Motions

Modbury Hospital

Dr McFETRIDGE (Morphett) (11:31): I move:

That this house condemns the government's decision to cut services at the Modbury Hospital and, in particular, to downgrade emergency departments and cut vital cardiac services which provide lifesaving treatment to hundreds of residents in Adelaide's North-East to—

(a) ensure patients do not have to travel 14 kilometres away to the Lyell McEwin Hospital for important medical care;

(b) ensure residents are not faced with long wait times; and

(c) ensure emergency surgery remains available to residents in their local area.

As a young child, my mum, dad and two older brothers moved to 85 Hogarth Road, Elizabeth South. I think it was in 1956 because there was only Elizabeth South and Elizabeth North then. The Philip Highway was a dirt road. The Pinnock sewing machine factory was the first factory built in Elizabeth across the road from us in Hogarth Road, and I remember the Holden factory being built. There was a farm there and I remember playing around the old buildings as a kid. For many years it was a place to paddock goats that were on their way to be slaughtered. Holden coming along was just a complete change.

Elizabeth grew and we moved to Salisbury in 1960, but I did go to Elizabeth South Primary School for those early years and I have very many fond memories of living in Elizabeth and then Salisbury. My mother still lives at Elizabeth Vale, in behind Calvary Central Districts Hospital. My brother now lives at Hillbank and I think that was formerly Elizabeth East. So I still have family out there and very many fond memories of a wonderful childhood in Elizabeth.

My younger brother, Stewart, came along in 1960. He was born at the Lyell McEwin Hospital. It is a wonderful hospital. It was a wonderful hospital then. It is a great hospital now and it has been expanded, but just go onto the hospital dashboards and look how overcrowded it is. It is a great hospital and people want to go there, but the demand that is put on that hospital is just overwhelming, and that is why I have real concerns, not only for the people of Modbury but also for the people of Elizabeth, about the increasing demand that is going to be put on to the Lyell McEwin Hospital as a result of the Transforming Health changes.

Modbury Hospital has been serving the area around Golden Grove, Modbury and Tea Tree Gully for a number of years. It was built in 1973 and, depending on which figures you read from which website, the numbers of beds vary, but all I can say is that those beds will not be providing the same range of services they do now or providing the same services to people of the Golden Grove, Tea Tree Gully and Modbury area. Many people will be forced to travel across to Lyell McEwin or into town. It is going to be an absolute disaster.

I am not exaggerating that and I am not trying to use shrill language to be alarmist. I have been following the health department's own websites. I have been following them for years and years and, every time I look at them, there is an evolving crisis. Even today, you can look at the number of mental health beds we are short of in South Australia and the numbers of people waiting for elective surgery, then take out Queen Elizabeth Hospital with all eight operating theatres shut because the air conditioning did not work.

At Modbury, we have a wonderful hospital. Let me read to the house the list of services that have been provided at Modbury. They include: cardiology; diagnostic imaging; ear, nose and throat surgery; emergency medicine; gastroenterology; general medicine; general surgery; geriatric evaluation and management; gynaecology; haematology; high dependency critical care unit; hospice and palliative care services; neurology; oncology; ophthalmology; orthopaedics; renal and transplantation.

I did not know about that, and I am not so sure that is still going on there. I would be surprised if it was with the money that this government has spent on the old Royal Adelaide when they transferred renal transplantation from the Queen Elizabeth into town—which they are going to bulldoze, which is another crazy decision by this government. Continuing the list of services at the Modbury hospital, there are: respiratory medicine; rheumatology; urology; and, of course, Woodleigh House mental health unit.

All of those services are there and, to add to the provision of those services, provided by hardworking doctors and nurses in South Australia, there are over 100 volunteers. I am hearing stories about the volunteers being replaced by contracted workers at Spotless, the people who provide the hotel services and nonclinical support in some of our hospitals. They are going to replace even the volunteers. If that is the case, that is a disgrace. Whether it is at the Lyell McEwin, Modbury or the Lavender Ladies down at the Royal Adelaide, if those volunteers go, this government is acting in a disgraceful and shameful way. In the past, they have raised money, given comfort to patients and given continuing support to not only the patients in the hospitals but also the staff. That would be a disgrace.

Under Transforming Health, Modbury is going to become one of three general hospitals in South Australia. The minister can come in here and say it is going to be alright because we will be able to transfer patients across from Modbury to the Lyell McEwin but he needs to go back and talk to the people who have been providing and receiving those services at Modbury or, better still, stop listening to the spin doctors and start listening to the real doctors and nurses out there. They are worried and afraid that there is going to be a real issue with the changes you are putting in.

In 2008, the Australasian College for Emergency Medicine put out a report on the number of deaths in Australia as a direct result of delays in emergency departments which said that 1,500 Australians were dying every year as a direct result of delays in emergency departments. South Australia's share of that is about 8 per cent, which is 120, more than the road toll. More than the road toll, every year in South Australia, are dying, already, as a direct result of delays in emergency departments. If I am wrong, minister, come in and tell us what the situation is in South Australia, because that is a completely unacceptable situation.

Go and look at your own dashboards, minister, and see the crisis. See the number of times at the Lyell McEwin Hospital, Modbury, Queen Elizabeth, Flinders, Royal Adelaide, Noarlunga, and the list goes on, on your traffic light system, that the emergency department is in the white zone. You need over 125 per cent capacity to get into the white zone. You have people waiting and waiting and waiting.

What we need to make sure we avoid, at all costs, is the Mid Staffordshire syndrome coming to South Australia. The Mid Staffordshire NHS area in England adopted a policy of less than four hours wait in emergency departments. People were being looked at within those four hours, according to the computers. They were either being admitted or discharged and, because of the bed pressure, some of those people were being discharged from hospital earlier than they should have been.

In one year in the Mid Staffordshire NHS region in England 1,200 people died as a result of that policy. This policy of Transforming Health is something that should be giving grave concern—and I use those words 'grave concern'—to the people of South Australia because lives are already at risk because of the current system, the delays that are there.

An ambulance bus will not help—an 'ambus'. Triaging patients in an 'ambus', well, you have got category 1 patients who are going into resus, you have got category 2 patients who need to be seen within 30 minutes, you have got category 3 patients who need to be seen within 90 minutes. I might be wrong on those figures, but you are categorising those patients, and you cannot pick and chose your patients who are going on that bus if you are at a major incident. You cannot pick and choose them, so a bus is not going to help.

Ambulances will be ferrying people back and forwards on that trip between Modbury and the Lyell McEwen. As good a hospital as the Lyell McEwen is there are only so many beds. The traffic is getting heavier and heavier out there because people love living out at Elizabeth, they love living out in the northern suburbs. They are great areas to live in. Mum is out there, my brother is out there.

The issue we have got here is that we need to make sure that we are delivering the best health service that we possibly can for South Australia. We have had the Menadue report, we have had other reports and now we have got the Transforming Health. I am very afraid, people should be very afraid and I am very alarmed that this government is not listening and is in denial over the fact that there is a looming crisis in health because of its changes.

Go, minister, look at your dashboards today. Go and look at them and you will see your own figures supporting what we are saying. The Lyell McEwen is a hospital in great demand. The doctors and nurses are working their backsides off down there to produce the results they are getting. It is high-quality health medicine in South Australia, but you cannot keep squeezing more people into the beds that we have got in South Australia.

It is a disgrace to see that the clinicians are being ignored. There are a few out there and I do not know where they are coming from. I really do not understand. Look, I am just a humble veterinarian and I look at what is happening. I know the complex situations they are dealing with. It would be nice to be able to specialise in one species and part of one species. I thought that would be great to be able to do that. My son is a doctor and I call him the specialist vet dealing in one species, and my daughter is a veterinarian.

We understand that is a wonderful thing to be able to do, to be able to specialise in one species or part of one species and get those results, and our doctors and nurses in South Australia do get those results, but they need the time to do the correct assessment of the patients, the diagnosis, the work-up and then the treatment and the surgery. They need the time to do that. They cannot do that if there is pressure on with people continuing to arrive at the front door.

There is bed block that we know about. We have been going on about it for years. It is a real crisis in our hospitals, and I am not going to sit back here and watch it be allowed to unfold without protesting about it and continuing to remind the minister and this government to look at what they are creating because be careful what you wish for.

The Hon. J.M. RANKINE (Wright) (11:42): The one thing that I would agree with the member for Morphett about is that the north and the north-east of Adelaide are great places to live, and it is nice to hear that he has still got some family living out there, but that certainly does not make him an expert in the health services that are being provided out in our area.

Needless to say that the state government opposes very strongly the motion put by the member for Morphett, and I venture to say that there is not one local member representing that area who has not welcomed the massive injection of funding by this state government into our health services out in the north.

Again, we have the opposition happy to play politics with fear. It thinks it is okay to frighten the people in the north and the north-eastern suburbs for its own political advantage, and in the main it is elderly people who are being frightened by the messages that it is putting out.

Certainly, I went along to the public meeting, as did you, Deputy Speaker, and as did the member for Newland when the Minister for Health came out to the north together with Professor Dorothy Keefe. A team of Liberal Party members came along and threw questions at the professor, which she was able to answer clearly, articulately and, really, I think, astounded people with the processes that are being put in place to ensure that we do have the very best health services out there in the north.

The Liberal Party are getting around implying that the services are going to be downgraded or that services will no longer be available or, worse still, that the Modbury Hospital and emergency departments are closing. It is irresponsible and it is misinformed. I well remember, as I know you do, when the Liberal Party privatised Modbury Hospital. We were inundated on a daily basis with complaints about the treatment that people were getting in that hospital. I had my own horrific experiences with my elderly father in that hospital under the private management, under the management of the state Liberal government.

The Modbury Hospital, as the member for Morphett said, was built by the Dunstan Labor government and opened in 1973 to service our area and, contrary to what the opposition would like the community to believe, this government is committed to the people of the north-eastern suburbs and we will continue to invest in Modbury Hospital. Since 2002, we have shown our commitment by returning Modbury Hospital to the hands of South Australians in 2007, after that disastrous privatisation experiment and investing $30 million to improve the services and infrastructure.

Under Transforming Health we are investing a further $32 million to upgrade Modbury Hospital so people in the north and north-eastern suburbs can have more health services as well as faster and better quality services close to home. I note part of the member for Morphett's motion refers to the 14 kilometres that people have to travel to the Lyell McEwin Hospital. When there was concern about the maternity services going to the Lyell McEwin, people came to see me about exactly that concern, and when we did a Google Maps search we found that in fact it was quicker to get to the Lyell McEwin than it was to get to Modbury Hospital, so again it is just a fallacy that they like to put up.

The way our hospitals provide some services will change but we make no apologies for this. All changes are based on clinical evidence and data and are driven by quality and ensuring the local community has access to a full range of public health services every hour of the day. Our community has grown and changed. The current configuration of our health services no longer reflects the population shifts towards our rapidly growing northern suburbs. We know that only around 55 per cent of northern and north-eastern residents receive care at their local hospitals compared to around 88 per cent in southern and central Adelaide.

We need to make changes to ensure fair and equitable provision of health services right across metropolitan Adelaide. This government believes the people of our north and north-eastern suburbs deserve the same access to the full range of public hospital services as their southern and central counterparts. Through changes the government is making under Transforming Health, the percentage of northern and north-eastern residents receiving care locally is expected to increase from 55 per cent to around 80 per cent.

Services at Modbury and Lyell McEwin hospitals will work together and complement each other. There will be more health staff, more health services provided closer to home for our residents under Transforming Health. Both hospitals will continue to operate emergency departments staffed by specialists 24 hours a day, seven days a week. Contrary to what those opposite would like the community to believe, most of the patients who currently attend the Modbury Hospital Emergency Department will continue to be seen at Modbury. The emergency department will continue to treat asthma and orthopaedics, including adult and paediatric fractures as well as chronic disease.

Senior doctors and nurses will continue to be available to respond to deteriorating patients anywhere in Modbury Hospital. Acutely unwell patients can continue to be referred either to Modbury or Lyell McEwin emergency departments, as is currently the case. As it happens now, if a patient presents at the Modbury Hospital Emergency Department, they will receive care from a fully functional emergency department staffed by specialist physicians who will be able to diagnose, stabilise and assess all patients. Only those suffering from ongoing, complex, life-threatening emergencies will be stabilised and transferred by ambulance to another hospital with diagnosis and management already in place.

Under the Liberal government, people would be taken by an ambulance; they would head towards Modbury, and patients would plead not to go to Modbury: 'Take me to the Royal Adelaide Hospital.' The people of the north and north-east will still be able to access other local health services at Modbury Hospital, such as mental health services, treatment for ongoing conditions—like diabetes, heart disease or lung disease—as well as geriatric medicine and palliative care services.

Despite what those opposite would have us believe, all current specialty outpatient services accessed by the local community at Modbury Hospital will continue. That is right—the people of the north-eastern suburbs will continue to receive the health services they have come to expect and deserve under a Labor government.

As well as a continuation of all these services, Modbury Hospital will become the elective surgery centre for the north and north-eastern area carrying out around 1,800 more elective procedures a year, including scopes. This will give the north and north-eastern residents faster access to elective surgery with fewer delays as can currently occur due to clinical teams being pulled away for emergency surgery.

Under Transforming Health, Modbury Hospital is expected to see an additional 3,000 patients a year. We know that around 80 per cent of the surgery currently carried out at Modbury Hospital is elective. The expansion of elective day surgery at Modbury will build on the expertise and exceptional service currently provided, and enable people in the north and north-east to receive day surgery closer to home.

Under the changes there will be an expanded one-stop breast service at Modbury Hospital, giving women access to a breast surgeon, a radiologist and a breast-care nurse in the same location, speeding up diagnosis and treatment. This service will enable patients to receive their biopsy results straightaway and access radiology services on the same day, rather than require two or three separate appointments.

Modbury Hospital will become a major rehabilitation and subacute service centre for the north, ensuring north and north-eastern residents have greater access to rehabilitation closer to home. We will see an increase in the number of rehabilitation beds and supported services, a new rehabilitation centre, rehabilitation gym and a hydrotherapy pool. Allied health will be available seven days a week at Modbury Hospital to ensure the local community can get the treatment they need, as soon as possible.

Building on the wide range of high quality public health services that will be provided at Modbury Hospital, Lyell McEwin Hospital will also service the people of the north and north-eastern suburbs treating major emergency and trauma patients, supported by 24-hour senior doctors and nurses, and diagnostic and imaging support. This will include a comprehensive 24/7 orthopaedic trauma surgery service, providing faster access to orthopaedic services.

This government is investing heavily in Modbury Hospital. We have invested heavily in the Lyell McEwin Hospital, and we will continue to ensure that many people who currently travel outside the north and north-eastern area for health care will have far greater access to high quality public hospital services closer to home. I am astounded that, with their record, the Liberal Party could bring such a motion to this house.

Mr GOLDSWORTHY (Kavel) (11:53): I want to speak in support of the motion that the member for Morphett has brought to the house. This is a very important issue. It is not only important for those residents in the suburbs of the north-eastern area of Adelaide, particularly the electorates of Florey, Wright and Newland, but it is also a very important issue for the residents in my electorate, particularly the northern areas of my electorate—Woodside, Gumeracha, Birdwood, Lobethal—those northern areas of the Adelaide Hills. No doubt, it is also important for those residents in the southern towns of the electorate of Schubert—Mount Pleasant, Kersbrook and Williamstown—because they all look to the Modbury Hospital for a very high level of health care.

What we have seen this government do over its 14 years, so far, of being a government, is to look to really set in place a certain style of spin. When I am talking about spin, they actually present what they are doing in a certain style to try to convince the constituency that they are actually improving services and delivery of whatever the government is responsible for to all South Australians.

What they are doing in relation to this initiative of Transforming Health, particularly in relation to Modbury Hospital, whichever way you look at it, is a pretty good exercise or a pretty poor exercise in spin. Let's get down to the tin tacks of it: Transforming Health is about reducing services and cutting costs, and that is exactly what is going to take place at the Modbury Hospital. They are reducing services and cutting costs at the Modbury Hospital, and that will obviously impact on the delivery of health care to all those residents in the north-east and also in the northern part of the Adelaide Hills.

It is a very serious issue, because the last thing we want to see is patient care compromised. I am yet to be convinced, and everybody on this side of the house is yet to be convinced, of the government's spin that moving and transferring services from the Modbury Hospital to the Lyell McEwin Hospital is not going to compromise patient safety or care. As the member for Morphett said in his motion, 'patients do not have to travel 14 kilometres away to the Lyell McEwin Hospital'. If a patient presents at the Modbury Hospital with a critical health issue, to then have to put them in an ambulance, or the 'ambus'—the latest thing is the ambulance bus, and nobody really knows how the 'ambus' is going to work.

Ms Bedford interjecting:

Mr GOLDSWORTHY: The minister was on the radio the other week—

The ACTING SPEAKER (Mr Bell): The member for Florey.

Mr GOLDSWORTHY: —and they were asking questions about the 'ambus'.

Members interjecting:

The ACTING SPEAKER (Mr Bell): Order!

Mr GOLDSWORTHY: Nobody really quite knows how the 'ambus' is going to work. Whether you wait for half a dozen patients to sort of be stockpiled at the Modbury, then to be transferred to the Lyell McEwin—they might be there for a couple of hours—

The Hon. J.M. Rankine interjecting:

The ACTING SPEAKER (Mr Bell): Order!

Mr GOLDSWORTHY: —in a seriously—

Mr Duluk interjecting:

Mr GOLDSWORTHY: The member for Davenport is right: they might be equivalent to sort of ramping. A staff member might come along and say, 'What are you lying on this bed for?' to a patient—

The Hon. J.M. Rankine interjecting:

The ACTING SPEAKER (Mr Bell): Order!

Mr GOLDSWORTHY: 'Oh, we're waiting for the bus. It comes at 12.05'—we do not have the timetable of the 'ambus' yet. For goodness' sake, get a grip on reality, government members, about what is going on in relation to this. Nobody on this side of the house, and I would not doubt an enormous percentage of the community that the Modbury Hospital delivers services to, is convinced that the transfer of important, lifesaving health services to the Lyell McEwin Hospital is not going to put—

The Hon. J.M. Rankine interjecting:

The ACTING SPEAKER (Mr Bell): Order!

Mr GOLDSWORTHY: —patient care at a potential risk.

The ACTING SPEAKER (Mr Bell): You've had your chance. Let the member speak.

Mr GOLDSWORTHY: Now we get to the issue—and I have raised this before in the house—concerning the information that some of the sitting Labor members are distributing in their electorates. I have raised this issue before about the material that has been distributed, particularly by the members for Florey and Newland in their electorates, listing the services that will be available at Modbury Hospital. We know that some of those services are going to be cut.

As I have said before in this place, I think it is the responsibility and the duty of those members to be honest with their electorates and now communicate in a factual manner to those electorates in the north-east about what the Modbury Hospital will deliver in terms of services now that Transforming Health is moving along and services will be cut. They have a responsibility and a duty to be honest with their constituents. We will be monitoring that very closely and, if it does not happen, I am telling them that it will be highlighted in those constituencies. On this side of the house, we do not base our views on wild reasoning or unsubstantiated facts. We base our reasoning and our argument—

The Hon. J.M. Rankine interjecting:

The ACTING SPEAKER (Mr Bell): Order!

The Hon. J.M. Rankine interjecting:

Mr GOLDSWORTHY: —on information that 30 medical specialists—

The ACTING SPEAKER (Mr Bell): Order! Member for Wright, you have had your chance to speak. I call you to order. Please let the member give his speech in silence.

Mr GOLDSWORTHY: Thank you, Mr Acting Speaker, for your protection. We know the member for Wright is a continual interjector and disruptor of the proceedings of the house. The government has this letter, because it is an open letter to the Minister for Health and SA Health. It is from 30 medical specialists from Modbury, and it lists a whole lot of issues. I do not think I have time to list them all but, under the first heading 'Overall', the letter states:

…the reconfiguration of services will deliver poorer patient and health system outcomes.

That is the opening line of their assessment of the effect that the Transforming Health reforms will have. The letter continues:

We feel strongly that Transforming Health…will deliver a downgraded Modbury Hospital with decreased capabilities and increased costs and risk.

That is the thing that concerns us the most—the potential for the increase in patients' risk, putting them on the 'ambus', getting on the timetable. 'Hang on, it's 12:05. Sorry, the bus has gone. We'll have to wait till 12:35 until the next bus arrives.' That whole thing is just ridiculous.

The letter talks about losses: the hospital will lose the high dependency unit, 30 acute medical beds and surgical inpatient beds and after-hours on-site anaesthetic airway management services, so there is an overall decrease in the number of beds available for medical patients in the NALHN.

Under the heading 'Unnecessary transfers', the letter states that, on the health department's own figures, there are 20 patient transfers per day from the Modbury Hospital to the Lyell McEwin hospital, which is nearly 7,500 patient transfers per year, costing $7.5 to $15 million per year and that that money would be better spent at Modbury.

This is an open letter to the Minister for Health and SA Health signed by 30 medical specialists. That is where we derive our information from—the health specialists who deliver services at that hospital.

Time expired.

Ms BEDFORD (Florey) (12:03): Just as I did with the debate around voluntary euthanasia, I am going to try to take the emotion out of this and just deal with the logical facts of the debate around the Modbury Hospital. I want to start with a bit of a history lesson for those of you who may not know as intimately as I do exactly what has happened at the Modbury Hospital over the past 30 years that I know of, which perhaps explains why I became interested in public health as an issue. I am very sorry that not all the members are able to stay to hear this, but I know they will read my Hansard tomorrow.

The Modbury Hospital, as we said, was started some 40 years ago and we know that Molly Byrne and Don Dunstan were integral to it, but so too is Dr Donald Beard, someone you on the other side will all know through his veteran's work in Korea and in Kapyong and Long Tan, Vietnam. I am happy to say I have a good working relationship with Dr Don, irrespective of the fact that we obviously come from different sides of the political persuasion. I know the Modbury Hospital is very dear to him, as it is to many people in the area for all sorts of other reasons.

The Modbury Hospital has had an amazing amount of fabulous work put into it by huge numbers of doctors and nurses, allied healthcare workers and their marvellous volunteers. It has a long and proud local history, and it has been shamelessly used as a political football for many, many years. I can only tell you that at every election I have to stand outside the Modbury Hospital and say, 'It's not closing,' and it never has, has it, while I have been here? And while I am here it will not close because of the large amount of money that has been invested in it—

Mr Pederick interjecting:

Ms BEDFORD: No, they don't.

The ACTING SPEAKER (Mr Bell): Order!

Ms BEDFORD: You see, this is where I am asking you to try to be reasonable, member for Hammond. I have listened to everybody else this morning and I am just asking you to listen to what I have to say. If I thought the Modbury Hospital was in any danger of closing I would be the first one to say so, believe me. Nobody has ever called me a shrinking violet.

I want to take you back to some of the changes that have happened in our hospital. The member for Wright mentioned earlier the failed privatisation experiment. I understand that you on the other side of the house knew you had to deal with health in some way, and this was the beginning of what you thought might be the answer to changing the delivery of health services. I have no problem with it, except it was the wrong model. What you had planned to do was to put a private hospital in one of the wards of the Modbury Hospital, without them paying levies or taxes, or even working out how they might even pay their electricity, in exchange for letting them run the main hospital, which you all thought was going to drain you of dough, so you had to do something to prop it up. I understand all that, but it was clearly the wrong model.

What that did is: it saw a mass exodus of really good and experienced staff leave our hospital, and your costs soared because you had to take in agency staff. Healthscope shares plummeted and the whole thing was a disaster, from which you were really pleased to extricate yourself, but only, luckily, because we had stopped you doing that at The Queen Elizabeth Hospital site. Goodness only knows what would have happened if you had unravelled the egg that far, because it might have been too hard to go back.

That aside, we then come to the question of the removal of delivery services for expectant mothers. Happily, I called a big public meeting and minister John Hill was there. We had an auditorium full of people. The AMA's representative on that night said there was no way you could keep maternity services there. It was not possible for him to offer the full suite of services because the anaesthetists would have to come from other areas because, like a lot of medical services at the Modbury Hospital and other sites within our system, these things are not available 24/7, people are on call.

It was a matter of looking at how we could provide the safest health care to people. If I cannot make sure all those services are there and provide women with the best possible outcomes with health, I am then faced with a model that is produced by the health professionals and presented to me as the outcome of their deliberations and the way they can ensure safety, and that is how we saw the birth of the Lyell McEwin birthing services. We all know about the great changes that have taken place in childbirth. We now have home deliveries happening, which we all thought would never happen in a safe way in this state. This has all happened very quietly and I have not heard one of you come in and say anything about that in the time I have been here.

So we lost maternity services and, again, as the member for Wright pointed out, people have been more than happy with the service that has been provided. So the proof has been in the—

Members interjecting:

The ACTING SPEAKER (Mr Bell): Order!

The Hon. J.M. Rankine: It's the best in the state.

The ACTING SPEAKER (Mr Bell): Order!

Ms BEDFORD: I want that 40 seconds added onto my time, and I mean it. The proof will be in the pudding. I have worked really hard with anyone who has had an adverse outcome of any variety in the birthing services. None of us on this side shirk from wanting to hear about the problems. We need to hear about any problems anyone faces because it is the only way we are going to sort out the health service. We really want best care, first time, every time, not only for my family but for your family, because unless it is there for you it will not be there for me.

The next thing we have to look at is paediatrics. Again, as a resident of the area, I have had two paediatric emergencies, one with each of my children. One of them, my son, unfortunately had a stroke when he was eight. I rang the Modbury Hospital and said, 'We're coming in.' She said, 'Take a Disprin, we are busy.' As a responsible parent, I knew, 'Okay, next step Women's and Children's.' It is about knowing where to go to access the services that you want.

Fortunately for me, after pulling ourselves together—you do not want a child's stroke if you can avoid it—we went into the Women's and Children's. Luckily for us, the registrar on duty knew exactly what was happening. They get 10 a year, and it was fabulous service because everyone wanted to look—no problem. My dribbling child in a wheelchair, incontinent and unable to move, has recovered and is a terrifically well-functioning adult. Boy, am I lucky! My daughter, on the other hand, had an overnight stay and was out of the hospital.

We now know that the paediatric ward had very few numbers going through it. For staff to have access to the large number of cases that give them the experience to handle these cases, they need a throughput which we did not have. We struggled. All our north-eastern members struggled. We got the overnight stay ward, which is now a paediatric area in the emergency and accident area, which has worked fine. I have had more than enough people say to me that it has worked fine. I have not had a complaint about it, and I encourage people to complain because I do not want to be the person standing back and having things happen when nothing should be going wrong.

Transforming Health is the newest look at how we might sustain health services for everybody. The Tea Tree Gully area—the council area rather than the suburb—has a large number of older people. Our shift, our focus has to be on handling the largest numbers of people we have. Our rehab ward which, I will be the first to admit, was part of a promise before an election which did not happen and is now back on the drawing boards and has started, gives me great confidence in saying to you that I will be in the best-placed position to make sure the residents of my area, and indeed as part of the whole plan of the north, will have access to the best possible rehab care close to home.

We know that the hospital at home service is working fabulously well. I have not had one person come and say anything about that to me, and I urge them, if they have issues, to come and say something, as it is the only way I can make sure they get what they need. The undermining of confidence in the hospital is deplorable. I have a surgeon one day wearing a T-shirt saying, 'I have survived Modbury Hospital' and, the next day, I have people saying it is a fabulous thing.

What is it with you people? Do you not understand the damage the scaremongering causes to the older people of our area? In hand-to-hand combat, each of my members have to speak to people for 10 to 15 minutes to calm them down because they have picked up some throwaway line, some bit of waffle, that has them scared to death that they cannot go to the hospital closest to them. Let's all get behind this health system and try to make it work. It has to work because, otherwise, there is no way we can make sure people get the best care that they need.

The other thing that really appals me is that no-one seems to understand how the health system is now going to work. The government has invested $314 million redeveloping the Lyell McEwin health service. Most people still think it is a Nissen hut in a paddock, because they have never been. You are only going to go and access acute health care when you are sick, and you need to know exactly where you are going to go and how you are going to get there. If you are that sick you are in an ambulance, it is not your decision. If you are not that sick, go to the closest hospital. If you are going to drive, go to the closest hospital.

The health system is not third-world. I cannot believe someone said to me the other day that the South Australian health system is third-world, but that is because people are eroding their confidence in the system. Third-world health services means there is nothing there when you get there, and that is very far from the truth now.

Our investments in the Lyell McEwin have seen it transform into a major, state-of-the-art, tertiary hospital, and we must have great confidence in delivering good services. The staff are going to be able to rotate through the general hospital to the tertiary hospital. It is actually, as Malcolm Turnbull would say, an 'exciting time' to be a health professional because you are going to be able to go and access this. I beg all of you to get behind Transforming Health and, instead of scaring people, encourage them to go and look for themselves.

Mr GRIFFITHS (Goyder) (12:14): I am pleased to make a contribution to this, and I do so on the premise that I consider myself to be a hospital brat. My mum was a nurse for 50 years. It was her life, and it has trained me in how to react to people in many ways because of the requirements of being a nurse and how you have to interact with people. So, when I stand up and speak on this, I do so not from a detailed knowledge of the individual circumstance but from the perception of what the community needs—that is the way I put it.

I did appreciate the member for Wright's contribution and the member for Florey's. It has put some information before the house that I believe is helpful for the public debate that will need to occur, and I want discussions to be accurate ones also.

It is interesting though that members from the government side will accuse the Liberal Party of scaremongering. I cannot remember those sort of words being said in 2007 when Country Health was being talked about when there were various versions of what the impact was going to be on regional hospitals with proposals by then minister Hill that would have resulted in significant downgrades for the level of services provided. That disappointed me immensely.

There were a variety of public meetings held. I know in the Goyder electorate there were three—one with 700 people, one with 500 people and one with 400 people. Other members from the government's side are shaking their heads saying, 'What is he talking about?' I can assure you that in trying to ensure that I had information available, I had health professionals there from the department to provide advice.

At the very first meeting in Yorketown, with 700 people there, the question was asked by the crowd, 'Where do you have to go for a certain level of care?' and the response was, 'Whyalla.' That is what the person who works within the department said. When that sort of advice comes from someone who is meant to know, who looks at it simply as closest on the lines of a map instead of what the reality of the world is—no Yorke Peninsula people are going to drive all the way up the gulf and down to Whyalla again, they are going to go to Adelaide for their services—it takes away all confidence in it.

I appreciated the member for Florey's comments and the member for Wright's about obstetrics and delivery of babies. The reason I rise, and how this relates to me in a personal way, is that when I am in Adelaide I live in the member for Torrens' electorate, so I am relatively close to Modbury. I have attended there twice myself when I have had little incidences when I am at that house and have needed some help, and they have been great. I offer no criticism at all to the staff. They have done exceptionally well.

My family is blessed by the fact that in five weeks and two days' time, if it goes to schedule, we are going to get a grandchild and they live three minutes away from Modbury Hospital. So the member for Wright, when you talk about the fact that the Lyell McEwin is closer, it is all relevant to where the location is and I understand that. It is not a criticism of your comments in particular. They have said to me that it is a 20-minute drive for them to get to Modbury. They have been for what they are required to do before the baby comes along. They have the route down pat. They know exactly where they have to go.

I came into this place with a belief that there were really key issues that government have a responsibility for and they are education, law and order, and health. No matter where you are, those are key issues for all people. Many people decide to live in particular areas because of the range of services provided for them in those areas, and when there are changes it creates concerns, it creates the need for information, and it creates an opportunity for political arguments to occur. I have no doubt about that.

The Hon. J.M. Rankine interjecting:

Mr GRIFFITHS: I do want my grandchild born in the safest environment.

The Hon. J.M. Rankine interjecting:

The DEPUTY SPEAKER: In fairness, there should be no interjections and you do not need to respond to them. I will speak to you later about having babies on the bathroom floor as that happened to my daughter eight weeks ago. Come and see me and I can tell you all about it.

Mr GRIFFITHS: I understand that some babies arrive in very interesting circumstances with a lack of notice, but it is an example of where the concerns come from. When the member for Kavel reads out portions of a letter that is signed by 30 professionals who come from Modbury Hospital who express concern, to me that is the credibility I need to see because it identifies those people who live it. They commit their life to it. They put their focus upon providing the best possible service they can.

When the professionals who work for the government and take some level of risk in putting their name to a letter that criticises the government about a decision that it is making, you have to listen to that sort of advice. It is not the political argument, but it is the reality of the world argument actually coming through that these people who work there worry about what the impact of it is going to be.

There is a necessity for change to occur. I am not crazy on that. I know the previous member for Kaurna, as minister for health at the time, spoke to me a couple of times and certainly mentioned in this place the fact that, unless changes occur to the provision of health services, it will consume the total budget of South Australia in the mid 2030s or thereabouts. I understand that, but I get concerned though when I hear impressive titles, such as Transforming Health, and I worry about what the impact is going to be upon people.

People are not as well informed as you, Deputy Speaker, when it comes to a crisis occurring and knowing where they need to go. There are many people in our community who still choose to remain completely blank about these sorts of things and, when something occurs, they have nowhere to go for assistance. You got a shocking response, initially, from the first professional service that you rang when they told you to go somewhere else.

The DEPUTY SPEAKER: 'Have a Disprin.'

Mr GRIFFITHS: Yes, 'Have a Disprin,' and then you went to the place that you needed to go: I understand that. However, for those in our community who are not engaged, not informed and do not know what their options are, they are going to take what they see as their closest possible option and go there. I am pleased for the member for Wright when she talks about the level of care that will take place—and there will only be, I believe, 20 people per day who have to be transferred between hospitals for a high level of care that will be available at other places—

The DEPUTY SPEAKER: It will change. We don't know how many people.

Mr GRIFFITHS: Okay, and I understand that, but my concern becomes: do people have to self triage? It is a term that I use. Do they have to determine where they have to go for the level of care? The member for Wright has talked about the fact that you present there.

The Hon. J.M. Rankine interjecting:

The DEPUTY SPEAKER: Order! Looking at me might be the safest thing to do. Just talk to me.

Mr GRIFFITHS: My apologies. Then I won't get distracted.

The DEPUTY SPEAKER: No, don't. Look to me.

Mr GRIFFITHS: Okay. I do believe in my heart that the motion is presented to the house with the best of intentions, that is, to try to ensure the best outcomes from Transforming Health—because it will be a program that will be pursued. No matter what we say in this political world, you will push for it in the two years to ensure that it is there, but I believe in my heart, also, that, in two years' time, someone else will have responsibility to make it work. There has to be an opportunity to ensure that the debate occurs about it and for information flow to occur, too.

The member for Morphett has brought this motion because he follows this completely. I know: I sit next to him in this chamber and the number of times he is talking about health issues proves to me that it is not a one-time opportune moment he is seizing on. It is something that is very dear to his heart. He has family in that area and he wants to make sure the best outcomes occur. When he and other members stand up and talk about it, it is because they care about people.

The DEPUTY SPEAKER: As do we.

Mr GRIFFITHS: As do you, Deputy Speaker. I understand that. That was quite evident when, even though you took the emotion out of your speech, there was still a lot of reflection upon that.

I hope that the debate about this motion is fulsome. There is a need for people to put their position on it, but the importance rests with government, as the holder of the cheque book—for the next two years, at least, and, hopefully, that is all—to ensure that the outcomes for people, no matter where they are from and no matter what their circumstances, provide them with what they need, and that is what government's responsibility is.

Mr TRELOAR (Flinders) (12:22): I rise today to support this excellent motion that has been brought to the house by the member for Morphett, who has had, for many years, a great passion for health and the state's health system. In fact, for a time, he was our shadow minister for health. The motion reads:

That this House condemns the Government's decision to cut services at the Modbury Hospital and in particular, to downgrade emergency departments and cut vital cardiac services which provide lifesaving treatment to hundreds of residents in Adelaide's North East to—

(a) ensure patients don't have to travel 14 kilometres away to the Lyell McEwin Hospital for important medical care;

(b) ensure residents are not faced with long wait times; and

(c) ensure emergency surgery remains available to residents in their local area.

It has created some excellent contributions from both sides of the house and, ultimately, what this motion reflects is the government's Transforming Health policy, which we hear a lot about and we are just starting to see evidence of how it is unfolding.

There is no doubt that services will be reduced at Modbury Hospital and, as the member for Kavel so succinctly put it—and with great passion, I might add—Transforming Health is all about reducing services and cutting costs. It seems to be a lot about centralisation and reducing hospital care in one area, and transferring those available facilities to another is exactly that. It is about centralisation.

Why are we seeing these services being reduced and cutting of costs? I think it is pretty obvious. We have a brand-new Royal Adelaide Hospital just down the road from here, which I am sure will be a marvellous building, but it is currently estimated to cost something like $2.3 billion. It has become like a vortex. It is sucking up so much of the state's energy, so much of the state's resources and so much of the health system that we are starting to feel the effects of that throughout the suburbs and throughout the country areas.

I think at one point it was described as the third most expensive building in the world ever built. It is extraordinary. We are doing that in Adelaide. Add to that the desal plant and you have got almost $5 billion worth of money, and the desal plant I might add is hardly being used at all. We have got $5 billion of expenses to a state with a budget and an economy that is struggling. It is extraordinary.

The up-shot of all of that is that we are seeing a reduction in services, as I said, in other hospitals, in the suburbs and most likely in country areas, and I fear that we have not even started to see how Transforming Health might be rolled out in the country areas. The member for Goyder spoke about 2008 when there was a very real threat to country hospitals, and there were certainly some large meetings in my electorate of Flinders on the Eyre Peninsula. I was a candidate at that point and I went along to big meetings in my home town of Cummins and also Streaky Bay.

Town halls were packed because they feared a reduction in their health services. That did not come to pass, but it was purely and simply because of the public involvement and public backlash. I sincerely hope that we do not have to get to that situation again. I think it is about centralisation, and I am starting to wonder when this government will ever realise that centralisation does not deliver savings or efficiencies, it simply delivers the reverse.

There is no doubt that the Modbury Hospital has provided invaluable health services to the north-east suburbs since it was first built in 1973, and, of course, in those days the north-east suburbs, suburbs like Golden Grove, Tea Tree Gully and Modbury, were brand-new suburbs. They were growing areas. There were young families having children. It was a vibrant place and it still is; it is still a growing area. Many of those families have elected to stay. Some of the original residents have become elderly, aged, and they are looking at another stage of life and require another part of healthcare—rather than mothers and babies and middle-aged people we are now looking at the elderly.

I think that one of the other real challenges for this government and this state will be how we deal with aged care, and that is something I might talk about a little bit more another day, but certainly the challenge is how we best deliver aged care in an ageing population, in a population where fewer working people are supporting a larger proportion of older people.

I know that just next week I have two meetings with constituents. One meeting will be in Cummins and one meeting will be in Cowell, and both those communities are really concerned about how they are going to provide ongoing, affordable and suitable aged-care facilities, because the people who live in these towns actually want to stay there, and it is very difficult for them to be able to do that. I think that, very seriously, we need to start looking at some new models about how we might best make that work. Anyway, we will decide how that best happens in a local environment in the next little while.

There is no doubt that a reduction in services at Modbury will increase pressure on the Lyell McEwen Hospital. Good healthcare is all about proximity. People do not want to be travelling miles and miles. Obstetrics has been mentioned, and on the Eyre Peninsula now can you can only have a baby in three places. A mother can only have a child—or is it a person? No, it is a mother, it is a woman. I digress. A woman can only have a baby at Port Lincoln, Ceduna or Whyalla and nowhere in between unless, of course, as the Deputy Speaker's daughter did, fortunately, they have a safe delivery on a bathroom floor, because that happens occasionally.

My wife is actually a nurse so I will declare an interest here, and she has often said that if a baby is going to come—

Mr Pengilly interjecting:

Mr TRELOAR: Yes, the nurses are everywhere, I know. She is working in community nursing at the moment, but she often says that if a baby is that ready to come then it is most likely to come safely, anyway. Good healthcare is all about proximity and we are finding, particularly in country areas, that people are having to travel further and further for good healthcare and, of course, that puts their welfare and safety at risk at times. Now, as a result of decisions like this, we are seeing people in the suburbs having to travel further and further, which is not acceptable in an emergency when one really needs to access health care quickly.

I know the house needs to get onto the next motion, but I would like to congratulate the member for Morphett on his motion. It is well thought through. As I said, his passion and diligence in the health portfolio has been well recounted today. I have to say that I hope the people in the north-eastern suburbs get behind their hospitals and vote with their feet.

Mr DULUK (Davenport) (12:30): I move:

That the debate be adjourned.

The house divided on the adjournment:

While the division bells were ringing: