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Tuesday, 16 August 2011
Page: 8224

Mr RAMSEY (Grey) (20:20): I rise to speak on the National Health Reform Amendment (National Health Performance Authority) Bill 2011. Just before I begin, I am just drawn to comment on the remarks by the member for Fraser, who suggested that the opposition had become a fringe opposition. I suggest he might prevail upon his Prime Minister to call an early election and we might test that opinion in the public arena and see whether in fact the majority of Australians agree with his assessment.

This bill is a demonstration that rhetoric is cheap; action is difficult. Once again we are witnessing the results of 'thought bubble' government. This government has continued to over-promise and under-deliver and this latest agreement on national hospitals is so far away from Kevin Rudd's original plans that it is barely recognisable. We on this side of the House go on almost ad nauseam on the government's failures, but it pays to reiterate them. I am sorry, but you are going to have to wear it again. Policy areas where we have seen backflips and changes of direction include Fuelwatch, GroceryWatch, pink batts, green loans, the NBN, the mining tax, asylum seeker policy—what a debacle that is—the Murray-Darling Basin reform, the live cattle disaster, the ETS and of course now the carbon tax. Paradoxically, the government is failing to deliver on the thought bubble of no carbon tax and they are actually delivering something which they said we would never have. Mr Deputy Speaker, I said this would make you a bit nauseous, a bit sick. It makes me a bit sick and that is without even mentioning the subjects of debt and surplus.

Government members have been on the doors of this place in the last few days telling us that this year, 2011, is the year of delivery for the Gillard government. They are claiming this bill, which is really a humiliating capitulation on health reform, as one of the delivered goods. They are also claiming the national disability insurance scheme as a delivered good. It is a good idea, but it is a long way from being delivered. They say the forestry agreement is a delivered good, when in fact it is wallowing in the Tasmanian parliament again. They say the Malaysian people deal is a delivered good. They say Manus Island is a delivered good. It is far from delivered. In fact, I have even heard the fast train said as being almost a delivered good, and that probably has a 20- to 30-year time frame.

Dr Mike Kelly: Mr Deputy Speaker, I rise on a point of order. I believe we are discussing the National Health Performance Authority. I have not heard a word about this bill so far. I ask the member to be relevant to the discussion.

Mrs Bronwyn Bishop: Mr Deputy Speaker, I rise on the point of order. I thought I had been exceedingly generous previously. If the minister across the chamber wishes to take this point, I will enforce it very stringently on theirs.

The DEPUTY SPEAKER ( Mr KJ Thomson ): I note the point of order. I invite the member for Grey to debate the bill and to relate his remarks to the bill before the House.

Mr RAMSEY: I am very pleased to do so because this bill is just latest in a raft of policies that are watered-down goods. This is a bill to establish yet another layer of bureaucracy, another statutory body, and it is another attempt to improve inadequate legislation. Why is this a watered-down bill? How did we get to this point? We have to consider the record. The previous Prime Minister, Kevin Rudd, gave the states 12 months to rebuild the health system or he would enforce a full takeover. He promised to end the blame game. The outcome of that commitment from Kevin Rudd was the 60 per cent funding formula, which was to take 30 per cent of the states' GST. Sixty per cent of funding was to come from the Commonwealth, and 40 per cent from the states and the Commonwealth was to meet the majority of all new costs. It was to implement activity based funding. The federal government was to take responsibility for standards and throughput. With that federal funding came the commitment—and this is very important—of local management. We were offered federal funding and local management.

When the deal fell through, when that thought bubble went away, there was the 50-50 deal, which finally came out as the meek and mild 45 per cent of increased costs from 2014-15. Interestingly enough there is to be nothing until after the next election. This funding commitment is to rise to 50 per cent in 2017-18—50 per cent of increased spending, not overall spending, and that will be after yet another election, two elections away. This is the year of delivery, and we are talking about 2018!

The government has indicated an extra $175 billion over 20 years. Twenty years is a long time for people to be able to foresee the future. It is 16 years outside the forward estimates. Chernobyl was 20 years ago. I am informed the internet was born 20 years ago today. Who 20 years ago would have predicted what influence the internet has on our lives today? To predict that there will be an extra $175 million over the next 20 years is very brave indeed. Perhaps we will put it in a time capsule. Significantly, this deal has given up the promise of Commonwealth control. The Commonwealth are instead to become a monitoring agency. The government has rolled over to the states on just about every issue. We were promised federal funding and local control, and we have to ask: what has happened?

The federal government has totally capitulated to the South Australian government because in fact there is to be no change to the current modus operandi. The state is to keep managing public hospitals and the local management is to be achieved through one body. There is one body for the whole of South Australia, and that body is to be Country Health SA. The regions of South Australia cover around one million square kilometres and we are to have one body, which answers to itself and ultimately to the government, to run the whole hospital health system. The government has implemented hospital and community committees, which have no power. They are muzzled. They are unincorporated advisory committees. That is the South Australian government tipping its hat to local control. My electorate alone has more than 30 hospitals, including two community hospitals. I will say a little more about them later.

It gets worse because we are dealing with the whole of South Australia, not just my electorate. There will be one local board to cover all the hospitals. From Mt Gambier to Ceduna is over 1,000 kilometres by road. From Yorketown to Coober Pedy is 900 kilometres by road and to the Marla clinic—if Country Health takes responsibility for the Marla clinic, as it should do—it is 1,300 kilometres. People who are required to have knowledge about Mt Gambier also need to have a working knowledge about Marla or Coober Pedy. Where will this powerful body reside? Adelaide. This new agreement just does not stack up as local control. The news from SA Health is that they do not expect to make any changes. In their opinion the current management models meet the criteria. For the record this means: no local boards, regional bureaucrats, HACC committees with no teeth and effective control in Adelaide. So this country health board, the author of the now disgraced and discredited country health plan in South Australia, which was a plan to shut down and downgrade country hospitals, is to be given full control by the Commonwealth government of hospitals in South Australia, just as they have done in the past.

I thought back on where we had been in this debate when I was planning what I would say in the House tonight on this bill. I looked at a newsletter I published in May last year for interest. It said:

There is no detail on the commitment to local control, but it won't mean local boards. There are vague references to Local Hospital Networks established by appointment. The news from Health SA is they don't expect to make any changes, in their opinion the current model meets the criteria! For the record this means, no local boards, regional bureaucrats, HACC committees with no teeth and effective control in Adelaide. No change!

The government has promulgated a view that state governments are broke and the Federal Government has a bottomless bucket of money. The fact is, while both have the ability to raise taxes to pay for services, whichever level of government raises the tax, it is the same Australians who will pay the bill.

That is what I said in May last year, I think with a better degree of a view of the future than perhaps the prediction of what we will see with the next 20 years of hospital funding. So there is no change—no change in the line of responsibility, no change to local management. Watered down is hardly the word for this health agreement the government lists as one of its delivered objectives.

I spent 10 years on local hospital boards servicing country South Australia. I can only speak for South Australia, but I have been appalled by the decline in local services, particularly over the last 10 years as the city-centric government in South Australia, the Rann state Labor government, has grasped control of hospital management. There are communities where surgery and birthing services have been withdrawn, requiring people to travel hundreds of kilometres for services their parents took for granted. This withdrawal of services leads to deskilling of local staff, dismantling and removing equipment, general rundown of hospital facilities and deferred maintenance until eventually this remote body, Country Health SA, declares the hospital is only fit as a first aid post and the locals will be better off without the service.

It is worth pointing out that the current South Australian state Labor government with the latest agreement has been endorsed as the operator of hospitals in South Australia. It is a great sadness that this government, which promised local control, has allowed that opportunity to slip. It has said: just keep doing what you are doing. I said I would mention the community hospitals affected in South Australia by the state government withdrawing funds. In fact we have passed motions in this House and in the Senate, both condemning the South Australian government and asking them to restore the funding to these three hospitals. These three hospitals are community hospitals and are serving the need just as public hospitals do in the system, but there has been no motion from the South Australian government to fix the problem and, I regret to say, it seems there has been little activity from the federal minister to actually carry out the wishes of this House and the Senate to get on the phone to John Hill and say, 'Put the money back.' In fact, the federal government, as you well know, Mr Deputy Speaker Thomson, has immense power over state governments because they provide the bulk of their funding.

Country people cannot understand how they continually pay more and more for health services but are losing their basic services. Why do they no longer have birthing services? Why can't they have elective surgery in their community? Why can't they in some cases get a broken arm set locally and instead have to drag children hundreds of kilometres? I am well aware of cases in this area enduring long hours of pain and delay waiting for something to be done that used to be delivered in their local hospital.

Remember when the midwives came to Canberra last year? They were campaigning for insurance and the right for people to have their babies in the home. That is well and good and I support them. But let me say, and I said it at the time, that women in my electorate were not coming to me and saying, 'Please, can I have a baby at home?' They were coming to me and saying, 'Please, can I have a baby in the hospital?' They were allowed to have a baby at home with a midwife but they were not allowed to have the baby in a hospital with a doctor. Instead, they have to travel. If you live in Roxby Downs, you have to travel 600 kilometres to Adelaide or 200 kilometres down the road to Port Augusta. If you live out where I do in Kimba, you are expected to go 160 kilometres to Whyalla to have a baby. I was born in the Kimba hospital and so was my—

Mr Vasta: Not that long ago.

Mr RAMSEY: Not very long ago, I must say. To think that we are actually going backwards in provision of services is of great concern to communities. To think that we are re-empowering the state government and Country Health SA to keep riding roughshod over these communities is a great loss of opportunity and an undelivered promise from this government. (Time expired)