Motions

SA Pathology and SA Medical Imaging

Mr PICTON (Kaurna) (11:30): I move:

That this house—

(a) notes the vitally important work of SA Pathology and SA Medical Imaging in public hospitals across the state in saving the lives of countless South Australians;

(b) condemns the state government for its savage cuts to SA Pathology and SA Medical Imaging in the 2018 budget;

(c) condemns the state government for its move towards the privatisation of SA Pathology and SA Medical Imaging;

(d) expresses grave concerns that the privatisation of these vital services could mean fewer labs, fewer clinicians and longer processing times—potentially leading to life-threatening delays for patients; and

(e) calls on the government to immediately reverse these cruel cuts to SA Pathology and SA Medical Imaging and to rule out the privatisation of these services.

Pathology services are integral to our health system as a whole, particularly for our public health system. They are used in more than 70 per cent of medical treatment plans. Most visits to a doctor, most visits to hospital, will involve pathology samples being taken, and SA Pathology is a vital element of that.

SA Pathology does the most complex work in South Australia. They undertake the bulk of the complex pathology tests. Private providers do not have the capacity to perform complex tests, as generally this is the type of work that does not turn a profit, so they rely on sending their complex work to SA Pathology or interstate to be done. They do not have the capacity to do it themselves.

SA Pathology are the people we turn to when there are public emergencies, when there are outbreaks. Only SA Pathology have the plans in place, the capacity and the testing capability to be able to respond to emergencies such as disease outbreaks, the identification of potentially dangerous unknown substances like white powder, as well as many food outbreaks that happen in this state. For example, only a few weeks ago we saw outbreaks in regard to some of our bakeries, and they were quickly identified thanks to the work of SA Pathology, the public pathology provider.

SA Pathology provides a vast amount of training in this area in South Australia. They train the people who work as pathologists and scientists. They are the ones who do that. The private sector relies on SA Pathology to train the next generation of staff. They do a vast majority of the research. If you look at the work being undertaken at SAHMRI, the work being undertaken throughout our hospitals and universities on developing the next big advances in medical science is being done by SA Pathology with those expert pathologists and medical scientists. It is not being done by the private sector. It is being done by SA Pathology.

If you look at regional South Australia—and this is something the member for Stuart and the member for Chaffey have been on the public record about—SA Pathology is relied upon in regional South Australia to make sure that we have those tests available when and where people need them across the entire breadth of this state.

So, if you look at all those reasons why SA Pathology is so important, what is the government's response? Months after coming into office, in their first state budget, their response has been to slash SA Pathology, with $105 million worth of cuts, brought in the Marshall government's first budget, directed at SA Pathology, directed at cutting these services that South Australians rely on. There was no mention of this before the election, no mention that they would be bringing in these cuts beforehand, and what happened?

The Hon. S.S. Marshall interjecting:

Mr PICTON: And you said you wouldn't do anything.

The SPEAKER: Order!

Mr PICTON: The Premier says there was a report previously.

The Hon. S.S. Marshall interjecting:

The SPEAKER: Order!

Mr PICTON: The Premier condemned the report.

Members interjecting:

The SPEAKER: Order, members on my right!

Mr PICTON: The Premier condemned that report. His then shadow minister—

Members interjecting:

The SPEAKER: Do not provoke the member for Kaurna.

Mr PICTON: —went out and said—

The SPEAKER: He doesn't need provocation.

Mr Cowdrey interjecting:

The SPEAKER: Member for Colton!

Mr PICTON: The Premier broke his promise to South Australia because the Premier's shadow minister, before the election, went out and said—

The Hon. S.S. Marshall interjecting:

The SPEAKER: Premier, please!

Mr PICTON: —that he would not be bringing in any changes like this without a lengthy consultation with clinicians. There was no mention of privatisation.

The Hon. S.S. Marshall interjecting:

Mr PICTON: You said you didn't have a privatisation agenda.

The Hon. S.S. Marshall interjecting:

The SPEAKER: Order!

Mr PICTON: You said you didn't have a privatisation agenda and now what we see in the budget in black and white is a privatisation agenda from this Premier for SA Pathology, and he laughs. He laughs at this issue, but this is not a laughing matter—

Members interjecting:

The SPEAKER: Order!

Mr PICTON: —for the people who rely on these services in South Australia. The Premier thinks that privatising SA Pathology is a laughing matter, but it is not a laughing matter. It is vitally important that SA Pathology stay in public hands. We on this side of the house will fight for that and you on that side of the house have brought this in in your first budget. They said, 'We are going to bring in $105 million worth of cuts to SA Pathology and, if they don't meet those cuts, we are going to privatise those services,' just like they privatised yesterday a high security prison, just like ETSA was privatised the last time they were in government, and now we are seeing these vital public health services—

The Hon. S.S. Marshall interjecting:

The SPEAKER: Order!

Mr PICTON: Again, we see the Premier saying that this is a laughing matter. He thinks it is a laughing matter to privatise SA Pathology.

Members interjecting:

The SPEAKER: Order!

Mr PICTON: Go to the people of South Australia. See what they think about privatising SA Pathology.

The Hon. S.S. Marshall: Is this a freak act? Is this over from the Fringe?

The SPEAKER: Premier!

Mr PICTON: The Premier is now sitting on a report from PwC—

Members interjecting:

The SPEAKER: Order!

Mr PICTON: —that he is refusing to release, outlining the ways in which he is going to cut $105 million from the work that SA Pathology does in our hospitals, in our communities.

Members interjecting:

The SPEAKER: Order, members on my right!

Mr PICTON: He should release that report. He should tell South Australians which services are going to be cut from SA Pathology. He should tell South Australians which clinics will be closing. He should tell South Australians which labs he is going to be closing. He should tell South Australians how much longer they are going to have to wait to get their samples done under the Marshall government. He should tell South Australians what the impact is going to be on South Australians in public hospitals and how much longer they are going to have to wait for their samples.

Under his leadership, we have already seen closures to clinics at Flinders Medical Centre; we have seen closures of immunology there. We have seen closures of a whole range of other important services at Flinders Medical Centre under his government. That is just a taste of what is going to come because within three months the first $25 million of cuts to SA Pathology will be about to hit. He might think it is a laughing matter, but these cuts are going to impact South Australians.

These cuts are going to reduce the number of scientists and pathologists who are working to benefit South Australians, to cure South Australians. It is going to lead to longer processing times, and he has held out the threat of privatising those services. He said, 'If you don't make these cuts of $105 million over three years, then we are going to outsource these services to private providers who don't have the capabilities to perform those tests.' We will see more tests going interstate. There already has been the signal from SA Pathology in the last couple of months that they are going to be sending more samples interstate to be tested rather than using our pathologists and our medical scientists here in South Australia.

We know that PwC has been asked by the government to do a report, and the government is sitting on this report. The Premier has it with him. He could release that and South Australians could see what is going to be coming down the line from the middle of this year, but we have not seen that released. When questioned by a select committee of the other place, the head of SA Pathology and the Deputy Chief Executive of SA Health said they had no idea how that first $25 million worth of cuts to come in July were going to happen, and we had excuses such as, 'We are going to wait to see this PwC report,' which we know that the government now has, 'to work out how those cuts are going to be brought in from July'.

We also do not know what the test is for when things are going to be privatised. Is it six months down the track, if those cuts are not met, when it will be privatised? Is it a year? Is it 18 months or two years? The government does not say. What we have heard is that all the representatives of the doctors and clinicians—expert people in this area—have said that it all looks as though the government is setting up SA Pathology to fail. It looks as though this is being set up to fail so that they can privatise this service because they are obsessed with privatisation and they are obsessed with the private sector.

These are vital public health services. These are essential services that should be staying in public hands. Only a few weeks ago, we saw the shock resignation of the head of SA Pathology, Glenn Edwards—someone who described himself as very passionate about public pathology and the important role it plays. So the head of SA Pathology, who is passionate about public pathology—

Members interjecting:

The SPEAKER: Order!

Mr PICTON: —and the important role it plays, months before these cuts come in, months before the privatisation plan of the Marshall government is going to come in, has bolted. He has gone out the door and the government does not know who is now going to run SA Pathology. The defender of public pathology, who was the head of SA Pathology, is out the door and going to Victoria.

There are many unanswered questions about the role of Michael Stanford, who was part of the KordaMentha review, while he was a board member of Australian Clinical Labs. This government brought in KordaMentha to review CALHN health services, which includes SA Pathology, and, as part of that review, it did not go to public tender. They had Michael Stanford there, who was on the board of a private pathology company. While that review was undertaken, the government comes out with the idea, 'Well, we're potentially going to privatise public pathology now.'

What involvement did Michael Stanford, a private pathologist on the board of a private pathology company, have as part of that review? Questions remain unanswered about that. He was on the board of Australian Clinical Labs, which is building a new lab at Adelaide Airport and recently opened a new collection centre at Elizabeth.

Despite the fact that these cuts have not yet come in, we have seen many cuts so far. We have had no idea from the government about how they are going to bring in their next round of cuts, but we have seen services axed at Flinders Medical Centre; immunology, genetics, molecular pathology and chemical pathology have been moved to Frome Road, away from the patients in the south who are using those services. This has led to concerns from clinicians that this will lead to more delays. We are particularly talking about kids who have cancer; they are going to experience delays in terms of getting that diagnosis. It could mean that there will be a delay in getting the treatment they need. Clinicians at Flinders say that those delays in services will lead to impacts on patient safety.

In January, we heard that more tests are being sent interstate. There is no justification or business plan about how that will work. More work sent interstate means more risk to patients and more delays in test results coming back to patients. That means that more patients will be stuck waiting in hospital, using beds, waiting for results, when we have professionals right here who could be doing the job.

Employee organisations are hearing from their members—scientists and clinicians at SA Pathology—that these cuts are dangerous and will risk public safety. These organisations have also been told directly by SA Pathology that the purpose of the recent changes is to cut jobs. They report that staff at SA Pathology are afraid to speak out about the impact of cuts because they fear being punished or potentially losing their jobs. It is hard to contribute to making efficiencies or consistently delivering good patient outcomes if staff are constantly living in fear of budget cuts and job losses.

If the government goes ahead with privatising SA Pathology, as it seems clear is the ultimate goal here, the impacts will be dire. Complex work that is currently undertaken by SA Pathology would need to be sent interstate or overseas; there just is not the capability for a private pathologist to do that work. There will be obvious delays in patients getting their results and increased risks of errors in those test results. South Australia would be left with no coordination and no expertise to deal with disease outbreaks, biohazard attacks or other statewide emergencies. Privatisations would likely mean that the junior workforce would have to go interstate to train and gain the necessary skills in the pathology field.

Staff are warning about the impact privatisation would have on research in South Australia—such an important growing area of work in this state and part of the future that we want for South Australia; that is why we invested in the biomedical precinct in South Australia. If you privatise SA Pathology, you are pulling out a huge chunk of the work that is needed. There is not a lot of work that happens in the research field without some involvement from SA Pathology. It will be hard to attract the next generation of pathologists and scientists with research capabilities and opportunities to develop their skills in the state and it will be very hard for our researchers to get the grants that they need if we do not have a public expert pathology laboratory service here in South Australia.

Taking SA Pathology services out of our public hospitals, as has happened at Flinders and potentially would happen at other hospitals like Lyell McEwin, The QEH and others if it were privatised and centralised, would mean worse patient outcomes and longer waits for patients. It would mean that we will ultimately see patients who need those results fast having to wait longer in hospitals. It is going to lead to more pressure on emergency departments and more ramping.

For instance, we have heard that immunology at Flinders has been tied to $1 million in hospital research funding, and now the government has cut that service. Not only is it impacting patients but it is also impacting the research revenue tied to it. If SA Pathology is privatised, regional communities will suffer the most. We know that because we have heard the member for Stuart and the member for Chaffey come out against the privatisation. They know that, if SA Pathology is cut and privatised, those regional areas that rely on SA Pathology and the public sector to provide those services are going to be hit the hardest. Regional health services, which are not as profitable as other services, would easily be the first in line to be hit.

I encourage the house to support this motion. We know that privatisation of essential services like SA Pathology is the wrong move. It is going to impact patients and it is going to impact our medical research in the state. The government need to reverse their cuts and reverse their privatisation agenda.

The Hon. D.C. VAN HOLST PELLEKAAN (Stuart—Minister for Energy and Mining) (11:46): On behalf of the government and the Minister for Health and Wellbeing in the other place, let me just say what an unfortunately politically charged, misleading and uninformed motion this is.

Mr Picton: You're not cutting and privatising? I will show you the budget paper.

The SPEAKER: Order!

The Hon. D.C. VAN HOLST PELLEKAAN: I move to amend the motion, as follows:

Delete paragraphs (d) and (e) and amend paragraphs (b) and (c) to read:

(b) notes the actions of the former Labor government to pursue efficiencies in SA Pathology;

(c) condemns the hypocrisy of the opposition, in particular former health ministers, in opposing efficiency measures in this parliament;

To put a bit of fact into the debate, it is terribly unfortunate that the shadow minister wants to try to confuse people and pretend that seeking efficiencies is automatically about imposing privatisation—it is not.

Mr Picton: That's what your budget paper says. Look at the budget paper.

The SPEAKER: The member for Kaurna is called to order.

The Hon. D.C. VAN HOLST PELLEKAAN: It is absolutely not about an automatic imposition. In fact, the Minister for Health in the other place, myself here during question time—

Mr Picton: Did you call the Premier to order?

The SPEAKER: Yes, I believe I did.

The Hon. D.C. VAN HOLST PELLEKAAN: —and the Premier could not have been clearer about the government's intentions. It is deliberately misleading for the shadow minister to try to paint it in any other way. There is one thing that we agree on, though. We agree very strongly on the importance of the work done by SA Pathology and SA Medical Imaging. Pathology and medical imaging work is a vital part of a contemporary health system. South Australian pathologists, radiologists, scientists, technicians, radiographers and phlebotomists are an integral part of the state's public health network.

In 2014, Labor commissioned Ernst and Young to review SA Pathology. Minister Snelling received the EY report in December. Among its six recommendations were the cutting of more than 300 FTEs and the privatisation of country pathology services. It took minister Snelling more than two months to rule out the privatisation of country health services. In 2015, Labor developed their efficiency improvement program, which aimed to cut 200 FTEs from SA Pathology as well as beginning the consolidation of tests that they now oppose.

The savings program was paused in 2017, with minister Snelling announcing that it would be revitalised after the 2018 election. Labor were going to revitalise their previously failed program after the election if they had been successful. Significant damage was done to staff morale through Labor's arrogant and unconsultative approach. This government has taken a distinctly different approach. Like the former Labor government, we will pursue efficiencies in SA Pathology and SA Medical Imaging but, unlike the former government, we are engaging clinicians. Unlike Labor, we have engaged with staff and unions on a regular basis following the budget announcement.

Mr PICTON: Point of order, Mr Speaker: the amendment moved by the Minister for Energy includes an unparliamentary term, so I ask you to rule that his amendment is out of order.

The SPEAKER: I have the point of order. To deal with an individual as a 'hypocrite' has been ruled unparliamentary; however, in this instance, we do have condemnation of the hypocrisy of the opposition in its entirety. At this stage, I am going to allow the motion, but we are still confirming.

The Hon. D.C. VAN HOLST PELLEKAAN: Unlike Labor, we have engaged with staff and unions on a regular basis following the budget announcement. Our government has made a commitment to release the data underlying the PwC report. Our government is committed to delivering quality and sustainable health services to South Australians. We are duty-bound to deal with inefficiencies where they are to be found. Labor and Professionals Australia thought they could be found before the election. Labor try to pretend that they have no interest in this matter, but it is entirely inappropriate for them to do that.

PwC and SA Pathology have been working together to identify potential opportunities for savings and ways to ensure that those savings will enable the organisation to reform the way it operates and to become a modern, sustainable service. SA Medical Imaging have provided advice that they will be able to meet their $6.2 million savings target. They will achieve this because they have identified more efficient and cost-effective ways to deliver their services.

The Marshall Liberal government is committed to fixing the health system that Labor broke, including delivering contemporary, sustainable and high-quality pathology and medical imaging services. Having had the opportunity to put those facts very clearly on the record for this chamber and for anybody following this issue, let me say again that it is extraordinary to me that the member for Kaurna would come to this chamber—

The SPEAKER: Excuse me, minister. I might pause you for just a moment. We have found a ruling from Speaker Snelling, believe it or not, in 2008, which is most ironic, where he noticed that the word 'hypocrisy' is not unparliamentary but that it is unparliamentary to refer to another member or members as hypocrites. However, 'hypocrisy' was not found to be unparliamentary. Therefore, I thank former Speaker Snelling and will allow the minister to continue. Thank you to the member for Kaurna for raising that point of order.

The Hon. D.C. VAN HOLST PELLEKAAN: Thank you very much, Mr Speaker.

Members interjecting:

The SPEAKER: Order!

The Hon. D.C. VAN HOLST PELLEKAAN: Former minister Snelling wanted to privatise SA Pathology. Then he said that he was not going to privatise SA Pathology and then, before the last election, he said that possibly the government would privatise SA Pathology after the election, if they were successful. Nonetheless, no doubt his ruling as Speaker is consistent, and I appreciate that.

The reality is that we are looking for efficiencies. It is inappropriate for the opposition to try to pretend that seeking efficiencies automatically means a deliberate, sneaky intention of privatisation, and it is also not very smart. When you look at MAC, when you look at the Lands Titles Office, when you look at the Repat hospital and when you look at SA Lotteries, it makes no sense why on earth anybody in the opposition would even want to raise this topic in the broader form with regard to privatisation.

We are fully committed to high-quality—the best possible quality—medical care that this state can afford for the people of South Australia and those who visit here. As the member for Stuart, I am committed to the very best care possible in the electorate that I represent. I was asked in question time many months ago whether I retract the things that I have previously said on this topic. No, absolutely not. The position of the government as a whole is that we need to seek efficiencies where we can find them, but they will not be at the expense of high-quality care. SA Pathology and SA Medical Imaging are part of that high-quality care, but we make no excuse for seeking sensible efficiencies where we can find them.

We make no excuse for engaging directly with clinicians and other medical service providers, and with unions, in a way in which the previous Labor government did not do. We are engaging with those people to work with them to find out where sensible savings can be made.

Members interjecting:

The SPEAKER: Order!

The Hon. D.C. VAN HOLST PELLEKAAN: We are working with these organisations. If the member opposite would like to check Hansard,he will understand that what he just interjected with is completely the opposite to what I said.

Let us get on with the work is what I say to members opposite. Understand that we are doing it in a very straightforward and transparent way, and we are doing it in an effort to get the best possible medical care that we can for South Australians. We value the work that SA Medical Imaging and SA Pathology do extremely highly. On that, we agree with the opposition.

Ms COOK (Hurtle Vale) (11:55): I rise to support the member for Kaurna's motion which, in a nutshell, condemns the state government for its outrageous budget cuts and movement towards the privatisation of SA Pathology and SA Medical Imaging. I will try to stay to what is ostensibly the clinical reasoning behind why we should maintain state services in state hands. However, before that, I would like to point out that the one privatisation that has not been mentioned today, which was a complete disaster for health care in South Australia, was Modbury Hospital. That was a disaster and it will never be the same again. It was a complete disaster.

When people present to our emergency departments, they are often suffering from a complex range of symptoms and need an expert team of clinicians enabled to order a wide range of investigations, and results need to come in a timely fashion. By 'timely' I mean minutes. To achieve this, we need a world-class pathology and imaging service at hand, ready to respond, which is what we currently have in our major hospitals.

Public pathology and imaging services provide for comprehensive access for all patients, with an extensive network of laboratories and technologies engaging in a 24-hour service for tests and analysis that patients need, regardless of their incomes. This is for all people all the time. Public pathology, and also imaging services, provide high-quality services across all settings, from in the community to the hospitals, providing integrated care and great continuity. This leads to efficient diagnosis and timely access to care needed to achieve the best possible outcomes for all South Australians. This is what we need in the heart of health care and clinical pathways. It must be part of the healthcare journey, part of an integrated clinical team.

Public pathologists, radiologists, radiographers and scientists are the experts in diagnosing patients with the most complex and life-threatening conditions. In the public hospital emergency departments, intensive care units, oncology units and more, we must have these quality clinicians and technicians available. In the case of public pathology, they develop and are often the sole providers of specialised testing, which is not funded by the Medicare Benefits Schedule (MBS). Who will do this if these systems are privatised?

Public pathologists are the most prestigious and highly regarded experts in their field, leading to streamlined, personalised care for patient management. Public pathology plays a major role in responding to public health emergencies, as the member for Kaurna talked about recently with the food poisoning that happened. Public pathology is essential. Public imaging is essential. All these services protect our communities.

Public pathology and imaging are both innovative. They translate research into new testing methods that improve our healthcare outcomes. Their collaborative teams ensure appropriate and timely use of their services. We want our clinical experts engaged in teaching and training. We want them to support new staff, medical specialists, graduates and science students; to become clinical leaders in technical innovations; and to improve service quality and patient outcomes. This is what public providers do. This is what the pathologists and the medical imaging specialists do: they play a role in teaching all students, and this includes nursing students as well. They are leaders in clinical and treatment innovation.

Public pathology and imaging are committed to patient safety, quality-assured services and improving health outcomes for patients. Our public pathology and imaging teams are always seen ensuring timely, accurate diagnoses leading to better clinical decisions. They focus on rational, evidence-based testing, driving efficiency and providing value for money. Public pathologists and imaging specialists provide direct care to patients on the wards and in outpatient clinics. There is a wider clinical governance, health policy and management responsibility in the health system.

Front-line clinical services are patient focused. Decisions must be made with patients at the heart of this, not profit. Public pathology and imaging providers also provide objective advice to governments. This is essential. They are free from commercial bias. I completely oppose the privatisation. I completely oppose the budget cuts that have been put in place to both imaging and pathology services. There will be risks to patient safety if these cuts continue. If privatisation occurs, it will create further problems with ramping, longer stays in hospital and greater emergency presentations. In 70 per cent of the times when a patient presents to the emergency department, they need the pathology service in place to deal with disease diagnosis and manage their complex conditions.

Health care statewide, but especially in my southern community, has always been a priority for me during my working life. I have met with, talked with and liaised with public pathology providers. I have also done the same with the imaging service down at Flinders. Staff members have come to me, very concerned about the future. These are the key points they talk about in regard to maintaining the public service in Flinders Medical Centre:

it is one of the busiest hospitals in South Australia;

as a group, the clinicians at Flinders are demanding a reliable and efficient diagnostic service with access to pathology on site to discuss the unities resulting from these diagnostic services;

currently, there are strong associations between diagnostic services at Flinders and the world-leading research units. The centralisation of these diagnostic units from Flinders Medical Centre to Frome Road would destroy that nexus. This is really dangerous; and

centralisation would lead to Flinders losing accreditation status for the training of their medical school and their pathologists. They are very concerned that this is going to lead to poorer outcomes for our southern community.

Public pathology needs to be produced from an integrated service located on hospital sites and also preferably as part of a health precinct such as SAHMRI, such as we have at Flinders. We urge you to keep your hands off public services.

Dr HARVEY (Newland) (12:02): I rise today in support of the amendment moved by the Minister for Energy and Mining to the motion moved by the member for Kaurna. Undoubtedly, pathology and medical imaging work is an essential part of a modern health system. SA Pathology is a key partner in protecting the health of South Australians through the high-quality diagnostic and specialist work in the area of public health and food safety. The organisation is a teaching, training and research leader, training the vast majority of pathologists in South Australia, including many who go on to work interstate in the public and private sectors.

In fact, many years ago, I did some work experience at what was then the old institute of medical and veterinary science (IMVS). We were working on a project for genotyping hepatitis C infections. Knowing what the genotype is has implications for the kind of treatment that you give. What we were working on was actually a new and more efficient test for doing this. The existing method had been quite labour intensive and had many, many steps and took a number of days. What I was looking at was a new method that was much quicker.

Rather than having to actually sequence the genotype, you could use a hybridisation method that would allow you to basically count the number of bands and work out what the genotype was based on that. It was a very interesting project. The point I want to make from that is probably also an example of an efficiency. As technologies develop, tests for a lot of these important processes can be refined and done much quicker and much more easily.

In addition to SA Pathology, SA Medical Imaging provides specialist medical imaging across South Australia, with more than 700 full-time equivalent staff, and provides timely and accessible services for the whole community, with more than 600,000 scans performed each year by the team. Both SA Pathology and SA Medical Imaging play an important role in our health system, and I am certainly sure everyone in here would agree with that. However, what is truly breathtaking is Labor's hypocrisy on this issue, particularly what we have heard this morning. It is really quite incredible.

In fact, in 2014, Labor commissioned Ernst and Young to review SA Pathology. Among the six recommendations was a recommendation to cut more than 300 full-time equivalent staff and another recommendation to privatise pathology services in the country. At the time, it took the minister more than two months to finally rule out privatising services in the country areas.

In 2015, Labor developed their efficiency improvement program, which aimed to cut 200 full-time equivalent staff from SA Pathology, as well as beginning the consolidation of tests, which now they have suddenly decided to oppose. At the time, Labor did not properly engage with staff as part of this efficiency program, nor did they release the underlying data behind the Ernst and Young report, which drove the efficiency program.

The savings program was paused in August 2017, with the then minister announcing that it would be revisited after the election. Now, of course, it seems that the Labor opposition would like to pretend that that was not the case. It is completely disingenuous for those opposite to come in here and carry on in a holier than thou manner and attempt to completely whitewash history. Given their record, it is difficult to comprehend how members opposite can possibly look the affected people in the eye and say the kinds of things we have heard this morning.

They are talking about privatisation and centralisation. Really, I cannot even think of the words to describe someone who could just turn around within 12 months and start talking about these things. This talk of privatisation is from a party that privatised the Motor Accident Commission, the Lands Titles Office, the forests. Basically, anything that was not stuck down was privatised under those opposite, including the outsourcing of many services within the health system.

We just heard the member for Hurtle Vale talking about centralisation. That was the cornerstone of Transforming Health, which meant that—

Mr Pederick: Don't forget the Repat.

Dr HARVEY: The Repat was closed, which of course they said they were not going to close. In my part of Adelaide, we had Modbury Hospital being significantly downgraded and services being centralised into other hospitals. It is breathtaking to hear those opposite come in here and talk about privatisation and centralisation, given that their record on that is far and above anything that is being contemplated on this side.

It is also worth noting that Sarah Andrews of Professionals Australia, at the time the Labor government decided to pause their savings program until after the 2018 election was quoted on the ABC as saying, 'I think invariably when you introduce new technologies to the workforce, efficiencies can be gained, and we're happy to be part of the working party to oversee that process.'

Significant damage was done to staff morale and to SA Pathology as a service through Labor's arrogant and unconsultative approach. This government has taken a very different approach. Where we are similar to the Labor government is that we are pursuing efficiencies because they are necessary to ensure that the system is sustainable, but in stark contrast to that we are actually engaging with clinicians. Also, unlike Labor, the government has engaged with staff and unions on a regular basis following the budget announcement.

The new government has committed to release the data underlying the PricewaterhouseCoopers report, and the government is committed to delivering quality and sustainable health services to South Australians. The government is duty bound to deal with inefficiencies where they are to be found. Labor and Professionals Australia thought efficiencies could be found before the election.

PwC has been reviewing SA Pathology to provide advice on achievable, sustainable and realistic health savings, and PwC and SA Pathology have been working together to identify potential opportunities for savings and ways to ensure those savings will enable the organisation to reform the way it operates and become a modern sustainable service. It is also worth noting that SA Medical Imaging have indicated they will be able to meet their savings target, and they will achieve this because they have identified more efficient and cost-effective ways to deliver their services.

The Marshall Liberal government is committed to fixing the health system that was left to us broken by the former Labor government, including delivering modern and sustainable pathology and medical imaging services.

Mr HUGHES (Giles) (12:10): I rise today to strongly support this motion and oppose the amendments proposed. I rise, especially, to flag that any move to privatise SA Pathology will have a disproportionate impact on regional communities. A number of things have been said by those opposite about the previous minister Mr Snelling and proposals to privatise, and I will get on to that in a few minutes because the position has been grossly misrepresented.

Unfortunately, privatisation, when it comes to SA Pathology, has a long history. Members opposite might recall, although probably not, in 1993, when the Liberals were in opposition, a previous Liberal member of parliament the member for Adelaide, Dr Michael Armitage, and rumours that were going around—and that was his word, 'rumours'—that if the Liberals were to come into government SA Pathology would be set up to be privatised.

At the time, the member for Adelaide completely rejected those rumours and said there was no intention on the part of the incoming Liberal government to privatise SA Pathology. It is worth quoting what the member for Adelaide had to say at that time in a letter, given that the member for Adelaide had a particular degree of expertise when it came to the health system, given he was a doctor and actively involved in both teaching hospitals and public hospitals. I quote from the letter:

As someone who has spent many years in teaching hospital environments [and public hospitals], I recognise the inherent dangers of such a proposal, and it is not my intention, or that of the Liberal Party, to follow that course.

He was referring to privatisation at the time. When the Liberals did come into government during that period, they were incredibly busy when it came to privatisation, and it was essential services that they privatised. They did not get around to SA Pathology, so here we are, all these years later, and the privatisation of SA Pathology is back on the agenda. If those opposite say, 'No, no, we are not talking about privatisation; we are just talking about efficiency gains,' then rule it out. They can rule it out, here and now, and say that SA Pathology will not be privatised, but I have not heard anyone opposite do that today so it is clearly on the agenda.

Reference has been made to the consultant's report back in 2014. Indeed, in that report there was a recommendation. The recommendation was not to privatise regional pathology services: what it did flag was to carry out a review to explore the idea of privatisation. I was fairly newly elected at that time but, representing a regional community, I knew what the impact of privatising SA Pathology would have on regional communities. I think that is why the member for Stuart at the time, as well as the member for Chaffey, had something to say.

I had a meeting with the minister for health at the time, as a regional member, and I asked him to rule out even looking at or even exploring the issue of privatisation. Within a short period of time, that was the course of action that was taken and we went on ABC television to give a totally unambiguous ruling out of any intent to privatise the service.

Mention has been made of efficiency gains. We should always be looking for efficiencies, but $105 million worth of cuts goes beyond mere efficiency gains—they are savage cuts. Technology does improve and the pace of research and development picks up. There are ways of doing things that will save us money and we should embrace those things and we should look at legitimate efficiency gains. I do not think there is any opposition to that on this side of the house, but there is strong opposition to the massive cuts proposed.

Because of SA Pathology, regional South Australia has a system integrated with the metropolitan area. SA Pathology employs people in Port Lincoln. In my community of Whyalla, there are close to 20 people employed by SA Pathology. There are about 10 people employed in Port Pirie and around another 10 in Port Augusta. SA Pathology also employs people in Victor Harbor. They employ up to 20 people in Mount Gambier and they also employ people in Wallaroo and Berri. We have an integrated system that carries out a whole range of functions that the private sector would not be interested in.

Reference was made to the last major privatisation of a health service by a Liberal government, Modbury Hospital. What we saw there, once that was privatised, was the constant bailing out of that particular service and a degradation of that service.

The range of services that SA Pathology provides in regional South Australia is incredibly significant. It provides a 24-hour, seven days a week, 365 days a year service. The private sector will not do that. It is intimately involved with communities such as the APY lands. The private sector would have absolutely no interest in doing that sort of work. There is a whole range of public service functions carried out by SA Pathology that a privatised system would not be interested in.

This is simple: if those opposite believe it is not going to be privatised, rule it out now in the same way that we did when we were in government. In response to that report in 2014, we ruled out the privatisation of SA Pathology. We made it very clear that that was not our intent. Go back and look at the media of the day. In those discussions, Jack Snelling fully accepted the argument. We were not coming out and opposing a policy of privatisation; we came out and cut off at the knees a review into looking at privatisation. We sent a clear message to regional communities that we would not privatise SA Pathology. I challenge those opposite and I challenge regional members opposite to come out and give that incredibly clear message: we will not privatise SA Pathology.

The Hon. G.G. BROCK (Frome) (12:18): I also rise to speak on the motion brought by the member for Kaurna. The Port Pirie region has been serviced by a very prompt and efficient radiology and medical imaging service for many years and it is well respected and admired by the community of not only Port Pirie but also the vast surrounding regions, including the northern areas, the Clare Valley and also Yorke Peninsula.

I see no reason for the government to contemplate the idea of privatisation of these services when there has been no indication that the people operating these greatly appreciated services have had issues expressed to them by the hundreds of thousands of patients who have been provided with the relevant service. It is my understanding that the latest ultrasound machine in the hospital at Port Pirie is valued at over $1 million, is of the highest standard and was successfully argued for by many passionate people involved with the community and those who work in these areas.

I understand that the consultation paper issued to staff in February 2019 asked for submissions, which closed yesterday, 19 March 2019. The consultation paper is titled 'Statewide Clinical Support Services, SA Medical Imaging, Port Pirie Medical Imaging, Private provider full service model'. I would be interested to ascertain when the local group was given the invitation to supply any documents regarding this organisational change.

For such a dramatic move, I would certainly hope that sufficient time was allowed for the submissions to explain the great and efficient service that has been undertaken by this very dedicated working group. It would be very interesting to know whether this consultation paper was also sent to local government councils. There are several that have many thousands of residents who live in the areas who utilise these services. To answer that, I made inquiries of the councils involved. To their dismay, they knew nothing about this proposal. The first indication they had was a phone call from me.

It is interesting that, according to my information, this consultation paper was only directed to staff and unions. I would have thought that the consultation for a service that affects thousands of people across a wide range of locations would have been promoted to these people. However, during my discussions with people across my electorate who utilise these services, and also with people I visit in areas outside my electorate for social and family events, they are amazed that the government is even contemplating such a move.

Their comments include 'stupid', 'heartless', 'money grabbing', 'typical of government' and 'no consideration for people'. One of the most common comments is, 'Does not surprise me as we are north of Gepps Cross.' These comments are coming from people who supported this government in the last state election, and I would comment that their views of the party have changed since this proposed move.

It is a well-known fact that many families in Port Pirie and the surrounding areas may have to utilise these services, but what will the case be if it is privatised? Will there be any concessional or bulk billing for those who cannot afford to have these life-saving treatments? It is interesting to note comments in the consultation paper, such as:

Engagement has already commenced with video conferencing with stakeholders, which included the opportunity for affected employees to speak with Employee Assistance Program providers.

Why is this, if a decision has not been made? Another comment is:

A further site visit will be held that will include the opportunity for affected employees to speak with Human Services staff from Statewide Clinical Support Services.

Again, I ask why if no decision has been made? Another statement is:

Following consultation etc., further communication will occur particularly as it relates to an implementation plan and the associated impact on staff, followed by engagement with stakeholders around planning for the implementation.

Again, why are we talking about that in a consultation paper if no decision has been made? Another part of the consultation paper states:

The Employees Assistance Program provides that free confidential and professional counselling will be available.

Again, why is that in a consultation paper if the decision has already been made? The FAQs brochure also states:

The benefits of the proposed model include improved access to medical imaging diagnostics and a more effective and value-for-money service.

It is also very interesting that the government spruik their support for the regions and the provision of more and better services, yet here we are again making decisions that will affect the regions. I strongly urge all members in this house to support this motion and for the government to allow the current systems to prevail.

I heard the member for Giles say that if, for argument's sake, it is not going to be privatised, please say so because privatisation is an issue that I believe is very detrimental to the people of regional South Australia. I certainly support the member for Kaurna's motion.

Mr MURRAY (Davenport) (12:24): I rise in support of the amended motion. I do so with particular interest, given that my electorate holds all the Flinders precinct, including the Flinders Medical Centre, which is the biggest teaching, clinical and training hospital in South Australia. I will focus my remarks primarily on SA Pathology, and I will do that because I have had extensive interaction with a large number of SA Pathology employees both as the member for Davenport and, prior to that, as a candidate in 2017. I have met with pathologists, technicians, teaching staff and union reps, and part of what I have derived as a result is germane to this discussion.

Insofar as the nature of pathology services themselves are concerned, the Grattan Institute put out a report in 2016 that talked about the ongoing increase in pathology services per patient. This is a reality for all health providers. We have a situation where, from 2004-05 and in the intervening decade to 2014-15, there was an increase of 40 per cent in per person pathology services provided, 15 per cent of which was due to an increase in the number of people deriving a test and 25 per cent was due to extra tests per person. That is the landscape, and I will return to that because it is germane to the way in which SA Pathology is funded and, in particular, the state of its books and processes that we as a government inherited.

SA Pathology is in many respects the best public pathology service in Australia. Some of the indicators for that are, for example, a report of the Primary Immunodeficiency Diseases Committee compiled in 2007 as an article written on behalf of the Australasian Society of Clinical Immunology and Allergy. In talking about primary immunodeficiency diseases in Australia, it made the point that the prevalence per 100,000 of population was 5.6 in Australia but 12.4 for the state of South Australia and, as a result, the presumed Australian rate was bumped up. That is one measure of the strike rate, if you will, of SA Pathology services in conducting their tests and isolating these particular types of diseases.

This is data is provided to me by the people I talked about before: members of SA Pathology—technicians, scientists and the like. The latest set of statistics published by the Australian government's Australian Institute of Health Welfare pertain to 2016-17. If they are to be believed, where diagnostic and allied health professionals costs are concerned, South Australia has the lowest per capita cost diagnostic (including pathology) recurrent expenditure in Australia, and South Australia has the highest efficiency diagnostic (including pathology) workforce in Australia, serving more than double the number of people per person employed on an FTE basis than, for example, New South Wales.

To recap, in 2016-17 the Australian federal government's statistical reports indicated that, on a per capita basis, South Australia had the lowest per capita costs and the highest efficiency. That is the system that existed in 2016-17. I will deal with that later. One of the other factors I have become aware of as a result of the very extensive involvement I have had with SA Pathology is the advent of a practice known as coning. Coning was introduced in 1992 as a means of offsetting the cost of providing the ever-increasing number of per patient tests. It works by means of the federal government only paying for the three most expensive test items.

Dr Michael Harrison, the CEO of Sullivan Nicolaides Pathology in Brisbane, was quoted in the Royal College of Pathologists of Australasia in 2015 pointing out that there are potentially 20 per cent of all potentially rebateable tests being performed for free in Australia. The evidence is that SA Pathology is performing, and has performed over a long period of time, most of the free tests for the private sector and as a result has by any measure a substantial deleterious revenue result. The practice of coning, as I said, results in there being no dollars paid for the remaining tests that are conducted and also no entry of the work conducted into the official statistics that are kept for the hospital system.

What we have seen with Labor and SA Pathology is Olympic-class hypocrisy. As other speakers have alluded to, in 2014 they commissioned an EY report, which recommended cuts of 300 full-time employees, and in 2015 they implemented a 200-FTE cuts program, all without any engagement with staff or any release of the data. As I alluded to, in 2017 it was my very great pleasure to be in a meeting of SA Pathology staff as they were being told of the pending cuts made by the prior government.

There was absolutely no doubt what was occurring—no consultation and lots and lots of fear. We heard discussions earlier today about fear. These people were threatened about speaking out. There was lots of slashing without any consideration of the low costs that SA Pathology has and the lost revenue as a result of the poor practices put in place by the previous government. We have moved from having Olympic-class privatisers when in government, and we now have Olympic-class hypocrites in opposition.

I might also point out that, in direct contrast with what staff wanted, the previous government implemented the EPLIS system so that the impact on SA Pathology and its processes and staff output, as well as safety, was such that the safety concerns incidents rate rose alarmingly. It is worth pointing out that in this context what we are working with is an SA Pathology system which has been busted—historically broken as a direct result of the ignorance and lack of detail and transparency from the previous government.

At the Flinders Medical Centre in 2011, the emergency department had 60,000 people processed in a facility designed to do 70,000 people. In 2018, they pushed through 92,000, a 50 per cent increase in seven years. This was foisted on them by Transforming Health. This was and is a direct result of the closure of the Repat and the services it provided in this respect, as well as the gutting of Noarlunga Hospital.

This government will continue to work to fix these issues. This government has undertaken to release the underlying data, and I look forward to analysing that data and continuing to fight for the best possible outcomes for SA Pathology, Flinders Medical Centre and my constituents.

Ms BEDFORD (Florey) (12:34): I am only going to speak briefly. I speak in support of the original motion, the motion as printed. At the outset, I declare that a family member works for SA Pathology. That being the case, I can attest to his dedication to the services provided by South Australian Pathology and, indeed, South Australian Medical Imaging.

He has been a committed and diligent medical scientist since his graduation from the University of Adelaide and works nearly every hour of the day, from what I can see, to make sure that the lab he works in runs efficiently and smoothly. He has made more efficiencies throughout his long employment there than anyone I can ever remember talking to me about.

I am at a loss to see how transferring work to Victoria can help keep South Australia's youngest and brightest here. I believe that that will be the result: the already limited options for medical science graduates in this state will diminish. It has always been Premier Marshall's mantra that he wants to keep our young and brightest here in this state, and this really appears to be the beginning of a backflip or a broken promise.

The long history of pathology services in South Australia really deserves full scrutiny, and you will be pleased to know that I am not the oracle on the subject, nor do I have my copious notes here today. What I can say is that any move to privatise these services will be viewed in the future as the worst possible decision, worse than anything that we have ever seen before.

Perhaps more than anybody else in this place, as the member for Florey I have witnessed every single writhing motion of Modbury Hospital, from the beginning of the outsourcing experiment to what we have today. Whatever has happened under previous governments, two wrongs will not make a right. Budget cuts have to be measured. I understand and appreciate all of that, but we do not have to throw the baby out with the bathwater.

I implore the government to think really long and hard about the unnecessary angst they are forcing on everybody who works in the medical area; I see it all the time. It is apparent with my family member, and he is just one of hundreds of people. I will definitely have no trouble in making sure that I do everything I possibly can to make sure that everyone in my electorate is right up to date with everything that is going on in this particular debate.

I can speak on behalf of the constituents who have already approached me. Not only the people who have family members working in SA Pathology but people in the street come up and say that this is one of the worst decisions they have ever heard about. I certainly hope the government knock it right on the head and make sure they find a better way to ensure that our medical services stay at the forefront, rather than selling them off to the other states.

Mr PEDERICK (Hammond) (12:36): I rise to support the motion as amended by the Minister for Energy and Mining. Everything that needs to be said from the government side has been said, but I just have a few comments in regard to the hypocrisy of the people on the other side. It was those people, when they were in government, who commissioned reports and commissioned the privatisation of medical services throughout South Australia.

Not only that, there is what they did in regard to the Daw Park Repatriation General Hospital. When in government, the Labor Party said, 'We will never, ever sell off the Repatriation General Hospital.' Guess what? What happened to 'never, ever'? That is exactly what they did.

Mrs Power: Shame!

Mr PEDERICK: It is exactly what they did, and it is shameful, as the member for Elder rightfully exclaims. It is shameful, and it is why we had good people out here on the steps for well over 100 nights campaigning for services at the Repatriation General Hospital to be kept. Thankfully, under the Marshall Liberal government and the guidance of minister Wade from the other place, we are setting up a whole new health precinct there.

In regard to the discussion around medical imaging, you would think fire and brimstone were going to fall on us if this were privatised across the state. Yes, there is a discussion from this side, just as there was on the other side under former minister Snelling. The difference with what is happening on this side of the chamber under a Liberal government is that we are actually talking to clinicians about what to do, unlike Labor did when they built a $2.2 billion lemon: the new Royal Adelaide Hospital. Millions and millions of dollars of work was needed to repair the hospital long before it was opened because of poor planning decisions, putting rooms in the wrong places, putting doors the wrong way around, putting light switches behind doors so you could not get to them when you opened the door and fire services having to be replaced.

There is a litany of problems with that build, but what do the Labor Party care? As long as they are spending taxpayer money, they do not care two hoots. They hate success, but they also do not care two hoots about taxpayer money. That is why, since coming into government 12 months ago—and the state of South Australia thanks us, as they showed in the polls the other day—we have had to inject an extra $900 million into health. The budget is sitting at $6 billion already and it takes up 30 per cent of the state budget. We have had to pump in hundreds and hundreds of millions of dollars to fix that up.

As the member for Frome indicated, we are looking at medical imaging at Port Pirie and we are looking at a tender process to ensure services deliver value for the taxpayer. Yes, it did begin under the former Labor government and, as I indicated, the option of a full service medical imaging model delivered by a private provider is being considered. Reporting services at sites are already provided privately, as is the case in another 14 sites across Country Health SA. The proposed model would provide improved access to medical imaging diagnostics, particularly after hours, for Murray Bridge and Port Pirie. This is what happens when you consult with staff: opportunities for current staff will be explored with the successful private provider.

I am really excited about what could happen in Murray Bridge where, after neglect of that hospital by Labor, we have managed to secure a $7 million full emergency department upgrade. The option for the medical imaging could turn into a seven days per week option, which would provide far better services for my constituents not just in Murray Bridge but across the Murraylands.

In winding up, I am not going to listen to those hypocrites on the other side. They talk about privatisation when they gave away the forests for $650 million. Most commentators would say they were worth $1 billion.

Mrs Power: Shame.

Mr PEDERICK: It is a shame. They were selling the Repat, they sold the Lands Titles Office and they sold the Motor Accident Commission (MAC). How much more? Do not ever lecture us about privatisations, and do not ever lecture us about hypocrisy, because when I look over at the other side I look at the member for Light and other members and see hypocrisy all over the other side.

Ms Bedford interjecting:

Mr PEDERICK: With those few words, I support the amended motion—I love the Independents, for the record—and I will not listen to the hypocrisy of the other side.

The Hon. A. PICCOLO (Light) (12:43): I would just like to make a small contribution to this debate. I will not cover the areas that have been covered quite well by my colleagues, but I need to mention a couple of things because they have not actually done the issue justice.

One of the things that we have learned from this government is to deflect the issue before us. They never actually debate the issue before us. They do not want to debate it because they cannot handle what the issue we are debating is, so they try to deflect. They try to deflect the issue by talking about other things, and this morning they have done it here on a number of occasions; in fact, they have done it in this debate as well. They have talked about everything else except the issue of their seeking to privatise Pathology SA. The pros and cons have been mentioned by my colleagues so I will not go into that.

Suffice to say, and I think it is worth putting it on the record, The Advertiser editorial of yesterday talked about this government's inability to accept responsibility of being in government. A year on, they are still here and still talking about the past. What the editorial says is interesting and quite instructive; that is, from here, meaning yesterday, 'the time for Premier Steven Marshall and his ministers to blame the ALP is over'. In other words, it is about time the Liberal Party and the government actually grew up, started acting like adults and took responsibility. The editorial goes further:

But now is the time to end this rhetoric. They are the government of the day and must assume full responsibility for the issues…

Mr PEDERICK: Point of order, Mr Deputy Speaker.

The DEPUTY SPEAKER: There is a point of order. Member for Light, you will need to sit down. The member for Hammond.

Mr PEDERICK: After being lectured about being relevant to the debate, this has been completely irrelevant.

The DEPUTY SPEAKER: I do not uphold that point of order, member for Hammond. It was a good try, but the member for Light is making a contribution to this motion.

The Hon. A. PICCOLO: Mr Deputy Speaker, it is relevant because this government seems to be incapable of doing what is required. It is very important. When we talk about SA Pathology, it is a bit like a person who does not like a tree that much but they do not have permission to remove it. That is what they do. They prune it so much that the tree dies, and that is what this government is going to do: they are going to prune SA Pathology so much that it will have to die and be sold off. That is what their agenda is. It is not about genuine efficiencies to provide the consumer with better services.

This is about pruning SA Pathology so much that they would have to sell it off or close it down because this government does not believe in public services. They do not believe in them. They want to close Service SA and a whole range of other public services. They want to privatise the public services because they do not believe in them. What they do is remove another player from the market and in the end the consumer will pay more. In the end, the people of South Australia will pay for this government's poor decisions to wind down SA Pathology.

Mr PICTON (Kaurna) (12:46): I rise to close the debate and indicate that the opposition will not be supporting the government's amendment. We will be supporting the original motion. I support all the members on this side, and the Independents as well, who spoke on this debate and made very good contributions. They have deplored what was said by those opposite and their ridiculous amendment to this motion.

We had the Minister for Energy, the member for Stuart, making some comments, and it drew me to look back at what the member for Stuart said when he was in opposition, talking about the very same subject. In The Transcontinental of Port Augusta, the member for Stuart said:

Generally I am a strong supporter of private industry, but I do not expect that a private pathology company would provide the same level of service in Port Augusta as SA Pathology currently does.

Hear, hear to that! He also said:

Privatising SA Pathology in Port Augusta would have been a very poor move so I think that the minister [the then minister in 2015] has made the only sensible decision available to him and I welcome it. Port Augusta is now assured of continued high quality service from our own SA Pathology lab and staff.

Funnily enough, the member for Chaffey, now also a minister in the government, made some comments at the time. In fact, he made a submission to a review at the time against privatisation. He said:

I applaud the decision [which was to rule out privatisation in 2015]. My concerns were that it wasn't a level playing field comparing pathology in metropolitan Adelaide with pathology services in the regions. Regional pathology go above and beyond. They're on call and they come out at any hour to provide a service and that's something that if pathology were to be privatised, may not occur anymore. Potentially, we could have also seen higher charges for pathology tests.

I support those comments from the member for Stuart and the member for Chaffey, who are now ministers in a government which, in its 2018 state budget, has set about the path for the privatisation of SA Pathology. It is not something those members were very keen to talk about, although I appreciate that the member for Hammond set it on the table pretty clearly that they are considering privatising SA Pathology. But for members who were more reluctant to speak about this, I will make clear what is in the actual budget papers where it states:

With the implementation of local health network boards from 2019-20, the public pathology service will be accountable for its performance. Should efficiencies not be achieved, it will be open to those boards to procure services from alternative providers.

That means that if $105 million of cuts that the government has put in are not met the government is saying that health services are free to ditch SA Pathology and go to private providers across the state to get those services. It is going to lead to the death of SA Pathology. It is going to lead to cuts in services in metro, but particularly in the country, and will impact not only on research and teaching but also on the services people encounter in this state.

I think that the hypocrisy in this argument is actually from those opposite, particularly country members who are now ministers, who went out of their way four or five years ago to say how bad privatising SA Pathology would be but who are now enthusiastic supporters of the state government's budget that says that they will embark upon cuts and then potentially the privatisation of SA Pathology. That will hit those communities they represent particularly hard. I encourage the house to support the original motion and oppose the ridiculous amendment from the Minister for Energy.

The house divided on the amendment:

Ayes 23

Noes 21

Majority 2

Amendment thus carried.

The house divided on the motion as amended:

Ayes 23

Noes 21

Majority 2

Motion as amended thus carried.

Sitting suspended from 13:01 to 14:00.