Ministerial time is a scarce commodity. Hence setting priorities is critical. But, unfortunately, the minute I walk into my new office I will be assailed by the smell of a dead cat on my desk emanating from a stack of briefs on private sector issues.

The private sector is unfinished business most recently left over from the smoke and mirrors game associated with the last private health insurance premium rises. The private health insurance funds and private hospitals are busy sledging each other in public and private, while private procedural specialists quietly run all the way to the bank. Keeping one’s hands clean, and ensuring that all my fingers are still attached after meeting these stakeholders, will be an early (imposed) priority. My task will be to help them see that they sink or swim together and they can’t keep looking to government (mum or dad) because their brother or sister is being nasty to them.

Depending on the outcome of the election, there may be negotiations required as part of a hung parliament. If with the Greens, it will be about addressing an obvious gap in the Australian healthcare system: universal access to dental care. Negotiating the shape and extent of the initial phase of a new program will thus become another imposed, albeit welcome, priority. As minister, I would like to ensure that whatever is negotiated is acknowledged as part of a decade-long plan for a full rollout. Work will be required in tempering expectations, but getting a universal scheme started will be a major achievement.

But once I’ve cleaned these issues off my desk, I’d like to move beyond the urgent and quickly address four priorities.

Firstly, continuing the reform of primary care. Multiple reports landed on minister Mark Butler’s desk in the lead-up to the election, all pointing in the same direction: more multidisciplinary teams, more funding for primary care, a different approach to funding, and allowing all health professionals to work to their full scope of practice. Negotiations with stakeholders and states and territories will be a priority and very important in achieving much needed longer-term reform. I might even be able to get some expansion of community-led clinics up and running.

Secondly, mental health care is a mess, with access issues in all states. Labor has promised an expansion of free-to-the consumer Medicare Mental Health Centres, the Opposition an expansion of the Better Access Program. The new National Early Intervention Scheme is on track for implementation from 1 January 2026, but more still needs to be done. But the impact and potential of the new service and the other expansions needs to be evaluated before determining the next steps. Slowing expectations of stakeholders to allow a proper evaluation and work out what is a good next investment will require skill. A talkfest of psychiatrists — or is the collective noun a prescription? — will be camped outside my door before the car gets back from Government House. Gently suggesting to each of them that their favoured nostrums just can’t be implemented tomorrow will require tact.

Thirdly, a start needs to be made on revitalising prevention. This will again require ministerial time and skill to address the social, economic and commercial determinants of health. The purveyors of ill-health are powerful and vocal. But, perhaps, a start might be made by introducing a tax on sugary drinks which might help pay for other initiatives such as a start on oral health care. Unfinished business also abounds in this area, including the much-vaunted Centre for Disease Control which remains a unicorn – talked about, but as yet unseen. Social and economic determinants particularly affect the health of First Nations peoples and so working with my colleagues to make progress in this area will be critical for me.

Fourthly, negotiations with the states on the next National Health Reform (sic) Agreement have stalled and a one-year extension was announced just before the election. But the end date of the extension (30 June 2026) gets closer every day. Public hospital funding is tied up with NDIS funding in a Gordian knot: states want more in both buckets, but my cabinet colleagues and Commonwealth Treasury think enough has been put on the table and states need to do more in terms of disability foundational supports. Negotiating a way through is a high priority and will not be easy.

While I’m dealing with these issues, every stakeholder group will be at my door, offering me kind advice about how and why their priorities are important, and why they should be funded. Ideally, I would be able to increase the hours in the day and create a magic pudding of money to get every one’s wish list fulfilled. But, as I said at the start, priorities need to be set, and some stakeholders should be sent away with empty hands so that other more effective and more equitable policies can be implemented within the available funds.

Stephen Duckett has a long history advocating for and achieving reform in the health sector. He holds an Irish whisky tasting certificate from Jameson’s in Dublin.