Tony Abbott reflects on his time as federal health minister and says the upcoming health care agreements could achieve most of the benefits of a federal government's  takeover of public hospitals.

At the recent 2020 summit, delegates' frustration with the dog's breakfast of divided responsibilities in health was sidetracked into proposals for a national preventive health agency funded by a tax on junk food and a new health equality commission. Keeping people healthy and giving everyone the best possible health outcomes are worthy goals, but are unlikely to be achieved by creating new bureaucracies. Avoiding discussion of today's actual problems by focusing, instead, on vague aspirations for the distant future seems to be the new government's style. Let's find something that sounds visionary, but that doesn't threaten current power structures or imply blame for current problems. That way, we can all be seen to work together.

It's regrettable that the summit did not, as chairman Michael Good wanted, consider the problems caused by having the federal government part-fund, but state governments wholly run, Australia's public hospital systems. This would have been a meaningful challenge for our best and brightest minds. Instead, as usual, it seems that the politicians and public servants will have to wrestle with this as they renegotiate the Health Care Agreements over the course of this year. Because they deal with the sickest people, public hospitals will always be the heart of health care systems. The next round of Agreements gives the federal government its once-in-five years chance to make a difference to the most difficult and most important aspect of health care delivery.

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