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

It gives me pleasure to speak on the National Health and Hospitals Network Bill 2010 because it gives me an opportunity to talk about some things happening in my electorate. I was a local hospital chairman for seven years of my life before I entered this place. I must say that, when I look back on that time in local hospital management, the frustration of seeing more and more of the health budget soaked up in administration rather than actually being spent at the coalface of health delivery as it were has been of great concern to me. We extended office space and we created more work stations but we did not build any extra beds. In effect we had more admin and fewer health workers.

This bill unfortunately is more of the same. It is another layer of bureaucracy. It is yet another body devising hoops for the work-stressed health professionals to jump through. Usually these types of bodies are more interested in making themselves an indispensable part of the system, which is protecting their jobs

This bill talks about setting national standards. Unfortunately, what we deal with in my electorate are the loss of standards and the loss of service as a result of the recent state budget. In South Australia we have had eight years of the Rann-Foley government and in that time we have seen an explosion in public service jobs—almost 18,000 in total. The state Treasurer, Kevin Foley, has been telling us for eight years that he is the greatest treasurer in Australia. He has built this reputation upon a AAA credit rating, which has actually been built on the billions of dollars of unbudgeted revenue that have flowed into the state from the GST rivers of gold and the explosion in land tax receipts.

Unfortunately, like their federal counterparts, they have spent it all and then some. In fact, the state is now $7 billion in debt, and it is worth casting our mind back to the State Bank disaster in South Australia, which left the state $11 billion in total debt. We are fast approaching that horrific level of debt, which hung like an albatross around the neck of the state for years to follow.

In eight out of the eight budgets Mr Foley has delivered actual outlays have exceeded budgeted outlays. Now he says we are in deep trouble and we need to make drastic cuts. I could give you the whole list, Mr Deputy Speaker Scott, but essentially: 3,750 public servants are going to be retired and one would have to ask why on earth they were put on in the first place if we do not need them now; there is a reduction in long service entitlements and a move to abolish leave loadings for public servants; removal of a 3.3c subsidy for country petrol; mining royalties are up; cuts to small school supports; and taxes are to increase over the forward estimates by $1 billion, meaning a 76 per cent increase since the Rann government came to office.

This is where the issue comes back to this bill. Importantly, in health there is a grand saving of $1.2 million in support of four community owned not-for-profit private hospitals. There are two in my electorate and they all are in state Liberal-held seats. The two hospitals in question in my electorate are Moonta and Ardrossan and they are both community not-for-profit hospitals. Last Friday, I attended a large angry meeting in the township of Ardrossan and today, as we speak, there is a protest crowd gathering in Adelaide at the Adelaide Oval, and they will be marching upon Parliament House.

Ardrossan is the biggest town in the Yorke Peninsula council area. It has a population of around 1,200 but it services a total population of about 3,000. The hospital was established in 1914 and offers an accident and emergency section, 22 acute-care beds and an attached 25-bed aged-care facility. Mr Foley’s budget cut, in which he plans to save this $1.2 million in support of four hospitals, amounts to $140,000 at Ardrossan Hospital. It is a piddling amount but that $140,000 pays about 50 per cent of the costs of the accident and emergency section. But, for a community that is already raising a significant amount of funds in support of its hospital and has a high rate of private health insurance in support of a private hospital, it is a real obstacle. Fifty per cent of the admissions to the acute-care section of the hospital come through accident and emergency. So you can see that the loss of accident and emergency care at Ardrossan Hospital would lead to a dramatic drop in the admission rates to the acute-care section of the hospital. In effect, if we lose A and E, we are likely to lose the acute-care facility at the hospital as well.

One must then ask what will happen to the 25-bed aged-care facility. A 25-bed aged-care facility, as we know, is well below the optimum size to operate for profit or even to break even. So, if they lose that link with the hospital, their dependency on the hospital for laundry, cleaning and kitchen services will in effect threaten the viability of the aged-care services as well. What will happen then? There is a staff of about 50 involved in the whole operation. I must say that it is not so far in terms of distance to the next public hospital. It is 20 minutes up the road to Maitland, but there is another 20 to 30 minutes on top of that for the catchment area for the Ardrossan Hospital so some people would be looking at periods of 50 minutes to an hour to access accident and emergency services at the hospital.

Additionally, Ardrossan is in fact a fast-growing area, like much of the very beautiful Yorke Peninsula. It is only about 1½ hours from Adelaide and people are looking at this beautiful coastal region of South Australia as a retirement option. There is also a very high probability of mining very close to the town. Rex Minerals’ Hillside project is shaping up to be a world-class copper prospect. It is likely that we will see some hundreds of mining jobs come on stream there in the next few years, so there is likely to be a growing demand in this area. The extra demand caused by the closure of the Ardrossan Hospital and the anticipated expansion in the workforce and in the population will almost undoubtedly lead to the overload of the Maitland facilities, and we have to ask: what then? Are we looking at a substantial rebuild of the Maitland Hospital?

I will turn now to the Moonta community hospital, which is also affected by these budget cuts. Once again we have an acute-care facility, accident and emergency and an aged-care facility. There are 14 acute-care beds and a 64-bed aged-care facility. The state has been providing up to $280,000 to pay for the provision of eight public bed spaces at the princely rate of $120 a day. That is a pretty good deal for the taxpayer, I would have to say—$120 a day for a bed in hospital. That allows the public access. It is a very low fee, there are no capital outlays for the government and they do not pay for unused capacity. If there is no-one in those beds they do not pay the $120 a day, so it is a pretty good deal for the taxpayer generally. If the Moonta acute care crashes, obviously the accident and emergency would go because there is not much point in having an accident and emergency section at a hospital if you are not going to actually have a hospital, so that would be the end of that service.

Because Moonta has the 64-bed facility we could argue that it would be more than likely to be converted to a full aged-care facility, which actually gives a future for the workforce and facilities. But the patient load would be transferred to the Wallaroo public hospital. It amounts to around 1,400 private bed days a year and 1,800 public bed days. Wallaroo has 21 public beds and six private beds, and I can tell you that it is already under pressure. It is operating at capacity. In fact, the overload from the Wallaroo Hospital gets sent to the aforementioned Maitland, which is about an hour down the road. So you can see that this is all coming together and we are going to see a great loss of access to acute-care beds in hospitals in this region of the state. The Wallaroo Hospital is not that old but there are already plans for a major rebuild to expand its facilities to 50 public beds.

This is where it links back to talking about the Commonwealth’s involvement in this. We have just had a bill tabled by the minister, addressing the new funding arrangements. If the Commonwealth is going to pick up 60 per cent of the responsibility for healthcare funding in the hospital system, then, if we have to spend, say, another $10 million at Wallaroo and another $5 million at Maitland to meet this extra demand on the hospitals just because the state government has withdrawn this small amount of money which allows these private hospitals to exist, in the end it comes back to the feet of the federal taxpayer and the federal government. The government has been talking about this new relationship with the states in which no blame will pass between them, but here, with an underhand movement, we are seeing the pushing back of funding of hospitals to the federal government. It is madness, in my opinion, to be forcing the closure of these two hospitals only for the government to try to save $420,000 a year between them, when they will be spending millions to meet that increased demand on the public hospitals that are the next in line. Really, it is a measure to fix today’s budget problems in the state with very little regard to the future.

The other two of the four hospitals affected are Keith and District Hospital and Glenelg Community Hospital. Keith hospital is in the south-east, in the federal electorate of Barker—I know that my good friend the member for Barker has had a fair bit to say about this issue as well. Over 1,000 people turned up at a public meeting about this issue in Keith. Glenelg Community Hospital is in the city of Adelaide. I do not profess to fully understand the workings of the Glenelg hospital, other than to say that it was established by an organisation of which I am a life member, and that is the Glenelg Apex Club. I am a member of Apex. These are four private hospitals but none of them are for profit. None of them are about making money. I feel that the state government has quite possibly got this thing about private hospitals not being a concern of the government. These are community hospitals. When the state government was taking over many community hospitals in the state, these hospitals stood their ground and said, ‘No, we would prefer to operate under our existing entity.’ Here we are, some years down the track, and they are being deserted by the very small amount of public support that they were receiving.

This bill is about national standards, and it incorporates the building of a new bureaucracy. As I said, part of the new deal is that we are not supposed to blame the states, but we are faced with a practice where very little has changed. I think the intent of this bill will change things very little, except to put in a new raft of bureaucratic changes.

There is a rally in Adelaide today, as I said. They are probably marching as I speak. I wish them well, and I wish I could be with them. I believe that the chairman has a meeting with the state minister, John Hill. I also wish them well. While this is not a direct federal responsibility, I have drawn attention to the fact that it has federal implications, and I ask Minister Roxon to take an interest in these issues and to turn her mind to the practical things that will deliver a standard of medical care for regional and metropolitan areas across Australia.

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