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Legislative Assembly for the ACT: 2003 Week 3 Hansard (13 March) . . Page.. 1044 ..



The model underpinning the agreements needs to better accommodate these changing models of care, to provide for better integration of care between general practitioners, community health care and the hospital sector. We need to provide services that meet the needs of older Canberrans, and indeed all older Australians, in responses to the key reform issues based on health care both in Canberra and across the country, including Aboriginal and Torres Strait Islander health. We need to improve access to elective surgery, work force, mental health issues and quality.

To deliver this, we need an Australian Health Care Agreement to provide flexibility and adequate funding. The lack of adequate funding is significantly affecting the ability of states and territories to provide health services. The AHCAs have not been indexed at levels sufficient to cover the increase in costs incurred by our public hospital systems.

Under the current agreements, the Commonwealth, states and territories appointed an independent arbiter to determine the indexation levels for the funding provided under the agreements. However, when the Commonwealth did not like the answer, they simply refused to abide by the independent umpire's decision, and set their own lower indexation level. This has cost the states and territories, including the ACT, millions of dollars under the current arrangements.

In the ACT, Mr Speaker, overall, the current AHCAs provide less money in real terms than the previous agreements did. However, over the same five-year period, the ACT government's own health expenditure has increased in real terms by an average of 5 per cent per annum. The Commonwealth must provide real-term increases under the next agreement, to simply keep track with the continuing increases in health costs.

As a minimum starting point, the new AHCAs must make up the indexation shortfall, and the new agreements must have indexation arrangements that reflect the growth in costs for the hospital system. This covers not only inflation but increasing costs arising from factors like new technology and the continuing ageing of our population.

The Commonwealth Minister for Health and Ageing, Senator Patterson, in granting substantial premium increases for private health insurers, has acknowledged that costs in health are growing at a rate well above inflation. All we are asking, Mr Speaker, as a territory-and indeed as states and territories-is that she agrees to give the public health system the same increases in funding she is prepared to give to the private system.

In addition to inadequate indexation, there are areas where states and territories are having to make up for the shortfalls in services that are the Commonwealth's responsibility. The first is in aged care. Residential aged care is the responsibility of the Commonwealth, and the Commonwealth simply does not fund enough places.

I note that Senator Patterson has said in the press that the Commonwealth has provided 26 per cent more aged care places over the last decade. What she does not say is that the target population for aged care services-people over 70-has increased by 90 per cent.

According to the Commonwealth's own target-setting process, it should be funding over 17,000 more residential aged care places across the country than are currently available. The shortfall in places means the residential care system is underfunded by at least

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