Legislative Council Fifty-First Parliament, Second Session (51-2) 51 2 Parliament of South Australia Legislative Council published Bills Health Care Bill HEALTH CARE BILL Committee Stage Committee Stage In committee. (Continued from 26 February 2008. Page 1765.) Clause 11. The Hon. SANDRA KANCK Legislative Council The Hon. SANDRA KANCK: I move: Page 14, after line 26— Insert: (4a)	The minister must establish arrangements to meet with HPC on a regular basis. I think this amendment is fairly self evident. While we have been told that the minister will consult with this new council, nothing actually requires him to do so. This council is one of the few mechanisms that exist in these new governance arrangements where direct contact is possible for health consumers and health service providers and so on with the minister. So, this puts it in black and white that the minister has to meet with the council on a regular basis. The Hon. G.E. GAGO Legislative Council The Hon. G.E. GAGO: The government understands that this new clause is intended to ensure the HPC has regular meetings with the minister so that it and the minister can be informed regularly of any issues about any work being undertaken by the council. The government recognises that there may be some concern that there should be a commitment by the minister to meet with the HPC. This has always been the intent of the minister; therefore, the government is happy to support this amendment. The Hon. J.M.A. LENSINK Legislative Council The Hon. J.M.A. LENSINK: The Liberal Party also supports this amendment; however, I want to ask a question of the minister about how often it is envisaged that the minister will meet with this group per annum. The Hon. G.E. GAGO Legislative Council The Hon. G.E. GAGO: We have not specified a time as yet, but we imagine it will be something like three or four times a year. Amendment carried; clause as amended passed. Clauses 12 to 16 passed. Clause 17. The Hon. SANDRA KANCK Legislative Council The Hon. SANDRA KANCK: I move: Page 18, after line 26—Insert: (4a)	If a HAC is established in relation to an incorporated hospital established to provide services within the country areas of the state, the constitution or rules of the HAC (as the case may be) must provide that a majority of members of the governing body of the HAC (in the case of an incorporated HAC) or a majority of members of the HAC (in the case of a HAC that is not incorporated) are persons who are selected or appointed on the basis of being members of the local community. In moving this amendment, I want to repeat a little of what I said in my second reading speech. Although there have been some concerns—and I have to say they are minimal, because only one representative member of a country health board and one local government entity contacted me with any concerns about this bill, so the levels of concern are not high—in deciding whether or not the health advisory committees (HACs) would be an adequate replacement for the hospital boards, I looked at some of the history and determined that, in the end, the boards have basically been following the dictates of what head office has given anyway. So, it did not seem to me an issue that one should die in a ditch over. However, I was concerned about the potential that was there for a health advisory committee to be constituted with a majority of the membership being appointees of the minister, and this ensures that the HACs in the country areas will not be able to have membership that is majority dominated by the minister. The Hon. G.E. GAGO Legislative Council The Hon. G.E. GAGO: The government understands that this new clause is intended to ensure that a health advisory council established to replace a board for a health service in the country region of South Australia established under the South Australian Health Commission Act 1976 will have the majority of members being representatives from that local community. The government recognises that some concerns remain regarding the participation of their local community in the country region in relation to health advisory councils. Therefore, it will support this amendment and ensure that local health advisory councils to the various health services sites established under this bill have a majority of members from their local community. The Hon. J.M.A. LENSINK Legislative Council The Hon. J.M.A. LENSINK: The Liberal Party supports this amendment, but we note that the HACs will not have very much to do with the minister at all. Amendment carried; clause as amended passed. Clauses 18 to 57 passed. Clause 58. The Hon. G.E. GAGO Legislative Council The Hon. G.E. GAGO: I move: Page 40, after line 12—After subclause (13) insert: (13a)	The Minister may, by the terms or conditions of a licence, limit the scope of a licence to specified services or classes of services. Clause 58 enables the minister to approve applications for a restricted ambulance licence and enables the minister to attach conditions to a licence. Proposed new subclause (13a) enables the minister to place conditions on a licence that limits the scope of the restricted ambulance service licence to a specified class of services or activities. Amendment carried; clause as amended passed. Remaining clauses (59 to 100) passed. New clause 101. The Hon. D.G.E. HOOD Legislative Council The Hon. D.G.E. HOOD: I move: Page 61, after line 34— After clause 100 insert: 101—Review of governance arrangements—Country regions of State (1)	HPC must, within a reasonable time after the third anniversary of the commencement of this Act, furnish to the Minister a report on the operations, over the 3-year period from the commencement of this Act, of the HACs established in relation to any incorporated hospital or hospitals established to provide services in the country areas of the State. (2)	The report must— (a)	review the effectiveness of the relevant HACs in promoting the interests of local communities; and (b)	review the level of satisfaction with the governance arrangements between the relevant HACs and any relevant hospital from the perspective of the members of the HACs, the local community, and the hospital; and (c)	identify any other significant issues relating to the operations of the HACs considered relevant by HPC. (3)	The Minister must, within 12 sitting days after receipt of a report under this section, cause a copy of the report to be laid before both Houses of Parliament. (4)	The Minister must, within 6 months after receipt of a report under this section, cause a formal response to the report to be laid before both Houses of Parliament. This is a simple amendment, requiring the minister, who is in agreement with it, to require that a report be produced on the third anniversary of the act coming into effect to look at three key areas, namely: first, the effectiveness of the reforms in terms of the impact on promoting the interests of local communities, which is the whole intention of the bill; secondly, the satisfaction with the governance arrangements within local communities; and, finally, to identify any other significant issues that have resulted from these reforms. It then requires the minister within 12 sitting days of having received that report to table it before both houses of parliament, and it requires him within six months after that date to cause a formal response to that report to be tabled in parliament. To the health minister's credit, he had no problems with my suggestion of including this in the bill. It is a significant reform. Initially, when the bill was first floated in the public arena, there was genuine concern in country regions and we had a high level of correspondence and contact with constituents over the issues about which people were genuinely concerned. That has dropped off substantially in the past few months, which all of us would have noticed in our dealings with constituents on this issue. However, it is such a major reform that it should be reviewed formally and that is what this amendment will do. The Hon. G.E. GAGO Legislative Council The Hon. G.E. GAGO: The government recognises that some concerns remain in the country regions in relation to health advisory councils. The government understands that the proposed amendment seeks to address these concerns by ensuring that people in country regions can report on how the establishment of health advisory councils has affected their health services and the level of satisfaction or otherwise with the health advisory councils. The government sees the health performance council, which is to provide a report on the effectiveness of health advisory councils and related matters, as an independent body and will therefore ensure that the report it provides is independent of the department and the minister. The proposed clause will ensure that the impact of health advisory councils can be assessed, and the government will support it. The Hon. J.M.A. LENSINK Legislative Council The Hon. J.M.A. LENSINK: This is a reasonable clause to include. However, our concerns remain with the new governance arrangements, which we believe take the country out of the hospitals. New clause inserted. Schedules 1 to 4 passed. Bill reported with amendments. Third Reading Third Reading The Hon. G.E. GAGO Legislative Council Minister for Environment and Conservation Minister for Mental Health and Substance Abuse Minister Assisting the Minister for Health The Hon. G.E. GAGO (Minister for Environment and Conservation, Minister for Mental Health and Substance Abuse, Minister Assisting the Minister for Health) (11:20): I move: That this bill be now read a third time. The council divided on the third reading: AYES (12) Bressington, A. Darley, J.A. Evans, A.L. Finnigan, B.V. Gago, G.E. (teller) Gazzola, J.M. Holloway, P. Hood, D.G.E. Kanck, S.M. Parnell, M. Wortley, R.P. Zollo, C. NOES (7) Dawkins, J.S.L. Lawson, R.D. Lensink, J.M.A. (teller) Ridgway, D.W. Schaefer, C.V. Stephens, T.J. Wade, S.G. PAIRS (2) Hunter, I.K. Lucas, R.I. Majority of 5 for the ayes. Bill thus read a third time and passed.