KANGAROO ISLAND MEDICAL SERVICES

Mr PENGILLY (Finniss) (12:45): I move:

That this house condemns the Labor government on its failure to ensure that obstetrics, elective surgery and after-hours emergency service negotiations with Kangaroo Island doctors have been handled satisfactorily and that the residents of Kangaroo Island be assured all these services remain in place on a permanent basis.

This is a debacle perpetrated purely by the Minister for Health's failure to come to grips with this issue and deal with it appropriately. I have been talking with the doctors in private practice on Kangaroo Island since October-November last year about the ongoing negotiations. For the record, I actually agree with the minister and the government on bringing in a consistent contract price for doctors across the state for providing an after hours, on-call, emergency service.

What I do not agree with is this nonsense that has been going on for weeks and weeks, which has severely upset the medical practice for one. The people of Kangaroo Island are even more upset over this and the way it has been handled. The fact is that the minister has not, until almost the last moment, put in place a senior person to negotiate on this matter. The Rural Doctors Association has been involved, through Dr Peter Rischbieth and others, but this has just gone pear-shaped for week after week.

In this chamber this week we have witnessed, time after time, speeches from the Treasurer talking about the money that is being put into Adelaide Oval. Indeed, the $450 million we started with that was non-negotiable is now running at $535 million and we do not know where it is going to stop. Meanwhile, the people in rural South Australia are struggling to get the services they desperately need. In this particular case, where the government is quibbling over money with Kangaroo Island doctors under contract for providing after-hours emergency calls, we are fiddling around and the place is burning down around us.

Purely and simply, what happened here was that we had junior, or not so senior, officers from Country Health SA dealing with this issue from the outset. We have had the senior bureaucrats now stepping in, I suspect at the bequest of the minister, to try and negotiate this. I suggested some weeks ago that he get an independent facilitator in there. This would never have happened under former minister Lea Stevens, but unfortunately the current minister will not listen to anybody. He gets fed a lot of nonsense from his bureaucrats without dealing with the fact of what people in small communities need: they need the services they have always had.

What I say about this is, 'Yes, doctors have changed in the way they deliver services and in their lifestyles.' I put on the record, so that no-one is in any doubt and can accuse me of a conflict of interest, that my wife is actually a practice nurse with that medical clinic in Kingscote for a couple of days a week. We have some very good doctors over there who run a private practice and do the after-hours, emergency on-call work at the hospital, the obstetrics services and work in with the elective surgery when the visiting specialists come over to do that.

In relation to my friend the member for Hammond, for example, or the member for Goyder, if their constituents have a problem that cannot be treated at one of their local hospitals such as the Murray Bridge Soldiers Memorial Hospital, they can get in their car and be in Adelaide in 45 minutes or an hour. When residents on Kangaroo Island have something go wrong and have to be transferred to Adelaide, if they do not go by the emergency helicopter or the Royal Flying Doctor Service, they have to catch either a commercial flight or the ferry. Now, if you live on the west end of Kangaroo Island, it takes an hour or 1½ hours to get to Penneshaw to catch the ferry, an hour or thereabouts on the ferry to get to Cape Jervis; then another 1½ hours to get into the city. That is just all fine and dandy if you are not all that sick, but if a woman is eight or nine months pregnant it is not a lot of fun.

Common sense should have come into this a long time ago. What has happened is that now obstetric and elective surgery services have about a month's grace and the government is providing a locum to do emergency on-call after hours. What needs to happen is: first, the obstetric services need to be maintained; secondly, the elective surgery services need to be maintained on a permanent and ongoing basis in the best interests of the residents of Kangaroo Island and the 180,000 visitors a year who come to the island (and that number is growing by about 6 per cent a year); and, thirdly, we need to come to an arrangement whereby the doctors on the island may do one week in three or one week in four on weekends and after-hours emergency in order to get some sensible outcomes. At the moment the locum doctor that the government provides is costing $1,700 a day and the local doctors are sitting at home at night.

The local doctors want to lead their lives in a certain way. A lot of them have young families and are involved in the community. They also have other activities: one milks goats, another one goes fishing, another one goes surfing and another one lives out in the bush part of the time. That is the lifestyle that they have chosen. Doctor services in the bush have changed considerably from 10, 15 or 20 years ago. We want to keep the doctors we have on Kangaroo Island, on Kangaroo Island. We do not want them looking to come to the city or to transfer to other areas in the country; we want to keep them on Kangaroo Island. We want happy doctors—a happy doctor means a happy community, and that is what we need.

How we can spend $535 million doing something with Adelaide Oval is beyond me when we cannot find the money to put into rural health. I do not need telling by the government or the minister about the cost of health service delivery in South Australia. I was involved for many years on local and regional boards and I am well aware of it. One of the failings of Australian society, in my view, is that people go to the doctor too often now. If they get a sniffle they go to the doctor. An old friend of mine (who passed away a couple of years ago) was talking to another friend and he said, 'I've got a cold.' He was asked what he was going to do about it and he said, 'Well, if I take something it will be gone in two weeks; if I do nothing it will be better in a fortnight.' The attitude in Australia now is to go to the doctor for everything—it is a failure.

I heard what the member for Fisher said earlier, and I support his words. People—men particularly—should have checkups. Doctors and health services are working on that, and I have no argument with that; however, we are what we are and that is the way Australian society is going. Therefore, the cost of health service delivery in this nation is appallingly high and will continue to be high. All I ask in this case is to get back to basics, to maintain and deliver services in rural and regional South Australia (and, more importantly, on Kangaroo Island) as they have always been delivered. Not so many years ago we had one doctor servicing most of Kangaroo Island and another doctor, Dr Mary McHugh, the wife of a soldier-settler, used to service the Parndana area. We had two doctors and they did all the work required on Kangaroo Island. We have had up to six doctors. These doctors do not know where they are going.

I also have an issue with Yankalilla and the Southern Fleurieu Medical Practice which I will raise at another time in this place because we had a problem there. We fixed the problem when we had regional boards, we fixed the problem when we had local boards, we could communicate with the doctors and we could work through these systems, but now it is all gone; it has all gone to this centralised bureaucracy in Hindmarsh Square. They do not know how the other half lives, quite frankly; they have absolutely no idea. They would be well served to get out and see what it is like to live in the bush—wherever that may be in South Australia—and find out how the other half live. People want to live in the bush; they do not all want to live in Adelaide. The last place I want to live is Adelaide, quite frankly, but I will happily come here in the course of my work. People do not want to come to Adelaide.

If you are ill and if you do have to come to Adelaide from Kangaroo Island, you face those hurdles that I spoke about earlier. Why on earth should Mrs Jones be brought to Adelaide for an emergency service or some medical procedure? If her family wants to come up, they then have to go through this enormous expense of travelling up, whether by sea or by air, and be dislocated. Why should the good residents of Kangaroo Island have to come to the mainland for elective surgery or to have their babies away from family, away from friends and, let me tell you, at enormous cost to the state? My understanding is that it costs $10,000 per baby to have a baby delivered on Kangaroo Island. There are limited numbers of children born on Kangaroo Island.

Let me inform the house that the island community is absolutely stinking over this issue. When they get their heads together and decide to fight on something together, it is 'Look out!', let me tell you. I have borne the brunt of that over the years. We have a few fights over there between each other and when we have them they are ding-dongers, but when the island gets together and wants to take something on, look out!

There are only four and a half thousand people over there but they can make a lot of noise. It is very much a combined decision of all the people and groups and different communities on Kangaroo Island that this is a nonsense. They recognise the huge part the doctors play in the local community. Yes; they are a private practice, and for the minister to even suggest that the government will put in a public GP service at Kangaroo Island Hospital is an absolute nonsense. Quite apart from the fact that they will have to build new buildings and provide locums, nurses and everything else, what in heaven's name will that cost per year? It is absolutely ridiculous. That is a threat to the local community and a threat to the local doctors in the private practice. It is a threat we did not need. I thought it was most foolish of the minister to suggest that. It is not helpful. All it does is inflame the situation where cool heads should prevail.

I did suggest two or three weeks ago that a couple of good people may have been the former minister Lea Stevens or former minister Dean Brown. The minister has chosen not to do that. We now have the head of Country Health, Clare Douglas, involved and a couple of other officers. They are meeting again next week. I think they meet on Tuesday. I say to the house and I say to the government: you need to tell minister Hill to come to a compromise because I believe the doctors over there will come to a compromise. Maintain permanently our elective surgery, maintain permanently our obstetric services on Kangaroo Island and maintain some emergency after hours on call with the local doctors contributing to that. It is most critical. I urge the house to listen to what I have to say and I commend my motion to the house.

Mr GRIFFITHS (Goyder) (12:58): I wish to speak in support of the motion of the member for Finniss. As a fellow regional member of parliament, I am very aware of the issues facing our communities when it comes to the provision of health services and this one was actually brought to my attention by one of my own constituents. It is not a person who has a property interest in Kangaroo Island. It was just a person who lives only about 15 kilometres south of me who contacted me when they heard about this on radio and said, 'What sort of madness is actually going on here, when you have 4,500 people living on Kangaroo Island who have no guarantee of their health services?'

It is appropriate that the member for Finniss brings this motion before the house and it is appropriate that the government does everything within its power as quickly as possible to sort the situation out, to ensure that the doctors that are there have the opportunity to continue to practise the skills that they bring to that community and, importantly, to ensure that obstetrics, emergency care and after-hours emergency care is available for the community and the some 180,000 visitors who go to Kangaroo Island each year.

Kangaroo Island is a very unique place. There is the real difficulty of travel to the mainland. There is a difficulty, probably, in some professions in recruiting the people that you need for that community, but it deserves the absolute best of care and it is important that we as a parliament enforce upon the ministers in charge of the departments that every effort is made to ensure that this level of service is maintained and that these people have continuity of care and are under no threat in the future.

Debate adjourned on motion of Ms Thompson.

[Sitting suspended from 13:00 to 14:00]