Motions

Repatriation General Hospital

Mr MARSHALL (Dunstan—Leader of the Opposition) (11:31): I move:

That this house urges the Minister for Veterans' Affairs and Defence Industries, a veteran, to immediately reverse the decision to close the Repatriation General Hospital to—

(a) ensure South Australia continues to have a dedicated veterans' hospital for ex-servicemen and women;

(b) ensure veterans continue to have access to the quality medical care that they require following their brave and selfless service to our nation;

(c) support our veterans as we mark the important ANZAC Centenary;

(d) ensure the Labor government stands by its 2010 commitment to never close the hospital; and

(e) support the people of Waite who use the local hospital and will face longer wait times and increased travel if the hospital closes.

The Repatriation General Hospital is a fantastic institution. The staff, the patients, the board, the veterans who volunteer their time, and the whole community are completely unique. I visited my grandfather there when he was a patient; I visited friends there; and, when we were in furniture manufacturing, I manufactured beds for the Repatriation General Hospital. I was very grateful at one stage to convert, free of charge to the Daw House Hospice, some of their wind-up beds to electric-operated beds with batteries, so that patients could go out into the beautiful garden there and still have all the advantages of those beds without having to be plugged in in a ward. It is a fantastic hospital. Every single time I have visited I have been struck by this unique campus and all that it offers.

In 2012 I was taken on a tour of the grounds by veterans Laurie Lewis and Mike Currie. Both volunteered their time to visit patients at the hospital to ensure that the veterans' community was supported as they underwent important health battles. They were proud to show me the facility, and pointed out that almost every ward at the Repat is separated by a garden or courtyard, which is why the Repat has been dubbed 'a hospital in a park'. They took me to the Memorial Chapel, with its magnificent stained glass windows. This is another place for quiet reflection and contemplation.

At the time both men were very concerned about the impending closure of the acute referral unit, another decision by this government, taken with very little consultation. In fact, they feared that closing the acute referral unit was the government's first step in closing the whole hospital. They were fearful of the Repat's future and they had every right to be.

There is no doubt that the Repat Hospital is an incredible hospital for the veterans' community, but I would also like to reflect in speaking to this motion this morning on the incredible work this hospital does for the wider community in South Australia. Ninety per cent of Repat patients are in fact from the community, and it is an incredible workhorse in terms of elective surgery in this state: 25 per cent of all the state's orthopaedic and neurological elective surgery is performed at the Repat Hospital.

Adelaide's elective surgery capacity is already completely overstretched. It would be an absolute disaster if we were to lose further capacity with 250 beds, 170,000 outpatient attendances per annum, and a massive transfer of patients from the Repat to the Flinders Medical Centre. As of this morning—I looked at the statistics—1,514 patients were already on the waiting list for elected surgery at the Repat, with 37 already well overdue.

Removing these elective surgery beds will do absolutely nothing to improve the lot of the people who are waiting for elective surgery in South Australia. To date there has been no announcement on the future location of many of the Repat specialist services, including orthopaedics, ophthalmology, urology, rheumatology, respirology and diabetes. Nothing is clear to the people of the wider community as to where these services are going to be provided into the future, and when we look at the most recent statistics which have been handed down on elective surgery it is telling—it is very telling.

In fact, South Australia was the only state in the nation that last year did fewer elective surgery procedures than we did the previous year—the only state in Australia where elective surgery procedures went backwards. Every other state increased the amount of elective surgery, and the government's response to being bottom of the league table is to actually remove capacity for elective surgery in South Australia.

This will be an absolute disaster, and the AMA specifically referred to this in its submission to the Transforming Health consultation period where it was concerned that the collocation of elective and emergency surgeries increased the likelihood of infection, and I quote:

The proposal to amalgamate the Repat's orthopaedic services at the Flinders Medical Centre could lead to blended trauma and elective lists. This is seen by medical experts as a major precursor to increased infection rates for patients undergoing elective surgery and a backward step. It will also increase delays in receiving elective surgery as trauma patients take priority over the limited operating theatre time available.

So, as members can see, this is a hospital which does a lot more in terms of its capacity and its workload than just the veterans, but clearly that is its number one focus. I mentioned earlier the unique layout of the campus. The gardens and campus-style layout provides a therapeutic environment conducive to recovery and rehabilitation. The care, quality and commitment of the staff working out of the Repat are also second to none. They have built a culture which is treasured by many South Australians. It is clear that the closure of the Repat General Hospital will affect the veterans of South Australia and residents of the inner south in particular.

The Repatriation Hospital is a living history for the people of South Australia. In this year especially, in the midst of the Centenary of ANZAC, it is vital that we understand and appreciate the importance of this hospital to our veterans' community and the proud history of our nation. This hospital was built in 1942. The hospital began operating as the 105 Adelaide Military Hospital with 150 beds on a site largely surrounded by orchards and open land.

In 1942 the first patients were admitted with the first wards in tents and temporary huts. The hospital's primary objective to care for wounded veterans was overwhelmingly fulfilled as service men and women returned from World War II. In 1943 and 1944 the hospital's capacity peaked at 1,000 beds, and the nearby Springbank camp swelled with service men and women.

In 1947 the hospital became the Repatriation General Hospital Springbank, and then in 1967 its name was changed to the Repatriation General Hospital Daw Park. In the early 1970s the hospital's role broadened as it began accepting community patients and became a teaching hospital affiliated with the Flinders University of South Australia. The federal ANZAC Centenary website says this about the Centenary of ANZAC:

…is Australia's most important period of national commemoration. Marking 100 years since our involvement in the First World War, the Anzac Centenary is a time to honour the service and sacrifice of our original ANZACs, and the generations of Australian servicemen and women who have defended our values and freedoms, in wars, conflicts and peace operations throughout a Century of Service.

Which begs the question: how are we honouring the service and sacrifice of our ANZAC legends by closing their hospital? And, indeed, it is their hospital. One of the most visited outdoor areas of the Repat is the peace garden. It includes a hedge grown from rosemary cuttings that a digger brought back from Gallipoli. In a recent open letter, the RSL stated its support for keeping the Repat open. It said:

The Repatriation General Hospital is a sacred institution—an expression of our duty to honour the sacrifice of all who have served and died in the defence of our nation by caring for the health and welfare of the service men and women who returned.

Despite everything you have heard here today, despite the history, despite the value to the veterans' communities, despite the world-class services, the Weatherill Labor government has decided to close the Repat. The closure is also a breach of the promises made time and time again by this current Labor government.

Let us reflect on some of those commitments that have been made to the people of South Australia and, of course, most importantly, to the veterans' communities. Former premier Mike Rann once promised:

The Repat Hospital is here to stay. The Repat hospital will never ever be closed by a Labor government.

Former health minister John Hill said that any suggestion that the Repat would close was 'ridiculous' and promised that 'it's not something that's going to be done by the government'. That was the solemn promise from the former premier Mike Rann and from the former health minister John Hill. The current health minister, Jack Snelling, the architect of the Repat's downfall, once said:

SA Health is dedicated to maintaining the same high level of care that Veterans and the local community have come to expect from the [Repatriation General Hospital] both now and into the future.

But look at where we are at the moment: we have been told that this hospital is going to close. We have an expression of interest process underway for the redevelopment of the Daw Park site. The government needs to stop its campaign to destroy the Repat and take this opportunity of the expression of interest process to bring together partners, non-government and private, who can renew and redevelop the Repat as a veterans' and ageing health precinct.

Last year, the member for Waite, acting as the health minister, promised that the veteran community and the public would have the opportunity to have their say on the proposals outlined in the expression of interest submission. Minister Snelling repudiated the commitment in parliament only last month. We are saying, on behalf of this side of the parliament, that the government must hold firm to its commitment. It should, of course, hold firm to its commitment to never, ever close the Repat but, at a bare minimum, it must hold firm to its commitment only made in the last six months for the people of South Australia to see the various proposals that are being put forward for this site.

We completely and utterly reject the government's proposal to close this site and to take it away from the people of South Australia as a major teaching hospital, an elective surgery hub and, of course, an ageing care specialist site. As I said, it is much more than just the Repat hospital for veterans. It serves as a centre for excellence in the ageing sector. This site has specialist care in terms of geriatric care, aged mental health and the wonderful Daw House Hospice for palliative care and rehabilitation.

The government's plan is to scatter these services to a range of hospitals right across South Australia which, by the way, we on this side of the chamber think is not only poor in terms of overall service to our veteran community in South Australia but also a complete and utter waste of money. We have spent almost $50 million in upgrading facilities on that Repat site in the past decade. All of that will be completely lost. The government's proposal is to then spend a further $159 million on the Flinders site. And what are they going to do on that site? They are going to essentially replicate facilities that already exist on the Repat site.

We are going to stick the wrecking ball through the tens of millions of dollars that we have invested on that site and we are going to replicate them at the cost to taxpayers of $159 million by building a new 55-bed rehab centre at Flinders, a new palliative care unit and a new aged mental health facility. Those facilities already exist and it is a complete waste of taxpayers' money to replicate them just a few hundred metres down the road from where they are currently domiciled.

Ms Sanderson: It's more Labor waste.

Mr MARSHALL: It is more Labor waste, as the member for Adelaide has said.

The DEPUTY SPEAKER: Order! You're not in your seat, member for Adelaide; you shouldn't be interjecting.

Mr MARSHALL: I want to just conclude my remarks by really addressing the fundamental issue that veterans raise with me time and time again. The issue is how we treat our veterans who might have comorbidity issues. The government, the minister and the acting minister (the member for Waite) have repeatedly said that many of our veterans are now using the major teaching hospitals for their treatment and that is true. There is no doubt about that.

When a veteran might have a specific general medical need, they will often go to the closest hospital, but many of our veterans have comorbidity issues. Many of our veterans are suffering from post-traumatic stress disorder and this is when the Repat comes into its own. There is a specialist service. The doctors, the nurses and all the ground staff—everybody who works on that site—are completely focused on giving the best service to veterans who might be living with comorbidity issues. This is why it is so critical to keep this in place. The current model of the government is to scatter these services across South Australia and the most reprehensible of these decisions is to relocate Ward 17 to the Glenside site.

You cannot treat post-traumatic stress disorder in isolation. It needs to be part of an overall precinct which is going to service the total needs of the veterans community. I have with me today the Second Interim Report of the Select Committee on Transforming Health and, in particular, the area that deals with the relocation of Ward 17 to the Repatriation General Hospital. What is quite clear from this well-considered report is that the service to the veterans community with regard to the post-traumatic stress disorder unit really misses the opportunity to co-locate these services. What should be co-located is quite specific in this report.

On-site access to medical and surgical care, will that be at the Glenside site? No. Access to allied health services, dietetics, occupational therapy, pain management, physiotherapy and podiatry? No. Access to the diabetes clinic? No. Access to the sleep disorders unit? No. So, as you see, there is a major diminution of services to our veterans community with this appalling decision to relocate Ward 17 away from this suite of services they currently enjoy with Ward 17 being based at the Repatriation General Hospital at Daw Park.

Does Ward 17 need to be updated? Absolutely, it is long overdue. This government has been in place for 14 years. It was well overdue for update a decade ago, and they have been sitting on their hands, but the solution they have come up with is completely and utterly unacceptable. On this side of the house, we would like to see the Repatriation General Hospital saved; we do not want to see it sold off. Once it is gone, it is gone; there is nothing that can be done.

We see it is as absolutely critical that this year, the 75^th year since the establishment of the Repatriation General Hospital, our government should focus on renewing this site, making it a specialist centre for our veterans, keeping their services together, updating this and making it a real centre for aged care in South Australia, maybe co-locating with some private sector services but unequivocally saving this site for future generations.

Dr McFETRIDGE (Morphett) (11:47): The Veterans' Service Guarantee is a document that is still on the government's website. It lists all the things this government is guaranteeing that veterans' will receive at the Repatriation General Hospital, a 250-bed acute hospital that is still today listed on the government's own website. When you look at that veterans' guarantee, there is absolutely no way that that can be replicated in any shape or form at any of the other places that they are going to push veterans to under Transforming Health. Whether it is parking, access to specialists, right down to that free cappuccino, that veterans guarantee has been torn up and thrown away.

The Minister for Veterans' Affairs and I work as much as we can in a bipartisan way in veterans' affairs. When there was the initial furore over the member for Waite's move to the government benches, my federal colleagues were saying, 'We're not going to talk to that man, but we will talk to you.' I made a point of saying that I was not going to work that way and that this was all about the veterans, and I insisted that they deal with the minister as well as me.

I have had great pleasure working with the minister and going to Lone Pine, and I am going to France with him in June, but this is one area where he and I differ. We could not be stronger in our disagreement on where we are going with the Repat. I would drive the bulldozer through some of those buildings at the Repat because they are out of date, but what the Repat offers the people of South Australia—besides the 250 acute beds, the 3,500 arthroplasty and neurology surgeries and the over 100,000 outpatient appointments there—is a spiritual home for the veterans.

If you go down to the chapel there, as the minister and I have on many occasions, whether it is for the bombing of Darwin remembrance day or for other days, you also go to Ward 17 and talk to the people in there, you go out to the remembrance garden and see the beautiful sculptures, and you see the little smokers hut (and I do not think there is any minister in this place who is brave enough to tell the veterans there that they cannot have a smoke); when you do all that, you know that you cannot replicate it anywhere.

That is where the minister has to stand up to the government and say, 'Stop, rethink what you're doing.' We are hearing it from the AMA, and we are hearing it from the Salaried Medical Officers Association. We are hearing it from every avenue across South Australia, at the moment, that Transforming Health is not doing the job that it was designed to do. It will transform it—sure—but what is it going to transform it into? People will die.

I asked the minister a question—I think I interjected, which would have been out of order anyway—but I interjected about EPAS at Noarlunga, and I said patients are at risk. The minister said, and it is in Hansard, 'Yes, patients are at risk.' Now, we know the fiasco that EPAS is. Where did they try and run EPAS as a trial? Noarlunga. Has it worked? No, it has not worked. They need to stop the run they are doing with EPAS and stop wasting millions and millions of dollars. More importantly, they need to stop and think again about the Repat.

Just this week, in my portfolio of disabilities—and it is a wonderful portfolio; you meet some of the most amazing people—I met with people from the motor neurone disease board. Stephen Hawking is probably the most well-known person with motor neurone disease, but he is an exception to the rule. You do not know if you are going to get motor neurone disease, there is no cure for it, and you would normally die within two years. From go to whoa: two years. Where is the motor neurone disease clinic in South Australia? At the Repat. That will never ever be replicated anywhere in South Australia.

The palliative care that is offered at the Repat; the sleep disorder clinic that is offered there; the appliances, orthotics and the specialist rehabilitation services there that modify wheelchairs and provide other appliances to these people with motor neurone disease—you will never replicate that anywhere else, just as you will never ever get the veterans' guarantee replicated anywhere else. You will not get Ward 17 replicated anywhere else. Why? Because when you stick it over at Glenside in a flash new building—it is not quite a flash new building, but was going to be; now it is part of the intermediate care facilities there. What you were promised is not what you are getting, anyway.

I would say that the vast majority of those patients who go into Ward 17 have comorbidities. What are you going to do? Get the 'ambus' and run them across to the Royal Adelaide? Run them down to Flinders? What are you going to do with them? You need to have a better thought-out plan. This plan, Transforming Health, is transforming in a direction that nobody other than the tamed doctors want. I do not know why these doctors are betraying their principles, but also their patients and their practices. They are betraying them because they must know.

Even the latest import, the Canadian lady who has just come in—and I have not met her, but she is probably well intentioned—is misinformed. They are not transforming health in South Australia into where it should be, and where it needs to be. The current minister is the third Minister for Health we have had in this state. The first minister was a teacher who was well intentioned. We had the reviews of the health department then: the Menadue report. The government ignored that. Under minister Hill, we had review after review.

All of a sudden we had this thought bubble; the most expensive thought bubble in the world. The hospital down the road—the most expensive hospital in the world, the third-most expensive building in the word—the black hole of all black holes of health funding was being built down the road. What will be the consequences of that decision; that thought bubble? The victims are going to be right across South Australia. They are going to be the veterans, they are going to be the women, the men and children of South Australia. All of them will suffer the consequences of that ill thought-out decision.

The bit that galls me most of all is the sacrifice that has been made by our veterans, and they are being sacrificed on the temple of Transforming Health. It is just so wrong. This is where the minister has to man up. He has to go and tell the Minister for Health to do exactly what the AMA wants, what the doctors want, what SASMOA wants, and what South Australians want. They want a health service like minister Hill described. The minister said here in October 2011:

The people of South Australia expect me to deliver the very best public health service I can.

That is what minister Hill said. He also said that the buck stops with him. That is what he said in this place; it is in the Hansard. This minister—the third minister—needs to understand that that is his responsibility. He needs to stop. He needs to listen. He needs to think about where South Australia is going to be, because this is not a short-term solution for a long-term problem. What we are putting in place is a very ill thought out long-term solution for a very long-term problem, because if we continue down this path we are all going to pay.

This is where it is beholden on the Minister for Veterans' Affairs and certainly the member for Frome, the Minister for Regional Development. Both of those people should be influential people on that side. They are not listening to the veterans who slept out the front for 100 days or to the 120,000 people who signed the petition. They are simply not listening, and this is where it is up to these two crucial members of the cabinet to say to the Premier, to the Treasurer and to the Minister for Health, 'Stop. We do need to listen. We do need to rethink.'

We will not think any less of you. There will be a bit of flak, sure, but you are not in here for your own ego, you are not in here for your own benefit, you are here to do the very best to deliver long-term solutions for the people of South Australia. If this minister, the Minister for Veterans' Affairs, and the member for Frome, the Minister for Regional Development, do not do that, they do it at their peril. They do it at their severe political peril.

What I need to emphasise is that this is not just about the veterans at the Repat; this is about all South Australians and a 250-acute bed hospital. We know—and I will put it on the record—that a lot of the veterans have the gold card and use private hospitals. Good on them. The DVA helps out with federal funding. But do not sacrifice the whole hospital system because of your mismanagement. You are building a Taj Mahal down the end of North Terrace, and I just hope beyond hope that it actually works because that is going to be the next state bank for South Australia.

Everybody on the government side should remember what this is all about. It is not about us in this place. It is about the people who are walking up and down North Terrace now and the people who are lying in the beds in the Repat now. It is about the people in Daw House right now. It is about the people in the motor neurone disease clinic right now. It is about them. It is about each and every one of them. I am not saying abandon it and throw it all out the window, but stop, think about it and make sure you are getting the results we all want and need.

Mr ODENWALDER: I move:

That the debate be adjourned.

The house divided on the motion:

Ayes 23

Noes 19

Majority 4

Motion thus carried; debate adjourned.

The SPEAKER: The member for Chaffey, a force for good order at this time of the day.