At the National Press Club in Canberra on 22 March, ten journalists were given the privilege of addressing questions to the Prime Minister and the Leader of the Opposition on the subject of their debate, health and hospitals reform, a debate that was critiqued in the previous piece: Comprehending the Great Big New Health Debate.
Amongst many striking aspects of that debate was the calibre of the questions asked by the ten journalists. Presumably they were the cream of the media outlets that nominated them. In a sense they represented the rest of us, those of us who would have valued the privilege of asking questions, but couldn’t.
How well did they ask questions on our behalf? In my view, not all that well. Which begs the question – is that the best there is?
This piece critically analyses the questions they asked, queries what some of them were hoping to achieve, and asks why most of the questions were unnecessarily verbose and at times scarcely intelligible. In some instances a more succinct alternative is offered.
First I acknowledge the source of the questions – a piece by Grog on Grog’s Gamut of 23 March The Health Debate – Kevin grins, Tony grits, Journalists talk. You will find it a reliable and very readable account of the health debate.
Referring to the questions asked, Grog observes: “...any journalist who complains about Rudd going on and on, should look at how long most of these questions are...”
Let’s take the questions seriatim. They have been placed in italics. Suggestions for alternative wording are in bold italics. Because the questions are replicated verbatim, this piece is quite long.
Paul Bongiorno - Network 10
Prime Minister – why 60-40, why not 100%, aren’t you at least going to have a 40% blame game?
That is a sound question, laudably brief, but hardly incisive.
To Tony Abbot – I judge from your remarks today that you’re not happy with the 60-40, does that mean you want 100%, is that what you will hold out to the Australian people? And you’re critical of bureaucracy, who will run the hospital boards, who will appoint them? Will it be a new layer of bureaucrats, or will you trust the states this time as you didn’t when health minister and you felt they needed to hand over everything to the Federal Government?
Another reasonable question, but so tortuous. Why not say: “To Tony Abbot – I judge from your remarks today that you’re not happy with the 60-40; does that mean you want 100% Federal funding? And as you’re critical of bureaucracy, what bureaucracy will be needed to run the hospital boards in your plan?
Like so many of his colleagues, Paul asks a multi-choice question, in this case about the bureaucracy: Who will run hospital boards? Who will appoint them? Will it be a new layer of bureaucrats? Will you trust the states this time as you didn’t when health minister...?
Why do journalists do this? I suppose it’s to pack a number of questions into one, but it serves only to confuse the audience and lose their attention, and allows the politician to answer whatever part of the question that is easiest to address.
Did we get an answer to his multiple questions? No.
Sandra O'Malley - AAP
“To both leaders – we’ve heard the horror stories of how the aging population will overwhelm the budget in the coming decades; at the same time many of us drink too much, smoke too much, don’t exercise enough, adding to the burden of chronic disease; at what point do Australians need to become more realistic about what they can expect governments to provide in terms of health care, and why shouldn’t there be a sensible debate about health care rationing as part of public health care policy into the future?”
That’s over eighty words. She could have used just thirty words: With the aging population and the steadily increasing burden of chronic and lifestyle disease, should we be considering rationing health care rather than trying to meet people’s unrealistic expectations?
But surely she didn’t expect a politician to endorse the concept of rationing, which makes it a silly question, a wasted question. Why did she ask it?
Sue Dunlevy -The Daily Telegraph
“There’s a gaping cavity in this nation’s health care and I want to extract an answer from each of you on the problem. Over 1 in 4 Australians has untreated tooth decay – half a million are waiting for up to 10 years to get dental treatment, and we’re getting Thai Buddhist dentists coming out to Central Australia to do charity work because there are not enough services in this country.
“Kevin Rudd: your Health and Hospital Reform Policy on page 83 says we should have a nationally funded dental health plan paid for by a 0.54% increase in the Medicare levy – will you deliver it?
“Tony Abbott: you say in your book, Battlelines on page 104 Medicare should fund dental care for every Australian – will you deliver it?
That’s 126 words. Questions about dental care are appropriate, but instead of the long-winded preamble, in which she tries to strike a clever note, why not simply ask: This question is to you both – please tell us your plans for dental care for which there is a pressing need? And asking 'will you deliver it?' is hardly likely to elicit a negative response.
Lyndal Curtis - ABC Radio
“You both come into this debate with experience in health, as a bureaucrat and as a health minister, yet neither of you has brought your whole policy here. We’re only months away from an election, and neither of you have the full answers to questions, like how are you going to deliver more hospital beds, what are you doing on aged care, and what you’re doing on mental health, isn’t this just a chance for you to score political points from each other, and isn’t that just what voters are heartily sick of?”
This was a typically acerbic Lyndal question and another multi-choice one – hospital beds, aged care, mental health. She knows full well that neither intended to bring the full health policy to the debate – Rudd intends to present it in stages, possibly on the grounds that to reveal the lot at once would cause confusion in journalists’ minds, and have them accuse him once more of complexity and overkill. Abbott never intended to reveal his, and it appears to be fragmentary anyway. So why did Lyndal waste the question?
She could have asked: When will we see the full health policy from each side? Or How long will the electorate have to wait for the full policy from you both? Or as Grog suggested: What are you going to do about aged care or mental health?
Mark Riley – Network Seven
“Prime Minister, of the $42b stimulus package about $16b was spent very visibly on improving schools, school halls, and sometimes duplicate school halls and libraries, I wonder if you can explain why none of that money was spent on another sector – the health sector, the hospital sector is crying out for capital investment – we visited dozens of schools [he meant hospitals] with you in recent months and it’s obvious that there’s a real need there for capital investment; why have there not been more operating theatres, more cancer centres built with that stimulus money that would have flowed through the economy just as well?
“And Mr Abbott if you take government before the money is spent would you redirect some of the stimulus spending, the infrastructure spending towards capital investment in hospitals, and if so how much?”
That’s over 130 words. What a hotchpotch, and how inept. If Mark doesn’t know by now that capital investment in such items as hospital theatres and cancer centres take lots of planning time, far more than was available to address the urgent problem of an economy heading towards recession, he should get another job. And of course he had to give an unnecessary backhander over the BER just to be smart.
Why didn’t he say to Rudd: Why didn’t you spend some of the stimulus money on hospital theatres and cancer centres? It would have been no sillier than the one he asked, would have taken much less time, and would have evoked the very response he got from Rudd which demonstrated how silly his question was.
Laura Tingle – Australian Financial Review
“You’ve both talked about cutting bureaucracy as part of this whole exercise, but I’d like to know where between the 150 odd local hospital networks in the Labor’s case, or the 750 odd local hospital boards in your [Abbott] case who would actually run things? Who are those bodies going to answer to, are they all going to ring Jane Halten [the Secretary of the Dept of Health and Aging] in the Department of Health? Do you presume that when you get rid of area health services in New South Wales there will be nothing between them and head office in New South Wales? How is it actually going to work so that all the money you both say the Commonwealth doesn’t get enough say in, actually is accountable to the Commonwealth and Commonwealth taxpayers?”
Laura is a top journalist and her question was one that needs answering, but did it need over 130 words arranged confusingly into multiple questions? Why not say: Since you both wish to reduce bureaucracy, how will you do this Mr Rudd with your regional networks, and Mr Abbott with your local hospital boards? She could not expect anything other than general comments, which begs the question, was her question worth asking in the form in which she presented it?
Matthew Franklin – The Australian
“Hi gentlemen, to Prime Minister I’d like to follow up on Mark Riley’s question. I understand why you spent the stimulus money, but when you sat down and worked it out, why did you decide that we need to put a building in every school rather than addressing what you here today say is a major problem and that is deficiencies in the health system; was it because you got more political bang for your buck by putting a school hall in every school, rather than a smaller number of hospital wards?”
I suppose Matthew thought he was being clever in asking this long winded question, but I wonder did he realize that an estimated 900,000 viewers were watching him being a smart aleck? The question portrayed his bias, which has been on display in his articles in The Australian where the theme of ‘waste and mismanagement’ in the BER have been pursued with a fervour that has come to be the hallmark of News Limited papers. The question was treated with the disdain it deserved. It was a silly question, a wasted question.
“And Mr Abbott you have proposed to do something very un-Liberal – increase a tax to provide what some people say is an excessively generous paid parental leave scheme (but you wouldn’t say that would you – I think he just did... some people would) but I would just like to know, if health is so important have you considered… and why don’t you lift taxes so that you can find the money to make the sort of improvements that I think we all can agree are needed in the hospital system?”
What a contorted question, what gibberish, what grotesque English from a senior journalist from our national newspaper?
Grog assessed Matthew’s questions thus: “...this question to Rudd was perhaps the worst of the day, and displayed even less economics acumen than did Riley’s. His question to Abbott was a better effort, but really did he seriously think Abbott was going to say he would increase taxes to pay for hospitals?
I won’t attempt to rephrase this silly question; it never should have been asked.
Michelle Grattan - The Age
“Mr Rudd, can I to take you to Private Health Insurance. Apart from the means test on the rebate which you haven’t been able to get through the Senate, can you guarantee that if you’re elected for another term there will be no more changes to the Private Health Insurance rebate arrangement?”
Michelle should know by now that asking politicians to ‘guarantee’ anything is unlikely to evoke a positive response. So why does she waste a precious question doing so?
“And to Mr Abbott, you’ve talked repeatedly about the problem of divided responsibility – you’ve said in Battlelines that any hospital reform program is beyond the states, we know that you have advocated a Federal takeover of policy and funding when you were in government and health minister, why can’t you just say now “I believe in the Commonwealth being the sole or dominant funder and having made policy responsibility, I will work out an alternative plan to the Government’s one, but taking that as the central principle?”
Another pointless question and long winded at that. Abbott had already said he would reveal his health policy ‘well before the election’. So why ask for it now – clearly he either didn’t have one or he was not going to tell us what it was.
It is surprising that someone as experienced as Michelle wasted both her questions.
Jayne Azzopardi Nine Network
“Look I want to talk about what I think most voters think about when it comes to hospital reform, and that’s bed numbers. Now Prime Minister you’ve mentioned funding from the past but you still say we need more beds, yet your plan doesn’t actually specify any extra beds, how can voters take you seriously this close to an election when you’ve called this debate and you haven’t covered that issue?”
Was there any need for the impertinent “Look I want to talk about” and “...how can voters take you seriously...”. Who does she think she is? Is this the best Channel Nine can muster? Had she forgotten that increases in bed numbers are already being funded? Did she seriously think the reform plan would not address bed shortages? Did she not read that greater emphasis on primary care was designed to treat more people outside of hospital, thereby reducing the number of hospital beds needed? Why do journalists come to such debates so ill-informed, so ill-equipped to ask sensible questions?
“And Tony Abbott you talk about consideration of 3,500 new hospital beds; is that an iron clad promise or could the number reduce if you can’t find the money?”
Here we go again – asking for ‘an iron-clad promise’. Abbott might hint that is his intention, but an iron-clad promise, no – he would not be that stupid.
Both questions were silly – a precious opportunity wasted.
Karen Middleton – SBS
“I have the same question for both leaders. The Prime Minister mentioned earlier that the patient should be the centre of this. One of the common complaints we hear from people using the health system now is that even if you have private health insurance you’re still out of pocket when you go to the doctor or you receive hospital treatment. We’ve heard a lot about funding and the structure of the system, but I’d like to ask, what are you polices going to do to reduce the out of pocket costs of people actually using the system – the patients?”
Out-of-pocket expenses are an issue, but why ask about them in the middle of a debate about a multi-facetted hospitals and health reform, as if she expected some announcement here and now to reduce them? Co-payments are here to stay and with health funding likely to fall further and further behind that needed as the population ages, they are more likely to increase than decrease. The reason the health debate is on now is that the cost of health care will be unsustainable via state budgets by 2050.
So this is another wasted long winded question that could have been restricted to just her last sentence, if it was worth asking at all.
Andrew Probyn - West Australian
“My question is directed at the Prime Minister primarily, but I know you’ll want a say, and it’s about activity based funding of hospitals, which is (for normal people) a fancy way of saying you pay for services that the hospitals provide. Victorians have been doing this for 17 years and they decided that the so-called case-mix doesn’t work for rural hospitals; in fact they dumped it, instead they give block grants. Now why do you think Prime Minister that a Federal activity based funding model would work when the Victorian Health Minister says it won’t no matter what weightings you give it?”
That was the last question and the most pertinent of all. It did evoke a response from Rudd that he would consider block funding rural hospitals for which case-mix might prove unsuitable. That has been described by the media variously as a ‘concession’, a ‘back flip’, a ‘change of policy’, or ‘policy on the run’. It’s none of these. Go back to the earliest statements on funding mechanisms and you will find that Kevin Rudd and Nicola Roxon both indicated that if case-mix funding proved unsuitable for rural hospitals, other funding mechanisms would be considered, and that no rural hospital would close because of unsuitable funding arrangements. Some journalists have short memories or don’t listen attentively.
In summary, the calibre of the questions asked was poor. Several were irrelevant or too vague, most were too wordy, some were convoluted, a few were impertinent, and all except a handful really challenged Rudd or Abbott or tripped them up. Around a half were plain silly. Opportunities to ask questions on such important occasions are few; what a pity so many were wasted by the journalists and the public they represented let down. Being a journalist is a serious pursuit, not a game. The privilege of asking important people questions on our behalf should be taken seriously.
Journalists seem not to understand even the fundamentals of questioning. In medicine, where sound questioning is at the heart of decision making, it has long been known that the style of question governs the likely response. Direct questions are likely to evoke a direct answer: “Are you intending to increase funding for mental health?” Closed questions require a specific response: “Is your plan to double dental health funding?” Leading questions demand a ‘yes’ or ‘no’ answer: “Are you going to resign?” Open questions do not presume a defined response.: “Tell us about your plans to improve primary health care?” Each has its place, and should be used adroitly to elicit the type of response required. It’s not that difficult, but seems to be beyond even some of our most experienced journalists.
There seems to be a strong element of one-upmanship among journalists when asking questions, a touch of smart aleck behaviour, a trace of arrogance and impertinence, a degree of prolixity that sometimes surpasses that of the respondent, a level of gobbledegook that exceeds what they endlessly criticise the PM for speaking, a paucity of background information on the subject, a limited memory even for recent events, and a restricted capacity to ask relevant questions in a clear and succinct manner.
Which leads to the depressing question – is this the best there is?