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Tuesday, 26 May 2009
Page: 4373

Mr OAKESHOTT (5:06 PM) —I wholeheartedly support the Health Workforce Australia Bill 2009 and say the very simple word: hallelujah! If this is the moment in time when we see the Australian government, regardless of its political persuasion, step up to the plate and start to take some authority with regard to health planning generally within this country, it is a moment that is long overdue and will be welcomed by many into the future.

I am sure all of my fellow local members—there are 150 of us in this place—see what I see on a daily basis when working in the electorate and working on the issues around health services on the ground: a disconnected and fractured arrangement between state and federal government in the delivery of health services and a constant passing of the buck—for want of a better phrase—between the two tiers of government in what should be the provision of health services for the greater good. If this is the moment that creates the entity that allows the various Council of Australian Government ministers to come together and start, in a very practical sense, to deliver outcomes in the public interest rather than in the state’s best interest or the Commonwealth government’s best interest, then this is a good initiative, a welcome initiative and one I strongly support.

It is potentially the start of the conversation with community on some of the language we have heard from government over the last 12 months and in some of the reviews, including the Garling review, that we have seen in the last 12 months with regard to the hopefully increased role that the Commonwealth could and should take in health services in this country. If this is that moment, I place great significance on it. Perhaps in the future we will see the High Court case of 2006, called the WorkChoices case—ironically used to test the corporations powers with regard to the entity that was being created by the Commonwealth—pushing the issue with the states, who ultimately have authority in the decision-making process in workforce planning and health services generally. I do not think that is a moment that any of us in public planning should shy away from; rather, all of us in public planning should be fully supportive of a minister and a government if that is part of the agenda that we are seeing with this bill.

The mid-North Coast of New South Wales is covered by an entity called the North Coast Area Health Service, whose operating budget this year has a deficit of between $30 million and $40 million. In response to this situation, it is looking to lay off up to 400 staff across the region—from Johns River in the south to the Queensland border in the north. That is a significant change in the way health services will be delivered within our region. The financial pressure on the area health service is due to the resource distribution formula. The resources are supposedly allocated on fairness and equity principles, but in reality the allocation is both unfair and inequitable.

The allocation of funds to the North Coast Area Health Service under the RDF is, I am sure, a concern shared by my colleague the member for Page. Because the mid-North Coast is a high-growth area, the state government has traditionally underfunded the North Coast Area Health Service by between two and four per cent of the resource distribution formula. That might not sound like much, but in real dollar terms it means that between $20 million and $40 million per annum is going not to our region but to other areas of New South Wales on an inequitable and unfair basis.

If the North Coast Area Health Service were receiving equitable funding from the state under the resource distribution formula, we would not be facing the workforce issues that we are currently facing in the Hastings-Macleay region. The CEO of the area health service is talking about laying off 40 staff in a number of different roles across the entire area health service. As I said previously, up to 400 staff are potentially going to be laid off as part of this budget deficit.

If the state were providing equitable funding under the RDF, we would not be in this situation and the budget would be balanced. The area health service has been left in the extremely difficult position of having to lay off a large number of its workforce. Communities will suffer the inevitable service delivery issues within the health sector as a consequence of the state government’s unwillingness to make the hard decisions in other areas of New South Wales to establish equity and fairness in their own resource distribution formula.

That is why this bill, if it allows the Commonwealth to start to mobilise in regard to workforce planning, is not just a piece of paper that we are never going to see anything more of again. It is vitally important work being done by the Commonwealth, and hopefully it will be a trigger for very real action in the future and for the Commonwealth to have significant involvement in this problem.

The New South Wales government is dysfunctional, disconnected and doing a disservice to communities on the North Coast. It is not willing to make the difficult decisions that it should make, particularly about the traditional sandstone hospitals in the Sydney CBD. They are difficult decisions but that is exactly the role that governments need to and should play. We have a half-a-dozen sandstone hospitals smack in the centre of the CBD that are essentially money for the region. Whenever these issues arise, the regions should have a stake in these conversations. Unless they do, we will continue to see inequitable and unfair delivery of government budgeting, which is what we are currently seeing.

The government has been quite open about it. On the North Coast—and it would be a similar story in other areas with high growth rates—we are at least $20 million, and up to $40 million, per annum behind on our fair slice of the pie based on the government’s own funding formula. The area health service is incredibly frustrated, as are all the communities on the North Coast. If we only got fairness—and I stand here and ask only for fairness—it would significantly alter the workforce issues and health service delivery issues in one of the fastest-growing regions in Australia.

This is important legislation. I hope that the government’s intent in creating this entity, and the authority attached to it, is honourable, whether it be pursued through the informal processes of the COAG negotiations and the conversations between ministers and the various stakeholders or, as I previously said, used in the more legal and formal context we have seen through pushing issues such as Corporations Law and issues of a constitutional nature. Whatever it takes, health service delivery and health workforce issues can be done better in this country. I think there would be general agreement on that.

I am pleased that the government has recognised that. I am pleased that we are seeing this bill go through. My request now to the government, to the executive and to the minister in particular, is to make it work practically and to use this legislation and the powers of Health Workforce Australia to create a better health system for all of us in Australia.