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Tuesday, 16 August 2011
Page: 8227


Dr MIKE KELLY (Eden-MonaroParliamentary Secretary for Agriculture, Fisheries and Forestry) (20:35): What an exciting time it is to be a member representing a rural and regional seat in this parliament and as part of this government. What a pleasure it is to be standing alongside the Minister for Regional Australia, Regional Development and Local Government, who is doing such a magnificent job in carrying forward regional and rural development. The most exciting part of that agenda is our health reform agenda. There is absolutely no question that for people in rural and regional areas the No.1 issue was the neglect of their health services through those many Rip Van Winkle years of the Howard government, particularly the damage done by the Leader of the Opposition in allowing the Commonwealth's contribution to health services to drop to 40 per cent, effectively ripping a billion dollars out of the system.

This was setting state budgets in health on an unsustainable path. There was no question about it. We knew in New South Wales, for example, that by around 2045 the health budget would consume the entire New South Wales state budget. That was simply unsustainable. In addition to that we have to find more efficiencies and more savings in the system to also meet the future budgetary demands of the changing demographics and other issues that we face in this community. Also very encouraging from my point of view is the emphasis that the government is placing on preventative health to help ease the burden—an area totally neglected by the previous government. In my own region this is a critical issue. Last year I conducted a survey of the electorate and I had over 7,000 responses. It was a magnificent response from the community, engaging with me genuinely in a conversation about the needs of the community. The No. 1 issue among those 7,000 responses to that survey was health—no question about it.

The previous speaker talked about delivery, and delivery has certainly been happening apace in health in my region. This reform, the National Health Performance Authority, is part of that magnificent package that now forms the National Health Reform Agreement. It is part of those oversight and efficiency mechanisms—the three columns, as we might refer to them—which also include the clinical standards monitoring authority. Certainly we have had some issues in our region in relation to clinical standards, including the famous, or infamous, Dr Reeves incident, and we certainly know how important it is to monitor those clinical standards. We in rural and regional areas just are not prepared to put up with second best, as we are not prepared to put up with second best in relation to the National Broadband Network, which will also underpin the efficient delivery of health services in our regions. Another column is the pricing authority, which will establish the efficient cost of the delivery of these activities in our health performance agreements, our health performance monitoring authority and the performance that is delivered in the various levels of health services in the region.

The National Health Performance Authority mechanism will include functions of monitoring and reporting on the performance of local hospital networks, public and private hospitals, primary healthcare organisations and other bodies that provide healthcare service, and it will publish reports. It will also perform the functions of formulating performance indicators, collecting, analysing and interpreting performance information, and promoting, supporting, encouraging, conducting and evaluating research. You cannot run a system without information. We must be constantly keeping on top of what is a changing dynamic in the health area, with the improvements in technology, issues with costs as they evolve and also the demographics in particular communities.

That is important for a region like mine, where there were certainly great concerns about the Greater Southern Area Health Service. There were many decent and hardworking men and women who served faithfully in the Greater Southern Area Health Service, but I think it is fair to say that there was a great deal of dissatisfaction with the way that that service worked. Mainly those people were victims of the structure of that organisation. Now we have stepped forward to cure that with the establishment of local hospital networks. These networks do give the community a voice in their system to bring it back to a more local scale that will enable it to meet, reflect and respond to the regional needs, interests and issues that the community raises. Within those local hospital networks, you will have clinical representation and you will have consumer and community representation. That is already up and running and operating successfully in Eden-Monaro. This performance authority will be able to monitor the performance of the governing councils of those local hospital networks and to ensure that they are performing to the standard necessary. There will be transparency associated with this. The minister will have the ability to publish reports as they see fit, while of course ensuring confidential material is not revealed, and certainly there are privacy protections in this legislation.

Also we have preserved the relationship with the states through this system. The state and territory health ministers will be sent copies of any reports where there is an indication of poor performance of a local hospital network or public hospital and then they will have 30 days to provide comments on the report. Once the consultation period has expired, the ministers will be provided with a copy of the final draft report and be invited to provide any further comments within 15 days of receiving that report. So the engagement with the state authorities will be effectively enshrined in here. It is important to emphasise that the difference with the previous proposal is that the states have insisted on retaining responsibility for their local hospital systems. It will now be important for the state government in New South Wales to deliver on promises made in my own region in that respect. They have asked to retain that authority; therefore they have no-one but themselves to answer to in relation to the delivery of outcomes in my region, including the undertakings that have been made to the Pambula hospital, for example.

There are many other aspects to this health reform that make up this matrix. An exciting announcement was made today by the health minister, who I believe will go down in the history of this country as the most successful health minister we have ever seen, delivering groundbreaking reform for this nation to set us on the path for a decent health service. I congratulate her on her work and the work of the government in general in delivering this package. The announcement made today—around the IT infrastructure for electronic health delivery for the personally controlled electronic health records system—is a great milestone and step forward in delivering our e-health. This e-health objective is critical because we know that up to 80 per cent of the mistakes that are made in treating patients are made through faulty record management or difficulties with record management. We also know that a lot of costs in the system arise from double servicing or over-servicing of patients. Certainly an effective and efficient e-health system will help reduce or eliminate those inefficiencies and save money in the system in that respect as well. This is another great step forward for the system and I congratulate the minister on that announcement.

When we see the National Broadband Network rollout, we will see huge advances for regional health in terms of the delivery of telemedicine opportunities. We have already seen the Medicare schedule adjustment so that there can be combined consultations with specialists. Patients in rural and regional areas will be able to sit with their GP and consult with specialists who may be halfway around the world if necessary, without even leaving their local town. We have also seen the delivery of home based services through telemedicine for patients who may not even need to leave their home in certain circumstances. This will be a tremendous outcome for rural and regional areas: the National Broadband Network underpinning the delivery of this health system.

Certainly, we also know that there is a lot to catch up on in relation to our rural hospitals. We intend to maintain the block funding arrangements for those small rural and regional hospitals. It is very important that we do so; there is a lot to catch up on there. I know that the minister visited the Bega hospital with me and understood clearly what the situation was there, and understands the situation generally around the country.

The previous speaker talked about delivery. I am intensely proud of what we had already delivered even before the agreement was secured in my own region. As I indicated, we had urgent problems in relation to a deficiency of doctors and facilities. You will not attract decent health workforce personnel to poor facilities in isolated areas. You need to provide the support mechanisms, the incentives and the facilities. I am pleased to say that we are doing that. We have seen already the GP superclinic open and operational in Queanbeyan, doing that wonderful job of meshing our allied health services with our GP services and providing after-hours services which are so necessary.

We have seen the advancement of the GP superclinic for Jindabyne. That will be open by 2013. The process is in progress there, with consultations with council and the Southern General Practice Network. We have seen very crucial and timely investments in places like Bombala, with $260,000 to assist with a doctor's house and surgery facilities to enable us to attract a new doctor. The local doctor in Bombala, Dr Colin Pate, was just about ready to fall over with the workload that he had. He was close to packing up because he could just could not cope. That timely investment of money enabled us to attract the doctor. It is true that that doctor has now decided to move on, but because we have made that investment we will be able to attract a replacement for her.

We have also seen, of course, many investments in GP clinics all around the region to add medical training facilities for students, and this is attracting students into our region. They see the benefits and the beauty of the lifestyle in our wonderful region. We are, in fact, one of the happiest regions in the country. If you look at the wellbeing index you will see that it rates just about at the top of happy areas in this country. So once you demonstrate the lifestyle to medical students you have a better chance of hanging on to them. The facilities are there to provide good training and to give them the range of experience that you get in rural practices, which is helping to keep those personnel in our region.

There was $500,000 for the Bombala Street medical practice in Cooma. We have seen $500,000 going into the Queen Street practice in Moruya and we established a new practice in Tuross Heads for $212,000, new dental facilities in Dalmeny for $200,000, and a mobile dental service to help with our Indigenous community for $380,000. We have paid $100,000 to a number of clinics to establish after-hours services, such as at the Brindabella practice in Queanbeyan, at the Blue House Surgery in Narooma, and also in Bungendore. There have also been investments in Braidwood to establish dental services there.

I am of course really proud to say that, most importantly of all, there is the new regional hospital—the only C1 hospital in our region—at Bega, where funding of $160 million of federal money has been committed for a brand new hospital, adding to that $10 million of state money which will bring home the final piece of the puzzle for us. This will be a magnificent, state-of-the-art facility which will take advantage of all that new technology and will add magnificently to the capacity of health service delivery in our region. On its own and in its own location it will be able to do pharmacy, pathology and imaging services. There will be 136 beds in this facility, including for the first time an expanded possibility for mental health beds. It will have an expanded emergency department and will be able to take advantage of the available technology in telemedicine and the latest developments there.

This is a facility that has been welcomed with open arms within my community. They have been absolutely delighted by this investment. But I have to say that we know that it is all under threat. All of these things—all of this health reform—is under threat. There is the $70 billion hole that we know is coming our way if the coalition were to succeed at the next election. This threatens all of this—all of it would go, including the NBN that would underpin these health services for these rural and regional areas. You would need fibre cable to deliver it: it would go. The regional hospital in Bega would go. You would not be able to fund that hospital by taking $70 billion out of the budget, and we already know that the coalition says they would pull the pin on this health reform. It would all go; it would not be there. The funding would not be there.

My community knows that; they know what they voted for at the last election and they are seeing the delivery of it. That was the choice at the last election: there was no commitment to a regional hospital by my opponent at the 2010 election. All he offered was a paltry amount of about $1 million for the Bega hospital, which was even under costed for what he was promising.

This is the big risk: $70 billion will rip the guts out of our health system, will once again betray rural and regional Australia. It will take away all these reforms and deliveries that will finally see the sorts of services that the previous coalition government ripped off rural and regional areas or neglected to deliver to them. Now that people are seeing it they will not let it go. They have their hands on the prize, they understand what is at stake and they will not be treated as second-class citizens with the city getting the Bentley in the NBN and the country getting the Commodore. They are not going to put up with that either. The choice is very simple, and my community is ready to make that choice.