Health Care Adjournment

I rise to report to the Senate some concerns about the provision of health care in country South Australia. I had the privilege last week of spending two days in regional South Australia with Senator Fiona Nash, the Assistant Minister for Health, who also has responsibility for, among other things, rural health, Indigenous health and palliative care and also has a role on the Ice Taskforce. We canvassed many of those issue with people in regional areas spanning from the south-east to the Riverland to the lower north. The prime purpose of our visit was to talk about training for junior doctors, particularly the provision of intern places in South Australia. We currently have five. We used to have six; it has now gone down to five. According to a rural workforce agency report of a couple of years ago, we need a minimum of about 20. So we are looking to see how we can constructively work with the university sector, with the state government if they will come on board, and with GPs in rural communities to bring about such a program.

The topic I would like to talk on tonight is palliative care services. One of the concerns raised with us in Mount Gambier is the fact that, as of 1 July, palliative nursing staff numbers will be halved, bereavement services for Mount Gambier and Naracoorte will go and a head of palliative care position will also be cut. This comes at a time when in the media we are seeing reports that in Adelaide the state government is choosing to spend some $7 million to relocate palliative care services from Daw House at the repat hospital to the Flinders Medical Centre and will be building a 15-bed facility there. The closure of the repat hospital is a separate issue and I will perhaps discuss that on a separate occasion. Whilst I am thrilled for people in the metropolitan area of Adelaide that there will be a brand-new facility with 15 beds at the Flinders Medical Centre, I do question the relative priorities of the state Labor government that they are spending $7 million to relocate an existing facility—albeit an aged one—but at the same time are completely cutting services in one of South Australia’s largest regional towns and the hinterland around that.

A couple of reports have come out just recently in which people in the community who have highlighted the impact that these positive palliative care services have had. In a story that came out on the ABC in June this year, Mr Chris Couch talks about the support that he and his brother Andrew received from the palliative care team at the Mount Gambier hospital for their father. It highlighted the real difference that that made to their ability to care for their father in the community compared to the options that they might have faced if that support had not been there. So it is clearly an issue that the community is concerned about. I would like to raise tonight and highlight that this is an issue that the state government has in its remit to fix if it so chooses.

The response to the media in Mount Gambier and the south-east from Country Health SA is to blame the end of the Commonwealth national partnership program. I have gone back to look at that program to understand exactly what was provided, and I will give you a little bit of context. This was a program that was set up as a top up, if you like, to try to overcome some of the inefficiencies in hospital services. It was set up under the former Labor government, and I give them credit for spending that money. In looking at the program, under schedule E to the partnership agreement, South Australia received some $119.7 million between 2010-11 and 2013-14 for additional subacute beds, and the palliative care area falls under that as well as rehabilitation services. What it also highlights is that, if you go to page 8 and table 1, which is part 5 of the financial arrangements, the investment in the subacute beds finished in the financial year 2013-14 even though the overall agreement stretched out to 2016-17.

Mr Rann, who was then the Premier, signed up to this agreement. So the South Australian health department knew when they signed the agreement that this top-up funding was going to finish at the end of June 2014, or that that would be the last time it would be funded. Under that agreement for the following years there was no funding. So for them, now, to turn around and say that they are pulling these services in country areas in South Australia because this agreement has ended in just inaccurate. If you look at the agreement, that funding stopped anyway under what they signed.

It is also worth pointing out that under the coalition government we have continued to fund and increased funding to South Australian hospitals. In fact under the National Health Reform Agreement, under the activity based funding arrangements, the Commonwealth will pay 45 per cent of efficient growth in public health costs out to 2017-18. This is just part of the health funding. Overall, as I have talked about in this place many times before, funding to the hospital sector in South Australia increases year on year on year, but this particular part in 2014 was $1.124 billion and by 2018 that had gone up to $1.3 billion. So there is a 16 per cent increase across the forward estimates in the area that the South Australian government is making choices as to where it spends its money. If you couple that with the fact that there is some $1.8 billion of additional revenue that the South Australian government is receiving through GST that was not forecast at the time when we came to government, it says that they have no shortage of funds to spend to support the health services of people living in regional South Australia. This comes down, purely, to an issue of the priorities of the Weatherill government and Minister Snelling as to where they think it is worth spending money to provide health services for South Australian residents. Clearly people living in regional communities are not seen as a priority.

Unfortunately for South Australians most country areas are represented by Liberal Party members, so it is very difficult for them to get political leverage to convince the state Labor government to spend this money in regional areas. I would encourage anyone in South Australia listening to this debate, who has family in the city or, indeed, who lives in the city, to take this up as an issue of equity. Governments govern for all regardless of who you vote for, regardless of whether you live in the city or country. Good government is here to govern for all and to make sure that there is an equitable distribution of available funds to provide services that are essential for people.

In this area, where the Commonwealth still provides funding and increases funding,—as I said a 16.3 per cent increase over the forward estimates for the additional GST funding—this is a decision that the South Australian government can and should be making to support people living in regional South Australia. Bear in mind at the moment that much of South Australia’s economy is dependent on the agriculture sector, yet those communities who provide this income for the state also need the health services that gives them the confidence, gives young families the confidence, to establish a career in a regional area. Whether they be people working in the ag sector, the health sector or in many other parts of the community, they go there to have a functional and sustainable community.

In terms of palliative care the Australian government is funding some $52 million over three years to develop and deliver national palliative care projects that palliative care groups have identified as critical to improving the quality and service delivery of palliative care. In South Australia Flinders University has three such projects running. This is an important topic for people in South Australia. For those people in the city, I urge you to take this up as a matter of equity. For those people in the country, particularly in the south-east at the moment who are affected, I encourage you to not give up your fight but continue to advocate and call for equity in funding from the state Labor government.