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Legislative Council - Fifty-First Parliament, Second Session (51-2)
2008-02-13 Daily Xml
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HEALTH CARE BILL

Second Reading

Adjourned debate on second reading.

(Continued from 12 February 2008. Page 1631.)

The Hon. C.V. SCHAEFER (21:27): I am reminded as I speak of the history of the small hospital of which I was a board member for some eight to 10 years, during which time regional hospital boards increasingly became disenchanted with centralist administration of the health policy and finances of regional and rural health. When the Brown government came to power in 1993, the then health minister (Hon. Michael Armitage) attempted to reform the Health Act at that time, giving true autonomy to local hospital boards.

That particular piece of legislation was thwarted by the opposition and Independents in the upper house at the time, so what we were left with was something of a compromise, or even a mishmash of what Michael Armitage's original intentions had been. But there was a genuine attempt to devolve power out of the city and back into country areas, and that was very much appreciated by country people. So, I guess what I see is: what goes around comes around, because we are now back in the throes of a Labor government that has decided to recentralise all real power, all real administration, and particularly all real budgeting, back into a central pool in the city.

This is an ideological gap which does not seem to be able to be cured between the ALP in its view, which seems to me to be that if you live in the country you could not possibly have the brains to administer your own health budget, and the Liberal Party, which vehemently disagrees with that.

As I said, my experience comes from having been on the board of a country and regional health service for a number of years, and I wonder at the thought process that if you go to work in a high-rise building in the middle of the city you will definitely know more about country health and how people wish to have their country health dollar administered than if you happen to live in a regional city or even a small town.

It disappoints me greatly, because the history of small country hospitals has been very much built on volunteerism. In many cases, the land on which the hospitals are built was donated, and the hospitals themselves were built with voluntary labour. Certainly, until I left Kimba in 1998, a large component of the capital improvements to the hospital was donated, and much of the painting and general maintenance was done by volunteers. None of that will be the case under the current legislation.

The government has said that it is improving, I think, four or five regional hospitals across the state. What it has done, as it is very clever at doing, is a pea and thimble, a sleight of hand trick. Its headlines at the time that this bill was announced were, 'Additional funding to country health'. What it failed to say is that it is very slowly squeezing the life out of country health: drip by drip; just like water dripping on marble. Very slowly, health services in country South Australia are eroding to nothing, other than the money which is being spent, and which I am sure will be gratefully accepted, in these few super hospitals, for want of a better name.

However, it will be cold comfort for someone who has a farm accident at Kimba to know that they have marvellous and upgraded facilities at either Port Lincoln, which is three hours' drive away, or Whyalla, which is two and a half hours' drive away. Of course, those of us who have lived out there know that, if you take away the facilities of a hospital, you then take away any incentive for a general practitioner to practise in that town, because they have no equipment to use. You take away the incentive for nurses to continue working at that hospital. So, eventually, as I said, drip by drip, drop by drop, what you have is a series of nursing homes, with no facilities and possibly a very scaled down emergency facility.

I think everything that needs to be said about this piece of legislation probably has been said: I just wanted to add my perspective. Members of my family have had very serious accidents and illnesses, and they have been very well treated at small hospitals. Certainly, the care and consideration that is given to one in a small hospital by the nursing staff, who very often are people who you know and with whom you socialise, is second to none. However, none of these facilities will, in fact, exist once these super hospitals are built and once any autonomy and any decision making is taken out of the hands of the local community. That is what this bill seeks to do, and that is what it will achieve. Eventually, if you take away that volunteer aspect, that sense of ownership—both real and perceived—of people within a community, you take away their interest in their own community.

I see this piece of legislation as absolutely disastrous for country communities. As these hospitals gradually close or are downgraded to such an extent that they are a mere facade, it will also take away one of the major employment opportunities within small country towns. For instance, a nursing staff of 20 may well be supporting 20 families, and 20 families taken out of a small country town means that the closure of the supermarket or the general store, whichever the case may be. This piece of legislation has very far-reaching effects for our isolated communities, our smaller communities and our communities that are increasingly forgotten by an increasingly arrogant and centralist government.

Debate adjourned on motion of Hon. J.S.L. Dawkins.

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