Health Care (Governance) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 14 May 2019.)

The Hon. D.G.E. HOOD (15:25): I rise to speak in support of the Health Care (Governance) Amendment Bill, which introduces measures to fulfil the Marshall Liberal government's election promise of developing a new governance and accountability framework for South Australia's public health system.

As you would be aware, the state government committed to developing decision-making in the public health system through the establishment of metropolitan and regional boards, deferring responsibility and accountability for health services at the local level with appropriate oversight and holding governing boards accountable for the performance of their respective local health networks (LHNs).

This was a determined effort to shift away from the previous Labor state government's endeavour to centralise control of our health system through abolishing local health boards via the introduction of the Health Care Act in 2008. It has always been the Marshall Liberal team's firm position that a $6 billion sector, comprising 77 hospitals and health services and almost 40,000 employees, would be best administered at a local level.

Critical decisions pertaining to health care should be made as close as possible to the areas and people who will be affected, to enable the involvement and engagement of these communities and their local health professionals in the process at hand. This policy was developed by the Marshall Liberal team prior to the 2018 election. It was consulted with stakeholders prior to the election and it was taken to the election as a clear and publicly held policy.

It goes without saying that the government was then elected, endorsing the policy taken to the election. It was followed by a first round of legislation, with consultation, and now a second. I am proud to be part of a government which, unlike the former Labor government, lays its cards on the table ahead of the election. For the Leader of the Opposition to talk about a lack of consultation is to add insult—

The Hon. I.K. Hunter: And then lies about it. That's what you've done: lied about privatisation. You lie about all your promises.

The PRESIDENT: Order! The Hon. Mr Hunter, please!

The Hon. D.G.E. HOOD: For the Leader of the Opposition to talk about a lack of consultation is to add insult to the injury of their consistent opposition to this government's work to fix their mess which was the health system.

Let's be clear: Labor abolished the boards. Labor criticised our policy at the election. Labor opposed the bill which reintroduced boards. Labor is continuing to play the wrecker with this bill. If members recognise the mandate of the government or support devolution, they should be very wary of Labor's games on this bill.

As the Minister for Health and Wellbeing outlined in his second reading explanation, the first stage of implementation of the Liberal government strategy included the formation of governing boards, which provided for board chairs to be appointed in preparation for the commencement of their operation on 1 July this year. Those boards would be responsible for the delivery of high-quality, accessible local health services within their geographical areas and will be required to demonstrate their progress against key performance indicators, with ultimate accountability to the minister. This bill provides for the execution of that second stage, which is the establishment of a new governance and accountability framework for public health.

To reiterate the specifics of the bill, it amends the Health Care Act 2008 to revise the functions of the chief executive of the Department for Health and Wellbeing; formalise service agreements between the chief executive of the department, LHNs and SA Ambulance Service; dissolve the Health Performance Council once a commission on excellence and innovation has been established; create transitional provisions for the annual reporting and transfer of assets and liabilities from the metropolitan governing councils that will be resolved on 1 July; and introduces minor amendments to certain sections of the act to reflect the new framework or to clarify their intent.

I note Labor's opposition to this bill. Of course, they opposed the last bill, too. They will do anything they can to make it difficult for the government to improve the healthcare system. That is a shame indeed. The Health Performance Council is a case in point. The Health Performance Council was established by the former Labor government in the context of the dissolution of local boards and the centralisation of control into the department.

In his contribution the Leader of the Opposition spoke in some outrage about the proposed dissolution of the Health Performance Council. He described it as, 'the body that sits atop the SA Health system and, importantly, provides independence, oversight, reporting to parliament and the view of the entire healthcare system for South Australia, not just hospitals.'

What the member does not say is that the government in which he was a minister introduced bills in this parliament twice to dissolve the Health Performance Council—twice—while maintaining the centralised control, which was one of the factors in their Transforming Health disaster. It was only the amendments moved by the Marshall Liberal team that prevented the dissolution of the Health Performance Council, and our defence of the Health Performance Council was in the context of the health system as it was then structured. The member for Bragg made that quite clear when, in her contribution, she pointed out that there are no boards to provide accountability in the system.

The Marshall Liberal team has been consistent in its approach. When the health system was centralised without the accountability of boards, we supported the functions of the Health Performance Council. Now we are increasing accountability through the institution of boards; we believe the boards and a range of alternative arrangements will now provide robust performance monitoring.

In contrast, Labor tried, in government, to reduce their own accountability and then, when the Marshall Liberal government is reforming health governance to increase accountability, Labor simply acts as wreckers. This council deserves better from its members than those sorts of cynical political games.

In my estimation it has been evident that reform of the current system has been warranted to reinstate the influence of local medical professionals and residents on the outcome of possible healthcare service changes, and it is no surprise that the Liberal government's plan has been particularly well received in country South Australia. Since my election to this place, the requests for assistance I have received from constituents have often pertained to their personal healthcare needs or to concerns with the adequacy of services provided in the regions. I have no doubt other members present would have had a similar experience during their time in this place.

As a result, from the time Labor pursued its own overhaul to our health system just over a decade ago I have become increasingly active in my advocacy for South Australians receiving unsatisfactory or insufficient health care, most often on behalf of those residing in rural and regional South Australia. Indeed, I attempted to legislate for a guarantee of greater consultation and scrutiny when the government of the day, the Labor government, proposed the closure of any country hospital, held community meetings to gauge the sentiment of local residents when the provision of medical services were at risk of diminishing, and also raised awareness of numerous needs that were seemingly being ignored due to a move towards centralised decision-making.

South Australians have clearly been calling for change, and this bill seeks to fulfil a key aspect of the Marshall Liberal government's comprehensive strategy to improve health care for all South Australians. We are intent on reducing excessive bureaucracy that has the propensity to inhibit productivity whilst focusing on the quality, safety and accessibility of basic medical necessities for all patients.

In a state as vast and diverse as South Australia, our hospitals and health centres demand a structure that facilitates the development and execution of measures that respond appropriately to challenges unique to their specific localities. I am confident that this framework will result in a reliable public healthcare regime that better meets these varying needs.

South Australians deserve a sustainable, transparent and robust system that adopts best practice wherever possible and espouses the collaboration of clinicians, managers, health service partners and consumers for an innovative and pragmatic approach to meeting the evolved requirements of the changing population. I strongly support the bill.

Debate adjourned on motion of Hon. J.E. Hanson.