Andrew Wilkie (Clark, Independent) Share this | Hansard source

I'm delighted to second the member for Indi's motion because it hinges on equity, access and dignity for every Australian. Healthcare facilities in rural and regional areas have long been neglected, leading to an urgent need for dedicated federal funding. Of course it's unacceptable that, in a country as rich as Australia, rural Australians receive $1,090 less healthcare funding per person each year than city residents. Indeed, according to the National Rural Health Alliance, that shortfall now amounts to over $8 billion annually, resulting in longer wait times, a lack of specialist services, staff shortages and, of course, outdated infrastructure.

In Tasmania, where most of the state is classified rural and remote, the impact is especially acute, because, while Tasmania's four major public hospitals provide vital services, they're also supported by13 district hospitals, from King Island to New Norfolk, from Smithton to St Marys. These facilities are the backbone of their communities. But, when you talk to families or health workers across Tasmania, you hear the same concerns: facilities are outdated, emergency departments are cramped or overflowing, diagnostics are limited, and, too often, care is delayed. Remember—in places like St Helens or Ouse, where private providers have withdrawn services or closed, the public system is not the safety net; it's the only net. We must be honest about the problem here: federal funding has not kept pace with the realities on the ground.

In February this year, Australian governments did extend the National Health Reform Agreement by one year. Under this agreement, Tasmania will receive $754 million in federal health funding this financial year. But, when you consider that Tasmania's public hospitals are said to cost over $3 billion annually and that our hospital costs are growing at nearly three times the national average, it becomes clear that this agreement does not go far enough. Clearly, a renewed multi-year NHRA agreement must remain a priority. But let's not pretend such funding absolves the federal government of responsibility to those living in regional and rural areas of Australia.

The fund the member for Indi is proposing, however, would allow for targeted, needs based investment that lifts up rural and regional communities. Let me be clear: this is not about asking for more than our fair share; it's about fairness. Quite simply, it costs more to build and maintain healthcare infrastructure in regional and remote areas. Moreover, workforce shortages and geographic isolation can also create real barriers to effective care. For example, as of September, over 9,000 Tasmanians were on the elective surgery waitlist, and only 63 per cent were seen on time. Another 10,700 Tasmanians are waiting for public oral health care. At the Royal Hobart Hospital in particular, bed block has led to major surgery cancellations, and ambulance ramping continues. Adding to the pain, in August, Royal Hobart Hospital staff were informed that a planned $130 million redevelopment of the emergency department was being shelved due to budgetary issues, replaced instead with a 'lower scope design' that management itself acknowledged is not fit for purpose. There's also the closure of the St Helens hospital and the broken-down BreastScreen Tasmania bus, which leaves women in remote areas without access to vital early detection services.

With private health services in Hobart in trouble, including the collapse of smaller GP clinics and storm clouds over the Hobart clinic and Hobart private hospital, we're only going to see more pressure build on the public health system. Again, that comes with painful human impacts—for example, the heartbreaking case of a Hobart child that suffered devastating burns as a baby. He is only two years old now and in a critical recovery phase. His parents have fought for laser therapy that could drastically improve his lifelong recovery, only to be told that the laser machine at the Royal Hobart Hospital had broken down, and would not be replaced due to cost.

Sadly, while other states have invested in new health infrastructure, the Tasmanian government is still patching up what should have been replaced a decade ago. It's a false economy, and it's hurting people.

Clearly, we need a dedicated rural health infrastructure funding arrangement and commitments to upgrade or rebuild our district hospitals. We also need fit-for-purpose facilities that can recruit and retain staff and deliver timely care as well as support modern services. This is not about politics; it's about people. Governments owe it to them to deliver a system that works, no matter where they live in this country.

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