Senator the Hon Anne Ruston

Shadow Minister for Health and Aged Care

Shadow Minister for Sport

Manager of Opposition Business in the Senate

TRANSCRIPT

Interview with Rafael Epstein, ABC Radio Melbourne

25 February 2025

Topics: Medicare commitment, Labor’s primary healthcare crisis, GP bulk billing data, public service numbers

E&OE…………………………………

Rafael Epstein: The Coalition backed the plan to spend on the weekend. Anne Ruston is the Shadow Health Minister and also one of the Liberal Senators for South Australia. Good morning.

Anne Ruston: Good morning.

Rafael Epstein: Why did you back the spend if you didn't know the detail?

Anne Ruston: Well, obviously, it's been pretty clear to us right the way through the term of this government that we've seen an absolute free fall in the access and affordability of primary care. You know, it's quite extraordinary that 1.5 million Australians last year said that they didn't see their doctor because they said they couldn't afford to do so, which means they're ending up in your emergency departments of the state hospital. So, we knew that something needed to be done to try and address the crisis that is in primary care. And so, we welcomed the fact that this injection, and supported the injection of $8.5 billion into primary care, because we clearly understood that it needed it, because of the damage that's been done.

Rafael Epstein: I'm just curious about the why, because you constantly say Labor spends before they think, but on Saturday you back the spending without being able to work through it. Is that - Like, why? Because you're always saying they do things without detail and without thinking. Why is this different?

Anne Ruston: Well, I've been working on policies in relation to supporting primary care and getting Australians affordable and getting access to primary care almost for the entire time that I've been the Shadow Minister. So, I was well and truly across the details of the announcement. It only took me about one second after hearing the announcement from the Labor Government of what the implications of this were likely to be in terms of getting Australians quicker and more affordable access to primary care, which is something that I can say has been concerning me and the Coalition for many years now. In fact, it was Peter Dutton who first went out in the first Budget [in Reply] and said that he would restore the mental health cuts that this government made in 2013, understanding that access to Medicare-funded support for Australians is just so important. So, this came as no surprise to me or the Coalition that the Federal Government needed to make this investment because of the state of primary care in this country.

Rafael Epstein: As Shadow Health Minister, Anne Ruston, I realise the policy is majorly your concern. But where the money comes from. Peter Dutton was asked yesterday - If I can just play this - where the money will come from, should the Coalition be the majority Government after the election? He's Peter Dutton.

[Clip plays]

Peter Dutton: Well, as I say, the Government's put on an additional 36,000 public servants. We will reduce that number and the savings there will be about $6 billion a year.

[Clip ends]

Rafael Epstein: So, Anne Ruston, does that mean that you cut back on Health Department staff to fund this?

Anne Ruston: Not at all. But we know that Australians don't need more public servants in Canberra. What they need is more frontline services that are actually delivering the things that they need, and most importantly in all that are doctors and nurses. And so, that's why we're really focussed on making sure that the money that we spend on behalf of the taxpayers of Australia are going to things that are going to be important, that are going to make a difference, and there is nothing more important than the health care of Australians, because a healthy Australia is a productive Australia. And if we invest in primary care, which is what's happening here, then hopefully we can avoid some of those downstream costs that are much, much more expensive when people turn up at hospitals. It means that people are healthier, which is better for them, but it also means that our budget will be healthier because we're not spending money in hospitals.

Rafael Epstein: You said not at all there. So Peter Dutton's spoken about getting rid of 36,000 public servants. There've been 2,500 Health Department staff added in the last few years. Will they need to go for you to commit to this?

Anne Ruston: Well, obviously, we need to make sure that the Health Department is resourced to make sure that we are delivering the primary care out on the ground. Because, you know, if you look at every single metric at the moment, whether it's been the free fall in bulk billing that's gone down by 11% in the last three years, whether it's the 1.5 million Australians -

Rafael Epstein: Well, from a hike in Covid, but still.

Anne Ruston: Yeah, but okay. Well, let's put the facts right there. When we went into Covid in 2019, or early 2020, the bulk billing rate was 86 plus per cent. So, sure, you can talk about a slight spike from 86.6% to 88.2% during Covid. But the reality is, from when we inherited government in 2013, the bulk billing rate was 82%. Peter Dutton got it up to 84%. It then continued to rise to 86%, then went up again in Covid, and it has free fallen by 11% to 77%. And even if you take it off the 86% mark, it is still a significant reduction.

Rafael Epstein: I'm not sure everyone's going to follow that and I appreciate you making the point. Just, where the the money is going to come from. There's 2,500 Health Department staff that have been added in the last few years. Like, do they need to go, or do they all stay? How do you even know what they're doing if you're not in government?

Anne Ruston: Well, I think the point here is that we need to make sure that we are providing the frontline services, because I think that's what Australians expect. Now, obviously, public servants in Canberra come in many shapes and sizes, and that's obviously a matter for government, as you rightly point out. But what we are saying is that Australians are expecting us to be delivering services that are going to benefit them, and I think Australians would, on the by and by, actually accept the fact that public servants in Canberra are not delivering the same way that they would be expecting, you know, frontline services to deliver, whether that be police, whether that be nurses, whether that be doctors - They're the kinds of people that we think are going to deliver the best outcome for Australians.

Rafael Epstein: I guess, what I'm curious about - You had heaps more private contractors when you were last in government. You had more than 36,000 people and they were just private contractors. They cost more than public servants. So are you just going to do the same thing, sack the public servants and replace them with private contractors?

Anne Ruston: What we are going to do is to make sure that every single dollar of taxpayer money that is entrusted in our care to be spent, is spent in the best possible way to deliver the outcomes for Australians. So whether that is -

Rafael Epstein: Well, do you think that was the best possible way last time, to have more expensive private contractors?

Anne Ruston: Well, I think everything needs to be a mix and it depends on the circumstances. But I think the prudent management, and I think the track record of Coalition governments over many, many decades, has shown that we are good and responsible economic managers. That's why we are able to afford to do things. I mean, just as an example, Peter Dutton was able to establish the Medical Research Future Fund on the back of good economic management - $20 billion that's now benefitted hundreds of thousands of Australians, because of the research that is able to be undertaken in that institution. So I think our track record speaks for itself about economic management.

Rafael Epstein: Just a final principle. Final question. How do you ensure people that you can work out which public servant's frontline and which public servant is a waste? Because, last time, you replaced the public sectors with private contractors. What makes you think you're going to be better this time at working out which public servant is not delivering frontline services?

Anne Ruston: Well, we need to be focusing on the outcomes we want to deliver for Australians, and making sure that that's delivered in the most efficient and effective way to deliver those outcomes. So we will be very, very focussed on making sure that we are good fiscal managers. But at the same time, we also understand Australians need the social services, the health care, the NDIS and those services that I think a rich country like Australia can and should be delivering to their citizens. But at the same time, you only are able to deliver all those social services and those social goods if you've got a strong economy. And that's what we have a proven track record in being able to deliver.

Rafael Epstein: Do you think your proven track record includes doubling the debt? You did double the debt last time you were there. You didn't reduce the debt, you doubled the debt.

Anne Ruston: Well, I think we also have to accept the fact that Australians needed an enormous amount of support and protection to get through Covid. I mean, we came through Covid -

Rafael Epstein: That doesn't include Covid. Doubling the debt was before Covid.

Anne Ruston: Most of the debt that was put onto the books of this government came through Covid.

Rafael Epstein: That's not correct. You doubled the debt before Covid and then it tripled for really good reasons. I just wanted to go back to my question. If you doubled the debt before Covid, does that mean you're good economic managers?

Anne Ruston: Well, I mean, you only have to look at the strength of the economy when we were in government. And obviously there are different types of expenditures. There are those that are going to be productive - I mean, infrastructure to make our country the economic powerhouse that it needs to be, investing in the sectors that are generating economy, the sectors that are providing us with our international trade, that gives us export dollars earnt by the country. I mean, I think by every measure the Coalition governments over many, many governments have proved to be good economic managers. And that's why we've made the kinds of investments that we've been able to make into it. If you want to have a look at the current government, and we come back to my portfolio of health, you've only got to look at every statistic that there possibly is in health to realise that health is going backwards under this government. So I'll stand by the Coalition's record as good economic managers every day.

Rafael Epstein: Thank you for your time. I expect we'll speak more with the campaign almost upon us. Thanks a lot.

Anne Ruston: Thanks, mate. Bye.

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