House of Assembly Fifty-Second Parliament, First Session (52-1) 52 1 Parliament of South Australia House of Assembly published Ministerial Statement Country Health Services COUNTRY HEALTH SERVICES The Hon. J.D. HILL House of Assembly Kaurna Minister for Health Minister for Mental Health and Substance Abuse Minister for the Southern Suburbs Minister Assisting the Premier in the Arts The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for Mental Health and Substance Abuse, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:07): I seek leave to make a ministerial statement. Leave granted. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: The state government's key commitment is for the provision of quality public health services across our state. The Rann Labor government is absolutely committed to ensuring the best public health care for all South Australians regardless of where they live. An honourable member interjecting: The Speaker House of Assembly The SPEAKER: Order! You will listen to the minister in silence. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Thank you, Madam Speaker. Every year the state government puts more funding into public health care, with a record $4.5 billion for this financial year, including an extra 13 per cent or $84 million for country South Australian public health services. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! I warn the member for MacKillop. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I will repeat that: in this current financial year we have put in an extra 13 per cent or $84 million for country South Australian public health services. The increase in funding for country South Australia this budget was considerably higher than the statewide increase which stood at 10.5 per cent. Every year, demand for services in our public health system continues to grow as our population grows. In the current financial climate, where the global financial crisis impacted the state's revenue by some $1.4 billion, the government has taken the prudent steps of implementing some savings measures, as members would know. Members interjecting: The Speaker House of Assembly The SPEAKER: Order, the Leader of the Opposition! I warn the leader. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: This is a serious issue and I am trying to go through— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Leader of the Opposition, you are on a second warning. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: As health is the single largest component of state spending, it cannot be exempt from the savings measures. Remember that we have to find $1.4 billion as a government. Members interjecting: The Speaker House of Assembly The SPEAKER: Order, member for Schubert! Mr Venning interjecting: The Speaker House of Assembly The SPEAKER: Member for Schubert, I warn you. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: So, health, which takes up over a third of the state budget, cannot be exempt from these savings measures, and it is not unreasonable, it seems to me, that the private sector—which is funded through the health sector—should not be included. That process has led to the withdrawal of some funding to three private community hospitals: at Moonta, Ardrossan and, of course, at Keith. As private— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Listen to what the minister has to say. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Thank you, Madam Speaker. Private hospitals receive most of their funding, of course, from private health insurers for the provision of private services to private patients, and no-one should find that unusual. They also receive commonwealth funding for the provision of aged care which, of course, is the commonwealth's responsibility. The state government has no jurisdictional responsibility for funding aged care, but there are some historic arrangements, such as these subsidies, that do not reflect proper jurisdictional responsibility. For historic reasons, that funding has been given in some cases. The state subsidy, of course, is a small part of the budgets for each of the three hospitals. There have been a lot of exaggerated claims about the possible impact of the budget— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Thank you, Madam Speaker. Mr Williams interjecting: The Speaker House of Assembly The SPEAKER: Order! I warn the member for MacKillop for the second time. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Thank you, Madam Speaker. As I was saying, there have been exaggerated claims made about the possible impacts on the budget decisions. Ms Chapman House of Assembly Ms Chapman: You coward! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Madam Speaker, I would ask— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Madam Speaker, the member for Bragg reflected on me by calling me a coward, and I ask her to withdraw that. I think that is unparliamentary. If she wants to make claims about me, that is fine, but she should do it in the proper way. The Speaker House of Assembly The SPEAKER: Yes. Member for Bragg, I would ask you to withdraw that remark. It was heard very clearly across the floor. Ms Chapman House of Assembly Ms Chapman: I withdraw the remark. Unfortunately, we have to continue to listen to this nonsense. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: There have been a lot of exaggerated claims about the possible impact of the budget decisions, and I would like to take this opportunity to give some details of what it means for each of the hospitals. In relation to Keith, the full subsidy of $627,000 will be made available again this financial year for the provision of a range of services, including emergency care and three public inpatient beds. Through the 2010-11 state budget process, $300,000 will continue to be made available for the provision of emergency care for the following year and beyond—so, 2011-12 and beyond. This, of course, is in addition to the $70,000 on-call payments made available to the general practitioners in Keith for on-call emergency service. There are, I am told, approximately 600 patients a year who are either emergency department patients or outpatients of that hospital. Let us assume that they are all emergency patients. That is the equivalent of just under two patients a day. In other words, the government is prepared to put in $370,000— Mr Pederick interjecting: The Speaker House of Assembly The SPEAKER: Order, the member for Hammond! Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The minister will continue. Mr Pederick interjecting: The Speaker House of Assembly The SPEAKER: Order! The member for Hammond, I warn you. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: For the 600 or so patients a year (approximately two a day), the government is prepared to put in $370,000 of subsidies. I will allow members themselves to— Mr Pengilly House of Assembly Mr Pengilly: You're a wuss. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Is that right? I am not sure whether that is unparliamentary, Madam Speaker. The Speaker House of Assembly The SPEAKER: Yes, I am trying to work out whether 'wuss' is unparliamentary. I would be very careful if I were you, member for Finniss. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! I know that you have an audience, but I would ask you, please, to restrain yourselves and behave. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I hope that the audience would appreciate that what I am trying to do is give facts; what the other side is doing is making personal abuse. Mr Williams interjecting: The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I am meeting with people this afternoon, as you know. Mr Williams interjecting: The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I wasn't invited. The Speaker House of Assembly The SPEAKER: Order! This is a parliament, not the front bar of the local pub. Behave! Mr Williams House of Assembly Mr Williams: Why is he treating us like idiots, then? The Speaker House of Assembly The SPEAKER: Order! Member for MacKillop, behave yourself! If you listen you might understand that he is not treating you like idiots. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Madam Speaker, as you would be aware, I am trying in a very sensible way to go through the facts. Now— Mr Pengilly House of Assembly Mr Pengilly: Why didn't you get out there on the steps of parliament? The Speaker House of Assembly The SPEAKER: Member for Finniss, I warn you! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I wasn't invited. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! This is getting ridiculous. Stop this childish behaviour and listen to the minister, or you will all leave the chamber! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Now, where was I? I don't want to miss any of the salient features here. The amount of state money withdrawn from Keith is about 13 per cent of the hospital's total budget, not the 60 per cent that is being claimed in the media. According to their own figures, in the last financial year there were 408 occupied bed days for public patients at the Keith Hospital, meaning that on average there was over just one public patient in Keith on any given day. In addition, in relation to Moonta, the state provides a subsidy currently of about $288,000, which funds eight long-stay aged-care beds—nursing home-style beds. The annual state subsidy to Moonta will be discontinued from 2011-12, so there is transition time, but the 64 aged-care beds that are funded by the commonwealth, of course, will remain funded. Up to $5,000 is provided to Moonta for accident and emergency. So, the main subsidy from the state government to Moonta is for eight aged-care style beds, which are really not the responsibility of the state. The commonwealth's responsibility for 64 is ongoing. In relation to Ardrossan, Ardrossan Hospital receives $140,000 from the state government to subsidise its accident and emergency service. Country Health SA estimates there would be about two patient presentations on average a day at that emergency department. I have no criticism of what they are doing; however, there is an excellent 24-hour day, seven-day a week emergency service at Maitland, which is just 23 kilometres from Ardrossan. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: It is also important to note that at Moonta and Ardrossan, if a patient does not have private health insurance and needs to be admitted after seeing the emergency department, they would be sent to a public hospital elsewhere, at Wallaroo, Maitland or Adelaide, or pay a premium. So, let's be clear about this: the emergency department cannot admit public patients to the hospitals unless they pay the private premium. The state government's responsibility is for public hospital services to provide acute care when— Mr Williams interjecting: The Speaker House of Assembly The SPEAKER: Order! Member for MacKillop, you are on your third warning. Next time, you are out. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: The state government's responsibility is for public hospital services to provide acute care when patients need it, not to fund aged care and not to fund services which are not used. It is also the state's responsibility to spend money on public country hospitals, hospitals such as Wallaroo, Maitland, Yorketown and Bordertown. For example, the state government recently spent $1 million upgrading Wallaroo Hospital with a new emergency department and birthing facilities. Mr Pengilly interjecting: The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I just say to the member for Finniss that, if he thinks I'm arrogant, then why does he ring me privately and ask for little private deals about issues in his constituency which he wants fixed? Ask me in here in future! Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Mr Pengilly interjecting: The Speaker House of Assembly The SPEAKER: Member for Finniss, you are on your second warning. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Thank you, Madam Speaker. The state government's responsibility is for public hospital services to provide acute care when patients need it, not to fund aged care and not to fund services which are not used. We have been putting extra resources in the public hospitals. As I said, we recently spent $1 million upgrading Wallaroo with a new emergency department and birthing facilities. I do want to acknowledge the good work of the three hospitals in question in their communities and the efforts of the local community to support their hospitals. I acknowledge that, and I also acknowledge that the communities are concerned about their hospitals and, therefore, I want to commit the assistance of my department, and Country Health SA within it, to work with these hospitals and their boards to help them through this transition. Already, Country Health SA has been in— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Already, Country Health has been in contact with the commonwealth to explore extra funding support from the federal government for these hospitals. My office and my department have been contacted, with representatives from at least two of the hospitals seeking a discussion. I welcome the commitment to an open dialogue with these communities and look forward to discussions that are open and frank, but within the acceptance of the budget parameters. I have also accepted an invitation from a number of members opposite to meet with them and representatives of the hospitals this afternoon. I will happily do that and go through some of these issues with them then.