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Legislative Council - Fifty-First Parliament, Second Session (51-2)
2008-07-23 Daily Xml
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NORTHERN FLINDERS RANGES HEALTH SERVICES

The Hon. C.V. SCHAEFER (17:10): I move:

That the Legislative Council—

1. Notes the Resolution of the Residents of the Northern Flinders Ranges, viz:

We the residents of the Northern Flinders Ranges move that the proposed current health plan is unacceptable in its current form, and request that the minister himself consult with the residents of all towns that will be affected by any further drastic changes to hospitals and health services in their towns; and

2. Requires the Premier and Minister of Health to respond to the resolution as a matter of urgency.

I have moved this motion in a somewhat unusual form at the request of the residents of the Northern Flinders Ranges who attended the public meeting in Quorn a week ago, but I am sure their sentiments express those of the thousands of people I have now seen at these public meetings throughout northern and western South Australia. They asked me to move it because they were not convinced that there was any other way that it would be brought before the parliament, so I have done that on their behalf, but it has given me a chance to raise again with great sincerity the genuine concerns I have about this ill-conceived and badly devised plan for country health in South Australia.

This government started this I believe with its now carried new Health Act, and in that act it took the step of scrapping regional health boards and then abolishing local hospital boards, so now there is no-one from the local areas to refer to and indeed no-one to consult. There are HACs, as they are euphemistically called, which are health advisory committees which have no autonomy and no power. The government gave assurances in this and another place that the assets that had been built up by small country hospital boards, many over generations, would remain the property of those country hospital boards. Certainly, as long as I can remember, fund raising has been done and bequests given to the local hospital.

There has always been a great sense of ownership of the local hospital, and in some places the previous hospital boards had considerable assets. In the case of one small hospital where I attended a public meeting a couple of weeks ago, the community had assets in excess of $380,000. However, all of these new health advisory committees have been told that the most they can spend out of their own money—raised by them and invested frugally over many years by them—without seeking the permission of the minister is $5,000, and in this case it is $5,000 out of over $380,000.

That seems to me to be the beginning of a centralist move, which has then gone on to develop into what is now the Country Health Care Plan. In some ways I feel sorry for minister Hill, because I think he has been conned by his own bureaucracy. I served for eight or 10 years on a local hospital board, and I remember that the minister at the time, Dr Cornwall, tried to introduce something similar, and it was largely nipped in the bud at that time. So, there have been bureaucrats around with this centralist plan for a very long time.

The plan seeks to set up three levels of hospitals in South Australia: very much the haves, the might haves and the definitely have nots. The haves will be four general hospitals: one at Berri, which happens to be in minister Maywald's electorate; one at Mount Gambier, which happens to be in minister McEwen's electorate; one at Whyalla, which is the only Labor country seat; and one, because they could not think of anywhere else to put it, I suppose, at Port Lincoln.

If you look at the geography of that: Port Lincoln is bounded on two sides of its triangle by sea and is at the southern most extremity of Eyre Peninsula; Mount Gambier is very close to Victoria and is, again, bounded on two sides by sea; and Berri is fairly close to Mildura and New South Wales. So, while they will service their local communities, and I am sure will service them quite well, the idea of them being a catchment for country people is quite ludicrous.

There have been many stages in the evolution of this plan, but in the early stages the minister quoted at various times that 85 per cent of country people were within 90 minutes of one of these general hospitals. Well, only if you do not count the sea. If people from Port Pirie, Wallaroo, Moonta and so on cannot cross by hovercraft or something to Whyalla, there is no way that any of them are within 90 minutes of one of these general hospitals.

Similarly, very few, if any, of the residents of Eyre Peninsula are within 90 minutes of one of these general hospitals. So, even at the top level, the plan has been ill-conceived and ill thought out. I think I have previously said that we do not have enough specialists in South Australia to service the waiting lists in the metropolitan area, and yet suddenly we are going to have four general hospitals fully equipped and with resident specialists. It is a puzzle to me where any of those resident specialists will come from.

I move now to the might haves. There are 11 community hospitals under this scheme which, we have been told, will be given additional services, but nowhere in the budget is it pointed out where the additional services will come from or who will pay for them. We then move to the 43 that are now called GP Plus Emergency. Basically, they lose their acute beds and become little more than first aid posts.

I only personally realised how concerning this is when the doctor from Port Broughton described what an acute bed is. An acute bed is anything that is not an observation bed. So, what this would essentially mean is that, if someone had an operation at one of the general hospitals or one of the community hospitals, they could not go back to their own small hospital for post-operative care. They could not go back to their own hospital for postnatal care. Should they have an accident and need to be stitched up and have antibiotics administered, they could not do that in their local hospital. So, where are their family going to stay, or are they going to be visited? The answer to those questions is no.

Having seen the outrage that this has caused, minister Hill has now started to do backflip upon backflip upon backflip. The 43 have now become 14, but the rest of the 43 have only been offered a stay of execution. They are not free. They are still on death row; it is just not immediate. Dr Steve Holmes, who is chair of the Regional Doctors' Association, said in The Advertiser:

Successive country health plans have failed, but this government has gone one step further. It has planned to fail. Not only that, it has planned who will fail first and in what order.

That is exactly what the government has done. I think this is a cynical attempt to set country communities against each other. I am glad to say that it will not work.

At the last two public meetings that I have been to the personnel from the towns which have had a stay of execution but which are still in the 43 have said, 'One out, all out. If anyone loses their privileges we will all go.' But as someone else said to me, 'There is more than one way to kill a sheep. You do not have to cut its throat; you can just put it in a paddock with no food and water.' I think that is what this government will do: it will slowly starve these smaller hospitals of budgets and privileges until their doctors can no longer stay there and practice their profession, and then those towns will have no doctor and no services.

Again, Dr Steve Holmes was the doctor at Blyth when the Labor government at the time closed the Blyth hospital. He has a very illuminating set of slides showing all the small businesses that closed in Blyth within 18 months of their hospital closing. That is what we can look forward to if this government is not stopped.

It is interesting to note that not just country people are objecting. We have had the country GPs, the Rural Doctors Association of Australia, the Rural Doctors Association of South Australia, Dr Tony Lian-Lloyd from Quorn, Dr Peter Rischbieth, Dr Mackinnon, and the Nurses Federation of Australia all stand up at public meetings and condemn this plan. So, it is not just the Liberal Party playing politics. This is a threat to the very fibre of country people.

For those of you who are not terribly concerned about this, let's hope none of you have a car accident and that none of you go fishing and have an accident, because there will be no health services and they will not be accessible within 90 minutes. The volunteer ambulance services are overstretched as it is, so there is unlikely to be transport. Most of the places do not have airstrips—and I note members opposite yawning—but there are unlikely to be methods of shifting patients who are badly injured, and those who have to decide whether or not they are badly injured are unlikely to be doctors.

This comes at a time when we are actually beginning to win over the problem of a lack of country professionals. Within the next five or six years, I am assured by the Rural Doctors Association that we will have sufficient graduates to fill many of the positions that we are told by Mr Hill will not be filled. There will be sufficient graduates but, if they do not have a working hospital to go to, they will naturally go interstate thereby making this a self-fulfilling prophecy.

I will continue as long as I can to fight this. I think it is the worst piece of planning that I have seen in my 15 years in parliament. I have now been to six of the public meetings and at each one of those there has been a huge crowd. Last night at Kimba, it was estimated to be between 300 and 400 people in a district of 1,200 people. Quorn would have a similar population and had a similar number in attendance. The people of Quorn were so incensed that they asked me to move this motion on their behalf and I am happy and proud to do so on their behalf, but I suppose it will fall on deaf ears. I suppose the government will do nothing about it. I suppose someone will get up and move an adjournment and that will be the last we will hear of this motion, but at least my conscience is clear.

Debate adjourned on motion of Hon. J.M. Gazzola.

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