Best Person to Handle Health's Heady Brew
John Howard's unexpected Ministerial reshuffle clearly indicates his own lack of certainty about the next election. This is not a job-rotation exercise but a clear effort to shore up strengths and reduce weaknesses.
Some of the changes are clearing out dead-wood. The most significant of these is the retirement of the fascinatingly combative but accident-prone Wilson Tuckey and the demise of Richard Alston who has failed to give us a phone and TV system of North American quality. Kay Patterson is moved from the demanding Health portfolio where she struggled against the sector's numerous and noisy special interest groups. The reshuffle means that Ms Gillard, one of the Opposition's rising stars, will now have to confront Tony Abbott---the Cabinet's most original thinker and one of its best debaters.
Moving the tough no-nonsense Amanda Vanstone to the immigration hot-seat is a master stroke and shifting Phillip Ruddock to the less controversial but still demanding Attorney-General portfolio retains and rewards a late blossoming, loyal and effective performer.
Kevin Andrews' move to the Industrial Relations portfolio replaces the feather-ruffling, reform-insistent Abbott dynamo with a dour politician who must have given up on the prospects of advancement.
The Abbott change is crucial. On the one hand it removes a source of conflict, somebody who has marked the way forward but whose posture and persistence might be a disadvantage in pushing reform through the often red-tinged Democrats. Kevin Andrews offers better prospects of achieving an accommodation to inch away at the long march to reforming labour relations. In the case of the construction sector, labour relations are anchored in Leninist notions of class war and equally important are the public servant unions, which form the backbone of the ALP's support base.
By the same token, health is the area where spending blowouts threaten to derail all developed country budgets. We have an ageing population, a determination by the baby-boomers to hold and extend their leisure privileges, declining number of working-age providers, and a reservoir of hard luck stories that the media and Opposition can present as screaming out for attention by a cold-hearted government. Australia's own health expenditure rose nearly 80 per cent per head over the past decade with more exotic cures, increased labour costs and rising expectations all playing their part.
Health also presents a heady brew in view of the three way split in its funding between state and federal governments and individuals and their health funds. This makes for constant tussles as the three sources of finance each seeks to push the costs on to the others. The histrionics at the latest CoAG meeting, where the State Premiers staged a public walk-out over health funding, is symptomatic of the tensions in the system.
Tony Abbott promises to be more effective in holding the Commonwealth's corner in these inevitable disputes and offers the best political hope of finding a way to staunch the cost increases.