"The Federal Coalition wants to privatise public health care. Just like America."
NSW Nurses and Midwives' Association on Tuesday, August 13, 2013 in an advertisement on commercial TV networks
Does the Federal Coalition want to privatise public health care like in the US?
The union representing nurses and midwives in New South Wales has paid for television advertisements warning that the Coalition will privatise health care.
Featuring an American nurse named "Britta" who warns that she sees patients daily who cannot afford to pay their medical bills, the ads sound a stark warning of what Australians face next time they go to the hospital under the Coalition. "Just like America," it says.
As fans of film-maker Michael Moore may know, US citizens face some of the world’s most expensive health care bills: medicine costs more, doctors cost more and hospital visits cost more, sometimes ten or twenty times more than in other developed nations.
The US only finally moved to a universal health care system in 2010 (well, it’s almost universal — about 95 per cent coverage) after Barack Obama fought a colossal political battle, including claims he was a socialist and would bring in "death panels" of bureaucrats who will decide whether sick Americans get to live or die.
(Incidentally, that was our US partner PolitiFact's 2009 'Lie of the Year').
"Treatment for cancer could run tens of thousands – even hundreds of thousands – of dollars in the US," says Britta in the nursing association ads. Later, a voiceover: "Vote for your right to public health care."
The fine print reveals the ads were "authorised by B. Holmes": Brett Holmes, the association’s General Secretary.
Nursing unions around the country have been sounding the warning for months, citing comments by the Coalition’s health care spokesman, Peter Dutton, about outsourcing hospital management to private operators.
The comments appeared in the Australian Financial Review on April 4 and were again made on ABC’s Q&A in April in response to a question raised by Holmes.
"I just think we shouldn't be afraid of having a debate about where the best delivery model, the best management practices lie and if it lies within the public sector that's fine," Dutton said on Q&A.
"If that's the most efficient delivery mechanism but if it's within private management of those services then we shouldn't be afraid to have that debate."
The Coalition has not released all the elements of its election health policy, but it insists it does not plan to sell public hospitals or make public hospitals open to private patients only.
We asked Mr Dutton about this – and he was unequivocal.
"Mr Dutton has never said public hospitals should be sold off, in fact he has said the opposite," says his spokesman, Jen Cochrane, in an email.
"If elected the Coalition will continue funding public hospitals through the State Governments, as we did when we were last in Government and as has been provided by Labor over the last 6 years… Therefore the [union’s] claim is ridiculous."
In any case, as Ms Cochrane correctly pointed out, such decisions are a matter for state and territory governments, not the federal government.
This is spelt out under the 2011 National Health Agreement, which says that states and territories can privatise the management of hospitals.
Clause A52 of the agreement says: "Where a State contracts with a private or not-for-profit provider to operate a public hospital, that hospital will be treated as a public hospital for the purposes of this Agreement, and may be, or form part of, a Local Hospital Network."
It is perhaps worth noting that this agreement, which continued existing arrangements under previous agreements, was signed off by federal Labor under Julia Gillard.
We spoke to the NSW Nurses and Midwives’ Association, which says Dutton plans to change the health funding agreement with the states to transfer hospitals to private control.
"What is being proposed here is to use the Commonwealth’s power through future agreements and COAG and the like," says the association’s media advisor, John Moran. "If they come in they will alter the agreement."
Dutton insists he has no plans to change it:
"We do not propose changes to the role of the States as managers of the public hospital system in accordance with the current healthcare agreement," says his spokeswoman, Ms Cochrane.
"We are completely committed to the universal provision of free public hospital care as is currently provided through government and non-government hospitals under state governments of both political persuasions."
State governments can and do privatise the management of hospitals. It has not happened often — and sometimes, as in the case of Port Macquarie hospital in New South Wales — the management has been returned to public hands.
The most recent privatisation move was by the Queensland premier, Campbell Newman, who plans to privatise the management of the new Sunshine Coast University Hospital, which is due to open in 2016.
But privatising the management of hospitals — and even turning them into fully privatised, for-profit hospitals, which states and territories can also do — does not stop public patients from attending under the public system.
So could the federal government find a way to influence the states on the issue of managing hospitals?
Stephen Duckett, health program director at the Grattan Institute, says he cannot recall federal governments finding ways to push privatisation of hospital management.
"They have never done so in the past," he says. "Labor at the Commonwealth level has never intervened to stop it [privatisation of management] and the Liberals at the Commonwealth level have never intervened to encourage it."
Dutton is certainly free to start a debate on privatising hospital management, whenever he likes: indeed, the nurses’ advertisement and the present fact-check suggests that he already has.
But, given that he has ruled out overhauling the state-federal health agreement, he can do little else.
And transferring hospitals to private management is a far cry from closing the door to public patients or scaling back universal health care. Likening it to the American healthcare system pushes this ad into Swift Boat territory.
We rate the statement Pants on Fire.
Published: Wednesday, August 14, 2013 at 6:15 p.m.
Coalition eyes private model for hospitals, April 4, 2013
ABC Q&A, April 22, 2013
NSW Nurses and Midwives’ Association advertisement, Patient before profits commercial
ABC News, Queensland Government to privatise new $1.8 billion Sunshine Coast University hospital, July 25 2013
NSW Government, Port Macquarie Base Hospital, 23 December 2004
Phone interview with Stephen Duckett, health program director at the Grattan Institute, August 12, 2013
Email correspondence with Jen Cochrane, office of Peter Dutton, MP, August 12, 2013.
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PolitiFact Australia wants to help keep our politicians honest. We fact-check the accuracy of claims by elected officials and other influential people in the Australian political debate.
We research and rate statements with our Truth-O-Meter. Its goal is to reflect the relative accuracy of a statement. The meter has six ratings, in decreasing level of truthfulness:
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FALSE - The statement is not accurate.
PANTS ON FIRE - The statement is not accurate and makes a ridiculous claim.