Is this budget proposal for the good of our health?
Sometimes support comes from an unlikely corner. In the second week of the government’s budget sales pitch, Tony Abbott has faced furious premiers, stroppy students, cranky seniors and a senate that will oppose key measures.
Bolshie talkback callers have taken him to task over broken promises and increased taxes. Opinion polls have shown a dramatic collapse in support for the Coalition.
Premiers have warned that ripping $80 billion from future funding to states for hospitals and schools will force them to close more than 1000 hospital beds, while the businessman whose name became synonymous with school funding reform – David Gonski – has urged Abbott to reconsider the cuts.
Even the budget’s “good news” centrepiece – a $20 billion medical research fund – has drawn mixed reviews from the eminent scientists the Coalition had hoped would enthusiastically support it.
Amid this backlash, though, one high-profile researcher has spoken out strongly in the government’s defence.
Stem cell pioneer Alan Trounson is certainly not the scientist whom Abbott would have picked as chief cheerleader for the fund, which will be paid for in part by cuts to health spending and new doctors’ fees.
The two men have in previous years been at odds over embryonic stem cell research, which Abbott staunchly opposes. Yet Trounson – who will soon return to Australia from California after six years as president of the world’s largest embryonic stem cell research group – was delighted by the government’s decision to create the fund, which will dole out $1 billion a year by 2023, doubling funding for medical research.
“This is a very good way to help the community but also create wealth and jobs,” Trounson tells The Saturday Paper. “Yes, it means you’re going to pay a little more for visiting a doctor. But I think people in Australia can generally afford that and there would be such good returns on it that it would be absolutely worthwhile.
“I want to come back to Australia and see a country that is really lively and doing the things it’s capable of doing, rather than just wallowing.”
Trounson says there is the potential for breakthroughs in research into vaccines and inflammatory diseases, as well as a cell-based approach to curing cancer that uses the patient’s own immune system to destroy the disease.
Many scientists have been conflicted about budget measures that slash other research but fund medical science through cuts to health programs and the introduction of $7 fees for GP visits, X-rays and blood tests.
The future of the fund is uncertain, given senate opposition to the increased medical fees. Labor, the Greens and the Palmer United Party have all said they will oppose the $7 co-payments – $5 of which would go to the research fund – describing the measure as an attack on universal healthcare and an unfair burden on the sickest and poorest.
Abbott counters that Labor previously introduced a GP co-payment, under Bob Hawke. The compulsory fee of $3.50 per consultation was introduced by Hawke in the 1991 budget but lasted just three months before being scrapped by Paul Keating when he came to power.
But, says Labor’s shadow treasurer Chris Bowen, “the cures of tomorrow should not be funded by taxing the sick of today”.
“I think what they’re engaging in frankly is an attempted political wedge, to say: ‘I know what we’ll do, we’ll be extra clever, saying Bill Shorten likes medical research, why don’t we put the money in a medical research fund?’ It’s a pretty cynical move,” says Bowen.
Abbott has pitched the medical research fund as a long-term savings measure, saying on Wednesday that “the treatments and cures which the medical research will give us will ultimately bring down the cost and increase the effectiveness of our health system”.
Enthusiasm not shared
No one disputes that medical research has real and important health advantages, but some economists point out that helping people live longer can lead to higher costs of supporting an ageing population.
Trounson’s enthusiasm is not universally shared. Even respected researcher and 2003 Australian of the Year Fiona Stanley, whom Treasurer Joe Hockey mentioned in his budget speech, has said she is conflicted and feels it is “unpalatable” to charge the sickest and poorest to fund a medical research budget.
Renowned scientist Sir Gustav Nossal, who was also name-checked by Hockey, has likewise warned that the budget has split the scientific community by cutting $111 million from the CSIRO, $80 million from co-operative research centres and $75 million from the Australian Research Council.
Immunologist and Nobel prize-winner Peter Doherty says he is “nonplussed” by those research funding cuts, as the CSIRO and CRCs are more effective than the medical sciences at research that supports employment and commercial outcomes.
“I don’t understand why they would cut those agencies,” he tells The Saturday Paper.
Doherty, who is based at the University of Melbourne, adds that the GP co-payments will likely lead to a cost-shift to more expensive hospital treatment.
If the medical fund is established, he says, it should have a broad scope, rather than just a narrow focus on curing disease, as medical research reaches across the scientific spectrum.
“It would be good if it could be opened up, for instance, so that if you’re trying to get a new beam line to the synchrotron that would have a lot of medical applications, you should be able to go to that fund,” he says.
“My concern about this fund, if it does get up and does get funded, is it could be used by future governments, of either stripe, to cut the NHMRC [National Health and Medical Research Council] funding.”
Both Trounson and Doherty say the fund must be open to the private sector, rather than just public institutions.
Details of how the fund will work are scant, beyond that it will be overseen by the Future Fund guardians with the NHMRC advising on disbursements, leaving the impression it has been hatched quickly as a defence against claims the government is breaching its pre-election pledge to not cut health funding.
The fact the Coalition has struggled to sell even this centrepiece of its budget shows just how tough it has been for it to get its message across to a public that is focused on increased charges and broken promises.
Backbenchers have been gauging the mood in their electorates ahead of two parliamentary sitting weeks.
One Liberal MP says the budget sales pitch has been bogged down in detail rather than explaining the need for the measures, which voters could understand and accept.
“There’s no doubt people have a lot of questions and some people feel there have been breaches as to what we said we would do and what we have ended up doing,” says this Liberal MP.
But another government MP says that, among constituents, there is little understanding of the detail and the protections. He cites the safety net on GP co-payments after 10 visits for some patients and the fact pensions are not being cut, just growing at a slower rate.
A third MP insists the response from constituents has been mild and does not reflect the mood of anger suggested by media coverage.
Opinion polls tell a different story.
The Newspoll, published in The Australian on Monday, showed Labor leader Bill Shorten had taken a shock 10-point lead over Abbott as preferred prime minister, and that 48 per cent of voters believed the budget was bad for Australia.
Likewise, Fairfax/Nielsen’s post-budget poll, also published on Monday, showed Labor was leading the Coalition 56 per cent to 44 per cent on a two-party-preferred basis, and that almost two-thirds of voters thought the budget was “not fair”.
In a sign that this has made Abbott’s other goals more complicated, the poll also showed more voters back keeping the carbon and mining taxes than support an increase to petrol excise, as proposed in the budget.
This backlash has reinvigorated Labor, which had struggled to cut through in opposition. It has also distracted from a setback in Victoria to Shorten’s party reform proposals, as factions from his own state combined to resist his push for a dramatic expansion in membership.
The Coalition was never going to find its first budget easy, given the conflicting promises it had blithely made in opposition. In coming weeks and months, as Abbott and Hockey seek to secure its passage through the senate, it will become clear whether these are just the teething problems of a new government or a fundamental rupture in its relationship with voters.
Trounson may not be the researcher whom Abbott would have chosen to defend his budget centrepiece but, right now, the prime minister needs all the support he can get.
This article was first published in the print edition of The Saturday Paper on May 24, 2014 as "For the good of our health? ". Subscribe here.