House of Assembly: Thursday, September 28, 2017

Contents

Regional Health Services

Mr TRELOAR (Flinders) (15:35): This week, in this place we have been debating the inquiry into regional health services, which was referred to the Social Development Committee as a result of a number of concerns raised following the implementation of the Health Care Act, the subsequent dismantling of hospital boards and the restructuring of the health system. The inquiry was guided by principles which underpin the state's universal healthcare system and which provide that all South Australians shall have equitable access to appropriate health care. The governance framework of such a system should ensure that some people are not left behind merely because of where they live relative to a city or regional centre.

The committee acknowledged and commended the many individuals, groups and organisations who work tirelessly in both paid and unpaid positions for the benefit of their communities and country health services. From the organisation of fundraising events to raise money for new medical equipment, to volunteers and the South Australian Ambulance Service, to providing local tradespeople with employment, the numerous examples in the evidence are reflective of the spirit of country people and the investment they make in their health service resources.

Consistent with the image of country people as resilient, resourceful and generous, the large volume of evidence brought before the committee showed the unique and committed relationships many country towns have with their health services. Many of the submissions were received by the newly formed health advisory committees (HACs), and of particular concern to many of the HACs who gave evidence was the lack of financial information being provided by Country Health South Australia.

The issue was raised that there were operations in which the HACs could potentially have a meaningful role, such as service planning, but were not able to contribute due to limited input into hospital budget planning. HACs reported that they had little control over the use of funds they were able to raise. Evidence indicated a general lack of confidence that the goods and services that HACs intended to use fundraising moneys for were in fact used for that purpose. In the 2017-18 state budget, the $1.1 billion health spend by the state government did not allocate a single dollar for capital investment in country hospitals or health services.

If elected in March 2018, a Marshall Liberal government will fix the backlog in country capital works by ensuring that all money raised in local communities is spent in those communities. It will act with urgency to address high-risk repairs and maintenance in country hospitals. We will implement a country capital works renewal strategy to address the maintenance backlog and plan positively for future development. We will develop arrangements to retain part of the private patient income in local hospitals for the benefit of local services.

Health advisory councils will be empowered to control their trust funds. This will ensure that locally generated funds meet local needs, protecting private donations and enabling local management of bequests. A Liberal government will also respect the valuable role of community-raised and generated funds and allow them to resource buildings, equipment and research in regional areas. This is what country people are crying out for. They have been so involved in the building, development and provision of country health services in their townships, and they feel that the government has walked away from them.

One of the recommendations, 12(b), includes Trends in Local Community Fundraising for Medical Equipment and Services and how funds currently and previously raised by local communities are held and spent with regard to authorisation on decision-making. Of course, the other recommendation is for a change of policy to the timing of provision of finalised operational budgets in country hospitals.

It would be remiss of me to talk about country health without talking about the Patient Assisted Transport Scheme. After 7½ years in this place, it is still the number one issue that I and my office are dealing with. A review was undertaken a couple of years ago; some of the recommended changes were made and implemented, but the scheme as a whole is falling a long way short of providing what it should for country people—the opportunity to travel safely and affordably to seek professional help in a faraway place. Unfortunately, bureaucrats appear to be overriding the directives of a GP, and it is a sad situation when that can occur.