Rowan Ramsey (Grey, Liberal Party) Share this | Hansard source

Before I speak on the Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009 I would like to draw attention to the member for Shortland’s seeming preoccupation with the member for O’Connor. I just hope that it is purely platonic. While she is dwelling on the voting record of this side of the House, I would draw her attention back to the time she spent on this side of the House and her party’s continued opposition to every economic reform that was brought in by the previous government.

I rise to speak tonight on the Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009. Let me say it is generally a good piece of legislation. The original accreditation scheme was implemented under the previous government. We could argue about the way that this new accreditation program is being rolled out but, by and large, it is right that people should know when they go to a medical-imaging establishment that they are going to get a quality service. It is my understanding that in South Australia we have one major medical-imaging company that has already met the accreditation standards and I look forward to the rest doing the same.

My major issue with this bill is the sad story of unfulfilled commitment to my electorate which I have brought to the House before. It concerns a commitment from the government to establish a medical resonance imaging service at Port Augusta to service not just Port Augusta, which has a population of 14,000 people, but also Whyalla, which has 22,000 people; Port Pirie, 15,000; Port Lincoln, 14,000; the greater Eyre Peninsula, around 13,000; Roxby Downs, 5,000; and the Mid North, with probably another 8,000—in total more than 90,000 people. This machine, along with another 12, was committed by the Howard government in the second half of 2007. About an hour ago in this place I heard the member for Capricornia waxing lyrical about the government’s commitment to the MRI machine in the Rockhampton Hospital. Well she might, but it is a shame that the government have not shown the same commitment to the medical resonance imaging machine that they had promised to the people of Grey.

The tenders for the installation and operation of this service were due in by mid-November 2007. In February 2008 the Minister for Health and Ageing, Ms Roxon, as the representative of the new government, informed us of the new government’s commitment to delivering the service and I applauded that decision. She reaffirmed that commitment in May 2008 when announcing an extension to the tender process. I understand there were three tenders. The tenderers initially expected the announcement of the awarding of the contract within six months, but they have suffered no fewer than three extensions, eventually being informed in September 2009, almost two years after the tender was lodged, that the government had decided none of the tenders were suitable and was cancelling the project.

At no stage had the tenderers been asked for additional information, to make any alterations or had it adequately explained to them why they had been rejected. In fact, one tenderer who has confided in me said that during a debriefing after the rejection he was told his submission ticked all the boxes. He was told it was an excellent submission. These tenderers have had their lives on hold for almost two years, and they are financially committed to property so they can deliver what they promised they would deliver, only to be informed at the end of the process that the government was not interested in meeting this commitment that was made repeatedly from early 2008. The tenderers were required to meet a number of prerequisites including public access, professional standards, business plans, staff training programs et cetera.

Since the election I have inquired of the minister on a number of occasions when we could expect this service to commence and was continually referred to the minister’s January 2008 statement affirming her commitment. So it was that following the news of the cancellation in September last year I contacted the minister’s office and sought a meeting as a matter of urgency. At the meeting I explained that I believed her department had made an error of judgment. She committed to review the process and I committed to work with the minister. On 22 December, after the country’s media had gone to sleep for Christmas, I received information from the minister’s office reaffirming her decision to slash the project.

By this time I had been privy to one of the tender documents. Whilst the tender document requested start-up finance, it clearly stated that if it were not forthcoming then the proponents were prepared to meet the whole cost. This is where it gets mysterious: what is the cost to the taxpayer if the proponents are prepared to put all the money upfront? Where is the risk to the taxpayer? All they were asking for was the operating licence and the Medicare fee for service of payments, the same as every other MRI in Australia. The financial risk was all the proponents. If their business were to fail, what would the taxpayer have lost? Nothing. The taxpayer would not have funded the machine or the premises. Surely this is just a bureaucratic stuff-up. You just cannot believe that a department would give this kind of recommendation when they had been offered this kind of deal. I am very pleased to note that the Minister for Health and Ageing is in the House as I am speaking.

I wrote twice more to her asking her to take a personal interest in this issue. Her last reply is interesting. It alleged no tender had reached the four measured criteria. Those criteria were (a) a proposed pricing structure/patient charging policy, (b) hours of operation, emergency services and after-hours availability, (c) patient accessibility and (d) an ability to demonstrate an ongoing business plan. I have seen the tender and, in my opinion, it addresses all of those criteria. It is an excellent tender, as the tenderer was informed by the debriefing people from the department. However, the minister claimed that no tender reached a satisfactory level. The letter I received from the minister said:

You suggest in your letter of 8 January 2010, that if it is the case that all of the people in Port Augusta—

and I must make the point that we are not only talking about the people of Port Augusta but talking about most of the population of Grey—

who currently require MRI services are travelling to Adelaide for those services, the location of the MRI unit in Port Augusta would have no impact on the Government’s health budget.

That is what I said and it was quoted back to me. The letter went on to say:

However, previous experience clearly demonstrates that the provision of Medicare eligibility to an additional MRI unit results in additional Medicare rebateable MRI scans being provided, thus resulting in additional costs to the Government’s health budget. Therefore, the provision of Medicare eligibility to an MRI unit is not cost neutral.

So it comes back to money. The government’s commitment that they would spend whatever was needed to give the Australian public the health services they deserve comes back to money. And it would seem that the service we deserve in the country is less than that received in the city. This is preposterous. It makes second-class citizens of the country. Everything can be equal as long as it does not cost money. The nub of the problem seems to be about money and not the cost of delivery, but it costs more to get the same level of service in the country. That is not because the service costs more but because we are going to start receiving the same level of services that those in the city receive. The letter went on to say:

It was never the Government’s intention that supplementary funding over and above the necessary extra Medicare funding would be required to support the MRI business.

This was exactly what the tender I have seen offered. It said that if no extra funding were forthcoming they would meet the full costs of the installation of the MRI at their expense. It is a sorry tale of promises abandoned to go with all the other commitments that this government seems to be running away from by the day. I have suspicions that there are other complications. The South Australian Department of Health—SA Health—and Country Health SA have an interest in this. The state minister says he supports the MRI machine being positioned in Port Augusta. He has been visited by the mayors of Whyalla, Port Augusta and Port Pirie to support this proposition, but I am not so sure. This may be what the South Australian Minister for Health, John Hill, said, but I am not so sure it is fact. The Port Augusta hospital currently has no medical imaging contract. The contract expired last year and a call for a tender was unsuccessful. This could be just a coincidence or can we perhaps assume that there is a little more to this, that SA Health are recommending against the MRI in Port Augusta because they want to see more funds come back into their system? I am not convinced that SA Health are not trying to alter the deal to suit themselves. The minister went on to say in the letter:

I am considering other options which might be available to the Government and am consulting with relevant agencies. One possible alternative would be to redirect some of the Medicare funding planned for an MRI unit in Port Augusta to other worthwhile health projects in Port Augusta. Some possible projects, identified with the assistance of the South Australian Department of Health and Country Health SA, would involve the expansion of the day surgery waiting and outpatient consulting areas within the theatre and consulting suite at the Port Augusta Hospital, and the replacement of theatre equipment.

Apart from missing the point that this MRI machine is not about Port Augusta and the 14,000 people who live there but about the 90,000 people it would service, who benefits from this redirection of funds? The South Australian health department.

It is very interesting that this arises in the middle of the South Australian election campaign, and I might bring to this House the state of the seat of Stuart. Stuart has been held by the retiring member, Graham Gunn, who is retiring after almost 40 years, since its inception—in the last few elections, by a knife point. So we have two new candidates running for the major parties in the seat of Stuart: our candidate, Dan van Holst Pellekaan—a very fine man who is committed to this MRI machine in Port Augusta—and the Labor Party candidate.

What chance is it that in fact the funds that were to be directed to the MRI machine in Port Augusta will come out in a grand announcement in the next five weeks and support the local Labor candidate as we lead forward into the election? The fact is that the Port Augusta Hospital has no medical-imaging contract and I suspect the South Australian health minister has passed judgment that this machine should not be located there because he would like to see those resources put into the South Australian hospital system. It is about the federal government bailing out state government mismanagement.

I ask the minister to take the opportunity to come clean here. The state Liberal Party leader, Isobel Redmond, recently committed $2½ million to the establishment of this MRI unit in Port Augusta. This would cover all the set-up costs. All we need then are the Medicare operating fees. So will the health minister stand by her 2008 commitment and supply the operating licence? There is no risk. The funding will be met by other parties. The only difference is that the people of the region will start to receive the same level of service that those who live in the city receive.

In short, to come back to this bill, I will not be opposing the bill but I would dearly like to see the minister deliver on her commitments to my electorate so we too can enjoy the benefits of an accredited magnetic resonance imaging service within the electorate, thus avoiding the thousands of kilometres of travel to access this service in the city, and can address the admitted shortfall of service to my constituents.

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