Health Care (Governance) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 7 June 2018.)

The Hon. T.A. FRANKS (17:10): I rise on behalf of the Greens to indicate our support for the second reading of the Health Care (Governance) Amendment Bill. I note that the bill will seek to reform the South Australian health governance arrangements, and this legislation is the first of a suite intended to do that. This legislation seeks to create one statewide, three metropolitan and six regional LHNs and governing boards. It has the stated intent of devolving this decision-making and responsibility to local levels, and this will of course involve significant planning and consideration of how our public health system will work as a whole.

I note that, in the election campaign, the Liberal then opposition took this as an election policy, so in that way it is no surprise to the Greens. Certainly, one of the four pillars of the Greens is grassroots decision-making, and as a member of the Transforming Health select committee I heard time and time again how centralised decision-making was not good for the state of our health system. On those basic principles, the Greens are certainly of a mind to support the devolution of decision-making and that real input at local levels.

The bill before us is the first, and while we have strong support for the intent of the bill, we note that there has been a lack of appropriate consultation in this particular situation. That is because, as an election promise, the government has sought to introduce this within that self-imposed 100 days time frame. The government has also put out an expression of interest advertisement, which has been the subject of not necessarily debate in this place, because we did not quite get to the point of the motion being debated, but certainly some conjecture about whether or not the advertisement of positions presupposed the passage of the bill before us.

I put on the record that the Greens were in no way cowed into submission in terms of supporting this bill. We are very happy to support the principle of this bill, regardless of an ad in a newspaper, be that The Advertiser or any of the regional newspapers, and we note that the expression of interest process did have that due deference for the work of the parliament.

I also note that applications for those positions closed last Friday, and it is intended that they will take those positions into being appointed at the end of this month. With limited sitting days, there is a time pressure here that is not ideal but is certainly not a reason not to support this bill today, and certainly the second reading is strongly supported.

The Greens have undertaken some consultation with the limited time frame that we have been given. We have had feedback from the ANMF of South Australia, and that feedback certainly has raised some concerns that we hope will be addressed. Today, we have had one amendment tabled from the government minister and a raft of amendments tabled in the last 20 minutes or so from the opposition.

The Greens will be ensuring that the feedback, which I am about to seek leave to table, will be taken on board by both the government and opposition in their contributions to this debate as we enter both the second reading conclusion and the committee stage. The ANMF outlines some of their concerns with regard to the requirements of the hospital boards, and noting the terms of the provisions with regard to clarity around direction and also a single-stream accountability. They also seek to ensure that the medical practitioners include nursing and midwifery in this level of governance. At this point, Mr President, I seek leave to table the correspondence of the ANMF with regard to this particular bill.

Leave granted.

The Hon. T.A. FRANKS: Thank you, Mr President. I continue. It will be no surprise that the Greens also contacted the Australian Medical Association of South Australia and similarly have received some feedback from that particular body. They note their concerns with the tight time frame. They have, indeed, exercised their view in the correspondence that it is disappointing that this time frame is so short. I also reflect on the AMA's diligence in going through their old records and referencing the Health Care Act debate of 2008. Indeed, I suspect they were similarly displeased with, while a longer time frame, the lack of consultation with regard to the act that now exists that brings us to the bill in terms of unpicking some of that work.

Certainly, both sides are not covered in glory in their consultation with bringing either of these governance models before this parliament. At this point, Mr President, I seek leave to table the correspondence of the AMA of South Australia, dated 18 June, with regard to the bill.

Leave granted.

The Hon. T.A. FRANKS: The highlights of the AMA feedback are that the board membership should include medical practitioners, that doctors are needed in leadership roles and that consultation needs to be more adequately undertaken. They indicate their awareness that this is stage 1 of this process, and we certainly will not be so relaxed and comfortable should a further bill come before this place without the appropriate level of consultation. The highlights of that particular submission included: a need for accountability, country services and relationships with metropolitan services, appointments to the board on merit being defined and provisions for that consultation and engagement strategy needing to be more inclusive.

Finally, it will come as no surprise to members that the Health Consumers Alliance of South Australia has also made a submission, at my behest. Having received this legislation, I undertook to contact stakeholders through my office. None of what I have tabled so far has been received from either the government or opposition, and I just note that.

The feedback from the Health Consumers Alliance does express their grave disappointment. I put on record that the Greens echo that grave disappointment of a lack of a consumer voice in this debate. We will certainly be prosecuting their concerns as we enter the committee stage. There are several recommendations here that I would like the minister to respond to in the summing-up speech, or certainly by clause 1 of this bill. I seek leave to table the feedback on the draft Health Care (Governance) Amendment Bill from the Health Consumers Alliance.

Leave granted.

The Hon. T.A. FRANKS: Members will be very happy to hear that that was the last of the documents for which I have sought leave to table today. I have done this so that all members of this council and the other place have the benefit of those documents in guiding our deliberations on what has been set as a very short time frame.

With goodwill and good spirit, the Greens support the second reading of this bill. We will be looking to the Labor amendments. So far, from a brief glance, some of them seem to be quite constructive amendments that we will likely support, and we encourage the government to provide that feedback we have requested to the issues raised in those tabled documents as we progress this in a good spirit to ensure that that local governance in our health system addresses some of the concerns that the Greens and others have raised.

Just this week we have heard that some patients have been waiting more than 16 years for hospital treatments in South Australia. We have seen that Transforming Health, the most significant health reform in this state, was undertaken on a falsehood of a supposed 500 avoidable deaths, which were 500 fictional avoidable deaths. We will be testing both the new minister who has promised a greater transparency and clarity and we welcome the provisions for publication of real-time operational information that is contained in this bill.

But we will be holding both sides to account. We will be holding the Labor opposition to account for the failures of Transforming Health and the way that was undertaken and rolled out. Anyone who read the non-existent—well, you could not read the minutes of the consultations with regard to the closure of the Repat because they did not actually take any. Anyone who observed that process of how the Repat was closed and how the Jamie Larcombe Centre was created would not be able to sustain an argument that that was done with community support. We will hold this new minister to account for the same standard that he has set for the now opposition. With those few words, I indicate we look forward to the committee stage.

Debate adjourned on motion of Hon. D.G.E. Hood.