Australia’s outgoing health minister has been pilloried by doctors, but a review of the portfolio’s history shows just how much of a ‘hospital pass’ it can be.
Almost five hundred GPs, 46 per cent of those surveyed, ranked Peter Dutton the worst of the past 10 politicians to hold the position, but an experienced medical professional has come to his aid.
Rural Doctors Association of Australia president Dr Dennis Pashen says Mr Dutton’s poor polling can be explained by the freshness of the unpopular co-payment in doctors’ minds, which is probably not the minister’s fault.
“I get a sense the Medicare changes are a Tony Abbottism,” Dr Pashen says.
“Abbott has always disliked bulk billing, and unfortunately he’s taken a shotgun to it, and for whoever has to deliver this it’s a dumb piece of policy.
“Careers are destroyed in the health portfolio.”
Mr Abbott, himself a former health minister, ranked third-most unpopular since the Hawke era, earning 13 per cent of the vote compared to his Labor successor Nicola Roxon’s 17 per cent.
The survey of 1070 GPs conducted and published by Australian Doctor made a point of mentioning the Coalition’s Dr Michael Wooldridge, unpopular amongst some because he removed control over GP training from its royal college.
But Dr Pashen praised Dr Wooldridge, ranked fifth-most unpopular after Labor’s Tanya Plibersek, for his “strong” focus on public health and “very innovative” rural initiatives, proving just how contentious the portfolio can be.
Here’s a look back at some of the achievements and failures in health over the past three decades.
Mr Dutton, health minister for a little more than a year in the Abbott government, was hampered by a deeply unpopular federal budget beyond his control.
“Dutton was pretty much the same as Tony Abbott when he was health minister. Abbott had instructions from the prime minister to ‘just keep health off the front pages’,” says Dr Pashen.
Much of his time was spent defending the government’s plan for a $7 GP co-payment and an ill-explained medical research fund. He failed to pass both measures through a hostile Senate, choosing instead to regulate a watered-down version of the co-payment via backdoor regulation.
He also withdrew from Labor’s agreement with the states to fund half of the growth in hospital spending, choosing instead to keep the rate steady at 45 per cent until mid-2017.
Mr Dutton ordered a review into Medicare Locals, which almost all sides have criticised as unnecessarily bureaucratic. The review called for an overhaul of the Medicare Local system.
Ms Plibersek was appointed to health in the second Gillard ministry in 2011 and retained the portfolio in the second Rudd ministry until 2013.
The standout achievement during her time in the role was the introduction of the national disability insurance scheme (NDIS), but Gillard took most of the glory.
In her own right, she added child dental services to Medicare and subsidised the abortion pill RU486, dropping its price from up to $800 to just $12 for concession card holders.
Ms Plibersek, ranked as least popular by eight per cent on the GP survey, continued the drawn-out negotiations of her predecessor, Nicola Roxon, with the states over hospital funding reform, but any ground gained was quickly lost when Abbott came to power.
Health minister for five years under both Gillard and Rudd, Ms Roxon took on big tobacco and won, legislating the world’s first plain packaging law for cigarettes, for which she is praised among the medical community.
But her ranking as second-worst health minister (17 per cent) on the survey may be explained by the failure of the Labor government to push through its hospital funding reforms.
Labor’s attempt at health reform began as a broad vision that was gradually eroded as its failed to successfully negotiate with the states. For example, the government initially wanted to increase Canberra’s share, and thus its control, of public hospital funding to 60 per cent, which was eventually dropped to 50 per cent, and then overturned by Mr Abbott.
After several failed attempts, Ms Roxon finally legislated the alcopops tax, which was hiked by 70 per cent in 2008. The consensus seems to be that the tax was poorly planned and did not deter binge drinking among teenagers.
Another unpopular move was her halving of the rebate for cataract surgeries, which angered eye surgeons.
Mr Abbott was reportedly tasked by Prime Minister John Howard with making health a non-issue, and was arguably successful, at least for a time.
He reversed the Coalition’s unpopular erosion of Medicare rebates, with extra incentives for doctors to bulk bill children and pensioners, prompting Mr Abbott to declare himself “Medicare’s greatest friend”.
Mr Abbott’s worst month came in October 2007 when he was forced to apologise for implying that Bernie Banton, an asbestos compensation advocate, was “not pure of heart”. The comment was prompted by Mr Banton’s public protest outside Mr Abbott’s electoral office.
The next day, Mr Abbott arrived late to a debate with Nicola Roxon and was caught swearing at her for criticising his lack of punctuality.
Funding cuts to hospitals, his rejection of a ban on junk food advertising and his controversial refusal to allow access to abortion drug RU486 – later overturned by a conscience vote in Parliament – may explain his ranking as third-most unpopular on the GP survey.
Dr Patterson, a trained psychologist, was health minister under Mr Howard for almost two years before being replaced by Tony Abbott.
She was a strong advocate of stem cell research, pushing a law through Parliament that allowed the research method in limited circumstances.
Dr Patterson also included the full cost of subsidised medication on the label as a way of informing GPs and patients of the true cost to the health system.
With few other accomplishments to her name, Dr Pashen described her as a “policy lightweight”. Only one per cent of GPs ranked her worst, which may be explained by her low profile.
Reportedly very popular among rural doctors for his country focus, the medical doctor served in health from when Mr Howard took power in 1996 until 2001.
Dr Woolridge attempted to reform private health insurance, this time arguably with greater success than his predecessors. Private health insurance rates increased from 30 per cent in 1998 to 46 per cent in 2000.
He also improved vaccination policies, ending very low levels of childhood immunisation, and strengthened the nation’s medical research council, but Dr Wooldridge’s decision to remove GP training from the Royal Australian College of GPs angered some.
Dr Lawrence, a trained psychologist and the first female premier, was once touted as potentially Australia’s first female PM.
As Labor’s health minister between 1994 and 1996, she attempted to reform private health insurance by lowering costs and improving the range of products on offer with the intention of luring patients back to private cover.
But Dr Lawrence’s reforms were widely criticised for driving a wedge between doctors and private health insurers. The law gave too much power, its detractors said, to the private funds to negotiate unfair contracts with doctors.
Private premiums increased after the scheme’s introduction, for which the Coalition and some medical groups blamed Dr Lawrence.
Her political career was cut short by a scandal involving allegations she had misled the Western Australian parliament while premier. Dr Lawrence was acquitted of three counts of perjury to a royal commission into the affair, but quit politics soon after.
Graham Richardson, health minister from 1993 to 1994, warned that the health system was becoming unsustainable because of plummeting rates of private health insurance, which placed greater stress on the government-funded public sector.
He commissioned a review and drew up a list of recommendations to restore balance to the rates of private and public cover. The Keating cabinet blocked the Minister’s recommendations, and Mr Richardson resigned from the role after less than a year citing ill health, but in the midst of a scandal.
Mr Richardson had also promised to improve the health of Indigenous Australians before his brief period in the portfolio came to an end.
He also received a mere one per cent of the vote in the GP unpopularity stakes, probably because of his short tenure.
Mr Howe was health minister under Prime Minister Bob Hawke from 1990 to 1993.
He implemented Australia’s first-ever national mental health strategy, and extended the federal government’s role in the areas of dental care and disability services with two national schemes.
He also introduced a $3.50 co-payment for GP consultations in 1991 in an attempt to dissuade those who did not need to see a doctor from clogging up the system.
But the co-payment was quickly abolished after Paul Keating seized the prime ministership from Mr Hawke.
Mr Howe’s unpopularity was also one per cent in the survey.
Dr Blewett was health minister when Medicare, Australia’s widely popular system of universal healthcare, was introduced under the Hawke government.
“Basic health care should be the right of every Australian,” he declared at the time.
Serving in health from 1983 to 1990, Dr Blewett was also responsible for the first disability services law, and a ‘drug offensive’ that also included tobacco smoking and alcohol consumption.
Dr Blewett, who hid his homosexuality until the year 2000, implemented a national strategy to counter the 1980s AIDS epidemic and outlaw discrimination against HIV/AIDS sufferers.
His Liberal counterpart, medical doctor Peter Baume, agreed to take a bipartisan approach to the crisis in order to reduce the number of lives lost to the epidemic, which Dr Blewett has praised.