House of Assembly: Tuesday, April 28, 2020

Contents

Modbury Hospital

Ms BEDFORD (Florey) (15:39): As South Australia continues to grapple, thankfully successfully, with the COVID-19 global pandemic, it is timely to reflect on our state's overall health policy—the no doubt well-meaning at the time but often piecemeal and haphazard initiatives taken over recent decades and their impacts.

The folly of privatisation, outsourcing and competitive tendering, the constant rounds of cuts and closures and the imagining that delivery of health services can be turned into a for-profit market where the provision of universal health care—a hard-won principle that emerged as part of the postwar settlement—has been under sustained attack for decades. Universal health care belongs in government hands because only government is accountable to the public, not to shareholders, and nationally the irrational extraordinarily generous subsidies enable the private health industry to remain where it is when it is clear that consumers are already voting with their feet.

Members will know that I have been and remain a constant advocate for publicly managed, publicly outsourced and publicly accountable health care. I have always opposed privatisation, starting with the failed experiment inflicted on my community when Modbury Hospital's administration was privatised or outsourced decades ago. Equally, I have always opposed the constant erosion of services through cuts and closures.

The former Labor government learned the strength of my resolve when it came to downgrading services at Modbury Hospital. I fear, however, that the current Liberal government is yet to fully appreciate how important this issue is to the people of the north-east. I am, of course, pleased the government has commenced renovations and building works at Modbury Hospital and is moving to restore a high dependency unit. That was a key election promise, and it is a promise they must keep and keep in full, not just in time for the next election.

The works are already budgeted and no doubt form part of shovel-ready projects, so necessary to keep our construction workers in jobs, but what will this mean for the displaced medical workers who are victims of the early closure—and here I acknowledge the early opening of the theatre suite is the carrot—of Modbury's operating theatre suite, day stay and overnight wards?

Reports have recently reached me relating to the state's preparedness for its COVID-19 response. On the Thursday afternoon prior to Easter, Modbury staff were told that the entire level would be closed for 12 months to allow 16 beds to remain idle until the anticipated explosion in COVID patients required their use. In the interim, the response of the government and the population has seen overwhelmingly great results in containing the coronavirus spread.

As a result, it is not unreasonable to think there could be an opportunity to review the plan to shut the surgical level at Modbury Hospital; however, NALHN, and in turn the government, appear unwilling to do this, but where is the truth? I understand there are some advantages to the length of the redevelopment program if the entire floor is closed, yet the displacement of over 100 staff, including medical, nursing, clerical and ancillary staff, local patients who use the service and the economic climate we are facing, may now be a more important factor in the final decision.

By keeping the two theatres at Modbury working, the number of patients who might be outsourced, including elderly vulnerable patients requiring eye and urology services, would be considerably reduced with a corresponding saving in expenditure. Additional to the savings that occur by not outsourcing patients would be the staff who may be displaced by the closure and who continue to receive an income despite not participating in clinical or other productive work, they will not be draining the public purse unnecessarily.

The economic argument in the current climate is the most compelling to keep the theatres and ward open. I am told NALHN identified efficiencies at the Lyell McEwin Hospital that would allow a portion—and I repeat 'a portion'—of work currently performed at Modbury to be moved there. If Modbury theatres close, where would the remainder of the Modbury work go? Would it need to be outsourced to private facilities and practitioners at an inflated cost to the service that a public hospital can provide?

I was obviously originally pleased to hear recently the intention of government to start the theatre works earlier than scheduled, but I am now worried, as are staff at Modbury Hospital, that their jobs will not be protected and that case flow between hospitals has not been well planned. For instance, I understand the sterilisation staff at Modbury Hospital—all highly qualified workers—are the only such staff in hospitals in this state whose work is outsourced to a private company, and that the closure of the theatres will result in their displacement.

Where will they be left when the theatres close early? If true, this would be very concerning and makes me wonder how many other parts of our public health system are riddled with outsourced, quasi-privatised or contracted out work roles. Indeed, I worry that, given the concerns I have heard from staff, we are returning to the bad old days of ambulance transfers shuttling patients in between hospitals. To me, any move like this would be privatisation by another name.

The threats from outsourcing, contracting out and privatisation to health service delivery and the jobs of the workers who provide them must stop. When talking about the amazing response to the health service here in South Australia to the COVID threat, a huge accolade must be handed on to all, and particularly to all at SA Pathology. Their work in this current threat to public health is nothing short of amazing, and SA Pathology should be no longer facing any threat to its existence within the public health service.

To this end, I will be introducing two bills this week: one to ensure SA Pathology has its own standing within the public health system and another to enshrine the right to parliament to examine any move by any further government to privatise any part of our public health system.