Primary care in trouble? Here, have a submarine

4 minute read


The AUKUS deal tells us a lot about our government's priorities, regardless of party.


How is that we live in a world in which Australia needs second-hand submarines in 15 years’ time more than it needs properly funded primary care right now?

For those of you who have been too busy keeping people alive and running your own families, here is a brief precis of the ridiculous situation in which we find ourselves.

As part of AUKUS – a Morrison-era trilateral security pact between Australia, the UK and the US – Australia will build eight nuclear-powered subs which won’t begin service until the 2040s. In the meantime, to fill what apparently is a dangerous gap in our naval capability, we will buy a few used subs from the US – but only if Congress agrees, bless them. And not until the 2030s. Oh, and we have to figure out what to do with all that nuclear waste ourselves.

It’s “all systems go with Uncle Joe”, apparently. Because it worked out so well when we went all the way with LBJ. Don’t even get me started on the finer print of the deal – like more visits to Australia by US nuke-laden subs, and Royal Australian Navy personnel heading off to serve time with the US Navy and the RN.

The whole thing is estimated to cost about $368 billion – that’s a “b” for “bulk-billing”, not an “m” for “Medicare rebates”.

I’m not entirely sure what we’re supposed to do if some superpower’s navy decides to go us in the meantime, but I’m sure our political overlords have that all worked out.

Former PM Paul Keating called the whole thing “the worst deal in history” and likened it to the Labor government’s decision to introduce conscription at the start of WWI. In the process he destroyed the psyche of a generation of political reporters and blew Laura Tingle’s hair back. Bless.

Victorian Premier Dan Andrews said Victoria wasn’t going to take the waste and it should be sent to the state that was going to get all the benefit from the deal (that’s South Australia, by the way). And then he quietly mentioned that if the country can afford $400 billion for subs then we can afford to fix Medicare.

“We can afford to make sure that states and territories are supported to deliver the services that families need. That’s the strategic threat,” he said, harking to a series of war-with-China-imminent articles coming out of Nine Newspapers recently. “Remember those days? When you used to be able to find a free doctor when you needed it?”

Oh yes Dan, yes we do.

PM Albo immediately shot back with the predictable walk-and-chew-gum argument. “It’s not either or,” he said.

Put your money where your mouth is, Albo. Prove it. Now, before the damage becomes irreparable in primary care, emergency care, chronic disease outcomes, aged care, mental health and all the other parts of the healthcare system that are about to pop their rivets.

I would love to see a health economist or two work out how much downstream money could be saved by pouring a couple of hundred billion dollars into healthcare reform right now. I’d bet my last subsidised allied health visit for the year that it would work out cheaper than at least two secondhand radioactive tin cans.

Someone, of course, will say “oh the money for health comes out of a different bucket than the money for defence”.

Of course it does. But only because some mandarin in Treasury says so. It’s not an actual bucket. Cross out the words “for clapped out US sub” and write in “for underpaid, overworked, under-resourced, burntout doctors, nurses and allied health people and systems that just got us through a global pandemic with barely a word of thanks”, and push the damn button.

Tangible, right-now reform that will help Australians. For crying out loud.

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