Leaders go head-to-head on health

Prime Minister Kevin Rudd and Opposition Leader Tony Abbott have clashed angrily in their first pre-election debate on health system reforms.

Mr Rudd used the showdown to call for urgent reform, saying that in Australia's current health system "too much bureaucracy is getting in the way of frontline services".

He said the cost of healthcare was "going completely through the roof", and warned that, if action was not taken, "state budgets will be overwhelmed".

YOUR SAY: Who do you think won the debate?

Head of the Australian Medical Association, Dr Andrew Pesce told SBS that as far as his organisation was concerned, both sides had announced new policy points during the debate. Mr Abbott had committed to 3,500 new beds, and Mr Rudd had undertaken to examine new funding arrangements for small, rural hospitals, Dr Pesce said.

Mr Abbott said Mr Rudd's record showed he could not be trusted to deliver changes to the health system.

Before the last election, the Opposition Leader explained, Mr Rudd pledged to fix public hospitals by the middle of last year.

"It's probably his biggest single broken promise," Mr Abbott said. "If we couldn't trust his old promises, how could we trust his new promises," he said.

However, Mr Abbott's assertion that the Prime Minister cannot be trusted was empty, Dr Pesce added.

"Show me a politician who has never failed to deliver an election promise and I'll be very impressed," he said.

'Not enough doctors, nurses'

"If you can't trust a government to get insulation into people's roofs and computers into schools... how can you trust a government with the most complex service delivery system of all, namely public hospitals."

Bur Mr Rudd hit back, pointing out that, as Health Minister under the Howard government in 2007, Mr Abbott had promised a major public hospital policy "in the next week or so".

"That was two-and-a-half years ago," Mr Rudd said, adding that Mr Abbott had been health minister for twice the time that Labor had been in government.

"We are still waiting for a policy on hospitals."

The debate, at the National Press Club, is the first of three showdowns in the lead up to the federal election expected later this year.

Mr Rudd said his own experience of hospitals as a child had convinced him a first class health system was part of the "Australian fair go".

Waiting lists 'too long'

"Wherever you come from, however much money you've got it's one of those guarantees, as it should be, for being part of the Australian family," he said.

But he admitted that at present the country did not have enough doctors and nurses, and that hospital waiting lists were too long.

Mr Abbott hit back, saying the government's plans would not make a difference quickly enough.

"Mr Rudd's system won't provide an extra doctor, an extra nurse or even an extra bed before 2014 at the earliest - that's two elections away," he said.

The PM reiterated his aim for a health system "funded nationally, and run locally", and repeated his threat to take the matter to a referendum if he could not reach agreement with the states.

Plea for states' cooperation

"It's time that, as leaders, we stopped pointing fingers at one another and started to point for the way ahead.

"I believe we can reach agreement across the state and the political divide because working families, pensioners and carers right across Australia are demanding that we do so."

But Mr Abbott said Mr Rudd's scheme would make the situation worse, not better.

"Ask yourself this question, if Mr Rudd's plan was in place, which minister would actually be running NSW or Queensland public hospitals?" he said.

"There are problems already, but Mr Rudd's scheme is going to make a bad situation worse, much worse."

Mr Abbott also used the debate to defend his record as health minister under the previous Howard government.

During that time, he said, public hospital spending had increased by $10 billion, and higher Medicare rebates were delivered to patients.

Local hospital board plan

Nine new medical schools were established, as well as 200,0000 additional aged-care places and half all Australians moved into private health insurance.

"There was more to do, there's always is, but it's a solid record of achievement," he said.

Neither Labor nor the coalition are yet to release a complete health policy.

Mr Rudd has announced two key elements of his reform agenda.

He wants the commonwealth to become the major funder of public hospitals with local networks managing them.

He has also pledged $632 million to address the shortage of doctors.

Rudd calls for bipartisan plan

On Tuesday, Mr Rudd once again called on Mr Abbott to give his bipartisan support to fixing the nation's health system.

"Let's work together on how we build a system for the future," he said, before being momentarily drowned out by Mr Abbott laughing.

"All I've heard so far from Mr Abbott is a negative attack on everything the government has said and done."

Mr Abbott said if the prime minister stopped "telling lies" about him, the coalition would work constructively with Labor on hospital reform.

Mr Abbott earlier this year announced that if coalition was elected it would establish local hospital boards in NSW and Queensland.

On Tuesday, the Opposition Leader said he was committed to a strong public hospital system backed by a strong private system.

'Strong, sustainable economy'

And he attacked the government's ability to manage the economy, saying it had a poor track record.

"You can't have a sustainable healthcare system without a strong and sustainable economy," Mr Abbott said.

Australia would need a strong economy to continue to spend "as we should" on a larger and an older population.

"And my fear from Mr Rudd and his team is that there will be a lot of social spending but not much economic reform.

"When it comes to economic reform we've actually gone backwards over the last two-and-half years."

Public hospital funding cut

But Mr Rudd said the previous government had failed to deliver hospital reform despite being in charge of an economy awash with revenue because of the mining boom.

"The revenue through taxes was increasing but their contribution to the actual public hospital system went through the floor, which is why none of these fundamental problems were dealt with."

Labor scored a valuable win before the debate began, forcing the Liberal Party to amend a graph on public hospital expenditure, which it was using to prove funding had risen during Mr Abbott's tenure as health minister.

Health Minister Nicola Roxon pointed out that the graph actually contained $500 million injected by Labor in 2007-08.

By Tuesday morning, Labor reported that the graph had been taken off the Liberal Party website, only to reappear a few hours later with the Labor money noted on the graphic.