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House of Assembly - Fifty-First Parliament, Second Session (51-2)
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No-Confidence Motion

NO CONFIDENCE MOTION: MINISTER FOR HEALTH

Mr HAMILTON-SMITH (Waite—Leader of the Opposition) (14:18): I move:

That this house has no confidence in the Minister for Health for his failure of leadership across the health portfolio, resulting in the resignation of over 130 doctors, the collapse of essential health services in metropolitan Adelaide, and for the introduction of a country health plan which puts lives at risk across the state:, and that the house calls on him to resign and, if he fails to do so, that the Premier removes him for his failure to safely and effectively manage the public health system.

How did it get to this? The health system is in crisis. In February 2002 the Premier described, with crocodile tears in his eyes, the situation where patients waited on trolleys in corridors. He is trying to trivialise the health crisis—look at him; trying to have a joke. The Premier said it was a 'genuine health crisis'. When he was offering himself to be elected, he said:

People are scared they will end up on a trolley in a hospital corridor, waiting frantically for 24 hours or more to be admitted.

He got himself elected and then, rather than do something about it, it got worse. Under the watch of the Minister for Health, doctors are resigning. In doing so, they publicly reveal that patients waiting on trolleys in corridors is an everyday occurrence under this Premier and this minister. In some cases they are there for five days at a time. One patient spent five days in a corridor, according to doctors. This is the South Australian health system in 2008 under state Labor. Instead of minister Hill spending money on his radio ads, perhaps he should commission a report into why that patient spent the best part of a week in a hospital corridor.

Doctors are handing resignations to the minister en masse. Dr David Rodda of the Queen Elizabeth Hospital has quit because he has had 'a gutful'. He said he 'has just got to the point where I have just had a gutful, it has all become too hard.' There are 44 anaesthetists who have handed their resignations to this minister, and 50 emergency department doctors have quit the health system this minister is mismanaging. Including other letters received, there are over 130 doctors willing to resign who do not want to work for this minister and this minister's health system. And what does the Premier and his health minister say to these people? They accuse them of blackmail and extortion. Well, that helps. These doctors are treating the dying every day, people in pain—

Members interjecting:

Mr HAMILTON-SMITH: They think it is a joke, Mr Speaker; they think our health system is a joke. The member for West Torrens thinks it is a joke, the member for Mount Gambier thinks it is a joke. Anyone else? Well, it is not a joke; these doctors are looking into the eyes of injured people pleading for their help. Some of them die in emergency departments, some lose limbs, their families wait anxiously, and this minister will not listen to them. It is little wonder that three senior chief executives of public hospitals—the Royal Adelaide Hospital, Flinders Medical Centre, and the Women's and Children's Hospital—have left their posts under the regime of this minister. This is a health system in crisis, and the Minister for Health is responsible for it. He should resign.

The Hon. K.O. Foley: It is not in crisis.

Mr HAMILTON-SMITH: It is not in crisis, says the Treasurer. He wants to spend his money on half a billion dollars-worth of trams. Where? To his own electorate. And he says the health system has not got any problems, it is not in crisis. That is the Treasurer, that is the member for Port Adelaide, that is the bloke with the cheque book. The health system is not in crisis, it is all wonderfully sweet. He should answer to the people.

Mr Speaker, cast your mind back 12 months. The writing was on the wall. Nurses were imposing bans on non-urgent elective surgery, psychiatrists working in the state's public hospitals pushed ahead with up to 60 resignation threats, and our public dentists were offering patients free treatment as their work bans escalated. We are witnessing a pattern of behaviour; Labor's arrogance and bullying tactics have alienated an entire sector. Who suffers as a result of this poor management of the health system and its key workers? Well, the ones suffering are the most vulnerable in our society—the sick and the injured in need of help—and all because this Premier and his minister need the health budget to pay consultants to put together a funding model for this shiny, multi billion-dollar hospital—a monument to Mr Rann and this minister, who dreamt it up.

As a government, have the guts to put that decision to the people at the next state election. Give them a choice: rebuild the Royal Adelaide Hospital or sink billions into the hospital we do not need. Put it to an election on 20 March 2010, let the people who depend on doctors and nurses have their say.

You are a gutless government. A choice between bricks and mortar or doctors and nurses—go on, show us how courageous you can be. Report after report has revealed that South Australia is increasing its spending on health, increasing the number of doctors and nurses, while at the same time getting the worst outcomes. The health system is badly run. It is the incompetence of this minister that has brought the health system to its knees. This government must take responsibility; this minister must start taking responsibility.

According to the Productivity Commission, SA has the highest ratio of all of full-time nurses employed in public health services and South Australia has a higher than average number of medical practitioners. Many of these were brought into the public system when the management of state-owned Modbury Hospital changed from a private company back into the health department. We did not gain any extra staff: they simply went—

The Hon. K.O. FOLEY: A point of order, Mr Speaker—

An honourable member: What's the standing order number?

The SPEAKER: Order!

The Hon. M.D. Rann: 303.

The SPEAKER: Order!

The Hon. K.O. FOLEY: Is the leader in order to be moving a negative motion critical of the government and then speaking in support of the government?

The SPEAKER: There is no point of order.

Mr HAMILTON-SMITH: We did not gain any extra staff: we simply fiddled the books. We moved nurses and doctors from the private sector to the government sector and then we went around and said to everybody, 'Look, we have increased the number of doctors and nurses. South Australia has more doctors and nurses.' Do you know what? They had the same as before; they just went from one employer to the other, and they have been regretting it ever since.

The Premier responds to any criticisms of his government by trotting out numbers that show that he spends more than any government ever, but using inflation and natural expansion to claim you are delivering a better service does not add up. More is not better; it is how you run the system that counts.

What is it our nurses are really doing, I ask the house? This government is using nurses for clerical work. This is confirmed by the Paxton report. The report also discusses the constant bailout of funding required for the health budget—another sign of bad management. The minister cannot manage his health budget but he can find taxpayers' dollars to fund his political advertising campaign to try to discredit our doctors during an industrial dispute. Shame on you for that alone, minister. The problem is that they do not have the support of this minister. They are not valued by this government and patients are suffering as a result.

The Hon. J.D. Hill interjecting:

Mr HAMILTON-SMITH: You will get your go in a minute. You explain to the doctors and nurses and the ill why you have delivered chaos. You will get your go. They sit up here day after day; we ask a question (tightly time-limited), yet they have unlimited time to blast away. They do not like it when it comes back. They have glass jaws when their failures are spelt out to the people of South Australia. Yesterday, TV news viewers were treated to the sight of the health minister claiming that his cuts to country health would deliver a better service. Perhaps he was not out on the front steps of Parliament House because the public saw on television last night doctors, nurses and administrators flatly rejecting his stupid claim. 'What would they know?' is the attitude of this health minister. What would people who treat patients and run hospitals know about health?

Representatives and CEOs from country hospitals were invited to a briefing on country health on budget day. Many of them were on their way to the 2 o'clock meeting when they received a phone call from the minister's office that there would be no briefing until 5pm. Why, you may ask? Because the Minister for Health was tabling the bad news for country health at 5pm on budget day in the hope that no-one would notice. He was so proud of it, he skulked out there in the depths of the afternoon hoping that it would slither and sink without trace. That is the calibre of this minister in facing up to the people in the health system whom he supposedly serves. Shame on you for that, minister.

One doctor told us how regional staff were prepared for the changes. The week before budget they were sent to the city for training. Was it training on health administration? No, it was not: it was media training. Media Mike. It was media training. That says it all about this government and this health minister. You love your TV ads, you love your radio ads, you have spent hundreds of thousands of dollars just in the last few weeks, but you cannot be bothered listening to the people who deal with emergencies, chronic disease and the aged. These are the people who deliver a child in a country hospital and then care for the child through to adulthood. They deal with almost every chapter of country people's lives. They know what you have done to gut their hospitals, and that is what you have done, and you will not listen to them.

If you want the truth, let us see the Reid McKay report into the true state of working conditions in our public hospitals. The taxpayers paid for it, they deserve to see it. This minister has kept it secret. Be prepared to be judged. Release the Reid McKay report. This minister talks and talks and talks. He assures, he assuages—the persuasive minister—but he fails the sick and the injured, he fails the doctors and nurses, he fails their families. We say to the minister: resign.

The Hon. M.D. RANN (Ramsay—Premier, Minister for Economic Development, Minister for Social Inclusion, Minister for the Arts, Minister for Sustainability and Climate Change) (14:32): Occasionally over the years, no-confidence motions have been politically dangerous. They were dangerous at the time when there was a majority of one, when governments on both sides had to rely on the vote of an Independent. There were times, for example, in coalition when we had to rely on the support of Peter Lewis and had to determine which way he was going to vote. What we have seen with this Leader of the Opposition is the boy who cried wolf.

This is Thursday; it is the sixth day in a series. We have seen a pattern. 'When in doubt, what do we do?' The brains trust around the office, 'I know, maybe if we do a no-confidence motion. We didn't get a great run last night on the leader's address. Maybe if we have a no-confidence motion at least we're guaranteed that the tellies will run him. At least we are guaranteed that. Okay, it might say at the end it was defeated on party lines.' That is basically what this is about: 'How do we get on the telly today?' Of course, it is a bit the same when they are talking about medical figures. It is a bit the same as what the brains trust in the leader's office does on unemployment figures day. It must be really depressing for them that there are now 87,000 more people in jobs than when he was in cabinet.

Today, because they are written for him, he did not actually read through his speech before he read it out in parliament. He read out, with damnation on his face, the productivity council's report, which said that we have more doctors and more nurses per head in this state than in the other states of Australia. Then, suddenly, he went red in the face because he realised what he had just read out. Read the speeches that are written for you before you come into this chamber. Of course, his priority was not hospitals: his priority was not to have a new hospital but to have stadium.

The Hon. P.F. Conlon interjecting:

The Hon. M.D. RANN: Yes, we were wasting money on hospitals. That is what the Leader of the Opposition has said until today. He was going to have a $1 billion stadium. My challenge to him and the people of this state is: if you want a $1 billion stadium, vote for the Liberals, and if you want a brand new hospital at the centre of a rebuilt hospital system, vote Labor. That is what this is all about today. Let us look at the figures. This government has dramatically increased spending on health care since we came to office. This year we will spend over $1.3 billion more on health than the Liberal government spent in their last year in office.

If he thinks that is the inflation rate, then he is not qualified to be premier of South Australia. We have been successful in recruiting extra doctors. We now have 699 more doctors in our health system than when he was in cabinet—699 more doctors than when he was in power. We also have 2,406 extra nurses in our health system. The Labor government is rebuilding our health system, building a new emergency department, and extra capacity at Flinders, practically doubling the size of the Lyell McEwin Hospital, and rebuilding the Queen Elizabeth Hospital—the hospital the Liberals wanted to privatise. Just as we saw what they did to the Modbury Hospital and this government has brought them back into the public fold. Also we are building a new state of the art central hospital.

Let me tell the Leader of the Opposition, I have seen the polling and the people of this state know that Labor and this government is massively, overwhelmingly better for public health than the Liberals, whose only solution was to cut and cut and cut, and then privatise. If you want the next election campaign to be about public health, then bring it on: bring it on, because you can have your stadiums and we will rebuild our health system and employ record numbers of doctors and nurses.

We are also working to take the pressure off our hospitals. We are committed to employing an additional 20 staff in emergency departments, building GP Plus centres, one-stop shop primary health care across Adelaide, establishing the Health Direct Call Centre with fully trained registered nurses, and under the cooperative arrangements with the federal Labor government we expect to deliver real improvements in hospital care and primary care.

This rebuilding, this massively greater expenditure on health, was done at the time of a federal Liberal government that every time that we increased funding was taking its funding away. For years the federal Liberals cut their contribution to the states under the health care agreement. Instead of funding our hospital system as equal partners under a 50-50 arrangement, Howard and Abbott contributed barely more than 40 per cent to the cost of our hospital system. Eleven years of federal Liberal neglect, and those Liberals opposite have the audacity, the arrogance to preach to us. You, sir, are phoney on hospitals. You, sir, want only to cut hospitals and privatise hospitals, just as you did when you were in government. I was talking just a moment ago to Colin Heath in the gallery. He could see what is happening in this state and what would happen under the Liberals.

The industrial dispute: the state government has made a $260 million offer to the doctors' union and has committed to negotiate a fair resolution to this dispute; or, if you believe that your answer is to cave into every demand, then my simple proposition to you, or to any industrial party, is if you do not think that we are being fair, then take it to the Industrial Commission, and let the independent umpire decide. We, on this side of politics, are prepared to accept the independent umpire's decision, even if we do not like it.

My message to all of the parties that are currently going through their three-yearly cycle of argy-bargy, is to listen to the independent umpire. We will negotiate with you fairly, but if you do not think that we are being fair, take it to the Industrial Relations Commission and you, we hope, will accept the independent umpire's decision.

Let us look at some of the things that are being said. The Leader of the Opposition led with his chin and said that he read the productivity report, which completely undermined his own argument and said that there were more doctors and nurses in this state per capita than anywhere in Australia. Well, let us have a look.

It says that the government offer will place South Australian Public Service doctors amongst the best paid in the nation. A senior doctor currently earning a remuneration package of about $199,000 will have an increase to about $325,000 under our arrangements. That is an increase of $126,000 over three years. Not many workers in this state, professional or otherwise, would get a $126,000 pay increase, and that is what we are offering.

Also, under our arrangements a senior emergency department doctor would earn a package of around $356,000. A senior anaesthetist not in private practice could earn a package of about $325,000, or up to $392,000 with private practice. In comparison, the doctors' union is seeking an increase in remuneration packages for emergency department doctors in excess to $424,000, for anaesthetists an increase to $453,000, for an anaesthetist with private practice an increase up to $532,000. Wouldn't every worker in this state like to have increases like that?

We are not going to be generous; we are going to be fair, and we are prepared to listen to the independent umpire. But the Leader of the Opposition is totally, absolutely phoney, because, when they were in power, in association with the federal Liberals, all they did was cut, cut, cut public health, try to Americanise the system, and try to ringbark the public hospital system—of course, ultimately, with one desire and one desire only: to do to our public hospitals what they did to our power system, which was to privatise the lot.

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (14:42): In May 2006 the Treasurer announced that his budget was under such enormous financial pressure that he would have to delay the state budget for months and go and get a consultant's advice in New South Wales, because the health costs were such a pressure on his budget. That is how desperate the financial situation was in South Australia.

The Hon. K.O. FOLEY: I have a point of order, Mr Speaker. Just to clarify, is this a no-confidence motion in me or the Minister for Health?

The SPEAKER: There is no point of order. The Deputy Leader of the Opposition.

Ms CHAPMAN: Thank you. At the same time, in May 2006, the Minister for Health and his advisers, along with the Premier and his advisers, were burrowing away into how they were going to plan a $1.9 billion hospital. I can imagine how it went. It went something like this: 'Everyone else in Australia is building a new hospital. We need one. In Hobart in Tasmania they are building one in a railway yard; perhaps we will do the same.' While the Treasurer is saying our budget has to be delayed for four months, they are planning and plotting a new $1.9 billion hospital.

As if there was not enough money to throw around, they decided they might waste a bit more. They moved down to the Modbury Hospital, having said they were going to deprivatise it. What was the cost of that? The cost of it was $42.5 million for this state to pay out the Healthscope contract, the extra cost of running the hospital for the length of the contract, and the loss of $5 million a year in payroll tax alone. That is how costly that little exercise was. Of course, the real purpose was to bring the staff back so that they could strip that hospital of obstetrics and paediatric services.

Then we have the next pearler. While the minister is sitting in cabinet and listening to the Premier announce that he is going to build a $47.5 million film production studio in the middle of the Glenside Hospital, of course, other ministers are saying that we will have to sell off half this site to pay for the redevelopment. But, no, they have got $47.5 million, for the Premier to pay $2.5 million for a big slice of the hospital—

An honourable member interjecting:

Ms CHAPMAN: Read the budget papers—and $45 million to put a studio there. We have so much money. However, the Premier is in New South Wales trying to get some advice about how to put a budget together. You tell me about the fiscal responsibility of this government. Here is the last little pearler. They are going to build the Marjorie Jackson-Nelson Hospital and bulldoze the Royal Adelaide Hospital. What are they going to do? At a cost of $15 million, they are going to relocate the renal transplant unit (which is happily accommodated at the Queen Elizabeth Hospital) at the Royal Adelaide Hospital, which they are going to bulldoze. That is an absolute ripper of a financial fiscal responsibility.

When things start to fall apart, the bureaucracy goes out of control. Three CEOs do not even want to work for the government in their hospitals. They do not want to give us the Paxton report. It is like pulling teeth to get that out of them. That tells us fairly and squarely about the extraordinary waste under this minister. They will not show us the Reid McKay report, the IMVS due diligence report, or even the food report into public hospitals, because they are embarrassing. Their own FOI officer tells us that they will not release these reports because they could be used for mischief. Well, it would be mischief all right, because the people of South Australia are paying tens of thousands of dollars and they need to see these reports.

Of course, we have the failure in both public health and safety. For instance, for elective surgery, one in five patients wait for more than a year for a hip replacement in this state and a 6½ hour average wait in emergency departments—the worst in the nation for an emergency department. Let the minister go to Flinders Medical Centre. This week it is on code grey. Code grey means that they are in serious trouble in the emergency department. Code grey means that there are 20 people waiting in the corridors to get a bed. That is how serious it is at that hospital—and that is this week under his management.

Let us look at protecting the public in the street. He cannot even protect South Australians from an HIV-infected person who is currently charged with the multiple wilful infection of people. For two years that was hidden from the people of South Australia. What does this minister do about it? He has a review. Has anyone been sacked over it? Not a one. An absolute mismanagement, leaving people at risk in this state. Let us look at the workforce mismanagement. First of all, we have the cosy little deal with Dr Chris Cain (former AMA president): $70 million extra for some specialists as we go into the 2006 election—not all specialists just some specialists: the neurosurgeons and few others who were cherry picked; a few little sweetheart deals.

You made a rod for your own back, minister, because, in the past two years, we have had protracted disputes, threatened resignations, interruption to patient treatment, nurses, radiologists, psychiatrists and intensivists all out there—the intensivist was a winner. Of course, in January 2007, the Royal Adelaide Hospital, the major tertiary hospital in this state, was threatened with loss of accreditation, and we had to quickly do a little deal. Little wonder that we now have 100 resignations placed on the minister's desk and the future of trainees put at risk.

What has gone wrong? First of all, he sent the minister sitting next to him to try to manage this. This is the man who oversaw a $1 billion blow-out in WorkCover—and he sent him to handle the negotiations! That is mistake No. 1. Mistake No. 2 is to sabotage the negotiations. When you try to resolve a matter—10 months later at this stage—you have to come to the table in good faith, put the information fairly and squarely on the table, and also send the representative who has the authority to make the decisions. This minister has failed in every single one of these matters. All he has done is have a public fight with the doctors about who is earning what and what they should be earning. He does not even have the decency to disclose the Reid McKay report and put that information on the table.

Even when he fails to put his message across, he uses more taxpayers' money to have an ad campaign to try to convince them that he is right and the doctors are wrong. Be honest, the minister has to disclose this information. This is the absolute ultimate failure in the minister's conduct in relation to this exercise. Ten months down the track, he is telling the people of South Australia that, as the Premier did today, it is up to the commission—'I will leave it to the commission.' The minister knows full well, or he should know—or get advice from the bloke sitting next to him—that enterprise bargain agreements are not arbitrated by the commissioner.

The commissioner has a due role in this jurisdiction to provide advice, support and guidelines—you should tell the Premier this, because obviously he does not understand that there is an independent umpire's decision. That is a complete furphy. The truth is that they have an advisory capacity and, if the minister and the Premier are genuine in saying this to the people of South Australia, they need to come clean on this. They have to say to the commissioner: 'With all the information before you—and we will give you the Reid McKay report—you put a recommendation and we will undertake to accept your recommendation.' That is an independent umpire. But he will not do that. He obviously does not have a clue about what he has to do to achieve it. Meanwhile, all the patients who had their elective surgery cancelled and who are at risk of major trauma in those hospitals remain in pain and at risk.

The final insult that has been issued this week to the people of South Australia as the news has filtered out after the secret little Country Health Care Plan is the utter discrimination against country people. There has been an absolute public outcry about this. Even the nurses federation came out this morning and condemned aspects of this program. Other speakers will speak on this, but it will be very interesting to see how the member for Chaffey and the member for Mount Gambier vote on this motion. I will be watching that very carefully, and so will the people in their electorates. I have received piles and piles of complaints about the inequity, how it would fail—

An honourable member interjecting:

The SPEAKER: Order! The minister will come to order.

Ms CHAPMAN: Interestingly, I have received a memorandum, purportedly from the Department of Health. It tells us that the consultation claim is a sham; that it is a misleading and shallow analysis of the data; that the four hub hospitals will not work because they are in the wrong place; that it will decimate the local towns; that it is inconsistent with the government's mantra; and, in fact, when it talks about remote areas, it will be a blatantly dangerous and ignorant plan. The rest of South Australia is telling you this. Let me read from a letter that arrived this morning from a lady at Mannum. She said:

May none of Mr Hill's kith and kin have the misfortune to be in dire need of acute care whilst out in country SA—as they may just end up shit creek without a paddle with this new doctrine.

The Hon. K.O. FOLEY (Port Adelaide—Deputy Premier, Treasurer, Minister for Industry and Trade, Minister for Federal/State Relations) (14:52): Mr Speaker, may I, on behalf of all parliamentarians, apologise to the schoolchildren in the chamber today.

Ms CHAPMAN: I rise on a point of order, Mr Speaker: we did the apology on Tuesday.

The SPEAKER: Order! There is no point of order. The Treasurer.

Members interjecting:

The SPEAKER: Order!

The Hon. K.O. FOLEY: Mr Speaker, I would ask that the deputy leader now withdraw the slur she just made on the parliament's apology on Tuesday.

Members interjecting:

The SPEAKER: Order! There is no need for the deputy leader to withdraw. The Treasurer has the call.

The Hon. K.O. FOLEY: I would like to conduct this debate with a degree of dignity. I would again say to members opposite that we are on public display for our behaviour in this chamber. We have with us a large number of impressionable schoolchildren and, on behalf of the government, I would like to apologise to the students in the gallery for the language just used by the Deputy Leader of the Opposition. I will let her reflect in a quieter moment on the use of that word when the gallery is full of schoolchildren. I think that was a very unfortunate incident.

Ms Chapman interjecting:

The SPEAKER: Order!

The Hon. K.O. FOLEY: I reflected last night in a speech—and I will touch on that now—that when we were in opposition the Labor Party was a formidable opponent. However, we fought from a position underpinned by philosophical beliefs, as a Labor Party.

Members interjecting:

The Hon. K.O. FOLEY: I know that members opposite have not got over what happened seven years ago, but we fought from a philosophical position. What we see today in the modern Liberal Party must make a number of senior Liberals extremely disappointed, because this is a party that will throw away the philosophical and moral support base that it has had for a century.

This modern Liberal Party in South Australia would have us believe that it would be fair to workers, that it would be prepared to pay any wage that a union asked for. That is what they said yesterday when even the member for Unley said, 'We're not paying the teachers enough.' Do people honestly believe that the conservative side of politics would be a side of politics in a modern parliament today arguing to pay unions whatever they ask for; a political party that would be critical of a government for reforming WorkCover? The truth is that that is not a conservative party's philosophical base. However, the team over there does not have the honesty or the decency to stand behind the Liberal philosophy and cause when it brings policies into this parliament.

In regard to wages, we have a classic enterprise bargaining dispute where one party wants more than what the other party is prepared to give. That is not a new occurrence; it is a stock standard procedure in these types of disputes. I will make a prediction: there will be a settlement; we will reach agreement—because we always do. What you do not do is offer up what the union ambit wants. I seriously doubt that anyone on the Liberal side of politics would ever be expecting that.

I find that, in earlier days (perhaps a year ago) the Leader of the Opposition was more honest and was basing his attack on government from the Liberal Party's philosophical base. He criticised me when he said that our state credit rating was under threat. He said the reason was 'Treasurer Foley's inability to contain state debt, combined with public sector growth in wages'.

A year ago I was being criticised for putting our finances at risk because we had not controlled wages. However, for the purposes of this argument, we are being criticised for not paying enough. The Leader of the Opposition is a master at contradictions. He hopes one will never remember what he said earlier. However, there was a classic one after the budget where he said:

The rate they're going they're running out of money; they're awash with cash.

He normally takes a day to contradict himself, but he contradicted himself then in the same sentence. That is what we are dealing with.

Then, what does he do? He says, 'We are not going to build a new Royal Adelaide Hospital; we are going to upgrade the current one.' We have already said what that will be. He might say $300 million, but it will take 15 years, not seven.

Mr Hamilton-Smith interjecting:

The Hon. K.O. FOLEY: I have not made that up.

Mr Hamilton-Smith interjecting:

The Hon. K.O. FOLEY: The leader just said, 'Unless you can prove it, you've made it up'—unless it is based on fact. What about the consultant's report into the stadium that you would not even release, or say the name of, or even who did it? What the Leader of the Opposition is saying is that we will rebuild the Royal Adelaide Hospital; a construction site for 15 years; that we would maybe save $300 million. Then what does he say?

Mr Hamilton-Smith interjecting:

The Hon. K.O. FOLEY: That is interesting, because approximately $200 million of that is for the relocation of the railyards. If you go ahead with your Federation Square or your new stadium or entertainment centre, you are still going to have to move the railyards. So you will still have to spend the 200, and 500 minus 200 equals 300. What does he want to do with that $500 million? Oh, 'Let's pour it into wages.' So, is that $500 million per year, or $50 million a year over 10 years, or $25 million over 20 years? What is it? You are taking capital and putting it into recurrent.

I have here a great read, the 'Too Little Too Late' document. What does the Leader of the Opposition criticise the government for? Remember, he said today that he will take half a million dollars earmarked for capital and spend it on recurrent salaries, but what do we see on page 11 of the document? It states:

Including GST and windfall gains from other taxes and charges from 2002-03 to 2007-08, the government will have collected a massive $3.7 billion more than they expected. Had this larger total been provisioned for infrastructure into a future fund and not spent on recurrent expenses, state Labor could have paid cash for...[the] electrification of [our] rail [system]...

Putting aside the nonsense of that particular piece, I agree with the essence of what he said: you should not spend money for capital on recurrent. He attacks the government, saying it should not have spent all this money on recurrent but should have spent it on capital, yet in today's argument he says, 'Let's not spend it on capital, let's spend it on recurrent.' It is a hollow argument and one that has no theme of consistency.

I will end on this. Whatever our faults as a government, whatever our weaknesses, whatever the Labor Party stands for (which some agree with and some do not), at least those of us on this side of the house have a philosophical underpinning of our policy formation. With Labor, what you get is what you see. I do not believe it would actually occur in government but, for the purposes of getting a headline and getting into government, members opposite have mortgaged their philosophical position and their moral authority as Liberal politicians. They have been prepared to jettison their philosophical beliefs and long-held traditions as a Liberal Party to behave in a manner that is all things to all people in order to get into government. We have seen Liberal governments operate in this state, and we have seen that they do not do what they say. South Australians will not be fooled into voting for a political party that says what they say, knowing that it is not the Liberal way of doing things.

In support of my parliamentary colleague the Minister for Health, I would also like to say that, in my view, he is the best health minister this state has probably ever had.

Ms Chapman interjecting:

The Hon. K.O. FOLEY: Lea Stevens was an outstanding minister, but in this case John's workload over the last two years has, in my view, shown him to be the best performing health minister this state has had—on both sides of politics. Members opposite have moved a no-confidence motion in someone with the courage and ability to rebuild our hospital system, to rebuild our state's health system. They have picked the wrong minister.

The Hon. R.G. KERIN (Frome) (15:04): I rise in strong support of the motion, and point out that the Deputy Premier's contribution was probably based on the lecture he got from Janet Giles.

Yesterday the government saw, but failed to acknowledge, the anger building in rural communities over the Country Health Care Plan. Given the tyranny of distance and the cost of travelling nowadays, it was a huge response, with a thousand people there—including a few nurses I spoke to who were told they were not allowed to attend but who felt so strongly that they chose to do so anyway. Country people rightly see this as an attack on their communities, their families, their future, their businesses, their services and very much their dedicated health professionals.

Yesterday we heard the Minister for Health selectively choose articles and a letter written about the plan. Minister, get your clipping services working because they have ignored 99 per cent of the opinion. I did not hear the minister quote the many concerned doctors who have already spoken out nor did I hear any mention from the minister of the Flinders News article about how up to 200 country doctors are planning to resign nor any mention of the editorials screaming for the rights of country people and the fact that they have been betrayed. Yes, I concede that there may be four communities which benefit but, minister, what about the other 54 communities and all their smaller satellite towns and remote areas? You are dividing rural South Australia. You have picked four winners and dammed the rest.

Minister, I have wondered ever since the plan was secretly released in the slipstream of the good news budget whether you and I are talking about the same plan.

Members interjecting:

The SPEAKER: Order!

The Hon. R.G. KERIN: The one I have is nowhere near as generous to country community hospitals and GP Plus emergency hospitals as you continue to claim. I wonder what your colleagues on that side have been told and given. I am never discourteous enough to attribute discussions outside the house but I would point out to the two members I was talking to last night that my copy, and that on the website, does not have 'draft' plastered all over it; in fact, I cannot even find the word 'draft' in the entire document.

Minister, I might not be as clever as your bureaucrats but I do understand rural communities and I understand that for many years, due to better transport, technology and viability, we have as good as lost many of our communities. It used to take a longer time to travel a given distance; so, as we have got better vehicles and better roads, towns and communities were rationalised—in fact, they have got closer. However, I am here to tell the minister that that process has actually ceased and, for the first time ever, it is being reversed by the government's neglect of rural roads to the extent that speed limits are currently being progressively reduced by this government, extending travelling times between hospitals.

The Hon. K.O. Foley: Saving lives, Kero. It's saving lives.

The Hon. R.G. KERIN: It doesn't save lives when you take longer to get to a hospital. This plan threatens to reduce significantly the number of viable towns. Thousands of rural South Australians have, in recent years, left smaller communities and invested in housing in bigger towns, primarily in the towns which will be downgraded to GP Plus emergency hospitals where now the presence of a doctor is under threat.

Let me mention Port Broughton where the doctor has made it clear that she will leave if the plan is implemented. Port Broughton has become a major centre for people retiring. People have settled there from a whole range of towns around the place and people have come to Port Broughton, and many other similar towns, because of the fact that they have a working hospital and a doctor. What now? Will the minister guarantee that all these country community hospitals retain a doctor? Of course he will not. What about backup services if the doctor leaves? There will be no guarantee there either. When the doctor leaves any of these 43 hospitals, what will happen? What will the bureaucrats then be recommending to the minister? You wonder why people are scared.

This plan is potentially a disaster for rural South Australia. The distances to travel right across the state are mind-boggling. Fuel prices are part of the disaster. The greater concern is the safety of our people, whether they be aged or young. I wish the minister, government and cabinet shared the respect my colleagues, our constituents and I have for our dedicated rural doctors, nurses and other health staff. The plan and the manner in which it has been imposed is an absolute disgrace. It shows absolutely no respect for our health professionals or the hundreds of thousands of South Australians affected. The scoffing at their concerns by the government only adds insult to injury. There is no doubt that the agenda of this plan and its architects has been to centralise to Adelaide the major health needs of the bulk of South Australians. Minister, the remoteness from 75 per cent of rural South Australians of the four general hospitals is but confirmation of that agenda.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (15:09): I start by thanking my colleagues for their strong support.

Members interjecting:

The Hon. J.D. HILL: Well, I would not expect the leader and deputy leader of my party not to support me. I am also grateful for the support I am getting from the broader community. Yesterday, I referred to the support I received from Stuart Andrew, the well-known member of the Liberal Party from the Riverland, and I would like to repeat some of what he said yesterday. He stated:

A politician is someone with whose politics you don't agree: if you agree with him he is a statesman.

He said:

It is my judgement that Health Minister John Hill is both.

In my contribution today, I hope that I am exhibiting both those attributes. The other thing that I am really pleased to learn is that the mayor of Mount Gambier, Steve Perryman, who is also the Liberal candidate for the state seat at the next election, also supports the plan, I understand, as it affects his community. I am pleased with that support also.

Members interjecting:

The Hon. J.D. HILL: The chief of staff will get on the phone again no doubt. I listened to the three speakers on the other side, and I think all of them were wrong. I do distinguish, though, the member for Frome because at least he was sincere in his statements. He may not have been accurate but he was definitely sincere.

In the time that I have I want to tell the health story for the benefit of the house. We know that in South Australia the demand for health services will continue to grow until about 2040. That is as a result of the demography that we currently have in our state. As people get older they need more health services, so demand will grow. The unfortunate thing is that the rate of demand growth is outstripping our capacity to pay for that growth. At the current rate of expansion in health services—about 8 or 9 per cent growth in real funding every year—our entire state budget will be sucked up by the health budget by about 2032. Clearly, that is unsustainable.

What we have to do as a state, whether it is a Labor or Liberal government in office, is to make that system sustainable so that we can build a strong, safe, affordable and complete health-care system which is sustainable. That requires guts, courage, reform and change. And that is what this party and this government is about, and that is what I am about as minister.

I want to go through some of the things that we have attempted to do or are doing. First, we have put in more resources so that we can build the infrastructure that we will need for the future, expanding the capacity of the hospitals so that that extra demand can be absorbed. It is true that there are problems in our hospitals because they have been under-invested in for many years. We have been wanting to improve the capacity at Flinders, Lyell McEwin, QEH and, of course, build a brand-new hospital which will create extra capacity in the city.

At the time we are doing that, of course, the opposition has opposed it. We have also used money to buy more doctors and nurses to put into our system. It was a total and absolutely fabrication when the Leader of the Opposition said that the extra doctors are those who came out of Modbury. I can assure the house that from the advice I have—and I checked it again—the extra doctors (700 extra doctors and 2,400 extra nurses) are on top of the doctors and nurses that came into the system as a result of Modbury being brought back into the system. But, I think it was good of the opposition to draw the attention of the house to the fact that it privatised Modbury, and that it would do it again if it had half the chance.

The other thing that we are trying to do is to improve the governance so that we have a streamlined, effective, coordinated management system in place in health. We have not have that in the past. We introduced legislation; the Health Care Act was passed by both houses. The only people in opposition were those on the other side. The Liberal Party was opposed to it because it made more efficient.

The third thing that we are doing is trying to better use our existing resources. That is the key to all of this. We put out a health care plan a year ago to try to streamline the use of resources, get a better use of resources, and reduce overlap and duplication. That is what the Generational Health Review said that we should do. We put this out and, of course, what did they do? They opposed that as well. We released a report by Paxton Partners into the efficiency of a number of our hospitals. That report has been referred to by the opposition to attack me, but when we try to implement it to make those efficiencies we get attacked, so they oppose that as well.

I tried to create a new pathology service for South Australia so that we can bring together those resources to make efficiencies, and they opposed that as well. But I am pleased to say that the upper house earlier today passed the legislation, so that will happen despite what members opposite want. We are also putting much greater emphasis on primary health care through our GP Plus health care strategy. We want to roll it out in the city and the country so that people have more access to primary health care. That is the area of the greatest need for reform. We have to increase the access to primary health care, and we have to better focus on prevention so that fewer people get ill and fewer people need our hospital system. We are doing that as a government but, of course, they oppose that as well.

I will refer briefly to the particular issues. In relation to the resignations, I am very optimistic that we will reach settlement with the union over this matter. The resignation letters, I believe, will be withdrawn. I hope that next week or the week after, whenever this is settled and we have got the doctors back to work, the opposition will come in here and move a vote of confidence in me for being able to achieve this outcome.

In relation to country health, I went through this in extensive detail yesterday. The opposition continues to make up stories about what we are proposing to do. What we are proposing to do is improve the quality of health care in the country, increase the amount of resources, have more hospitals with more services for more people. Yet they deny it, they claim it is not true. They are wrong. Just today I have received a note informing me that the Country Health SA Board met on Wednesday 18 June 2008 and resolved to support the government's South Australian Country Health Care Plan.

All those people are from all over country South Australia, and they come from the previous boards that were in place. The reason that they support it is that they support the objectives of the plan: the tiered structure of services; the emphasis on primary health care; the development of specific strategies for implementing the plan on a service by service basis in consultation with local communities, health advisory committees and clinicians; the improvement of IT infrastructure as a priority; and continuing to improve patient transport to support the new services structure. So members of the Country Health SA Board support what we are doing because they have had a chance to look at it, they have had a chance to think through it and they have had a chance to understand it. When they did that, they came to the same conclusion.

I will pick up a couple of the points made by those opposite. It was interesting to hear the Leader of the Opposition refer to the productivity report because, as the Premier said, he had a bit of a doofus moment as he was reading through it because he realised that what he was reading supported our side of the argument, that there are more doctors, there are more nurses and there are more beds. In fact, since we have been in government we have created 158 extra beds in Adelaide.

Ms Chapman interjecting:

The Hon. K.O. FOLEY: I rise on a point of order. The member just said we are wasting money on the doctors we are paying.

The SPEAKER: There is no point of order.

The Hon. J.D. HILL: That one interjection by the deputy leader undercuts completely that notion: 158 extra beds is a waste of money; 699 extra doctors is a waste of money. That is the view of the Deputy Leader of the Opposition.

Finally, the member for Frome referred to a headline saying 200 country doctors would resign. Mr Steve Holmes, from the Rural Doctors Association, said on Radio FIVEaa the other day that that was a gross exaggeration, or words to that effect. The newspaper, in its headline, got it wrong, just as the opposition has got it wrong here today.

The house divided on the motion:

AYES (14)

Chapman, V.A. Evans, I.F. Goldsworthy, M.R.
Griffiths, S.P. Gunn, G.M. Hamilton-Smith, M.L.J. (teller)
Kerin, R.G. McFetridge, D. Pederick, A.S.
Penfold, E.M. Pisoni, D.G. Redmond, I.M.
Venning, I.H. Williams, M.R.

NOES (28)

Atkinson, M.J. Bedford, F.E. Bignell, L.W.
Caica, P. Ciccarello, V. Conlon, P.F.
Foley, K.O. Fox, C.C. Geraghty, R.K.
Hill, J.D. Kenyon, T.R. Key, S.W.
Koutsantonis, T. Lomax-Smith, J.D. Maywald, K.A.
McEwen, R.J. O'Brien, M.F. Piccolo, T.
Portolesi, G. Rankine, J.M. Rann, M.D. (teller)
Rau, J.R. Simmons, L.A. Stevens, L.
Thompson, M.G. Weatherill, J.W. White, P.L.
Wright, M.J.

PAIRS (2)

Pengilly, M. Breuer, L.R.


Majority of 14 for the noes.

Motion thus negatived.

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