Regional Health Services Motion


Regional Health Services

Mr VAN HOLST PELLEKAAN ( Stuart ) ( 11:01 :31 ): I move:

That this house establish a select committee to inquire into and report on—

  1. The review by the Health Performance Council on the operations of the health advisory councils in accordance with the Health Care Act 2008.

a)       The current provision and plans for future delivery of health services in regional South Australia, with particular reference to—

b)      the role and responsibilities of health advisory councils and the benefits, or otherwise, of the removal of local hospital boards;

c)       amalgamations of health advisory councils in regional South Australia;

d)      trends in local community fundraising for medical equipment and services;

e)       how funds currently and previously raised by local communities are held and spent, with particular regard to authorisation and decision-making;

f)        timing of provision of finalised operation budgets in country hospitals;

g)      ownership and transfer of property titles of country hospitals;

h)       the process and timing of the hiring of staff for new and existing positions;

i)         South Australian Ambulance Service arrangements, including the role of volunteers, fees and fundraising and the benefits, or otherwise, to local community events;

j)         scope of practice of general practitioners to country hospitals and the provision of accident and emergency care;

k)       procurement by Country Health SA and the benefits, or otherwise, to country communities;

l)         mandated fees to DPTI for management of maintenance and minor works;

m)     the benefits, or otherwise, of all rural and remote South Australia being classified as one primary health network within the federal health system;

n)       the implementation of EPAS in country hospitals;

  • o)      integrated mental health inpatient centres for regional South Australia; and

p)      any other relevant matters.

This motion is extremely similar to one that was moved by the Liberal opposition back in February 2011. On 23 February 2011, the Hon. Michelle Lensink, on my and my colleagues' behalf, moved in the other place a motion with very similar terms of reference.

The reason this was done was that, back in May 2008, the state Labor government put forward its country health plan, and every member in this place, even those who were not elected at the time, will remember the enormous community backlash against that plan, including from people in metropolitan Adelaide, I have to say. They were very supportive of country South Australia because they have friends and relatives in country areas. They want to go on holidays or short visits to country areas. They understand far better than this government does that its job is to represent all of South Australia, not just metropolitan areas, so even people in the city supported people in the country.

It is imprinted on my mind, as it is upon the minds of all other country members of parliament, how passionately, vehemently, strongly and, in many cases, angrily country people voiced their opposition to what the government wanted to do, which essentially was a watering down of all of country health, removal of local decision-making opportunities and authorities and, really, centralising all that power back to Adelaide.

Of course, there are decisions that only professional, trained medical practitioners, whether they be doctors, nurses, allied health professionals, whoever they are, can make but community people have an enormous role to play with regard to the best way for that medical support to be delivered into their communities, and for the government to be trying to water down that contribution is absolutely disgraceful.

To the government's credit, and to the minister's credit, back in early 2011 former minister Hill said, 'Look, that's okay, Dan. I'm happy to have that inquiry. Let's figure out the terms of reference together. If we can agree together those terms of reference, then yes, I'll certainly agree to it.' We did exactly that. Minister Hill and I sat down and agreed a very reasonable, very responsible terms of reference, which would suit my aims with regard to having a frank and thorough inquiry into the delivery of health services in country areas, and which was also, minister Hill said, one that he was very comfortable to have inquired into as well. So good on former minister Hill for doing that. Current minister Snelling has been very, very quiet on this issue, and I think unfortunately so.

The SPEAKER: 'The Minister for Health' will be sufficient. We do not need his surname.

Mr VAN HOLST PELLEKAAN: The current Minister for Health has been very quiet on this issue and that is, of course, concerning, but the government at one stage did say, 'Yes, we will participate in this inquiry.' Government members in the other place were allowed to join with all other members and it was unanimously supported that the Social Development Committee would undertake this inquiry. I thought that was great: bipartisan, genuine, looking to country health—terrific. The terms of reference were agreed and everybody was on side.

But, Mr Speaker, nothing has happened since then—absolutely nothing has happened since then. I very regularly engaged with the Social Development Committee. I was perpetually told that this would be the next inquiry—'not the current one, but the one after that, and we will get on to your country health inquiry'—but it never ever happened.

On Friday 3 August, I wrote to the Hon. John Gazzola, who was then the chair of that committee, and asked him exactly what the status was, because my verbal approaches were not making any headway. He wrote back on 10 October, eight months later. I will not read the whole letter out, but essentially it stated:

The terms of reference into the delivery of health services in regional South Australia remain on the committee's work program for 2013.

It was a bit slow, but the chair said that it would happen in 2013. In February 2013, I wrote to the then chair of the Social Development Committee, the Hon. Russell Wortley, and said, 'I have been advised it will happen in 2013. Committee chair, can you give me an update, please?' Again, I will not read the whole letter out, but, just as in the previous letter, the last sentence says it all:

The committee secretary will keep you apprised of the committee's continuing work program.

So, far less specific than the former chair, which of course set off even more alarm bells. That is why I have come back to this house asking for a select committee, because I am not comfortable with leaving it with the Social Development Committee. That is no reflection upon the members of the Social Development Committee, who I am sure are jointly trying to do the very, very best work that they can. But clearly since early 2011 no progress has been made on this matter by the committee, despite the chairs telling me that it would actually be progressed.

That is why I am uncomfortable with asking the Social Development Committee to embark upon this work and that is why I am specifically asking this house to establish a select committee to look into this issue. I have been advised by the minister's office that they have a strong preference for asking the Social Development Committee to continue to do this work. I appreciate the fact that the minister and his staff have been forthright with me and given me their position on their preference. However, as I have said quite openly to them, we have been down that track before, and it will not satisfy the people I represent or the people in broader regional South Australia to be told again, 'Well, we'll just hand it over to a committee that may or may not be able to do the work.'

I also said in my discussions, 'If I could be given some form of commitment on exactly when this will happen I could be persuaded to consider accepting that suggestion.' Unfortunately, no such commitment has been forthcoming, so I think the only appropriate path to take is to have this house establish a select committee because I have no confidence, and the people I represent in regional South Australia have no confidence, that the Social Development Committee will get to this piece of work.

There are nine hospitals in the electorate of Stuart and every single one of them is an incredibly important institution that provides very good health care with really capable people working exceptionally hard in those hospitals and in all of the other medical support services that are typically linked to hospitals. Of course, they do not just support the towns they are in; they support the districts that surround them and the towns that surround them.

My reason for pursuing this issue is that not only do I still have constituents who range from being concerned all the way through to being exceptionally angry about what the government has flagged that it wants to do with country health services—which is the case, of course, as people are there in my electorate—but I am also approached regularly by doctors, nurses, allied health professionals and members of health advisory committees (HACs), people who work in the system who say, 'There are problems with the system. We need this inquiry to go ahead.' It is not about trying to axe everything that goes on; it is about trying to improve everything that goes on. Professional people working in the system want this inquiry, and patients and potential patients want this inquiry.

There are nine hospitals in the electorate of Stuart. I do not know how many there are across all of country South Australia, but there is an enormous number of them and they are all saying with a united and responsible voice, 'We want this to go ahead.' If it is deferred to the Social Development Committee, those people—the patients, the potential patients and the health professionals—have no confidence that it will ever reach an active stage of work.

I do not have time to discuss all the terms of reference I am proposing here, but I will just touch on a few of them. Trends in local community fundraising for medical equipment: it is a fact that over the last several years country communities' appetites for fundraising have diminished significantly because they are worried about where the money is going to go. Provision of finalised operating budgets to HACs: it is a fact that the people who represent their communities on health advisory councils are not getting timely advice, so how on earth can they make recommendations on behalf of their committee when they do not get timely advice on how hospital finances are operating?

Property titles, which were held by the community, are now held by the government—for example, SA Ambulance Service. Deputy Speaker, give you a very real and very specific example. Booleroo Centre and District Ambulance Service was founded as a community-run ambulance service operating under the St John banner. It operated independently, and fundraising by the Booleroo Centre community provided the funds for the purchase of assets for the BCDAS, as normal ambulances could not cater for multiple patients or whole-day attendances.

In 1986, the community identified the need for a mobile field unit to provide a mobile room operating as a first-aid station for community events and natural disasters. The community raised enough money to purchase a Toyota truck and cab chassis, and it built a body to suit the requirement. The community did that work.

Inside the purpose-built body, additions included a high-low raising platform to lift patients into the area, cupboards, a permanent bed, a stretcher, a fridge, air conditioning and heating, and bench space was built or bought by the community to create a unique vehicle satisfying the community's needs. Many people worked tirelessly to make this happen, with many hours and dollars put in by the community to achieve this unique engineering feat. Since the vehicle was finished virtually every annual or one-off event held within the community serviced by the BCDAS was successfully attended by this unit.

During 2005-06 BCDAS was seconded to the South Australian Ambulance Service from St John but continued to be owned and operated by BCDAS. On 1 July 2009 the Boolaroo Centre and District Ambulance Service ceased to exist and was amalgamated with the SAAS. All assets came under SAAS ownership. This included land, vehicles, equipment and associated assets of the services. The field unit was sent to Adelaide to be rebadged in SAAS colours and returned to Boolaroo where it continues to operate successfully.

In February 2014 the vehicle was asked to attend the Peterborough Rodeo, but three days prior to the event the SAAS regional team leader declined the use of the mobile field unit and, for some reason, this perfectly functional and useful unit was required to be reassessed. No formal notification was given to the Booleroo Centre team and it was only when a team member inquired about the result of the inspection of the unit on 17 June that they were informed that the unit was to be decommissioned.

Without any further consultation with ambulance members or the community who built the vehicle, it was taken to Adelaide on 26 June and stripped, and it is now awaiting auction on 16 October. I could give you hundreds of examples, but that is a shining real-world example of what the government is trying to do to country health and it needs to be investigated.


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