04 May 2015

CHRIS HAMMER:Good morning to both of you. Now there is a suggestion today, Andrew Laming, that the Government will revisit and attempt to salvage the ALP e-health scheme and put more money into it in the Budget. Does that make sense to you?


ANDREW LAMING, MEMBER FOR BOWMAN: It does and before we get too critical of predecessors, this is one of the most complex areas of health policy and virtually every government in every country has made a mess of it. It is extraordinarily complex. There is a group called NEHTA, who are the experts in this area, my sense is that they have not succeeded. It is easy to point fingers and find wasted money but by stepping into this area Minister Ley takes on one of the most complex areas in health. This will require not just the electronic health records that we all know about; it's the actual authentication system under it called NASH that is in disarray with money being spent with IBM that failed and now we are going back to an original system. That was a big mistake in 2011, fixing NASH must come before using the electronic health record. Everyone supports that, secondly we need the record for the seriously unwell, complex chronic disease patients. It's no good sitting in shopping centres enrolling 20 year olds. We need to make sure the system begins with the cohort who needs it most.

HAMMER: So you say that this is a problem internationally and the former Minister Peter Dutton pointed the finger at Labor, is it time for both sides of politics to stop pointing the finger on this issue?

LAMING: No that's a [inaudible] response, you would expect from an opposition but in reality it is extraordinarily complex. We expect oppositions to point fingers, thats called scrutiny. But we need to know that this won't be a simple thing to fix. We shouldn't be over-promising here, it will take a long time, lots of money. The UK spent billions, most of which yielded nothing. It is a complex area, but in the end we are going to have to have a shared record every practitioner can find, we've got to authenticate who they are and what they are allowed to see. We've just got to try and do it as efficiently as possible and not farm out huge contracts to huge, multinational consulting companies who deliver on the letter of the document but in the end produce something that is of very little value to the country.

HAMMER: Stephen Jones, would you agree with Andrew Laming's analysis here?

STEPHEN JONES, SHADOW ASSISTANT MINISTER FOR HEALTH: Look I do. It's not unusual that you get a big initiative conceived by one government completed by another and the e-health record is one of those initiatives. Why does it matter? Because if we are going to put the majority of our emphasis in the health system around primary care, that is that first interface with your doctors and your allied health professionals, you want it to be as good as possible. You want to ensure that we aren't getting duplication. So particularly in these large medical centres, where someone might see a different doctor each time they go or they might move around a lot and go to a different doctor in a different suburb on each visit - we need to ensure that you are not getting doubling up. That the same blood tests aren't going to be ordered four or five times or x-rays aren't going to have to be completed or other medical imaging. There is lots of duplication, lots of waste and better client care can occur if we've got a joined up e-health system. That is why it matters. I welcome the fact that the Government has decided to get back on board with it. That is going to be a good thing for patients and it will save money over the long term.

HAMMER: Andrew Laming, Susan Ley said that she wants better healthcare for chronic diseases such as diabetes and I guess when it comes to the elderly. Can you have better care for chronic afflictions like that without an e-health system?

LAMING: It is very difficult to do but the new Primary Healthcare Networks, formerly Medicare Locals, were attempting to identify this cohort. I refer to it as the two per cent, the people that consume 40 per cent of the health resources and 60 per cent of hospital resources. We need to show that things work for those people who need it most. The great failure of previous electronic health records was that we tried to sell it to the entire nation and we wondered why we spent billions with very little in return. I again agree with the Minister here, focus on looking after those with complex chronic disease, show that it works, save some money and that becomes your starting point for expanding it. Don't be too ambitious and don't rush the project.

JONES: Look a point of difference on this one. Andrew seems to be saying that there is going to be an age threshold after which you are signed up on the e-health record. If I've got him wrong on this then I apologise but frankly young people become old people. The importance of us having a continuous record, of doctors having a continuous record, of somebody's health conditions over a lifetime - that is where you get better preventative care and that is where the primary healthcare system really kicks in. Eventually it stops people having to present to hospitals for things that can be dealt with in a doctor's surgery.

HAMMER: To clarify, are you talking about that Andrew Laming? A two-tier system or a comprehensive system?

LAMING: Look it's actually both. So you start with your chronic, complex disease patients - they can be as young as three months of age, it's got nothing to do with age, you expand the system from the sick out to those who need it in ten years time -

HAMMER: So a staggered introduction in other words?

LAMING: Yeah exactly and you stage it but what you don't want is a million young healthy athletes signed up because they were captured in Westfield Shopping Town and all of your complex, chronic disease patients with ethnic minorities who you can't reach not being on the system; that is what you don't want.

HAMMER: Okay now let's move on. There's a Productivity Commission report investigating the possibilities of selling the right to migrate to Australia. Stephen Jones what do you make of this suggestion?

JONES: Look I think it rubs against the Australian ethos of a fair go for all. Particularly where I come from, it's made up of people who have come to Australia with an empty suitcase and built a life and in many instances built wealth and livelihood for themselves but also other Australians on the back of their skills, their ingenuity and their effort. If we are saying no to those and that the way into Australia is if you can afford it you can buy a visa, I think that is the wrong message and I think it is the wrong way to go. It is against the Australian notion of a fair go for all.

HAMMER: But when migrants come to Australia, the Government spends a considerable amount of resources into settling them, English language classes and the like. Should they not bear some of the cost of that?

JONES: Overwhelmingly, and again I fall back to the experience in my electorate, where over one in four have come from another country, worked their entire life, contributed, paid taxes, built wealth and built a vibrant community, they have more than paid for the cost. If they were ten pound poms, than the cost of them coming to this country and the various schemes that they did. The other point I will make is this Chris, we already have a business migration scheme. If somebody has got millions of dollars in the bank there is already a mechanism for them to come to Australia and establish a business. But saying that the rich can come and everybody else but show their hand, is not the Australian way.

HAMMER: Andrew Laming what do you make of this report?

LAMING: Well Stephen has got me thoroughly confused. He wants a fair go for all but of course didn't shut down the wealthy businessman scheme. So the reality is we already have a blended scheme, a combination of looking for skills, family reunification and of course the humanitarian programme. I suspect that will stay, it might change. But in these highly contested categories, where already people are paying $30,000 to sit on a queue for eight years or $100,000 plus to be brought up the queue you already have the system working. It is the Productivity Commission, what I love about them is that they consider all options and I think in the end we will end up with something similar to what we have at the moment, with just some tweaking at the edges.

HAMMER: Do you think the Commission might be confusing what is good for the Government and the Budget bottom line with what is good for the society and what is good for the economy?

LAMING: Probably not that simple, because in the end and it is easy for Stephen and I to have these banal statements about wanting to look after the poor and hook more out of the rich, but in reality you've got a list of people. You don't know much about their attributes, you've got to work it out. Its like standing at a deli in Woollies, everyone has taken a ticket and they are all standing in the queue. In the end you can extract from those who can pay a fee, we do that with everyone it is a matter of how much.

JONES: We already have a business scheme and that is the point. If we want to attract millionaires to invest in this country there is criteria that they have to meet. We already have a scheme for that, what is the Government proposing to do here? Sell additional places which come from other parts of our migration programme, I certainly hope not.

HAMMER: Is there a problem, Andrew Laming, that if people come who are wealthy and can afford it, that they may not contribute as much to the productivity of the country? On the other hand you might get people coming from poor countries that, you know the entire village contributes, it beggars the people remaining in the country of origin to fund someone to come to Australia, than most of the money that they make goes to paying off government debt or sending remissions back to that country. It creates more problems than it is worth, doesn't it?

LAMING: Look, fabulous intellectual question but in a practical sense really not much use pondering it. We have got a blended scheme already; family reunification costs tens of thousands of dollars, particularly bringing in close elder family members. The system will probably stay like that but I'm just glad the Productivity Commission is considering all options. That is not the Government, it is the Productivity Commission.

HAMMER: Andrew Laming the Aged Pension. The Government attempted to bring costs under control off into future decades in the last Budget, raising the pension age to 70 and also changing the indexation of CPI alone - a measure that was calculated to be worth something like $23 billion over ten years. Now that got blocked in the Senate, does the Government really need to revisit this policy in the Budget? Does it need to refine it?

LAMING: N-O. We made it very clear over the last three months that this was a policy - indexation changes to the Aged Pension - that I didn't want to see proceeding. Personally and among a number of other Coalition backbenchers, not only great concern about that but also relief that Scott Morrison has mapped a new path. Clearly it is the right one, it has been well received and I would say we need to look at activity and participation requirements around those who have the larger amount of assets outside of their family home. We don't need to be nickle and diming the most needy by changing indexation. We don't need to go back to that formula, we know that that won't work. We can have a sustainable pension, it is already one of the most means-tested in the world. So we are set up to get this right, let's just play around the edges of those receiving part pensions who actually may not need it because they own hundreds of thousands of dollars outside of their family home. Most Australians would agree with it.

HAMMER: So what do you understand the features of the new scheme to be?

LAMING: Well, I'm saying that we're not going to be - I hope and I've worked very hard on this personally - re-indexing Aged Pensions, that has been moved away from. Because that hits every pensioner, we've moved more so to a system that looks at the edges of the pension system to see if people who have large amounts of assets outside of their home should be receiving part pensions. Most Australians would agree that if you are going to change pensions, that would be the area to do it.

HAMMER: So sorry I'm a bit confused here. Are you saying that pensions should be indexed as CPI alone or to average weekly earnings? Exactly what are you saying?

LAMING: [inaudible] remains exactly where it is, which is [inaudible]. And instead we look at those who are receiving part pensions who own large amounts of assets outside their family home and that is similar to the ACAS proposition and I'm hoping that the federal Government will head in that direction.

HAMMER: Stephen Jones, is that what you expect?

JONES: Oh look we are yet to see, even with Andrew's contribution, a clear understanding from the Government of what they are proposing to do with pensions. From what I understand Andrew is floating here, is changing the taper rates and that is the amount of your pension that cuts off depending on your own isolated income. Look the problem that the Government has in this area - first, they broke an election promise not to cut pensions but secondly they are looking at pensions as a closed box and not looking at retirement incomes as a whole. We announced some policy propositions three weeks ago which - unusually for an opposition - we invite the Government to steal. We invite the Government to take these up, because if you start looking at the absolute distortion that we have in the superannuation taxation arrangements and we start closing some loopholes down we can be saving $14 billion, which would go a long way towards helping the Government with its problem. You don't have to take the money out of the lowest end of the pensions, you can be looking at those very wealthy people, closing down some of those loopholes, $14 billion over a ten year period, significant savings if you look at retirement incomes as a whole. How does that work? If you are drawing a $75,000 or more out of your superannuation fund at pension phase than you will be paying more tax. Reversing the Peter Costello windfall, which was about saying that that income, $75,000 or more, is tax free. We are saying let's put a reasonable rate of tax on that. That is the most important part of the scheme, but also ensuring that we remove some of the other distortions at the top end. Look at retirement incomes as a whole and you don't get into this silly territory of hurting the worst off the hardest.

HAMMER: Okay gentleman, thanks for your time.