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House of Assembly - Fifty-Second Parliament, First Session (52-1)
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COUNTRY HEALTH

Mr VENNING (Schubert) (11:20): I move:

That this house—

(a) congratulates the Liberal opposition on its long-term support of country health, and in particular a new Barossa hospital; and

(b) condemns the Rann Labor Government for its continued failure to address the issue of equity in the provision of health services in regional South Australia.

Ms Bedford: That's a bit harsh, isn't it?

Mr VENNING: Madam Speaker—it is a day of change. The women have taken over today, haven't they? Women, at all levels. On a very historic day, when the women are dominating, the Liberal opposition has always been extremely supportive of country health, particularly my female leader, the Hon. Isobel Redmond. This support has been clearly demonstrated over a number of years. We mobilised, along with country communities, to force the Rann Labor government to withdraw the Country Health Care Plan released in 2008, which outlined cuts to services in 43 of South Australia's 66 country hospitals.

We fiercely advocated for the retention of hospital boards—local hospital boards—to keep management of hospitals local. Unfortunately, I believe, to the detriment of health services in the country, we were not successful and health advisory councils (or HACs as we know them) were introduced, which now serve as nothing more than mouthpieces for the government. It is interesting to note that the No. 1 draft of the now ex-Rudd government's National Health Plan contained the policy of reintroducing local management to hospitals. I believe that has now gone.

Recently, the draft ten year service plan for the inner north country health services (including the Barossa, Gawler, Eudunda and Kapunda) was released for public consultation and feedback. My issue with this is that comments and the feedback on the plan are to be directed to the health advisory councils. I find this to be a major cop-out, because, as I understand it, the HACs were asked to undertake community engagement and provide feedback to country groups in the first place about the gaps in service provision, community needs and views on their health services so that this information could be taken into account when forming the plan.

HACs were not ultimately responsible for the formulation of the draft plan. Country Health SA was responsible (it is its plan, after all); therefore, I find it a cop-out that feedback is required to be directed to the HACs. It is just another example of the Rann Labor government passing the buck when it comes to its responsibilities to country health. I also know that there have been issues with simple media releases, such as releases announcing the community engagement that HACs were undertaking. Up to a month or two ago, HACs were not even allowed to put out media releases without them first being vetted and approved by Country Health SA's media unit.

I understand that this situation has been rectified now, as many of the HACs were extremely unhappy that, despite the Rann Labor government repeatedly asserting that HACs were separate from the government, they were bound by the government's rule and instruction. Here we have two examples demonstrating how the Rann Labor government has been using the HACs to peddle its own political agendas. Now we find out that the Rann Labor government is working to seize the land assets of South Australian country hospitals and health services under the new Crown Land Management Act due to come into effect from 1 July.

This will involve all the trust grants which contain the land title of the hospitals being transferred to the Minister for Health. This is a very serious matter, Madam Speaker, and you particularly, as a country member, should be very concerned. We on this side of the house have a completely different view of country health from that of the Rann Labor government. We believe that functioning health services are vital to regional and rural communities, and they must be maintained to ensure that populations residing in country South Australia are supported.

Country people need assurance that, if they need medical treatment, there is somewhere for them to go locally, not just be sent off to the city because the government has stripped their services from their local hospital. Prior to the election, we demonstrated a commitment to country health to support regional and rural communities in several ways: committing to the construction of a new $35 million health facility in the Barossa—a matter very dear to my heart; guaranteeing after hours medical services at the Renmark hospital with a funding injection of $1.3 million over four years—great work by the new member for Chaffey; an additional $4 million over four years to the South Australian Patient Assisted Transport Scheme (the PAT scheme as we know it) and all credit to my country colleagues.

I commend my colleagues for agreeing to commit to the construction of a new Barossa health facility. The Barossa community has been waiting for a new health facility to service the region for a very long time, over 15 years now, and I received so many positive responses following our announcement. 'It's about time' was a sentiment I heard echoed over and over again.

I think the thing that surprised most of the community, myself included, was that the Rann Labor government failed to respond at all to the Liberal announcement and despite commissioning a business case, it did not put forward its own proposal or commitment. There was nothing. Unfortunately, we were not elected and so the Barossa community must continue to wait for its new health services—and I note that the member for Light listens with great interest and I appreciate that.

My big concern is that, once the new RAH gets underway on the rail yards, it will totally absorb all the health funds, especially from country health, and the Barossa will continue with a below standard facility for many years into the future. There is no money being spent on it—this is the Angaston facility—not even minor upgrades. Why? Because the facility is worn out, totally outmoded and way past its use-by date. Again I pay credit to those people who work in there and give great health care in a worn-out facility.

The disappointment for me (and this was experienced by the Barossa community) was that the realisation that the new health facility for the region would not come to fruition any time soon was not new. They have experienced this before. In 2001, the Liberals committed to building a new facility to be located in Nuriootpa with construction to commence in the 2004-05 financial year. However, since the Rann Labor government came to power in 2002, very little progress was made and it was shelved—another example of how little the Rann government does for country health. It is a physical example, a tangible example, of how Labor does not spend anything outside Adelaide.

The Rann Labor government withdrew its failed country health plan on 31 July and released a revised Country Health Care Plan—the draft strategy for planning country health services in South Australia—on 6 November 2008. The plan does not secure the future of health services in rural and regional South Australia as it lacks any detail or specific information. Currently, Country Health SA is releasing a draft ten year health plan for rural and regional South Australia and this is also vague in nature and lacks any specific detail, funding or service commitments.

The executive summary of the draft 10-year service plan for inner north country health services states, on page 5, that 'maintenance of current services is the primary focus of the draft plan.' This being the case, I question the need for a new plan at all. If the focus of this plan is existing services and provides nothing new, surely it defeats the purpose of having a new plan at all. How much has this exercise cost the taxpayer? And for what: just more lip service.

The Rann government has tried to downgrade and close country hospitals. It remained silent following the announcement of the Liberals' plan to build a new hospital in the Barossa and plans to build a new Royal Adelaide hospital on the rail yards which will, as I said, absorb all the funds from health for years and years to come leaving nothing for country areas.

Tack this onto the huge cost of the Adelaide Oval redevelopment and our state debt will be greater than State Bank proportions—no hope for a new Barossa hospital then. Yes, I do acknowledge the three new generators that have been promised for Angaston, Kapunda (thanks to the member for Stuart) and Berri (again, thanks to the member for Chaffey).

Today we have the ultimate insult: a press release by minister Hill, which I will quote:

New Investment in Medical Equipment for Lower North

The state government is investing $55,000 in new medical equipment for hospitals in the Barossa—

I say 'in the Barossa'—

to improve health care for people in the local community.

After saying 'in the Barossa', the three communities in the list are: Clare Hospital receives $20,000 for replacement scopes. Clare—is that the Barossa? No. Maybe we will keep going. Snowtown and Port Broughton Hospital, $20,000 for an Optilog ventilator. Barossa? Far from it.

An honourable member interjecting:

Mr VENNING: What about Burra Hospital? $15,000 for defibrillators. Madam Speaker, what an insult this is. Why put the words 'in the Barossa' when you name three—and we are grateful for the money and, again, credit to the members for doing this. However, it is a small amount of money. Again, the minister puts the name 'Barossa' there and those hospitals are all far from the Barossa. Minister, please, I would appreciate you getting it right some time. I have the Barossa media ringing me this morning asking for comment about that and, I am sorry, I cannot be complimentary at all to the minister, his press release or his staff who wrote it.

The Rann Labor government continues to fail to deliver adequate health services in country South Australia and fails to address inequities in service provision. It is not good enough and country people deserve better. I will not rest on my laurels in this matter, particularly in relation to equity in health, and our country people are paying a huge price, and I hope the member for Frome will speak.

I do recognise there are certain things that have been done, like dialysis in Port Pirie. I think that is a good move. I have been pushing that for years. When I was first elected 20 years ago that was an issue then because Port Pirie was in my electorate. At long last we are seeing something, but we have a long way to go.

I think the government ought to have the hide or the strength to say, 'Hang on, we got this hospital thing wrong. We will upgrade the Royal Adelaide where it is and we will put the money saved into our rural hospitals.' That is what we wanted. That would be a mature and perfectly smart thing to do. Not all ideas of the opposition are wrong and I believe, if you adopt that policy tomorrow, you would get more credit for it rather than criticism.

So I plead to the government: the amount of money you are going to waste on this new facility, when I think more than half South Australians want to upgrade the current RAH where it is, and the money we can save we can spend on country communities where, Madam Speaker, as you would know, it will certainly be appreciated. I ask members of the house to consider this and I would be very grateful for their support.

Mr PICCOLO (Light) (11:33): I rise to speak against this motion because, as usual, these sorts of motions put up by the opposition are long on rhetoric and lack the detail or any credibility when you consider them.

Mr Venning interjecting:

Mr PICCOLO: Member for Schubert, I sat here quietly and listened to you; I would ask that you give me the same respect. The member for Schubert has outlined things that he would like to see done. I agree with the member for Schubert that a functional health service for regional and rural communities is important. I have no difficulty with that. However, I would actually go further: we need a functional health system for the whole state. So we need to stop playing this city versus regional and rural type of dichotomy; this sort of debate to try to divide the community. I am a member of the state parliament and I work for the whole state, because part of my community is urban and part of my community is rural and regional.

Mr Venning interjecting:

Mr PICCOLO: As I mentioned, I sat here quietly and listened to you; I would suggest you do the same.

An honourable member interjecting:

Mr PICCOLO: I suggest, yes. Only the Speaker can direct.

Members interjecting:

The DEPUTY SPEAKER: I am fully on top of my game. I am listening with bated breath.

Mr PICCOLO: What is lacking in the member for Schubert's discussion and also lacking, generally speaking, in the Liberal Party approach to health, among other things, is a discussion about sustainability of services. The key thing about equity for anybody in this state—whether you are in Gawler, the Barossa or Clare, etc—is to ensure that we have services for the long-term. The underlying sustainability of our health system is important. When the member for Schubert gets up and talks about equity, he ignores the second, very important, part of that equation. It is important to have equity within the existing service, but it is also important to have a service which is sustainable in the long term.

When you look through the Liberal Party's health policy and their pronouncements—they have ignored that. They make these ad hoc decisions, that are all over the place, about what should be done and respond to what may be at times popular things, but which are not sustainable. Unfortunately, the health system they left for us, when we came into government, was full of ad hoc decisions which we now have to repair, get back on track and maintain.

The reality is—as the member for Stuart said yesterday—that costs to the health system are actually increasing at a greater rate than the normal CPI. He is quite right. When you look at the graphs of increasing health costs and what is required to sustain it—and this house has been told by the minister a number of times—unless there are dramatic reforms, we will not have a health system. There will not be equity for anybody, irrespective of where you live in this state.

The first thing you need to ensure is that the health system is sustainable. This is what the whole health plan was about: firstly, the state health plan, secondly, the country health plan. What are the underlying themes of those two health plans? One is to make sure we can actually afford a system which all South Australians can access on an equitable basis. This means that there is a hierarchy of services acknowledging: firstly, the provision of services—in other words, what can be provided—and secondly, the demand for services. You need to match the delivery of services to where they are demanded, which is very important.

The fact that there are more facilities in an urban area should not surprise us as the fact is that there is more demand for them in metropolitan Adelaide. That does not mean that people in rural and country areas should not have access to that service. We need to make sure that we get those services as close to the people as possible. This is an important element of the health plan. The health plan is about having a hierarchy of services to make sure that you can provide any procedure or medical need at the closest possible position. This is what we did. We upgraded a number of country hospitals: Mount Gambier, Berri, Whyalla.

Mr Griffiths: You haven't done it yet.

Mr PICCOLO: Well, it is planned. The plan clearly states that those hospitals will be upgraded to maximise additional services; that is to say, there will be a greater range of services to those centres. Part of that hierarchy is to ensure that people have access to those services. In reality, not every service will be provided at every health facility. If the Liberals are suggesting that they going to do that, I would like to see the numbers and financials for that.

We have moved services to country people. For example, in Whyalla, I understand, there is a new dialysis unit, so people do not have to come to the city for that service, so that people in the country area can actually get that service. I also understand, but there was also a recent announcement in Gawler moving a number of chairs for cancer services more locally, so people are not—

Mr PENGILLY: Point of order, Madam Deputy Speaker. This is plagiarism. This is what the minister read out yesterday.

The DEPUTY SPEAKER: That is a very serious accusation, member for Finniss: very, very serious. Given that I—

An honourable member interjecting:

The DEPUTY SPEAKER: I think you'll find I'm talking. Given that I have not read the statement that you speak of, I cannot rule on such a thing. At this point, I think we will give the member for Light the benefit of the doubt, because I suspect that at other times in this place, members on my left might have done something a little similar. So—

Mr Pederick: Outrage!

The DEPUTY SPEAKER: Outrage, perhaps. We must accept this and move on. Member for Light, the call is yours.

Mr PICCOLO: I can assure the house that I am not plagiarising anything. I just happen to know something about the health system and I take an interest in it. I actually try to know what we are doing, particularly in my own electorate.

Mr Venning: What about the Barossa Hospital?

Mr PICCOLO: The Barossa Hospital was not in my electorate the last time I looked, member for Schubert. If you want to secede your electorate to me, I am happy to look at it. As I said, there is a hierarchy of health services, and, as I was saying before I was interrupted by the member for Finniss—

The DEPUTY SPEAKER: Yes, but you shouldn't respond to interjections either, so let's just carry on.

Mr PICCOLO: Madam Deputy Speaker, I wasn't, actually. He had a point of order.

The DEPUTY SPEAKER: Yes, you were. You were just then.

Mr PICCOLO: Thank you, Madam Deputy Speaker for your support—and guidance, of course. For example, we have moved a whole range of new services to those country hospitals, recognising (as the member for Stuart quite rightly pointed out yesterday) that, when people in the country have to come to the city for services, it does not just affect the patients but also their families and a whole range of people.

The government recognises that and that is why, wherever possible, we are decentralising a whole range of services in conjunction with this hierarchy of hospital and health services. We have tried to link services so they can come closer to the people who need them. Members should also know that we have introduced a number of cancer chairs in my own local hospital in Gawler, in recognition that when people come into the city for services it is very disruptive not only for the patient but also the family.

The first thing about equity is to ensure that you have a system that can be equitable, which the Liberals have given up on. They just make these ad hoc promises all over the place. As the member for Schubert said, by his own admission, for 15 years they have been talking about the Barossa hospital, but eight of those were under a Liberal government. Why wasn't it built in the eight years the Liberals were in government? My understanding of the Barossa hospital, acknowledging it is not in my electorate, is that it is being investigated for future delivery.

The other point about consultation is that, under the new proposal, the health advisory committees do consult with communities. It is an interesting point that, on the one hand, the member for Schubert accused the government of devolving its responsibility when it asked those committees to consult with the communities but, on the other hand, we do not allow those committees to be consulted with. You cannot have it both ways—although he tries to—but the reality is that the health advisory committees' role is to consult with the communities. My own health advisory committee, for example, has just prepared a draft 10-year plan for services required in that community, and it has consulted quite widely, and that is its role and charter, and I see no problem with that.

When you look at the motion, when you actually (as the post-modernists would say) de-construct it, it is lacking, as usual, in any accuracy and is just a mishmash, ad hoc range of statements that cannot be sustained. Neither their policy nor the health system could be sustained, should they be elected. So it was not unfortunate that the Liberal Party was not elected at the last election; it was very fortunate for the people of South Australia that they were not, because we can continue with these reforms to ensure that there is equity in the system for all South Australians, including regional and rural South Australians, and that we have a sustainable system which is there for all South Australians, not the sort of system that they would insist upon, which would be fewer services for all of us in this state.

Time expired.

The DEPUTY SPEAKER: Thank you, member for Light, and thank you for your introduction of the postmodern dialectic into our discussions. The member for Fisher.

The Hon. R.B. SUCH (Fisher) (11:43): I want to be very brief because I know a lot of—

The Hon. S.W. Key: Famous last words!

The Hon. R.B. SUCH: You have hurt my feelings so I won't talk for long, now. I know a lot of the country members want to have a say. I want to talk for a minute or two and point out that, at the moment, country people, men and women, are disadvantaged in terms of health services. They are disadvantaged in the sense of access to services, the cost of accessing services if they have to come to the city, and in their mortality rates. I will give one example.

In prostate cancer research we know that the death rate amongst country men is 25 per cent higher than for city men. That is because they do not get the information, the services, and all the package in terms of health issues. I think you can argue it is similar in relation to women in the country as well. It is information, access to services and cost. In terms of the treatment, some of the high-level technology is not easily available to people in country areas. They have to travel to the city for some of the cancer treatments, and so on, and that should not be the case in a society like ours.

I will conclude by saying that my step-brother-in-law, who comes from that wonderful city of Port Pirie (I will not say his name), was in Adelaide last week to have a prostatectomy, with the robot at the Royal Adelaide Hospital. That cost him a bit, and he is happy to pay towards that, even though it is in the public hospital. But, in terms of the cost of the accommodation and post operation recovery (he will probably kill me for saying this), he can afford it, but many people in country areas would struggle.

He is staying in a cabin at Holdfast Shores. I think just for a cabin it is about $170 a night; I think he gets some discount. So, that will be two weeks times $150 a night, and it is hardly luxurious, and he is recovering from the surgery he had last week at the Royal Adelaide Hospital. I think that helps make the point. People could say that he could have a conventional operation maybe at Pirie, but he is entitled to have access to the same sophisticated robotic surgery as anyone else, but the cost to him on top of the operation is enormous, plus the inconvenience of not being able to access services in the country. That was brief, I think, Madam Deputy Speaker.

The DEPUTY SPEAKER: That was astonishingly brief, and we all celebrate you. The member for Stuart.

Mr VAN HOLST PELLEKAAN (Stuart) (11:46): Thank you, Madam Deputy Speaker. I appreciate the brief comments from the member for Fisher. I am here to support the member for Schubert in his motion. To me, the most important part of this motion is the second part:

(b) condemns the Rann Labor government for its continued failure to address the issues of equity in the provision of health services in regional South Australia.

Very clearly, what he means is in regional South Australia compared to Adelaide. That is really what I am here to talk about. I am a little bit disappointed to hear the member for Light. I think the longer he stays in the Labor government and the longer the urban sprawl overtakes his electorate, the less he is interested in the real country.

I am here to represent the people of Stuart. We have hospitals in Port Augusta, Kapunda, Eudunda, Peterborough, Jamestown, Orroroo, Boolaroo Centre, Burra and Leigh Creek—good country hospitals, which are relied upon by every single person who lives in those communities and the people who work very hard in them as well. The people who work in those hospitals and do their very best to provide services for local people are—

Mr Piccolo interjecting:

Mr PENGILLY: Point of order: 131.

The DEPUTY SPEAKER: Point of order 131; would you like to describe that to me in detail, member for Finniss?

Mr PENGILLY: A member may not interrupt another member who is speaking.

Members interjecting:

The DEPUTY SPEAKER: Member for Finniss! I have to say that is incredibly naughty, because I have watched you from the august place of the back bench for many years interject like there is no tomorrow. There is no point of order, member for Finniss. Nice try, but no banana. Please carry on, member for Stuart.

Mr VAN HOLST PELLEKAAN: They are nine very important country hospitals that provide services to people all throughout the electorate of Stuart. That is what the member for Schubert is talking about, in Stuart, in Schubert, in Flinders, in Chaffey, all around regional South Australia, and talking about the inequity of delivery of services and the inequity of priority of this government, for health services, to regional areas compared to the metro area.

I am quite happy to say, as I did yesterday, health is a very difficult portfolio, very difficult. Regardless of who is in government—Liberal or Labor—it is a toughie. I am not here to give any individual person a hard time about the difficulty of the portfolio. What I am here to do is talk about the inequity of priorities. I was supported very well yesterday by both the health minister and the Treasurer who provided information on that. The health minister said, and I am reading from Hansard:

...$630.4 million will be spent on public hospitals and health services in country South Australia. This is $250 million, or 66 per cent, more than in 2001-02, the last year of the former Liberal government...I can assure the member[s] that there has not been an inflation rate of 66 per cent since 2002.

The Treasurer, at another time yesterday, said:

Health expenditure is running, on the most generous assessment at 8 per cent per year but, when one really looks at the wage inflation of the profession and the technical advancements that we are continually and thankfully making in health, health costs are running more in the order of 9 to 11 per cent compounding per year.

You only have to look at the fact that, since the last Liberal government (so, eight years ago) we were spending, say, $2 billion. That is in eight years. That is so far in excess of inflation.

So, two big points: they claim, in nominal spending terms, a 100 per cent increase in spending over that period in the city and they claim, in nominal terms, a 66 per cent increase in spending in regional areas in country health. That is an inequity, clearly, as stated by both of those ministers yesterday. The other thing I would like to say, very clearly, is that I do not think the numbers are quite right. Based on what the Treasurer said yesterday, inflation in the health sector is 9 per cent to 11 per cent per annum.

Dr McFetridge: 12 per cent he said.

Mr VAN HOLST PELLEKAAN: That will make the case even more strongly for you, thank you, shadow minister. Let us use 10 per cent because it is a good easy number and smack in the middle of what Hansard says that the Treasurer said yesterday. A 10 per cent compounding inflation rate over eight years is 114 per cent; 114 per cent to just keep pace with the spending that would have been required to spend, in real terms, the same amount of money to, in real terms, provide the same amount of service has gone backwards.

The Treasurer claims that 100 per cent is fantastic. Guess what? It should have been 114 just to keep even. The health minister claims 66 per cent in the country is fantastic. Guess what? It should have been 114 per cent, nearly double, to just keep even. So, two major points: the government is not spending nearly as much, by percentage increase, in the country as it is in the city, and it is not even keeping pace with the industry's inflation rate, as mentioned by the Treasurer yesterday. That is very clearly an inequity by this government with regard to support for country health versus metro health in Adelaide.

The issues with regard to country health, very broadly, have been outlined very well by the people who spoke before me. Everybody understands that taking away country health boards was a disgraceful move. Moving them to the health advisory committees (HACs) and taking genuine people in country areas away from having responsibility for their hospitals was just disgraceful. We go back to the Liberal Party's pre-election promise, a very sensible promise: rebuild the RAH where it is and spend the savings on health throughout the rest of the state. That would have looked after regional health. That would have looked after the people in those nine hospitals in Stuart and lots of others throughout the rest of regional South Australia. That is the way to look after regional people: spread the savings. Don't waste more and more money building a new rail yards hospital where a revamp onsite would have been very good.

I remember very well, about a year and a half ago, going to public meetings, where hundreds and hundreds of people in towns all over regional South Australia turned out because they understand that they are getting dudded. It is not just the opposition saying, 'We are not happy.' It is not just the opposition trying to give the government a hard time, and it is not just the opposition providing factual information to show that regional communities have not been looked after in the same way that Adelaide has. People know. People who work in those hospitals, people who work in emergency services, people who are volunteers in ambulance services, people who are doctors, all sorts of people, let alone the patients, understand that they are getting dudded.

One of the most disgraceful ways that the people of regional South Australia are being dudded by this government when it comes to the provision of health services, is in a very sneaky, sly, underhanded attrition, trying to wear people down, taking services away so that they cannot be accessed, so that they can then say, 'They weren't accessed, there wasn't a line up, there wasn't a queue, nobody cared, so we don't need them any more.'

I will give you a very good example of that: the Hawker hospital, which went without a doctor for about six months, so the people from the Hawker district had to start going to the Quorn hospital. No doubt they got excellent service from the Quorn hospital and from the doctors and staff there. Guess what? None went to the Hawker hospital. The patients did not go to the Hawker hospital because there was no doctor there. Now you look at the statistics of people turning up at the Hawker hospital for service and the people turning up at the Quorn hospital for service and the government says, 'There's lots of people going to Quorn, there's no-one going to Hawker, so fait accompli, we don't need to reinstate the doctor.' Now that is just disgraceful. That is absolutely sly and disgraceful, and not looking after country people the way they should be.

The member for Finniss mentioned travel and he talked about the difficulties. Before the election, we offered $4 million extra for PATS (Patient Assistance Transport Scheme), which is very important. It would not be important to the member for Light because his people do not live far enough away from health services, but, in country areas, it is very important. That is the sort of thing that enables people to come to the city for medical treatment. I understand that not every single service will be provided in every single hospital, but providing things like that supports the health system in regional South Australia. It is not only about hospitals but also about supporting the communities more broadly so that they can get access to the services they need.

I finish by asking one simple question. Yesterday, both the Treasurer and the health minister incorrectly said that, over the last eight years, their spending in health has kept up with inflation in the health industry at 10 per cent (as they said). They have put it at 66 per cent in regional South Australia and 100 per cent in the city. Clearly, there is an inequity. What I would like to know is: what has the inflation rate been in pandas? What has the inflation rate been in trams? What has the inflation rate been in money given to Lance Armstrong compared to the increase in money given to rural health and people living in country South Australia to address their health needs? Thank you, Madam Deputy Speaker.

Mr BROCK (Frome) (11:56): I totally agree with all the previous speakers. I think the health subject would be the greatest challenge facing whoever is in government, whether it is state or federal government. We are becoming an older population. We are asking people to be more concerned about their health and to have more examinations to try to prevent their having to go to hospital, but as our population grows older, we require more attention, more hospitalisation and more services.

I take on board all the previous speakers. The member for Stuart is correct. I am concerned about the inequity in regional South Australia compared to the metropolitan area of South Australia. We have, in my area, a good hospital, a good regional health service at Port Pirie. We have a good service at Clare. We have excellent district hospitals at Port Broughton and Crystal Brook. However, my concern is that, over the many years, services have been allowed to continue without any maintenance or improvements going forward. Up until about a month ago, I had been fighting very hard for renal dialysis machines in the Port Pirie Regional Health Service. I have mentioned in this house previously that in my role as the mayor of the Port Pirie Regional Council, some 15 years ago, the community and I fought very hard to get these renal dialysis units in Port Pirie. We were not successful.

I congratulate the government and the minister with whom I have had personal dealings over the past six or eight months. He is now establishing the facilities for four renal units in Port Pirie. Prior to that, these patients had to travel to Port Augusta on three or four days a week, and from Port Broughton they had to travel to Clare. As the member for Stuart has indicated—and I think the member for Finniss also indicated—there is a cost factor.

Unfortunately, this is a separate issue—and I will be taking this up with the minister at a later date—and the PATS payment does not assist disadvantaged people in regional South Australia. People travelling from Port Broughton to Clare do not get any reimbursement because it is below the threshold. It does not meet the minimum requirement for these people to travel on three or four days a week, stay there with a carer to look after them and have the dialysis treatment because once they have had the dialysis treatment they cannot and should not drive their car home. That is an issue.

No matter who is in government it has been going on for many years. We put a service into a location. The frequency may be every month for that service to visit those locations. As it continues we look at cost savings. The member for Light rightly said that it needs to be sustainable but, at the same time, we need to ensure that services are there on a regular basis, not start them out one monthly or two monthly and then push them out to three, four or five month intervals.

That does not help the patients requiring the service because those patients will say, 'I cannot afford to travel 100 kilometres four days a week so, therefore, I will defer it and only go once.' They may not even go for treatment. In the interim period the injury or disease may be getting worse.

The member for Fisher has talked about his brother-in-law. I am talking now about the female side of the cancer. The mammogram machine in Port Pirie Regional Health Service has been out of action for 12 months. I have had many complaints in the past two weeks from medical practitioners in the region who say that replacing the machine is not the issue. Rather, the replacement of the service provider is becoming a nightmare. It has now been going on for 12 months. Again, I will be taking up this issue with the minister directly. I do not expect to win this, but I understand that the replacement of a service provider through the bureaucratic system is becoming a nightmare and longwinded.

Currently, we continue to promote examinations by women to ensure they do not get breast cancer, they do not aggravate it, they get it before it gets too far down the line. In that respect I can talk from experience. My late mother-in-law a long time ago did not have the regular examination because of the non-availability of a machine. Instead of having it every month, she deferred it for three or four months. Unfortunately, in her case the disease, the complaint, went too far and it took her life after an agonising six months not only in hospital but also at home.

I am very passionate about examinations. Even my partner has to have regular mammogram examinations. She is very aware of that because breast cancer is in her family. We all have these issues. We need to ensure that equity in regional South Australia is the same as in the metropolitan area.

I agree that the Royal Adelaide Hospital is a hot topic between the two parties, between the government and the opposition. However, as a parliament we need to ensure we work together for health into the future. We should be able to reach a compromise and agree where these facilities should be. We are here to represent the people of regional South Australia and the metropolitan area of Adelaide, and we need to ensure those people do not suffer because of issues on which we disagree in this house.

The member for Fisher mentioned his brother-in-law. I would be interested to know whether his brother-in-law reads Hansard and finds that the member for Fisher has indicated he can afford to come to Adelaide. There is a cost factor. It has a traumatic effect on your health to come down for a start. You are away from your family. There are financial implications on your family. At the moment my chief of staff is at the Ashford Hospital for an operation. She is very stressed because she is missing her family. If those services could go into regional South Australia then we would have a far better home life, and so on.

In closing, I just want to reassure members that I am really passionate about health across the whole of South Australia. I am very passionate about regional South Australia. I just want to see the current services and equipment that is in regional hospitals maintained, not decreased and not reduced. Also, I want to see an increase in the services and frequency of specialist services to ensure that regional South Australia feels part of the rest of the population of this great state.

Dr McFETRIDGE (Morphett) (12:05): It is a tragedy to hear the tales from the member for Frome, and I congratulate him on being so frank, because it was just recently that the Minister for Health and the Minister for Environment did over the Port Pirie community with that politically-based media release on lead levels in children. They had been consulting with the community, they knew what was happening up there, but no, to suit their own purposes, they drop out this press release and it put the community right back on its heels. It is not fair the way they treated that community, and I support the member for Frome in his statements.

Also, to hear that the good citizens in Frome cannot get the services they deserve with respect to cancer detection and screening is just another case of where the bureaucrats are winning and beds are being cut. We had the minister in here yesterday saying that $250 million more is being spent on health in South Australia today than under the former Liberal government. If the minister wants, I will get the Treasurer's media statement with regard to health inflation being 12 per cent. Today they should be spending $740 million on country health at a 10 per cent inflation rate, but the minister said 12 per cent, so I am giving him a bit more.

I am a bit closer to prime minister Rudd's—he is not the prime minister any more, it is Prime Minister Gillard this morning, isn't it; and didn't Rudd get what he deserves? The Premier has said an 8 per cent inflation rate for health—8 per cent, 9.3 per cent, 12 per cent. I put it at about 10 per cent. They should be spending $740 million on health in the country if the minister is to be believed on what is going on in health services in South Australia. I am not so sure that he knows what is going on, because in his answer to a question yesterday he also said that we have 23 extra full-time equivalent doctors working in the country.

That may be the case. I have no doubt that the minister would not mislead this house deliberately, but what I am hearing is that there is a tremendous shortage of doctors in the country, to the point where on Kangaroo Island and at Karoonda, Millicent, Bordertown, Port Lincoln and the Riverland it is fly-in/fly-out locums. And what are we paying for those locums? We are not paying a reasonable fee to the local practices to provide after-hour services; we are paying $2,400 a day for fly-in/fly-out locums on Kangaroo Island. We are paying locums about $1,800 a day, we are paying travel and accommodation and an agency fee of about 15 per cent.

You are paying more to the agency than you are to the local doctors for being on call. Sure, they get a fee for service on top of that, so they are not working for $220 a day. We all know that. However, to say to those doctors in the country, 'Well, look, we're not going to argue with you, we're not going to debate with you and we're not going to consult with you about the terms of your contract; we're going to bring in paramedics and ambulance services.' I have the highest regard for our paramedics and ambulance service members, but they are not doctors. They have limits to their abilities.

I will be perfectly honest, if I was in a crash on the side of the road, I would rather have an ambo than a doctor because they are skilled in rapid early intervention. They are fantastic there, but it goes on from there. To have paramedics looking after patients in the hospital at Kingscote and then the local doctors having to come in and tidy up or advise them where they should be going is a tragedy for the people of South Australia. If that is happening all over South Australia, and I am hearing that that is the case, this government should hang its head in shame. It should be spending the $740 million (if the inflation rate the minister quoted in the past is correct), not the $630 million that he is saying now.

They are doing them by $100 million. Where would that go to providing extra doctors and extra facilities? The member for Frome probably would have his breast screening and the member for Stuart would probably have an MRI provided up there.

That is a federal issue in many ways, but the state government is getting in the way. We heard the member for Light talking about country health. We just have to look at what is happening with Gawler hospital. At Gawler hospital, the A&E services there are an absolute mess. Nobody knew what was going to go on there. The government could have provided an answer to the issues up there very quickly for very little money, but no, they let it go on and on and on—typical of this government—until it is crisis management. You deny, you deny, you deny and then you try to deflect from the real issues. This happens all the time with this government.

What this government should be aware of is that the people out there know the real facts. They know what is really going on in the health services in South Australia. Yesterday's report from the Australian Institute of Health and Welfare Management says that people living in rural and remote areas tend to have higher levels of disease risk factors and illnesses than those in major cities.

So there is a need, and a real need, to make sure that we are not getting behind in our provision of health services to those people who are doing it tough out there in the rural and regional areas. They have had droughts; they have had many, many issues such as a lack of water up there in the Riverland to cope with. They have enough stresses. This is not just their physical health we are talking about, we should remember: this is mental health as well.

We need to make sure that our country cousins are being looked after. You cannot have a heart transplant at every hospital. We know that and we all agree that you cannot do that. Our country cousins do not want that, but what they do want is not to have their local hospital downgraded to an observation post where a nurse—a very qualified, very professional and high integrity nurse—will be looking after you but if, in her opinion, you cannot be seen or treated in that hospital, you then have to travel off to a regional hospital right out of your community, away from your family, away from your friends, hundreds of miles away—and with the price of petrol nowadays.

We heard the member for Frome talk about the inadequate PAT scheme that we have had. It is just not fair and that is what South Australians want: they just want a fair go. They do not expect to have a heart transplant in every hospital. They just want a fair go. That is what they want and that is what they deserve. This government has not delivered on that. There has been lots of rhetoric.

The member for Schubert talked about the Barossa hospital. Yes; we did promise to build that in 2001. The cost then was about $17 million. On our estimates—I think it was a 55-bed hospital that we were going to build up there—it was about $35 million, and that was deliverable. It should be delivered. Angaston Hospital is really past its use-by date. That land there could be used for some other purpose and help fund the building of a new hospital where the land has been donated by the local council to help build that new hospital. It should be a priority for this government.

With the Army battalion coming out to the northern suburbs, there is going to be massive pressure on Lyell McEwin and Gawler hospitals, so we should be doing something else about providing extra hospital services out that way. Building a hospital at Barossa is something that should not be overlooked, and it should not be put out there for further consultation and delays as we see in so many cases—forming a committee and having an investigation. It has been planned. I understand that the business case for it has actually been done. There is a real opportunity to get on and do it now because we know that prices will be going up and up and up.

We have just seen in Western Australia a tragic example of what can go wrong if you do not control hospital costs. The Fiona Stanley Hospital there was planned by the former Labor government at about $460 million. It is now $1.7 billion which is a $1.3 billion increase in costs—a massive blowout in costs—and it is going to be delivered four years later than was originally planned. If you do not have your eye on the ball with health, it will get out of control.

We have heard all the scare tactics that are used by the government in Australia and the bureaucrats to say that, if we do not watch ourselves, the health budget is going to consume the whole of the state budget. I would say: only if you keep going the way you are. You should not have to do that. You should be able to spend money much more wisely and do it in a smart way, not just pouring the dollars in. You do not need to do that; you do it in a smart way. People will respect you if you are treating them fairly and that is what they want. That is what they deserve—not just in Adelaide, not just out at Gepps Cross and down at Hackham and Elizabeth. They need a good level of services out there obviously; we do not want to forget that we do have the main population around the Adelaide metropolitan area but never forget that the tyranny of distance is still there.

Our friends in the country in remote, rural and regional areas deserve more than they are getting from this government. It is not just the opposition: it is also independent members of this place who are acknowledging that there are serious issues. You cannot solve them all tomorrow, but you had better have a plan in place, because it is going to get more and more expensive if you do not have that plan in place. If you are not expecting to be able to provide those services in a timely fashion it will get completely out of control. The minister and his bureaucrats must realise that Adelaide is not the be all and end all; we cannot centralise everything here. Do not forget the country people of South Australia.

Mr WHETSTONE (Chaffey) (12:15): I have grave concerns for regional hospitals, particularly the Riverland hospitals, and I do support my regional colleagues in outlining the flaws in the system as they are at the moment. Not only is the Berri regional hospital continually being put on hold but I would also like to update the member for Light that, of the $41 million pledged to the Berri regional hospital, not a dollar has been spent, not a sod of soil has been turned and not a brick has been laid.

Currently, the government is seizing the land and the assets of the Riverland country hospitals and their health services. Country Health SA has directed country health advisory councils to transfer the land titles of country hospitals and health services over to the Minister for Health. The flimsy rationale being used to justify this acquisition of health assets is to minimise future administrative workloads in Country Health SA.

Country health advisory councils have trust grants which contain the land title of the country hospital. These HAC trust grants are being transferred to the Minister for Health under the new Crown Land Management Act 2009 which comes into effect on 1 July 2010. The Loxton and Districts Health Advisory Council raised concerns about the centralised takeover last week and now the HACs in Renmark and Waikerie have echoed those same concerns. Loxton, Renmark and Waikerie communities have worked tirelessly raising funds for their hospitals, while I understand that the Renmark hospital's land has been bequeathed to the local community and not the health minister.

The land and asset grab is being undertaken with no real consultation with the communities who have the real and vested interest in the running and ownership of their hospitals. The Minister for Health has already disbanded hospital boards, and now he is taking away the community's stake in their hospital. The minister must explain why Country Health SA needs to acquire so many assets, why it is rushing this asset grab, why it does not appear to be following due process as set out in the Health Act and what it proposes to do with these assets. I have grave concerns that, once absorbed into the centralised pool of Treasury, Riverland and regional hospital revenue, land and buildings could be sold to finance the ever-ballooning budget of the rail yards hospital in Adelaide.

Mr GRIFFITHS (Goyder) (12:18): It is my pleasure to stand in the house today and support the member for Schubert and his motion. It is obvious to me that he brings with it a real desire to ensure that the people not only in his community but also, importantly, the people in all of regional South Australia get the quality of health services that they need. Many people on this side of the chamber have spoken and given the historical version of several years ago when country health plan mark 1 was announced on the same day as the budget, very late in the afternoon as I seem to recall, and the emotion that caused within the community.

In my own electorate of Goyder it was rather interesting. We held three public meetings and, yes, I advertised these and I convened them and acted as the MC for the evening. Importantly, I called them on the basis that they were an opportunity for the community to be informed, so people who work within the country health structure were invited to present the position of the minister to ensure that the minister, through their voices, had the opportunity to inform the community about what the intention of the plan was.

At the first meeting at Yorketown where we had 700 people in attendance—an amazing crowd—it was interesting. One question was raised by a member of the community about where they had to go for a specific service. The chap from the country health bureaucracy who stood up and answered said, in relation to that, that the people of Yorke Peninsula had to go to Whyalla—absolute madness! You should have heard the reaction of the crowd. This person obviously did not respect where he was and where, indeed, the travelling routes would be for people. To expect people from Yorke Peninsula to go to Whyalla for a service at a hospital is absolute silliness.

I am sure that chap will forever regret having said that, because I know that everybody I talk to who was at the meeting that night reflects upon that one comment. They think that this is just absolute madness which demonstrates more than anything else that this is a government that has absolutely no respect for the people who live in regional South Australia. They took great offence to it. No matter what I said, I knew that very night that I was going to get re-elected because that was my campaign in one. It just showed that these are people who do not respect it. I note your smile, Madam Deputy Speaker.

The DEPUTY SPEAKER: Well, I am a kind of smiley person.

Mr GRIFFITHS: You are a happy natured person, and I respect that.

The DEPUTY SPEAKER: My good humour is noted. I wouldn't take that smile too personally.

Mr GRIFFITHS: It is renowned by all of us. We respect that. Well done.

The DEPUTY SPEAKER: Thank you and carry on.

Mr GRIFFITHS: I also held meetings at Maitland and Balaklava. There were 500 people at Balaklava and 400 people at Maitland—all very passionate about their hospitals. I told the story of one chap who had been involved with the Maitland Hospital Board for a period, I believe, of some 22 years. He told me that the continued effort, over that time, within the community to raise funds was close to, I am pretty sure, $1 million. That is an enormous effort; it is an average of $50,000 per year. You do not raise that sort of money without a continual level of support from the community. They do so because hospitals mean absolutely everything to them and, when their hospital is threatened, you will find that the community rises as one.

I think all of us in this chamber might get a little bit frustrated sometimes when we think that there is a level of apathy that exists in the community and that they should be more politically engaged, no matter what their opinion is. However, when you do something from a government perspective that threatens one of the most absolutely basic of services that a community expects, you will find that the vengeance of the people is immense.

I was so pleased to see people that I had not seen engaged in other matters in previous years, suddenly come forward and ask: 'Steven, what can we do to ensure the future of our hospital?' They have continued that fight and I commend them on that. We had people rallying on the steps of Parliament House in late June of that year, I believe. They said (this is one example given to me), 'Look, I am sick of paying my taxes and not getting any return on it. I would rather write a cheque out straight to the Maitland Hospital. How can I make this happen?' I said, 'It doesn't work that way. We can't make it work that way, but you being here this afternoon demonstrates the passion and commitment that you have for your health services.'

The member for Schubert has brought this motion forward. It is not just an opportunity for political nitpicking across the chamber. This is a very serious issue that people on both sides of the chamber need to respect and understand. It is one that we on this side will never lose our trust and faith in and our commitment to. We will always continue to do that.

The member's motion also talks about the Barossa Hospital, which was a subject of some discussion within the party room when it came to a policy decision upon it.

Mr Venning: Putting it nicely.

Mr GRIFFITHS: Putting it nicely. It is a significant amount—$35 million. We have heard of some initial estimates from within country health of significantly more than that, but it was a sign of support for the people of the Barossa and, indeed, the wider area it supported that would gain services from that. We decided that this is an important policy decision which we want to put out here. We want the community—which is very much a growing community—to understand our commitment to them and to understand that, in government, the member for Schubert would ensure the opening of that hospital. I commend him on that because he spoke passionately about it. Indeed, all of us, when it came to policy issues, spoke passionately on the things that were important to our communities.

The issue is: how do we move forward now? Other members have spoken about other areas that are important in regard to country health, such as the Patient Assistance Transfer Scheme. The member for Stuart spoke about the $4 million commitment over four years that we had, which I was very pleased to support.

I also want to raise the need for obstetrics. Within Yorke Peninsula, I am rather amazed that for any child to be born on the peninsula—as part of a scheduled birth, without it being an emergency delivery at one of the hospitals—they have to go to Wallaroo. The people who live at Marion Bay—who have young families and are bringing children into the world—are probably looking at a two-hour drive at least. They will obviously present to the Yorktown Memorial Hospital, which, until some 18 months ago still delivered babies, but that service was lost through a variety of issues.

There should have been a desire to ensure that it remained there and was available to the community. The Maitland Hospital lost the delivery of baby options probably four years before that, with the loss of the one GP who had that particular skill. That is a great shame, I think, because now these families are being forced to relocate for that key time immediately before the birth of a child to Adelaide, at great cost and inconvenience, and it is a great loss to the support network that exists around them. So we need to ensure that the delivery of services remains local as much as possible.

There will be much said about the costs associated with health and, again, I respect the member for Stuart's contribution on this point, picking up the points of the Treasurer and the Minister for Health. There is no doubt that health costs are extremely expensive and a consumer of a large proportion of the budget of the South Australian government. We need to ensure that the sums are right and that there is a far greater contribution from the federal government, and to recognise the fact that it should have been for the many years that the 50-50 split agreement had been in place.

My understanding is that the current agreement is something like 43 per cent from the federal government and 57 per cent from the state government, creating some equity in the service delivery cost. A greater contribution from the federal government—which, after all, has the greatest capacity to raise revenue within the nation, is important. Now we have, apparently, because the Labor governments have agreed to it (recognising, of course, that Western Australia is not willing to sign up at this stage), a reduction in the level of GST to compensate partially for an increased level of commitment from the federal government into health. It needs to be right.

I was rather surprised that the Premier was, apparently, willing to openly support this agreement based on one telephone call from the prime minister, I believe.

Mr Pengilly: The former prime minister.

Mr GRIFFITHS: The former prime minister, as we have all discovered today, with the overthrow of Kevin Rudd by Julia Gillard. Our Premier was prepared to accept an agreement without actually seriously considering (it would appear to me) the implications to the finances of South Australia. We now know, because other states held out, that the return to the state is going to be far improved. Therefore, one has to ask the question as to why the Premier did not ensure that he played hard ball and negotiated the absolute best possible deal for this state from the start and that we were not just seen as a willing accomplice to this agreement which, seemingly, for political expediency, suited him at the time.

My final point is that the Liberal Party went into the election campaign with a very significant proposal for the rebuild of the RAH costing $700 million, also intended to be funded by a public private partnership, compared to the Labor government's proposal of a completely new RAH costing an estimated $1.7 billion. Now we think that is probably closer to $2.2 billion, and expanding, with significant costs for the cleanup required.

The Hon. A. Koutsantonis: What is 'significant'?

Mr GRIFFITHS: I am getting to that.

The Hon. A. Koutsantonis: Your mate Rob Lucas?

Mr GRIFFITHS: Lots of different figures are out there, minister. I will quote the $2.2 billion, which I believe my leader has talked about most recently.

The Hon. A. Koutsantonis: Not your other leader?

Mr GRIFFITHS: There is no division from me, minister. There were a lot of discussions about costings in the period approaching the election, there is no doubt about that, because it is important for the people. Our policy, very clearly, was that every dollar saved by our proposal, in comparison to the government's proposal, would be spent within health in South Australia—in regional areas and in metropolitan and suburban hospitals. A PPP component was a vital issue for both projects but, as it turns out, being over 30 years, the significant savings would be directed, and we would commit to that.

Time expired.

Mr PENGILLY (Finniss) (12:28): I obviously rise to support the member for Schubert's motion, as other speakers on our side of the house have indicated this morning. Local hospitals and health services around rural South Australia are the heart and soul of our communities. They have been for many years and will continue to be, despite the way they have been handled in the last few years by the Rann government.

In many cases, these hospitals were built by the local communities. They were owned by the local communities and, in many places, the councils actually funded them. That is what happened. There is any number of soldiers' memorial hospitals also around the state of South Australia. They are the heartbeat of our communities. So, let me say that, quite frankly, I am appalled at the way in which country health is being treated in South Australia currently.

How the minister had the gall to stand in this place yesterday and trot out a great long list of announcements on money that they have been spending in rural hospitals around South Australia defies comprehension. I say that because one only has to have a look at the hundreds of millions of dollars that the government is trotting out to put into the Adelaide Oval, whereby it intends to satisfy the metropolitan community, which is fine, and nearby rural communities, who are in the fortunate position that they can come to the football in South Australia—not all that often, I might add. For the minister to then have the gall to stand here yesterday and trot out these seemingly small amounts of money, I have trouble believing him.

That is only part of the argument. The member for Schubert refers to the Barossa Hospital. As was correctly said by the member for Goyder a few minutes ago, there was a lot of angst in our party room in the lead-up to our election deciding upon that policy; there really was. The member for Schubert was not a very happy fellow on a number of occasions but, ultimately, the Barossa Hospital project did get up. The ones who care about health across all of South Australia are the members of the Liberal Party on this side of the house, and I suspect there is also support from some Independents, from comments that have been made during the course of this debate this morning.

Let me turn to the farcical situation that is taking place in my electorate at the moment in two places. One is Yankalilla's Southern Fleurieu Medical Practice, which is a private practice that services the Yankalilla Normanville area. It saves the public health sector, because it runs an after-hours emergency on call for that area. By doing that, it saves the public purse and people having to travel to either the Noarlunga Health Service or the South Coast District Hospital at Victor Harbor. It saves them having to go there. It has been seeking a level of support from the government to continue that, because it is going backwards financially in running this service. It operates 24 hours a day, seven days a week. The clinic is open Saturdays and Sundays during daylight hours to cater for people; and after-hours doctors are on call.

The general manager of the practice emailed the minister's office in early May seeking some dialogue and support. He did not get a response, so he emailed the minister again in early June (I think it was maybe 4 June), and he still has not had a response. I believe it is inexcusable for this to have taken place. I do not expect the minister to answer every single email, quite clearly, that comes through to the minister dot health or minister dot whatever; however, those below him should have the courtesy and the decency to make sure that the residents of South Australia and those involved in places like health services get a response to those emails.

I do not think it is good enough. I have taken it up with the minister's office. I do not think it is good enough, and I urge the Minister for Health to pick up on that issue, and I urge his departmental people or his ministerial staff to pick up the phone, ring the Southern Fleurieu Medical Practice, talk to these people and get dialogue going. There seems to be a lack of capacity to have dialogue on issues relating to country health. The minister does not appear to want to get his hands dirty at all.

I will take it one step further and talk about the current situation on Kangaroo Island, with the doctors in private practice and the relationship they have with the Kangaroo Island Health Service and the emergency after-hours on-call service at the hospital. This nonsense has been going on for eight months. For eight months they have been trying to negotiate. I am not saying that the local doctors on the island are always right, and I am also not saying that the Minister for Health's department is always right either; but to strike some sensible solution to this it would appear to show common sense.

I have urged that for some time. Bureaucrats from the department have gone to the island, they have had different levels of bureaucrats, but it just has not worked. Some weeks ago I called for an independent facilitator to be put in place, and I think I have done that in this place as well. It still has not happened. It just cannot go on. I do not expect, and I am sure no members on this side or on the other side have the expectation that the government will trot out tens of thousands of dollars to pay doctors or anyone else to provide services over and above what would appear to be a sensible rate of money.

The latest story I have heard out of this debacle on the island was on Saturday morning at the football at Wisanger oval. A family came up to me and told me that their son, who is, I think, 10 or 11, had hurt himself at school and had gone home complaining of his leg. They took him in to see the locum doctor in Kingscote at the after hours service. They were in the outpatients section with a number of other people and after they had waited there some considerable time, the locum came in and said, 'I'm not seeing you tonight, you can come back tomorrow morning.'

The parents suspected that he had a broken leg or broken ankle. The locum sent him home and said, 'Come back tomorrow.' They went there the next morning at 9 o'clock and at a quarter to 12 the locum finally saw them and said, 'Yes, you've got a broken leg. I'm not going to fix it. Go back and see your GP on Monday.' This is absolute contempt for rural people, the way they are being treated. I think it is an outrageous disgrace, and that is just one example.

The locums that they are sending there are sometimes okay, sometimes very poor. This is an isolated community. A locum comes there and leaves three weeks early and they bring in paramedics to take the place of a locum while the local doctor is at home. It happens to be on an island but it could easily be Oodnadatta, Ceduna or anywhere, it does not matter much, but when you have a private practice there serving the community, seeing people every day, for the life of me I cannot understand why the minister will not do something about it, and I urge him to send someone in to talk sensibly and either arrive at a decision to get a contract signed, or let's push on from there.

Now, it has not happened. The community is still irate. The doctors are all over the place on it. They are upset; their families are upset. Pure common sense needs to take over. I have discussed this privately with the minister, and I am not going into those conversations, but the time is well passed. It is no good fiddling around while Rome burns. I urge the house to support the member for Schubert's motion. It is a motion in the right direction for the future of rural health in South Australia. The member correctly condemns the Rann Labor government.

Mr PEGLER (Mount Gambier) (12:38): First, I would commend both sides of the house on what they have achieved in health services in this state and in regional South Australia, but I would also say that from both sides of the house the improvements are not to the degree that they should be. I certainly support the intention of the mover of the motion that we must have much better health services than we presently have in regional South Australia.

To give an example: a young fellow, who is a friend of mine, had to go to the Mount Gambier hospital the other day to have some stitches in his forehead. He waited there for seven hours just to have a few stitches in his head. In the meantime, I was informed by his mother, many people who were waiting in that queue in front of him ended up leaving there to seek assistance or just gave up. As far as I am concerned, our waiting times at A&E are completely inadequate.

Mr Venning: Where was that?

Mr PEGLER: Mount Gambier. Another person contacted me through the week. They have been waiting for two years for a hip replacement. This is an older gentlemen. He fell over the other day and his wife said that you could hear bone rubbing against bone. It is not good enough that someone has to wait that length of time—and then he was informed that he might be lucky if he has that hip replacement by Christmas. You can imagine the agony that someone like that is in.

As far as our PATS goes, because we do not have the services in Mount Gambier which we probably should have, a lot of people have to come to Adelaide either by flying doctor or by their own means to get the services they require. Unfortunately, PATS is completely inadequate in compensating those people both for their travel and accommodation, and they are often left very much out of pocket. A friend of mine whose wife died of cancer recently had done the books on what it had cost them to travel backwards and forwards to Adelaide over the three, four or five years (whatever it was) that she was slowly dying. It had cost them about $240,000 out of their own pocket. Luckily, those people could afford to pay some of that money, but many people in our community cannot afford that, and as a government and a society we should be looking after those who are much more vulnerable than us.

There have been some achievements from both governments in health services, but particularly in renal health services in Mount Gambier. We used to have none: we now have renal health services. We now have a 24-hour A&E service, but, as I said before, whilst the staff work exceptionally well, the number of staff is inadequate. Of course, as we improve technology and as we live longer, the demands on our health system will be greater and greater all the time. As far as I am concerned, in this state and country, we should be trying to organise health in a much better and more cohesive manner so that we can deliver the services to our people.

The mental health services we have in Mount Gambier have been completely inadequate for a long time under both governments. I refer to a letter from David Cappo, Commissioner for Social Inclusion, Office of the Commissioner for Social Inclusion. The report was done in 2007, I believe. The letter states:

In our Stepping Up report, the Social Inclusion Board recommended a stepping system of care for mental health as critical to people's rehabilitation and recovery. In this context I note in particular your concerns to support people to make the transition into the Mount Gambier community following hospitalisation in Adelaide. While the government is committed to establishing 10 intermediate care places in Mount Gambier to assist in this process, I am disappointed that the completion dates for these have been delayed from December 2008 until July 2010.

I am informed today that we will be getting those 10 beds, but not by July 2010. I understand the reasons why, but, as far as I am concerned, we should all be moving much quicker to assist our people and we must have those services in place.

In the Mount Gambier region, we cater for a population of 64,000 people. We have no psychiatrists whatsoever; we have to use the services from Adelaide. We have a lack of psychologists and a lack of mental health workers. We should probably have three psychologists in our education system to look after young people who have behavioural problems, but we do not have the resources in place. So, I would suggest that, in the future, we will have young adults causing problems because they were not supported in their early years.

As far as I am concerned, the health system could be a lot better. We in South Australia must try to encourage professional people from other areas to come into our regions. We have a lack of doctors. The waiting times to see doctors are anything up to two months. In the Mount Gambier region circulatory diseases in men are about 28 per cent higher than the state average; and the same goes for obesity. Of course, far too many of our people smoke and drink. We must have better prevention programs in place throughout the region so that our people can better look after themselves. I support the intention of the motion and the fact that we must have much better health services across regional South Australia and Australia.

Mr PEDERICK (Hammond) (12:46): I rise to support the motion of the member for Schubert. I acknowledge his support of the regional electorates he has represented over the past 20 years and one day. I note his continuing commitment to issues in his electorate, especially with country health, and his passion to get a new hospital in the Barossa region. I know he has a passion because I have seen him debate it amongst members; and, rightly, we took the building of new hospital in the Barossa forward as a policy issue at the last election. It is badly needed. The Angaston Hospital is, essentially, falling into disrepair. As the member for Schubert informed me, it is hardly worth spending any money on it. It is a very poor facility.

The Hon. A. Koutsantonis interjecting:

Mr PEDERICK: If the member for West Torrens would like to contribute to the debate I am sure he can give a 10 minute speech. It is interesting to note the question from the member for Croydon yesterday to the Minister for Health, where the member for Croydon asked, 'What is the government doing to provide medical services closer to home for South Australians living outside the metropolitan area?' There is quite a longwinded answer.

Obviously, there has been a change of heart inside the Labor Party because it was not long ago in this place that in relation to the initial Country Health Plan minister Hill said that no-one would be further than 90 minutes from a hospital. I find that quite disparaging to rural people who deserve far better than that. Labor, rightly so, caused unrest in country areas, and even quite a few people in the city realised they travel through country areas from the city and occasionally need services in the bush. It is outrageous to think it is satisfactory that people should be only 90 minutes from a hospital. It seems that they have had a graphic policy change in the Labor Party, so I would be pleased to hear more of what is being handed out along the way.

As other country members have reflected today, I reflect on the situation in my electorate where under Labor's initial Country Health Plan I was going to lose Pinnaroo, Lameroo, Karoonda and Strathalbyn hospitals. The Meningie hospital on the edge of my electorate was under threat, as well as Mannum District Hospital across the river from my electorate in the seat of Schubert; and Tailem Bend, as well, would have gone. I am bemused more than anything about the question asked of the Minister for Health yesterday in relation to what is being done for country hospitals.

I will acknowledge that a few hundred thousand dollars are being handed out to country hospitals around the region, and I do acknowledge the $192,000 for the new cardiac monitor at Murray Bridge and that the Mannum Hospital (which is in the member for Schubert's electorate) is getting a new infusion system for $117,000 and $200,000 for its emergency department. That is well and good, but in a health budget that transcends well into the billions and cuts into almost a third of the state's budget it is slim pickings for country health.

We must remember that the Liberals were going to pour far more money into country health if we had been elected with our plan to upgrade the Royal Adelaide Hospital where it is. That is what we were going to do, and over time it would have freed up $1 billion to be put into regional hospitals as well as other hospitals in Adelaide. Sadly, if it goes ahead, the Royal Adelaide Hospital project on the rail yards will destroy the opportunity for an iconic sports venue and entertainment venue to be built there instead of at the Adelaide Oval if Labor's proposed upgrade of the Adelaide Oval goes ahead. It will be very sad if it does happen. It will be a real loss for this state if that does happen.

I do support country health. I have lived in the country all my life, and it is time that members opposite and others in the larger towns and cities realised that you need good health services in the country because, if you ever get injured or need assistance in the bush, you will need the services to be assisted. I commend the motion, and I commend the member for Schubert for bringing the motion to this place.

Mr VENNING (Schubert) (12:51): I do thank all members who participated in the debate this morning. I found it very worthwhile. Certainly, it will be very interesting reading in the months ahead as we strive to getter a better deal for our country hospitals. I thank particularly my country colleagues on this side of the house. I have certainly appreciated the support they have given me, not only before the election with respect to the Barossa hospital but also even since then in terms of fighting for their local communities. After all, our hospitals are the most vital part of our communities. I also thank the two Independent members for their contributions. I appreciate that as well. I commend the motion to the house.

The house divided on the motion:

AYES (17)
Brock, G.G. Evans, I.F. Gardner, J.A.W.
Goldsworthy, M.R. Griffiths, S.P. Hamilton-Smith, M.L.J.
Marshall, S.S. Pederick, A.S. Pegler, D.W.
Pengilly, M. Pisoni, D.G. Redmond, I.M.
Sanderson, R. Treloar, P.A. van Holst Pellekaan, D.C.
Venning, I.H. (teller) Williams, M.R.
NOES (24)
Atkinson, M.J. Bedford, F.E. Bignell, L.W.
Caica, P. Conlon, P.F. (teller) Foley, K.O.
Fox, C.C. Hill, J.D. Kenyon, T.R.
Key, S.W. Koutsantonis, A. O'Brien, M.F.
Odenwalder, L.K. Piccolo, T. Portolesi, G.
Rankine, J.M. Rann, M.D. Rau, J.R.
Sibbons, A.L. Snelling, J.J. Thompson, M.G.
Vlahos, L.A. Weatherill, J.W. Wright, M.J.
PAIRS (2)
McFetridge, D. Geraghty, R.K.

Majority of 7 for the noes.

Motion thus negatived.

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