COUNTRY HOSPITALS

Mr VAN HOLST PELLEKAAN (Stuart) (11:31): I move:

That this house—

(a) notes the importance of country hospitals to small country towns; and

(b) recognises the extremely valuable contributions that the health professionals make to the quality of care to local residents and to rural and regional communities more broadly.

I would like to just start out by making it very clear that when I say 'health professionals', I am deliberately talking about the very wide range of people who contribute to health in country communities. Of course, immediately doctors and nurses spring to mind, and when I say doctors, it is typically local GPs who come to people's minds. Those people do a fantastic job and they really are at the core of most health services that we receive in country, rural and remote South Australia, but of course there are many others.

There are many allied health workers and in fact there are many city-based specialists who come out to country areas to provide their medical support and service as well. I would just like to make it clear that I am talking about everybody who provides this support at country hospitals in country South Australia and, of course, in other associated medical services, including private practices.

In the electorate that I represent—the electorate of Stuart—we actually have nine hospitals: Port Augusta, Kapunda, Jamestown, Peterborough, Burra, Eudunda, Booleroo Centre, Orroroo and Leigh Creek. Every single one of them is exceptionally important to their local communities, obviously for the health service they provide but in many other ways as well.

I would also like to point out that many people I represent in the electorate of Stuart also get supported very well by hospitals just outside of our electorate. People from Stuart are served by the Hawker hospital, the Quorn hospital, the Nuriootpa hospital, Waikerie Hospital, the Mannum hospital and others including, very importantly, hospitals in Adelaide. I think that it is important to point out, too, that there is an enormous amount of cross-support when it comes to this issue.

I am focusing on country hospitals but it is fair to recognise that country people do get support in Adelaide, and it is also very important to recognise that city people very often get a lot of support in country hospitals when they are there for work or business or travelling for tourism. When they fall sick or have an accident, they need our country hospitals very much as well.

As I have mentioned in this house before on a different topic, I was very fortunate last year to have the support of an intern from the University of Adelaide, Ms Alexandra Grigg, who is a very capable young woman who did some work for me looking into the benefits and important contribution that infrastructure and government services make to rural and regional South Australia, over and above their primary function for being there. I accept that we do not put medical services in place when medical care is not required, but they do a lot of very good work in addition. I will read some quotes out of her report:

...investment in rural health facilities in South Australia has a positive effect on the communities (sic) volunteer rates (as a percentage of town population), population and age group spread.

Age group spread is a very important indicator of community health—lots of young people, lots of middle-aged people, lots of old people. Whether the total population is small or large, having that good spread of ages is very important. Another quote:

...the regressions show, health facilities increase part time employment rates by 30.54% within a community.

Again, another quote:

Health facilities in regional communities not only provide health services that meet the requirements of both young and old, but they also provide employment opportunities and training for the towns' residents. Through the engagement and participation of the whole community, health facilities in regional South Australian communities add to the social welfare of the district and contribute constructively to community strength.

Again, I quote:

Health facilities, including local hospitals, generate a sense of identity and pride within regional South Australian communities...As a result, these services facilitate a high degree of community involvement through volunteerism...Consequently, support networks are strengthened and a sense of trust is generated...In turn, people are attracted to districts with these facilities as they provide benefits above their primary purpose of health care. Subsequently, investment in regional health facilities increases community strength and social welfare...

Again, I quote:

...health facilities in regional South Australian communities provide multiplier effects throughout the community above their primary purpose, encouraging community involvement through volunteerism and providing employment opportunities both directly and indirectly within the community...The intimate size of country hospitals in South Australia enables these facilities to tailor their services to the requirements of the community...Whilst the cost of maintaining regional South Australian health facilities is extremely expensive...the removal of these services significantly compromises the strength of local community...

Finally, I quote:

Long term, social equity considerations must be used in conjunction with economic rationalism to fully understand the influences infrastructure expenditure has on community strength. Future regional development and infrastructure polices in South Australia need to consider the social welfare and indirect economic multiplier effects associated with investment or disinvestment in sporting, health, educational and transport facilities in remote communities. Infrastructure investment in regional South Australian communities provide benefits beyond their primary purpose.

Lastly from that report, I would like to provide some information from a website which Ms Grigg created and it can be found by looking up 'communitystrengthinregionalSouthAustralia'. On that website she has highlighted the economic multipliers, and this is specifically with regard to healthcare facilities. The economic multiplier effects include direct and indirect employment opportunities, increased demand for local goods and services, and increased expenditure throughout the wide community.

The social multiplier effects include increased trust, immediate access to support networks, increased volunteer participation, increased social inclusion, increased group diversity, and lower mortality rates. Lastly, I quote from the website where Ms Grigg has written:

...health care facilities significantly increase the clusters of businesses in a community, furthering the multiplier effects of the institution. Furthermore, health care facilities based in regional South Australian towns increases their full time employment rates by 33%, holding all else constant.

Mr Deputy Speaker, I am sure that you will agree that that information, which is a small part of Ms Grigg's research, is very compelling. I would like to add some information to those facts for the house. She is not working in a social context, health context, sport or any other context—Ms Grigg is a young economist. This information is factually based on a very extensive study of facilities throughout regional South Australia.

This is exceptionally important for us, and I say again: over and above the very obvious healthcare benefits, this is exceptionally important because we need to keep people living and working in our regions. All these benefits that the health services supply in addition to health care support are keeping people in regions. If you do not have good health care, you will not have families with young children staying. If you do not have good health care, you will not have older South Australians staying.

Let me point out that all studies clearly show that, while we have approximately one-quarter of our state population living in regional South Australia, those people actually generate between two-thirds and three-quarters of our gross state product. If the people do not live in the regions, that gross state product will not be generated and our entire state will suffer. This is very important and something that is often lost on members in this house who are not intimately connected with regional issues. If you do not have the services, the people cannot live in the country. If the people do not live in the country, our whole state will suffer economically—that is very important.

They suffer because country towns, without the health services, will not have aged care, they will not have chemists, they will not have a GP, they will not have grocery stores, they will not have food services, they will not have other maintenance suppliers, and they will not have hospitality facilities like hotels and many others. The health service generates the people, creates the jobs and keeps all those people there working. Without those facilities, people will not be living in country South Australia.

Of course, I am reminded of the government's country health plan, which was brought forward quite a few years ago. Regional South Australia stood up defiantly against the government to knock back that country health plan. The government had absolutely no choice but to knock it back. I remember going to many public meetings attended by hundreds of people, where people made it really clear that, in the regions, they understood all the things I have just spoken about. They got it, they knew it, it was their life and it was their children's and grandchildren's futures that were at stake. Clearly, the government did not get it, and I am here to remind the government again, every single day, how very important this is to regional South Australia.

Part of the government's health plan it did not reverse was the removal of local hospital boards. Local hospital boards, which comprised a combination of health professionals, government representatives and local people from the local area contributing to make decisions on the running and management of their hospital, were disbanded and replaced with health advisory committees (HACs). Many of the good people who were on the local hospital boards transferred across to the health advisory committees. As a local member of parliament with, as I said before, nine hospitals in their constituency and the opportunity to nominate people onto those HACs, I can tell you that people do not want to be on them. They do not want to be on them in the same way that they did want to be on the local hospital boards.

The reason for that has nothing to do with the name change. The reason is that the government also took away the decision-making authority those local people had to have a positive impact on the running of their health services. There are certainly some people—a minority of people in my electorate—who have hung on and continue to represent their communities the very best they can, but they also tell me that it is not working, that it is not a good system, and they are incredibly disheartened. They are in the minority. Most people have just left and walked away because they do not see that they get a direct benefit for the volunteer time and effort they put into their local communities because it is not transferring into decisions in their local communities.

These are decisions which you would think would be very readily understood by the government—decisions such as how to spend tens of thousands of dollars or, in some cases, hundreds of thousands of dollars the local community has fundraised for their local hospital. But now local people are not allowed to decide how that money is spent. They have to bow down to the government in Adelaide in regard to decisions on how that money gets spent. You can imagine how heart wrenching it would be to have raised hundreds of thousands of dollars, in some cases over decades, and now be told, 'But now we have changed the system. You don't get to decide how your money is going to be spent in your region.'

That is a prime example of the reasons that local people do not want to participate in the way that they did—not because their hearts are not in it, but because they do not have the opportunity to make the decisions. I reiterate again that our policy as a Liberal opposition, if we are successful at the next election, is to immediately reinstate those local hospital boards and provide that authority back to people that they used to have, because it is an exceptionally important thing. The local health professionals understand that they were better served in their work previously when they had that active local involvement.

I will turn to the Royal Adelaide Hospital very briefly. While it is in Adelaide, it does link in very directly to this argument. At the last election we had a policy to renovate the Royal Adelaide Hospital and the government had a policy to build a brand new hospital. The reality is that over the entire life of the project there would have been approximately a billion dollars saved by renovating versus rebuilding. People can argue, 'Well, one might have blown out, the other might have blown out; one might have been cheaper, the other might have been cheaper,' but the reality is that over the life of the project approximately a billion dollars could have been saved. The gap would have stayed about the same.

We would have put that money into all of the other hospitals throughout the entire rest of the state, including some in Adelaide, but all of the benefits throughout Regional South Australia as well. It is no wonder that the government is now running out of money, is in a dreadful position financially and is struggling to financially support health care in rural and regional South Australia: because it made that decision. There will be a brand new flash hospital and no doubt it will be a good job. We can argue about whether or not it will be good enough, but the reality is that the government let go of the opportunity to have an extra billion dollars over the entire life of the project spent on other healthcare services throughout South Australia. That would have benefitted regional South Australia enormously and meant that we were not in the difficult situation that we are today.

Time expired.

Mr WHETSTONE (Chaffey) (11:47): I commend the member for Stuart for his motion. There is no doubt that country hospitals are vital to all towns and all communities. It is not just about the regions. They are vital for existence so, again, I commend the member for Stuart for his motion. I will start off by talking about the importance of country hospitals. My electorate is made up of many small towns that rely on the small country hospitals, and my constituents are very proud and passionate to support them. They really are part of the fabric of a regional community.

If we look at a bit of history of how country hospitals have been supported over many years, it is about the community taking some ownership and giving recognition to the importance of what country hospitals represent. Over many years, country hospitals have slowly been wound back and in some way, shape or form, sadly, defunded in many ways. What we are seeing these days with this current government in particular is centralisation of health, particularly in country health. It really has started to play out over the last few years exactly what centralisation means. In essence, it is taking away a lot of the ownership. As I have said, the regions have a respect for their hospitals and for the staff, particularly for the doctors and nurses—the frontline people who are there and provide the services, but also the people who support those country hospitals.

Today it is about being able to commend and express appreciation for their valuable contribution. A good percentage of the community population is part of the health system. It is not just about nurses and doctors, it is about the supporting staff around the hospital. It is about the maintenance staff, the cleaners and administration. It really is a network that in most country areas is the biggest employer of that town. Again, it is providing a vital healthcare service, but it is also providing a vital employment opportunity for community members.

I would like to talk a little about the hospitals I have in my electorate—Waikerie, Barmera, Berri, Loxton and Renmark; and with the electoral boundaries about to change, I will take in another three hospitals—Pinnaroo, Lameroo and of course Karoonda. That really does put a significant amount of hospitals in any one electorate, although, as the member for Stuart has said, he has many hospitals in an electorate that is vast in this state's land layout.

What I would like to touch on is obviously the community having ownership of hospitals. As the member for Stuart has said, the community have lost some of that touch with country health and country hospitals because of the taking away, I guess, of some of the direction of those hospital boards and now giving it to the health advisory committees. I think the health advisory committees are doing a great job. They have been compromised and the boards have almost lost some of that ownership or the conduit into the community, if you like.

To give one example of what country communities do to look after, support and care for hospitals, to keep their hospitals' doors open, to keep the facilities maintained and to put extra services into their hospital, I know that recently the Berri Lions Club donated a new ultrasound machine for the birthing unit, a $60,000 piece of equipment, to the Berri Regional Hospital. That is the sort of thing that some of the service clubs are doing. Just last week, the Hon. Rob Lucas from another place, shadow spokesman for health, visited a country hospital and the aged-care facilities in my electorate, as well as the Flinders regional training facility. He was very impressed with the community's ownership of their hospitals.

Let's look at some of the moneys that are in the coffers that, sadly, the state government almost has control of at the moment. Two of the hospitals in particular have had large accounts through their boards but which now come under the HACs. The government has taken control of that money, the very money that the community have raised and the very money that has been bequeathed to those hospitals. They are taking control of it essentially so that they can actually use that money for their budget bottom line. I think it is outrageous that the government is dictating to a country hospital how they can spend their money for the benefit of the hospital. It is sad to see that happening.

The Berri Hospital is now being turned into a general hospital for the Riverland. It is supported by all the outlying towns' hospitals—Renmark, Loxton, Barmera and Waikerie. I have already mentioned the soon-to-be Chaffey Mallee hospitals at Karoonda, Lameroo and Pinnaroo, which I am sure I will learn more about. I think the essence and fabric of country hospitals has already been underlined in what I have said. Again, there are always issues in these hospitals, particularly with visiting specialists and being able to attract specialists, doctors, nursing staff and administration staff to those hospitals so that we can continue to keep the health services that these small communities so much deserve.

The Berri Hospital has 36 beds with acute illness facilities. That has a 24-hour accident and emergency service, and it has an accident and emergency service provided by River Docs, which is something fairly new. I touched on the Flinders University campus and, in 2002, the Renmark Hospital supported its new rural clinical school initiative with 20 students beginning a Bachelor of Nursing degree at Renmark. In 2005, that intake rose to 30. That gives an opportunity to regional students (regional wannabe nurses and doctors) to be able to train in the regions—to live at home and train.

The burden of having to train away from home is an extra cost. It is living away from home and having to find accommodation, not being around your friends, and not having the social upbringing you are accustomed to. It is not only about learning a new profession: it is about being supported by your family and friends. The Flinders University campus in Renmark is one of 17 across the nation, and it is an excellent opportunity for regional wannabe nurses and doctors to train in the country.

Loxton Hospital has for a long time been regarded as a very important part of the Loxton community. It is almost famous for its birthing facilities and family-style apartment suites. I visited it last week, and it really does provide a unique experience, where the mother-to-be can come and give birth and the rest of the family can come in and live in the hospital while they are going through one of those life-changing experiences of giving birth and bringing into the family a new loved one. I commend Loxton for what it has achieved. Sadly, Loxton has money in the coffers and is not able to spend that money. I look at all the hospitals within the regions, and I commend what they offer. I have much more to offer but, sadly, my time is up. I commend the motion.

Mrs REDMOND (Heysen) (11:57): It is my pleasure, also, to rise to support this motion, and I commend the member for Stuart for bringing it to the house. Many members would be aware that I have a particular passion for the small hospitals around this state, particularly because I spent 28 years of my life serving on the board of the Stirling District Hospital and, indeed, only gave up that position when I was elected as leader of the parliamentary Liberal Party and could no longer find the time to devote to that hospital. It stands, I think, as a shining beacon of what can be achieved by communities if only government will get out of the way.

That brings me to the main points I want to make. When you go back to the very early days of this government, one of the very first things they did (incompetent as they have been over the ensuing years) was engage a chap by the name of John Menadue from New South Wales—at considerable expense—to tell us what I think was the bleeding obvious in the first place. He came, at considerable expense to the taxpayers of this state, and, surprise, surprise, the conclusion that Mr Menadue came to in his report a decade ago, or more, was that we need to focus on primary health care. We need to focus on the care out in the community and preventative health care.

How better could we achieve that than by supporting the many hospitals across our state? Look at hospitals like, for instance, the Keith hospital. The government, in the last couple of years, decided it would withdraw funding from the Keith hospital. The Keith hospital had several major things going for it. It was a combined asset created—

Mr Whetstone: I was born in Keith.

Mrs REDMOND: The member for Chaffey was born in the Keith hospital, which means it is a place of historical significance to this state. Where would we be without the Keith hospital and the member for Chaffey having been born there? That hospital provides not just hospital care but it combines also an aged-care service and a medical centre; and, indeed, Keith happened to be the point to where the rescue helicopter from the Royal Adelaide Hospital could get without having to refuel so it could pick up and retrieve patients and get them back to the Royal Adelaide. So, it was a significant point and, of course, it was at the junction of two major highways which have been the source, sadly, of many significant and severe accidents in this state.

It was a vital part of the healthcare for not just the people in and around Keith, but for all the people traversing the roads between Melbourne and Adelaide, and indeed many other places around this state. But, this government chose to say, 'No, we're going to withdraw the funding,' because the then minister for health said, 'This is a private hospital.' He kept saying, 'This is a private hospital; why would government spend money supporting a private hospital?'

That illustrates, more than anything else, the completely erroneous thinking of this government, because it is private only in the sense that it is not a public hospital. It is a community-based hospital. Nowhere else can the government actually get a hospital where the land has been provided by the community itself; where the buildings are provided by the community itself; where the running of the hospital (via its board) is provided, generally at no cost, by volunteers from the community itself; and where the running costs are kept to a minimum because the people who are engaged in the provision of services (such as cleaners, cooks and so on) are able to do the duties for all of the different sectors, thus making the running of the hospital much cheaper.

When we talk about hospitals, we generally talk about something called 'occupied bed days'. Occupied bed days have a particular cost, and to have a facility such as the Keith Hospital, the occupied bed day cost for this government compared to the occupied bed day cost of any of the public hospitals completely paid for by the government is minuscule because of the contributions that these communities make. They make these contributions for a very good reason; it is because they are used to caring for themselves and each other, as evidenced by their responses in all sorts of situations.

And yet, this government, in its bizarre wisdom, decides they are going to pull the money from hospitals such as Keith, Moonta, Glenelg and Ardrossan. All of those hospitals were in that same boat of providing to the public of this state—whether or not they were locals—the ability to get assistance at a hospital. Apart from that, there is the issue of the fact that people need to be able to access health care closer to home a lot of the time.

What this government has focused on doing all along is centralising all of the health care in this state into the hospitals in the city, and indeed even from the Queen Victoria, that used to be, and now the Queen Elizabeth Hospital in the western suburbs. They are centralising from there into the city itself. That makes no sense. What we need to be doing, according to the government's own report by Menadue, is actually focusing our attention back into the community so that people are kept better out in their communities, and we do more preventative work out in the community.

The member for Stuart made the very realistic point that regional areas in this state will die if we do not actually allow the people who live in those areas to have the facilities that they need to be able to have a reasonable life out there. The member for Chaffey made the point about the money that is held by these hospitals that cannot be spent, and I am sure we will hear more about that from other members.

The other point I want to make is that not only have these hospitals run very efficiently, they continue to enjoy the support of the community. In the case of the Stirling District Hospital, for instance, I am able to say that our local op shop, known as the Stirling Community Shop, makes a profit every year. It gets second-hand clothing, largely, and a few other goods, and it sells those and makes a profit. From that money, it provides to the local hospital things like electric beds, which cost many thousands of dollars each and make a significant improvement in not only the care of the patients but the ability of the nurses to do the care, because they are helpful for lifting, and so on.

That is regularly provided by the community supporting the community shop, which in turn supports the hospital. I know, from my observations and discussions at numerous hospitals around the state—I have visited most of the hospitals around this state; including those up in the Riverland, over on Eyre Peninsula, and up in the northern parts of the state—that community support is inherent in the way that country people in this state help our hospitals, and thereby help the overall health budget.

One of the things about the health budget in this state is that we know that it is escalating at a rate more rapid than the CPI and more rapid than the rate at which the budget is going up. Indeed, under the management of this government, our budget is in steep decline, so we have a situation where common sense makes it manifestly evident that we would should be supporting these hospitals which do so much to support themselves. Instead of that, this government chooses time after time to kick sand in the face of the people who are involved in supporting these hospitals and says, 'We are withdrawing our funding. We are going to make life difficult. We are going to close these down because we have a better, bigger, newer operation.'

To replace our country hospitals, what are we going to have? We are going to have a bill of $1.1 million each and every day for 30 years because of having the new Royal Adelaide Hospital when I am guaranteeing you that that money would be better spent if we put more facilities out into our communities where they are needed most. No-one is suggesting that we need to have a burns unit in every hospital or the ability to deal with heart situations and so on. Absolutely, on our population, we need some things centralised but we need to be able to provide basic, good, sound health care, and that could include hospitalisation in our country hospitals right around the regions of our state. That is the only way we are going to have a sustainable state and make the regions of this state sustainable.

They provide a huge economic boost to this state through mining, agriculture, the marine areas and they account for a greater percentage of the economy of this state than the amount that is spent on them. I thank the member for Stuart for bringing this motion before the house. I think it is a much needed motion and I look forward to seeing the government support it.

The Hon. J.D. HILL (Kaurna) (12:07): I am beginning to enjoy my Thursday backbench duty in this place. You never know what issue is coming before the place, which I may—

Mrs Redmond interjecting:

The Hon. J.D. HILL: Well, you never quite know what is on until you get here, of course. The order of business does change from time to time, member for Heysen. I am pleased to talk on this debate. I heard only the last part of the member for Heysen's speech but she articulated, I suppose, the Liberal rhetoric which does not bear any resemblance to the real facts of life in country South Australia. I know probably more about country health than any other single person in this place because I was the minister responsible for country health—

Members interjecting:

The DEPUTY SPEAKER: Order!

The Hon. J.D. HILL: —for seven years. I know about all of the hospitals, not just the ones that happen to be in your own patch. I know about the whole system and I know in particular how that system has been strengthened and developed over the seven years that I was in charge of it and it continues to be developed. There is a view being put by those on the other side, and they like to put it in their own community—it goes does well obviously—that the big, nasty government in the city is wasting all the money on themselves and they are ignoring people in the country, but the reality is vastly different.

I do not have the mathematics in front of me but I do know that over the term of this government, the investing in country health has increased dramatically. There is now more elective surgery happening in the country than it ever did before, not just the volume of surgical procedures but the complexity of surgical procedures as well. We have strategies in place to increase the amount of mental health services provided for the country. There were some legislative changes that were needed to make that happen which have occurred but there has also been investment in places for people from the country who have mental illness to be attended to.

We have a network of TV screens which allows patients to be helped by trained psychiatrists in the city who in the past would not have had access to those helpers because of the technology that has been put in place. We are developing a strategy to increase the amount of cancer services available for people in the country. All of that is being done at great expense and with a great deal of care to make sure that fewer people in the country have to come to the city.

It happens. I went to a country hospital, Port Pirie Hospital, which had a very good local chemotherapy service which had been developed locally at the hospital, and I was told that about 25 per cent of country chemotherapy was conducted at that one hospital. That did not mean that a lot of people from the country were going to Port Pirie but that many people in the country who could be provided with chemotherapy in the country were coming to Adelaide.

Port Pirie was a standout, but that is because of a system that we used to have, where individual hospitals made their own decisions about what services they may or may not provide. There was no system-wide approach but, because I had developed an integrated approach to country health, I was able to say, 'We're going to have a strategy to make sure that we optimise the amount of chemotherapy that can be provided to people in the country.' As a consequence, I think we identified a dozen or so hospitals in larger communities where chemotherapy will be rolled out, all done in an integrated way with the leadership of Dorothy Keefe, who is the chief oncologist at the Royal Adelaide Hospital.

In addition, of course, to the increase in services, we dramatically increased the amount of capital spend in country health, and we are upgrading a number of the major hospitals: the Whyalla Hospital; Port Augusta Hospital is having work done; Port Pirie; Port Lincoln; Berri, a major redevelopment at Berri; and, of course, in Mount Gambier. Other hospitals have had capital works on them, as well.

All of that is the truth, and yet those truths are ignored by the Liberals, who are focused on rhetoric which maintains an attitude of victimhood which they perpetuate in relation to their own constituents because that is how they get elected. They say to their constituents, 'Don't look at the facts—'

Mr VAN HOLST PELLEKAAN: Point of order: standing order 125, words to be objected to when used. I take great offence to the fact that the minister would impute that there is any improper motive in this motion. If he had had the opportunity to listen to my speech, I think he would understand that what he is saying is incorrect. I think words like 'only put these things up so that they can get elected' are completely inappropriate.

The DEPUTY SPEAKER: There is no point of order, and can I remind members that they were heard in silence, and I expect the member for Kaurna also to be heard in silence.

The Hon. J.D. HILL: Thank you, Mr Deputy Speaker. I did not hear what the honourable member said; I am sure he made some reasonable points, and I do not cast any negative comments about him. I am talking generally about his party which for decades has made a practice of the game of victimhood in relation to their constituents in order to optimise votes. They make the claim that the government ignores them and that the government believes that the city ends at Gepps Cross or wherever it happens to be, and all the expenditure is in the city.

The former leader of the opposition, the member for Heysen, made the exact point, member for Stuart, in her contribution when she said that the money being spent on the Royal Adelaide Hospital would be better spent in the country, saying that the country had been neglected. I was making the point that the country has not been neglected; in fact, there has been an increase in capital expenditure, there has been an increase in services that has not been acknowledged by those on the other side who continue to repeat in their communities that the country has been neglected by this government. It is completely untrue. If you do not like that analysis, that is fine: you come forward with your own analysis. I am just telling you what I observed over a number of years.

In relation to the Royal Adelaide Hospital, the other truth which members on the other side neglect to put to their constituents when they talk about the city hospital, the Royal Adelaide Hospital, is that the Royal Adelaide Hospital is the biggest country hospital in South Australia. On any average night, about 25 per cent of the patients who are in that hospital come from country South Australia. It is a hospital for all South Australians. It is not a hospital for the people of the city. If you say that people in the country would be better off if all that money were spent in small country towns to provide infrastructure which could not be utilised because the services would not be there—

Members interjecting:

The Hon. J.D. HILL: You will have your chance to have a say later, if you like. The interjections just show, I think, a lack of good behaviour on the part of those opposite. The point I am making is that if members opposite believe, as a member for Heysen was saying, that that money would be better spent on country facilities, they would be facilities which were stranded because the services would not be able to be provided to the people in the country who need the services of the Royal Adelaide Hospital.

If you have advanced cancer, an advanced heart condition or an advanced brain condition, or you need a transplantation or you are in a traumatic accident, you do not get those services in any of the country hospitals no matter how splendidly they are equipped and no matter how dedicated the doctors and nurses are. You only get them in a major hospital such as the Royal Adelaide Hospital. The Royal Adelaide Hospital's infrastructure is outdated; it is in a state of powerless decline and it is impossible to maintain it to the standard of a modern facility. This government made the very strong and good decision, in my view, which hit—

Mr Venning: Go look at the Barossa; it's a lot worse than that.

The DEPUTY SPEAKER: Order!

The Hon. J.D. HILL: This government made the correct decision, a commitment for the future of our community, to properly invest in a hospital which will serve all citizens of the state, including those from the country. As I say, one in four of those patients, on any average day, are country people.

I would agree with the sentiment of this motion, that this house notes the importance of country hospitals to small communities, but I think it is more important to note the importance of country hospitals to country people. If the argument is that we have to keep providing infrastructure in order to prop up small country towns—I acknowledge that that is a sentiment that is often expressed—that does not necessarily mean that the community is getting benefit out of that investment for their health services. The health department has to invest in health services to benefit people's health, not to benefit the community's survival.

That is something that is a by-product, I suppose, of having a hospital in a town. However, our focus has to be on our planning and the health department's focus has to be on what are the health needs of a community. It would be bad to neglect the health needs of a particular community by spending too much money on something which it did not need for its health benefits but rather, for other purposes.

That is a hard decision that needs to be thought through and discussed with the health advisory councils, and I understand that the health advisory councils have all been through a process of developing 10-year plans to do just that. Finally, I would like to recognise the outstanding work done by people in local communities: the health professionals who do deliver high-quality care in sometimes very difficult circumstances a long way from support and advice. I would be churlish not to recognise that.

Mr PEGLER (Mount Gambier) (12:17): I certainly support this motion. One slight change I would like to see is in part (a) which states, 'notes the importance of country hospitals to small country towns'. I would also add there 'to regional communities' because really that is what all of this is about. Our hospitals and health services in our regional communities are extremely important to all of us.

The Mount Gambier and District Health Service is a major regional hospital for the South-East region and some areas of Victoria. About 63,000 people are catered for in the South-East and up to another 20,000 in western Victoria, so it is an extremely important hospital to all of us. The hospital has a 78-bed public capacity and also a further 20-bed private hospital there. There are currently at least 25 resident doctors, nine Mount Gambier specialists, 19 visiting specialists and 270 nursing staff practising in the Mount Gambier and District Health Service.

The health service has a total workforce of some 440-odd people, of which close on 300 are full-time equivalents. The health service provides a broad range of health services which include: acute in-patient care (that is overnight and same-day patients); a 24-hour, seven days a week accident and emergency department with on-site salaried medical officers; general surgery; general medicine; a high dependency unit; obstetrics and gynaecology; orthopaedic surgery; ophthalmology; paediatric services; ear, nose and throat; a cardiologist; a physician; consulting rooms; pre-admission clinics; out-patient services; rehabilitation; palliative care based in the hospital; mental health services; and an accredited teacher facility.

Just on the teaching facilities, I think that has been a great initiative, both in the Riverland and in the South-East, where students from Flinders University who are in their final years of becoming GPs actually come into the country areas to train. That system has worked exceptionally well, and many of those students, once qualified, have returned to the country areas. That has been a great initiative. The South-East Regional Community Health Service provides a broad range of services across the South-East including:

allied health services (occupational therapy, physiotherapy, social work, dietitians, speech pathology and podiatry);

the community nursing programs, which are home-based visits and centre-based nursing clinics;

immunisations;

diabetes education, including the DAFNE program and a nurse practitioner;

continence advisory services;

a respiratory support nurse;

health promotion screening and prevention programs, including Pit Stop, community education, events, etc.;

facilitated physical activity, including tai chi, Easy Moves for Active Ageing, Wise Moves, walking groups, Come 'n Try, Hands On Health, and falls and balance groups;

Home and Community Care programs, including an Aboriginal-specific HACC service, which provide assessment, social support, respite care, domestic assistance, personal care, maintenance, home modifications and equipment;

the Women's Health Program, which includes health screening and support and a breast care nurse;

the palliative care service, which is home-based and integrated;

a geriatric evaluation and management team (assessment and care planning for older people at risk of functional decline, including access to a geriatrician);

rehabilitation (ambulatory and inpatient within the hospital):

GP Plus strategies, including support for clients with complex needs, care coordination, minimisation of avoidable hospital stays;

a Rapid Intensive Brokerage Service and Country Home Link (support to enable the minimisation of hospital stays);

cardiac rehabilitation groups and individual support pulmonary rehabilitation;

cancer care coordination and support;

transitional care packages, which is home-based restorative care for older people;

drug and alcohol services, and a drug diversion program for youth;

renal dialysis, which is in-centre dialysis and home-based support (this is something we did not have at all a few years ago, but I think we now have about six units and there are plans to grow that further);

aged-care services, including aged-care assessment, community aged-care packages, day care and day therapy centres, and a community-based respite program;

children's services, which include paediatrics, early childhood intervention and service development, child development clinics, and allied health therapies both individual and group;

chronic conditions prevention, self-management and support programs including Moving Towards Wellness group;

community midwifery and ante and postnatal support;

youth programs; and

an equipment loan service.

From all that members can see how important our regional health service and our hospital are to our entire community. In 2009-10 the Mount Gambier and District Health Service had a total of 8,819 patient discharges, including 2,931 day patients. The public hospitals had a bit over 5,000 overnight and close on 2,000 same day patients, and the private hospital had 850 overnight and 950 same day patients.

The Mount Gambier and District Health Service Emergency Department had 16,823 patients, and the outpatients/consulting rooms had a further 14,285 patients. The Mount Gambier and District Health Services operating theatres had 5,107 elective and emergency procedures (that is both public and private patients). The Mount Gambier and Districts Health Service maternity and paediatric ward admitted 1,633 patients, and there were 575 births. The high dependency unit admitted 760 patients, the medical ward admitted 971 patients, the surgical ward admitted 1,844 patients, and the day only ward admitted a further 1,287. The top five reasons for admission to the Mount Gambier and Districts Health Service were: neonatal care, normal delivery, lens procedures, metabolic disorders, and Caesarean delivery.

The South-East Regional Community Health Service provides allied health services, community nursing, aged-care services, children's services, chronic conditions programs, mental health programs, and equipment loan across the South-East region. The service has approximately 320 staff across the South-East and 350 volunteers, some shared with the Mount Gambier and Districts Health Service. The South-East Regional Community Health Service has approximately 5,000 to 6,000 active clients across the South-East.

Going forward from where we are now, I certainly congratulate the government on securing the $26.7 million funding program to do major building works at the hospital. Through those works, we are going to have a new six-bed mental health unit, which has been lacking in the South-East for many years. Of course, a lot of people who are now flown straight through to Adelaide when they have acute disorders with their mental health can now be handled within their own community.

Our public dental health service, which has up to a four-year waiting list, is going to go from six chairs to 10, so that will certainly help. Our A&E services are to be more than doubled so that people will be able to be seen much more quickly. Of course, oncology services will also be improved. Just yesterday, I met with the mental health people from Country Health SA.

Time expired.

Mr VENNING (Schubert) (12:27): I cannot let an opportunity go past to speak on a motion such as this. I commend the member for Stuart for bringing it in here. I have been an unwavering advocate for country hospitals and the importance they have in their respective communities for as long as I have been in this place, and that is now almost 23 years. I served on a hospital board for many years before coming here. It is unfortunate that the state Labor government does not value the importance of country hospitals to small towns. I heard the member for Kaurna say a few words and will refute them entirely.

We have seen much evidence of this in recent years. The Keith community had to fight tooth and nail for $300,000 to be able to continue to run their hospital. The government also cut funding to the Ardrossan and Moonta private hospitals. In the 10 years that this government has been in office, country facilities have been ignored and generally rundown; we just have not had the funding.

In fact, the hospital they are walking away from—the beautiful Royal Adelaide—is far better than most country hospitals, particularly the Barossa hospital. It is a disgrace that you are leaving a building the people in the Barossa would love to have. Everybody knows—and the minister certainly knows—the condition of this hospital, yet you allow it to continue. The beautiful Barossa should have the facility. That really is a disgrace.

When I first arrived in this place the then Bannon Labor government closed the Blyth District Hospital and it devastated that small community. Country hospitals do provide peace of mind to their communities, not just peace of mind that residents in the small towns will be able to access medical treatment when and if the need arises. The existence of hospitals in rural and regional areas also provides a sense of stability for the future of these small communities. It would be extremely remiss of me, given the topic of the country hospitals, not to take the opportunity to again raise the matter of the need for a new hospital in the Barossa.

I have said ad nauseam in this place that the two facilities we have in the Barossa at Angaston and Tanunda are outdated and inefficient. They are only seven kilometres apart, which creates financial inefficiencies with staffing and managing two sites so close together. The facilities are outdated and not of a standard people would expect from modern health care, particularly in the beautiful Barossa. These two facilities also lack services that should be offered: dialysis, modern operating theatres, chemotherapy services, and the list goes on. Also a helipad is desperately needed.

As I have done many times before, I pay tribute to the staff who work so hard to provide the very best of care in these facilities, and I note that the member's motion highlights this. I know many people who have received treatment at either Angaston or Tanunda hospitals and they speak very highly of the level of care they received.

Another very important country hospital in my electorate is the Mannum hospital, which has a public aged-care facility for the most vulnerable members of our community. I visit this facility regularly as a very dear friend resides there. The facilities are in desperate need of an upgrade. There are no private bedrooms. Bathrooms are shared between four residents. I think there are several rooms that do not have windows and are used as a thoroughfare for other residents and visitors to access the sunroom.

This facility is extremely important to the local community because Mannum is a very important place strategically, but it has repeatedly been ignored by the current Labor government. I understand there have been plans for some time for new single rooms to be constructed at this facility but again, as is the case with all projects in country areas, the government says it does not have the funding to carry out such plans.

I pay tribute to the staff who work in this facility. The care and compassion they show and the manner in which I have seen staff try to maintain the dignity of residents, as much as the shared living conditions allow, is admirable. The member for Finniss has just showed me the front page of the Stock Journal and you would not guess what the headline is. It is exactly this: 'Rural health needs a check-up.'

Mr Pengilly: Two million lost through ineffective resources.

Mr VENNING: Two million dollars lost through inefficient resources—so there it is. The rural media is certainly onto it, and I commend them for that. The Mannum hospital also needs a helipad. There is a space for that and there is some discussion.

I also pay tribute to Crystal Brook Hospital. I note that the member is here, and I am a constituent of his. The facilities offered at Crystal Brook are absolutely first-class, in total opposite to the Mannum and Barossa hospitals, and considering it is so close to Port Pirie that is amazing. Many of the resources supplied to Crystal Brook Hospital come from the local community.

Mr van Holst Pellekaan: You have a particular interest in the aged care facility?

Mr VENNING: Yes, I have. Both my parents were farewelled from this hospital, and can I say that the care that they got was absolutely fabulous. Many families pay their gratitude by leaving bequeaths to upgrade those facilities, showing appreciation in a very tangible way.

Crystal Brook does need a helipad, and Dr Bill Griggs from the emergency retrieval unit said just that, because of its vital position near the highway. A helicopter would be able to land there at all hours and in all weather, able to retrieve and stabilise passengers coming down from the north. It is a great spot and we really do need a helipad. That will be one of the prime projects I will be dealing with in the community when I leave this place. I think the future of that hospital depends on the vision of a helipad close to the hospital, not down the other side of the town.

There can be no debate that country hospitals are vital to their communities. I have been extremely disappointed in recent years to see the demise of input from community members through health advisory councils, commonly known as HACs. I heard what the minister had to say; well, I am sorry, but I could not disagree more. Compared to when local hospital boards were in place—I know that the Barossa health advisory board no longer has any GP representatives on it, no local government representative and only a couple of community representatives despite there being places for many more to be involved—health advisory councils have been a disaster, a total failure. They have curbed people's enthusiasm to want to serve because they have become so bureaucratic, nothing more than a mouthpiece for the minister.

HACs have removed the powers people had to make an effective contribution, to bring about change, to provide real representation to the community and to serve their community. We had a wealth of experience and knowledge on our local hospital boards and all of that has been lost since they were abolished and replaced with health advisory councils as a result of the Health Care Act 2008.

The Kapunda Hospital—which used to be in my area, but the member for Stuart has it now—had money bequeathed to it, a lot of money, and donated, to provide a new aged health care unit. How incensed was I, as the local member, when I heard that they were denied the ability to spend their own money on their health facility. There was war, and it took some months for them to say, 'Okay, it's your money, you spend it how you like, but we were going to control it.'

They wanted to put it through their facilities and it was going to lose about a third of the total money—no way. Eventually, common sense did prevail, but this sort of business goes on. The review that was handed down this time last year about the implementation of the 41 HACs was far from complementary, and I quote:

The ingredients for a successful change were not evident, lacked effective implementation, or were still under development, despite these relationships operating for three years.

The level of satisfaction with the governance arrangements between country HACs and the local health system from the perspective of community members, HACs and local health service staff is low.

Country HACs...are not well supported or promoted by the health system.

That is from the Health Performance Council Review of Country Health Advisory Councils' Governance Arrangements, December 2011. So, there it is: refute that. It is a disgrace. It is clear that HACs are not being supported and have been set up to fail. This is another bad Labor experiment that has failed dismally. I would dearly love to see hospital boards reinstated—and our government will—so that country communities can again feel they are able to truly serve their local hospital that is so important to their small town, and for them to resume ownership and input into it. Yes, the new Royal Adelaide Hospital will starve our country hospitals of funds to sustain them.

Again, I commend the member for raising this motion today. Nothing could be more important to a country town than its hospital. It is a hub for a lot of activity. A lot of the hospital boards had, or did have, a working group of people who used to raise money for that hospital. They provided local catering services in those communities.

What did they call them? The women's auxiliaries, that is what they called them. They are all gone because people on the other side of the house do not understand what these groups do in the community. These hospitals were largely self-funding. Now look at what you have. You have destroyed the incentive, you have taken away the machinery, you have killed off that desire that people have to keep that facility there.

I commend the member for this motion again and not just the hospital itself but the people who work in it, the people who serve, and a lot of them are volunteers, so thank you very much for that. I include in that the ambulance service because we really need these people to be the front-line providers of our health care. I support this motion and congratulate the member for Stuart.

Mr BROCK (Frome) (12:38): Thank you, Mr Deputy Speaker. I will be very quick, but I thank you very much for the opportunity of speaking on this very important issue for country people. As other members have indicated, I also thank the member for Stuart for bringing it to the attention of this house. Hospitals in country areas have been a mainstay of not only employment opportunities but also the well-being and safety of the people living in those regions, and for people who are travelling on the roads, the tourists, whether they are from Adelaide, interstate or international. This state has promoted itself as a great place for tourists and one thing we must ensure we have is good medical facilities and we must maintain that for the well-being of our communities.

I will be very quick because I think there are other members who want to speak. Country hospitals provide economic growth and employment opportunities. In my electorate of Frome, prior to me becoming the elected member, the small community of Blyth had a beautiful hospital and it closed. That was a loss to the Blyth community and for employment opportunities there. Whilst there was another hospital a small distance from Blyth, it certainly made a big difference. The service station went and the general store started to fall apart; they are still going, but it was a mainstay of the community of Blyth.

Port Pirie Regional Health Service is the second biggest single employer in our community of Port Pirie; well and truly over 350 people are employed in that hospital. It is one of the best hospitals outside Adelaide and, I would say, within the state, and I am very proud of that. As the member for Schubert has indicated, the Crystal Brook hospital, even though it is only 20 kilometres from Port Pirie, is renowned for its birthing facilities, the specialists and the operations performed there.

This state has to ensure that we do not close, or threaten to close, any more South Australian country hospitals. When I first entered this place after the 2010 by-election, I asked the previous minister for health a question, and he gave me an undertaking that the South Australian Labor government was not looking at cutting any more hospitals or services in Country Health in the regions. I again put that challenge to both the current government and the current opposition to give a commitment that they will not close any more country hospitals or further reduce services in the regions.

Another thing we need to ensure is important for the population there. I am not too sure who mentioned it, but one-quarter of the population of this state live in the country, but over two-thirds of the resources and the income for the state is generated from the regions. If we do not have hospitals, schools and associated activities out there, we will not have people living in the regions and we would not then be able to produce two-thirds of the state's revenue to ensure that this state continues to move on.

I would also like to mention the local hospital boards. I hear that members of the Liberal Party on this side of the house have given an indication that they will revert back to hospital boards if they are elected. I will be watching that very closely because I believe that the current system of the HACs does not really understand how regional hospitals and communities work, which has been mentioned. There are quite a few locations in the electorate of Frome where the local community have put substantial funds into the local hospitals for equipment and so forth.

One community, where over $2.5 million is going to be bequeathed, should have the right to spend that money on issues and items within that hospital, but they cannot do it under the current system. I certainly believe that, if we could go back to local authority and delegation and let them be able to spend that bequeathed money on stuff that is required by those hospitals, it would be a great thing. I will stop there to allow other speakers to make a contribution. Certainly, I am very passionate about country hospitals, and I will be keeping a very close eye on both sides of politics.

Mr GRIFFITHS (Goyder) (12:43): I thank the member for Fisher for allowing me to speak now. I try to be fair in all this. I listened to the member for Kaurna's contribution, and I do recognise that, in my electorate, Wallaroo Hospital has had some investment, with an A&E facility and also a chemotherapy unit that have been upgraded, and considerable effort has gone into that. However, I do want to put on the record some issues that relate to the community I serve—and I try to say the same thing all the time, no matter where I am.

I have four public hospitals—Balaklava, Yorketown, Maitland and Wallaroo—and I have what used to be a public hospital at Minlaton but is now an aged-care facility, and I have community hospitals—a term I use very strongly—at Ardrossan, Moonta and Mallala. So, in that way, I do respect what the member for Mount Gambier was saying when he talked about regional communities—that it is not necessarily small country towns; regional communities benefit from these hospitals, too.

I am a bit of a hospital brat, actually. My mum retired last year as a nurse. I grew up in Yorketown, where there was a hospital, even though, sadly, it lost obstetrics, for example, about four or five years ago. I am lucky that, since the age of eight, I have lived in communities that have always had country hospitals. I live in Maitland, a town with 1,000 people, and it is the biggest town I have lived in. So, in that regard, I am very lucky.

But because I have lived in a few communities, and because I have read the history of those townships and spoken to people, I understand a bit of the effort that has gone into putting them there and therefore have the respect for the fact that they are there and the significance they have for the communities they serve, not just the town but the area around it.

I was in this parliament when the suggestion of what I classify as Country Health mark 1 was moved, and that was in mid-2008. Anybody who was around the place listening, watching and talking to people would never forget it, because it made country people rise as one when it came to the importance of their hospitals.

In my area, I arranged for three what I would call public meetings, where there was an opportunity for the department, and the minister was good enough to ensure that there were two staff from his department at each of those meetings to put the departmental position. I had local doctors speak and Health Advisory Board members, as they were then, before they were council members, and Vickie Chapman as the then shadow minister for health spoke too. I chaired those.

At Yorketown I had 700 people, at Balaklava 500 people and at Maitland 400 people. I have never seen such a crowd. It was just fantastic, because it was people who in some way had been impacted or who recognised the importance of the hospital, and they were prepared to fight and to do whatever it took to be there. I commend those people. They argued the case, they wanted to know the information, they were upset by what they were told, they were concerned about the future, and they chose to use the democratic principles that we have in this nation very strongly to put their voice forward.

Some change did happen, and I recognise that. It needed to, because it would have potentially absolutely decimated the people of those areas. The member for Stuart's motion talks about the significance and the importance of them, and it recognises the contributions that have been made. The town I lived in had the centenary of its hospital last year. It has existed for 100 years. It had a celebratory dinner. I went to the opening of a healing garden that occurred on the Sunday.

It is a reflective place where people who are dealing with terrible circumstances, be it themselves or their families, can go to be in nice surroundings and a bit away from the sterility of the surrounding building where the hospital is to reflect upon that and try to get some personal satisfaction from it. That is a wonderful thing too, and there was a big crowd at that, because it is not just everybody who is there for the centenary. They had 150 people, I think, for the dinner, but it was the people who wanted to pay their tributes; that is good.

I have been very concerned about the withdrawal of funding from, in my particular area, Ardrossan and Moonta hospitals. The previous minister used the term 'private' all the time. I take up the member for Heysen's words that they are community hospitals. That is what I have always believed also. At the hospital's request in Moonta a public rally was organised, again late on a Friday afternoon, I think at about 5 o'clock.

Moonta hospital is a bit of a U-shape and there were 1,000 people there on the lawns in front and on the roads out the front—1,000 people from that town had come out to fight about that. That was the withdrawal of funding that impacted on accident and emergency and on bed spaces.

In the Moonta case—the member for Heysen referred to this, about the relativities of cost—Moonta was providing beds in a private hospital, in a community hospital, as part of the public system as an overflow opportunity at, I think, $104 per night, compared to what I believe then was the RAH cost to provide a bed of about $1,400 a night. So it was making those beds available at less than 10 per cent of the cost and that opportunity was withdrawn.

Moonta and Ardrossan have decided to move forward and I put on record the member for Kaurna's assistance to ensure that future financial plans were prepared for those hospitals, to give them some surety and to access a better level of funding from the federal government for aged care services. I understand that that occurred; the member nods too.

The Hon. J.D. Hill: And they are better off now.

Mr GRIFFITHS: Yes; they are. It has created some change, but the withdrawal of funding support that recognised A&E services and the impact that that has had has still greatly concerned me. Aged care is one issue and A&E is one issue too, and Keith has been very strong on that. When we had the public meeting at Maitland (it was about mid-2008), I had one person stand up at the back of the hall in the elevated area who had been a board member for 24 years, and he talked about how much had been raised in that community for the Maitland hospital.

That chap is about to celebrate his 70th birthday on Sunday. He lives in the same street as me. He is the Old Fella from television, the comedian Mr Rod Gregory. He told me that in his 24 years on the board they had raised $2 million. That is not just tens of thousands or hundreds of thousands, but $2 million had come from a community to go towards health services in that area because of the regional community's commitment to it.

When you hear that sort of figure, how can you dispute it? How can you argue against what a community believes about a hospital and the importance that it places upon it? It is not just political rhetoric opportunities that we take here; this is putting on record the actual facts and the respect that people hold for it. As a son of a nurse, I will always respect the health professionals and the volunteers who work in hospitals. I am particularly pleased that part (b) of the motion recognises that, because in many cases these are people who have given up decades of their life to serve people.

Again, in the town I live in at Maitland, Dr Bill Chappel, who has now retired from medicine, was the sole practitioner for Maitland and the surrounding area for about 30 years. I cannot even begin to imagine the pressure on one person being the sole doctor in an area to respond to every health issue where they are not able to be serviced by the nursing people in the hospital, where the doctor has been available at their beck and call. He is an outstanding man.

Sadly he lost his wife a couple of years ago but he is still involved in Rotary and he is still involved in the community, and I tell you that when Dr Bill stands up and talks, people listen to him because of the respect that is held for him. That is where part (b) of the motion is particularly relevant and it is symptomatic, I think, of all the professionals and all the people who work in hospitals. No matter what role they hold and what level of importance might be attached to it, they have all contributed to it.

When we support this motion, we do not do it for political pointscoring; we do it from absolute sincerity to try to recognise the importance placed on country health and the importance it holds for the future. Other members have reflected on tourism numbers; it is very important that hospitals are available for them, too. I want our communities to grow; it is very important that hospitals are available for them, also.

Collectively, yes, there are 500 people or thereabouts from regional South Australia in the RAH and in metropolitan hospitals each evening being treated in some way, so when the member for Kaurna talks about the RAH being the biggest country hospital in the state, I can understand the significance of that, but we should never lose those existing hospitals—and I think there are about 55 or thereabouts—because they are an important part of our great state and they need our support now more than ever.

The Hon. R.B. SUCH (Fisher) (12:51): I will be brief because I believe other members want to speak. I commend the member for Stuart for bringing this motion. As I have said before and I say again, this is the Parliament of South Australia and our responsibility and our concerns extend beyond Darlington and Gepps Cross. Whilst I have a principally urban electorate, there is some rural part to it. I think it is important that we remember that country hospitals are critical in terms of the sense of community and providing a service to the people who live in the town and in the surrounding areas.

One of my sisters trained at the Victor Harbor hospital many years ago and another one became Director of Nursing at Karoonda (which was very convenient when we went rabbiting because we could call in at 3am and get a cup of tea and a biscuit), so within the family there has been a connection with some of the country hospitals. Beyond just the hospital per se—and I know members have acknowledged doctors and other health professionals—what does concern me is that the health outcomes in rural areas are generally below those of people who live in the city. And it is not just males in country areas: overall, the health outcomes are not as good.

There is often lack of access to medical services in terms of having check-ups, screening and so on and there is often difficulty in accessing treatments for things like cancer. I know there has been some progress in some areas in terms of providing additional facilities but a lot of country people still have to travel to get basic medical services. I put it to the major parties to consider that there should be a charter of services so that people, irrespective of where they live in South Australia, get a reasonable service when it comes to health or other matters. Western Australia has had Royalties for Regions, but I think there should be a basic charter that encompasses basic services, particularly health, for people who live in country areas.

This is an important motion. Whilst there have been some improvements, I think it should be acknowledged that country people like to have a sense of ownership of their local hospital and I think they should be allowed to have a major say in the provision of medical services and hospital services in their area and not have those services left totally in the hands of bureaucrats. I commend this motion. It is important and I acknowledge that more needs to be done to ensure that country people can keep their hospitals, that they are maintained and that the services provided are of the highest quality.

Mr PENGILLY (Finniss) (12:54): I also wish to say a few words regarding this good motion put up by the member for Stuart, and the comments from the member for Kaurna only serve to further inspire me. I have never heard such a diatribe of verbal diarrhoea regarding country health in all my born days. It shows clearly that the member does not really understand country health, and for him to pontificate on what a wonderful job was done during his tenure as minister I find absolutely bewildering.

These hospitals are critical. Along with schools in our country communities, the communities are particularly centred around their hospitals. Former minister Lea Stevens understood that, and she did not adopt the recommendations of John Menadue and that, ultimately, cost her her job. I think that that was most unfortunate because Lea Stevens understood that country towns and communities with hospitals, or towns with adjacent hospitals, revolved around those hospitals. They were great sources of employment, and they were great sources of pride to those communities.

Earlier, I think the member for Chaffey referred to what is going on now with the HACs, the Health Advisory Councils, and the fact that some of those most loyal people from the board days are still on the HACs and find themselves in a totally useless situation. They come to me from the South Coast District Hospital, Victor Harbor HAC, and from Kangaroo Island, the two hospitals in my electorate, and they say they want to get out because they are achieving absolutely nothing.

They feel as though they have been blown away by the bureaucracy and the dictates of the minister of the day. It is a sad indictment of the sick way in which this Labor government has treated country hospitals in South Australia. That is not how it is meant to be, and I sincerely hope that, should we be lucky enough to win the election in March next year, we will instigate a proper system of some form of local or regional management into our hospitals, which are still much loved despite the best efforts of the Labor Party to stuff them up properly. That is what I hope.

The Hon. J.D. Hill interjecting:

Mr PENGILLY: Here we go. I seek protection from the wet blanket attack from the other side, sir. It is interesting that they do not like it. They can hand it out but they do not like it. You want to come to our country hospitals and have a look at what goes on around them and how they are, as I said, loved by the community, and how the community has put (and in some cases still tries to put) enormous amounts of money into those hospitals. Those hospitals used to be, by and large, completely run by the community, initially through local government. In a past life, I had dealings with the member for Flinders' father, when he was heavily involved in country health, and that went through the local government sector.

There are still some older members of the community who believe that local government still runs the hospitals; they have not done so for a long time, but that is the way things go. In relation to the second part of the member's motion regarding health professionals, I am proud to be involved with the health professionals who operate in my units, Just at the moment we are going through a process where the Department of Health under the current minister is trying to screw down the doctors at South Coast District Hospital and also over on Kangaroo Island. So, we have these two completely useless arguments going on because the bureaucracy has just taken over the complete running of the hospitals.

What a difference there was when the regional boards were in place. I happened to be chair of the Hills Mallee Southern Regional Health Service Board before I came into this place. We did not have this sort of tension existing between the doctors and the department because the regional general manager, Mr Kevin Eglinton, who is an extremely good operator, along with other RGMs around the state, was able to actually put in place agreements which work well.

But no, along came the state Labor government under the former minister and decided to throw the baby out with the bathwater—it 'didn't work'. It's only worked for decades and decades. Local management worked for decades, and then on to regional boards. He wasn't satisfied with that. He had to chuck it all out. So, I sincerely hope that we get some common sense with the return of the Liberal government in this state.

Along with the disastrous mess that this government has made of everything else—400 jobs this week, wasn't it, guys? Along with the disastrous mess they have made here we need to revert and fix up what has happened in our country hospitals and bring some self-management back in. I seek leave to continue my remarks.

Leave granted; debate adjourned.

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