Sharon Bird (Cunningham, Australian Labor Party) Share this | Hansard source

I rise today to support the National Health and Hospitals Network Bill 2010 as presented to the parliament by the Minister for Health and Ageing. I want to do three things in the time that I have available to me today: firstly, to talk about the content of the bill as it stands before the House; secondly, to put the bill within the context of the national health and hospital reform agenda of this government; and, finally, to talk about the implications of that for my own electorate.

The National Health and Hospitals Network Bill 2010 is part of a suite of bills that are aimed at implementing major reforms to the funding and governance of the Australian healthcare system. The intention of the reforms is to place the healthcare system on a sustainable foundation for the future. The new governance arrangements will involve the establishment of three agencies. The first agency is the Independent Hospital Pricing Authority; the second is the National Performance Authority; and the third is the Australian Commission on Safety and Quality in Health Care, which is the one referred to in the legislation before us today. It is intended that this bill will be amended to include provisions to establish the Independent Hospital Pricing Authority and the National Performance Authority—the other two agencies I mentioned.

It is imperative that there is a strong focus on improving the safety and quality of health care as it is delivered throughout Australia. Part of the national COAG agreement was around issues of not only funding but also quality assurance and transparency. To ensure that this is achieved, the bill will establish the Australian Commission on Safety and Quality in Health Care. It will be a permanent independent body under the Commonwealth Authorities and Companies Act 1997. The intention of placing it in this way is to ensure the independence of the commission. It is important to ensure its standing as an authoritative source of knowledge on healthcare safety and quality matters. I think that is achieved by the construction of the commission and where it is placed. It will continue its important role in helping to reduce harm caused by preventable errors. Some of the contributions to this debate from both sides of the House have acknowledged the important culture change that has occurred over recent decades from a less closed, defensive view by medical practitioners to a more collaborative and review type of culture. Certainly the commission will continue its role of looking at areas in which preventable errors occur. I think that is important because it is part of building community trust and confidence in not only the system but also its processes.

An important part of the commission’s expanded role will be to set new national clinical standards and also to strengthen clinical governance. This is an extension of some of that earlier work and it is to lead the drive towards continuous improvement in quality and to safeguard high standards of care. It is an important component of the ongoing commitment of the whole health services sector in looking for ways to be constantly improving clinical standards and increasing community confidence in them. The commission’s expanded remit also extends to ensuring the appropriateness of care in all health settings and, importantly, including both primary care and mental health—two areas which we have given particular focus to since coming to government.

The accreditation of health service providers is currently undertaken by a multiplicity of accreditation bodies and some high-risk services are not yet subject to accreditation, which leads to a nationally inconsistent assessment of safety and quality standards. Part of the commission’s role will be to continue its work in developing a national accreditation system, and it will develop a national model accreditation scheme. The development of national clinical standards, guidelines and indicators, as outlined in my previous comments, together with its work on a national accreditation model, will support the take-up of the commission’s work by health authorities.

The state and territory authorities have been consulted on this bill and are generally supportive of it. This bill, as I indicated, sits within the reform agenda of this government to address the problems within the health and hospital system on coming into government. I listened to the contribution of the member for Grey. I acknowledge that he was talking about some of the capacity constraints and issues that exist in his electorate. I am sure that we could all talk about constraints like that across all of our electorates. It is exactly why this government has undertaken health and hospital reform. I think you should be a bit fairer to some of the state governments, in that the increasing pressure they have been under to fund hospitals over a period where there was a growth in demand and expectation of our hospital system occurred when the Howard government was failing to expand its commitment to the public hospital system. The end result was, in effect, a billion dollars withdrawn from the public hospital system.

Hospital authorities, particularly those of state and territory governments, were struggling to meet a growing demand with a decreasing responsibility by the federal government in putting its shoulder to the wheel in that task. That is part of what was addressed in the House of Representatives Standing Committee on Health and Ageing report The blame game. It certainly contributed towards the development of our policy that we took to both the 2007 and 2010 elections and that I believe is well supported in the community.

We are attempting to address two areas through this reform. One is to address the physical challenges and capacity constraints in our health system of capital and hospitals—money for equipment and so forth—and the other is to address the chronic shortages that had developed in the provision of hospital staff—doctors, nurses, allied health professionals and so forth as a result of the caps and constraints on the training places in place for so long under the Howard government. It is a big task and we understand that.

This bill sits within that reform process, particularly as it was developed through the COAG process. Part of that reform is investing $1.2 billion in doctors, nurses and allied health professionals. Communities constantly say they are concerned—even when you get new capital for the hospital or a new GP superclinic or where many GP services, as in my area, have applied for the upgrade program available under the superclinic program—about shortages of medical staff and ask whether their new facility will be able to be serviced. It is important that, in parallel with those commitments, we are developing and giving commitment to the training of new doctors, nurses and allied health professionals. That is something that suffered significantly under the Howard government and was creating real challenges for health services. In my own area, the University of Wollongong’s medical school has a unique and very well developed program to bring in doctors from regional areas to train at the university and keep them connected to their regional areas by doing practice placements in GP clinics in regional parts of the nation. Therefore, hopefully, having retained their connections to the communities, they will go back and service those communities.

We have also invested in beds and facilities in hospitals as well as undertaken to provide 60 per cent of the capital requirement for new facilities at hospitals. That is only one part of the health and hospital reform. I am particularly pleased that we are also taking over 100 per cent of primary care. An ounce of prevention is worth a pound of cure, as the old saying goes. It does not take very long when you talk to health professionals to get a very clear picture that, if we do the primary care at the end of the spectrum better, that is one of the most significant things that we can do to ease the pressure on our hospital system. This bill sits within a comprehensive take on reforming the health system and making it function more effectively, recognising that it is increasingly important, as it is an increasing share of state budgets, that the federal government continue to sustain its commitment to health and hospitals.

In the few minutes I have left I want to talk about what has actually happened in my electorate under this government’s reform process. In September 2009, the Minister for Ageing came to our area as part of the reforms that occurred all around the country under the health and hospital reform agenda and we had a consultation session with many health service providers in the region. Certainly there was a great deal of advocacy for better hospital support in our region, but also raised at that forum were preventative health, primary healthcare and mental health issues. At that time, in September 2009, we were part of the rollout of elective surgery money which was an attempt to reduce waiting lists. There was over $400,000 injected into the Wollongong Hospital to help with that waiting list reduction plan. That obviously was very, very welcome at the time and, in particular, for the Wollongong Hospital, which is the major referral hospital for the region.

This was followed in April 2010 by a visit from the Prime Minister, who announced that we would be putting $12.1 million towards the Illawarra Cancer Care Centre at Wollongong Hospital. That component of Illawarra cancer care is the major referral for cancer support services in the rest of the region. As part of that package, Nowra also got a component of funding to make that cancer care centre operate more effectively as a regional hub service. That money was matched with $2 million from the state government. It was to provide radiotherapy services at the Illawarra Cancer Care Centre. It included additional infrastructure for outpatient clinics and day oncology. It included enhanced facilities for haematology and therapies. It included one additional linear accelerator and one additional radiotherapy bunker, six additional chemotherapy chair beds and medical diagnostic equipment. It was extremely welcomed not only by the health professionals and the patients who were there but also by the community more broadly, as it was something for which we had been lobbying for quite a long time.

In June 2010 the health minister visited the area to announce an additional 21 new beds—19 emergency department and two high-dependency beds—for the Wollongong Hospital, which were part of the COAG agreement. At the same time we met with some young doctors in training as the health minister announced an additional $5 million for new training facilities at the Wollongong Hospital. That was important. There were about half-a-dozen students in training that we met at that time, all of whom were young people from regional and rural New South Wales. They were doing their training at the University of Wollongong and their hospital placements at Wollongong Hospital and they certainly welcomed the commitment under the clinical teaching and training grants that the minister announced on the day.

For me and my constituency the reality is that over the past two years we have seen important commitments made by this government to the health and hospitals in the area, not only for physical buildings but for equipment and staffing—all the components that add up to making it work. Out of fairness to the former government I thought I would check what money they had injected into the hospitals in my region over the nearly 12 years they were in power. Sadly, I could not find anything. I leave it up to them to correct the record, but I did go to Senator Connie Fierravanti-Wells’ website, where she had outlined all the money that had been given to the region—very handy; thank you very much, Senator. Under health and ageing funding I can find the ongoing recurrent money that federal governments commit for general practice, hearing services, aged care and so forth, but no actual hospital money and certainly no new injections. So I commend what this government has done not only with its commitment to reform of the system and to reform of training and development opportunities for health professionals, but also specifically with its commitment to upgrade the services and facilities in regions like mine.

See this speech in context