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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2013-10-30 Daily Xml
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HEALTH CARE (ADMINISTRATION) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 16 October 2013.)

Dr McFETRIDGE (Morphett) (12:45): I can indicate I am the lead speaker for the opposition on this bill and I will not hold up the house for long. I can say that the opposition has considered the bill. Because it was brought forward for debate and I thought it was coming on a bit later today, there are some areas where there are still some concerns, and I assume the Hon. Rob Lucas, in the other place, is sorting out those queries. At this stage, I can say that the Liberal Party is more than likely to support the bill as is.

The bill seeks to make a number of amendments to the Health Care Act which came into effect on 1 July 2008 and covers seven areas of amendment, the most notable of which are:

the fees for services provided by the South Australian Ambulance Service that do not involve ambulance transport;

the employment of clinicians in the Department for Health central office; and

proclamations to dissolve three now non-operational incorporated associations and transfer their assets to the appropriate incorporated health advisory council.

The bill also seeks to improve the functioning of the act and clarify the intention of certain provisions by rearranging the wording of section 29(1)(b) of the act to clarify that a body under the act does not need to be providing services and facilities specifically to an incorporated hospital for the undertaking of that body, or part thereof, to be transferred to the incorporated hospital.

It also inserts a provision into part 5 of the act to allow the Governor, on application from the minister, to make proclamations to transfer functions, assets, rights and liabilities from one incorporated hospital to another without the incorporated hospital to which these first belonged being dissolved. It also goes on to remove section 49(5) of the act, which allows the minister to determine the constitution of the South Australian Ambulance Service. The functions and powers of the SAAS are clearly set out in the act. The bill also amends section 93(3) of the act to align the terminology used with other legislation. The bill is supported by key stakeholders such as the South Australian Salaried Medical Officers Association and the Australian Medical Association.

The bill is a relatively short piece of legislation. The employment of clinical staff in the central office of the Department for Health is obviously something that is necessary. You do need to have expertise there, but the numbers of clinical staff who are being taken away from clinical duties is something that I certainly would have concerns about. I understand there are 30 nurses who are clinically trained working in central office. I do not know how many other consultants or doctors are involved in central office, but I would hope they are still able to provide the services they are trained for to patients in our public health service.

The ability of SAAS to charge patients other than those transported by ambulance is understandable, certainly at sporting events, and there may be other areas where the ambulance service is being called upon. Clause 7, which amends section 59, talks about incidental services and states in new section 59(6)(a):

(i) attends at a place in response to a request for medical assistance (whether made by 000 emergency telephone call or other means) for a person who may have an injury or illness requiring immediate medical attention in order to maintain life or alleviate suffering;

The member of SAAS then assesses or treats the person, but the person is not transported by an ambulance. Certainly, at sporting events and many other functions that we see, such as WOMAD, and all the other wonderful things going on in South Australia, SAAS is there and doing a terrific job.

The only area of concern I have in this piece of legislation, though, is in clause 9, amending section 92—Conflict of interest. In the act, under conflict of interest, it provides:

(1) If a possible conflict of interest arises between a health employee's private interests and the duties of his or her employment, the health employee—

(a) must, as soon as practical after becoming aware of the conflict, report the matter to the appropriate authority.

I would like the minister to tell us, if he can, how many health employees, particularly in the South Australian Ambulance Service, work for the private ambulance provider service IMS, particularly any senior staff, because it has been raised with me that a conflict of interest may arise when the IMS service is competing with the SA Ambulance Service for a tender, say, for providing services at the races, for example. It has been put to me that there could be conflicts of interest there. Can the minister tell the chamber what the situation is and how those conflicts of interest are being managed, so that when people come to me with these concerns I can alleviate those concerns. Other than that, the bill is pretty straightforward, and I look forward to other members' contributions.

Mr WHETSTONE (Chaffey) (12:52): I rise to follow on from the member for Morphett. I have some real concerns when it comes to individuals who put in countless hours in providing health care and services, particularly in the regions. Of course, I rise to speak about what I am experiencing in the electorate of Chaffey—the Riverland and the Mallee.

One of the examples is the local health advisory councils (known as HACs). Regional communities, over many years, have expended significant time and effort, particularly fundraising for local hospitals and maintenance upgrades. What we have seen over a number of years is great infrastructure upgrades in those hospitals which have been achieved by the community, where they have gone out fundraising.

A lot of money has been bequeathed to those hospitals not only for the benefit of the hospital but also, inevitably, for the benefit of the community. It is for the benefit of incoming patients to have hospitals with those extra services that have been provided by what I guess you would call auxiliary groups which fundraise for the hospital.

Of course, we cannot forget the service clubs, because they are invaluable, with their contribution particularly to the local hospitals in my electorate. As we speak, they are out there doing their bit. Whether it is a sausage sizzle or a raffle or producing calendars to raise money, it really does have a significant impact on what can be achieved for the hospital.

Unfortunately, in what is more than the last few months, we have seen the unfortunate move by this current Weatherill government to place restrictions on HACs being able to access the millions of dollars that have been fundraised, hard earned or bequeathed to put towards assets within a hospital. I understand that, in some cases, people's priorities are perhaps not a preferred priority on what needs to be upgraded at a hospital or what money needs to be put forward.

Recently, I had the Hon. Rob Lucas from another place up in my electorate having a look around. We went to several hospitals and looked at what had been achieved with those funds. It is an outstanding achievement to see that we have, in some cases, almost a new wing on hospitals which has been supplied by the money that has come out of the community's pocket.

Again, what we are seeing is that these restrictions are now putting on hold those hard-earned fundraising dollars. The local HACs have been told that only new money raised, particularly in the 2012-13 financial year, can be spent and previous money remains in the government coffers. As I understand it, that money that has been raised in the 2012-13 financial year is not something for when we do upgrades in a hospital like it was just decided today to spend the money and tomorrow it is achieved. It takes a lot of planning, it takes the regulation that it has to go through, and it just cannot be achieved overnight. That money that is sitting there is sitting there to stump up this current government's budget.

I noted during estimates this year that minister Snelling admitted that the HAC money is being used to prop up a cash strapped Labor government budget. That is sending a message to the communities, it is sending a message to the people who are there in a position who want to be part of putting money aside to upgrade hospitals. It is sending a message to them to the effect of, 'Don't do it.' It is sending a message to the community, why fundraise? The government is going to just hold that money back to make themselves look better at the budget bottom line but we are not getting any benefit.

I have talked to the community volunteers, the HACs and people who have spent a lot of their latter stage of life in hospital, and they are saying, 'We are not prepared to put the money towards the hospital because we don't even know whether that money will end up benefitting the hospital or whether it might end up benefitting my children or my grandchildren or further on.' It really is sending out a bad message that the community is being disengaged, if you like, from helping that hospital. Particularly the elderly I have visited in the hospitals say that they have considered leaving money to the hospital but that they have decided not to because there is no certainty that money will be of benefit.

Again, communities feel as though they are losing their sense of ownership over local country hospitals due to poor decisions from this current government. It is a sad indictment that this money is sitting there in a budget bottom line for the government and it is not there for the benefit of the hospital. We see hospital upgrades that are needed all the time. We see centralisation of country hospitals due to the numbers dwindling away in our country communities, and yet there is money there to benefit the hospitals, there is money there for the ongoing benefit of the communities, but that money is being held in a budget bottom line by the current government.

It is a sad indictment, it is a sad indication, and it is a disincentive for people to engage and be part of making our community and our regional hospitals better places to visit, to have medical treatment and better places to be ready for the incoming sick and vulnerable who need the hospital.

In closing, I have said on a number of occasions that I have been a part of fundraising to put chairs in a chemotherapy unit. I have looked at some of the forward planning with the upgrade of the regional hospital in the Riverland and there was a chemotherapy unit there ready to go, but we have had a budget cutback on that upgrade of the hospital from $41 million to $36 million and suddenly we find that the chemotherapy unit does not have any chairs. It does not have the equipment that completes a chemotherapy unit. I think that is an example of what we are seeing at the moment. We are seeing funds being directed away from services that are needed in a hospital and the government is leaning on the volunteers and the community spirit to help progress the development of their hospitals and to help progress services that we all expect to have in our hospitals. With that, I conclude my contribution.

Mr VAN HOLST PELLEKAAN (Stuart) (13:00): As the member for Morphett has said in his capacity as our spokesperson in this house on health matters, we have a few concerns. At this stage we are likely to support this bill but that will be finally determined between the houses. The contribution that I would like to make is very much with regard to the impact and the capacity that this bill gives the government with regard to its handling of what are essentially community health assets. I seek leave to continue my remarks.

Leave granted; debate adjourned.


[Sitting suspended from 13:01 to 14:00]


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