House of Assembly: Tuesday, March 04, 2008

Contents

COUNTRY HEALTH SERVICES

Mrs PENFOLD (Flinders) (15:23): The Labor state government is finding ways of giving the remote regional areas of our state a Third World health service. I refer to the emasculation of health services in rural and regional South Australia, where Labor policies and agendas, such as the Health Care Bill that passed through the house today and its shared services initiative, are depriving people of basic health services and employment. Mothers are being forced to go hundreds of kilometres from their homes and, more particularly, away from their support networks to have their babies. There are doctors who have been delivering babies for years, including one from Tumby Bay, who said he now feels like half a doctor, since changes to health regulations insist that there must be an anaesthetist within 100 kilometres for a woman giving birth.

How can country hospitals attract and keep doctors and staff who have all the skills, when they cannot use them all? Is it a ploy to get them all to move to larger centres, thus deskilling large geographical areas of the state and greatly lifting the risk in times of emergency? The government is forever lifting the bar to suit its agenda to centralise but ignores the needs of the people. By making health services supposedly viable, more and more country centres are being deprived.

Using obstetrics as an example, I have been contacted many times regarding the inflexibility of the government's rules relating to birthing. Families are forced to wait for the birth closer to the hospital where their baby will be born. No flexibility is extended to families. Instead, the cold face of government bureaucracy insists that deliveries will occur in the closest regional government hospital—no taking into account that support networks are not available. Take, for example, a constituent of mine, pregnant with her third child. She was advised that she had to deliver in the Whyalla Hospital, disregarding the fact that grandma, who had been organised to care for two preschoolers, lives in Port Lincoln. The family could have stayed with grandma at no cost to the government but, instead, grandma, mum, dad and two preschoolers had to relocate to wait for the birth, paying for accommodation in Whyalla. So, not only are families being forced to go away to have babies but they must uproot extended families—to my mind, totally unnecessarily.

I have been told that the number of births by caesarean section is increasing. This is understandable when viewed against a family's life. By having a caesarean birth, a mother can set a time for the delivery and plan around it to cope with the many problems that going away from home and family creates. Cost is a big factor, as well as time, family disruption (such as getting children to and from school) and work responsibilities for a partner. What should be a simple matter becomes a logistical and financial nightmare at a time when drought, fire and cost pressures are already putting regional families under major pressure and fewer young people are choosing to live in country areas.

Questions of safety arise as a result of the government's current policies. The likelihood of road accidents increases as families stress about when and where to give birth. A woman at Wudinna arranged to have her baby at Kadina. She and her husband left, they thought, in plenty of time before the expected date of arrival. The couple got as far as the Port Augusta Hospital where she had her baby. She was fortunate; some babies are born in cars.

Small country hospitals generally have great facilities that are well maintained—often due to the generosity and hard work of local communities and dedicated staff who choose to be there and who understand just how wonderful our regional communities are. A hospital with both acute and aged care beds and staffed by a doctor and a trained health professional is a focal point in any thriving regional community. Overloading larger hospitals when smaller hospitals reduce their services is an issue. Bed availability can be doubtful, particularly when a maternity patient arrives unannounced; and patients may be discharged too soon in order to make a bed available.

The government's callous rejection of the health needs of those of us who live outside the metropolitan area is again demonstrated in dental surgery. Streaky Bay has a locally-based dental surgeon who has been refused permission to use the theatres at the local hospital. The reasons given are risk and the possibility of litigation, yet the risk and possibility of litigation should be no greater than in any hospital anywhere in the state. Government action is driving people away from dental care, leading to even more difficult and complex health problems.

The Patient Assisted Transport Scheme (a Liberal initiative) needs an update to suit changed circumstances arising from these Labor government practices. Volunteer ambulance services must be re-assessed for the same reason. Volunteers are being asked to leave their businesses, employment and families to undertake volunteer ambulance services (often at great personal effort and cost) for the benefit of their communities.

Time expired.