MOTIONS
Dr RYAN (Kooyong) (19:17): Australians' living standards have gone backwards in the last five years. In the face of below-average productivity and high inflation, real wages have fallen to about 2011 levels. If we can't boost our productivity, then social objectives like health and disability care and climate action will be compromised.
The care economy—health, aged care and disability—employs 2.4 million people. That's one in six Australian workers. In 2023-24, health spending was $270 billion, close to 10 per cent of the GDP.
If we're serious about productivity, we can't leave health care out of the conversation. Productivity in health care doesn't mean nurses have to work harder or that we have to relentlessly cut services. It's about how much healthcare value can be created with the resources available.
It's about better outcomes for every dollar spent. Our clinicians want that as much as any Treasury official. A healthy population is a productive population.
People with chronic disease are 60 per cent more likely to be out of the labour force. Eighty-two billion dollars of our health spending goes to chronic conditions. Many of them are preventable.
Health spending is not a cost burden. It's an investment in our workforce, but it needs to be done wisely. I suggest four priorities.
The first is prevention. The Treasury has found that every dollar spent on preventive health care returns $14 in savings, but we spend less than two per cent of our health budget on public health and disease prevention. Take dental care—more than two million Australians deferred dental treatment, many because of cost, last year.
The AIHW has estimated that as many as 89,000 hospitalisations for emergency treatment of dental conditions every year are preventable. Delivering preventive primary dental care, starting with children and seniors, would be a worthy productivity reform in this country. The second is workforce.
Our health workforce is supplied through domestic training and immigration across multiple jurisdictions, portfolios, regulators and employers, but no single body oversees it. We don't know who ends up where, doing what or where the gaps are. Ahpra can't even tell us whether the government's recently introduced expedited specialist pathway is actually putting specialist international medical graduates into rural areas of need.
The Snowball review, accreditation systems review and National Medical Workforce Strategy have all called for a national planning body with the authority and expertise to match supply to demand by speciality and region. Thirdly, every dollar invested in health and medical research returns almost four to our economy, yet our R&D spending has fallen to under 1.7 per cent of GDP.
We're cutting jobs at the CSIRO and we're underspending from the MRFF. The government's planned changes to the R&D tax incentive will strip supporting activities out of the scheme. They propose that companies older than 10 years lose the ability to claim the cash refund.
This could well drive Australian firms that are turning research into products in this country offshore. We have to retain eligibility for supporting activities directly linked to core R&D. We should replace that arbitrary 10-year cut-off with a test based on the stage of growth and commercialisation, and we should put savings into incentives that reward industry for doing more research here, not less.
The fourth is technology. Artificial intelligence is arriving faster than our capacity to regulate it. Our healthcare system is unprepared.
We have no coordinated national approach. The productivity dividend from new diagnostic tools, AI scribes and administrative automation will be real, but so will the risks: loss of sovereign patient data, with foreign platforms potentially underpinning Australian health care; and, as we've seen with vertically integrated telehealth, business models which are built on prescribing volume, not on patient care.
Underpinning all of this is measurement. We still have no agreed method for measuring the productivity of our care economy. The government has reviews of its medical research strategy, the R&D sector, health technology and a scope of practice in train, but it has been too slow to execute them.
The prize, if we execute them properly, could be a healthier workforce, more efficient systems, a sovereign medical technology sector and a more productive Australia.