House of Assembly: Thursday, November 15, 2012

Contents

COUNTRY HEALTH SA

Mr PENGILLY (Finniss) (15:22): In the past couple of days we have been hearing a few examples of some of the more ridiculous attempts by Country Health SA to negotiate a new agreement with GPs in rural areas. It is hard enough to get good doctors in the country areas, so it beggars belief that this government seems intent on doing all it can to be as offensive as it can to hardworking, dedicated, experienced doctors who care deeply about the service they provide.

When I look at this case it is not hard to wonder why people believe that this government is out of touch with people in regional areas when you consider the entirely unnecessary problems that this government has created in Keith, Clare, Snowtown, Victor Harbor and in other places. In my electorate of Finniss, the doctors at the South Coast District Hospital have a good system that is incredibly cost effective to the taxpayer. Doctors from the Fleurieu's four private practices provide the hospital with a 24-hour service in anaesthetics and obstetrics, as well as an accident and emergency service from 8am to 8pm.

The only service they needed to relinquish many years ago because of the workload was the overnight emergency service from 8pm to 8am. Those hours are worked by locum doctors. The system works well, and the people of the Fleurieu are very well catered for at that hospital.

In the past 10 years demands for services at the South Coast District Hospital have in some cases doubled, including in emergency care. That is not entirely surprising—it is an area of South Australia with an increasing population. Many of the residents are retirees, and it is a booming holiday destination that can double the size of the permanent population at certain times of the year, like this weekend. It is a busy place.

The range of medical services required is diverse, so as the doctors have become busier at the hospital work at their own practices is also getting busier. It can sometimes take residents five to six weeks to get an appointment. The people of this region reasonably expect their local public hospital to provide around-the-clock service, and they get it. The overnight locum doctors are busy. They do not go there now for a lie down and a peaceful sleep. They are up all night and they work hard. On occasions they even have to call in local doctors to help with the load on particularly busy nights.

So when the health minister came into this house yesterday and said that the new agreement he is forcing them to sign would not require them to be on call for 36 hours he was showing up his obvious ignorance of how the system works. That, quite frankly, is offensive to those doctors who currently work around the clock to provide a safe and reliable service. Of course this new agreement will require them to work 36 hours straight, and we are not talking—

The Hon. J.D. Hill interjecting:

Mr PENGILLY: —calm down, minister—about 36 hours of being on call, we are talking 36 hours of being awake and practising medicine. If they work in their practice all day, work in a busy hospital all night and then go back to work in their practice the next day, how many hours does the minister think that is? If the minister, or Country Health SA, say to the doctors, 'Wait, we are now going part subsidise you to take the next day off by paying you a new safe work payment,' there goes another day of cancelled appointments for their other patients at their practices. So, the six week wait for an appointment with a local GP turns into seven weeks, or eight weeks, or longer. The doctors do not want any extra money. They do not want the safe work payment. They are not even seeking better conditions. They are seeking a continuation of the system that works incredibly well for the people of the Fleurieu Peninsula and allows the doctors to deliver a safe and reliable service.

What was also offensive about yesterday's contribution to the house by the minister was his assertion that Victor Harbor relies on ad hoc arrangements for after-hours callouts for obstetrics, anaesthetics and daytime surgery. The minister has no idea of what he is talking about. There is a formalised obstetric roster for weekends and on week days individual GP obstetricians cover their own patients—

The Hon. J.D. Hill interjecting:

Mr PENGILLY: —you stuffed it up, mate—with a roster for GPs for caesarean sections. There is also an emergency roster that covers all clinics. According to these doctors, they can only recall one instance over many years when an anaesthetist was not available, and that could happen for a variety of reasons in the country whether there was a new GP agreement in place or not. In the 18 month so-called negotiation period for this new agreement with the Victor Harbor doctors, not once did Country Health SA ask the doctors about their specific needs or issues.

Every country area of South Australia has varying needs and demands for medical services, and that is recognised by Country Health SA. That is why there are differing emergency care service agreements: for Whyalla, Port Augusta and Port Pirie there is the Upper Spencer Gulf Agreement; the Riverland has the River Doctors ED Service Agreement, applicable to Berri, Renmark and Barmera; Gawler has the Gawler GP Inc. Service Agreement; Mount Barker is the Adelaide Hills Division of General Practice Emergency and GP After Hours Service Agreement; and then there is the Mount Gambier Emergency Department, which is a different situation again. So, there are varying agreements all over the state and it is about time someone from Country Health SA recognised the particular needs of the doctors at Victor Harbor.

I am inviting the minister to come to my electorate and personally speak to the dedicated doctors who provide the South Coast District Hospital with outstanding medical care and find out for himself why there is no need to alter current arrangements. There is no need for the high-handed heavy duty threats to ban these doctors from the hospital if they do not sign the GP agreement, which is a ludicrous threat to make in light of the lack of available doctors to staff the hospital.

The crux of the situation is that the doctors do not want more money. They are not asking for improvement to their conditions. They simply want the current arrangement that provides the people of the Fleurieu Peninsula with a safe and reliable medical service to continue. I do not think that would be too difficult to manage, even for this government.

Time expired.