Ken Wyatt (Hasluck, Liberal Party) Share this | Hansard source

I rise to speak against the National Health and Hospitals Network Bill 2010 and to support the second reading amendment. I also want to congratulate you, Mr Deputy Speaker Sidebottom, on your appointment to your position as well. It is intriguing standing talking about this issue, given that recently I was a public servant heavily involved in the many facets of the national partnership agreements that were led by the Commonwealth and through the COAG processes that were to streamline both reporting, financial arrangements and the commitments to significant reforms across the continuum of health care provided to Australians. That included reforms around hospitals and the funding that would be required and the targets that were established in respect of elective surgery lists.

Some of those processes were negotiated through jurisdictions led by Commonwealth bureaucrats or, in many instances, by ministers supported through the Australian Health Ministers Advisory Council. They included the National Healthcare Agreement. It includes Indigenous health, aged care, workforce, preventative health and the findings of the National Preventative Health Taskforce and, ultimately, the National Health and Hospitals Reform Commission. All of those documents and the work that led to the finalisation of the agreement meant that there was considered thinking around the types of services where the gaps were existing within all jurisdictions and the ways in which health care was provided to all Australians.

I saw great opportunity through both of these significant mechanisms of AHMAC, the Australian Health Ministers Advisory Council, and the reform process that would mean that all Australians would enjoy a healthcare service that would meet their needs. Whilst I was campaigning there was a constant concern raised by Hasluck constituents about the evolving changes being proposed by the Gillard government and the translation of changes impacting on their families. Hasluck has two public hospitals—the Kalamunda District Community Hospital and the Swan District Hospital. The new Midland Health campus will replace the old Swan District Hospital, which has served the community for some considerable time and will be a critical hub of healthcare access for people within its area. It is long overdue. Its model will provide a range of services not available to my constituents in that area. At the southern end of Hasluck, the closest hospital is Armadale Kelmscottt Memorial Hospital in the seat of Canning. As with all Australians, constituents want better health care and access to primary healthcare services.

In this new model of the way health is to be addressed, the GP superclinics were announced. A GP superclinic is to be built at Midland, adjacent to the new Midland hospital at the cost of $10 million. It will provide a range of services and is co-funded by the state government and the Commonwealth government. There already exists within Midland, not far from the proposed site, a general practice that provides a good comprehensive service to the people of Midland. These local GPs are well supported by the local area because the service they provide is of a high standard. The GP superclinic in Midland was not awarded to the local GPs even though they had an established practice which provided a range of services. In another part of my electorate, people living in the suburb of Gosnells have limited access to local GPs who bulk bill, which means that they can wait for up to a week in order to access a GP that will see them. This matter was raised regularly by constituents who I met whilst campaigning and to me it would have been the better place for a GP superclinic because it would have been much more accessible.

The current bill does not satisfy the needs of my constituents. In Hasluck there is a lack of specialised services such as pathology and radiology and, more importantly, mental health services, given the circumstances that young people find themselves placed in and the pressures that are brought to bear on families. I am in agreement that the Australian health system is in need of the reform that was foreshadowed within the national report, which states:

Australia’s health system is in need of reform to meet a range of long-term challenges, including access to services, the growing burden of chronic disease, population ageing, costs and inefficiencies generated by blame and cost shifting, and the escalating costs of new health technologies.

Hasluck needs to benefit from these reforms. It continues:

By April 2008, the Commission will provide advice on the framework for the next Australian Health Care Agreements (AHCAs), including robust performance benchmarks in areas such as (but not restricted to) elective surgery, aged and transition care, and quality of health care—

so the collection of data and the rigour around that had commenced—

3. By June 2009, the Commission will report on a long-term health reform plan to provide sustainable improvements in the performance of the health system addressing the need to:

a. reduce inefficiencies generated by cost-shifting, blame-shifting and buck-passing;

b. better integrate and coordinate care across all aspects of the health sector, particularly between primary care and hospital services around key measurable outputs for health;

c. bring a greater focus on prevention to the health system—

so that prevention was to become a hallmark in the way in which the health of Australians would go upstream to the front-end as opposed to relying on the care provided through tertiary hospitals—

d. better integrate acute services and aged care services, and improve the transition between hospital and aged care—

Certainly, within the dynamics of the electorate of Hasluck, that modelling and provision of service would meet the needs of the constituents. Further, it states:

e. improve frontline care to better promote healthy lifestyles and prevent and intervene early in chronic illness;

f. improve the provision of health services in rural areas;

g. improve Indigenous health outcomes; and

h. provide a well qualified and sustainable health workforce into the future

I would say with a high degree of confidence that not many of the constituents in Hasluck would have contributed to the consultation process for the national health reform agenda. However, all of those elements were encapsulated in the COAG reform process, led by Minister Roxon, the Australian Health Ministers Advisory Council and senior officers within both Commonwealth and state and territory jurisdictions. So the outcomes will lead us to the reforms that are being sought in this legislation without the legislation being required.

The National Health and Hospitals Reform Commission was established by the Rudd government in 2008 to assist the government in addressing a range of health related challenges. In that process consultation with the public sector was extensive. One of the elements is that:

The Government will introduce Local Hospital Networks to run small groups of hospitals, so that hospitals better respond to the needs of their local community. Local Hospital Networks will collaborate to provide patient care, manage their own budgets, and be held directly accountable for their performance.

This would mean that many Hasluck constituents will have limited involvement in shaping the services they need because they do not have a hospital in the southern region, but those in the Midland area would have access to being involved in the establishment and in framing what is purported to be the direction we will take.

The other element that I want to have a look at is that the hospital networks will perform a function, but there already exists in many sections of every state and territory jurisdiction the types of governance frameworks that allow for community and consumer advice into the provision and shaping of services. There are models of clinical care that go to clinical governance that already exist. I find it unfathomable that we have to re-establish or duplicate another set of governing frameworks when states and territories have for some period of time been reforming, under the guidance of the national partnership agreements, the directions in which health should be taken. In the government’s consultations many clinicians and local communities made it clear they do not feel they have the opportunity to be involved in decisions about the delivery of health services in their community, and they certainly wanted to have a greater say.

Let me say that the constituents that I represent feel strongly about what they need but do not get the opportunity to customise services within the electorate, and this legislation does not provide them with that opportunity to shape the types of services. The result is that services are not likely to be responsive to local needs and opportunities to improve clinical safety and quality will be lost through a national framework. I had the opportunity of contributing to the consultations of the reform agenda and I see this as a watershed of opportunity to shape and develop an approach in health that is far reaching, but I would like to see that led at the state and territory level. The Commonwealth have demonstrated in a number of initiatives that the implementation process cannot be done by Canberra; it has to be done at the local level.

Tinkering at the edges will not deliver the healthcare reforms proposed. It will become another failure for Labor but, more importantly, it will fail to deliver the reform that has been promoted by the Gillard government. How the commission will make a difference to a person living in Hasluck who wants access to good-quality health care across the continuant need still escapes me, particularly the person who is on a waiting list. I suspect the impact would be very little.

When I looked through section 9 and I looked at the functions of the act, I saw that many of those functions that are promoting both accountability and reporting are already being done by the Department of Health and Ageing, a highly competent organisation that has been established for a long period of time. The analysis of reports is undertaken by other institutions. The Australian Institute of Health and Welfare provides annual reports on the activities within the health arena. To establish another body or set of bodies requires funding to be directed away from frontline services. I see that it will add another layer to the way in which health is administered and the way in which negotiations will occur.

The principles of the partnership agreements go to primary responsibility for health service delivery and the legislation gives the responsibility alignment between the states and territories and Commonwealth. It focuses on improving the health and wellbeing of Australians. It focuses on coordinated federal action, accountability, financial support and greater incentives for economic and social reform. So the act does not require undertaking that role when we already have mechanisms in place.

The provision of the act proposes to ensure Australians will enjoy the benefits of a nationally unified and locally controlled healthcare system which guarantees that Australians enjoy world-class health care and universal access to health care that has merit. This would be supported with enthusiasm by the constituents of my electorate of Hasluck. What I do not want to see is the three bodies established and the funding being directed at the establishment of those to the exclusion of the provision of frontline services. I think some of the challenges that we have with this legislation is that there are already existing structures, that there are already existing mechanisms and that those functions and the constitutional related requirements referred to in the bill are in place now and do have the opportunity of having the level of impact.

Western Australia certainly has not signed up to the agreement, because it does not wish to relinquish its GST and to have the Commonwealth manage and control that money and that allocation. It does not want to see a reduction in its share of the GST. To reach a state of complete mental and social wellbeing as an individual group we must be able to realise the aspirations to satisfy needs to change or cope with the health environment. That is a choice that people need to make within the context of the choices that they will want to establish in conjunction with their state and territory governments. In conclusion I want to finish by using these words from Rethinking the Future by Peter Senge:

Those that succeed will, I believe, have unique advantages in the twenty-first century, because they will harness the imagination, spirit and intelligence of people in ways that no traditional authoritarian organisation ever can—

or authoritarian legislation ever can.

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