Country Health Services

Mr WHETSTONE (Chaffey) (12:45): I move:

That this house—

(a) notes the importance of providing adequate health care and facilities in country South Australia;

(b) calls on the state government to address the $150 million backlog of maintenance and noncompliance issues in country hospitals across South Australia; and

(c) condemns the state government for failing to provide funding to correct compliance issues at the Loxton and Waikerie hospitals, instead leaving it to health advisory councils to fund.

I put forward this motion after I received correspondence from the Waikerie hospital's HAC that the operating theatre was facing closure. It was brought to my attention by the local health advisory council that several significant issues relating to occupational health and safety had been identified. This is a hospital run by Country Health SA, so you would assume that any noncompliance issues in an ageing hospital would be addressed by the state government. These issues included an air conditioner no longer working in the operating theatre and noncompliant doors. The cost of repairs and compliance was around $140,000. I was further advised that Country Health SA would not pay for these upgrades and that the budget was not large enough to cover these issues.

The South Australian government's priority that Country Health could not shell out $140,000 to keep an operating theatre open and workable is an absolute disgrace. The scenario the community faced meant that the Waikerie hospital's operating theatre would have to close in any circumstances where the air conditioner would normally be turned on to provide ventilation. Essentially, this would have left the hospital without minor surgery and no operation of the birthing suite over summer, including for emergency caesarean births.

After repeated requests to the state government to fund noncompliance repairs, the HAC decided it had no other choice but to use community-raised funds to fix the issues. Luckily for the state government, a crisis was avoided. This raised an even greater question: given the $150 million backlog of maintenance and noncompliance issues in country hospitals across South Australia, how many HACs are being given no choice but to fund their own maintenance and compliance issues? The most recently tabled annual reports for the HAC in my electorate also showed further examples of what appear to be funds raised by the community used for basic fixes.

I note that the Loxton and Districts Health Advisory Council used money raised and donated by the community to upgrade bathrooms in the west wing of the Loxton Hospital to ensure that they have disability access as well as a new call-bell system. To me, providing disability access to the hospital toilet is a vital service, and the call-bell system should fall under the responsibility of the state government. However, it was good to see that these hospitals have been proactive in getting upgrade and compliance issues addressed and using local tradespeople.

Likewise, concerns were raised by the Renmark Paringa District HAC. At the time of the annual report being written, the HAC was still waiting for a response from the Minister for Health about a letter it sent out outlining concerns about acute services at the Renmark hospital. The letter, supported by the Flinders University rural clinical school and the GPs at the Renmark Medical Clinic raised serious issues. The importance of having adequate health care and facilities in country South Australia should not be understated.

Too often, we see a city-centric focus. We are spending billions of dollars on new metropolitan hospitals, priority projects to the city-centric government. I am sure that the new Royal Adelaide Hospital will be state-of-the-art, but in the overall scheme of health budgets, how can a state government not find a measly $140,000 to keep an operating theatre open in Waikerie and potentially save lives? The closest hospital to Waikerie residents is a good 40 minutes away in either Berri or Loxton. The question I ask is: what value does the current government put on life? What value is there on a life in regional South Australia as opposed to a life in metropolitan South Australia? Interestingly, the government's South Australia's Health Care Plan states:

If you need to have elective surgery, you'll want to do so as soon as possible, and as close to home as possible…You may no longer have to travel long distances.

I note an opinion piece in today's Advertiser by Janice Fletcher, President of the AMA in South Australia, which starts with, 'Country doctors have had enough.' It reads:

The feeling outside of metropolitan Adelaide is of relentless and mindless cost-saving to finance the new RAH.

Dr Fletcher goes on:

We hear a distinct lack of trust in the government, firstly to have the will to step up on country issues and, secondly, to deliver.

Even when concerns may be groundless, the government simply is not believed. What we have seen for too long is a piecemeal approach that leaves regional communities and local doctors in doubt and fear about their future. Adequate funding is of course the other big part of this picture, and that is up to the Premier and the Treasury.

Constant budget reductions can only be met by service cuts, and the community suffers. Whether it is Yorketown, Quorn, Port Augusta, Mount Gambier or the Riverland, health care in all these areas has had major issues. Some of the most isolated and disadvantaged people live in regional and rural South Australia and they need adequate health care.

A Marshall Liberal team recently released welcome health policy, which recognised the need for local communities to have stronger input into local health services' decision making, and Country Health SA has said to the HACs that there is $150 million worth of noncompliance issues in country hospitals here in South Australia, yet the government allocated $15 million towards those issues in the last financial year.

While the $36 million upgrade to the Riverland General Hospital has been welcomed, there is continued community concern that the services at other hospitals in the region will be centralised. Reducing the need for patients to travel to Adelaide for specialist care is another area that requires ongoing improvement in the regions. While I acknowledge that more specialist care, such as chemotherapy, is now available, in many cases the demand well outstrips the number of treatment places that are available.

A large number of community groups have raised money towards the approximately $26,000  needed for the four chemotherapy chairs after they were informed of a shortfall. It is disappointing that $5 million was cut from the budget at the Riverland regional hospital and the government was then relying on the goodwill of Riverland people to raise enough money to purchase the chair. In 2015, the health advisory councils under the Weatherill government placed restrictions on the HACs to access millions of hard-earned dollars for local hospital maintenance and upgrades, fundraised by local communities in their goodwill gesture.

Local HACs were being told that only new money raised in the 2012-13 financial year could be spent, and previous money would remain in the Labor government's coffers. That was an absolute disgrace. These country hospitals are supported by their communities—fundraised by their communities, supported, bequeathed by their local communities—yet we have this arrogant state government that continues to say, 'We'll hold the money and you can raise more money.'

Dedicated and passionate volunteers on health advisory councils commit extensive time and effort raising money for their local hospitals, but the Weatherill Labor government took control of community-raised money and funds bequeathed to all those hospitals. Communities were angry that the government was dictating to country hospitals how they can spend their own money. The hospital auxiliary funds holding money raised by community must not be used as part of the health budget, and any restrictions on accessing this money should be removed. Local determination of the allocation of funds, especially those which have been locally raised, ensures money is spent in the area, spent on local tradespeople, and is in direct need of the greatest impact to services.

I note that many concerns have been raised in the past regarding the shortage of health professionals, such as nurses and front-line services in our hospitals; the need for more specialists visiting regional hospitals, particularly in the Riverland and Mallee; the lack of community and Aboriginal health services; and the lack of mental health services. These are all services that are taken for granted in metropolitan hospitals in South Australia, yet we see regional hospitals being denied these services that are critical for the continuation of our communities.

Emergency care in the Riverland—in particular, accident and emergency care—is undertaken by River Doc's ED. This is a fantastic organisation, but it is a private provider, so there is a fee, whereas across metropolitan South Australia the government provides accident and emergency free of charge. People in South Australia need to understand that we have a city-centric government that does not give any priority to regional healthcare services, particularly after-hours care.

In conclusion, I think it is extremely important to continually discuss the shortfalls in Country Health. It is abundantly clear where this government's priorities lie. Every South Australian deserves adequate health care and this is something that should never be forgotten.

Mr HUGHES (Giles) (12:55): I move to amend the motion:

By deleting all words in (b) and (c) and inserting the following words in lieu thereof:

(b) notes that the state government, through Country Health South Australia, is working with health advisory councils to address and prioritise maintenance and noncompliance issues in country hospitals across South Australia; and

(c) extends its appreciation to all country health advisory councils for their dedication to supporting health care in regional South Australia.

I think one of the incredibly important roles of any member of parliament is to effectively represent their community, so bringing to the parliament the legitimate concerns of the constituents and the services in their community is important. The health system is an incredibly complex system. Health is by far the largest budget item for the state government. I think the allocation in the last budget was $5.8 billion for 2016-17.

The argument has been used that there have been cutbacks in country South Australia to the health budget, but the facts are somewhat different. Recurrent funding has actually increased. There is always going to be a race between the increase in recurrent funding and the resources needed to meet those needs. Recurrent funding for Country Health back in 2013-14 was $769 million. In the most recent budget, that was increased to $819 million for recurrent expenditure in regional South Australia.

Capital funding over recent years has also been very significant in country South Australia. We have seen an expenditure in regional South Australia of $213 million over the last six years. It has been acknowledged that there has been additional investment in regional South Australia. We should not lose sight of that because in many centres it has led to a very significant improvement in services, not least in Whyalla but also in a number of other major regional centres plus some of the smaller centres.

The member for Chaffey did refer to the expenditure in Berri, which was welcomed, where the state government spent $36 million. In Whyalla, the state government invested $15 million, which was part of a $70 million upgrade. It was thanks to the former federal Labor government that an upgrade of that significance happened. It is worth reflecting that a number of those major upgrades in regional South Australia were all consistently opposed by the Liberal opposition in Canberra. If they had got their way, Whyalla would not have had the $70 million investment.

In Port Lincoln, there was a $12.2 million investment on the part of the state government and a $40.5 million investment on the part of the then Labor government. I seek leave to continue my remarks.

Leave granted; debate adjourned.

Sitting suspended from 13:00 to 14:00.