Strained health system, infrastructure blowouts on national cabinet agenda

State and federal leaders will wrestle with the nation’s strained health system and blowout infrastructure costs in the final national cabinet meeting before next month’s federal budget.

Pharmacies will receive an expanded remit to vaccinate, a new funding program will encourage GP clinics to open after hours, and visa eligibility rules for bringing overseas doctors to Australia will be discussed when Prime Minister Anthony Albanese meets state and territory leaders in Brisbane on Friday.

Prime Minister Anthony Albanese will meet state and territory leaders in Brisbane on Friday.Credit: Alex Ellinghausen

The measures are an attempt to revive primary care and relieve pressures on state hospital emergency departments, which have buckled as bulk-billing rates decline and make GP visits less accessible for swathes of Australians.

Victorian Premier Daniel Andrews said fixing Medicare and Australia’s “broken primary care system” remained his top priority for Friday’s meeting, which will also be the first attended by new NSW Premier Chris Minns.

Former NSW premier Dominic Perrottet and Andrews had previously called for the government to boost GP rebates, and the Victorian leader said that remained on his agenda.

“We urgently need to pay GPs more ... increase university places to get a pipeline of new doctors across the nation, attract GPs from overseas to Australia faster – and break down the barriers between primary care and our hospital system,” Andrews said again on Thursday.

Leaked national cabinet papers also reveal the Commonwealth is launching a major review of its infrastructure investment program.

The documents say the government will take a “refreshed approach” that focuses on sustainability, and called on leaders to recognise “the need for a more sustainable infrastructure pipeline aligned to market capacity and macroeconomic needs”.

A 2020 analysis by the Grattan Institute found state and federal governments spent $34 billion, or 21 per cent, more on transport projects completed since 2001 than they first told taxpayers the works would cost.

The papers say the federal government wants to limit funding to about $120 billion over ten years, laying the groundwork for potentially large-scale changes to the delivery of road and rail projects in Australia.

But some states are concerned it could lead to cuts and delays to federal-state funded projects in a bid to save money in the upcoming budget.

Sources in Victoria, Queensland and South Australia confirmed talks were being held with the Commonwealth about either staggering, delaying or cutting projects as building firms grapple with rising costs and labour shortages.

In Victoria, the airport rail link will be delayed by years and sources said the $16 billion North-East Link was also being discussed as a project from which money could be saved.

The South Australian government is working with the federal government on the $15.4 billion North-South Corridor, though it is unclear if this project would be up for review. In Queensland, sources said changes could be made to the $1.8 billion South-East Queensland City Deal, while the Bruce Highway Brisbane to Sunshine Coast rail extension could also be scrutinised.

‘We urgently need to pay GPs more ... increase university places to get a pipeline of new doctors across the nation, attract GPs from overseas to Australia faster...’

Victorian Premier Daniel Andrews

The National Disability Insurance Scheme, another growing budget expense, is also on the agenda.

The federal government wants the states to pitch in through their health and education systems to reduce pressure on the scheme. Despite an initial 50:50 funding agreement for the NDIS, the Commonwealth is now paying more than 66 per cent of the costs.

Hospital funding arrangements between the states and the Commonwealth, currently being reviewed, are also a sticking point. At the last meeting in February, Albanese presented the federal government’s ‘Strengthening Medicare taskforce’ report to lay out the blueprint for health system reform.

Part of that involves expanding what pharmacies can do – including by doing more vaccinations, for which payments and rules vary between states and territories.

Another recommendation from the taskforce was expanding GP operating hours. The government said the current after-hours program, funded through primary health networks in each state, was approaching a funding cliff at the end of this financial year.

It will renew the program with additional funding, sourced from the $750 million Medicare taskforce allocation, which will invite GPs to apply for grants to open longer hours. Details of that funding will be in the budget.

The national cabinet will also receive an interim review from Robyn Kruk, who has been reviewing visa processing times and how the government can streamline recruitment processes for overseas workers in hospitals and GP clinics.

On housing, national cabinet papers state that the Commonwealth and states will seek to harmonise renters’ rights across all states, ending a situation in which renters have vastly different allowances depending on the city in which they live.

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