Public Works Committee: Modbury Hospital Transforming Health Project

Adjourned debate on motion of Ms Digance:

That the 530^th report of the committee, entitled Modbury Hospital Transforming Health Project, be noted.

(Continued from 10 May 2017.)

Mr GARDNER (Morialta) (11:44): It is with some interest that I rise to speak about the Public Works Committee's 530^th report on the Modbury Hospital Transforming Health Project because just this week we discovered that some of the money that the government is spending on its Transforming Health plan has been spent on plastic wraps around TheLeader Messenger newspapers going to households in north-eastern suburbs identifying that money is being invested in Modbury Hospital and presumably paid for out of taxpayer funds as part of the Transforming Health proposal.

This is wrap that covers the whole newspaper, with a purple background and white writing in big, 50-point font, saying that money has been invested in Modbury Hospital to provide care close to home. It goes on, on the other side, with white background and big purple writing, to say that there will be a new rehabilitation centre and more rehabilitation beds, and to find out more people are directed to the Transforming Health website.

I know that the State Theatre Company currently has 1984 playing, but the doublespeak in the state government's Transforming Health plan would put George Orwell to shame. It is an extraordinary example of spin. As services, particularly to emergency care and emergency surgery at Modbury Hospital, are being emaciated by this government, they are trying to spend taxpayers' money in the north-eastern suburbs, telling the same taxpayers that this is all being done in their best interests, all being done to help them, that it is not an example of this Labor government fundamentally betraying the people who have supported their local members and candidates, often on promises of protecting Modbury Hospital.

Of course the architect of all this is none other than the health minister himself, one of those same candidates who has been the beneficiary of Labor Party campaigns to save Modbury Hospital in the past. He is now the one ripping its heart out. It is extraordinary. Not only that, they take the member for Florey—who has, from time to time, demonstrated a little bit of credibility in this area—and they give her preselection to that very same health minister who is ripping the heart out of Modbury Hospital. The Labor Party now wants us to believe that the people of Florey are going to accept him as their champion. It is nothing less than extraordinary.

There is even more, Deputy Speaker. I am sure you will be shocked to hear that one of the groups that expresses interest in these matters from time to time is involved in local government. I know there are champions for Modbury Hospital who have been involved in local government before, and we will be very interested to see what happens in the near future. There is a new member in the other place—some people may have met Mr Justin Hanson, who has recently been elevated to the Legislative Council—and his departure from the Tea Tree Gully council has caused a by-election.

I note that in the last week there have been a number of nominations: Dylan Brown, Jody Mayfield, Wayne Smith, Sonia Blackwell, Kathryn Nicholls, Robyn Dowley, Mary Kasperski, Peter Panagaris and James Ellery. These are candidates for Balmoral Ward in the Tea Tree Gully council, and they are going to have a very critical role in expressing community sentiment regarding the Tea Tree Gully council's position on Modbury Hospital and the state government's emaciation of Modbury Hospital.

The DEPUTY SPEAKER: Member for Morialta, we do need to get back to the actual hospital.

Mr GARDNER: I will get back to that right now. What the Public Works Committee report shows, if one reads it in detail, is the services that will be lost at the same time as the government is putting elements into rehabilitation, which the Public Works Committee particularly identifies. However, you cannot understand the impact of the things identified by the Public Works Committee unless you also identify what is being lost. You are replacing one thing with another, and what the community has come to expect, and of course what Tea Tree Gully council has come to expect, is that there is going to be emergency surgery available at Modbury Hospital as well as the range of services that that community has come to expect.

One of the candidates at this by-election has a particular insight into what has been happening, because she works for Jack Snelling, the Minister for Health. Mary Kasperski, as identified by the health minister when he stepped down as Speaker, has been an invaluable member of his office—

Ms DIGANCE: Point of order, relevance. We need relevance.

The DEPUTY SPEAKER: We do need to go back to the actual Transforming Health project.

Mr GARDNER: Thank you for your wise guidance, Deputy Speaker, and, of course, your benevolence to the government side despite what they have done to you. I think it is very generous-spirited of you. When considering the Public Work Committee's consideration of the Transforming Health proposals for Modbury Hospital—transforming from health to a lack of emergency surgery, as I personally think of it—the point I make is that we need to have community advocates who are also going to be reading this Public Works Committee response.

We want everybody to read the Public Works Committee's consideration of this matter so that they too can understand that the government's proposals for Transforming Health are going to have an extraordinarily poor impact—and already have been having an extraordinarily poor impact—on the health of people in the north-eastern suburbs as a result of what this government is doing to Modbury Hospital. Those same residents have an opportunity in the coming month to have their say on who is going to represent them on the Tea Tree Gully council, and they have the opportunity to support someone who is working for the health minister who is emaciating their hospital, or someone who stands for others. I hope that they will take this opportunity and vote accordingly.

Mr TRELOAR (Flinders) (11:50): I rise today to make a contribution on this report. Modbury Hospital is a 174-bed acute care teaching hospital that provides inpatient, outpatient and emergency services to a population of almost 200,000 people living primarily in Adelaide's north-eastern suburbs. However, much of that is about to change as part of the Transforming Health announcements made by this government. Premier Weatherill and minister Jack Snelling have confirmed that the emergency departments of the Modbury, Queen Elizabeth and Noarlunga hospitals will be cut.

The emergency departments in these hospitals are already stretched to the brink and are not in a position to absorb the significant cuts. Under these reforms, patients will wait longer and travel farther for medical care. Good health care is about proximity and availability. Unfortunately, the government has not listened to the community in regard to this and has shown complete disregard for the growing number of people who do not support these cuts. Over 60,000 people have signed petitions across the state.

Under Transforming Health, Modbury will no longer be a general community hospital: it will be a centre for rehabilitation, day surgery and outpatients. Life-threatening emergencies will be diverted away from Modbury or stabilised and then transferred. Under the new plan, no ICU or HDU backup will be available on site. There will be no emergency surgery, and there will be no 24-hour on-site anaesthetic service and no theatre team present on site. There will be no acute surgical wards. Modbury will have lost two-thirds of its medical beds—now only short stay—and there will be no cardiology admissions. We all know how risky that will be.

In the lead-up to the 2014 election, the Labor government promised to spend $46 million to upgrade Modbury Hospital. This budget has since been cut by $14 million. Before that same election, a redeveloped the Modbury emergency department opened with 40 treatment and assessment bays. Only 29 of those bays are operating now. You can see a theme coming through here. Modbury emergency department no longer deals with life-threatening cases that could involve hospital admission, and they are simply shipped on. Lyell McEwin, the neighbouring hospital, is so overcrowded that it was subject to a safety notice in late 2016. At the moment, it frequently diverts patients to Modbury.

The dedicated ambulance shuttle from Modbury to Lyell McEwin stopped operating earlier this year, only a couple of months ago. The number of patients who attended Modbury emergency department has not changed significantly and, in fact, the cases seen by the emergency department are more complex, not less. South Australian Health wants the inpatient medical emergency team to be dropped and emergency department staff to take on the hospital emergency callout role. It is dangerous to plan for senior ED staff to leave their patients in an emergency department and be busy for hours in a separate building—simply untenable.

Modbury no longer has a comprehensive medical and surgical service. Modbury surgery focuses on day surgery involving up to 23-hour hospitalisation, and this is only about one-third of Modbury's previous load. Without critical backup for both treatment and diagnosis, emergency cases will have to be diverted to other hospitals. Older patients and other complex cases are more likely to have care scheduled at another hospital. The emergency department is having trouble, or so we hear, recruiting staff and covering overnight shifts, and there has been a loss of ability to teach and train medical students, specialists and trainee nurses at Modbury.

The future viability of Modbury Hospital is threatened. The government has toyed with the idea of closing Modbury Hospital. In June 2014, The Advertiser reported that, while upgrades in three other hospitals had also been suspended, Modbury appeared to be the most likely candidate for closure if the government decided on a big-ticket action to cover the gap. A report conducted for the state government by management consulting firm McKinsey and Company has considered the decommissioning of Modbury Hospital.

All this, as I said earlier, concerns a key medical facility which services 200,000 people in the growing north-eastern suburbs of Adelaide. My contribution so far has been quite specifically about Modbury, but in fact there is a bigger issue at stake, and it relates to health funding in general. I have a theory about all this. My theory is that the new Royal Adelaide Hospital, as wonderful as it will be, has become a black hole. It has become a vortex for funds, and it will burden the state for many years to come.

Members interjecting:

The DEPUTY SPEAKER: Order! There is too much conversation on my right.

Mr TRELOAR: The current cost is estimated to be around $2.3 billion. There is no doubt that that will blow out further. We have a patient record system that is costing around $430 million and is not actually operational.

Mr Pederick: It doesn't work.

Mr TRELOAR: It doesn't work, as the member for Hammond quite rightly said. This new facility, this new hospital, as majestic as it appears from the outside, has become a black hole for health funding, and it is a burden on the state government and will be for a long time. My theory extends further than that. Before coming in here, as many in this place will know, I was a grain farmer. Every grain farmer knows that 'you haven't got it until it's in the bag'. That is an analogy, and what it is saying is that the harvest is not complete, and the money does not arrive, until you have actually bagged the grain and sold it.

In December 2011, when I was a relatively new member of parliament, we were brought back to this place to debate the Olympic Dam indenture bill, which was going to facilitate the open pit expansion at Olympic Dam. Everyone was very excited about this, and rightly so; the opportunities would be boundless. Unfortunately, that expansion did not go ahead and probably will not go ahead now. I have to say that it seems to me that the state Labor government almost immediately started spending the money. There was an expectation that the royalties would roll in. There were a few other mining proposals floating around at that same time. Most of them seem to have fallen by the wayside.

In fact, the royalty flow did not eventuate and the government was caught with significant outgoings, projects that they had committed to. There was a desal plant at a cost of over $2 billion. Again, that is a lot of money—$2.2 billion for a desal plant we are not actually using. The Adelaide Oval, as lovely as it is, suffered significant blowouts in cost, exceeding $535 million. The O-Bahn project will cost $160 million. If ever there has been a case of pork-barrelling, that is it: a project to secure the north-eastern suburbs, the same suburbs that are serviced by Modbury Hospital. What they are taking away with one hand, they are giving with the other.

In other words, the government have overspent. As a result, we are seeing significant cuts not just to Modbury but to other health services and infrastructure around the state. We have talked about Modbury. The proposed cuts to services at Yorketown's general hospital have been in the news lately. I have spoken earlier in this place, just last week, about the Ceduna Koonibba health building. It is in the township of Ceduna, adjacent to the hospital. The building is in a diabolical state. The roof leaks, there are termites in the floors, the mice are getting in and there are shovels outside the door to kill the snakes. This is in a major regional centre. Where is the money to upgrade the building to at least a habitable state? It is about managing the health budget and the state's finances.

Mr ODENWALDER: Point of order: I think we may have strayed a little bit from the topic of Modbury Hospital.

The DEPUTY SPEAKER: I am going to start listening very closely to you—

Members interjecting:

The DEPUTY SPEAKER: Order! Do I have to stand up?

Mr Pederick interjecting:

The DEPUTY SPEAKER: Don't make me stand up, member for Hammond. Termites in a school somewhere else are not really connected to Modbury Hospital.

Mr TRELOAR: Deputy Speaker, the termites are in a health building.

The DEPUTY SPEAKER: They are not in Modbury Hospital, as far as I know. They are in my house in Modbury, but they are not in Modbury Hospital.

Mr TRELOAR: What I was attempting to do, Deputy Speaker, in my contribution—

The DEPUTY SPEAKER: You are going to come right back, I know. You are coming right back to the topic.

Mr TRELOAR: —was link the situation at Modbury with general health funding.

The DEPUTY SPEAKER: No, you can't actually do that, can you?

Mr TRELOAR: Well, I don't know.

The DEPUTY SPEAKER: Off you go; you only have another 40 seconds.

Mr TRELOAR: I will be quick then. In essence, we have been talking about Modbury, as have I, but it is about managing the state's entire health budget and the state's finances. Unfortunately, the state Labor government has proved itself incompetent once again. I will finish by saying that good health service is about proximity and it is about availability. Unfortunately, the people in the north-eastern suburbs will be failed by this government.

Debate adjourned on motion of Hon T.R. Kenyon.