Tuesday, 20 September 2022

Member for Albert Park

Valedictory statement

Mr FOLEY (Albert Park—Minister for Health, Minister for Ambulance Services, Minister for Equality) (17:25): I thank the Parliament for the opportunity for a few final words. I want to leave you with a few thoughts on what good government can do before thanking a lot of people who have helped us deliver it here in Victoria. But first, a long way away in the Hall of Peace in Siena you will find Lorenzetti’s 14th century civic masterpiece the Allegory of Good and Bad Government. It has for almost 700 years set out what governments ought to aspire to. Painted on the cusp of the Renaissance it reminded the leaders of Siena then, and speaks to us today, as to what government is really all about—namely, the common good. In this particular work good government is depicted as the agent of peace and prosperity. Government is assisted in this work by many virtues. On one side of the fresco you have wisdom, justice and concord. Their efforts join the people of the state to the right hand of the figure of the common good, who guides the operations of the state. On the same plane as the common good we have the virtues of peace, fortitude, prudence, magnanimity, temperance and, once again, justice—all striving for good government. It is a big wall with big ideas, and it as relevant today as it was in 1339, probably more so, particularly as it relates to the role that the states in this Commonwealth play in the areas of the health and care of the people of Victoria in the 21st century version of good government.

I have been fortunate, having spent most of my time here as a member of the cabinet in the portfolios of the provision and reform of the health and the care that the people of this state need. This effort has focused on the most vulnerable, who look to government to hold their lives together, whilst also seeking to meet the demands and scope of access to universal services. I think that in Victoria we are well on the way to establishing what we might call the caring state. Over my time, like in jurisdictions everywhere, we have seen social and economic changes leading to growing inequality and the exclusion of many from access to the services they need to achieve this caring support. This in turn has driven more people into ever more complex and poorer outcomes for their health and their care, the end result being more people need more from the state than ever before, and the state responses have grown accordingly.

All of this was well underway before the COVID-19 pandemic came along and rewrote all of the rules. COVID has amplified the pressures in our systems of care and forced us to look to how we deliver more services in more effective ways. As we continue to emerge from the pandemic, it will be with a chance to reform how we both govern and deliver health and care needs. The work of the Andrews government leads the nation in this response. We might well be calling it the caring state, as we look evermore to how the experience of the pandemic provides us with an opportunity to take this reform effort to even greater heights. We are poised to be building a new model of care that improves the lives of and builds opportunities for Victorians, especially our most at-risk communities.

If I have learned anything over the course of the pandemic, it is that government-delivered health and care provision is more valued and effective than ever. The evidence is in, and it is clear. Government-provided health and care has shown itself to be the critical social institution that has built trust and confidence at this time of crisis. It has shown itself in circumstances where confidence is invaluable to success to be the pillar of social solidarity and success in the pandemic response. True, its weaknesses have been exposed; there is much to reform and change. But more importantly the public-led model of care and the interventions it has seen in the crisis of the pandemic have seen its underlying strengths revealed when it counted most. On the back of this terrible pandemic, with somewhere over 17 million lives lost globally, we are seeing a commitment to reform and growth of public sector delivered care rightly dominate the policy agenda around the world. It is here. I welcome this focus, for the time of the shrinking state in health and care has passed. This government has laid the foundations for models of a caring state, an enlarged model of care. I am confident that it will continue to build on this over the next four years.

The expectations of what communities demand from government have come into sharper relief over the pandemic. So many things government would not have contemplated delivering just a few years ago, partnerships that were not on the agenda and measures not contemplated are now part of what we do, and there is no going back. At the same time COVID has magnified challenges across the health and caring sectors at the commonwealth and the state levels and for government and non-government services alike. It has also set new levels of what constitutes the expectations of care and it has expanded the role of how the state needs to respond. Whatever else it has done, COVID has seen the leadership of the states grow in service delivery. How we create services that people value, how we share them equitably for access across the community and how we grow these services in the face of never-ceasing demand all mean a bigger leadership role for states. It also creates pressures on the settlements with the commonwealth and the private sector on delivering and funding for who does what and who pays for what. These are big questions and they are not easily resolved. The tough real world is complex. Reform is hard. One thing reform requires is a government that is bold in its sense of mission. Government needs to take reforms in social policy and service provision seriously and to bring professional, quality and equality lenses to the job of reform to achieve this.

I have been fortunate that my portfolios have placed me close to these very tasks. Piece by piece the Andrews government has shown that reformist governments count in people’s lives. That hard work in progressive reform improves the real lives of real people. A few examples: how the responses to family violence have come to the centre of the national debate, not just about the way we deal with trauma and violence in all its forms, but more widely the role of women in society; how the Royal Commission into Victoria’s Mental Health System has brought the crisis of mental and emotional wellbeing and of treatment and of recovery to the centre of the community’s debates, but more importantly how that model of change designed here is now spreading around the commonwealth; how the push for better outcomes by Indigenous communities and a framework of truth and treaty are now locked together, not just here in Victoria but increasingly across the nation and now with the push to constitutional recognition of Indigenous voice; how the discrimination faced by LGBTIQ Victorians and others so easily excluded from our systems of care can be challenged through government-led and partnered programs that set about changing models of care and practice through community-led development and legislative reform; how ending the selling off of state-run aged care and investing in these services both showed its worth through the aged care royal commission and was brought into such deadly relief through the global pandemic; how efforts to keep people alive through a health-led response to addiction works as the first step to recovery rather than a policing-led model; how giving the agency that people need when they face the unconscionable suffering at the end of their life can go from controversial to the law of every part of this commonwealth in less than four years; and how early childhood education can be reframed as both a right and a necessary starting point for wellbeing and life opportunities that targets particularly those communities most in need.

I could go on—it is a long list of reforms in the way we care for people, how we treat people decently and how we can look after them—but time prohibits me. Impressive as it is, I know it is only the beginning. From the learnings from the global COVID-19 pandemic we now are in a position to drive even greater change to this reforming mission. We have the opportunity to question and end the failed systems of deregulatory approaches of market-led service provision when it comes to human care and health. There is now an opportunity to build new models of service—our public welfare and wellbeing valued, efficient and well designed around people and solutions that deal with the causes of poor health and drive better services and outcomes that people have confidence in: public services. It is a mission of building a caring state that people can see the value in because it involves them and works for them. We are not there yet; there is a way to go, but this government leads the way in this nation. Nowhere does this all come together more clearly than in our health system.

State health systems are at the intersection points of not only their own extraordinarily demanding pressures but the failures in other care sectors where the state system acts as a provider of last resort or increasingly as a provider of first resort. Consider, for instance, people with disabilities excluded from supports in the national disability insurance scheme who are stranded in our hospitals; the collapse of primary care and GPs and the pressures on community-based models of care which see people with little alternative but the emergency departments via the ambulance; the growth in mental health demands and presentations, especially amongst the young, where the missing middle of community-based alternative is bookended variously by the demand on primary care at one end and the acute mental health services at the other, with the spillover of each ending up in the emergency departments; the untreated chronic illnesses and conditions showing up way too late in ever more acute presentations; aged care residents with little or no supports in their homes or the settings where they live, where the providers are driven by profit or the lowest common denominator service contracts that are designed to channel the frail unwell into our acute health services rather than them being treated in their homes; or at-risk groups—Indigenous Victorians, the CALD and LGBTIQ addiction communities, the isolated, the lonely, any of those groups who are unsupported by our mainstream health system that puts them on a path to exclusion and shuts them out from the unresponsive mainstream services until it is too late.

Add to that the problems of the federation’s funding, of disparity of services based on geography and income and the very strangely diffused but oddly ad hoc model of how we govern key parts of our services nationally and the still unresolved issue of public versus private health delivery and we see many challenges for our health and care systems. Top all of that off with an ageing, culturally diverse community, a workforce and skills shortage, burnout and the technology-driven services in health, and our problems in a post-pandemic caring health system are all too real. Yet, COVID has given us the chance to give the reform of this system a red-hot go. It is now accepted by all but the harshest of flat-earth conservatives that the cornerstone of successful COVID responses everywhere has been having them government inspired and government led. Equally the failures globally, right around the world, of market-led responses to COVID and public health emergencies show the need for stronger, smarter government solutions that seek to bring new levels of what people value in services that work to meet their needs.

Innovation and reform are the order of the day. We need more better government, not less poorer government. One thing certain from this pandemic is that it seems that when it comes to our health system we are all Keynesians now. It is common ground in this state apparently that it is no longer a question of whether our health system is capable enough with the changes in our post-pandemic world, it is how much bigger and how much more capable government-delivered service provision for care and health needs to become. How are the issues highlighted during the pandemic to act as a starting point to deal with growing demand for services and address the causes of ill health and disadvantage? How will all this come together to make sure that we are better prepared to deal with the inevitable next pandemic or health shock? All of these roads lead back to the state, reimagined and reinvigorated as the major part of the solution. The Andrews government has been one that has stepped up to deal with this crisis. Time and time again we have filled gaps in services whilst looking to reform them at the same time, be it when the federal government failed so spectacularly over the era from 2014–22 or when aspects of our own system were not designed for the scale of the crisis they faced in the pandemic. At the same time, these public services have performed at globally leading levels of performance by delivering models of public health care and services and solutions that undoubtedly saved many lives. While we have been far from perfect, with too many tragic outcomes—and the faults of our systems have been rightly highlighted—we have been largely successful in our efforts.

From a public health preparedness model that was designed for short-run, high-impact rather than sustained crises, we have much to reform. This we have started to achieve, and by any global assessment we are amongst the world’s best, as last week’s Lancet commission report highlights. This we should be rightly proud of. It is our learning from COVID that will be at the heart of a new narrative of what government can do. It is a vision that extends well beyond health—one that is big on ambition, grand in its vision, broader and more encompassing in its mission, collaborative and bolder in its purpose, an idea of government that creates public value by its investment and leadership in new models of care and how they are delivered. That good government is not just possible; it is the main tool that we have to achieve the reforms at the scale required and in the time frames demanded for the delivery of that common good.

It is not the market’s job to do all of this but our responsibility, collectively through government agency. Only governments bring the resources, the legitimacy, the urgency, the management of risks and the relationships with other civic and economic players to drive the changes needed in health and care provision. Bigger, bolder government, more effective government, is back in town at lots of levels. Look no further than what is spent by the Commonwealth as measured by the general government sector expenses. These at the Commonwealth level have grown from $156.7 billion in 2001 to $651.9 billion in 2021, with the greatest increase coming in the pandemic years under the Morrison government. Projections show it is not heading backwards anytime soon.

Interestingly the rate of growth in those expenses has been a far lesser rate in the states, where most of the actual service delivery is undertaken. In New South Wales the same figure over the same period has only grown to $95.5 billion, with Victoria’s equivalent just topping out at $90 billion. There is plenty of scope in that lot for a new national settlement on funding, health and care provisions to make this spending more effective. I am hopeful that the government of grown-ups now in Canberra will partner with states in this overdue reform.

With all of this it matters, then, who you elect to this place. It matters who frames that mission and defines that idea of the common good. It matters when you elect a Labor government that believes in this expanded mission, that believes that reforming governments meet great demands that the world throws at us. It matters most to the people who rely on these services to meet their existence and their needs. The Andrews government has a record of achievement on reform like few others in our history. Our pursuit of the common good will be turbocharged coming out of COVID, as it needs to be.

That gives me the opportunity to thank a few of those who have been at the forefront of this effort in building the caring state, starting in health. I would like to thank all those who continue to deal with the COVID pandemic. In this regard I cannot speak highly enough of our nurses and midwives under the leadership of the Australian Nursing and Midwifery Federation. Time after time their counsel, their advocacy, their unrelenting straight talk and their real-world intelligence have been central to the government and the wider community COVID response. It has saved lives. It has kept our health system functioning in the face of pressures never previously contemplated. They have placed the needs of patients and workers at the heart of what this government does. If the ANMF’s members were the pillars of our health system pre pandemic, then they have been its heart, soul and muscle during the pandemic. I thank especially Lisa Fitzpatrick, her leadership team and their 97 000 wonderful members for their contribution to this state in its time of greatest peril. The same can be said for Danny Hill and the Victorian Ambulance Union, the AMA, the medical colleges and all the other health unions and professional bodies we work with. The success in the pandemic has been theirs.

I want to thank all those across government, but particularly in the Department of Health and the leadership of our health networks, that designed and rebuilt a new, more effective health COVID response in the midst of the pandemic. There are too many to mention them all, but I want to particularly thank Euan Wallace, Kym Peake, Nicole Brady, Naomi Bromley, Zoe Wainer, Kate Matson, Jodie Geissler, Sandy Pitcher, Ross Broad, Mary Perera, Kym Arthur, Jeroen Weimar, Brett Sutton, Allen Cheng and Ben Cowie amongst the many who have delivered one of the world’s most successful, if tragic, COVID responses. I thank Tony Walker and Ken Lay and their workforce at Ambulance Victoria for their efforts in these most difficult of times. A special call-out goes to the community health sector, the volunteers, the community organisations and those many groups whose responses, particularly with our most marginalised communities, continue to be extraordinary. I thank them all.

Beyond COVID, if there is a model of what government can achieve through design reform and serious investment, it is in mental health. I thank the Royal Commission into Victoria’s Mental Health System led by Penny Armytage and her team. The mental health system is rebuilding in a design co-led by government and an array of community partners. I thank the team led by Pam Anders, Simon Stafrace from Alfred Health and Katherine Whetton for commencing that work. You are implementing the blueprint for world-leading change, and it is unstoppable.

We are continuing to reshape the field of alcohol and drug addiction. Whilst all the focus is on safe injecting, which the evidence continues to show here and globally saves lives, it has been the growth in other treatment options—acute options, community, pharmacological and social—that has really at the heart of it defined our changes over the last eight years. I thank all of those involved for their advocacy and commitment to this health-led response.

I thank all those people with disabilities and their allies, especially those who continue to fight for an NDIS that meets your aspirations. I thank those in aged care and housing in both government and community sectors for their roles in making sure that the thousands of Victorians who depend on them for their services are heard and looked after. They are the pillars of the emerging caring state architecture.

If I can turn to the creative sectors that I have been privileged to act as minister for, we have taken the idea of arts as a cultural benefit to the state and built the idea of a wider set of outcomes to be valued by more people across a bigger range of economic, cultural, social and innovative outcomes. The economic value of our creative industries has always been important to jobs and our status as the creative capital of the nation, but we have brought them into a sharper focus and given them greater support and seen their importance grow. Beyond the focus on economic value, we have increased access to cultural experiences and built a framework for diversity and collaboration across sectors that has favoured the small and independents. We have democratised the arts and cultural sectors by focusing on diversity and participation, ensuring First Nations and diverse communities are supported whilst building the institutional capacity to meet the ever increasing demands of participation and visitation.

Creativity in all its diversity is an important part of our lives, our economy and our future. I thank all of those from Creative Victoria, the state’s cultural and arts agencies and all of those, whether they be large or small, independent arts organisations. I thank those in live music for driving new opportunities in venues and digital platforms, and particularly as the growth in gaming now dwarfs the traditionally important screen sectors, there is no more exciting place to be than Victoria.

Whilst well underway, there remains much to be done to take this level of creativity to a new height under our recovery. Once an aspiration, LGBTI equality is now on the way to being a reality. The equality portfolio was one that I took particular heart in, particularly as to how far and fast reform can really be driven. The celebration and engagement of diversity of LGBTIQ Victorians is embedded in a way now that it was not in 2014. Equality for Victorians is really not negotiable if you are an LGBTIQ Victorian anymore. But it is fragile and, as we have seen, constantly under threat from those who want to demonise the LGBTIQ community. So can I take this chance to issue a plea on behalf of trans kids, trans people and their families: can we not use trans kids and gender gotcha moments as clickbait in this coming election? Lives are at risk. Culture warriors and their deliberately hateful methods hurt real people. Can we just support people in being who they are?

It is impossible to name everyone, but I would just like to highlight a few leaders, like Ro Allen and Todd Fernando, amongst a host of others who have built and backed this equality project. Thanks to community leaders of rainbow organisations who have shown what a different model of community-led empowerment looks like. There are many fine people in the pantheon of LGBTIQ leaders and allies, and I thank them all. But can I give a shout-out to the number one rainbow ally who has backed every policy idea we have brought forward and had a few of his own—the Premier.

A final few thanks: the people of Albert Park district, besides being in the best place to live in this state, have supported me and educated me in ways that I am deeply appreciative of. All politics is local, and building better communities counts. I would like to think we leave Albert Park better than we found it.

To the officers and the staff of the Parliament: can I thank them all for their important work in our democratic system. They are the quiet operators of our parliamentary festival of democracy, and we would collapse without their support. I thank the Australian Labor Party, the oldest social democratic and most successful of labour parties globally. I wish the party well in the next important phase of its redemocratisation, so important to its success.

I thank the Australian Services Union and its members and indeed all Victorian unions as our most successful community organisations. The grounding provided by the union movement, especially my union branch—which, just saying, has landed three federal MPs, three state MPs and five ministers from that lot, our little band of activists in the 1980s and 1990s—has built an understanding of how we build campaigns for better workplaces and communities in the face of the changing world. The union movement’s lessons and its training have been central to modern Labor’s success.

I thank the Premier and all my cabinet colleagues for their support. A cabinet system that holds us to account and that tests ideas is what drives good government. I want to particularly thank those colleagues that I have relied upon more than others for support. Whilst everyone is valued around our cabinet table, and at the risk of leaving out some, can I particularly thank the member for Altona, the member for Mill Park, the member for Richmond, Gavin Jennings, Ingrid Stitt, the member for Bellarine, the Treasurer and of course, on just about every major issue, the Premier for their backing when it mattered.

To my electorate office staff—problem solvers, grief counsellors, community organisers and much, much more—I thank all of those who have served my community and particularly my battle-hardened COVID veterans. They have endured the abuse, the death threats, the bomb hoaxes and the level of demand from the pandemic more than anyone, and yet they kept coming back. To my ministerial office, my staff over the years have been critical to managing the demands and the details and complexity of a reformist government. It is a tough gig. They were led by Lisa Calabria, the quietly effective and brilliant political administrator whose work ethic, loyalty, direct honesty and advice were more valued than she could know, particularly in the toughest of times that was the pandemic. Your dedication to the wellbeing of this state and to the success of this government is deeply appreciated and valued. She led a small team of people who worked unbelievably hard over the course of the last eight years, but particularly the last three COVID years.

I thank all my wonderfully smart and loyal team of advisers, whose efforts were constant and never faltered and who operated under the highest levels of demand with a dedication and effectiveness that goes unnoticed, as it should, by many, because they worked so well as a team.

Thanks to the media teams and all those who delivered on all the challenges that they were set.

Thanks to my executive assistant, Kathie Noble, and my driver, Dianne Taylor. You got me there, and you got me through. I wish you all every success in a calmer future.

Finally, to my family—to them I owe it all. My children, Emma and Tom, have grown into fine adulthood. I hope my life in politics has not jaundiced your world view too badly. The fully rounded human beings you have become will see you into exciting futures, I am sure. I am beyond proud of you. I look forward to seeing what worlds you will conquer.

Sharon Duff has encouraged, counselled and sustained me in so many ways and in every part of our lives together. Wisely she saw my obsession with the Labor movement as the vehicle for progress and reform, as imperfect as it is, and has backed me at every step while building her own life. You treated it all with the necessary and real-world scepticism that it and I needed. The support that I have received from you to sustain these 35 years has been immense. Your love and commitment have been immeasurable and have reinforced me time after time. You have navigated and tolerated my setbacks, failings and occasional successes. The burden and joys of support have been ones that you have carried for us all. Thank you for this effort and love.

Whenever I look, from now on, to Lorenzetti’s allegory of good government, I will think of this Assembly and the work of the Andrews government. I will look to this place as being a place that gives form to the pursuit of the common good. I wish the Parliament well. I thank the house.

Members applauded.