Australia’s asylum seeker policy history: a story of blunders and shame


Carolyn Holbrook, Deakin University

This article was developed from a series of interviews with politicians, officials and other key players, including former Immigration minister Chris Evans and former Victorian premier Steve Bracks. Others preferred to remain anonymous.


We know very little about the kind of government Scott Morrison runs. After beating Peter Dutton and Julie Bishop to the prime ministership in August last year, most commentators assumed Morrison was keeping the chair warm until Labor’s Bill Shorten won the 2019 election.

Following the Coalition’s unexpected victory, it’s time to ask more searching questions, not only about Scott Morrison’s political values and policy aspirations, but about his prime ministerial style.

Recent history suggests processes of policy decision-making can make or break governments.




Read more:
Cruel, and no deterrent: why Australia’s policy on asylum seekers must change


Labor’s shambolic attempts to create asylum seeker policy during the Rudd-Gillard years are emblematic of the dire consequences when tried-and-tested processes of policy advice fail.

In the face of internal dissent, thousands of asylum seekers arriving by boat and a marauding opposition leader, the government rejected its most vital source of advice, the public service.

It began in 2009

In mid-October 2009, Prime Minister Kevin Rudd was informed that a vessel carrying 78 Sri Lankan asylum seekers was in danger of sinking in Indonesian waters. Rudd negotiated directly with the Indonesian president Susilo Bambang Yudhoyono and decided to dispatch a Customs vessel, the Oceanic Viking, to rescue the asylum seekers and return them to Indonesia.

The then immigration minister Chris Evans first heard of the plan when he received a phone call from Rudd’s chief of staff, Alister Jordan.

Jordan was not consulting the immigration minister, but rather informing him of a plan that had been enacted. Evans rang his departmental secretary, Andrew Metcalfe, who told him the plan would not work because the asylum seekers would refuse to disembark.

As Metcalfe had foreseen, the asylum seekers refused to leave the Australian boat at Bintan. Australian voice surveillance revealed there was talk of mass suicide.




Read more:
How the next Australian government can balance security and compassion for asylum seekers


The standoff lasted four weeks, until a deal was struck that saw the Sri Lankans resettled in countries including New Zealand.

Officials in the Immigration Department were dumbfounded. One told me:

The Oceanic Viking was a thought bubble from Rudd … It was an absolute debacle. It was crazy. It had nothing to do with immigration but we were asked to go in and fix it up. And that scuttled any possibility of us doing anything with Indonesia for a long time.

The boats kept coming. There were 6,555 boat arrivals in 2010. On the night he lost the prime ministership to Julia Gillard, Rudd told the Labor caucus that if he won the leadership vote, he would “not be lurching to the right on question of asylum seekers”.

What Rudd didn’t mention was that the government had been actively exploring offshore options for some time.

The Immigration Department had prepared a list of possible sites for offshore detention that included Malaysia, Pakistan, Thailand, Indonesia, and East Timor.

Sounding out the East Timorese government

Evans was focused on pursuing a multilateral solution. His officials consulted with members of the refugee lobby, including the prominent lawyer David Manne, about being part of a broader regional arrangement that had the approval of the United Nations High Commissioner for Refugees (UNHCR).

Evans and his department worked on an offshore deal that would meet with the approval of Australian stakeholders, neighbouring countries, and the UNHCR. But meanwhile, a small group of ministers focused on East Timor.




Read more:
A refugee law expert on a week of ‘reckless’ rhetoric and a new way to process asylum seeker claims


The former Victorian premier, Steve Bracks, was approached at an airport and asked to sound out the East Timorese government about a processing centre. Bracks reported back that Prime Minister Xanana Gusmao was interested, but he would need some time to win support within his government.

Gusmao wanted negotiations to be done through the president, Jose Ramos Horta. This process was in train when Kevin Rudd was overthrown as prime minister on June 24, 2010.

In a speech to the Lowy Institute on July 5, the new prime minister, Gillard, announced she had discussed with Horta the possibility of establishing a regional processing centre in East Timor. But in going public, she had pre-empted the internal East Timorese process. Gusmao distanced himself from the plan and it quickly fizzled.

Meanwhile, the public servants who had been working on the multilateral solution were left scratching their heads. One official told me:

I have no idea where [East Timor] sprang from.

We were working on arrangements … and one of the really difficult things was thought bubbles kept coming from funny quarters and then you’d have the media onto it, laughing at it or making a joke of it.

Failed Malaysia initiative

After the 2010 election, the new immigration minister Chris Bowen secured an offshore processing arrangement with Malaysia. Immigration Department officials had encouraged Bowen to bring refugee stakeholders and the UNCHR on board.




Read more:
Refugees are integrating just fine in regional Australia


But Bowen, who was facing immense political pressure from opposition leader Tony Abbott, preferred to deal unilaterally with his Malaysian counterpart, Hishamuddin Hussein, with whom he had developed a strong rapport.

Hours before the first 16 asylum seekers were due to be transported to Malaysia, Manne obtained an injunction against their removal from Australia, pending a challenge to the legality of the government’s agreement with Malaysia.

In September 2011, the High Court decided in a six-to-one decision that the Malaysia agreement contravened the Migration Act because the refugees would not be given the protection required by the Australian legislation.

According to a key player, the High Court ruling was the product of a profound failure of process:

the government did a very bad job at … going to the organisations who would be part of any solution. And, instead, pissed them off so comprehensively they went to the High Court.




Read more:
Robert Manne: How we came to be so cruel to asylum seekers


After the failure of the Malaysia initiative, the Gillard government hurriedly reopened the Nauru and Manus Island processing centres.

In 2013, then Prime Minister Kevin Rudd and Opposition Leader Tony Abbott debate about asylum seeker policy, and the ‘PNG solution’.

When Rudd replaced Gillard in June 2013, he announced that no one who arrived by boat would ever be settled in Australia. The boats slowed, but it was the institution of boat turnbacks under the Abbott government’s Operation Sovereign Borders that stopped them altogether.

The consequences of the Rudd and Gillard governments’ blundered handling of asylum seeker policy were considerable. Indonesia and East Timor were unnecessarily offended, the government’s political fortunes suffered and, most significantly, asylum seekers were again subjected to processing on Nauru and Manus Island.




Read more:
In Manus, theatre delivers home truths that can’t be dodged


It is conceivable that Manus and Nauru would have remained closed and Operation Sovereign Borders rendered unnecessary had the Rudd and Gillard governments heeded the advice of the Immigration Department to bring key refugee stakeholders and UNHCR on board into the process.

The institution of rigorous decision-making processes will not guarantee Scott Morrison’s success, but they could help him avoid many of the pitfalls that contributed to the downfall of the Rudd and Gillard governments.


Carolyn Holbrook is presenting a talk on this topic at the Australian Policy and History ‘History and the Hill’ Conference at Deakin University on Thursday, June 13The Conversation

Carolyn Holbrook, ARC DECRA Fellow at Deakin University, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Advertisements

Cruel, and no deterrent: why Australia’s policy on asylum seekers must change


Alex Reilly, University of Adelaide

The Coalition’s election victory on May 18 had an immediate psychological effect on the refugees on Manus Island, with reports of several people attempting suicide.

Two class-action lawsuits currently before the High Court allege “torture”, “persecution” and “other inhumane acts” in Australia’s offshore detention centres. This action follows an action for damages in 2018 that the federal government settled for A$70 million, effectively admitting that the claims of mistreatment were well-founded.

The Iranian-Kurdish journalist and poet Behrouz Boochani, who has been detained on Manus for six years, has borne witness to a cruel system in his book, No Friend But the Mountain. Written secretly on a mobile phone, the book has won a swag of major Australian literary awards.




Read more:
Book Review: Behrouz Boochani’s unsparing look at the brutality of Manus Island


As a result of the testimonials of Boochani and others, the terrible conditions on Nauru and Manus are well-known. There are regular reports of physical and mental illness due to unsanitary conditions, cruel treatment and hospitals with no capacity to deal with the extent and severity of the health crisis among the refugee populations.

These reports reinforce the underlying cruelty of subjecting innocent human beings to indefinite and arbitrary detention in the first place. And to what end?

There is no justification for offshore detention

For many years, there has been no justification for the detention of asylum seekers on Manus and Nauru.

The original justification of deterring others from making the dangerous journey from Indonesia to Australia carries no weight. The point has been well and truly made that attempting to reach Australia by boat is a futile exercise. In the words of the allegations in the class action, the journey will result in years of:

…arbitrary, indefinite detention in tents, barrack-style buildings, or small, hastily constructed dwellings where living conditions lead to poor health […] physical, sexual and psychological abuses, [and] systemic mental distress.

The government claimed that the medivac law passed in February risked a new wave of boat arrivals and spent over A$180 million reopening the Christmas Island detention centre in preparation for new arrivals. The government has since committed to closing Christmas Island again. The expense involved in this political exercise is staggering, with absolutely no benefit to the taxpayer.

There has also been no new wave of boat arrivals. Deputy Prime Minister Michael McCormack revealed Thursday that a boat from Sri Lanka had been intercepted near Christmas Island this month. However, the details of who was on board, and why the boat was in Australian waters has not been made publicly available.

There will always be the occasional refugee boat arriving Australian waters for a variety of reasons, but it is important to distinguish these isolated occurrences from a reigniting of the people-smuggling trade.




Read more:
Australia’s government failed to stand up for press freedom after Nauru barred ABC journalist


It’s high time the government ceased linking detention on Manus and Nauru to stopping the boats. The evidence does not stack up. As I, and others, have argued previously, the experience during the Howard years suggests that simply the possibility of offshore detention is a sufficient deterrent.

When the government settled asylum seekers on Nauru in Australia and New Zealand from 2002-04, without dismantling the offshore detention regime, asylum seekers did not begin arriving by boat.

Most asylum seekers in Indonesia are registered with the UNHCR and are waiting for resettlement through the UNHCR process. Their situation is admittedly desperate. Nonetheless, when interviewed after the passing of the medivac law, asylum seekers in Indonesia testified that they did not see taking a boat to Australia as an option.

It’s important to remember that asylum seekers have done nothing wrong in seeking our protection. Australia is a signatory to the UNHCR Refugee Convention, which establishes a responsibility to protect people who arrive on our border seeking protection. If offshore detention can be justified as deterrence at all, it must surely be kept to the bare minimum, in the context of our protection obligations.

Long-term detention is simply cruel and rightly labelled a “crime against humanity”.

Alternatives to detention

If there is even a remote possibility of a boat arriving in response to resettling refugees from Manus and Nauru in Australia and New Zealand, the government has many deterrence strategies at its disposal.

One novel strategy that avoids the need for offshore detention is Labor’s 2011 Malaysia arrangement. The deal was a simple one. In exchange for the transfer to Malaysia of 800 asylum seekers who arrived in Australia by boat, Australia would provide financial assistance to Malaysia and resettle 4,000 UNHCR-recognised refugees on top of existing commitments to resettle refugees from the region.




Read more:
Refugees and asylum seekers in Malaysia: the good, the bad and the unexpected


An important part of the arrangement was that those asylum seekers returned to Malaysia would not be penalised, and would be provided with housing, the right to work, and access to education for children.

The arrangement would act as an effective deterrent to people taking a boat to Australia to seek asylum because their expensive and dangerous journey would just result in their return to Malaysia. The Malaysia arrangement had the benefit of refocusing Australia’s response to asylum seekers and drawing in our neighbours to a regional response.

It’s critical that the Australian government take a new direction in refugee policy and move beyond its tired and false rhetoric of deterrence as a justification for detaining refugees on Nauru and Manus.The Conversation

Alex Reilly, Director of the Public Law and Policy Research Unit, Adelaide Law School, University of Adelaide

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Policies, not posturing, will help Albanese shake the ‘left-wing’ tag and restore faith in his party



Albanese has crafted his image as a knockabout bloke. But now he needs to craft an image as a potential prime minister.
Wes Mountain/The Conversation, CC BY-ND

John Wanna, Australian National University

Labor has taken a major gamble by appointing Anthony Albanese unopposed as party leader. His speedy elevation came because he was not tarred with the Bill Shorten-Chris Bowen brush that failed so spectacularly on May 18. So a cross-factional deal for a unity ticket held sway.

“Albo” has carefully crafted his image as a knockabout but likeable scallywag. He mixes easily with ordinary folks, “does” the local pubs and community centres, volunteers his services as an occasional DJ. He is a rugby league fanatic who regularly marches in the Sydney Mardi Gras and has a beer named in his honour. He’s an impish politician with a nose for a pithy or humorous riposte; an iconoclastic puncturer of hyperbole and bunkum (remember his throwaway dismissal of the “convoy of no consequence” when a pitiful truck convoy descended on Canberra).

Albanese was also Labor’s smartest parliamentary tactician as the Leader of the House in the Gillard government. He sees himself as a “commonsense guy” who is prepared to “stand up for what [he] thinks is commonsense propositions”.

He also has the distinction of remaining loyal to both former Labor PMs Kevin Rudd and then Julia Gillard, and has earned respect for this among his colleagues, unlike Shorten.




Read more:
How might Labor win in 2022? The answers can all be found in the lessons of 2019


Of more significance, he is from the left wing of the party, which could be a political millstone around his neck as leader.

He regards high office not simply as a vocation but as a messianic obligation. Given his advocacy of radical policies in his recent past, including death duties and redistributive taxes, his promotion to the leadership provides him with ample opportunities to shape the party’s policy agendas. He is, in reality, only the second left-wing leader of the ALP after the troubled H.V. “Doc” Evatt in the 1950s (Julia Gillard was nominally from the left, but more conservative than most of her party colleagues).

Anthony Albanese has cultivated an image of himself as a likeable scallywag, pub-goer, league fanatic and occasional volunteer DJ.
AAP/Daniel Munoz

Already, conservative media like The Australian have signalled a willingness to attack him along these lines.

Similarly, his political opponents have described him as “too left wing” to become prime minister. And some of his Labor colleagues from Victoria have argued that he is “too old and tired” to win an election.

In the Labor Party, the only real difference between the right and left factions is that the right don’t believe in anything much except that power is an end in itself. By contrast, the left are ideological, believe in social engineering and consider power as a means to pursue transformational agendas.

So, coming from the left may be Albanese’s Achilles’ heel, a vulnerability to his leadership. He has the opportunity in the immediate term to defuse many issues that bedevilled Labor over the past parliamentary term. These include: passing the Coalition’s full income tax cuts; agreeing to a bipartisan emissions target; working with the government on a joint policy towards Indigenous Australians; advocating a moratorium on further changes to superannuation; abolishing the symbolic medevac policy that feigns assistance to offshore detainees; and helping resolve some glaring disparities in welfare benefits.

But such concessions to the government would likely infuriate Labor’s tribal adversarial spear-throwers and its throng of left-Labor lawyers. An initial consensual approach, however, may make sections of the right-wing media look more closely at Albanese’s qualities as leader. Others might argue that “leopards cannot change their spots” and that Albanese will be confrontational and fight for redistributive agendas – making him a prime target for conservative media attacks that he remains a dangerous leftie.

Albanese now has two important imperatives – unify the party behind a refreshed policy agenda, and increase the party’s appeal to the community in order to rebuild the vote. Neither of these tasks is particularly easy, especially as Labor is likely to engage in a bout of recrimination after its recent disappointing electoral tilt.

He also has to work out tactically how to deal with the Morrison government basking in the afterglow of victory – so far, he has promised not to be an opposition leader like Tony Abbott, who opted for outright confrontational tactics.

Albanese’s immediate problems are to construct a shadow ministry on talent, not seniority or factional standing, with the right mix of skills to hold the government to account. He needs to match up his best performers against the high-profile or difficult portfolios (treasury, Indigenous affairs, water, NDIS) and the weaker government ministers (Stuart Robert, Sussan Ley, Ken Wyatt, Bridget McKenzie, Michaelia Cash and Greg Hunt). He will have to work out whether to give Shorten a significant shadow portfolio or find something else for him to do.

There are many in Labor’s caucus who demand more responsibility, especially women of ambition including Kristina Keneally, Katy Gallagher, Linda Burney, Jenny McAllister, Clare O’Neil, Ged Kearney, Terri Butler and Kimberley Kitching, as well as the likes of Jim Chalmers, Ed Husic, Stephen Jones, Murray Watt, Nick Champion and Andrew Leigh. Many of Labor’s previous front bench under Shorten failed to cut through and should be demoted.




Read more:
Grattan on Friday: Shocked Labor moves on – but to what policy destination?


Albanese’s Labor must address a series of debilitating and contentious policy areas – most of which should be either settled or defused. It needs to clarify where it stands on the big versus smaller government debate and whether increased federal involvement in multitudes of policy areas is prudent and responsible.

It ought to focus on the economy and increased productivity, while being less opportunistic on taxation proposals. For all Australians, Labor ought to allow a coherent set of policies on climate change and emissions targets. It could then consolidate effective environmental policies, rather than engaging in the chopping and changing that has characterised this sector (unlike our nearest neighbours in New Zealand). Labor has to define its position in relation to mining and, in particular, the coal industry. There is also scope to advance Indigenous well-being and some form of constitutional recognition.

Some mainstream media have speculated that the deputy leader, Richard Marles from the Victorian right, will be able to moderate any leftward drift under Albanese. This is possible, but the right faction is divided and fractious.

Albanese’s leftism represents a potential debility in the opposition’s platform, which a conservative government with wind in its sails might easily exploit.

The battle for the hearts and minds of Australians is more likely to be fought over practical and pragmatic policies than any ideological lurch to either the left by Labor or to the right by the government.The Conversation

John Wanna, Sir John Bunting Chair of Public Administration, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How the major parties’ Indigenous health election commitments stack up



File 20190430 136807 4nqv25.jpg?ixlib=rb 1.1
Government policies on Indigenous health have so far largely failed in closing the gap.
From shutterstock.com

David Coombs, UNSW and Diana Perche, UNSW

Eleven years after Australia adopted the Closing the Gap strategy, many pressing First Nations health issues remain unresolved.

The gap between Indigenous and non-Indigenous life expectancy, currently 10.8 years for men and 10.6 years for women, is actually widening.

Similarly, the target to close the gap between Indigenous and non-Indigenous child mortality has not been met. The Indigenous rate of 164 deaths per 100,000 children aged 0-4 years is still 2.4 times the non-Indigenous rate of 68 deaths per 100,000 in this age group.




Read more:
Indigenous health programs require more than just good ideas


The causes of Indigenous health inequality are complex. They stem from social determinants such as employment, education, social inclusion, and access to traditional land, rather than strictly biomedical causes.

Government policies have a critical role to play here. But funding cuts, policy incoherence, and governments retaining control over resources and decision-making explain why the gaps between Indigenous and non-Indigenous health outcomes are not closing.

Regardless of who wins the federal election on May 18, these enduring health issues affecting Indigenous Australians will require sustained and concerted policy attention.

A look at the major parties’ policy promises reveals some signs of hope, but also plenty of room for improvement.




Read more:
Three reasons why the gaps between Indigenous and non-Indigenous Australians aren’t closing


The Coalition’s commitments

Aboriginal and Torres Strait Islander groups criticised the lack of Indigenous-specific health measures in the Morrison government’s first budget detailed in April.

The budget did include A$35 million for First Nations solutions to family violence, and A$10 million for the Lowitja Institute for health research.

Indigenous youth suicide remains an urgent policy concern, with Indigenous children five times more likely to die in this way than non-Indigenous children. A coronial inquest recently identified complex causes including intergenerational trauma, poverty, and problems stemming from the home environment.




Read more:
Indigenous health leaders helped give us a plan to close the gap, and we must back it


The Coalition’s budget committed A$5 million over four years to address Indigenous youth suicide. This figure has since been increased to A$42 million following criticism from First Nations organisations and advocates.

Meanwhile, the budget directed A$129 million towards the expansion of a cashless welfare card system that operates in a number of Aboriginal communities. The card quarantines 80% of welfare recipients’ income for use in government-approved stores, and on government-approved items, to prevent spending on alcohol, cigarettes and gambling. This decision was taken despite a lack of evidence these cards reduce social harm or public expenditure.

The government also made some pre-budget commitments around Indigenous health. These included:

The Coalition also honoured a previous commitment of A$550 million for remote housing in the Northern Territory.

The Morrison government deserves some credit for its part in reaching an agreement between the Council of Australian Governments and a coalition of Aboriginal and Torres Strait Islander peak organisations in December 2018.

This agreement commits governments and Indigenous peak bodies to shared decision-making and joint accountability in devising and working towards new Closing the Gap targets.




Read more:
Budget 2019 boosts aged care and mental health, and modernises Medicare: health experts respond


Labor’s commitments

In keeping with its election campaign emphasis on health spending, Labor recently announced a A$115 million Indigenous health package.

The package includes almost A$30 million to reduce Indigenous youth suicide and mental ill-health.

It also offers A$33 million to address rheumatic heart disease, a preventable condition that disproportionately affects Indigenous children. The National Aboriginal Community Controlled Health Organisation (NACCHO) highlighted rheumatic heart disease as one of ten Indigenous health priorities for this election.

Labor has also promised A$20 million for sexual health promotion in northern Australia, A$13 million to combat vision loss, and A$16.5 million for the “Deadly Choices” initiative, which aims to prevent chronic disease through education.

Further, the opposition has announced a compensation scheme and healing fund for surviving members of the Stolen Generations and their families. This could help manage the effects of intergenerational trauma.

What’s lacking

Both parties’ funding commitments must be assessed in the context of the 2014 budget cut of more than A$500 million dollars to Indigenous affairs by the then Coalition government, which only the Greens have committed to restoring.

Impacts have been severe for specific programs, especially those run at the community level. These include youth services in Maningrida (NT) and employment and training programs in Inala (Queensland).

Funding for crucial Indigenous health infrastructure and capital works is also lacking, with the current shortfall estimated at A$500 million. Many Aboriginal Community Controlled Health Services are run from old buildings in desperate need of upgrades to accommodate increasing patient numbers and rising demand for services. The Coalition recently announced an incremental increase to infrastructure funding, but much more is needed.




Read more:
Antibiotic shortages are putting Aboriginal kids at risk


Neither the Coalition nor Labor has made any substantial commitment to a national Indigenous housing strategy. Inadequate, insecure and poor quality housing worsens physical and mental health through overcrowding, inadequate heating and cooling, injury hazards, and stress.

Similarly, both parties have been silent on reducing poverty in Indigenous communities. Poverty is another social determinant that contributes to Indigenous physical and mental ill-health, as well as high incarceration levels.

What about self-determination?

Labor has stated it will prioritise Aboriginal Community Controlled Organisations as the vehicles for delivering much needed health services.

As the Close the Gap steering committee’s shadow report emphasised, “when Aboriginal and Torres Strait Islander people are involved in the design of the services they need, we are far more likely to achieve success”.

The Coalition has been silent on the issue of community control, and funding reforms under the Indigenous Advancement Strategy and the Indigenous Australians’ Health Programme have destabilised the position of Aboriginal organisations.




Read more:
The Coalition’s report card on health includes some passes and quite a few fails


Community control is threatened by the government’s focus on competitive tendering, where First Nations organisations compete with “mainstream” service providers trying to secure contracts to deliver Indigenous health services.

Neither the Coalition nor Labor has outlined a response to these structural issues.

A final verdict

It’s difficult to identify major differences between the two parties’ Indigenous health promises. The likely impact of these polices is also hard to gauge given the significant role played by state and territory governments in service delivery.

Labor has promised to support Aboriginal Community Controlled Organisations but specific details have not been announced. Labor’s significant funding pledge for rheumatic heart disease, though, makes their Indigenous health offering perhaps slightly more likely to achieve health gains than the Coalition’s.




Read more:
Why are Aboriginal children still dying from rheumatic heart disease?


The Conversation


David Coombs, PhD candidate in Nura Gili Indigenous Studies, UNSW and Diana Perche, Senior Lecturer and Academic Coordinator, Nura Gili Indigenous Programs Unit, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

View from The Hill: Malcolm Turnbull’s home truths on the NEG help Labor in the climate wars


Michelle Grattan, University of Canberra

An Easter weekend in an election campaign might be a bit of a challenge for a pair of leaders who were atheists. But fortunately for Scott Morrison and Bill Shorten, declared believers, it wasn’t a problem.

Both attended church services during the so-called campaign cease-fire that the main parties had proclaimed for two of the four days.

Morrison on Sunday was pictured in full voice with raised arm at his Horizon Pentacostal church in The Shire, where the media were invited in. On Friday he’d been at a Maronite Catholic service in Sydney.

Sunday morning saw Shorten at an Anglican service in Brisbane, his family including mother-in-law Quentin Bryce, former governor-general.

Neither leader was hiding his light under a bushel.

Church, chocolate and penalty rates

Sunday was an opportunity to wheel out the kids, chasing Easter eggs (Shorten) or on the Rock Star ride at Sydney’s Royal Easter Show (Morrison). This was campaigning when you’re not (exactly) campaigning.

The minor players weren’t into the pretend game. For them, the relative restraint on the part of the majors presented rare opportunity. Usually Centre Alliance senator Rex Patrick would have little chance of being the feature interview on the ABC’s Insiders.

But while Friday and Sunday were lay days for the major parties Saturday was not (and Monday won’t be either).

For Labor, Easter has meshed nicely with one of the key planks of its wages policy – restoration of penalty rate cuts by the Fair Work Commission. Even on Sunday, Shorten pointedly thanked “everyone who’s working this weekend”.

It was the start of Labor’s campaign focus turning from health to wages this week, when it will cast the election as a “referendum on wages”.

Turnbull resurrects the NEG

The weekend standout, however, was the intervention of Malcolm Turnbull, who launched a series of pointed tweets about the National Energy Guarantee (NEG).

Turnbull was set off by a reference from journalist David Speers to “Malcolm Turnbull’s NEG”.

“In fact the NEG had the support of the entire Cabinet, including and especially the current PM and Treasurer. It was approved by the Party Room on several occasions”, the former prime minister tweeted.



“It had the support of the business community and energy sector in a way that no previous energy policy had. However a right wing minority in the Party Room refused to accept the majority position and threatened to cross the floor and defeat their own government”.

“That is the only reason it has been abandoned by the Government. The consequence is no integration of energy and climate policy, uncertainty continues to discourage investment with the consequence, as I have often warned, of both higher emissions and higher electricity prices.”

He wasn’t finished.



“And before anyone suggests the previous tweet is some kind of revelation – all of the economic ministers, including myself, @ScottMorrisonMP, @JoshFrydenberg spent months arguing for the NEG on the basis that it would reduce electricity prices and enable us to lower our emissions.”

And then:

“I see the @australian has already described the tweets above as attacking the Coalition. That’s rubbish. I am simply stating the truth: the NEG was designed & demonstrated to reduce electricity prices. So dumping it means prices will be higher than if it had been retained. QED”

“The @australian claims I ‘dropped the NEG’. False. When it was clear a number of LNP MPs were going to cross the floor the Cabinet resolved to not present the Bill at that time but maintain the policy as @ScottMorrisonMP, @JoshFrydenberg& I confirmed on 20 August.”



(Frydenberg, incidentally, has lost out every which way on the NEG. As energy minister he tried his hardest to get it up, only to see it fall over. Now he is subject to a big campaign against him in Kooyong on climate change, including from high-profile candidates and GetUp.)

Turnbull might justify the intervention as just reminding people of the history. But it is damaging for the government and an Easter gift for Labor – which is under pressure over how much its ambitious emissions reduction policy would cost the economy. It also feeds into Labor’s constant referencing of the coup against Turnbull.

Turnbull’s Easter tweets are a reminder

  • the Coalition sacrificed a coherent policy on energy and climate for a hotchpotch with adverse consequences for prices;

  • it dumped that policy simply because of internal bloodymindedness, and

  • the now-PM and treasurer were backers of the NEG, which had wide support from business.

Shorten has strengthened his commitment on the NEG, indicating on Saturday he’d pursue it in government even without bipartisan support.

“We’ll use some of the Turnbull, Morrison, Frydenberg architecture, and we will work with that structure,” he said.

Given the hole it has left in the government’s energy policy, pressing Morrison on the economic cost of walking away from the NEG is as legitimate as asking Shorten about the economic impact of his policy.




Read more:
VIDEO: Michelle Grattan on the starting line of the 2019 election campaign


The Conversation


Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

One Nation, guns and the Queensland question: what does it all mean for the 2019 federal election?



File 20190328 139371 1uycvcc.jpg?ixlib=rb 1.1
Pauline Hanson claims the Al Jazeera undercover “sting”, which has grabbed international headlines, was a media “stitch-up”.
AAP/Dan Peled

Chris Salisbury, The University of Queensland

Of all the controversies to conceivably bring Pauline Hanson undone, private discussions about gun law amendments wasn’t an obvious candidate.

Yet her recorded comments about the 1996 Port Arthur massacre and subsequent gun law reforms are potentially destructive for her One Nation party. Only potentially, though; Hanson’s supporters have long shown a propensity to forgive or shrug off her party’s outlandish or shocking assertions.




Read more:
Grattan on Friday: Scott Morrison struggles to straddle the south-north divide


Already, Hanson and party colleagues have shifted blame for the Al Jazeera “sting” to a media “stitch-up” and, they claimed, foreign political interference by an “Islamist media organisation”.

Presumably some Hanson adherents will find that plausible – the party has made anti-Muslim rhetoric part of its regular platform. Other One Nation supporters might now question the principles the party claims to stand for.

Why guns policy?

Why would One Nation seemingly risk whatever political capital it possesses by flirting with changes to gun controls and seeking assistance (if not funding) from gun lobby groups?

The party’s nativist policy positions on refugees, immigration and foreign investment are well known and readily detailed on its website. Until now, gun law amendment has sat well behind these. One Nation’s listed policies on firearms regulations include increasing penalties for gun-related crime and “streamlining” weapon licensing requirements. Not exactly controversial stuff.

But it is important to remember that the party first emerged in the wake of the Port Arthur shootings and rural resistance to the Howard government’s gun ownership reforms. Hanson and her candidates campaigned in the party’s early years on relaxing John Howard’s laws. They also benefited politically from a mainly regional backlash against these – and against Howard’s National Party partners.




Read more:
How Fraser Anning was elected to the Senate – and what the major parties can do to keep extremists out


Recently highlighted connections between Australian gun lobby groups and minor parties, including One Nation and Katter’s Australian Party, bring the backdrop to this policy agenda into sharper relief.

One Nation’s original and more recent platform caters to disaffected, largely non-metropolitan constituents who feel the party’s anti-immigration, anti-foreign business and anti-government intervention policies “speak for them”.

In its recent incarnation, One Nation has tried – and found ready accomplices in sections of the media – to “mainstream” its appeal and some of its positions. It’s been observed that the party’s Senate members have regularly supported the Coalition government’s legislative agenda during this term, on matters ranging from the reintroduction of the Australian Building and Construction Commission (ABCC) to reduced welfare spending.

The party’s suite of published policies covers matters of concern to many Australians, such as power prices, transport infrastructure, water supply and jobs creation.

In this respect, it was perhaps not so surprising that Liberal MPs should describe the party as “more responsible” than its earlier manifestation. Even former prime minister Tony Abbott, Hanson’s one-time political nemesis, endorsed One Nation owing to its “constructive” relationship with the government in parliament.

But this normalisation fails to mask the party’s extreme stances or inconsistent policy positions – even between its own members. One Nation adheres to curious policies decrying United Nations infringement on our sovereignty, as well as questionable claims about evidence-based climate policy.

Then there is the attention-seeking behaviour: Hanson wearing a burqa in the Senate chamber; or Queensland Senate candidate Steve Dickson suggesting the Safe Schools program involved teachers instructing students in masturbation techniques; or New South Wales upper house candidate Mark Latham proposing Indigenous welfare recipients undergo DNA testing. Stunts like these place One Nation firmly on the political fringe – though not without fellow dwellers. Notoriously, Coalition senators scrambled to backtrack on supporting Hanson’s Senate motion decreeing that “it’s OK to be white”.

Stunts such as Pauline Hanson wearing a burqa in the Senate place One Nation on the political fringe.
AAP/Mick Tsikas

This latest party engagement in seeking out overseas gun lobby assistance highlights another inconsistency, given Hanson’s vote in the Senate supporting new restrictions on foreign donations.

The Queensland question

Considering this, why do One Nation’s policies seemingly still appeal to significant numbers of voters, particularly in Queensland? Traces of an entrenched conservative political culture thumbing its nose at “the establishment” partly explain the party’s appeal in Queensland (and perhaps some of Peter Dutton’s ill-judged, racially charged comments as immigration minister).

It’s a culture underpinned by a history of less diverse migrant influence than other parts of the country and arguably a more wary, paternalistic past regarding Indigenous and minority communities.

Another reason is the accentuated city-country divide in Australia’s most decentralised mainland state. Here, some agrarian-themed party policies – such as for dam building or vegetation management – directly pander to regional voters. As a minor party not in government, though, One Nation has limited opportunity to carry these through, beyond aiming to wield balance-of-power influence in the Senate.

More telling is One Nation’s claimed inheritance of an old National Party constituency. It is one that feels “left behind” – a sentiment the Shooters, Fishers and Farmers Party successfully tapped into in the NSW election.

As in the past, the Nationals will seek to differentiate themselves from their Coalition partners and marginalise One Nation and other far-right parties ahead of the 2019 federal election.

But that’s no easy feat in Queensland. Since the Liberal and National parties merged in the state to form the LNP in 2008, there has been no distinct outward National Party. Some rural and regional voters in Queensland have felt unrepresented to a certain extent, and their grievances have placed many in a resurgent One Nation camp.

The party’s identification with aggrieved outer-urban and regional conservative interests keeps its voters’ preferences an issue. Again, this is especially so in Queensland, where several LNP MPs hold seats in such areas on tight margins.

But following this week’s revelations, and particularly in the wake of the Christchurch shootings, the preference issue will bedevil the Coalition in this state and elsewhere.




Read more:
Guns, politics and policy: what can we learn from Al Jazeera’s undercover NRA sting?


The prime minister’s latest announcement directing the Liberal Party’s state branches to preference Labor ahead of One Nation sends a needed message, but not unequivocally. It apparently leaves Liberals free to place One Nation ahead of the Greens or others, and is ambiguous on how this will apply to all LNP MPs in Queensland, or possibly influence Nationals MPs elsewhere.

But the clamouring of Queensland’s Nationals-aligned MPs for new coal-fired power stations – mirroring One Nation policy – indicates their likely preference leanings in favour of the minor party (and presumably leaves the Greens last of all).

The recorded actions and comments of Hanson and her party colleagues could bring a political reckoning for One Nation at the coming federal election. Voters will soon judge if the party warrants their electoral support and decide if this new controversy is a bridge too far.

For its part, the Coalition is treading a line between getting its hands burned over preference “deals”, as happened at Western Australia’s last election, or doing as John Howard (ultimately) did and jettisoning One Nation preferences altogether.The Conversation

Chris Salisbury, Research Associate, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Coalition’s record on social policy: big on promises, short on follow-through


Anja Hilkemeijer, University of Tasmania; Amy Maguire, University of Newcastle; Katharine Gelber, The University of Queensland, and Peter Whiteford, Crawford School of Public Policy, Australian National University

This article is part of a series examining the Coalition government’s record on key issues while in power and what Labor is promising if it wins the 2019 federal election.


Religious freedom

Anja Hilkemeijer, Law Lecturer, University of Tasmania; and Amy Maguire, Associate Professor, University of Newcastle Law School

In December 2017, joyous scenes accompanied the long-awaited enactment of marriage equality in Australia. This joy was soon replaced by outrage, however, when the community learned of the extent to which religious schools may legally discriminate against students and staff on the basis of their gender identity or sexual orientation.

In response, Prime Minister Scott Morrison announced last October that parliament would swiftly act to disallow religious schools to expel students on the basis of their sexuality.




Read more:
Talk of same-sex marriage impinging on religious freedom is misconceived: here’s why


However, action on removing the special exemptions in the Sex Discrimination Act 1984 (SDA) for religious schools quickly stalled. Following a number of private members’ bills, a range of amendments and two Senate inquiries, it became clear the Coalition government wanted religious schools to retain some special exemptions.

In a Senate committee report in February, Coalition senators insisted the matter of religious school exemptions from the SDA be referred to the Australian Law Reform Commission.

To date, no referral has been made. And given the few parliament sitting days scheduled before the federal election, it appears this issue will fall to the next parliament to resolve.

The Coalition has also announced a number of initiatives to boost protections of religious freedom following the release of the long-awaited Ruddock Religious Freedom Review in December.




Read more:
Why Australia needs a Religious Discrimination Act


Contrary to the panel’s recommendation, Morrison said the government would appoint a religious freedom commissioner to the Australian Human Rights Commission. He also said he wanted to pass a Religious Discrimination Act before the next federal election, but the government has not provided any details on what form such a statute might take.

While the Liberal Party’s election policies have yet to be released, it is safe to assume the Coalition would seek to implement all the proposals announced in response to the Ruddock report if re-elected.

What about Labor?

If Labor wins the May election, it will feel pressure to follow through on removing exemptions for religious schools in the SDA, as it has committed to doing.

Labor has also indicated it supports enacting a federal law to prohibit discrimination on the basis of religious beliefs, but it needs to see the details of such a proposal before committing to it.


Freedom of speech

Katharine Gelber, Professor of Politics and Public Policy, The University of Queensland

Freedom of speech has become a prominent topic in public debate in recent years. One trigger was the 2017 marriage equality survey. During the campaign, the Australian Christian Lobby argued that marriage equality would “take away” people’s right to free speech and former Prime Minister Tony Abbott insisted that a “no” vote was essential, “if you’re worried about religious freedom and freedom of speech”.

A second trigger was the 2017 parliamentary inquiry into freedom of speech, which raised the question of whether the wording of the racial vilification provision in federal law (Section 18C) should be changed, and whether the procedures under which complaints are dealt with by the Australian Human Rights Commission should be altered. Subsequent attempts to change the text of Section 18C were unsuccessful.




Read more:
Free speech: would removing Section 18C really give us the right to be bigots?


What has received far less media attention, though, are the multiple ways in which the Coalition has undermined free speech while in government. The Coalition appears to be a friend of free speech only when it suits them.

The list includes extensive laws that restrict free speech far more than is necessary for legitimate national security purposes.

These include counter-terrorism laws prohibiting the unauthorised disclosure of information that does not have a public interest exemption. Another new law ostensibly designed to prevent foreign interference in Australian affairs exposes journalists and charities to risk of prosecution.

In addition, the Coalition included secrecy provisions in the 2015 Border Force Act intended to prevent people who work in offshore detention centres from disclosing information. The legislation was so draconian, the UN special rapporteur on the human rights of migrants cancelled a planned visit to Australia in September 2015 on the grounds it would prevent him from doing his work. Eventually, in the face of a High Court challenge in 2017, the government removed the provisions.

What about Labor?

Labor’s position on free speech is less clearly stated. On the one hand, it has a record of support for national security laws that restrict free speech. However, Labor takes a different stance from the Coalition on anti-vilification laws, which it defends as narrow, valid restrictions that prevent racism, bigotry and discrimination.

Perhaps the biggest shift in public discourse around free speech has been the degree to which politicians from One Nation, Katter’s Australian Party and the United Australia Party, as well as some from the Coalition, have been emboldened to promote harmful stereotypes of migrants, asylum seekers, LBGTQI and other marginalised groups.

Indeed, in some quarters, political rhetoric has become so caustic that it has separated informed public debate from evidence and reasoning, and undermined core democratic institutions.

If Labor wins the election, its biggest challenge will be to provide the leadership to shift public discourse away from this and facilitate a political culture that embraces diversity and provides free speech to as many people as possible.


Social security and welfare

Peter Whiteford, Professor, Crawford School of Public Policy, Australian National University

Social security and welfare remains the largest component of government spending. In the latest budget released by the Coalition government, spending is projected to increase from A$180 billion in 2019-20 to just over A$200 billion in 2022-23. This represents a slight fall, however, from 36.0% of total spending to 35.8%.

Compared to previous budgets, there are no major proposed cutbacks in assistance. The Coalition government has attempted to slash funding for social security and welfare in its past six budgets, with little success.

There are some welcome initiatives set out in the budget, including a commitment of A$328 million over four years to the National Plan to Reduce Violence Against Women and Their Children, and a commitment of A$527.9 million over five years to establish the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability.




Read more:
Future budgets are going to have to spend more on welfare, which is fine. It’s spending on us


But the budget also extended the government’s Cashless Debit Card trials, which have courted controversy. The Australian Council of Social Service has argued the card curtails people’s freedoms and hasn’t resulted in any positive effects. This followed an Australian National Audit Office report, which concluded that the card had major flaws and it was difficult to see where social harm had been reduced due to a “lack of robustness in data collection.”

The Coalition government has attempted to play up its social security and welfare successes in recent years, pointing to the fact that the proportion of the working-age population receiving income support is at its lowest level since the early 1980s.

But this appears to be the result of fewer people applying for benefits rather than people moving off benefits more rapidly, as has been claimed. It also reflects a somewhat stronger labour market in recent years and changes introduced to the Parenting Payment Single and Disability Support Pension programs under the Rudd/Gillard governments.

What about Labor?

Whoever wins the next election will face pressure to further increase welfare and social security spending as the National Disability Insurance Scheme ramps up and the Aged Care Royal Commission releases its findings. The recent report by the Parliamentary Budget Office projects that real spending on aged care will increase by around A$16 billion over the next decade as a result of Australia’s rapidly ageing population.

Newstart, the main payment for unemployed Australians, is also increasingly being seen as inadequate. It has slipped relative to pensions and wages each year because it is indexed to the slower-growing consumer price index.

Labor has promised that, if elected, it will use a “root and branch review” to look at lifting the rate of the Newstart unemployment benefit. However, it is not just Newstart that is inadequate, but support for single parents and families with children, which has been cut by both major parties over the last 15 years.The Conversation

Anja Hilkemeijer, Lecturer in Law, University of Tasmania; Amy Maguire, Associate professor, University of Newcastle; Katharine Gelber, Professor of Politics and Public Policy, The University of Queensland, and Peter Whiteford, Professor, Crawford School of Public Policy, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Dog whistles, regional visas and wage theft – immigration policy is again an election issue


Jock Collins, University of Technology Sydney

This article is part of a series examining the Coalition government’s record on key issues while in power and what Labor is promising if it wins the 2019 federal election.


Immigration policy will be a major issue in the 2019 federal election. We know this because immigration has featured significantly at every Australian election since the 2001 “children overboard” election.

David Marr and Marian Wilkinson argued in their 2003 book, Dark Victory, that willingness to play the race card in relation to boat people was a decisive factor in John Howard’s election victory. For Tony Abbott, “Stop the boats” was a major campaign theme when the Coalition won back government in the 2013 election. The current prime minister, Scott Morrison, rose to prominence as Abbott’s unyielding immigration minister who stopped the boats.




Read more:
Australian politics explainer: the MV Tampa and the transformation of asylum-seeker policy


While the events of Christchurch may have cramped the opportunity for the Coalition to run hard on fear, promising to be tough on borders and tough on (Muslim) terrorism, the dog-whistle politics on the issue of refugees and asylum seekers will be there for those wanting to hear it.

For Labor these policy issues have been difficult. It was Kevin Rudd who as PM declared that those arriving by boat would never be settled in Australia, irrespective of the validity of their claims for protection under the UN Refugee Convention. Labor supported efforts to get children out of detention on Manus Island, but doesn’t want to give the conservatives too much space to convincingly advance a “Labor weak on border security” line.

Humanitarian intake is growing

The Coalition governments of Abbott, Turnbull and Morrison have in fact increased Australia’s annual humanitarian intake significantly. The number has risen from just over 13,750 to more than 18,000 – though the government has not loudly broadcast this fact.

In addition, Abbott in 2015 announced a one-off intake of 12,000 Syrian conflict refugees. Most of them arrived in 2017, effectively doubling the annual refugee intake in that year.

Australia – and the refugees – coped well, demonstrating the nation’s capacity to significantly increase refugee intakes. Our research with newly arrived Syrian, Iraqi and Afghan refugee families suggests they are settling well in Australia, receiving a warm welcome from locals in the cities and regional centres. Employment and family reunification are their key worries.




Read more:
Refugees are integrating just fine in regional Australia


Labor’s shadow immigration minister, Shayne Neumann, has flagged a new temporary sponsored visa for the parents of migrants. Unlike the current visa, it does not have a cap and it might assist refugees to get their parents to Australia.

Labor has announced it will increase the annual humanitarian intake of refugees to 27,000 by 2025. It will also abolish Temporary Protection Visas (TPVs). These visas provide boat arrivals who are found to be refugees the right to stay for only three years with work and study rights and access to Centrelink payments. As Labor argues, this places them “in a permanent state of limbo”.

The Coalition parties have not announced their policy intentions in relation to humanitarian intakes or the rights of asylum seekers, including those who arrived by boat.

At a time when Home Affairs Minister Peter Dutton scans the horizon for new boat arrivals, record number of asylum seekers are arriving by plane under tourist visas. In 2013-14, there were 18,718 asylum applications, including 9,072 boat arrivals. This had increased to 27,931 asylum applications, with no boat arrivals, by 2017-18.


Department of Home Affairs

Each year the Australia government sets the permanent immigration targets. Until recently this was set at 190,00. In practice just 162,000 immigrants have been admitted over the past year or so.

A token cut and 2 new visas

In this context Prime Minister Morrison’s announcement that the permanent immigration target will be cut to 160,000 is really no change in immigration policy. There is nothing to see here if you dismiss the need to be loudly anti-immigration in the current populist political climate.




Read more:
Government’s population plan is more about maximising ‘win-wins’ than cutting numbers


The announcement is linked to congestion-busting in the major cities of Sydney and Melbourne. It is accompanied by the introduction of two new visa pathways – the Skilled Work Regional (Provisional) Visa and the Skilled Employer Sponsored Regional (Provisional) Visa – for skilled migrants to live and work in regional areas for five years.

These visas offer the carrot of permanent residency at the end of three years to attract new immigrants to regional Australia. In addition, the budget announced that scholarships to the tune of $94 million over four years would be available to domestic and international students who study there.




Read more:
Settling migrants in regional areas will need more than a visa to succeed


Temporary migrants exploited

Most immigration policy debates centre on permanent immigration intakes, particularly of humanitarian immigrants and asylum seekers. Yet annual temporary migrant intakes – international students, working holidaymakers and temporary skilled workers – are three times greater than the permanent intake. Over 800,000 temporary migrants were in Australia in June 2018.

One key policy issue is the exploitation of temporary migrant workers. The Turnbull government abolished the 457 temporary skilled migration visa because of increasing reports of abuse and exploitation by employers.

One recent survey of 4,332 temporary migrant workers found “increasing evidence of widespread exploitation of temporary migrant workers, including wage theft”. Half of all temporary migrant workers may be underpaid. About one in three international students and backpackers earned $12 an hour or less – about half the minimum wage.

This issue goes not just to the ethics of maintaining a temporary migration program largely premised on migrant worker exploitation. It also resonates with Labor’s campaign for a living wage and the restoration of penalty rates for workers in response to the low rate of real wage growth in Australia, which constrains consumer demand.




Read more:
Ultra low wage growth isn’t accidental. It is the intended outcome of government policies


The 2019-20 federal budget allocated extra funding to the Fair Work Ombudsman to bolster enforcement action against employers who exploit vulnerable workers and announced the National Labour Hire Registration Scheme to target rogue operators in the labour hire industry. However, the research suggests wage theft is widespread in the small business sector, a key target for tax relief in the budget. It is an area of immigration policy that requires considerably more resources and punch.The Conversation

Jock Collins, Professor of Social Economics, UTS Business School, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Cutting cancer costs is a worthy policy, but we need to try to prevent it too


Terry Slevin, Australian National University and Simone Pettigrew, Curtin University

Removing the financial worries from Australians diagnosed with cancer is bound to be a popular move.

The Opposition’s A$2.3 billion cancer care plan – announced in Bill Shorten’s budget reply speech on Thursday night – aims to ensure cancer treatment costs for scans, specialists and drugs are bulk billed or subsidised under the Pharmaceutical Benefits Scheme (PBS). It would be a hard heart indeed that did not welcome such a move.

Maybe even better than avoiding the out-of-pocket costs of treatment is preventing future cases of cancer. Around one-third of all cancers are preventable by not smoking, staying at a healthy weight, eating healthy food, being physically active, minimising alcohol consumption, and avoiding excessive sun exposure.

But apart from a small commitment to tobacco control in the 2019 budget, neither the government or opposition has made even the vaguest commitment to, or investment in, cancer prevention.




Read more:
Budget 2019 boosts aged care and mental health, and modernises Medicare: health experts respond


So far we have heard virtually nothing from either party on efforts to tackle obesity, promote healthy eating, encourage more physical activity, reduce alcohol consumption, promote sun protection, or boost efforts to increase participation in cancer screening and vaccination programs.

The government currently spends around A$2 billion a year on “public health”, which includes monitoring, regulation, as well as prevention and vaccination. This amounts to less than 2% of the nation’s total health expenditure of A$170 billion. That is about half of what we spend on patient transport.

A boost to 5% – or closer to A$8.5 billion – could make enormous strides in better prevention programs, driven by high-quality research.

Poor track record

When it comes to investment in disease prevention, the story is not strong for the Coalition.

The Rudd Labor government established the Australian National Preventive Health Agency (ANPHA) in 2009, with funding of around A$60 million a year. The agency ran national programs focusing on tobacco, alcohol, healthy eating and reducing alcohol consumption.

But the new Abbott government axed the agency in 2014, after drafting legislation to expunge it from the books.




Read more:
INTERACTIVE: We mapped cancer rates across Australia – search for your postcode here


From 2008 to 2014, the National Partnership Agreement on Preventive Health (NPAPH) funded programs in Australia tackling unhealthy eating, physical inactivity, drinking too much, and smoking, via a funding pool of A$872 million.

Programs such as Live Lighter and Foodcents, for example, provided evidenced-based and practical help for people to live healthy lives. Other programs improved the availability of nutritious foods, and ensured walking and cycling were safe and viable components of transport planning.

In 2012, the then Labor government committed to the continuation of the NPAPH to 2018, but it was axed by the Abbott government in the 2014 federal budget.

Prevention programs aim to make it easier for people to make healthy choices, such as being physically active and eating a nutritious diet.
Annie Spratt

This took hundreds of millions of dollars otherwise committed to prevention efforts out of the federal budget calculations.

All of these discontinued efforts were likely to have had a major effect on reducing future generations of Australians from hearing those awful words: you have cancer.

Like any human endeavour that aims for big changes in systems and behaviours, stopping and starting the programs that lead these changes diminishes the prospect of success.

So why is it hard to get governments to invest in prevention?

Strong and influential industries consistently lobby governments to protect their commercial interests. That’s what happens in a market economy democracy. The alcohol, processed food and even tobacco industries continue to exercise an influential voice in the halls of power.

Unsurprisingly, industry aggressively opposes higher taxes on these products (“sin taxes”) and programs discouraging their use.




Read more:
More than one in four Aussie kids are overweight or obese: we’re failing them, and we need a plan


It is common to hear politicians tell stories of individuals, “real people” who benefit from a new treatment or access to new life-saving medical care or drugs. We all connect with these heart-warming stories and they illustrate the importance of the public funding investment.

Such stories are harder to tell in prevention. How do we find the 64-year-old enjoying his granddaughter’s first day at school, largely because he did not die of a smoking-related disease in his 50s because tobacco control efforts in his youth meant he did not take up smoking?

To tell of our success, we revert to dry and dusty but impressive statistics, with one estimate of 500,000 premature deaths prevented over the past 20 years.

Effective prevention policies, such as putting a minimum floor price on alcohol, work to reduce alcohol-related harm. But making it more difficult to reduce the price of alcohol is politically unpopular.

Reforms such as expanding smoke-free areas are taken for granted now, but were opposed when first introduced.

Tobacco control measures are now accepted and welcomed, but that wasn’t always so.
Patrick Brinksma

Finally, the benefits of prevention often take many years, even decades, to arrive. Political timeframes are often linked to election cycles of three or four years.

A long-term view is vital. Each dollar invested in skin cancer prevention, for example, returns about A$2.20 in cost saving in avoiding cost of treating the disease. But there are decades between reducing kids’ sun exposure and avoiding treatment when those kids reach their 50s and 60s.

As the election campaign unfolds, let’s hope both aspiring Australian governments continue to show a genuine interest in the health of Australians and commit to preventing disease. Is 5% of the health budget too much to ask for that?The Conversation

Terry Slevin, Adjunct Professor, School of Psychology, Curtin University and College of Health and Medicine, Australian National University and Simone Pettigrew, Professor, School of Psychology, Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Labor’s cancer package would cut the cost of care, but beware of unintended side effects



File 20190408 2909 1dbbi9k.jpg?ixlib=rb 1.1
The median out-of-pocket expenses for breast cancer treatment is A$4,192.
ESB Professional/Shutterstock

Kees Van Gool, University of Technology Sydney and Jane Hall, University of Technology Sydney

Labor’s big-ticket election promise is a A$2.3 billion package to provide free medical scans and specialist consultations for cancer patients, plus automatic listing of new cancer therapies on the Pharmaceutical Benefits Scheme (PBS) once they’re recommended by the nation’s expert advisory panel.

One in two Australians will be diagnosed with cancer by the age of 85, and around 145,000 new diagnoses are made each year. So most of us have a close relative or friend who will be affected by the policy.

But there are some important policy considerations a Shorten government would need to plan for to ensure the package provides optimal care, improves patient outcomes, and does actually reduce out-of-pocket costs.




Read more:
Shorten promises $2.3 billion package to relieve costs for cancer patients


What’s the problem with cancer care?

New therapies for cancer are rapidly evolving, and are often extremely expensive. Seeking treatment involves navigating a complex array of public and private providers across multiple health care sectors, often leaving patients with high out-of-pocket costs.

These costs are highly dependent on which providers the patients choose (and the fees they charge), the level of private insurance cover, and the volume of services used.

A recent Queensland study found the median out-of-pocket expenses for a breast cancer patient, for example, was A$4,192.

It’s possible but very time-consuming for patients to “shop around” to reduce costs. But this is an unreasonable burden to place on patients.

The Labor proposal provides an opportunity to develop a comprehensive cancer control program that encompasses prevention, early diagnosis, treatment and follow-up – at a reasonable cost.




Read more:
Cutting cancer costs is a worthy policy, but we need to try to prevent it too


Better care for cancer patients

Cancer treatment is well researched; there are clear evidence-based guidelines that establish clinical pathways for the best treatment.

Nevertheless, there is substantial variation in treatments given to cancer patients. This difference cannot always be explained by their clinical conditions, and sometimes the care is not evidence-based.

It’s important that the proposed reforms do not just fund more care, but support more of the best care.

The approach that has shown promise in other countries is known as “bundled payments”.

Under bundled payments, a series of health care services – that can span over time and across multiple health care sectors and providers – are bundled together for funding purposes. This gives providers or institutions greater flexibility in how they spend money delivering care to the patient.

There is a danger that bundling can provide incentives to skimp on care, because the provider receives the same amount of funding no matter how much care is provided. But this can be addressed by monitoring the quality of care and the patients’ outcomes.

Ensuring the financial benefits flow to patients

Australian governments have made several attempts to provide better safety nets that cushion patients from extra charges.

Study after study shows that, in these circumstances, providers are likely to raise their fees. So while patients get some financial benefit, the doctors benefit also.

Under current Medicare rules, the Australian government does not and cannot determine doctors’ fees. It can only determine the amount of the Medicare benefit.

In general practice, most consultations are bulk-billed implying that the fee the doctor charges is equivalent to the Medicare benefit.

Only 31% of specialist consultations are bulk-billed, leaving more patients with an out-of-pocket payment.




Read more:
Specialists are free to set their fees, but there are ways to ensure patients don’t get ripped off


What can government do to encourage cancer care providers to bulk-bill?

Labor has announced they will add a bulk-billing incentive payment, as occurs in primary care. Specialists will receive an additional payment if they bulk-bill a cancer-related service.

This will not guarantee that every patient will not incur any out-of-pocket costs – although it should increase the likelihood that they will. Indeed, the Labor target is that 80% of patients will be bulk-billed.

However, previous research has shown that while the GP bulk-billing incentive led to a reduction in costs for those eligible (concession card holders), it also increased costs for those not eligible.

Careful monitoring is required to ensure the volume of services – and their fees for non-cancer patients – do not go up.

Not all cancer care is based on the best available evidence.
Napocska/Shutterstock

A further unprecedented complication is that for some services, it will be necessary to differentiate Medicare payments on the basis of the patient’s cancer status.

To guarantee patients face no out-of-pocket costs would require more radical reform. Again, the bundled payment system could be a vehicle for such reforms whereby payments are conditional on all the patient’s service providers agreeing to deliver care with no additional fee to the patient.

Depending on whether a patient is privately insured, the bundled payment could be financed by private health funds and Medicare.

Of course, it’s not yet clear that bundled payment schemes can be directly applied to the Australian setting.

The Labor cancer package requires careful and rigorous research effort to inform and guide the policy development.

A new vision for Medicare

Medicare is now 35 years old. It was built on fee-for-service payment, and focused on short, acute episodes of illness.

Now it’s time to move to new funding mechanisms that provide better care for complex, ongoing conditions, at a cost patients and the country can be sure represent efficient use of resources.




Read more:
More visits to the doctor doesn’t mean better care – it’s time for a Medicare shake-up


Cancer is a good place to start and it could indeed be the most significant reform of Medicare so far.

Imagine a health system where every Australian was assured of optimal care, no matter what their illness or economic circumstances. That is a health system worth paying taxes for.The Conversation

Kees Van Gool, Health economist, University of Technology Sydney and Jane Hall, Professor of Health Economics and Director, Centre for Health Economics Research and Evaluation, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.