Motions

Repatriation General Hospital

Mr DULUK (Davenport) (11:32): I move:

That this house—

(a) recognises the extraordinary care provided to veterans and other South Australians by the Repatriation General Hospital at Daw Park over the past 75 years;

(b) notes the Labor government's promise to 'never, ever close the Repat';

(c) condemns the Weatherill Labor government for its plan to break its promise and close the hospital; and

(d) calls on the government to renew the Repatriation General Hospital as a health and medical precinct for veterans and residents of the southern suburbs.

To begin:

'The Repat', as it is affectionately known, remains a vital community asset and a valued symbol of past achievement.

Let me just say that again:

'The Repat', as it is affectionately known, remains a vital community asset and a valued symbol of past achievement.

They are not my own words, although they are words I do agree with. They are not the words of the Save the Repat Alliance or Professor Warren Jones, although I am sure they would also agree with that statement. They are not the words of more than 120,000 South Australian residents who have signed the petition opposing the closure of the Repat. These words are in fact posted on the state government's own SA Health website. Let me repeat:

'The Repat', as it is affectionately known, remains a vital community asset and a valued symbol of past achievement.

Never has a truer word been spoken. Let us be clear: the Weatherill Labor government itself acknowledges the uniqueness, symbolism and value of the Repatriation General Hospital to our state, yet despite this acknowledgement it continues to ignore the wishes of South Australians, ignore the wishes of southern Adelaide residents and ignore the wishes of healthcare professionals. Instead, the government is intent on ripping out the heart of the Southern Adelaide Local Health Network and continuing its plan to close the Repat. The SA Health website also notes, and I quote:

For more than seventy years the Repatriation General Hospital at Daw Park has delivered a very special kind of care to South Australian veterans and war widows.

It certainly has a very special place. Thousands upon thousands of South Australians from all walks of life are grateful for the treatment they have received at the Repat, including my own dad, who spent seven weeks in the Repat in the early 1970s as a young Army cadet. I am constantly reminded of the importance of the Repat to southern Adelaide residents, whether it is by phone calls, emails or letters to my office, or a street-corner meeting and at public events. I hear stories of the very special care the Repat has provided personally to a loved one or to a friend.

The clear message is that there is something incredibly special about the Repat, the people, the camaraderie and its culture. Its character and uniqueness are the sum of these parts, something that simply cannot be replicated anywhere else. As you break apart the Repat, moving each piece, shifting hospital wards to other facilities, carving out key clinical services and redistributing staff across the statewide hospital network, the removal of each piece will slowly erode the Repat's identity and, sadly, destroy the essence of what makes the Repat so special.

A letter was published in the compliments corner of the Southern Health News December 2016 edition. The author wanted to thank Ward 5 staff at the Repat for the wonderful care they provided to her father, her thanks extending not just to the medical staff but to the administrators and cleaners of the hospital as well, all of whom had demonstrated, to quote from that letter, 'empathy, respect and dignity', as well as a 'friendly attitude'.

Again, the Principal Community Visitor Annual Report, Mental Health Services 2015-16, noted that Ward 18 at the Repat 'was identified to have a model of best practice in place' in relation to treatment and care plans and that Ward 18 'demonstrated the ability to go above and beyond'. It should be noted that it was the only ward in South Australia to be singled out for praise by the Principal Community Visitor Annual Report in this regard. The compliments, recognition and appreciation for the Repat are endless.

The Southern Adelaide Local Health Network provides care for around 350,000 living in the southern metropolitan area, including those in my own electorate, as well as providing a number of statewide services and services to those in key regional areas. The key pillars of the network responsible for providing services within SALHN are the Flinders Medical Centre, Noarlunga Hospital and of course the Repat.

Closing the Repat and removing an entire hospital from the network will destabilise the very foundation of the health network in southern Adelaide. The impact of this closure will be felt far beyond our veterans; it will affect every South Australian, especially those in Adelaide's south. As SA Health's own website says, the Repat is a vital community asset; it plays a critical role in our state's health system.

There are approximately 170,000 visitations to the Repat each year. Specialist services are provided in urology, vascular surgery, respiratory medicine, cardiology, ophthalmology, diabetes and rheumatology, just to name a few. Each year, there around 2,000 transfers from the Flinders Medical Centre for overflow and convalescent patients, and it also provides more than 200 beds for general medicine, surgery, palliative care, mental health and rehabilitation services.

Closing the Repat will have a significant and longstanding impact on our community. It will be felt for generations, especially amongst our current armed forces personnel, who are our future veterans. Once these beds are removed, once the services are lost, they will never be regained. The closure of the Repat and the broader changes underway as part of Transforming Health have generated deep-seated community concern. What began as a ripple has fast become a tidal wave, as the full implications of Transforming Health are felt across our hospital network by South Australians not only in metropolitan Adelaide but in our regional areas as well.

The mayor of Onkaparinga council, Lorraine Rosenberg, wrote to me recently to voice her community's 'grave concerns about the impact of Transforming Health on their future access to hospital services'. The fast-growing southern region of Adelaide is worried: they are worried about access to essential health services, they are worried about the closure of Noarlunga Hospital's 29-bed medical ward, they are worried about the closure of Noarlunga's private hospital and they are worried about the severe downgrade of the Noarlunga Hospital emergency department.

They should be worried because closing the Repat will put more pressure on existing services at the Flinders Medical Centre and at Noarlunga, and reducing services at Noarlunga will drive more patients to Flinders. It will be a fast-gathering snowball, a snowball that is heading directly for the Flinders Medical Centre. People down south will be travelling further for medical treatment, they will be waiting longer, the staff will be under enormous pressure to meet the daily demand and good luck trying to find a car park at the Flinders Medical Centre.

On Tuesday 28 March, the Noarlunga Hospital ED was overcapacity for 12 hours straight, six straight hours of which were in Code White, which means that all treatment areas are occupied. For this entire 12-hour period, the Flinders Medical Centre ED was also overcapacity and in Code White for 11 hours straight. Unfortunately, this is the norm rather than the exception. During the 12-hour period from 1pm on Monday 27 March until 1am on Tuesday 28 March, Noarlunga Hospital's ED was also overcapacity for 12 hours straight, eight of which were Code White. Again, for this entire 12-hour period the Flinders ED was also overcapacity and in a Code White status for nine hours straight.

Right now, we have a health system that is clearly not working. What is the capacity of the system going to be to cope with the closure of the Repat? The access blocking occurring in the emergency departments at Noarlunga Hospital and Flinders is symptomatic of a network that is not coping with current demand. Transforming Health is simply not working. If all things are bad now, how much worse will they be, as I said before, when the Repat closes? It is not just immediate patient care and services that will suffer.

Opportunities will be lost, opportunities to maximise health outcomes for residents of southern Adelaide, opportunities to continue to foster a strong government partnership with Flinders in respect to training and research, training that is critical to preparing our next generation of healthcare professionals, training that is critical to attracting and retaining students, and research that is essential to creating job opportunities that our state so desperately needs. At Flinders, there is an opportunity for hospital and university staff to work together to ensure that patients benefit from the latest developments in research. An overworked and under-resourced Flinders Medical Centre threatens to erode this incredibly valuable collaboration.

Deputy Speaker, as you are well aware, in 2010 then premier Mike Rann said, 'The Repat Hospital is here to stay. The Repat Hospital will never, ever be closed by a Labor government.' Former minister for health John Hill, and now ACH board member, was also clear in his statements at the time. He said, 'It's not something that's going to be done by the government.' Before the last election, the current Minister for Health, the Hon. Jack Snelling, was adamant when he 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.

Despite these repeated promises from the Labor government under current administrations and former administrations to never, ever close the Repat, the health minister confirmed earlier this month in question time that he 'expects to be off the Repat site before the end of the year'. Before the end of the year, the government is planning to close the Repat facility that it said repeatedly, as recently as 2010 and then again in 2014, that it would never, ever close.

On 19 February this year, I attended the commemoration of the 75^th anniversary of the bombing of Darwin held in the Repat chapel. While sitting in the chapel, I started to reflect on the Repat and what it means both to me and the community. The Repat means 75 years of outstanding service to our veterans, to southern Adelaide and to all South Australians. Yet, sadly, in a year of what should be celebration, we are instead left in shock and despair at the Weatherill Labor government's intent to break its promise and bring to an end 75 years of history and service by closing this much-loved and treasured community asset. It is absurd and we will rue the day that the government took this decision, an incredibly short-sighted decision.

After 75 years, the state Labor government considers the Repat too old and too tired to invest in, yet this is a government that has just committed more than half a billion dollars of your taxpayer money for a patch-up job on South Australia's fragile electricity system when it could have spent $24 million to keep Alinta open. That $24 million would have helped ensure base load supply, provided a more reliable energy market and saved South Australians from further increases in their electricity bills.

The proposed half a billion dollar spend on this so-called energy crisis, much of which is the fault of this current government, is twice what the government is spending on capital works under the entire Transforming Health regime that they are trying to implement. The government could have totally rebuilt the Repat for that amount of money and still had a very healthy pocket of change left over.

So, today, I call on the government to stop its plan to sell the Repat. It is not too late. The Repat has not yet been sold. A contract with ACH has not yet been finalised. There is still time for the Weatherill Labor government to make the right decision to commit to its original promise to never, ever close the Repat. I call on the government to instead renew the Repat.

There being a disturbance in the strangers' gallery:

The DEPUTY SPEAKER: Order! The member must be heard in silence.

Mr DULUK: I call on the Independent member for Florey and Labor cabinet ministers the member for Frome and the member for Waite to stand up for South Australia's health network and stand up for the residents of southern Adelaide, and I call on the Minister for Veterans' Affairs to stand up for his constituents and demand that the government put to an end the appalling decision to close the Repat and, instead, commit to renewing it.

The government does not know how it is going to integrate the Repat services into the broader hospital network. It still cannot say where it will be able to shift the Repat's outpatient services, sleep unit, orthopaedic services or radiology services to. It does not know where it will shift the services to without crippling other parts of the network, and it does not know how the transition will be completed. Unless these questions can be answered, at the very least the government should suspend its negotiations with ACH and halt its plans to sell the Repat. Finally, I would like to acknowledge the Save the Repat campaigners and Augustinus Krikke for all your hard work, commitment and dedication to saving the Repat. From this side of the house, we thank you very much for your support.

There being a disturbance in the strangers' gallery:

The DEPUTY SPEAKER: Order! Member for Elder.

Ms DIGANCE (Elder) (11:46): Firstly, can I acknowledge all those in the gallery who are here on behalf of Save the Repat. I feel pretty sure I have met most of you along the way, and I acknowledge you for your commitment and passion on this particular issue. I share your passion as well.

Members interjecting:

The DEPUTY SPEAKER: Order!

Mr Treloar: She is supposed to be talking to us.

The DEPUTY SPEAKER: I beg your pardon?

Mr Treloar: Isn't she speaking to the house?

The DEPUTY SPEAKER: If you have a point of order, you need to stand up and tell me what it is.

Ms DIGANCE: We on this side are not in agreeance with the motion the member for Davenport has put forward, and that will come as no surprise. In particular, we are not in support of this motion, given it is very hollow and fearmongering with little positive aspect or glimmer of hope presented in it. We do accept though the premise of recognition—

There being a disturbance in the strangers' gallery:

The DEPUTY SPEAKER: Order! Sit down. Each member of the house is entitled to the right to speak in silence. I ask the members of the gallery to observe the standing orders as well. If there is any further comment, I will have to ask you to leave, and I do not want that to happen, so can we please listen to the members in silence. Member for Elder.

Ms DIGANCE: Thank you, Deputy Speaker. We do acknowledge the premise of recognition put forward here, however, that the Repat General Hospital at Daw Park for the past 75 years has provided extraordinary care to veterans and other South Australians. I am sure all of us would have a story to tell in relation to the history of care and kindness that this institution has shown towards South Australians.

My grandfather, post World War II, spent time at the Repat, along with uncles, friends, family and peers and nursing professionals who are actually still there at the Repat. I have a long connection with and memories of the Repat, so I, too, have sadness along with all of you. As the local member, I have spent time talking with you and fronting what have often been very angry, animated and, naturally enough, dismayed groups as we work through together the next chapters of health care in our state.

I think you would all agree that I have always been honest with you. I have always taken your views with the greatest respect. I have written letters to the minister on your behalf seeking answers and guidance. I understand that while as human beings we naturally gain comfort from things staying the same, we are of an intelligence that drives us to seek new and better ways through progress.

We see a flicker of agreeance in the member for Davenport's call to renew the Repat General Hospital as a health and medical precinct for veterans and residents of the southern suburbs. This plan will commence its journey in late 2017 with the ACH Group taking the lead to redevelop and open up the site. As has been widely reported, the submission of the South Australian-based, not-for-profit ACH Group consortium, Open Daws, proposes to develop an integrated health and housing precinct with a focus on ageing and teaching. Open Daws will invest $200 million into the redevelopment of the site over the next seven years, to be completed in 2024, with:

a strong community focus through providing health and aged-care services, including transition care and day hospital services;

rehabilitation services such as ambulatory care and inpatient and outpatient rehabilitation;

facilities for education and training as well as an innovation hub;

residential accommodation for different community groups; and

a childcare facility. The master plan includes allied health services, residential aged care, affordable housing, medical imaging, pathology and pharmacy services.

There will be a strong veterans presence, including health and community services for veterans on site. The chapel and remembrance gardens will be enhanced, and the veteran community will be engaged in a co-creation process for the future of the site. The ACH Group has a long history of working with and for the veteran community, with the foundations of the organisation lying in the development of affordable housing for war widows.

I know that those opposite have arrested vision and limited ability to predict a dynamic future for South Australians. They may be surprised to know—

Members interjecting:

The DEPUTY SPEAKER: Order! Member for Chaffey.

Ms DIGANCE: —that in fact this plan is being welcomed and talked about in a positive light by many.

Mr Pengilly interjecting:

The DEPUTY SPEAKER: Member for Finniss, order! Stop. Member for Finniss, I believe you want to speak next.

Mr Pengilly: I do.

The DEPUTY SPEAKER: Well, you won't be if you keep shouting over the top of the member for Elder. Member for Elder.

Ms DIGANCE: Thank you, Deputy Speaker. The Repat was established in 1942 to care for veterans after the Second World War. I heard Mr Bill Denny recently reference this as he addressed a memorial service at the Repat chapel I attended, commemorating the bombing of Darwin. He made the point that we must ensure that we maintain for the small number of those who remain from World War II the care that they have come to know, but that a new model of care is expected by those coming after them. What we heard that day was the acknowledgement that the delivery of health care has changed since 1942 and that it must change.

We know that only around one in five veterans who go to our public hospitals as inpatients go to the Repat and that veterans account for less than 10 per cent of the Repat's inpatients. We also know that the Repat is hard for some veterans to access, including those who live and work near the Edinburgh Defence Precinct in northern Adelaide. Historically, veterans have been understood to be older men who served during World War I and World War II or, more recently, Korea or Vietnam.

However, over the past 10 to 15 years a contemporary group of veterans has emerged. Not surprisingly, these younger veterans, who have been involved in peacekeeping activities or served in recent conflicts in the Middle East and who also include a higher proportion of women than in previous generations, have vastly different preferences and needs from those of our older veterans. These differences mean we have to rethink our traditional approach to providing health care for our veterans and their families, as well as the broader veteran community.

Upon discharge and transition to the civilian community, veterans are faced with an unfamiliar and complex health system. Veterans' health services and priorities must be accessible to all veterans, regardless of locality, and therefore beyond the grounds of the Repat. Every service currently provided to veterans and other users of the Repat will continue at different locations across metropolitan Adelaide—in many instances, in brand-new, state-of-the-art health infrastructure. No service is ceasing.

The state Labor government is investing more than $210 million at the Flinders Medical Centre, the Noarlunga Hospital and the Glenside health campus to build state-of-the-art, brand-new facilities as well as to improve and upgrade existing facilities. This significant investment will ensure these hospitals meet the future needs of people who live in the southern Adelaide area and, indeed, are able to cater for our patients who have previously gone to the Repat.

The upgrades included at Flinders will be a brand-new rehabilitation centre with 55 rehabilitation beds, new gyms and a hydrotherapy pool; a new 15-bed palliative care unit offering shared spaces and a large rooftop garden; more car parking, with a new 1,780-space multideck car park; a dedicated orthogeriatric service; and a new centre for the Older Persons Mental Health Service. While I know that some of the local constituents are sad that their hospital is closing, as am I, I know the interest is growing in the new and unfolding chapters of this precinct.

Flinders Medical Centre, with its upgrades and new additions, will give the care we all expect. To overcome the fear of parking, I have championed car parks for older and disabled patients as near to the entrances as possible, a concierge to assist their ease of passage around the hospital and one free car park per palliative care patient to assist in the stress of parking to visit someone in such need. Included in the plan is also the $12 million upgrade at Noarlunga Hospital, which will change it into an elective surgery centre for South Australia.

Significantly for our veterans, there will be a brand-new $15 million veterans' mental health precinct, named the Jamie Larcombe Centre, at the Glenside health campus. The new facility, which includes a post-traumatic stress disorder service, is being purpose built. It will have 24 single rooms with ensuites, outpatient rooms, a gymnasium, research spaces, gardens and areas for reflection, family-friendly spaces, including a children's playground, research spaces to advance veterans' mental health care, and car parking facilities.

The state-of-the-art facility, due for completion later this year, is named after Sapper Jamie Ronald Larcombe, who was born in Kingston, Kangaroo Island, and was deployed to Afghanistan in 2010. The name is a tribute to the service and sacrifice of Sapper Larcombe, who was killed in action on 19 February 2011. The service of all our veterans will be recognised in many ways throughout this precinct.

This project came to the Public Works Committee, which I chair, and received bipartisan support. On that day, we had present Save the Repat supporters—and I was grateful you were there—most of whom I had met previously. When I spoke to them post the plan having been presented at Public Works, they did agree that the plan looked to be appropriate and well designed and would be purpose built.

While I know change brings challenge, and fear for some, I look with hope and embrace the future of health care at the Repat site as it passes on to its next phase and continues to deliver health care and wellbeing services to South Australians. With that, I will say that we, on this side, oppose this motion.

An honourable member interjecting:

The DEPUTY SPEAKER: Order! Order!

Mr PENGILLY (Finniss) (11:56): I rise to support the member for Davenport's motion and I can scarcely believe what I am hearing from the other side of the chamber. The member for Florey has been a loud and vocal supporter of the Modbury Hospital for years and years and years.

The DEPUTY SPEAKER: Not that long.

Mr PENGILLY: You are interrupting me.

The DEPUTY SPEAKER: I'm sensitive about age.

Mr PENGILLY: The member for Florey has been slotted and the current Minister for Health, the one who has overseen this absolute debacle at the Repat, wants to be the next member for Florey, and then we have the member for Elder, who has just spoken, who has been slotted by the Labor Party. She is speaking on behalf of the government and putting up their weights on what they have done. I have never heard so much spin in all my born days.

This government is all about spin and not about substance. You have stuffed up the health system. You are stuffing up the Repat by closing it. You have stuffed up the power industry. You have water bills that nobody in South Australia can pay. You have power bills that no-one can pay. You have emergency services levies that you have ramped up, and that is only just the start of it. How you can come in here and try to defend the closure of the Repat is indefensible. You are a disgrace of a government.

I had a couple of comments noted that I was going to mention, but I do not think I will do that. It is not your hospital. It is not my hospital. It is no member of this house's hospital. It is no member of the other place's hospital. It is the veterans' hospital and it has been for a very long time. If you think this is going to go away, it is not. It is going to come back and bite the government severely because there is a group of people who have been out the front for months and months on end for extended periods—every Monday they are out there—and they are reminding South Australians what a disgraceful thing is happening to the Repat.

They do not want it to close. It is the veterans' hospital. It does not matter whether they are Second World War veterans who are still alive and in there or those currently serving overseas. It is their hospital. On that note, I am a personal friend of the Larcombe family on Kangaroo Island. I am very close to them and I knew Jamie. I know the girls really well. I am happy to have the facility named after Jamie, who was killed in Afghanistan, but I think it should not be used in this place. I do not think it is appropriate.

Going back to the loyal group of protesters who are out here every week, these are people, many of whom have served overseas or have family members who have, who are adamant that this facility is being closed when it should not be. It is just wrong. It is wrong, wrong, wrong. It was mentioned that it was about 1942 when it was first established. It does not matter whether it was 1942 or 1992, or whatever. The facilities inside and the medical care have been upgraded. It is a place they value and it is a place they know. A number of my constituents have served time in Ward 17 and that is where they feel comfortable. They do not want to go anywhere else, they want to stay there. That is their facility. That is how they see it.

The member for Davenport spoke with some clarity about this government saying that it would never, ever close the Repat. Well, hello, what is happening? You are closing it. You are making a complete mockery of your own government's decision to never, ever close it by going about it. All the spin in the world from Labor will not fix this debacle.

You can rest assured that not only this side of the house but those thousands of veterans out there will remind the people of South Australia, next March, just what they have done in relation to the Repat. They will not be allowed to forget what has happened. They will be given every opportunity to cast their votes on that, and a number of other issues, at the state election. All this government wants to do is to flog it off, flog off the land to try to fix up some of the financial disasters they have impinged on South Australia. They could not care less about people. They cannot even care about their own members, the member for Florey or the member for Elder. They have slotted them both. Where are you coming from?

I think the member for Davenport has said so much in his excellent contribution on his own motion that I do not think there is any real need for me to go over all of that again, and I do not intend to. I want to remind the house and remind the Weatherill Labor government of what they are doing and what they have done to South Australia, in this particular case, by closing the Repat. They have unleashed a firestorm on themselves electorally that will not be forgotten. I believe it is an absolute disgrace. With those few words, I will resume my seat.

Debate adjourned on motion of Mr Treloar.