Paying tribute to a humble reformer and significant Australian

Many people working in the health sector will have stories to share about Labor luminary Bill Hayden, whose death at age 90 has put the history of Medicare into the headlines.

Below, Adjunct Professor Alison Verhoeven shares some personal memories and wider reflections about his enduring impact upon policy and lives.

Alison Verhoeven writes:

Ten years ago on a Saturday afternoon, I answered a phone call and was surprised to find my caller was former Labor leader and Governor-General Bill Hayden, wanting to discuss the Medicare co-payment policy then being touted by that other Queensland policeman-turned-health minister, and now Opposition leader, Peter Dutton.

At that time, I was Chief Executive of the Australian Healthcare and Hospitals Association.

A lively conversation ensued, despite me being completely overwhelmed that this giant of health policy reform in Australia was seeking my opinions and thoughts.

Showing his abiding commitment to affordable and accessible healthcare, Bill Hayden had questions about the different positions various stakeholders had adopted with regard to the proposal, and was interested in the data and evidence available to support or counter those positions.

With his number now stored in my phone, I welcomed subsequent calls from Bill Hayden as he sought information about matters ranging from private health insurance reforms to Health Care Home design principles, the establishment of Primary Health Networks and public hospital funding caps.

His curiosity, thirst for information, appreciation of nuance, and a principled approach to issues of equity and sustainability were impressive, yet what impressed me most was his down-to-earth and modest manner.

Beacon of hope

To give some context, I grew up in Queensland in the 60s and 70s, when public hospitals were funded by lottery tickets, those living outside of Brisbane had access to only the most rudimentary of healthcare, and politics was dominated by a Country Party gerrymander.

Bill Hayden was a beacon of hope in that environment, a politician whose commitment to progressive social, economic and health policy reform inspired a generation of younger voters wanting something different and better for their country.

Amongst other attractive policies, the promise of a universal health insurance scheme was one which attracted voters tired of 23 years of conservative politics to elect the Whitlam government.

Two-and-a-half years of planning and political battles ensued, including rejection in the Senate three times, a double dissolution election fought largely on health issues, passing of the legislation in a joint sitting of both Houses in 1974, and finally implementation of Medibank in July 1975. For the first time, everyone could have free access to a public hospital as a public patient, thanks to the work of Bill Hayden and his colleagues.

Successive dismantlement of Medibank during the Fraser Government years led to a redesign process which resulted in Medicare. Introduced on 1 February 1984, only 11 months after the election of the Hawke government in March 1983, Medicare gained universal acceptance in a relatively stable political decade, to the point where all sides of politics embraced it.

Fifty years on, Australians are rightly protective of Medicare and a world-class health system, even though finding a bulk-billing GP can be difficult and public hospital waiting lists are long.

We take for granted other reforms initiated by Bill Hayden and colleagues, including single parents having access to financial support, and those experiencing domestic violence being able to seek safe refuge.

An open and well-governed economy has enabled us to survive and thrive, notwithstanding global financial crises and a  pandemic. Our place in the world is strengthened by foreign policy which largely receives bipartisan support.

Both Coalition and Labor governments during these past fifty years have made changes to the policies and reforms shepherded in by Bill Hayden and his Labor Party colleagues, but at heart, they remain fundamental to the Australian political fabric.

Innovative public policy

As obituaries and memoirs are written about Bill Hayden, he will frequently be described as the architect or founder of Medibank, and its successor Medicare. Bill was rightly proud of their development and implementation, and acknowledged the political hard yards required to shepherd them through murky political waters with conflicted stakeholders such as the AMA. But he did not claim this as his own work.

I was honoured to be asked by Bill Hayden in 2018 to provide, on his behalf, a eulogy he had written for Professor John Deeble. In his mid-80s, Bill was not well enough to travel and attend the funeral himself, but he wanted to acknowledge the significant work John and his colleague, Dick Scotton, had undertaken in designing Medicare.

His thoughtful eulogy described the friendship and respect he felt for both John Deeble and Dick Scotton, and noted the value of public servants, politicians and academics working together productively and creatively to develop innovative public policy (an extract is quoted in this 2018 Croakey article).

Today we are all too aware of the excessive influence and input of fee-for-service consultants and vested interests to public policy, misinformation and disinformation reign supreme, and progressive politics has sustained many blows.

Our political leaders would benefit from reflecting on the leadership of Bill Hayden who worked collaboratively with public servants, had a rigorous and evidence-based approach to public policy, and most of all, who put public interest and well-being at the centre of his life’s work.

A humble reformer and a significant Australian, Bill Hayden made Australia a better country.

• Alison Verhoeven is an Adjunct Professor with the Institute for Health Transformation, Deakin University, a Visiting Fellow at Queensland University of Technology, and a director of Croakey Health Media. She was previously Chief Executive of the Australian Healthcare and Hospitals Association, the independent peak membership body and advocate for the Australian healthcare system and a national voice for universally accessible, high quality healthcare in Australia.

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