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Monday, 28 February 2011
Page: 1781

Mr RAMSEY (7:20 PM) —I rise to support my colleague the member for Barker and add my voice to the call for the federal government to provide direct funding to the Ardrossan and Moonta hospitals in my electorate and the Keith hospital in the electorate of Barker. I must draw some attention to the comments from the member for Hindmarsh. I think this may in fact have been one of the most difficult speeches he has ever given in this place. I believe that in his heart he knows he is on the wrong side of this argument with his obligation to defend his state colleagues. Despite the public and community outrage, repeated attempts by the Liberal Party in South Australia and the approaches to the federal government by the members for Barker, Boothby and me, the South Australian government and now the new Treasurer insist on enforcing last year’s decision to withdraw funding for the three community owned, not-for-profit hospitals—a relatively small amount of around $1 million that supported the various public services which form a modest part of their individual budgets but which threatens to be the straw that breaks the camel’s back.

I have previously raised the plight of these hospitals during the debate on the National Health and Hospitals Network Bill late last year, and consequently wrote to the federal and state ministers. However, I was very disappointed that my inquiry to the Minister for Health and Ageing, Ms Roxon, was handballed to the parliamentary secretary, who suggested I write to the state minister—and who, ever so helpfully, included his address. I had in any case already contacted the state minister and my appeals have fallen on deaf ears. I pointed out to Minister Roxon that under the current or even the future funding commitments to the state health system, the abandonment of support has financial penalties for the Commonwealth and that she should involve herself in the process. I will explain further in a minute.

This motion is intended to provide a mechanism for the Commonwealth to take an interest in state government decisions, which will result in higher costs for the Commonwealth and lead to fewer health services for the affected people in these regional communities. To explain the issues at hand, I turn firstly to the Ardrossan Community Hospital. The hospital has been receiving $140,000 a year from the state government which recognises that the hospital’s accident and emergency department provides a significant service to those who would otherwise access the public system at full cost. In any event, this $140,000 has been meeting approximately 50 per cent of the cost of the accident and emergency department. Fifty per cent of the admissions to the Ardrossan Community Hospital come through the doors of accident and emergency. Consequently, the department is essential to the hospital’s survival. Quite simply, any ambulance service has to deliver patients to an accident and emergency section, and the loss of the service at Ardrossan is simply not an option.

Ardrossan is the biggest town in the Yorke Peninsula council area. It has a population of around 1,200 but services a total population of about 3,000. It is worth noting that there is considerable growth in the region and a prospecting company, Rex Minerals, expects to establish a significant copper mine in the area in the near future which is likely to employ hundreds. The hospital was established in 1914 and, as well as the accident and emergency department, has 22 acute-care beds and also runs an unattached 25-bed aged-care facility, which accesses hospital based services such as kitchen, maintenance and administration.

The shortcomings of the current arrangements in the funding for the aged-care sector have been well chronicled in the House by me and many others. Suffice it to say that a stand-alone facility of 25 beds would simply be unviable. It is inevitable that, if the hospital were to fail, so would the aged-care facility. Where this displaced activity might be moved and the implications for the consumers, the community and the federal government are an important point that I will return to a little later.

However, I take the opportunity to express the community’s anger and disgust at the state government which has been expressed at a very emotional town hall meeting, participation in a march on Parliament House in Adelaide and an ongoing campaign to raise the issue at every level. The community is bewildered at how a government which professes to care for communities could take what is such a small amount of money in the context of the state budget away from such a valuable and essential community service yet fail to understand the potential impact of the cut. The South Australian Minister for Health, John Hill, seems completely oblivious to the concerns.

In a similar situation, the community-owned-and-run, not-for-profit Moonta Hospital has had funding of $288,000 per annum cut from its operating budget by the state government. It is worth noting that Moonta, with a population of about 3,500, is one of three main towns in the District Council of the Copper Coast, which is the fastest growing council area in South Australia outside Adelaide. The $288,000 has been paying for public access to eight public beds—it is, in fact, a fee for the service of providing public beds. But there is an important point here: simple arithmetic tells us those beds are funded at less than $100 a night—one hundred bucks a night! We could solve the crisis in the Australian health system overnight if we could fund our occupied bed days at $100 a night Australia-wide. What a bargain! Why would the government walk away from such a good deal for the taxpayer? How can $100 per night per bed be so important to any hospital?

The Moonta Health and Aged Care Service—community owned and not-for-profit—operates 14 acute care beds, an accident and emergency section and a 64-bed aged-care facility. The $288,000 that the state government has been providing does little more than support a critical mass to allow the combined facility to operate efficiently. If the hospital is unable to keep occupancy rates up in the small acute care section of the facility, obviously its future viability is threatened. The $100 per day the government provides for access for public patients would struggle to meet the costs involved in supplying the service, but it does provide enough bums on beds to allow the hospital to operate efficiently. Unless the funding is reinstated, the long-term survival of the hospital services will depend on the facility attracting enough self-funded patients to fill the same beds.

It is likely that, if the hospital services were to fail in the medium term, the Moonta aged-care section, as the bigger part of the facility, would continue to operate. However, the loss of service to the local community and the resident doctors would be immediate and drastic. The Moonta community has been outraged in a similar way to the citizenry of Ardrossan. They packed a similar town meeting and attended the Adelaide demonstration.

Apart from the obvious and distressing impact on these communities, what is the federal government’s interest in the decisions, good or bad, of a state government? I took the opportunity last year to point out to the minister in correspondence that the failure of any of these units will lead to extra demand on the nearest fully publicly funded facility. Not only will the taxpayer pick up the full cost of the enforced transfer but they will also meet further costs because these facilities in turn will need capital investment.

It is a little difficult to know on any given day what the government’s commitment is to the state hospital system—whether it is 40 per cent, 100 per cent, 60 per cent less GST, 50 per cent or 50 per cent of new spending—but it is a given that the Commonwealth has a liability. If, for instance, the hospital facility at Moonta were to close, the patient load would inevitably end up in Wallaroo, which is about 20 kilometres to the north. The workload at Moonta is approximately 1,400 private-bed and 1,800 public-bed days per year, an average of nine per day. There are concerns that the public hospital at Wallaroo is already under pressure to meet demand. It operates a 21-bed public facility with an attached seven-bed private hospital—28 beds in all—and is often operating at full capacity. In fact, often patients are transferred to the Maitland hospital an hour to the south. Should the Moonta workload be transferred to Wallaroo, the dramatic increase in numbers would almost certainly result in the need for a multimillion-dollar expansion which, according to the Prime Minister’s last decree on health, the Commonwealth will take 50 per cent responsibility for. So it is highly likely that the efforts of the state government to save a few hundred thousand dollars could result in a multimillion-dollar bill for the Commonwealth.

Similarly, a loss of viability in the Ardrossan hospital would not only lead to the transfer of patient load to the hospital in Maitland, requiring substantial upgrades, but would also require the construction of new aged-care beds, also probably in Maitland. While this might look like a desirable outcome for that particular town, it certainly is not good use of public money. I have not spoken about the Keith hospital, which is not in my electorate and has been similarly affected, but I shall go no further than to fully endorse the comments of the member for Barker on the matter.

The impact of these short-sighted decisions by the state government on these communities can barely be overstated. The possible dislocation of the aged and frail, the loss of amenity and the enormous impact and the economy threatens to implode on the community. It is often said in regional Australia that, if you lose your school and your hospital, you have lost the battle. But underlying that is a clear financial interest for the taxpayer in the federal government taking control of this very small portion of health funding and feeding it directly to the local facility, because that is true local control.

I have spoken in this place before about the damage I believe the South Australian government has inflicted upon local and community involvement. This bill offers an opportunity for the federal government to send the message that enough is enough. (Time expired)