TRANSCRIPT: ABC Darwin, Tuesday 19 May 2015




TUESDAY, 19 MAY 2015

SUBJECTS: 2015 Budget; NT Government; Palmerston Hospital; STEM; palliative care


RICHARD MARGETSON: Tanya Plibersek, a very good morning to you.


MARGETSON: I am a little bit cynical about the arrival of federal politicians around this time of year. It seems that there’s a clutter at the moment, I think we’re expecting Joe Hockey as well, I think it’s just as it suddenly gets cold in Canberra.

PLIBERSEK: Well, I was here a few weeks ago as well, I never need an excuse to come to Darwin but I’ve got to say waking up this morning, beautiful day.

MARGETSON: The 2015 Federal Budget, obviously it’s been on everyone’s minds. $155 million for the Northern Territory, now this is one of the ones that didn’t get a lot of coverage on the national scale, but it’s very important for us. This is for the Northern Territory government to, long term, take full responsibility to deliver the essential services to the communities. The Northern Territory government at the moment still not fully sure about whether they’re accepting the deal on the table. Do you support that notion of remote communities being in the control of the territory government rather than the federal government?

PLIBERSEK: Well I support the notion that remote communities need a decent level of services and what I would ask of course is whether this one-off $155 million is going to deliver that for any length of time.

MARGETSON: Essentially they’re saying five years and then the money runs out and then we roll over to the Northern Territory government.

PLIBERSEK: Well I think the ‘then what?’ is the question. I genuinely- if the Northern Territory government can’t answer how they will continue to pay for services into the future, I think it makes those communities very nervous indeed.

MARGETSON: Pretty much what they’ve said is that they would carry on and they will continue to fund and there was a statement from Adam Giles saying “we’re not going to close [inaudible], it won’t be like the West Australian process”. But I’m just wondering whether or not the Labor Party believes they will continue to fund from the federal government.

PLIBERSEK: Well of course the proposition in Western Australia was very controversial and the reason it’s controversial is because the West Australian government made an assessment that they couldn’t afford to keep those communities going and it was incredibly nerve-wracking for the communities involved and the individuals involved within that community. I think it’s very important for Adam Giles to say how that funding will continue into the future and whether indeed communities would keep going with the level of services that they’ve got or indeed what you’d hope for in the future is increased levels of services.

MARGETSON: We will go on to of course to the things that you want to talk about with regard to education, but one of the other ones that’s been around is of course the Palmerston Hospital. Now I’m sure that if you were raising funds for Solomon, the candidate, Luke Gosling was wording you up on the situation from his point of view about the way in which the Palmerston Hospital has gone. A long time to get attended, a short time to get it built.

PLIBERSEK: Well Luke didn’t need to tell me about the Palmerston Hospital because I was the Health Minister, we offered $70 million as federal government to the NT government to build the Palmerston Hospital and we hoped that they would put in $40 million. They never did. They refused it that time - to put in $40 million so we took our funding up to $110 million which was plenty to build the hospital that the NT government back in the day said that they wanted, so around 60 beds from memory. The fact that we announced that additional funding in I think it was August 2013, and I think what you’ve got there now is an intersection, no hospital coming out of the ground now, is incredibly disappointing for all those people living in those fast growing parts of Darwin and-

MARGETSON: It’s taken around 1000 days to get through the tendering process and now the hospital’s expected to be arriving in October 2018. That’s about 885 to days to build.

PLIBERSEK: Yeah I think it’s optimistic given the delays we’ve seen all this while and I think it’s embarrassing that Natasha Griggs keeps making excuses for the NT government. She said that the wet season was the reason for one of the delays. I think people up here are used to timing their work, so they do the planning during the wet season and the construction during the dry season.

MARGETSON: Right across the Territory, Tanya Plibersek is with us in the studio this morning, and just with that long term notion, it’s okay to build the hospital but then you’ve got to run it. The AMA are pretty concerned that as you’ve seen in federal budgets, less and less support for regional hospitals, or just health budgets in general. They’re expecting a $600 million cut to commonwealth public hospital funding over a decade. That means you might build a regional hospital like Palmerston and then not be able to staff it and keep it going. What commitment would the Labor Party give running towards that and say “okay, we’ll give money to make sure it runs”?

PLIBERSEK: We increased hospital funding by $20 billion when we were in government and the trajectory from Labor was always to increase hospital funding faster than the rate of CPI growth which is what the current government has gone back to, CPI plus population growth, that means hundreds of millions of dollars cut from the NT health budget. There’s another problem as well, it’s not just the less dollars going into individual hospitals in the Northern Territory, the current government had gotten rid of all the workforce planning programs that we had. So one of the big problems here is funding the beds and the hospitals, and another big problem is getting the doctors, nurses and specialists to work in Darwin and in other parts of the Northern Territory. If you don’t have the money to pay for the hospital beds to be operating and you don’t have the doctors and the medical staff to look after the patients, then you’ve got real problems long term.

MARGETSON: We were talking obviously from our own point of view from the Northern Territory, how different are we to regional Australia elsewhere? I mean we consider ourselves pretty much as a city, or two cities, but we are regional in comparison to the east coast. How much are we a reflection of what’s going on in regional Australia?

PLIBERSEK: Well I think in regional Australia right across the board you’ve got medical personnel shortages. There’s not many parts of regional Australia that you go to that they say “we’ve got enough GPs, we’ve got enough dentists and health professionals and our hospital is fully staffed”. That’s why we put a lot of effort into Health Workforce Australia to making sure we are looking forward to where we need to employ doctors, nurses and medical staff and actually meeting those needs long term, that’s just not happening anymore. So the shortages are bound to be getting worse.

MARGETSON: You were talking about shortages in those areas, but you’re actually in the top end to address some shortages elsewhere. And you’re talking about HECS-free degrees. You’ll be down at Charles Darwin University today speaking about that. Give us a rough idea of what STEM is about, what are you trying to do for people in regional Australia with these HECS-free degrees that you’re proposing?

PLIBERSEK:  Well there are a few parts to this proposal. This is what Bill Shorten was talking about in his Budget Reply speech on Thursday night, investing in science and technology, engineering and maths so that we prepare ourselves and our kids for the jobs of the future. One of the things that you can safely say is that there are jobs around today that nobody imagined ten years ago, people are working internationally across the internet doing all sorts of research work, huge international studies where they’ve got hundreds of thousands of participants in medical research studies, just as one example. But what it relies on is our kids today being comfortable with using computers and it’s not just science students. You think about the work of a mechanic today, you basically can’t fix a car if you don’t know how to operate the computer diagnostics of a car these days. So all the jobs of the future are going to require our kids to have basic computer literacy skills and that’s what we’re talking about when we’re talking about coding.

MARGETSON: This is where it gets interesting, you just told us that what is missing in the Northern Territory is health professionals, and yet the investment that you’re announcing here has nothing to do with health professionals, it’s to do with science, technology, maths, you know, it’s not targeted to perhaps the students that you might be trying to pick up.

PLIBERSEK: We’re absolutely committed to getting more doctors and health professionals back to the top end, that’s why we had programs like Health Workforce Australia to get those-

MARGETSON: But why then the HECS-free degrees?

PLIBERSEK: Because it’s not a shortage of students that’s the problem. There are plenty of people who want to study to become doctors, the problem is then getting them to work in regional and remote locations. So the incentives need to be different. They need to be what we did for example in training people to be GPs in remote locations. If you take someone out to do their internship in a smaller hospital in a country area or a regional GP surgery, they’re much more likely to stay because they see that they like the lifestyle, they develop a connection to the local community, quite often they meet and marry someone in those few years that they’re studying to become a doctor-

MARGETSON: [inaudible]

PLIBERSEK: Maybe. So, you need to work out how to fix the individual shortages. It’s not a shortage of students, it’s a shortage of trained doctors so we need to provide the incentives there. When you’re talking about science, technology, engineering and maths, the problem is we don’t have enough science and maths trained teachers. There’s about 20,000 teachers teaching science and maths in our schools that don’t have a science and maths background. And you would remember, and all the listeners would remember that your teachers that most inspired you as a kid were the ones that were really into the thing that you were studying, they loved it, they had a passion for it. If people aren’t comfortable with the subject matter they’re teaching, it’s hard to inspire the next generation. We know that the jobs of the future are going to require people to be good at science, technology, engineering and maths so we need to train up a generation of teachers that’s comfortable teaching computer coding and all of those related subjects, and we need to really focus on making those lessons interesting for kids right through their school career so that they themselves choose those science, technology, engineering and maths careers.

MARGETSON: It’s eighteen to nine, 105.7 ABC Darwin, 783 in Alice Springs. A couple more things just before you go. It’s twenty years since the NT legislated for voluntary euthanasia and it was overridden by the federal government, that’s something I know that is pretty close to your heart, having seen your father go through those experiences towards the end of his life. Is voluntary euthanasia something that the Federal Labor government would put on the table or can afford politically to put back on the table?

PLIBERSEK: Euthanasia would be a conscience vote in the Labor Party, it’s one of the areas that we are very definite about having a conscience vote. So I can tell you-

MARGETSON: Unlike same-sex marriage

PLIBERSEK: I can tell you my personal view about it which is that you would have to have carefully crafted laws, and you have to have much, much better palliative care so that people really do have a true choice, you’re not making people live in terrible pain so the only choice they feel is available to them is ending their own lives. But I think in the right circumstances, with the right legislation, it should be something that people can choose. You mentioned my dad, and he actually had very good palliative care and most of the time he was [inaudible] to the last few days of his life, but he had a lot of pain from cancer and he had enough morphine there that if he had a drink of it, it would’ve been the end of him. Now, he was a supporter of voluntary euthanasia but he chose not to do it, because at the end he didn’t understand that he was going to [inaudible] at the very end of his life and he wanted to hang onto every last minute with us. So, you can’t first of all make assumptions, you have to have systems that are flexible enough to take into account that people change their minds and you have to have really good palliative care so it truly is a choice.

MARGETSON: But he would not have had in his situation any choice, there was no choice for him to legally take his own life.

PLIBERSEK: No, legally he could not take his own life but if he finished off the morphine that was in the bottle he effectively would have, I think. The other thing that’s really important is advanced care directives. So, a lot of people now have started to talk to their doctors about ‘what happens if I can’t communicate my wishes to you anymore?’ and when I was Health Minister we did a big project of trying to standardise all the different states’ advanced care directives and make it so you could put it on your personally controlled electronic health record. So say you’re, you know, a grandma who visits the kids interstate and she’s hit by a bus and she’s unconscious, the doctor interstate can look at the advanced care directive and say ‘oh, this lady’s got terminal cancer, she’s asked for no resuscitation, we’d have to do major hip surgery on her, the treatment would be worse than the cure', the kids will know that that’s what grandma wants so we will respect your wishes. And even that would be a very good step forward, making sure that we change the element in our hospitals, because doctors are trained to save lives and want to save lives, that they ignore the wishes sometimes, or patients can’t express their wishes clearly, and they intervene with these harsh treatments, big surgeries, you know tubes down the throat, respirating people when people would rather be let go peacefully.

MARGETSON: There’s plenty more to talk about and no doubt you’ll be discussing, as I say, the STEM program that you’ve got in mind for Charles Darwin University students later on today and I guess you’ll be soaking up the warm weather just until you have to go back to Canberra where it’s just freezing cold and miserable.

PLIBERSEK: Loving it, loving every minute.

MARGETSON: Tanya Plibersek, thanks for coming to spend some time with us this morning.


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