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House of Assembly - Fifty-Fourth Parliament, First Session (54-1)
2019-04-03 Daily Xml
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World Health Day

Mr ELLIS (Narungga) (16:55): I move:

That this house—

(a) acknowledges and celebrates United Nations World Health Day, which will be held on Sunday 7 April;

(b) acknowledges the commitment that the Marshall Liberal government has to health care in South Australia, particularly in regional South Australia;

(c) welcomes the commitment to address the backlog of capital works in regional hospitals and the efforts to address the shortage of regional healthcare professionals; and

(d) condemns the former Labor government’s Transforming Health program and the dire situation in which it has left health care in South Australia.

It is with great hope that I move this motion. I hope to get support from both sides of the house and that now those opposite have been relegated to the opposition benches they can see the folly of their ways and support this motion and its intent, acknowledging the mess they have left this state in.

Since becoming the member for Narungga, regional health services, and the importance of improving and maintaining them, have been the number one topic I have been contacted about. I feel compelled to make a difference to the constituents I represent, and the towns and communities they live in, as well as the whole population, which relies on the delivery of appropriate levels of health service.

Regions that cannot provide reliable, adequate health services and hospitals will die because it is an undisputed fact that families, retirees, the elderly, all age groups will choose not to live where they cannot confidently access the health services they need. They will choose to move to where they can see they will receive care when they need it, and with such population shifts come subsequent small business closures, job losses, school closures, loss of services across the board, and spiralling economic and social consequences.

With this motion, which acknowledges World Health Day and the value of quality healthcare provision across the world, I highlight the value of investment in regional health services in particular. I wish to commence with the good news: inroads are being made into the significant capital works and maintenance backlog in country hospitals that were left to spiral out of control by the previous city-centric Labor government to the tune of about $150 million.

Recently announced was a $2.7 million upgrade of the Snowtown Hospital's Lumeah Homes aged-care facility to meet fire safety compliance and replace roofing, a significant investment in a town that is heavily reliant on its hospital and its aged-care facility. When I toured there last August the Director of Nursing, Andrew Daulby, showed me specific areas of need, and we discussed the roof and what needed to be done as a priority.

The $2.7 million investment comes from the Asset Sustainment Program created by the Marshall Liberal government when it came into office, providing an additional $14 million per annum for the next 10 years to significantly improve country hospital infrastructure and undertake urgent upgrades such as the Snowtown Hospital Lumeah Homes project, which is expected to start this year and be completed next year.

This new fund has also ensured that other urgent maintenance at multiple hospitals in the Narungga electorate is now being addressed and scheduled for completion this year. These projects include a new generator and electrical switchboard for the Wallaroo Hospital, construction of the Central Sterile Supply Department at the Yorketown Hospital, and telephone and nurse call bell upgrades at Yorketown, Maitland, Wallaroo and Port Broughton hospitals as well as at the Melaleuca Court Nursing Home at Minlaton.

The Marshall Liberal government understands how crucial it is that health services are maintained in country areas and, whilst there is a huge backlog of work to do, we are getting on with the job. There is much to be done, and a good start has been the provision of $720,000 for the Ardrossan Community Hospital and $750,000 for the Yorketown Hospital, the latter to reinstate services removed in 2016 due to the hospital not being able to meet its theatre standards because of the lack of maintenance by the former government. This government understands the crucial need for ongoing maintenance for service retention and also the need for action to address GP staffing shortages across rural South Australia, which are impacting on service provision.

The dire need for improvements to regional health care was one of the driving forces behind my decision to contest the state election and represent the seat of Narungga. That has not changed, and providing enough healthcare professionals to service our electorate is a vital part of that. To that end, the Liberal government has developed a policy platform designed to increase the representation of rural GPs, registered midwives and other health professionals to provide vital services. We have committed $20 million directly into country health to fill skill gaps and attract specialists to help address the recognised ongoing medical staffing shortages in our regions.

The decision last October by Kadina Medical Associates to withdraw from the Wallaroo Hospital emergency department on-call roster was not a shock. What should be more of a surprise is how long the hardworking Kadina Medical Associates' GPs were able to continue to be the sole provider supporting the Wallaroo Hospital after the withdrawal from the roster in the last 18 to 24 months of both the Wallaroo and Moonta medical practices. Such unacceptable workloads are doing nothing to attract and retain GPs in our electorate and across regional SA, and outcomes are urgent from the policy work that has been underway for many months to address this issue.

The $20 million from the state Liberal government planned to address GP skill shortages includes:

doubling the number of medical interns in country areas;

allocating teaching hospital funding to country LHNs to enable those LHNs to negotiate cooperative shared training arrangements with metro LHNs;

supporting recruitment and retention of resident specialists in country SA through the engagement of interns, registrars and medical officers with specialist skills;

developing registered nurse/midwife collaborative graduate programs in regional, rural and remote South Australia;

encouraging rural and remote registered midwives to undertake training for dual registration;

ensuring that the Ambulance Service accommodates the changing employment and volunteering patterns in rural and regional areas; and

strengthening the Aboriginal health worker and allied health professional training opportunities across rural and remote SA.

I believe that the impending rollout of the Marshall Liberal government's new local health network governing boards will make a difference just by decentralising the system and putting real responsibility and accountability back in the hands of local board members. Our doctors, nurses and allied health staff are under great pressure, and the passage of the Health Care (Governance) Amendment Bill last year means that they will not have more pressure imposed by a remote head office out of touch with local needs and challenges specific to regional areas.

It has been well documented that in the last 10 years of Labor SA Health's head office staff was doubled, growing four times faster than our nursing workforce, and this excessive bureaucracy resulted in budget blowouts and poor project management. The cost of their Transforming Health plan has been put at at least $200 million, and that bill came with a reduction in services that the Marshall Liberal government is now having to spend more money to put back on. The Marshall Liberal government last month unveiled the final concept plan for a reopened Repat health precinct, with state-of-the-art services to care for brain and spinal rehabilitation patients and older mental health and dementia patients to be the focus of the site.

The former Labor government closed the Repat in 2015, after promising that they would never ever do so, leaving people in surrounding areas without that service, and set about selling the site. Thankfully, we were able to secure it as a public asset by terminating the sale contract two months after the March 2018 election. Health professionals and people at the coalface are now being listened to, and I can attest they are also being heard when assessing needs for country hospitals, long neglected, that are now requiring urgent high-risk repairs and maintenance. Under the new local health network governing boards, to commence in July, real responsibility and accountability will be put back at a local level and provide strengthened oversight and improve patient safety.

The new health governance measures legislated by the Marshall Liberal government ensure that money raised in local communities is spent in local communities, that local bequests and private donations go to where they have been pledged, and in doing so restore faith and connection between communities and governance, and that more regional and rural hospitals will not lose services and be downgraded.

In absolute frustration over the last 10 years, communities have become increasingly despondent about having no voice. It is believed that local communities lost decision-making authority over 42 country hospitals across South Australia when the previous government removed their management boards. In their stead, HACs were designed to be the local voice for the minister, but they were described as toothless tigers without directives on how to act without clear lines of communication and with no say on how funds they raised were allocated.

I heard the concerns firsthand. Locals wanting to donate to their hospital have not been sure where their money would go. Dr Max Van Dissell of the Kapunda Health Advisory Council lamented that, in 2016-17, two applications were made to use its fundraising to purchase a steriliser and an operating microscope the local clinicians deemed essential, but both applications were knocked back by the minister.

Another doctor, from the Nuriootpa Medical Centre, Dr Michael Hoopman, despaired publicly over the many battles faced by local doctors, which he listed as including outdated facilities, the winding down of services, such as obstetrics, and the lack of support patients who are experiencing mental illnesses receive. He said that he had been in the Barossa for 25 years and that numbers at the hospital had halved.

At a public meeting in Quorn in March 2017, local doctor Tony Lian-Lloyd addressed the packed town hall and described the loss of the lifeblood of many small townships—the local hospital, diminished by stealth, threatening the economic viability of rural doctors and, by extension, service delivery to patients. Of note were the supporting medical professionals who travelled from all over the state that night to attend—from Mount Gambier, Robe, Kimba, the Barossa, Burra, Cleve, Port Broughton, Bute, Maitland and Kadina and local mayors and members of the Rural Doctors Association and the Nursing and Midwifery Federation.

We are committed to fixing a broken health system. Patients in the Narungga electorate are often disadvantaged by distance and challenges in accessing doctor and specialist attention, but they, just like their city cousins, are entitled to fair access to health services. Regional areas cannot afford to lose anymore services. Retaining health services is at the top of the list of concerns for locals, and it is what I hear about most.

Our increasing and ageing population needs the state government to invest in its services. Since the Marshall Liberal government came to office in March 2018, regional health services have been significantly improved, and our communities in the Narungga electorate have been reassured by the evidence they have seen that regional healthcare matters to this government. Yes, the workload ahead to improve health services across metropolitan and regional South Australia is enormous such has been the damage done by the previous government and Transforming Health.

To be able to provide adequate, affordable health care and services is the goal of states and countries across the world, and we are all facing challenges. The World Health Organization's World Health Day is being celebrated on 7 April 2019, and the focus this year is universal health coverage. The campaign organisers state that the key to achieving universal health coverage is ensuring that everyone can obtain the care they need when they need it right in the heart of the community. The World Health Organizations say, and I state from its web site:

Progress is being made in countries in all regions of the world. But millions of people still have no access…to healthcare. Millions more are forced to choose between healthcare and other daily expenses such as food, clothing and even a home.

The World Health Organization does clarify that universal health care does not mean free coverage for all possible health interventions regardless of cost, as no country can provide all services free of charge on a sustainable basis.

I take this opportunity in marking World Health Day to recognise the vital role of this state's health sector and its extensive workforce of doctors, nurses, specialists and paramedics—everyone who works in the healthcare setting in any capacity. I also commend all within the World Health Organization for their dedicated effort to progress health standards and service provisions around the world—a vital contribution indeed.

I would also like to acknowledge the Minister for Health, who is doing a mighty job in his new role and contributing a great deal to regional health care. I have been honoured to host him in our electorate a couple of the times, once almost immediately after the election when he visited the Wallaroo Hospital.

Unlike the previous government, whose efforts at Transforming Health resulted in the closure of hospitals and the winding-back of services, this government cares about good health care. I find it ominous that those opposite have installed one of the architects of Transforming Health as the shadow minister for health. Heaven forbid he ever be afforded the opportunity to reconstitute it. I commend the motion to the house.

Mr PICTON (Kaurna) (17:09): I move an amendment to this motion:

Delete all the words after (b) and substitute:

(b) expresses grave concerns over the Liberal government's cuts and privatisation agenda for health, including the state budget reduction of 880 health staff this financial year;

(c) condemns cuts to our hospital system currently being undertaken by corporate liquidators KordaMentha; and

(d) condemns the budget cuts to SA Pathology, SA Medical Imaging, the Health Consumers Alliance, SHINE SA, HIV services and ambulance transfers.

It is important to mark United Nations World Health Day in this parliament. However, I think it is pretty typical of this government's approach to come into this place and mark it by trying to score political points for something that should be seen as an important non-partisan day to mark. We will return in spades what the government is throwing in terms of their attacks and outrageous abuse of parliamentary time in order to talk about this day because what we are seeing, day after day in this state, is a campaign of cuts, closures and privatisations in our health system in South Australia.

On the day the state budget was handed down, we could see immediately what was being envisaged by this government in terms of health services in South Australia: cuts, closures and privatisations. Already, we have seen the closure of health services in South Australia. SHINE SA has been singled out for very significant cuts in South Australia. The Health Consumers Alliance—the people who are representing patients in South Australia—have been singled out for cuts to the point where they may be forced to close. We have seen HIV services singled out for cuts, so that HIV services have closed in South Australia due to the actions of this government.

However, nothing says more about the priorities, opinions and budget of this government than what they are doing in the Central Adelaide Local Health Network by bringing in KordaMentha to run those health services. They have brought in corporate liquidators KordaMentha not to provide advice, not to look over the books, but to actually run health services in South Australia. It is completely unprecedented that two of our largest hospitals in South Australia are being run not by doctors, nurses or health management experts but by people whose job it is to be corporate liquidators. They are now running our hospitals.

This will affect patients across South Australia. We have seen their plan, and it involves closing 170 beds across those two hospitals. It will put more pressure on ramping. Ramping is worse now than ever before in South Australia. Just last week, we saw the effect this is having on clients from the statewide spinal surgery unit. Previously, invoices were very quickly approved for custom-built wheelchairs, so that patients could be discharged from hospital, get into the community and regain their lives.

Unfortunately, we are hearing from doctors in the service that it is now taking three months to get past KordaMentha and for those wheelchairs to be approved. It is delaying patients' discharge from hospital. It means that it is more expensive overall to the public because those patients are staying in hospital for longer, and it is leading to worse health outcomes for those patients.

Just today, we have seen the Central Adelaide Local Health Network, under the management of administrators KordaMentha, bringing in a new management plan for their health service. They will now appoint accountants and business managers to head each area of health delivery in that hospital. It will not be the doctors or nurses in charge of how your health services are delivered: accountants, business managers and corporate liquidators will be in charge. That goes to show that this government's priorities are all about saving money, not patient care.

Over the past few months, we have also seen this government close beds in our hospitals. They have closed 25 subacute beds at Hampstead, beds needed to help people recover and to free up other beds in our hospitals. We have seen 16 medical beds close at Flinders Medical Centre, beds needed to take the brunt of the load from emergency departments. These are critical beds in our health system and they have closed.

We saw a new ward at the Women's and Children's Hospital closed for months—an unprecedented length of time—up until the end of February. We have seen 10 mental health, high-acuity beds closed at Glenside since January. These beds are desperately needed in the system at the moment because there is such dramatic pressure on our emergency departments. We have seen ramping in our hospital system that our clinicians have said is worse than ever before. While those beds stay closed—that the government has closed—the pressure is only going to increase.

If the government goes ahead with its plans to close 170 beds across the central region, and no doubt more in other regions as well, we will see more pressure, more ramping and more cases of what we saw in the last few weeks where a patient stayed in emergency for 85 hours before they could get access to a bed. This has been described by doctors' groups as an abuse of human rights. The reaction from the minister was not to open any of those beds that he closed, not to take any action, but to cut more money out of the health system and put the corporate liquidators in charge. That was ultimately his response.

This government has closed 41 beds at Flinders and Hampstead. We have seen ramping worse than ever before and we are going to see more pressure on the health system because of those cuts and closures in terms of primary and community health services. We were talking about SHINE SA clinics in the north and south of Adelaide. Patients do not have access to those clinics anymore because they have been closed under this government and that means that more people will be going to emergency departments.

We have also seen closures of mental health services that were being run by the federal government. The government closed them with the transition to the NDIS. The NDIS has not picked up those services. We had a mental health services guarantee to ensure that those services would continue. This government has not done that and we are going to see more pressure on emergency departments because of that.

We have seen more patients on the emergency surgery waiting lists, we have seen that those waiting lists have expanded and we have seen more people overdue on those waiting lists since this government came to office. This government promised that they were going to eliminate colonoscopy waiting times for bowel cancer screening within 12 months. That 12 months has passed and there has been no action on that whatsoever. Not one dollar has been spent in terms of achieving that end and we have not seen the elimination of that.

At the moment, there is a dispute in regional South Australia with Keith hospital desperately calling out for support from this government. They had promises from the Premier and the health minister before the election. Those promises have now been broken and there is the potential that that regional hospital might close.

We are seeing governance reforms where more money is going to be spent on board members to the detriment of public health services. We are setting up new boards, we are paying those board members lots of money, we are setting up more bureaucracy around those boards and around all the other staff connected to that, all of which is taking money away from health services and away from the coalface where it is needed.

We are seeing the government privatise ambulance transfer services between Modbury Hospital and Lyell McEwin Hospital, when we know that almost all those patients being transferred are at a high acuity level. These are patients who need the dedicated work from SA Ambulance, but they are going to be shunted off to a private operator so the government can save money because we know that that is their priority.

We are seeing the government's plans crumble from what they promised at the election for Modbury HEU because they did not have a plan and they do not have support from the clinicians, and we know that the department is working on delivering something which is not what they promised. We have seen the government reject bringing in no jab no play in supporting our laws to do that.

What happened last year, and what I am sure is potentially going to happen this year as well, was a lax response to winter demand management from this government. Last year, it was halfway through winter before we had a demand plan. We knew that the government was sitting on that for months. There was no action taken and we saw one of the worst winters that we have ever seen. All the indications are that this winter is going to be even worse than that. There are fewer beds because of the action that the government has taken, our flu cases are up and there are likely to be more because of the action they are soon to be taking.

We have also seen just this week their cuts to SA Pathology: 200 staff to go and 10 clinics to close. We know that will lead to more wait times, longer delays for patients getting access to treatment, more pressure on emergency departments and more ramping. It is a bit rich for those opposite, with this record of cuts, closures and privatisations in just one year, to come in and say this. They should be condemned for the actions they are taking, and South Australians will hold them accountable.

The DEPUTY SPEAKER: The member for MacKillop.

Mr McBRIDE (MacKillop) (17:19): Thank you, Mr Deputy Speaker.

Mr Picton: Tell us about Keith hospital.

Mr McBRIDE: Of course. I rise today to speak in support of the motion by the member for Narungga:

That this house—

(a) acknowledges and celebrates United Nations World Health Day, which will be held on Sunday 7 April;

(b) acknowledges the commitment that the Marshall Liberal government has to health care in South Australia, particularly in regional South Australia;

(c) welcomes the commitment to address the backlog of capital works in regional hospitals and the efforts to address the shortage of regional healthcare professionals; and

(d) condemns the former Labor government’s Transforming Health program and the dire situation in which it has left health care in South Australia.

Like the member for Narungga, since becoming the member for MacKillop the issue of the status of regional health services has been one of the key matters about which my constituents contact me. It is appropriate that, in celebrating United Nations World Health Day, which will be held on Sunday 7 April, we highlight the commitment of the Marshall Liberal government to health care in regional South Australia.

It is unfortunate that South Australians in regional areas experience worse health outcomes than their metropolitan counterparts, in part due to less access to health services. I am proud to be part of a government that is committed to navigating this challenging area and to be part of a government for which regions matter. A key action that our government has taken included the formation of the local health network governing boards. I was pleased to see the formation of the South East Local Health Network Governing Board take a step forward with the recent appointment of board members to work with Grant King, the chair.

This action taken by the Marshall Liberal government will assist in ensuring that local decision-making is made regionally. It is a strong step forward that recognises the value of ensuring that there is local oversight and understanding of the needs of regional communities. I also welcome the action of the Marshall Liberal government in providing funding to support the outer Limestone Coast paramedic service. This service provides two paramedics who deliver extension services and backup to local GP providers serving the townships of Robe, Lucindale, Padthaway, Kingston and Beachport. The service is unique and is a new way to deliver regional healthcare services in areas and towns that are, by virtue of their location and distance, not able to support full-time GP services.

The hospital infrastructure and services in our region have been subject to appalling neglect and have suffered from centralisation of services. I welcome the commitment to address the backlog of capital works in regional hospitals and the efforts to address the shortage of regional healthcare professionals. There is much to do. Naracoorte hospital is tired and needs upgrading. Years of neglect have taken their toll on this important central hospital facility for the region.

During the term of the previous government, it took a private donor to fix the appalling condition of the roof of the Kingston hospital. It beggars belief that a private donor would have to step up so generously to address such a basic need for a public health service. Millicent hospital used to punch above its weight in providing services and local procedures akin to those of the larger hospital in Mount Gambier. During the neglectful years of the Labor government, we saw services stripped from the Millicent hospital. Services and procedures retreated back to Adelaide, leaving the hospital a shadow of its former self.

Despite these drawbacks, it must be said that our region has benefited from vision shown by local doctors such as those at the Kincraig Medical Clinic at Naracoorte, who have been forging ahead with great commitment to provide services to the community and attract visiting specialists to the region. The GP skill shortage is another critical area that our government has recognised needs to be addressed. The member for Narungga highlighted the initiatives earlier, and I believe that they are worth reiterating. The Marshall Liberal government's $20 million plan to address these shortages includes:

doubling the number of medical interns in the country;

allocating teaching hospital funding to country LHNs to enable cooperative training arrangements with local health networks;

developing a registered nurse/midwife collaborative graduate program in regional and remote South Australia;

supporting the recruitment and retention of resident specialists in country areas through the engagement of interns, registrars and medical officers with specialist skills;

encouraging rural and remote registered midwives to undertake training for dual registration;

ensuring that the Ambulance Service accommodates the changing employment and volunteering patterns in rural and regional areas; and

strengthening Aboriginal health worker and allied health professional training opportunities across rural and remote South Australia.

It is timely and on point, when referring to the critical shortages of GPs across the state, that this motion provides the opportunity to reflect on the status of regional health services in the MacKillop electorate, specifically and with reference to the Keith and District Hospital. The Keith and District Hospital, situated on the Dukes Highway, is a private community hospital. The hospital is an important regional community hospital facility that services a population of approximately 3,500 residents over more than a 10,000 square kilometre area.

The hospital includes 14 private acute beds and services a federally accredited 18-bed aged-care facility for permanent and respite care and a busy GP service to the Keith and Tintinara areas. The hospital is the only location between Murray Bridge and Bordertown that offers a 24/7 accident and emergency facility. This site is also a strategic operational site for rescue helicopters. One only needs to speak to locals and hospital staff to realise the critical importance this hospital plays in saving lives through the availability of a 24/7 accident and emergency facility.

We know that in 2017-18, the Keith and District Hospital accident and emergency department assisted more than 500 patients. Treatment times for emergency patients can be improved due to this location. Ambulances will travel to Keith to meet the rescue helicopter. At this stage, both Naracoorte and Bordertown hospitals are too far away to take a round trip without refuelling. The hospital currently offers private inpatient services only. Public beds were lost from the hospital during the years of neglect that were part and parcel of the then Labor government.

The Keith and District Hospital clearly provides a critical service to the community. The community recognise this and their financial support for the hospital reflects this value. The community of Keith provides substantial community donations. In 2017-18 alone, these donations amounted to more than $600,000. It is worth noting that the Keith community has raised more than $1.2 million in donations for its hospital in the last five years alone.

Like many regional locations, it has been a challenge for the Keith and District Hospital to recruit doctors. It is well documented that there are around 60 doctor vacancies—GP doctor vacancies—around the state. It is a struggle to recruit these GPs. This issue in particular is a key driver of the difficult position the Keith and District Hospital is in today.

As I identified earlier, the Marshall Liberal government is investing and taking action to address the GP shortage across the state. The Marshall Liberal government has been working with the Keith and District Hospital board and the South East Local Health Network board to address the issues being experienced by the hospital. As a local member, I am acutely aware of the importance of the hospital to the community and have been working with the Minister for Health, the hospital board and local government to advocate for a way forward in response to the challenges before the hospital.

The government, recognising the importance of the hospital and working through the South East Local Health Network board, has also initiated a review of the Keith hospital, with a view to seeking a sustainable, medium and long-term operating approach. Since the election, $400,000 has been provided, in addition to the $1 million funding support for the hospital. The government is continuing to work with the hospital board to seek to navigate through this challenging time. Work is ongoing in this area. I look forward to the finalisation of the review being conducted through the South East Local Health Network board and the outcome of ongoing discussions with the Keith hospital board, which I hope will secure the future of this important facility.

There is much work to do in the area of health and, in particular, to improve the delivery of health services in regional areas. The Marshall Liberal government has a plan to address this challenge. It is appropriate to take the opportunity to reflect on this plan in acknowledging and celebrating the United Nations World Health Day on 7 April. I commend the motion to the house.

The Hon. S.C. MULLIGHAN (Lee) (17:28): I also rise to speak on this motion ostensibly about World Health Day 2019—a day, of course, that is promoted by the World Health Organization to try to foster a greater understanding throughout the global community of the need to extend universal health care to the millions and millions of people who do not have access to it. Indeed, according to the World Health Organization, half of the global population do not have access to the health care they need. I thought it might be a large number, but I did not quite think it would be that significant.

Indeed, I understand that the World Health Organization advises that 100 million people are pushed into extreme poverty every year by attempting to fund their healthcare needs. It is timely for us to be contemplating what we could be doing as global citizens through our national government to try to foster greater access to health care for those millions and millions of people, or indeed billions of people, who do not have access to it. That is something we can reflect and ruminate on at length, I am sure. However, that is not quite the intent of this motion.

The intent of the motion actually is to use the opportunity of the United Nations World Health Day 2019 to try to chip some cheap political points more than a year into the fledgling life of the Marshall Liberal government and try to re-exercise the wearily tired arguments that they have been trotting out since 2015 about Transforming Health. Honestly, I thought the member for Narungga was a little bit better than that, but clearly he does not want to be a one-trick pony. He does not want to be about just splitting from his government on the mining bill. He is spreading his wings a lot more broadly these days. As the member for Kaurna already has, allow me to retort.

It is extraordinary that we would have a government or members of a government who would try to put to this house how terrible they think the former government's program of Transforming Health is while turning complete blind ignorance to the actions of their own government at the moment with the South Australian health system. This is a motion and this is a government that claim the Transforming Health process, which in its beginning was to seek the advice of corporates to try to reform the South Australian public health system to ensure that health services could be provided more efficiently, is a bad thing and that changing the public healthcare system here in South Australia in line with those recommendations is a bad thing.

Let's consider what this government is currently doing. Rather than go out to market and ask for a number of people to answer a tender call to provide their professional services to assist in the reform of the healthcare system, they just walked up to a corporate liquidator KordaMentha, which has no presence here in South Australia, and said, 'Would you like the job to come in and look at our healthcare system?' They started out by awarding them a contract, if I remember rightly, of about $880,000, in clear breach of the state's procurement guidelines. But that is okay; the Auditor-General has been informed and he, in return, has advised that he will look at this as a matter in his annual report. But it does not stop there.

Not only did they write their $880,000 report, but in that report it seems that they have recommended that their work scope be extended so that their maximum contract value might increase to $37 million. What a gig! I can understand how KordaMentha make all their cash: get a gig, preferably with a government that has deep pockets, and write your own recommendations to continue getting more work. That is $37 million that is not going to be spent on the front line, providing healthcare services to South Australians in the public healthcare system. How extraordinary!

Not only that, but those people who are providing the leadership in that organisation (KordaMentha) to provide these services have no experience in doing this type of work. None of them have been executives in a local healthcare network in the public health system, yet they have been appointed to substantive positions in local healthcare networks to try to run our public hospitals and to run our other healthcare agencies. It is absolutely remarkable.

We have had an early taste of what is to come from corporate liquidators KordaMentha. Not only do we have $1.25 billion of unidentified, unallocated savings for SA Health to achieve over the forward estimates, but they have attempted to get off to a cracking pace. They have started by trying to squeeze $105 million out of SA Pathology. Of course, we knew earlier this week, through a report that was selectively leaked to the media on the morning of federal budget day, that that is not working out so well. Instead, they have a one-year reprieve before privatisation will commence, when they are expected to save a further $20 million and sack 200 staff, including clinical staff.

We have already seen from last year's September state budget that 880 FTEs are to be saved from the Central Adelaide Local Health Network. As we have heard the member for Kaurna say, 41 beds have already been closed in Flinders and Hampstead. This is a remarkable number, particularly in Flinders, which I think has just had about a quarter of a billion dollars spent on it by the former Labor government to modernise and upgrade it. Those beds are closed while we experience the worst ramping this state has ever seen.

In fact, I cannot quite say 'worst ever seen' because the Minister for Health, the Hon. Stephen Wade in the other place, erected a wall so that the media could not see the ramping. Not only did he erect this privacy screen so that he could hide his poor performance as the health minister superintending our public health networks and the operations of our most important hospital, the Royal Adelaide Hospital, but when he was asked about it in parliament he did not tell the truth. He said that he did not know about it and that the first thing he heard about it was from the media. Then, of course, he had to come back in and correct the record because he did know. He sighted and approved advice from his department about the erection of the privacy screen. It is extraordinary.

We have just had the member for MacKillop placed in the invidious situation of having to make the excuses for his parliamentary colleagues over the treatment of the Keith hospital. Of course, they railed against the former health minister John Hill for not extending their funding by $100,000 a year, I think it was, to enable them to continue operating in the manner they needed to to keep their doors open. Now, under the current Liberal government, the situation is much worse. However, we can pay not hundreds of thousands of dollars but millions and millions of dollars on re-creating health boards for the local health networks.

It creates the extraordinary situation where we do not actually know who is responsible for the budgets of these local health networks. We do not know whether it is the board, who of course owe their fiduciary duty to the local health network and not to the overall superintendence of the public healthcare system. Is it them, is it the minister or is it one of the executives in between in the local health network? I guess we will wait for some of the disasters to continue to unfold under the superintendence of health minister Wade in the other place. I seek leave to continue my remarks.

Leave granted; debate adjourned.

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