people at the margins of our community a hand up, and ensuring everyone – everyone – in our community that our health service is to be paid for by all, and be available to all, whenever and wherever they need it.  

“So I say to you, Madam Speaker, and to the community, there will be nothing in this Budget that will decrease access to necessary care for those not able to afford private care by choice. There will be no additional co-payments for items on the Medical Benefits Scheme, including visits to general practitioners. There will be no disruption to bulk billing. 

“We accept that the steady rise in health care costs needs to be addressed, and we will be proposing major reviews of the efficiency of our services. We will not be moving to establish Medicare only as a safety net. We will do nothing further to make superior quality care available only to those who can afford it privately.  And, because we will retain the concept of universal contribution to health care, we will also maintain universal access to it – of all Australians – and not deny wealthier Australians access to it, especially if they need it for catastrophic illness or major surgery. 

“However, Madam Speaker, we accept that our overall Budget situation needs action in relation to the rate of increase in health spending. I have mentioned already our search for efficiency, and so we will be asking the states and territories to join with us, and our partners in the private sector, to determine a way forward in achieving efficiency targets that we will agree upon. We will be consulting with the specialist medical colleges to discuss ways in which useless treatment can be removed from the register of services paid for by Medicare. We will be discussing monopolies with specialty services. We will be examining pharmaceutical pricing.

“Madam Speaker there are two health service arrangements that I believe we need to consider critically, and they are the Australian National Preventive Health Agency and Medicare Locals.  

“The disease challenges we face as a nation make a strong claim for the enhancement of both these organisational entities. We need strong leadership to take us out of the epidemics of obesity, diabetes and heart disease, and prevention must provide that leadership. We need to see evidence of a strong strategic intention in the next year from the Agency.  

“Medicare Locals are aggregates of general practitioners and other community health workers that, in theory, could provide a critical element in the long-term care of people with chronic illnesses who, by default at present, too often end up in hospital. The name itself does not help these entities to function, and they will be rebranded and their mission clarified over the next 12 months. 

“Madam Speaker, these are my preliminary comments about health and I shall speak later about details. And now I turn to education….”

Feeling better? Good! Stand tall and face the day.