COUNTRY HEALTH CARE PLAN

The Hon. R.G. KERIN (Frome) (14:50): I have a supplementary question. I ask the minister: what extra services will be delivered at both Clare and Port Pirie? The minister's own plan identifies that Clare and Port Pirie may have a list of services which they currently already have.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:50): I think that is a fair question, because the plan does—

Mr Williams: They are all fair.

The SPEAKER: Order!

The Hon. J.D. HILL: No, they are not all fair questions at all. I think that is a fair question, and really that is part of the process of consultation that we need to go through, because in each of those locations—no, don't nod your head. Member for Frome, the point I make is we—

Mr Williams interjecting:

The SPEAKER: Order! The member for MacKillop is warned.

The Hon. J.D. HILL: This is a 10 year plan, which was the point I made in the beginning, and the point that Mr Andrew made in his letter to the paper. This is a 10 year plan. Nothing is going to change overnight. We want to build up services in those communities over time. Obviously, now that we are going through the detailed planning process, we need to work with the communities about the cocktail of services that best suit the needs of the community. They will change over time as the community ages, as people are more likely to have children, or whatever the needs of a particular community are.

But let me give you a flavour for the services that we would want to offer—and improved services in these areas. In Port Pirie, for example, in the country community hospital, we will enhance services in line with community needs, and this is the range of areas where we would want to improve services: obstetrics, surgery, acute medical inpatient beds, 24 hour emergency response, voluntary mental health admissions on site, community-based mental health care, primary care, palliative care, day rehab and early childhood services. That will be for the Mid North area and that will relate to all the other hospitals, also, and we will expand services there as we can, as the capacity is made available from the overall budget that we have. In relation to Clare, essentially the same kind of smorgasbord of services would be put in there.

But, of course, you cannot do all of the good things and none of the difficult things. You have to do it all, and it has to be managed over time. This is why we are talking to the community about how various bits of it will fit into the overall strategy and the time frame for bringing those services into the community. The overall goal or strategy is to improve services for country people so that fewer of them have to go to the city. We want to improve primary health care services for country people, because we know the primary health of people in the country is not as good as it is in the city. There is a range of reasons for that, but more people in the country smoke, more people in the country are obese, and there is a whole range of other factors.

There being a disturbance in the Speaker's gallery:

The Hon. J.D. HILL: I hear laughter from the gallery. Let me point out the statistics that we have, and I am happy to have them checked. In relation to diabetes, for example, a regular self-reporting survey undertaken by the SA health department shows that 1 in 11 people living in the country are being diagnosed with diabetes. That is compared to 1 in 15 in the metropolitan area, and that relates to a whole range of factors, but access to primary health care is one of the factors.

The obesity epidemic among children will exacerbate: we know that. The number of South Australians who are obese has almost doubled, rising from 11.5 per cent in 1996 to 22 per cent in 2006—these are statistics that are done on the basis of objective research—and obesity is ahead of tobacco as the number one preventable cause of death in South Australia. In the country the obesity rate is almost 6 per cent greater than in metropolitan Adelaide—25 per cent compared to 19 per cent.

In relation to smoking (this survey was done in 2007), 18.2 per cent of people in Adelaide smoked and in the country it was 24.2 per cent. So, the health circumstances in the country are not as good as the circumstances of people in the city.

This government's goal is to improve health services for country people, because we think that at the moment country people have a second-class health system. I think that if those who are attacking this plan are really saying, 'We want to keep the status quo,' they are demonstrating on the other side that they are true conservatives. They want to maintain things as they are. The hard decisions that improve circumstances and improve the health of country people are something they do not want to embrace because that will upset their political applecarts. It takes courage and bravery to take on these issues, and that is what we are doing.