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Wednesday, 13 November 2002
Page: 6306


Senator MARK BISHOP (10:27 PM) —I rise to speak on the adjournment debate tonight to address an issue that has been raised with me in recent times by Western Australian veterans relating to their access to health care. The nub of the issue is that Hollywood hospital is one of only three tier 1 private hospitals in Western Australia and the only one within the metropolitan area. Some veterans believe that this severely limits their access to quality health care. For the information of the Senate, a tier 1 hospital is one that a veteran can be admitted to without the prior approval of the Department of Veterans' Affairs. Prior approval is required for all non-tier 1 hospitals. This hospital treatment is provided under the auspices of the Repatriation Private Patient Scheme, which provides for the hospital care of eligible veterans, war widows and widowers. The scheme seeks to use tier 1 hospitals, which includes public hospitals, former repatriation hospitals and private hospitals selected through a competitive tendering process.

The tier 1 hospitals are called `veteran partnering' hospitals, of which there is only one in metropolitan Perth; namely, Hollywood. Since June this year, two private hospitals outside the metropolitan area in Geraldton and Bunbury have acquired tier 1 status. The situation in Western Australia contrasts with other states where there is much greater accessibility to tier 1 private hospital services. By contrast, veterans in New South Wales and the ACT have access to 49 tier 1 private hospitals. These figures struck me as unusual the first time I saw them given the geographic size of Western Australia and comparable, if not greater, veteran populations than other state capitals.

Hollywood Private Hospital is an acute-care private teaching hospital. Its history dates back to World War II. The Commonwealth government built Hollywood hospital during the Second World War in response to and in anticipation of casualties returning to Australia, so it was built to care for service men and women. The hospital was opened in 1942 as the Australian General Hospital. It was also known as 110 Military Hospital. The Repatriation Commission was given control of the hospital in 1947 and the hospital changed its name to the Repatriation General Hospital Hollywood.

In the early 1990s, the Commonwealth Labor government either transferred the repatriation hospitals to the states or, in the case of Hollywood and Greenslopes in Brisbane, sold them to the private sector. Ramsay Health Care purchased Hollywood hospital and became the owner-operator on 24 February 1994. Since then Ramsay Health Care has spent $50 million upgrading the facilities at Hollywood. The privatisation of Hollywood hospital has been a resounding success. The professionalism and quality of care by Ramsay Health Care is well recognised within the veteran community and there is considerable support for the hospital from within the veteran community and from doctors.

The issue has arisen whether Hollywood hospital should be the only provider of private hospital services to Western Australian gold card holders. While there is no dispute that Ramsay provide the veteran community with quality private health care, there are some members of the veteran community who seek access to other private hospitals within the metropolitan area. Those seeking access to alternative tier 1 hospitals point to their right to choose where they are treated, given that veterans in other states have a choice of private hospital and the changing demographics and urban sprawl of Perth resulting in increasing inconvenience of travelling the distance to Hollywood for veterans and their families. Certainly those complaints are legitimate. It is true that veterans in other states have access to their choice of private hospital and that the veteran population in Perth extends north of Joondalup and south to Rockingham where travelling times to Hollywood can be significant and inconvenient.

There are many within the veteran community who are happy to attend Hollywood and are concerned that the ability of the hospital to service them—and certainly this is one of Ramsay's concerns—might result in reduced accessibility and range of existing services to gold card holders. Ramsay has a contract with the Repatriation Commission until 2006. Ramsay holds the opinion that the contract gives them exclusive tier 1 status within the metropolitan area in recognition of their commitment to the expense as the result of caring for veterans. Yet the Repatriation Commission stated during Senate estimates in February this year that it has a different view of the contract. It does not believe that the contract gives Ramsay metropolitan exclusivity.

So at the heart of all this are the best interests of veterans. Some veterans believe that staying with Hollywood and maintaining the high level of existing services is in their best interests. Others, understandably, would like to be able to choose which private hospital they attend. The two options may very well, if Ramsay is correct, be mutually exclusive. Permitting tier 1 access to other metropolitan hospitals may well result in a decline in the range and quality of services that Hollywood can continue to provide to veterans. This supposition, however, needs to be tested. According to the Department of Veterans' Affairs, this has been the experience elsewhere, hence their decision not to intervene in Perth especially in light of what they believe is a high level of satisfaction with Hollywood. The Repatriation Commission's view on veteran partnering generally is that it should not be implemented at the expense of existing good relationships and services such as in Perth. If opening Hollywood to competition in the metropolitan area means that the hospital is not going to continue to be as accessible to veterans as it is presently, then there may be more veterans who will be disadvantaged by any change than the number who are concerned with the present arrangements. The RSL is undertaking a survey of its 10,000 financial members regarding the suitability of existing hospital arrangements for its members. I will be interested to see the outcome of that survey.

Most of the dissatisfaction with the existing arrangements seems to be coming from younger veterans who want to choose where they are treated. The TPI Federation and the SAS Association have both been very vocal in the calls for change. I have attended meetings convened by both the RSL and the TPI Federation and I am aware of the various opinions on this issue. At the former meeting there was considerable satisfaction with the present arrangements and at the latter meeting there were calls for the department to review those existing arrangements. I do consider this a matter which warrants the investigation of the Department of Veterans' Affairs. I support the call of a number of ex-service organisations for a review of the Western Australian arrangements. I would be very interested to see the outcome of such a review.