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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2008-09-25 Daily Xml
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HEALTH CARE (HEALTH ADVISORY COUNCILS) AMENDMENT BILL

Introduction and First Reading

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (10:50): Obtained leave and introduced a bill for an act to amend the Health Care Act 2008. Read a first time.

Second Reading

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (10:51): I move:

That this bill be now read a second time.

It is with pleasure that I move the Health Care (Health Advisory Councils) Amendment Bill. Historically, this has a genesis in the single fact that the government has moved to abolish hospital boards across the state, except with some protection originally to the hospital board of the Repatriation General Hospital and not attempting in any way to move with the health board that operates in the APY lands. We have since, of course, seen the demise of the board at the Repatriation General Hospital.

Having seen the abolition of the boards, which we had given very clear warning to the people of South Australia would silence the local communities in South Australia, particularly in country regions, we have subsequently seen the release, deliberately after the abolition of the boards, of the ill-fated country health plan by this government. This was a country health plan which had been issued after 12 months of alleged consultation and which was exposed as a complete and utter sham.

During the course of the attempt by the government to force feed country people that they should just accept in silence the savage attack on their country hospitals and health services, they responded. They filled halls across this state and objected loudly to the government's attempt to impose this measure and slash those services and to expose the fact that they had not been consulted at all and, indeed, that it was a complete and utter sham.

After this attempt to silence the people—having, of course, secured the absolute control and the single employment by Dr Tony Sherbon of all health professionals and employees in our public health system across the state and have them sign and execute as part of their employment contract that they are not to make any statement in relation to policy and having gagged their employees and silenced the people—the outrage, however, overflowed into the halls, the streets and other public forums on this issue.

The response to that is that the opposition says that we must give back to the people of South Australia—these communities—at least three rights. The first is to enable them to have a say—an absolute and clear say, which is the first of the proposed amendments—in what services are provided to the community. This amendment will allow the local community to have a say on the services that they have and any change of those services by the approval of the Health Advisory Council, which, for the purpose of this debate, I identify as the replacement body for health boards.

The government will retain absolute control of the funds, which has been the case for some 32 years, since the transfer of powers from local communities to state government funding, in the wake of the Whitlam reforms. So, if a hospital is entitled to $25 million or $30 million as an allocation through the budget, that will still be within the realm of the government. I seriously ask the government to accept this amendment. If it is genuine in its support for country people to have a voice, this will allow them to have one.

Interestingly, on this point, the government has allowed the Pika Wiya Health Council and the Ceduna/Koonibba council to get out of this whole central control system, and that is to be applauded. Frankly, it should let some others out, and I hope it will allow that to happen. However, in the meantime, we move this amendment to ensure that, if the people in the local community say, 'We want more aged beds and fewer acute beds,' or, 'We want more acute beds and fewer aged beds,' or 'We want obstetrics instead of paediatrics,' or whatever provision of services their hospital requires, they will have a say about it.

The second aspect of this bill is to provide for the local health advisory councils to have some control over the money that is raised in the local community. At the moment, we have the absurd situation where, a local community having raised its own money, the minister has to approve any project where it spends more than $5,000. What an absolute insult that is, especially as the local community has raised the money. We have already had the scandalous situation where the government has received money from the Mount Gambier district, which had raised money for a hydrotherapy pool, but where that money is languishing in a fund under the control of the government, and it has refused to give it back.

This amendment will ensure that we remove the $5,000 cap on local HACs being able to decide, on behalf of their community, how this money is spent. So, a minister cannot come along and say, for example, 'No, you are not allowed to put in a new sunroom or development area for the people who are living in this hospital; you have to spend it on the guttering.' That is totally unacceptable, it is unnecessary and it is an insult to the intelligence and the commitment of local communities to their hospitals.

The third matter is to ensure that the financial accounts of the health service or hospital are disclosed to the health advisory council. We have this absurd situation at the moment where the health advisory council is supposed to be advising the minister on important issues relevant to the health service in its community, yet it is isolated from the financial accounts of the hospital. It is one thing for the government to have now employed everyone to control all the money, to absolutely control the management of what happens in a hospital: it is another thing to expect that the health advisory council has the full capacity to properly advise a minister, freely and without fear or favour, without even knowing what the financials are.

So, that aspect of this bill will enable the health advisory council to be fully briefed with respect to the ongoing financial position of the hospital. This amendment, therefore, will require the department and/or Country Health SA (wherever it might be hidden) to at least provide the financial accounts every month to the health advisory council. I am talking about the balance sheet, the profit and loss statement and the cash flows. A full financial account will therefore be provided to the members of the health advisory council so that they know exactly what is going on in their hospital, understand which services are under pressure and are able to properly advise. At the moment, the isolation from this information is unacceptable.

I have asked a number of health advisory councils whether they have received the information when they have asked for it, because there is power for the health advisory council to write to the department and seek the minister's permission to have certain pieces of information, and some of them have not even received this. When we have asked about this at public meetings, the response has been, 'We will provide such information as we consider is reasonable.' Again, this is a complete isolation from fundamentally basic information that is necessary for those councils to form an opinion, consult with their local community, seek further advice and present a report to the minister. Without this information, they are unable to undertake even the very basic responsibility that the minister has given them.

These three initiatives which the opposition presents not only reflect many voices in country communities, but also we suggest they are modest in the area of reform that could occur in relation to governance. Governance has been absolutely executed at the local level, and we consider that a number of areas in the Health Care Act should never have been permitted. We are not proposing to revisit that, but we ask the government, on just these three areas, if it is genuine in its commitment to consult with the people of South Australia in the regional communities, to carefully consider and accept these modest areas of reform as some recognition of the concern of these communities. Indeed, if the government gives this matter its wholehearted support, it might be believed.

Interestingly, just this week, the government has released details of the task force, chaired by Mr Peter Blacker, that will prepare a report. It will revisit, consult on and redraw the country health plan. Of course, during the course of the last few months, mark 1 has been withdrawn, mark 2 is to be prepared as a revised draft, and further consultation is to occur. We still think the government has got this back to front. Before it does mark 2, frankly, it should be doing the consulting first.

But I think the task force has done two things. It has reported that there does need to be a new plan, full consultation and further monitoring on workforce issues, which we suggest the government will use as an instrument to get a backdoor reform through and decimate acute care services. We have given this warning before, and it is very clear that the government has not been listening. But, if it is genuine in saying, 'Yes, we agree we are going to revisit this and we are going to do a new plan and properly consult,' this is a bill that it can support, and we ask it to do so.

Debate adjourned on motion of Mrs Geraghty.

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