Jillian Skinner says NSW considering inviting GPs to treat patients in hospital to avoid $7 co-payment

Updated

Furious about health cuts in the federal budget, New South Wales Health Minister Jillian Skinner has proposed inviting GPs into public hospitals to treat their patients there.

Ms Skinner, who has held the $17 billion NSW portfolio for more than three years and currently chairs the ministerial council of all state and territory health ministers, has devised this countermeasure to the Abbott Government's refusal to fund future growth in state hospitals.

All state and territory leaders will meet in NSW Premier Mike Baird's office on Sunday for an emergency meeting to discuss the "missing" $80 billion to fund future growth in public hospitals and schools beyond current federal-state funding agreements.

Federal Finance Minister Mathias Cormann says the states need to look at their own spending on health and education to ensure it is as efficient as possible.

The Federal Government is arguing these areas are state responsibilities.

Senator Cormann told Sky News the Commonwealth needs to make sure its spending is realistic and sustainable - so the same should apply for the states.

"We would expect the states and territories to have a close look at their own schools and hospitals to ensure spending on their schools and hospitals is as efficient and well-targeted as possible," he said.

Ms Skinner has told 7.30 NSW she only had two hours' notice from Federal Health Minister Peter Dutton on budget night that future funding growth would be left to the states.

Railing against provocative put-downs that the states should behave like "grown-up adult governments", Ms Skinner and NSW Education Minister Adrian Piccoli condemned Canberra's intention to vacate future funding obligations without consultation.

Asked if an "an adult grown-up" state government would have to apply a co-payment for emergency department patients, an angry Ms Skinner said: "Let's look at which user pays. Is it the patient or is it the Commonwealth?"

"What the Commonwealth is saying is 'we're going to impose a payment on people going to the GP of $7'. They then say 'it's up to you states, you are now going to manage the health system. You can seek a co-payment for all those patients that are coming to you'," she said.

"That's an admission that they're sending GP patients to the emergency department.

"I'm going to be looking at options which invite a GP, for example, into the hospital to treat that patient. Now they're funded through Medicare by the Commonwealth. So that's a cost shift to the Commonwealth and that's exactly who should be paying for it. That's their obligation."

The NSW health system is the nation's biggest and includes more than 220 public hospitals. On a typical day, around 6,500 people are treated by the state's emergency departments.

State leaders schedule emergency meeting over 'missing' $80b

In the bearpit this week, Mr Baird did not rule out taxation reform, including the Goods and Services Tax (GST).

Changes to the GST are now clearly on the table for discussion, with Canberra seemingly forcing the states into a tax confrontation.

The dispute and the debate will be guided, it is said, by white papers now being prepared on federation and on taxation.

In the immediate political confrontation, the premiers are being urged to call Prime Minister Tony Abbott's bluff and seek an increase in the GST to 15 per cent to fund future growth in health and education.

There are also calls for a "blame Canberra" campaign in the likely event of voter backlash.

The GST is collected by the Commonwealth, but since its introduction by the Howard government its proceeds have been directed to the states on a contentious distribution formula.

Queensland Premier Campbell Newman will suggest to his counterparts that the states and territories push for a portion of income tax - up to 20 cents in the dollar.

He wants action within three to six months, and Victorian Premier Dennis Napthine agrees something must be done soon.

"We need a better arrangement between the Federal Government and the state governments so that these decisions that are made don't have this sudden impact, this sudden shock on state budgets," he said.

Liberal Party allegiances being tested

Treasurer Joe Hockey's budget is turning federal-state relations on its head, regardless of any Liberal Party allegiances.

In the 7.30 interview, Mr Piccolo and Ms Skinner ruled out imposing any further user-pays or co-payment regimes in public health and public education in the event the states and territories cannot force the Federal Government to back down.

Mr Piccoli ruled out privatising TAFE - the technical and further education facilities run throughout NSW by the Education Department.

User-pays already applies there with the Government announcing TAFE course fee increases this week on top of its recent controversial decision to dump popular fine arts courses.

Mr Abbott and Mr Hockey want the Commonwealth to vacate the field in public health and public education in Australia.

The federal budget, without prior consultation, now brings that agenda into the sharpest focus.

Topics: federal---state-issues, government-and-politics, budget, health-policy, health-administration, nsw, australia

First posted