14 January 2008

Press Conference, Brisbane

Note

SUBJECTS: Health, Hospitals, Health Ministers Meeting, Health Funding, Interest Rates, HIH

TREASURER:

We've 16 politicians here today, so I am going to ask everyone to be brief. Nicola and I are going to say a few words and then we'll here from each of the states and I'll call them one by one. And then of course we're happy to take questions after that. But I think its pretty fair to say that today we had a historic break through on health funding. We agreed to stage one of a four year comprehensive plan worth $600 million to tackle head on elective surgery waiting lists. The really important thing about today is that we worked co-operatively and this is how we are going to do business from now on. In effect we put an end to the blame game and instead of head butting each other we have put our heads together, we've put our heads together in the national interest to work cooperatively for a better Australia. And the form of federal state relations goes to the heart, to the very core of creating a wealthier country of lifting our productivity, of expanding our productive capacity and we today dealt with a number of issues that go to the core of that challenge. But most immediately I think those 1000's of people out there that are on elective surgery waiting lists will certainly welcome this new era of cooperation to reduce those waiting lists by 25,000 and I'll ask Nicola in a minute to say something about that. But we also today had a discussion about reform of specific purpose payments and today for the first time in a long time that Commonwealth and the states had a constructive discussion about getting rid of waste and duplication when it comes to federal state financial arrangements. We agreed on reducing the number of specific purpose payments by 75 percent. Not the quantity of money but the number of them, because too much of that money has been wasted and soaked up by administration, we've got to get rid of that waste and duplication when it comes to the funding arrangements between the Commonwealth and the states. And we also talked today about the funding of indigenous affairs and getting a handle on where that funding is going across the state and Commonwealth levels of government. So they are a number of areas we talked about, we also had a general discussion today about the economy and the challenges ahead and how the Commonwealth and the states could work in a cooperative way to meet those challenges in the future. I'll hand over to Nicola to say a few words about health.

HEALTH MINISTER:

Thanks very much for that Wayne. Can I say thank you to my state and territory colleagues for working over the last period when many other people have been on holidays to make sure that we could announce today the first grant of our elective surgery waiting lists commitment. This is $150 million that is going to relieve 25,000 people around the country who have been waiting too long for their elective surgery. And this is a pretty important first step for the Commonwealth to be putting money into to assist the states when we know they have been under so much pressure in providing hospital services. We know they have had money ripped out of the system and this is the first step to us saying we will work with you to provide better services to the community. 25,000 people will be saying 'thank you' I think, to us collectively for putting this money on the table throughout the course of this year their surgery will be undertaken and we know that that has a huge impact on their lives and their family. We increased the money to $150 million as announced at COAG with the Treasurers and the Leaders before Christmas because the states had put bids to us for what they could do with this money and it was in excess of the $100 million we had originally scheduled we said we are happy to work with you to make sure we can deliver to the community the commitments in reducing waiting lists around the country. So in the communiqué today you'll see the distribution between the states and territories. You will notice that it is not strictly done on a population basis but we have tried to take careful account of population but we've also looked carefully at need and capacity and we have had much feedback and many of our discussions as well today about how we make sure that stage two of this elective surgery funding process where capital will be available or where money will be available for capital that will mean further elective procedures can be undertaken. We'll need to take account of the distribution that have been made today. So I'm sure that some of the state and territory ministers will be pleased to know and hear me say that because of course we still have a negotiation process to go through for those next stages. The most important thing about today is that we said we would end the blame and today we have started to do that. $150 million, 25,000 people, all of the state and territories working with the Commonwealth we can a better outcome to the community and it will have health benefits to the community. So thank you to state and territory ministers for work with us on this arrangement and look forward to the many detailed negotiations that we will have about stage 2 and stage 3 of this commitment.

TREASURER:

Ok, we might call on NSW first.

MICHAEL COSTA, NSW TREASURER:

Look, NSW welcomes today's historic meeting. It is refreshing to have a very different approach to the way do it with these important issues for not only tax payers in NSW but on a national level. Today's meeting did see some additional funding for health and the NSW Health Minister will be available to deal with that. What I want to focus on is the reform to specific purpose payments. We have been asking the Commonwealth to take this issue seriously and finally we have a federal government that has recognised that having bureaucratic layer on bureaucratic layer is not the way to deliver specific programs to front line services. Today's process is the beginning of the process to reform this area I think it will be welcomed. It will be seen as historically as one of the most significant changes to the way the federation operates. It ends over a decade of blame between the different tiers of government. We welcome cooperation and we believe this process particularly in relation to the reform of specific purpose payments will lead to a better outcome at the front and that's precisely what the tax payers expect.

REBA MEAGHER, NSW HEALTH MINISTER:

Well today represented an historic opportunity to achieve much greater cooperation between Commonwealth and state government and NSW is very pleased with the result. We have been awarded. $43.3 million of the $150 million. We had to make a very strong case that we wouldn't be disadvantaged for the reform that we've already undertaken in regard to our elective surgery waiting list. I am pleased to say that we have had a very good hearing from the Commonwealth and the money that we've been awarded today will go towards ensuring that we can maintain the advances that we have made. But it also signals very clearly that as we move forward in negotiations for the second branch in relation to capitation and the third branch in relation to performance based incentive payments. That will be proceeding and arguing for a population based share of the money. But today has been a great day and I think that its one the tax payers of NSW would be very happy to see. People made it very clear at the last federal election that they were sick of state and Commonwealth government fighting because nothing got done. Today we have seen all of that change and we've seen the Commonwealth take responsibility and make additional investment in an area where they haven't done that before, elective surgery. So there will be a great benefit to the elective surgery patients in NSW and I would like to congratulate the Commonwealth government for organising this meeting so quickly so that we can see the benefits of when they are putting money on the table.

TREASURER:

Victoria.

JOHN LENDERS, Vic TREASURER:

Well, Victoria also welcomes the initiative of the Commonwealth to move forward and negotiate with the states on how the best way forward is. The new Prime Minister told us all to roll up our sleeves and this meeting in mid January is the starting of that. Not only have we seen the Commonwealth put money on the table for health, which my colleague will speak of. But we have also seen the historic reform of specific purpose payments and the work happening on that. For those who are not familiar with them, about 90 per cent of all state budgets come from these agreements, there are 90 agreements. And by having a discussion on this and the best way forward on this and working together on it will actually put some of this money to work where it matters. Things in Victoria that matter to us in the future are things that infrastructure, public transport, [inaudible], roads. These are the things we would rather focus on, than historically on administrating 90 separate agreements with 90 per cent of our budget. So we see this as a great step forward, we welcome the collaboration with the Commonwealth, we are delighted to work with them because we are all elected for one purpose and that's to deliver services to our citizens.

DANIEL ANDREWS, Vic HEALTH MINISTER:

And as the Treasurer made clear, those services in terms of health, there are a few services that are more important to our growing Victorian community and the government we have invested strongly in each and every year of our term in office. Particularly in relation to doing more elective surgery, trying to cut down a total amount of time that Victorians that need surgery wait. What's really impressive about today and what's really pleasant for me as the health minister and I'm sure for the broader Victorian community. Is that at last we have a Commonwealth Government that's prepared to work with us, a Commonwealth government that's prepared to give us the funding and resources that we need in a true partnership to do more of that important work to bring down the total number of people in our state and indeed all the states who wait longer than the clinically appropriate time. So this is a really important step forward it builds on the work we did as the very first ministerial council of health ministers and minister Roxon down in Hobart late last year. This is an important step forward, our share is an important additional amount of money nearly 6000 Victorians will receive their elective surgery sooner than they otherwise would have because of the Commonwealth government and us, the Victorian government have been able to reach an agreement where an additional 34m will flow to us during the calendar year 2008. An important start and one that will be of direct benefit to almost 6000 Victorians.

TREASURER:

Thank you. Queensland.

ANDREW FRASER, Qld TREASURER:

Ah, thank you, we and Queensland joins the chorus of support for the work of the Commonwealth in flagging this work they are doing on the specific purpose payments. To give you a sense of the SPPs the top ten SPPs cover about 85 per cent of the funds that are provided under specific purpose payments. When you take account of that there are about 90 of them in existence, it gives you an indication of how urgent this work is. I think it is an important first step in reforming federal state financial relations and certainly one that comes with our full support and one I think that's been entered into in a renewed spirit of cooperation between the Commonwealth and the states. Why its important is that SPPs have blown up by topsy over the recent times. They have been there to deal with specific points, specific issues at a time and place, what we need are less time and place politics about this and more long term administration of funding to the state. These are funds that are dedicated to the front line and if you've got an overlay of too many agreements and an overlay of too much bureaucracy then they become self perpetuating and detract from everyone's effort in putting funds forward into front line service delivery. We are very pleased with the meeting and we are very pleased with the way in which everyone has signalled an intent to focus on the real game here and go to putting funds into front line service delivery and we believe that the result for health here in Queensland is also very welcome one which the Minister will detail.

STEPHEN ROBERTSON, Qld HEALTH MINISTER:

We certainly welcome our share of the $150 million that the Rudd Government has put on the table to tackle long wait elective surgery lists. Our portion of that will be around about $28 million which will fund some 4000 long wait procedures; these are people that are waiting longer than is clinically desirable for their elective surgery procedure across a range of specialties and that will make a very useful and very important contribution to bringing down our elective surgery waiting lists. I can only endorse what my Victorian counterpart said that this meeting today builds on the most productive meeting of health ministers that I've attended. Being the first one in Hobart last month and long may the maturity of discussions that we have now as health ministers both Commonwealth and state long may that continue. Because it can only benefit the people of Australia in coming up with sensible, rational health policy and health service delivery.

TREASURER:

South Australia

KEVIN FOLEY, SA TREASURER:

Thanks, Wayne. I will be brief. Can I just say that I have been coming to Treasurers' conferences now for six years, they were always forums of conflict and confrontation where Peter Costello was only interested in putting politics number one on the agenda. What we've had in 5 weeks of Labor, is that we've had cooperation, consultation and a serious attempt to move the nation forward when it comes to economic reform. Achieved in 5 weeks under the Rudd/Swan economic leadership what Peter Costello simply neither wanted to or was able to deal with as he was clearly in direct conflict with his own prime Minister, so what's encouraging for myself who have been to these meetings for six years is that we actually have a serious opportunity work together to reform this nation and ensure that not only is the blame game ended but we're serious about taking this economy forward in terms of economic reform. Labor has been the party of economic reform in this nation, we've got the opportunity now at a state and Commonwealth level now to ensure that we maintain that and to you Wayne and the Prime Minister and the Cabinet, our state as all states are demonstrated today are very serious about being part of that. There are a lot of hard decisions to be taken by the states and the Commonwealth but these meetings are now meetings of outcomes not meetings of petty politics.

JOHN HILL, SA HEALTH MINISTER:

Thanks, Treasurer. The point I'd like to make is that the cooperation we've had been terrific, but what's been truly outstanding that that's cooperation that's been backed up by extra funding and that's something we've been calling for, for a very long time. All the states have been under pressure from the Commonwealth under funding of health services and that's gone down over the time so having money put on the table to allow us to do more things is something we've desperately wanted for a very long time. SA is an extra $13.6 million which will mean 2,262 extra people will have services provided this year.

TREASURER:

Western Australia.

ERIC RIPPER, WA TREASURER:

Thanks, Wayne. We've got an unparallel opportunity in this country for significant reform of Federal-state relationships and today the Treasurer's have made a good start on elective surgery waiting times, on reform of Commonwealth Specific Purpose Payments and on analysing and reporting funding for indigenous services. If I can start first of all with elective surgery, the state of Western Australia welcomes $15.4 million for more 2,700 elective surgery procedures that are to be undertaken this calendar year. This will enable us to build on the work that we have already done as a state to reduce waiting times for elective surgery and it will be very welcomed by the more than 2,700 people who will benefit from this additional Commonwealth funding. WA has campaigned for a decade or more for reform of Commonwealth SPP now at last with federal Labor's approach we do have an opportunity for real reform in this area. We need to reduce waste and duplication and we need to focus more on the actual delivery of services. In short we need to focus not so much on what we each spend, but on what we together achieve. Cost effectiveness is important but what's valued by the people of the country is the effective delivery of the services. Others haven't commented so much on the funding of indigenous services, but that's an import area where if we have a better information base on what each level of government spends on providing services to indigenous people we have a better basis on which we can go forward with more effective programs for better outcomes. I think we all recognise that we need more effective programs, we need better outcomes for indigenous people, and this information building exercise is a first step. I must say I am very optimistic about the progress of federal state relationships as a result of the attitude adopted by Kevin Rudd and Wayne Swan. It's been a very productive Treasurers' meeting and I think all the states look forward to a substantial program of cooperative reform being implemented as a result of the new approach of the new Federal Government.

TREASURER:

Tassie.

MICHAEL AIRD, Tas TREASURER:

Well quite frankly, there was a breath of fresh air at today's meeting. It was something that in terms of the new era of Commonwealth-State Financial relationships, it was a very important meeting and I'd like to congratulate Wayne on the way he conducted the meeting in seeking our assistance in delivering joint outcomes. We have agreed that we are going to work together cooperatively and I'm sure that in the future that our relationship is going to build to achieve the right services that we want for our communities. In particularly the specific purpose payments, that reform is going to be significant. Getting rid of waste and duplication and achieving those targeted areas of assistance and obviously in terms of health the previous government short changed Tasmania by about $350 million in terms of health funding and it's a great thing for us to be here today where we can welcome the assistance of the Commonwealth Government to help our health system.

LARA GIDDINGS, Tas HEALTH MINISTER:

I must say on November the 24, I felt a huge sigh of relief that we had a Federal Labor government and that we could indeed end that blame game, and today's evidence of exactly that. We've had the government both, the Australian government level and the states committed to a public health system and I would like to personally thank both Nicola Roxon the Health Minister and the Treasurer Wayne Swan and the other states, because Tasmania out of this deal has done very, very well. We've gotten more than twice our populations share and that shows the commitment to a state like Tasmania where we have had under funding from the federal government for many years. We have taken some tough decisions in recent times and we have developed a very strong Tasmania health plan of which this elective surgery strategy initiative will be firmly a part of it. So I would like to thank my state colleagues, who've been able to stand by Tasmania as well as the federal Minister. I look forward to working with you on the elective surgery imitative and of course seeing many more Tasmanians' off our waiting list.

TREASURER:

ACT

JON STANHOPE, ACT TREASURER:

The ACT echoes the sentiments and comments of all the Treasurer's and Health Ministers of the day, it was truly a meeting with a difference, it was an occasion of genuine dialog, real decisions were taken and it was a meeting or meetings made in a very different spirit either myself or my Minister for Education, Kaye Gallagher who apologises she is detained feeding her baby at this very minute and isn't here for that very reason, but they were meetings of a very different order than any I have ever experienced in my time certainly in politics. I do congratulate the Treasurer and the Minister for Health for today's meeting. It really was a meeting with a difference. We have made significant progress on three areas of enormous importance, economic reform particularly through the SPP, one of the most pressing issues in relation to health and health care, mainly waiting times for elective surgery. We are genuinely appreciative of the significant addition to funding, money which yesterday we didn't have for elective surgery procedures. 250 Canberrans will be particularly grateful by the end of the year for services which would not have been provided this year. Similarly in relation to one of the most pressing issues facing our nation, namely the health status and other status of indigenous people is an issue that I am very pleased to see on a Treasury agenda. It's an issue that hasn't received the attention that it should have in the last decade. It is particularly pleasing to me as Chief Minister, Indigenous Affairs and Treasurer to see a meeting of treasurers this particular issue the importance it deserves. Congratulations, thank you Wayne and Nicola for today's meetings.

TREASURER:

Northern Territory.

DELIA PHOEBE, NT TREASURER:

Last, but by no means least. A refreshing new era in Territorian and Commonwealth relations, important steps forward today and you've heard an end to the blame game. We are working together with the Commonwealth to deliver much better services to Territorians, right across the territory, whether they are in our urban centres, our regional or importantly our remote centres. An exciting step forward with elective surgery waiting lists, which I'll leave our Health Minister to talk about. But certainly in terms of reforming the red tape, cutting the red tape that exists between Commonwealth and territory agreements, freeing up our public servants to work hard on delivering those important services to Territorians. A reduction in inefficiency a reduction in red tape and better outcomes for the dollar spent coming from the tax payer. Importantly also for the Territory though we're going to be part of in the future, a national framework that assess spending on indigenous services. The Territory already has its own Indigenous expenditure review which means that we know exactly what dollars are coming and being spent in delivering the services to indigenous Territorians. But only a small picture is shown in that review, we need to see what funding is coming from the Commonwealth and how that is being spent as well. We welcome the new national framework that we will work on to look at funding for indigenous services. I hope that will achieve quantum leaps forward in the living conditions of indigenous Territorians, and I really do welcome the commitment that the Commonwealth has and the work that will be undertaken by treasuries right across Australia to reach a better outcome in the lives of our families in the Territory.

BRUCE BURNS, NT HEALTH MINISTER:

As Northern Territory Health Minister I certainly welcome this $5.3 million grant from the Commonwealth to have an elective surgery blitz. It certainly builds on the blitz that we had last year and achieved a lot of success with. It certainly also recognises the special needs and challenges in delivering services within the Northern Territory, and as other speakers have said here today, this is really a historic meeting because it ushers in whole new era of cooperation between the Commonwealth, the States and the Territories and as someone who has been a health professional for a significant part of my life, I'd like to say that I think that most health professionals around Australia should really welcome this new era because many good people have been struggling for a long time against systems where resources haven't been available and reform was badly needed. What we have today between the Commonwealth the states and the territories is a commitment to follow through on reform, reform that's badly needed within our Australian health system and to support not only our health professionals but more importantly the men and women of Australia who rely on our health system for support. Thank you.

TREASURER:

Ok, questions?

JOURNALIST:

(inaudible)

TREASURER:

I'll get Nicola to run through that distribution.

HEALTH MINISTER:

You have, as I understand it, in front of you the communiqué so those sums are easy enough to do. What we made sure was that attention was paid to the population share, but also we acknowledged where there was the highest demand for particular states and territories had trouble with elective surgery waiting lists. But that we not penalise those states who have actually been able to achieve some decent outcomes. So it's a delicate balancing act to make sure those issues are taken account of. And what you'll see I think is a pretty good distribution, relatively close to the population, but not fixed on it, where we've made a slight adjustment if the states waiting lists haven't been that long, where we've taken into account that some states that are waiting for capital investment before they will be able to undertake further procedures. So I think those sums can be easily done by you, John. And it is clear that we have balanced all of those competing requirements to make sure we come to a good outcome for the whole country.

TREASURER:

I might also add that this is stage one of a four year program.

JOURNALIST:

[Inaudible] … are there states that this is their maximum elective surgery throughput?

HEALTH MINISTER:

Oh well I mean, there certainly are for example, I don't think the ACT will mind me using them for an example. They put a bid to us where they had received in terms of the $2.5 million to do 250 people, but if you can provide an extra amount of money for capital, we could do these additional procedures. Well this is stage one, certainly when we are talking about stage two, ACT will have a strong claim to some of the first money in that area, because they have received a small amount of money than some other populated with comparable size. So of course we have taken into account those issues, we don't intend to provide money if procedures can't be undertaken. And we wanted to make sure that states able to commit to the number of procedures, we want this to delivered to the community, we've put in place very stringent reporting requirement. Something that will also be privy to pretty extensive negotiation because we are very willing to contribute and work with the states help clear their waiting lists, but we also want to make sure that we are able, in return for the Commonwealth money, to keep a close track on what's being done. And obviously you'll see in the future a lot more of that sort of reporting and management to make sure that we are getting value for money but also to make sure that the state are very clear where the money is going to particular procedures.

JOURNALIST:

Mr Swan, what role did incentive payments play in the reform of the SPPs?

TREASURER:

Well we've agreed that there will be an incentive based approach built into our system, but the SPPs and the reduction in number itself is not contingent on incentive payments. There are two processes here, one is to simplify the SPPs, but the other one is to build a system that rewards behaviour through incentive payments on top of base level payments that are given to the states. And designing and constructing those incentive payments are a task before of this group over the next few months.

JOURNALIST:

Has there been an estimate made of how much will be saved or, freed up by that delivery system?

TREASURER:

No, we don't have an estimate of the total that is saved, but Ministers are confident there are savings there. All tiers of government will employ people for example whose major task is to track the individual components of all of the inputs. We don't believe that its necessary any longer, we believe that we can collapse a number of payments by at least 75 per cent and concentrate our valuation on outputs rather than on inputs.

JOURNALIST:

Mr Swan, if your going to collapse the number of SPPs by 75 per cent, Minister Andrew Fraser said that the top ten account for about 85 percent of the quantum, will that mean that a lot of small SPPs just disappear and if that's the case, can you give us any idea of what sort of areas that might cover?

TREASURER:

There are a multitude of small SPPs, small amounts of money across a range of policy areas, I can give you a list of them later on. So a large number of small SPPs will most certainly disappear. But discussing what area they go into, what the major categories will be is the task ahead of us. But I imagine we can get the number of SPPs down to around 20, possibly even fewer, that would certainly be our objective. And the number and the areas that we categorise will influence which ones go where.

JOURNALIST:

Nicola, you mentioned reporting positions for states to give back to you. If they don't match up to expectations, will you start to get tough now and then turn the money off?

HEALTH MINISTER:

Well look, absolutely, these payments the $150 million that we have identified is going to be paid to the states, we have said we'll provide this money and they have committed to undertaking a certain number of procedures. But we now have in place, with subject to some very minor negotiations that need to be had with a few officials, a reporting regime for elective surgery which will roll into our health care agreement negotiation which will be the baseline that's used for our incentive payment that is stage three of this program. We have made absolutely clear that this recording is for a purpose, its so that the public understand the performance of the state and territory and its also so we can make sure that we provide money in the future when we're talking about providing incentive payments that really are linked to performance. But this $150 million has been committed to, stage two is capital money which we will be starting a process of negotiation over soon, but these reporting requirements will provide the baseline when we introduce those incentive payments in stage three and that's going to be a really important part of how we do business in health in the future.

JOURNALIST:

Will that $150 million start flowing this month?

HEALTH MINISTER:

Yes, as soon as we sign the agreements with the states and territories $50 million of that will be on the table. We anticipate that that extra $100 million would be available from the 1st July. But if any of the states and territories have been able to spend that money and undertake the procedures earlier we will certainly be happy to look at providing the rest of the money earlier. It will be based on their performance in terms of that timing, but otherwise they will have their money provided to them by the start of the next financial year.

JOURNALIST:

Minister you spoke to the delegate [inaudible] calculations I guess in terms of distributing this month. Have you decided what formula you will use in terms of the capital funding. NSW staked a claim on population basis. Has the Commonwealth decided what its preferred formula will be?

HEALTH MINISTER:

Well, we understand that it is not just NSW but a number of the other States are keen to make sure that there is some relationship with population and there will be of course some strong negotiations, probably of those views will be contradictory that are expressed by the states and territories. We will work through with all of the states and territories the basis for that payment. I do think that it will loosely conform to the population base. But we need to make sure that in certain states and territories where a small investment of capital can have a significant change, then we need to consider those bids. We want to make this money, $150 million of capital money, have the best impact it possibly can. So we will be looking closely at the views put forward by the states and territories to make sure that we are going to get value for that money we are investing.

JOURNALIST:

Do you think that at the end of this four year period there will be a comparable quality of care across the states, or will we see some states perform better than others?

HEALTH MINISTER:

Well certainly, we would hope that this extra investment in the Commonwealth [inaudible] will enable there to be good service provision across the whole country. We know that we are going in to a range of negotiations with the states and territories over the service provision in Government. It is not just about elective surgery, and we would hope that our negotiations and investment will bring all of the states and territories up to a good strong national standard. But of course, because we are looking at incentive payments some of the states and territories that have reformed their systems will inevitably end up with more money through the incentive payments system.

JOURNALIST:

Ms Roxon, is this the first step on the road the road to the Commonwealth not having to take over the state hospital system?

HEALTH MINISTER:

Well look we have always made it clear from day one when Kevin and I announced our proposal and commitment to reform the health and hospital system in this country that we would want to work cooperatively with the states and territories to deliver better services to the community. And that is exactly what we have done today, 25,000 extra services to the community, and 25,000 extra people who will benefit from it. Of course, if we can continue to have fruitful negotiations and cooperative performance from the states and territories we won't go down that path. We have always said that our interest in taking over financial control of the hospital was only if we would not be able to achieve outcomes through a cooperative negotiation process. And I am very confident that if today is any sign that we will be able to work well for the benefit of all of the country and their health care needs.

JOURNALIST:

Mr Swan, can I ask what are the main gaps in knowledge on Indigenous spending and why is it on the Treasury agenda?

TREASURER:

Well, it is on the Treasury agenda because it is a significant area of social disadvantage and intergenerational poverty in this community which needs to be dealt with in the long term. And it is as much an economic issue as it is a social issue. Providing opportunity for all Australians lies at the very base of the objectives of this Government. And doing something about disadvantage wherever it is goes to the very core of our approach to social and economic policy. And of course this the area where people are seriously disadvantaged. There has been entrenched intergenerational poverty, social dislocation of the core of many of our communities. And we think it is about time Treasury has got involved. You will recall that I said at the very beginning of our election that we were ambitious to ensure that the Treasury got involved in all areas of policy, not just in the traditional area. Our Treasury should be as expert as education policy as they are in overall macroeconomic policy. And this reflects the increasing concern that this government has about intergenerational welfare dependents and social dissipation in Indigenous communities, and reflects our priority of working with the state, local government and then the voluntary sector to solve the problem in the long term.

JOURNALIST:

Mr Swan, what are the major areas and the gaps?

TREASURER:

Well I think there are significant gaps because what is always difficult to identify is the extent to which services are received, or not being received, by Indigenous people in mainstream areas. So we need to identify the extent to which they receive services be it in education or health, or do not, through mainstream services as opposed to those specific services used and exclusively delivered to Indigenous people. Of course, there is one other area as well. Alcohol rehabilitation was one such issue that we identified at the last COAG meeting. And we put forward some additional funding to the states in that area.

JOURNALIST:

Mr Swan, are you putting your goods and services providers on notice today?

TREASURER:

No we are not doing anything with it like that. We are trying to get a road map of where funding is coming from at every level.

JOURNALIST:

It now appears likely that this week Merryl Lynch and City Group are going to announce write downs of somewhere between 30 and 40 billion US. And it appears that this is going to be taken up by the Commonwealth funds from Saudi Arabia, Kuwait, Singapore and perhaps China. Are we approaching a time when governments around the world are going to have to get together and look at the way the international financial system is operating and whether we need some new sets of rules for the way the state-based sovereign wealth funds are entering into the financial system.

TREASURER:

Well, I acknowledge that the investments of sovereign wealth funds are an issue internationally and indeed those investments have been put on the agenda at a number of international meets. And there will be further discussions at such international meetings in the months and years ahead. But I am not going to say anymore than this, but the most important thing when we are looking at this area of foreign investment domestically is the transparency of the investment. We have a set of foreign investment guidelines which I am entrusted with which I must administer in the national interest, and that is what I will do.

JOURNALIST:

Has the inflationary data today that shows that the figures not good and yearly have not been good. Is an interest rate rise next month inevitable in your view?

TREASURER:

Well, I don't comment on decisions by the Reserve Bank. But the parting gift of the Liberals to the incoming Rudd Government was an elevated level of inflation at or above the Reserve Bank target band for the next 18 months. And we have said from day one that it has taken a long time for these inflationary pressures to build in the Australian economy and it will take us a significant amount of time to deal with them. But we began dealing with them on day one and the discussions that we have had today about economic reform in Federal State Relations goes to the core of putting forward an economic agenda which will deliver efficiency and will make our economy more productive. Nothing could be more important than the fight against inflation, than those objectives. And so, we are continuing to work away at a broad economic agenda which puts downward pressure on inflation and relieves the pressure on the Reserve Bank.

JOURNALIST:

So you will be able to apportion blame to the former Howard government for the next 18 months [inaudible]?

TREASURER:

It is simply a fact that the parting gift of the Liberal Party to the people of Australia was a elevated level of inflation at, or above, the Reserve Bank's target band. That's simply a fact. And Peter Costello's economic report card will not be complete until the Australian people see the December and March quarterly CPI figures.

JOURNALIST:

Ms Roxon, how do you see the $150 million that has been spent. Has there been enough [inaudible]?

HEALTH MINISTER:

Thank you, well we are confident that the money that has been provided to the states on the basis of [inaudible] is clearly achievable. We know that different states are going to use different mechanisms. Some are going to use the private sector, some are going to employ staff to do extra shifts. There is a range of different options. And one of the reasons that we have gone through this process of asking for bids first to form the basis of our negotiations was to ensure that the states and territories are confident that these are achievable numbers. Certainly, we know that long term there are a range of pressures on workforce that will need to be dealt with both in terms of education commitments that we make into the future. I am sure the work that the Health Reform Commission and others will need to deal with some decisions that will be made long term about ensuring that we have sustainable workforce for the growing demand in the community. I am very confident that this $150 million can be spent easily and well by the states to provide 25,278 prosthesis as committed to in the Communiqué.

JOURNALIST:

Are you confident that the Commonwealth is receiving accurate data on waiting lists, elective surgery through put and on waiting lists state by state? Are you confident with the information you are receiving?

HEALTH MINISTER:

Well, I think it is a little bit of a common misunderstanding really. The states do already provide either through the loan reporting mechanisms or to the Commonwealth quite a lot of information. What we are seeking to do here is to make sure that we are getting that in a consistent format. And to make sure that we are also having some quality measures such as readmissions, unplanned readmissions after 28 days. Because we want to make sure not just the procedures are being done, but they are being done in a safe way and are high quality. The states have agreed to this and I am sure they are fundamentally concerned about these issues as well. I think what we need to do in the health arena is to report more consistently, make sure the amount of information that is available is useful for the public to be able to make assessments about which procedures are being undertaken, and where how public money is being spent to provide services to them.

JOURNALIST:

You mentioned the Health Care Agreement [inaudible]?

HEALTH MINISTER:

Well, certainly in the separate health ministers' meeting we discuss a range of up coming issues and the Health Care Agreement was the top of the list and we have commenced informally our discussions about the Health Care Agreement. And we are hoping to have that agreement negotiated and signed by the 30th June. So there is no time to wait. And it is certainly an issue that we are going to give a lot of thought to in the meetings with the health ministers.

JOURNALIST:

Are you still looking at a shortened determined Agreement?

HEALTH MINISTER:

My expectation is that we will aim to have an agreement reached by the 30th June. There five year agreements ordinarily. That is our intention. We haven't commenced detailed discussions in any way. It may be that the states and territories will put something else to it. But that is certainly our intention to negotiate on that basis.

JOURNALIST:

Treasurer, do you think Ray Williams will be a productive member of society?

TREASURER:

Well, I think today the thousands of investors who lost substantial amounts of money in companies run by him would be angered by the fact that he has walked free today.

JOURNALIST:

What about you? Are you angry about it?

TREASURER:

Well, I think everybody will be angry about what occurred with HIH. Okay.

JOURNALIST:

One more question. In the UK the Prime Minister over there has floated the idea of an automatic organ donation register which has presumed consent. Is that something the Australian Government will consider?

HEALTH MINISTER:

Well, look it is not an option that we are considering at the moment. The issue is [inaudible] more generally that transplantation and organ donation was dealt with in the March meeting in Hobart. We are moving towards making sure that we have more national consistency. But I think those steps are more important to get right first. They will hopefully have some significant impact on improving the rate of donation transplantation. But we are not contemplating a measure such as that has been floated in the UK.

JOURNALIST:

What are the alternatives?

HEALTH MINISTER:

Well, I am here today to talk about elective surgery. I really don't want to enter into what is a very complex debate. So I think that the processes that we have gone through, this has been an issue for discussion for health ministers for a very long time. We needed to make sure that we get some national consistency. That was achieved at the last meeting, and more detail will be provided about that in the coming week. But we are not contemplating going down the path the UK has flagged. We will, of course, continue to look at ways that we can improve the rate of transplantation and organ donation. And I must say colleagues in a number of states have already raised this as an issue that long term we need to discuss. But we don't have on the agenda the proposals that have been announced in the UK.