COUNTRY HEALTH SERVICES

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (14:39): My question is to the Minister for Health. Which of the identified 25 country hospitals will be closed and developed as aged-care centres to be announced in this year's budget?

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:40): I challenge the way in which the honourable member put the question. She said, 'Which of the 25 identified hospitals?' I am not sure which hospitals she has identified, but, if she has identified hospitals, I suggest that she identify them publicly. I am not sure what the honourable member has in her mind—although it is not an area where I particularly want to go.

As part of the reform of the South Australian health care system and the release of the South Australian Health Care Plan, I announced the development of the Country Health SA Services Plan to better coordinate the delivery of health services for country South Australians. While the specific details of this plan are still being formulated, I can outline the key principles that will guide reform of the South Australian country health system. Our intention is to consider the health services of Country Health SA as a whole, rather than as a series of individual services operating in isolation.

Mrs Redmond interjecting:

The Hon. J.D. HILL: That amuses the member for Heysen. The fact that we are trying to reform and make the health system work in the country for country people is something of amusement for members of the opposition. That just shows that they pay only lip service to these issues. Their interests in the country are political and not to do with the health of country people. The fact that country people have a lower set of health outcomes than city people is of no concern to them. Why should we do anything to try to improve those outcomes? Members opposite do not care. They are interested only in the political outcome for them in the country, not the health outcomes for people who live in the country.

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: Our intention is to consider the health services of Country Health SA as a whole, rather than in broken down bits and pieces of individual services operating in isolation (as they are now). The change in governance arrangements for country hospitals through the new Health Care Act will mean that the 44 individual health units currently run separately by 44 individual boards will become part of an integrated system of health care. There will be collective planning and common treatment protocols to reduce unnecessary duplication and to offer a wider range of services within a region.

Strategic planning of this nature is needed to maintain the long-term affordability and sustainability of country health services by ensuring the most effective and efficient use of infrastructure and equipment. A common planning approach will also deliver an economy of scale that will generate the volume of activity required for clinicians to maintain the skill levels necessary to ensure clinical safety and quality standards which, in turn, will make it easier to attract doctors and nurses. The opposition and others are always on about attracting doctors and nurses into country South Australia and this will help to do that.

With the principle of an integrated health service in mind, we are assessing the viability and future service role of each individual service on a case-by-case basis against key criteria. Those criteria include the consideration of: projections for the population and health needs of each community against the availability facilities and workforce; the distance between facilities and the availability of transport; the blend of in-hospital and out-of-hospital services required to meet the health needs of each community; and the future available workforce and the service models known to maximise recruitment and retention in country areas.

Assessing current services against these criteria will allow us to identify areas where the complexity of services needs to increase or decrease or remain constant to meet future needs. We have been consulting widely across country South Australia on the country health plan, talking with doctors, nurses and community members about the needs of their various communities. The new health advisory councils will enable country people to be involved in the decision making processes at their local health care service level.

The most important benefit for country South Australians to come out of these reforms will be the provision of more services in country South Australia. Department of Health figures show that, currently, on any given day, there are 550 country inpatients in metropolitan hospitals receiving treatment, and that more than 45 per cent of the public hospital costs spent on country people are spent in metropolitan hospitals.

We have already committed over $100 million to capital works projects in Country Health SA. We have also committed to increasing services at four key country hospitals, namely, Berri, Whyalla, Mount Gambier and Port Lincoln. These hospitals will be the focus of the state government's plan to provide more services that would normally be available only in Adelaide. Services including surgical services, rehabilitation services and palliative care will be expanded so that fewer country people will need to travel to metropolitan Adelaide for care.

Without reform, the current system of health care delivery in country South Australia will not be sustainable in the longer term. That is why we are taking action now to build a health care system for the future for people in rural and regional South Australia. I will have more to say on this important matter in the future.