The Minister for Unfinished Business leaves plenty of scope for successor

In the articles below, Dr Melissa Sweet reports on reaction to the news of Minister Greg Hunt’s impending retirement from federal Parliament, and Associate Professor Lesley Russell examines the implications of a “lame duck Minister” for the forthcoming federal election campaign.

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Melissa Sweet writes:

When Health Minister Greg Hunt officially announced that he would not contest the next election, he suggested it was time “for a strong, brilliant woman to be the Liberal candidate for Flinders”.

Hunt, who recently turned 56, has represented Flinders, centred on Victoria’s Mornington Peninsula, since 2001 and has been Health Minister since January 2017, also taking on the Aged Care portfolio last year.

Before Parliament, he worked in law, and then as a senior adviser to then Opposition Leader and subsequent Minister for Foreign Affairs, Alexander Downer, and then for the consultancy firm, McKinsey and Co.

Hunt cited family reasons for his retirement, saying that his wife Paula, a nurse, had raised their two children largely as a single mother.

Referring to his father, Alan Hunt, who was a Minister in Victorian Liberal governments, Greg Hunt said: “As much as I love the Liberal Party, I love this place more. My father said of the parliament: ‘Honour the parliament. Be a parliamentarian before a politician’.”

In announcing his retirement, Hunt thanked several of his staff – Lynne Strahan, Sarah Meredith, Tina McGuffie, Denise Garnock, Lisa Burgess, Wendy Black, and Joanne Tester – and told about helping a young girl with a rare genetic condition obtain compassionate access to a medication, whose health then improved.

“…if there had been nothing else in these last 20 years, that alone would have been enough,” he said.

It was a fitting anecdote for a Minister who made an art form of announcing new listings for medicines, often including their brand names, in a way that Croakey doesn’t recall happening under any previous health minister.

Solid record

Contrasting Hunt’s record with another outgoing Minister, Christian Porter, political journalist Michelle Grattan said the Health Minister left with “a solid record of performance, despite some criticism and ambition for higher things unfulfilled”.

Writing in The Conversation, she said:

Hunt has been indefatigable in a difficult pandemic world, where advice is necessarily always changing and the outlook often uncertain.

One of his tools of trade, in his public presentations, has been a command of numbers, which gush out in his press conferences and interviews. He’s the positive spinner. Mistakes are not admitted.

On the downside, however, were the missteps in vaccine ordering and the slow rollout that had the Government on the back foot for months. Hunt’s health department came under increasing criticism and a military man was appointed roll-out supremo.

Earlier, the nation had been shocked by the 2020 wave of deaths among aged care residents. Although multiple factors were involved, aged care is a federal responsibility, coming under the health department, and what happened showed the vulnerabilities and lack of preparedness in the sector.”

Grattan also wrote that: “In personal terms, Hunt is a volatile character, liable to blow up at people. His then departmental head, Martin Bowles, formally complained about him after one incident a few years ago. Bowles wasn’t the only senior bureaucrat to find him difficult to deal with.”

Croakey has also recorded some such instances – for example, his response to questioning by ABC’s Michael Rowland about the inclusion of a Liberal Party logo on a Government vaccine announcement that had provoked concerns.

Rather than addressing the legitimate questions raised by Rowland, Hunt made a ham-fisted attempt to bluster through the interview, talking up the “heritage” of the Liberal party and making unjustified ad hominem attacks on Rowland.

At the time, Adjunct Professor Tarun Weeramanthri, President of the Public Health Association of Australia, tweeted that Rowland’s question was “legitimate and important”, adding that “attacking a journalist for asking a question is not OK. The question remains unanswered.”

Hunt also made a personal attack on prominent health policy analyst and economist Professor Stephen Duckett, who asserted his right of reply in this Croakey article.

Statements of thanks

As usually happens at these times, the news of Hunt’s retirement was followed by a series of laudatory releases from the health sector, often with the dual function of also promoting sectional interests.

The Rural Doctors Association of Australia praised Hunt for his “strong leadership” and “tireless work”; the Australian Private Hospitals Association congratulated Hunt for his contributions to the COVID response and healthcare reform.

The Australian College of Nursing (ACN) described “the incredible support Minister Hunt has provided to the nursing community during a very difficult time” and said Hunt “has been a champion of the Australian nursing community ”. Hunt often mentioned that his mother was a nurse, like his wife.

(No mention, though, of the lack of nursing representation on the new National Aged Care Advisory Council).

Meanwhile, the Chair of Beyond Blue, former Prime Minister Julia Gillard, thanked Hunt for being a dedicated, “caring and passionate advocate for mental health”.

“Notably, he seized the potential of telehealth to expand access to mental health and wellbeing support,” she said in a statement.

“He recognised the healing potential of universal aftercare for those in suicidal distress. And importantly, he championed the voices of lived experience, talking openly of his own family’s experience with mental illness.”

The Consumers Health Forum of Australia thanked Hunt “for his service to healthcare especially during the challenges of the COVID pandemic and the national vaccination rollout” and “for recognising the need for diverse voices in policy design, and in particular his support for the Youth Health Forum”.

The Royal Australian College of General Practitioners (RACGP) thanked Hunt for “being evidence-based throughout the pandemic response and COVID-19 vaccine rollout”.

“The fact that he’s been willing to listen to the science has meant we’ve been able to manage the virus and come to a good outcome for Australia, particularly compared to other countries,” College president Dr Karen Price said in statement.

“Everyone involved in the response to the COVID-19 pandemic and national vaccine rollout, including Minister Hunt, has worked pretty much 24 hours a day, seven days a week for nearly two years, doing all we can to protect our community. I hope he gets to enjoy spending more time with his family.”

The Australian Medical Association listed many achievements from their close working relationship with Hunt, notwithstanding “some notable disagreements” over the years, and described “the Minister’s unique ability to bring stakeholders together in order to resolve issues – a skill critical to the health portfolio”.

The Society of Hospital Pharmacists of Australia (SHPA) said Minister Hunt’s COVID leadership among federal and state government colleagues was reflected in Australia having one of the world’s lowest mortality rates as well as the highest vaccination rates.

The Medical Technology Association of Australia (MTAA) thanked Hunt for “his long-standing commitment to the medical devices industry”,  while the medical technology company Stryker said the Minister’s leadership in the early days of the pandemic saw him bring together industry and government stakeholders for crucial collaboration.

The Minister was essential in securing vital medical supplies (such as ventilators, testing kits and PPE) during global shortages and supply chain disruptions, the company said.

(The statement did not mention ongoing concerns about the Government’s delays in procuring COVID vaccines).

The Australasian Association of Nuclear Medicine Specialists (AANMS) also issued a statement of thanks.

Critical matters

At these times, it’s also important to look for what is not said.

We have not heard much, if anything, about Minister Hunt’s commitment to health justice for Aboriginal and Torres Strait Islander people, or to addressing the underlying drivers of health inequities.

In the UK, by contrast, the Secretary of State for Health and Social Care, Sajid Javid, has put addressing health and wider disparities on a cross-government agenda, in responding to COVID. Imagine Hunt making a speech like this one by Javid a few months ago.

In the week that Hunt officially announced his retirement plans, the Royal Australasian College of Physicians (which also issued a statement of thanks) released this 121-page report, Climate Change and Australia’s Health Systems: A Review of Literature, Policy and Practice.

The report repeatedly notes a lack of national leadership on climate and health. For instance:

Policy literature and evidence relating to the impacts of climate change on the health system in Australia reveals considerable variation in the approach across the jurisdictions to addressing the impacts of climate change on the health sector.

Most notable is a lack of leadership from the Commonwealth, despite considerable evidence about the risks to health from climate change.”

Hunt will be remembered by many health leaders for his failure to engage with climate change as one of the biggest public health threats facing humanity.

Indeed, in weighing up the ledger on Hunt’s contribution to public health, let’s not forget that he was Environment Minister in the Abbott Government, whose signature act was to repeal effective climate change legislation.

In 2014, photographers recorded colleagues congratulating Hunt for the passage of the Clean Energy Legislation (Carbon Tax Repeal) Act 2014. As journalist Peter Hannam tweeted recently, this is probably how history will remember his main contribution to public policy, “and probably not fondly”.

In one of his first acts in the portfolio, Hunt – who famously wrote a thesis at university titled A Tax to Make the Polluter Pay – informed the Climate Commission that the new Government was shutting them down.

As Associate Professor Lesley Russell writes below, many other critical policy areas did not benefit from Hunt’s tenure.

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Lesley Russell writes:

A federal election campaign looms and – at a time when Australians have never been more conscious of the value of the healthcare system and the need to ensure the health and wellbeing of all Australians – the Morrison Government now has a lame duck Minister for Health.

What impact will the announcement of Greg Hunt’s retirement have on the health portfolio and the Coalition’s election commitments in this area?

There are concerns that economic recovery issues will dominate the campaign and that Morrison and Frydenberg will argue healthcare funding has been sufficiently boosted through support for pandemic-specific issues, including additional funding for aged care and mental health.

Expect the focus to be on “look what we’ve done for you” and “can you trust Labor?”

Whatever is on offer in terms of Coalition health policy in the lead up to the election (and possibly in an early federal budget), it will be difficult for Hunt to convince voters that this will be delivered.

It’s not just that this task will fall to someone yet to be elected and named, but that Hunt’s record over almost five years as Health Minister offers no hope for long-term planning and needed reforms and only small encouragement for increased funding.

During his tenure, Hunt has readily fallen in line with the Morrison approach to governing: ignore previous reports and recommendations; sidestep the big issues, casting them off to advisory groups and consultants; no long-term vision but band-aid solutions and short-term commitments; never do quickly what can be delayed.

Unfinished business

The list of unfinished strategies and plans and incompletely delivered commitments in his portfolio is shockingly long. These will be his legacy as the Minister for Unfinished Business.

It will be hard for Hunt to defend his record on primary care when the 10-year plan (announced in August 2019) is yet to be finalised.

The Sixth National Mental Health Strategy involving $770 million for mental health and suicide prevention, aimed at addressing the needs of those who currently struggle to find help (the “missing middle”) is still in draft form as the Federal Government and States and Territories argue over responsibilities.

There has been an interminable delay on the release of the National Preventive Health Strategy. It was announced in June 2019 and consultations were completed in 2020; it is due to be launched next week.

The health workforce crisis (heightened by the pandemic but an issue long before coronavirus arrived) is addressed by easing immigration barriers for overseas doctors and nurses, while the need for long-term health workforce planning is ignored.

Silences and spin

The issues that are really impacting Australians’ health – poverty, housing, social inequality and inequitable access to services, climate change, and obesity – are never mentioned.

It is already apparent that Morrison and his team will campaign on broad issues such as additional funding delivered for hospital, mental health and aged care services during the pandemic while ignoring the need for major system reforms in these areas and the fact that much of this funding is short-term.

They will also make every effort to claim the success of the coronavirus vaccination campaign, again, ignoring their many failures.

Hunt is already being portrayed as “steering Australia through this pandemic where we now have one of the highest vaccination rates in the world and one of the lowest fatality rates in the world” when in fact he contributed to the initial problems with vaccine supply and slow roll-out.

The Health Minister touts his efforts around telehealth as a key achievement during the pandemic and a “revolution” in healthcare. It is indicative of his approach to policy that Medicare telehealth items have been introduced, expanded and extended in an ad hoc manner that reflect doctors’ needs rather than those of patients (this includes removal of the initial requirement that these services are bulk billed).

In November last year Hunt announced that telehealth would become a permanent fixture of Australia’s healthcare system. But efforts to co-design permanent post pandemic telehealth as part of broader primary care reforms are still underway.

The telehealth story epitomises Hunt’s legacy – promises bigger than the reality and unfinished business.

That’s a hard sell in an election campaign, especially if you won’t be back to step up to the task.

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Read Croakey’s previous stories on the 2022 federal election and health.