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Legislative Council - Fifty-Fourth Parliament, First Session (54-1)
2019-04-03 Daily Xml
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Matters of Interest

SA Pathology

The Hon. T.A. FRANKS (15:24): I rise today to speak on the privatisation of SA Pathology. Every time we go for a blood test to investigate or keep track of an illness or have a tissue sample from a pap test or a suspicious mole sent off for analysis, the wheels of the pathology industry are put to work.

Pathology is big business and many in the private sector see the profit motive rather than public health outcomes as the reason to be in the business of pathology. Pathology is at the heart of our healthcare system. It provides the accurate and timely information that so affects our population's health, and allows clinicians the insights they need to properly manage the health of patients. By putting a bottom line of profit ahead of services, this government would indeed threaten people's lives, something that no government should be seen to be doing. Indeed, all governments should be seeking to improve and protect the health of their citizens.

Pathology directly reduces the cost of health care. It provides that certainty needed to achieve the minimum hospital lengths of stay and to avoid unnecessary treatments and unnecessary hospital admissions. We cannot expect SA Pathology to be cost competitive against private providers, so the arguments of contestability are moot. Private providers will not do the same tests that SA Pathology does because they simply are not profitable. SA Pathology does public testing that is not on the Medicare Benefits Schedule and as such is not funded to make that profit. They do not get money for it, which is why others will not do it, so how they can ever be contestable?

The danger is that where we lose the critical mass of SA Pathology, we will lose the expertise and the depth of services and cross-subsidisation to ensure that those tests are done in a timely way. Indeed, those tests no longer covered by the MBS mean that the patient will bear the full cost. That would be the case for people with established diabetes who need a haemoglobin A1c test, which is rebated for only four tests in a 12-month period. These tests are required for monitoring that disease and if the patient needs more than four tests in that time frame, they may well be required to pay the full price—they certainly will be required to pay the full price in a privatised system.

About 85 per cent of all pathology services are bulk billed, and that is the highest rate of any medical speciality, which is as it should be. It is worth noting that non-Medicare funded pathology is mostly purchased or funded by government authorities other than Medicare, such as workers compensation, public hospitals or, in fact, the Department of Veterans' Affairs.

It is also worth noting that some one in seven workers within SA Pathology have been told—not through formal communications, but through an announcement in the press and on the radio—that they may well be losing their jobs in the next few years. They have been told this in a context that SA Pathology is being deemed somehow inefficient, unviable and in need of privatisation. They have been told this in a context that doctors and nurses, as front-line staff, will have their jobs in the public health sector protected, but these so-called backroom staff are under no such protections and yet they are expert, capable, skilled public health professionals in our public health system.

If you want to know how important these so-called backroom people are, I think we should listen to those very doctors and nurses who have been saved from the health scalpel under this Marshall government. Associate Professor William Tan has called this move one that will create chaos, one that is a weird experiment and has cautioned that it would see the cherrypicking of the most lucrative and profitable sections of SA Pathology by sourcing those out to the private sector as a false economy because you would lose that cross-subsidisation for the more expensive tests and it would also put in danger the training and skills we need to keep in this state to ensure we have the best outcomes.

It is like an episode of Yes, Minister where the most profitable and efficient hospital had no patients. That is what we are looking at if we privatise SA Pathology.

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