Hospital Beds (7.05.2014)

Written on the 13 May 2014


Mr JENNINGS (South Eastern Metropolitan) -- I move:

That this house --
(1) notes --

- the Australian Institute of Health and Welfare's data made public on 30 April 2014 showing that only 43 new hospital beds have been added to Victorian hospitals since the government was elected;

- that the Minister for Heath has been unwilling and/or unable to identify a single new hospital bed created this term;

- the Minister for Health's failure to acknowledge the impacts of the federal government's 2013 midyear economic and fiscal outlook hospital funding cuts in Legislative Council question time; and

(2) requires the Legal and Social Issues References Committee to inquire into, consider and report, no later than 30 June 2014, on the progress of the coalition government's 2010 election commitment to deliver 800 new hospital beds by the end of November 2014 and requires the committee to call as witnesses --

- the Secretary of the Department of Health;

- the CEOs of Bendigo Health, Eastern Health, the Royal Children's Hospital, Peninsula Health, Melbourne Health and Monash Health; and

- any other CEOs of health networks the committee thinks appropriate.

As members would appreciate, this motion has arisen from some of the lengthy debates we have had during the term of this government, some of which have occurred during question time. During question time neither questioners nor ministers answering should debate a question, but nonetheless this has been a hotly contested issue on virtually every sitting day of the Parliament during the term of this government. The reason why it is a burning issue for the Parliament and a burning issue for the community is that this government came to office promising much in relation to improving health care in this state. In coming to office coalition members pointed to what they described as Labor's failures in the administration of health care, and they pointed to occasions on which Victorian patients had suffered, indicating that that suffering had occurred as a consequence of what they perceived to be Labor's failure.

The coalition promised much: it promised to turn around the performance of the health system, to improve it by every measure and to provide an additional 800 beds to Victorian hospitals during its first term in government. On every single measure the coalition's performance in relation to health has deteriorated during its first term in government, and in fact all of the data that has been generated within the state of Victoria in relation to health and all of the data that has been outlined in the national reporting of the Australian Institute of Health and Welfare have indicated that the increase that was promised in relation to hospital beds has not occurred.

The budget papers for each of the budgets delivered by this government have clearly indicated savings being made in the health portfolio. In each of those budgets the government has taken away funds that could have been made available to the hospital system to improve services and to add to the capacity of our system.

There have been savings measures in relation to health in all of the budgets this government has delivered, and that includes the budget that was announced by Treasurer O'Brien yesterday. It is true to say that the savings in relation to health in the latest budget are not in the same order of magnitude of the first three budgets, but the government's first three budgets identified $826 million worth of savings that have already being inflicted on the hospital system in Victoria.

The data that was released by the Australian Institute of Health and Welfare a little over a week ago indicated that the number of beds that operate in Victoria that are available for patients to receive acute hospital care has actually grown very modestly. Indeed today there are only 43 more beds than there were when the coalition came to office. That is after three and a half years of the coalition's administration, and on coming to government the coalition promised to deliver 800 beds over its first term.

Why has this monumental miscarriage of truth and justice transpired? The Minister for Health was the opposition spokesperson for health when the coalition was in opposition. You would think he would have known better about the capacity of a government to improve on hospital bed numbers when the coalition made that promise in the lead-up to the 2010 election. Not only were 800 beds promised but the costings that were delivered by the coalition identified funding that would be available in each and every budget year of its first term in government to be able to acquit that promise. This was not a flight of fantasy of the coalition. There was a perceived need, and the Australian Medical Association had been calling for these beds. The incoming coalition government responded by identifying a target of 800 beds and a costing to deliver those 800 beds. However, the sorry truth for Victorians has been that during the life of the coalition government that funding has not been made available and those beds have not been made available.

Why would an opposition spokesperson promise 800 beds and believe that they could be delivered but then identify budget savings and fall sorely short of that original commitment?

I have gone back and looked at the relevant data that was made available by the Australian Institute of Health and Welfare over the course of the last term of the Labor government and into the term of this government, and I have a sneaking suspicion that the opposition spokesman at that time, now the Minister for Health, made the mistake of assuming there was natural growth in the hospital budget that would deliver somewhere in the order of 200 beds each and every year to the hospital system.

Why would the then opposition spokesman for health, David Davis, have believed that? Because in the last term of the Labor government the outcome was that on average more than 200 beds were added to the system each and every year. If you go back and look at the performance of the Labor government in its last term of office and look at the data provided by the Australia Institute of Health and Welfare, using the benchmark of the number of beds in Victoria in 2006-07, which was the last financial year prior to the re-election of the Labor government in 2006, you will see that there were 12 300 beds available in the Victorian public acute hospital sector. That is the benchmark -- 12 300 beds.

By 2007-08 the Labor government had funded and provided for 12 528 beds, which was an increase of 228 beds during the course of that financial year.

In 2008-09 there were 12 715 beds, which was an increase of 187 beds during the course of the financial year. In 2009-10 there were 13 032 beds in Victoria, an increase of 317 beds during the course of that year, and in the 2010-11 financial year -- the final year of the Labor government -- there were 13 254 beds funded, which was an increase of 222 beds. That is an increase of 954 beds funded over the last four budgets delivered by the Labor government in Victoria. The additional beds delivered to the Victorian public hospital system added 238 beds on average each and every year over the last term of the Labor government in Victoria.

What have we seen during the life of this government? If we take the benchmark established by Labor in 2010-11 of 13 254 beds, we see that the number of beds operating in Victoria was 13 218, which was a net reduction of 36 beds. In 2012-13, according to data published on 30 April this year, the number of beds was 13 297, an increase of 79 beds over that financial year.

In the budget cycles of the coalition government that have been recorded by the Australian Institute of Health and Welfare, there has been one year where the number of beds went down by 36 and one year where the number of beds went up by 79 -- that is, a net increase of 43 beds. During the life of this government there have been, on average, 21.5 beds added to the hospital system during the course of the budget cycles that it has funded and that have been reported on, compared to the last four budgets of the Labor government when the increase in beds per year was 238.5 beds.

Mr Lenders -- If the minister was here, he might learn something.

Mr JENNINGS -- It is not surprising. My leader has interrupted me to say that, if the Minister for Health were here, he may learn something.

I think it is very unlikely, in terms of his ministerial responsibilities, that the minister will learn these facts, be able to talk on these facts or be able to reflect on his monumental failure during the course of this term in government, because in fact it is clearly a broken promise.

The independent reporting provided by the Australian Institute of Health and Welfare is the authority on hospital performance data across the country and was the authority the minister relied upon from day one when he was called on to identify where his new beds were. He consistently relied upon that data in the first year or two of his ministerial responsibilities as the authority for the number of beds available in Victoria. The Minister for Health no longer refers to this dataset as the authority. In fact he does not rely on any dataset as his authority for indicating where hospital beds may be located in Victoria because there have been ongoing debates not only in this chamber of Parliament but in the other chamber about where the reporting would occur.

During 2011 the previous Premier, Ted Baillieu, indicated that his belief was that the number of hospital beds in Victoria would be reported within the budget and within hospital annual reports that are published and tabled in the Parliament. Unfortunately Premier Baillieu had either been misinformed or his undertaking and belief that this would be the reporting mechanism in Victoria has not been met.

On a number of occasions the Minister for Health has been asked to account for that commitment and to refer to any evidence that appears in the budget papers or in any hospital and health service annual report that has been tabled in Parliament. On no occasion within the past three and a half years has he drawn on any documentary evidence or any dataset showing that he knows where additional bed capacity has been identified, that a hospital has been able to identify additional bed capacity or his department has been able to identify this on his behalf and provide a report to the Parliament.

The Department of Health's annual report does not include this dataset. It does not comment on the number of hospital beds that are available in Victoria. The minister has not been able to draw the attention of the Parliament or people of Victoria to any evidence of his assertion that there is additional bed capacity in Victoria. He has not been able to identify any budget allocation specifically provided to add to the number of hospital beds in Victoria. His failure to allay the concerns of the Victorian population that he is satisfying or will satisfy his commitment is a monumental measure of his failure as minister. He is now guaranteed only a further seven months of public administration before he and his government are accountable to the people in terms of satisfying their promise. Where will they be able to identify 757 additional beds to meet their 800-bed commitment?

Within three and a half years they are sitting at 43 beds, and within the next seven months they want to get to 800 beds. Where are the 757 beds going to come from to make up that difference?

Mr Leane -- They will just make up numbers. They will just make it up.

Mr JENNINGS -- Unfortunately that is the sorry history, and they will desperately try to make up those numbers.

But in an extraordinary disclosure the Victorian Treasurer, Michael O'Brien, indicated last weekend, in anticipation of the Victorian budget and the Abbott federal government's budget that is to be brought down next week, that a number of beds may be reduced during the course of this financial year. Treasurer O'Brien has identified 222 beds that were funded during the last year of the Labor government in Victoria by agreement with the then federal Labor government to increase the number of subacute beds in Victoria. That comprised 222 beds that were funded in the last full budget cycle of the former Labor government in Victoria, and those beds may be lost to Victoria if the Abbott government refuses to provide ongoing funding for them.

We may have the extraordinary circumstance where instead of growing the system by approximately 238 beds each and every year as occurred under Labor, 222 beds may be taken out in the next financial year as a result of the coincidence of there being coalition governments across state and federal jurisdictions.

The Victorian budget papers yesterday indicated those 222 beds are at risk because there was no ongoing funding provided for them within the Victorian budget. Within the next week we will know whether the Abbott government is going to make up the shortfall of those 222 beds, or whether it is quite happy to see 222 beds taken away from the Victorian hospital system at the expense of quality of care in Victoria and presumably at the expense of the languishing coalition government in Victoria and its ability to maintain the proper good working order of the Victorian hospital system.

I have moved the motion today to provide the Parliament, representatives of the health sector, including the health department, CEOs who work within the hospital sector and public servants who provide worthwhile services and commitment to the Victorian community with a voice of authority beyond what I have argued to the Parliament -- that is, the ability to verify either the datasets and information I rely on and put on the public record each and every parliamentary sitting week, or they can verify the assertions that are not supported by any dataset or evidence by the Minister for Health.

Let us get to the heart of the matter. Let us get some assessment from people at the coalface, either at a bureaucratic level from the Department of Health or from the CEOs at the coalface who are responsible for health care every day in hospital settings across the width and breath of Victoria. What is the truth from their vantage point? Where do they see the situation in relation to bed numbers?

Can they identify beds that have either not been reported by the Australian Institute of Health and Welfare or have not been identified within their annual reports or within the annual report of the Department of Health? Is there any dataset that they rely on or we can rely on to indicate that there has been growth in the public hospital system in Victoria, or is all the evidence clearly running one way -- that at the moment we have a health minister who runs away from the facts because he cannot bear to deal with the truth, because the truth not only hurts his political standing and credibility but hurts patients each and every day across Victoria?

That is not a glib, idle statement, because the real victims of this failed public administration in health and the failure of this minister to deliver on his promise are the people who are waiting for care.

They may be waiting on elective surgery waiting lists for their procedures, they may be waiting for an ambulance to arrive, they may be waiting in an emergency department to receive care or they may be waiting for subacute care. They may be waiting for a range of services to meet sometimes their urgent need and sometimes their chronic need to have their pain and suffering addressed. Patients right across Victoria are the ones who have been suffering because of the lack of investment and support provided by the Victorian government.

How do we measure that? We can measure it in a variety of ways. We can measure it by the indisputable fact that when this government came to office there were 38 000 people on the elective surgery waiting lists and, by the last measure, there are now more than 48 000 people on the waiting lists. During the course of its three and a half years in office this government has added over 10 000 people to the waiting lists, and at one stage during the course of this government that number was even higher. In the last full reporting cycle, for 2012-13, which was the last full year that was reported on for the number of elective surgeries that have taken place in Victoria, there were 4157 fewer surgeries performed under this government during that financial year than in the last financial year of the Labor government.

Every single citizen who is capable of any analytical reflection on health-care needs -- and we know that health-care needs grow each and every year as demand grows with the ageing of the population and population growth -- and who has analysed that across the nation understands that health-care needs continue to grow. However, what we have seen in the life of this government is that it has funded fewer surgeries in its budgets. There is a direct connection with the fact that not enough money has been put in and there is not enough investment by this government.

It is falling behind growth, it is funding fewer activities across the system and of course, because of that, the number of people who are waiting for service continues to grow. That is for elective surgery.

The same analysis applies for emergency departments. There are a range of commitments for treatment times within emergency departments that have been established and reported on in the budgets in Victoria for many years, and they have also been subject to performance targets as part of the national health-care agreement. As recently as yesterday in the Parliament I asked the minister whether he could identify one hospital in Victoria that met performance targets for emergency department treatment times -- just one -- and he did not do so.

The Minister for Health, who was charged by the people of Victoria with having responsibility for the system and to meet performance targets and acquit his responsibility to provide quality care, was asked to identify, of all the hospitals in Victoria, where there is a hospital that meets its performance targets for emergency department care. He could not identify one. He could not give any confidence to the Victorian community that there was even one location across Victoria where that performance target was being met.

Unfortunately that is not the end of this story in relation to the failures and inability of the minister to deliver on the promises and the performance targets. I asked him a question about ambulance performance as well. I asked him about transfer times from ambulances into emergency departments and where in Victoria it is achieved that ambulances, when they arrive at hospitals, transfer 90 per cent of their patients within 40 minutes.

That is what the target is. Ambulance patients do not have instant access into emergency departments. It should not be onerous or difficult to achieve that. This is a measure to say that nine-tenths of the time you can get the patient from the ambulance into a hospital emergency department within 40 minutes. Forty minutes is the target. I asked the minister to identify where it occurred in Victoria, and he did identify one location. He identified Dandenong Hospital and said that in the last quarter that target had been achieved on 91 per cent of occasions. That was the only hospital in Victoria he was able to volunteer where that had occurred. For every other hospital in Victoria the target is not met, that performance is not delivered and patients suffer because they are sitting outside hospitals in what is known as ramping. The ambulances ramp up outside hospitals. They queue up to get their patients seen, so that performance target is not being met.

The direct consequence of that is pain, suffering and anxiety for Victorian patients. There is another measure relating to whether ambulances turn up once they have received the 000 message to say that there is a code 1 emergency and that it is a life or death situation. The expectation is that on 85 per cent of occasions those ambulances will arrive within 15 minutes. That is the target but it is not being met across the state. In fact if you look at each and every successive budget from 2009-10 to 2014-15 -- the budget that was released yesterday -- the trend reveals an alarming deterioration during the course of that period. If you look at the outcomes that have been reported in successive budgets from 2009-10 up to the present budget, what we see is that in 2009-10, 81 per cent was the achieved target for ambulances arriving within a 15 minute horizon for code 1 emergencies; in 2010-11 that number had been reduced to 77 per cent; in 2011-12 it was down to 74 per cent; in 2012-13 it was down to 73 per cent; and in 2013-14 it stayed at 73 per cent.

In less than three-quarters of occasions, ambulances turn up for code 1 emergencies within 15 minutes, and in fact the trend over the last five budget cycles has been continual free fall of that performance target being met.

The Minister for Health tries to run away from this. The minister tries to talk about other measures. On some occasions when the system that he administers does not deliver on those performance targets in the budget, he will say, 'We are doing our best', or he will talk about another performance measure -- cardiac survival rates. He does that because there was one Productivity Commission report during the course of this government that indicated that cardiac survival rates had actually increased during the first year of his administration. Unfortunately for Victorian patients he does not rely on that measure anymore because the next report indicated that that same performance measure had gone down; cardiac survival rates had gone down in the second year. The Minister for Health does not refer to that data anymore. He only did it very briefly for one encouraging dataset.

What you will find with this minister is that time and time again, when he is asked to identify information that supports his interpretation of the delivery of the system, he will call on any data that he may desperately scramble to identify. Unfortunately there have been far too few cases he has been able to grasp hold of, and when he has grasped hold of them they have evaporated. They have evaporated because there are not enough beds in the system, despite his promise to deliver more beds. There is not enough funding in the system to deliver on the outcomes and to keep up with patient demand growth. It is Victorian patients who are suffering as a consequence. The minister is floundering in terms of his undertakings to the Victorian public.

Yesterday's budget was a clear indication that the government has not remedied this problem. I refer the house to two major stakeholders. The minister often discounts arguments mounted by either paramedics or nurses and midwives because, according to the minister, they are militant unions. Although those stakeholders have a view about the deterioration of health care and the pressures relating to hospitals and ambulance services across the state, they are not entitled to express that view. Apparently the minister discounts their views because they are organised workforces. Those employees have the audacity to try to organise themselves and to protect working conditions and the welfare of patients. I will refer to another part of the workforce in the health-care sector. How did members of the Australian Medical Association (AMA). respond to yesterday's budget? What did they say? The AMA is not recognised by the government as being a militant union. Its members are not recognised as being in the pockets of the Labor Party, or vice versa. What did the AMA in Victoria say about yesterday's budget?

The president of the Victorian branch of the AMA, Dr Stephen Parnis, issued a press release on 6 May. It says:

Since the coalition was elected in 2010, elective surgery waiting lists have increased by 10 000, or approximately 20 per cent. The budget allocation of $190 million for elective surgery is not nearly enough.
The media release also says:

'Surgery waiting lists continue to grow, ambulances are ramped, hospitals are on bypass, there are not enough hospital beds and today's budget fails to adequately consider the increasing growth in demand', AMA Victoria president Dr Stephen Parnis said today.

About 12 months ago authorities the minister relied on included the Victorian Healthcare Association and hospitals that operate across Victoria, and he asked them to join him in a chorus of discontent about the midyear economic and financial statement of the then Gillard federal government and the reductions in funding that had been impacted by that government. Hospitals right across Victoria complained about that fact and supported the minister's view about any restrictions in funding coming to Victoria. He congratulated them and I congratulated them for standing up for Victorian hospitals, and I will do it again today, because the Victorian Healthcare Association yesterday clearly criticised the Treasurer's budget and the failure of the Minister for Health in a media release. It stated as follows:

VHA chief executive Trevor Carr said this was a disappointing result, given the budget's $1.3 billion surplus, which will increase to a $3 billion surplus in 2015-16.

'Taking inflation and population growth into account, this budget continues the flat-line trend we saw last year. There is little respite for health services that are dealing with rapidly increasing demand, particularly in the state's growth areas'.

Mr Carr said the end of commonwealth government funding for subacute care would amount to a $150 million cut to Victoria, or the equivalent of losing 85 000 subacute bed days compared to 2013-14.

Mr Carr said that while funding to acute care increased by 4.5 per cent, output targets also increased by more than 6 per cent, which meant health services were being expected to 'do more with less'.

The sorry truth is that he knows, I know, patients know and people working in hospitals know that it is impossible to keep up with 6 per cent growth rates within hospital care and think you can get away with it by putting in only 4.5 per cent growth in your budget. This minister has failed to appreciate that it is inadequate growth money and commitments within the budget allocation that have led to a continual slide in the performance of hospital care and that the appropriate level of infrastructure growth or recurrent funding has not gone into funding during the course of the last four years.

Another way of measuring that beyond what I have already indicated is that in each of the last four budgets brought down by Labor in Victoria an additional 238 beds were funded. Now we have a situation where on average 21 beds have been added to the system per year, so there has been a less than 10 per cent achievement of Labor's performance under this government. Another way of measuring the less than 10 per cent achievement is to have a look at how much capital was allocated in the last budget of the Labor government in 2010-11, when there was $2.3 billion worth of capital investment in infrastructure -- in rebuilding hospitals.

Let us have a look at how much was announced yesterday: $228 million, of which $35 million was allocated to medical equipment. It has not been allocated to rebuilding hospitals, because in fact it is the number that appears in the budget each and every year -- $35 million for medical equipment -- which comprises about $1 in $6 allocated for capital investment in yesterday's budget for health. This is another occasion when the government's contribution to bed numbers runs at less than 10 per cent of the performance of the outgoing Labor government, and the infrastructure spend in health in this last budget is less than 10 per cent of what it was under Labor in 2011.

That is the fundamental reason why this government has failed and continues to fail in health. All indications are that it has given up on Victorian patients and that patients are on their own. All indications are that the government has decided that health is electorally expendable.

The government made a commitment in 2010 of 800 beds that are not going to be delivered. There is no pretence anymore that they are going to be delivered. There is no measure to demonstrate they are going to be delivered, and there is a monumental sense of denial by the Minister for Health and the Premier in relation to their responsibility in health.

The motion I have moved today provides an opportunity for every accusation and every piece of information I have put on the record in terms of the datasets, the reports and the budget analysis to be tested, and I am thoroughly prepared to have them tested by a bipartisan committee of the Parliament to assess the veracity of what I have said and to find some independent authorities within the health bureaucracy to ascertain the truth about whether the datasets, the reports and the budget analysis that I rely on should be accepted or whether we should rely on the assertions of the Minister for Health with no data, no budget analysis and no independent reports from the Australian Institute of Health and Welfare. What is the minister relying on in his assertion that the system is working well, that there is enough funding in the system and that he will deliver on his 800 beds?

How does he pretend that those outcomes are going to occur? That is the opportunity that this motion provides for.

I am certain that, given the confidence they will have in their minister, government members will get up and say, 'Of course our minister has delivered. Of course he's prepared to be tested. Of course he will submit to the independent and thorough scrutiny of a parliamentary committee, backed up by his health bureaucracy and his department, which will validate every single one of his assertions'. Of course they will say that. That is exactly what they are going to say. When I sit down, having spoken in support of my motion, they will rise to support this motion because they know that this will validate their minister.

Unfortunately Hansard has a great deal of difficulty dealing with irony; what I have just said will not occur. Government members will not support this motion. They will not want independent scrutiny. They will not have the confidence to say that their health bureaucrats will back their minister.

In fact what they will do is delay this motion so that it does not come to a vote, or they will vote it down. There is no way they will allow for their minister's assertions to be tested in any public forum. If they can do better than that, I challenge them to do so.



Ms HARTLAND (Western Metropolitan) -- As Mr Jennings has given a comprehensive reason why we should have this referral, I am not going to go back over it. I will, however, take up his last comments because I too would like to think the government has enough confidence in the minister and the health bureaucracy to allow transparency and to allow these assertions to be questioned, possibly resulting in a finding that the Minister for Health is right or that the Shadow Minister for Health is right. Let us have the opportunity to examine these assertions.

The way we refer matters to committees concerns me.

These are genuine issues that need to be resolved, and they include this motion and several motions that I have put forward. I am hoping to finish drafting a motion today on heatwave planning. These motions are never allowed to proceed to committee. They are never allowed to be questioned. Tomorrow, however, the Minister for Health will move the following:

That, noting the Australian Health Practitioner Regulation Agency 2012-13 annual report, particularly as it relates to the registration of pharmacists in Victoria, this house requires the Legal and Social Issues Legislation Committee to inquire into and report by 14 October 2014 on the role and opportunities for community pharmacy in primary and preventative care in Victoria.

I have only had a quick look at the annual report, but I have read the section on pharmacy, and it does not actually mention community pharmacy, so I am not sure what we are going to be looking at.
The government rejects a referral on heatwave planning because it somehow believes it has everything under control. It rejects Mr Jennings's motion despite it being a valid motion. This is clearly because the government does not want transparency. It does not want to be questioned about how it is managing health. I find it quite surprising that the Minister for Health is not in the chamber when we have these kinds of motions. Ms Crozier will do an incredibly capable job, I am sure of that, but the health minister, if he is so convinced of all of this, should be in the chamber. He should be the one talking about this. His absence says to me that he is not convinced of the job he is doing. If he were convinced, he would be in this chamber talking about this motion.



Ms CROZIER (Southern Metropolitan) -- I am pleased to rise this morning to speak on Mr Jennings's motion. I thank Ms Hartland for her comments about my capacity to debate this issue. I reassure her that the government does have confidence in both the minister and the bureaucracy that she doubts. I reassure her that the departments and those who work in our health services and public health sector right across the spectrum do a terrific job in providing services to Victorians and sometimes interstate patients. We should never forget the work they do. We should also acknowledge that we have a very good health service and health system here in Victoria. I think that is something other parts of the country, and indeed the world, are very envious of.

Let us get back to the main thrust of what we are doing here today, which is debating Mr Jennings's motion. I will make a few points in relation to his motion.

In the first instance I will talk about the issue he raised when he noted that the Minister for Health had at times noted the failures of the Labor administration in health. I have to say that the minister is quite correct in noting those failures. I agree that there were a number of failures in that administration, and I will come to those. There were failures in the previous Labor government in a whole range of areas. I am not going to go through them, but I note that when we came to government in December 2010 we were confronted with a litany of unfunded projects and project blow-outs.

We were elected in December 2010 to fix that mess, and that is exactly what we have been doing. Yesterday's budget was testament to the hard work that we have done to cap that out-of-control spending of 8 per cent and draw it back in line so that it is something more manageable. As a result we have a robust and sound bottom line, and we are able to fund the infrastructure projects that were announced yesterday that all Victorians will benefit from.

It is going to be absolutely critical not only for areas of commerce but also in the area of health. People drive to work in the health sector, and they go from area to area. Things like the east-west link will make a great difference for a number of people who work in the health sector.

I applaud the Treasurer for the budget he brought down yesterday and the government for reining in the spending of the Labor government and its maladministration in the many areas I have mentioned.

One area I will particularly mention is the benchmark. Let us not forget that when we came to government in November 2010 we had seven months to go in the budget cycle for that financial year. It is very important to put that on the record. There were some elements of the budget cycle we needed to address.

One instance of Labor maladministration we found when we came to government was the shortfall of $55.2 million to pay for wages for health workers in the 2010 Christmas-New Year period. That is an extraordinary oversight by the Labor administration. Did it forget to factor it into its budget? I am not quite sure. Nevertheless that was money we had to find immediately when we came to government. That is just one area of Labor maladministration we had to deal with.

Mr Jennings talks about the benchmark established by Labor in 2010-11. I want to go to that point because it is an important baseline to take note of and the key point of the debate. We came in with seven months to run in that financial year. The Australian Institute of Health and Welfare data comes out each April, which is why we are debating this issue now. If you look at the baseline from 2009-10 -- that is, when Labor was in government -- you see that the average available number of beds baseline at that time was 13 198.

I will come back to that figure later in my contribution, but it is important to mention that that was when we came into government and so we needed to look at what had been going on.

It is also important to note that clinical treatment can be done in the community or in the home. We have a contemporary health-care service, and we see that time and again. Under the Labor government and the national partnership agreement on improving hospital services, it was also recognised that funding was required for bed equivalents for community-based and non-admitted services. That was undertaken by then Premier Brumby and then Minister for Health Daniel Andrews. I think we are all in agreement about our contemporary health-care setting and what we need to do in terms of clinical treatment and how it can be achieved looking at those bed equivalents.

During the last Parliament the then Treasurer Mr Lenders was asked a question by the then member for Templestowe Mr Bill Forwood in relation to output groups. Mr Lenders referred Mr Forwood's letter to the then Minister for Health Bronwyn Pike. I bring this up because it is relevant to the issue we are talking about -- the average number of available beds and how beds are categorised. In a letter responding to Mr Lenders, Bronwyn Pike said:

The core of Mr Forwood's question was, '... with respect to the following output groups:

- acute health services (budget paper 3, page 70)

- subacute care services (budget paper 3, page 71)

- mental health (budget paper 3, page 75)

- small rural services (budget paper 3, page 82)


- aged and home care (budget paper 3, page 77)

How many beds will be available in each of the categories funded through these output groups in each of the following health services, facilities and centres?

The following points are provided in reply to Mr Forwood.

The Department of Human Services does not specify available beds as an output measure for any of these five output groups. The output measures are set out in the budget paper and include activity targets specified in terms of quantitative measures of activity such as separations, weighted inlier equivalent separations (WIES), bed days and aged-care units. The number and types of beds required to meet these targets is left to the discretion of each health service.
The letter goes on to say:

Hospitals provide an increasingly wide range of services requiring different types of beds or equivalent modes of delivering care. The number of beds required to meet each activity target will depend on a number of day-to-day factors including:

- short-term fluctuations in the demand for the various specialised services;

- the degree of inter-changeability of the beds and wards used for each specialised service; and

- within each specialty, the extent to which the demand requires the use of intensive care units, non-intensive care overnight wards of the 'traditional' type, same-day procedure beds, and off-campus arrangements such as 'medi-hotel' and 'hospital in the home' services.

As the numbers and types of beds required to meet the output commitments must be managed to accommodate day-to-day demand, it is not possible to specify in advance the numbers and types of beds that will be provided in future periods.
The reason I have provided that information to the chamber is that it demonstrates that we are in a contemporary health-care setting in which various areas of service are provided and demand fluctuates. As we know, during the Christmas and Easter periods a number of beds close; Mr Jennings would understand that. At times we need to meet rising demand. In the winter months -- peak flu season -- demand rises. Hospitals and health services manage those peak times.

When I was working at the Royal Women's Hospital we would cater for a peak in births in August and September. Members can work that timing out for themselves; I note the Acting President is indicating that he was born at that time.

That is what hospital and health services do; they manage the demand according to fluctuations in seasonal activities, Christmas and holiday periods and other things like that.

That is nothing new; it is what an efficient health service should do. I note that in April this year the Standing Council on Health met and that health ministers agreed to develop a more accurate measure in the context of contemporary health care, including for the first time the ability to capture data nationally for the capacity of hospital-in-the-home care and services such as same-day dialysis and chemotherapy chairs, and also the ability to capture data on the capacity contracted from the private sector as well as ambulatory care services. When we are looking at what is happening, we need to ensure that we capture that data to see how management of care is undertaken.

I am aware of people who are very complimentary of hospital-in-the-home care.

I refer to an instance of somebody who in the last couple of years has unfortunately been very ill after they contracted a severe infection. We know that the rates of infection in our hospitals are a great challenge and that there are increasing levels of antibiotic resistance. We have a very good system in Victoria, and things like hand washing are part of the practical measures to help address infection rates. In other parts of the world antibiotic resistance and infection rates are very high. Nevertheless, this individual contracted a severe methicillin-resistant staphylococcus aureus infection and has been undertaking long-term intravenous antibiotic treatment in the home, which is a contemporary health-care measure that we use. It suits the individual and frees up an acute bed, whereas in years gone by they would have had to have been admitted to hospital and treated on a long-term basis with intravenous care because we did not have the capacity to manage hospital-in-the-home care.

Some excellent work is being undertaken by our health professionals and allied health professionals to give individuals greater flexibility and choice in the delivery of their health-care service, and that is just one area. I applaud the work of the health ministers at the Standing Council on Health for looking at this issue in more detail, putting more measures in place and identifying how we can further improve things.

To get back to the issue of baseline data in contemporary health care, and I say that because Australian Institute of Health and Welfare data not only looks at average available beds but also hospital-in-the-home care, prevention and care beds, subacute ambulatory care bed equivalents and the private contracted elective surgery bed equivalents. To go back to my point about the earlier baseline figure which I am discussing, when we came to power in December 2010, there had been seven months of Labor administration in that financial year. If we consider the baseline figure for beds in 2009-10, as I said, there were 13 198 average available beds. The government was clearly working towards improving and increasing bed capacity, and by the end of 2012-13 it was looking to put on an additional 300 beds, which is exactly what the government has done.

I want to go back to that point because when we are talking about beds, we are talking about a range of beds.

In the Victorian budget submission of 2009-10 Mr Jennings referred to the Australian Medical Association (AMA). At the time AMA Victoria explicitly noted the need to change the way hospital capacity is recorded. In that submission AMA Victoria said:

... it is unlikely that ... standard acute beds will be the most appropriate mix of beds and services to provide the extra capacity needed in Victorian public hospitals ... AMA Victoria would also welcome this (additional) funding being used for programs such as hospital in the home and the hospital admission risk program (HARP) which are designed to provide what has traditionally been hospital-based care in more appropriate setting.

As I said, in 2009-10 there were 13 198 average available beds, 491 hospital-in-the-home beds, 94 prevention and recovery care beds, 677 subacute ambulatory care services bed equivalents and no private contracted elective surgery bed equivalents, making a total of 14 460 beds. As we have put in additional funding we have progressed, and I will return to the claim made by Mr Jennings about a lack of infrastructure spending, which I find quite extraordinary in light of what we have done. In 2010-11 -- clearly our first full year of government administration -- average available beds totalled 13 474, and there were 481 hospital-in-the-home bed equivalents, 134 prevention and recovery care beds and 702 subacute ambulatory care equivalent beds, taking the total to 14 791 beds. In 2011-12 the average available bed figure was 13 495, 487 hospital-in-the-home bed equivalents, 154 prevention and recovery care beds, 740 subacute ambulatory care bed equivalents and no private contracted elective surgery bed equivalents.

In 2012-13 there has clearly been an increase in bed numbers. The average available beds are now 13 449, there are 539 hospital-in-the-home beds, 184 prevention and recovery care beds, 805 subacute ambulatory care bed equivalents and 3 private contracted elective surgery bed equivalents, and that is an area the government is working on. That takes the total to 520 new hospital beds, and that is absolutely the point. We are looking at the figures and the benchmark of our administration. As I said, the baseline under Labor's administration of 2009-10 -- --

Mr Jennings -- That is incredible!

Ms CROZIER -- They are the figures, Mr Jennings. I will go to the next point Mr Jennings made about the lack of infrastructure -- and he said it, it is incredible. We have put in record funding and we have increased capacity in relation to infrastructure spend across the state.

The government and the minister should be commended for the work they have done. This new investment builds on more than $4.5 billion of existing health infrastructure projects. Further funding announcements made in the budget speech yesterday were for areas that are expanding. In Geelong, Barwon Health North will be delivering further health services to the region. There has been significant population growth in this state not only over the past couple of years when we have seen in excess of 100 000 people coming to the state but also over the period of the Labor administration. Thousands and thousands of people came to Victoria, but there was very little planning to cater for that growing population and indeed an ageing population. I commend the government and the minister for the forward planning and what they have done in just three and a half years.

I remind the chamber of what the government has done in three and a half years. As I said, just yesterday it was announced that we have put additional money, $73 million, into expanding the Latrobe Regional Hospital.

Mr D. D. O'Brien -- Hear, hear!

Ms CROZIER -- Yes, it is in the area that Mr O'Brien represents very well.

There is $28 million to build Barwon Health North in Geelong's northern suburbs, money for a major redevelopment of the Boort hospital and some additional funding for Moyne Health Services in Port Fairy. That funding is for projects in addition to the works already being undertaken. We will have one of the biggest regional hospitals in Australia in the $630 million Bendigo Hospital. The Victorian Comprehensive Cancer Centre project has $1 billion worth of infrastructure.

That will be a quite extraordinary facility for not only Victoria but also Australia, and I am sure that it will be groundbreaking in the work that will be undertaken and the care that will be delivered there. There are also the $46.4 million expansion of the Ballarat hospital, the $65.6 million Echuca hospital redevelopment and the $10 million Castlemaine hospital upgrade. There has been in excess of $165 million, I think from memory, for the redevelopment of the Royal Victorian Eye and Ear Hospital. There have been hospital redevelopments at Mildura, Swan Hill, Kerang, Charlton, Numurkah, Geelong and Kilmore, and there is $40 million to expand and reconfigure the Frankston Hospital emergency department.

Let us not forget Monash Children's, a terrific second paediatric hospital that this state desperately needs. I remind the chamber also that back in 2002 Labor members actually talked about this and they did absolutely nothing. It took our government to make this a reality.

I will be delighted to see that project up and running midway through this year when that work commences. It will be a huge benefit for the south-east parts of Melbourne and indeed Victoria, and it will cater for well over 1 million people. That is just an example of what our government has done. It has taken on the issues, understanding the need, planning for future growth and actually getting on and doing it. That is a very significant project to achieve in just three and half years. As I said, Labor members talked about it all those years ago but they ignored it and did nothing about it. Many other investments have been made along the way. They have been in capital improvements in the health sector and in putting in additional resources. The expenditure in the health budget is significant, it is at record levels and it is catering for growth and the requirements of Victoria.

Another point in Mr Jennings's motion refers to the minister's failure to acknowledge the impacts of the federal government's 2013 midyear economic and fiscal outlook hospital funding cuts. He rightly points out that he has raised the matter in question time. On a number of occasions the minister has given a detailed explanation of the case. I know that the matter has been raised with the minister, that the current federal health minister understands the problem and that adjustments have been made to the midyear funding with a parallel payment, so there has been absolutely no cut in funding to hospitals. Minister Davis has explained that very eloquently to the house on a number of occasions.

While talking of cuts, I cannot let the opportunity go of reminding the chamber also of the $107 million cut to funding for Victorian hospitals and health services by the then federal Minister for Health Tanya Plibersek. That cut was made midway through a financial year and with no consultation. It required hospitals and health services across the state to make adjustments.

Part of those adjustments was an adjustment to the services they delivered to patients. How anyone could think that a cut of such significance would not have an impact on the delivery of services is beyond belief. It demonstrates the lack of understanding that the then federal health minister Tanya Plibersek had of the delivery of health services, the impact of the cut and the difficulties and challenges that health services had to meet. It was an extraordinary undertaking by the former federal government.

We understand that members of that government had absolutely no idea of how to manage money. Their legacy has been quite extraordinary, and the current federal government has an enormous challenge in bringing down a budget next week with the legacy that Labor has left. The dreadful waste of money under that Labor administration is just breathtaking. It really will be a challenge for the federal government to address that legacy, and I wish its members all the best in doing that.

It is clearly in direct contrast to what we have here in Victoria with our Treasurer, Michael O'Brien, who has done a magnificent job. I pay tribute to him and to former Treasurer Kim Wells, now the Minister for Police and Emergency Services, in understanding that you cannot spend more than the revenue that comes in. That is why we are in such a strong position here. That has been recognised by a number of agencies, and it is why we are maintaining our AAA credit rating and attracting business to Victoria.

That $107 million cut I mentioned, as I said, had an enormous impact, and I acknowledge the work of the health services and hospitals in managing that, because given the huge impact it had on their ability to deliver what was expected, they worked extremely hard. All the health services and hospitals across the state should be commended for the efforts they undertook to identify savings and work through them.

Let us not forget what happened here. It was our Minister for Health, Mr Davis, who led the argument across the country on this issue. It was not only Victoria that was being affected; it was the whole of the country. Mr Davis led the charge on this and argued the case for having that money returned, and after exhaustive debate and acknowledgement, the federal Labor government caved in, as it should have. It took some time for it to do so, but that funding was reinstated.

That shows our minister fighting on behalf of Victorian patients and health services and hospitals across the state to get that money back so that the government could put it back into the services it needs to deliver.

He will do so again. We know there will be issues, and he will be again arguing authoritatively and strongly the case for Victorian patients.

Mr Jennings -- That is a very nice turn of phrase.

Ms CROZIER -- It has been demonstrated, Mr Jennings, and you have to say that he did extremely well in getting that money back.

Mr Jennings interjected.

Ms CROZIER -- Absolutely.

He led the charge on that, and he should be congratulated for it. Mr Jennings's federal colleagues caved in, as they should have, and returned the money, and that is a good thing for Victorian hospitals.

To get back to the number of hospitals mentioned, I am not quite sure why those particular health services, along with their CEOs, have been highlighted in the motion. I think they go to the point, however, that I have already reiterated. We are redeveloping and looking at the Bendigo Hospital, with a $630 million development that will cater for the northern parts of Victoria and will cater for patients in a 21st century manner. It will provide contemporary health-care services to that region, and it is going to be a very exciting health facility when it is completed.

On numerous occasions, for instance in relation to yesterday's budget, I hear opposition members saying, 'You know, these projects are not going to be delivered for a period of time'. Well, these things take time. They require careful planning, and when the new Bendigo Hospital is delivered, it will be a very good service. Equally we have seen some good redevelopment at Eastern Health, with a $447 million contribution to that and a good outcome in relation to the increased services that the health facility will provide. As we have mentioned, Peninsula Health has a new emergency department, and that will be a good new facility for that part of Victoria. Melbourne Health is part of the extremely exciting Victorian Comprehensive Cancer Centre project, and that centre will be the envy of other states. In the area covered by Monash Health, the state's biggest health service, we have identified a need for a children's hospital, and that is exactly what we are delivering, unlike Labor, which thought about it and did nothing.

To go back to what we are debating here and the issues at hand, I note that our government has delivered on a number of areas in health, delivering new capacity, improved health services and more money for infrastructure to cater for a growing and ageing population and increasing those bed numbers, whether they be, as I said, acute health beds, hospital-in-the-home beds, prevention and recovery care beds, subacute ambulatory care bed equivalents or even private contractor beds. We have delivered the numbers we said we would.

Mr Jennings's motion will not be supported by the government. I have outlined clearly why that is the case, and I think Mr Jennings has made some extraordinary claims about the lack of infrastructure spending and other measures. Let us not forget that the baseline and the legacy of his administration are things our government has been working very hard to fix and address while catering for the growing health needs of all Victorians.


Mr SCHEFFER (Eastern Victoria) -- This morning I will be speaking in support of Mr Jennings's motion. Only weeks away from election day, on 11 November 2010 the then opposition leader, Ted Baillieu, the member for Hawthorn in the Assembly, committed the coalition to bring online an extra 800 hospital beds under a coalition government. This was reported, and one instance of that report was at 5.15 p.m. that day. Reporting on 20 April last year, the Australian newspaper also conceded the fact that despite the coalition's promise to deliver 800 beds in its first term and 300 by the end of the 2012-13 year, by April 2013 there were in fact fewer beds. On 29 April this year the Age also reported that the coalition committed to delivering 300 beds in its first two budgets and that the number of beds that had been delivered by that time in public hospitals in Victoria was flatlining. This is not, therefore, the Labor Party making things up; these are widely known and undisputed facts that even the Australian and the Herald Sun have reported.

It is also a fact, as Mr Jennings stated in his motion, that on 30 April, nearly four years after the 800-bed commitment was made, the Australian Institute of Health and Welfare data showed that only 43 new hospital beds had been added to Victorian hospitals since the government was elected.

This much is clear, but what is not clear is how this monumental failure has come about and why the Minister for Health has spent so much time ducking and weaving in the Parliament to avoid explaining to the people of Victoria how these policy and program failures were allowed to happen.

Despite Mr Jennings's albeit ironic encouragement of government members to endorse the referral of this important matter to the Legal and Social Issues References Committee, I do not fancy that the government will agree to it, and Ms Crozier's remarks in her contribution clearly indicated that the government has conformed to our expectation that it will not support any such reference. The reason for that is we are only a few months away from an extremely testing election and the government, notwithstanding the avalanche of commitments we have heard outlined in relation to its latest budget, is still struggling to earn back the goodwill it has squandered over its three and half years in office. The government is hoping for a boost out of yesterday's budget, and on day two this avalanche of infrastructure announcements is already beginning to buckle under scrutiny.

We have heard that health in general and hospital beds in particular will be faced with further cuts to public investment.

It is clearly the right thing to do to provide the Legal and Social Issues References Committee with a reference to investigate the matters Mr Jennings has brought before the Parliament. Voters have a right, especially so close to an election, to see how and why it is has come about that a key health commitment of the coalition has barely been commenced.

A more important reason why it is necessary for the Legal and Social Issues References Committee to investigate this matter is that the minister himself has now effectively said that the Australian Institute of Health and Welfare (AIHW) got it wrong -- he said that it is not 43 beds that have been added since 2010 but 520. In his contribution Mr Jennings pointed out that this is not just another example of the minister's prevarication and his inclination to fudge reality. It is just not true -- the figure of 520 extra beds cannot be corroborated in any of the data.

Mr Jennings has caught out the minister by revealing that the 520 beds the minister referred to are a concoction of both the beds that Labor, not the coalition, delivered in the 2010-11 budget and the beds that had been allocated to the Hospital in the Home program. As Mr Jennings said, the Australian Institute of Health and Welfare clearly states that Hospital in the Home beds are counted as treatment days, not as hospital beds.

If you think that the measures used by the Australian Institute of Health and Welfare are in dispute, the minister himself said in this Parliament that the Australian Institute of Health and Welfare reports in an authoritative way. This has been mentioned in the house a number of times, and Mr Jennings reiterated it in his contribution earlier today. Everyone agrees, even the minister, that the data has integrity, and it clearly shows that the coalition government has delivered not 520 extra hospital beds out of 800 -- which by the way, would still be a failure -- but a mere 43.

By contrast, in its last year in office Labor delivered 222 additional beds, making a total of 13 254 acute beds delivered over its period in office. According to the Australian Institute of Health and Welfare data, by the end of the 2012-13 financial year there were 13 297 acute beds in the system, which means that 43 beds had been added since Labor left office. As I have said, the minister has tried to fudge the figures with his conceit that the coalition delivered those 520 beds. It is astonishing that the government and those opposite are not cringing with embarrassment about this. However, it gets worse. We also know that 27 of those 43 beds were actually provided on the basis of the 2010 national health reform agreement, which was made when Labor was in government both nationally and in Victoria. This means that the Minister for Health has delivered only 16 beds out of the promised 800.

When the 800-bed election commitment was made, would any Victorian have thought that all the while the coalition did not really mean that the hospital beds would actually be delivered? Is it any wonder that the Minister for Health has no credibility and that consequentially the coalition members who defend him have no credibility? The minister and the government must account for misleading the Victorian public. It would be a good start to provide this reference to the Legal and Social Issues Reference Committee. Mr Jennings's motion refers to the minister's failure to acknowledge in question time, on a number of occasions, the impacts on Victoria of the federal government's December 2013 midyear economic and fiscal outlook statement. Let us remember that when the federal coalition government made its first budget statement in December 2013 it put forward the view that the economy was in a very bad shape because of the performance of the federal Labor government. At the time most people accepted that while the federal Labor government faced budget challenges, the coalition's December budget statement was used as a political exercise to alarm the public and of course discredit Labor.

We are seeing a continuation of this setpiece conservative first budget strategy in last week's release of the report of the National Commission of Audit and the theatre surrounding the forthcoming release of the federal budget on 13 May. The 2013 midyear economic and fiscal outlook statement warned that wasteful spending would have to be rooted out and that pain was on its way -- the hairshirts were being prepared to chastise an extravagant and profligate electorate.

The federal Treasurer pointed out that, regrettably, much of the projected growth in spending is in -- you guessed it -- the social programs, including health.

A look at the Australian Institute of Health and Welfare website paints a much more realistic account of the situation. The institute says that health spending has increased from 7.9 per cent to 9.4 per cent over the last decade, but this is because the health system is busier owing to increased visits to the GP and increased demand for prescribed medicines, ambulance services and hospital admissions, including elective surgery, births, emergencies and alcohol and other drug-related treatments.

What is interesting is that health spending in Australia corresponds almost exactly to the rest of the countries in the Organisation for Economic Cooperation and Development (OECD). In 1999 the median rate of spending in OECD countries was 7.8 per cent of gross domestic product (GDP) and in 2009 it was 9.6 per cent, with Australia spending slightly less than the OECD average. By that measure, nothing extraordinary is going on in Australia. An interesting comparison is that the USA sits at 17.4 per cent of gross domestic product.

To return to the minister's failure to acknowledge the impacts of the midyear economic and fiscal outlook referred to in Mr Jennings's motion, we need to remember that the reason it was always going to be impossible for the Victorian coalition to deliver 800 extra beds is that it embarked on what can only be described as an ideologically driven and politically motivated austerity program. Of course the inescapable fact is that real hospital beds cost real money.

Over the four budgets delivered since the coalition government came to office, some $831 million has been taken out of Victorian hospitals. The government was never going to be able to hold to its commitment, and it did not have the guts to come out and say that it would renege on that particular promise. The fundamental contradiction in all of this is that a government cannot promise to fix the problems if it deprives itself of the resources it needs to get the work done. Problems are fixed through good investment, not through slashing and burning. It has been the same in education where the Victorian Schools Plan was trashed and $1.2 billion was pulled out of the TAFE system. Similarly we have seen this in public transport and infrastructure, notwithstanding the previously noted avalanche of promises that we saw in yesterday's budget.

Of course it has got worse with the Abbott federal government's announcement in December that it would pull some $277 million out of Victoria's hospitals over the next four years.

This has well and truly left the Victorian coalition and the Minister for Health with nowhere to go as Victoria can no longer rely on the federal administration coming good with additional hospital funding. Now we are at the mercy of a federal government that shares the same conservative austerity obsession that the Victorian government has demonstrated in its first three years. It is a zero sum game.


Mr D. R. J. O'BRIEN (Western Victoria) -- It is with great pleasure that I rise to support Ms Crozier's excellent repudiation of Mr Jennings's motion and to confirm that the Victorian government has made, and continues to make, significant contributions, in terms of capital investment as well as hospital support and reform, to the provision of hospital beds in Victoria. It is a continual surprise that the Labor opposition continue to make these claims in relation to hospitals, given the failure of the previous federal government to support Victoria's hospitals. This is at the heart of motion.

As has been put on the record numerous times by the Minister for Health, Mr David Davis, and indeed by Ms Crozier in her contribution to this debate, the Victorian government has grown hospital capacity by 520 beds since it was elected.

I thought Mr Scheffer might be prepared to speak a bit longer on this motion. As a consequence I had to race up the stairs to be in the chamber in time to take my spot to make my contribution to the debate Mr Scheffer was rather short in his support for Mr Jennings's motion. His heart was not in it because he knew he could not support such a flimsy motion, particularly as it seeks a referral to the Legal and Social Issues

References Committee which is about to receive a more important reference into community pharmacies.

The key point I seek to place on the record is that again we can see a significant and clear distinction between our government's record in office and what Labor failed to deliver at both a state and federal level. The handing down of the most recent Victorian budget for 2014-15 has confirmed a very simple distinction in the way state and federal coalition governments have conducted themselves in office in relation to financial management and their engagement in financial responsibility, prudence and the careful management of budgets to enable long-term infrastructure delivery -- which is to the tune of $27 billion in the budget.

That is a very significant infrastructure contribution, and it is reflected across all sectors of the economy, including the health sector.

It is also important to remember that, regrettably, the Victorian coalition government was somewhat hampered by the activities of its counterpart in Canberra when it was under the Gillard administration and very briefly the final death throes of the second Rudd government. What happened in the Gillard administration in relation to health from a budgetary point of view was absolutely disgraceful, because that government made a post-budget cut that it had not budgeted for or said would happen; it made this cut post budget when the then Treasurer, Wayne Swan -- and we all remember Wayne Swan -- was scrambling for a surplus. He had promised and not delivered a surplus no less than five times. Labor's commonwealth financial position went from inheriting a net asset-rich budget, whereby it had something like $70 billion in the game when it came to government in 2007, to leaving a legacy of debt that will have to be paid off for generations.

In relation to health this resulted in $107 million in cuts being imposed on Victorian hospitals by the former Gillard Labor government in December 2012. We remember the motions that the Victorian health minister put in this chamber on numerous occasions calling upon Labor Party members on the other side to support Victorian hospitals by voting against these commonwealth cuts. Those motions were opposed by the opposition, and those cuts remained in place. Nevertheless, the health minister eventually was able to persuade the then federal health minister, Tanya Plibersek, to redact some of those cuts, albeit it after they had been incurred. I recall there was a lot of concern over the impact of those cuts in relation to Colac hospital, particularly on emergency beds and other beds, while Mr Cheeseman, the then member for the federal seat of Corangamite, sought to blame the need for these cuts on the high Australian dollar.

Returning to what the Victorian government has had to do -- notwithstanding the interference and irresponsible fiscal management of the Gillard federal government -- it has provided a more than 500-bed equivalence since the 2009-10 baseline. This has also occurred in the context of a Gillard government that broke another promise. I am not sure if you are aware of this promise, Acting President, but it promised it would not bring in a carbon tax. I see the Acting President is reminded of that broken promise. That broken promise had another very significant impact on hospitals and health budgets, and the scary thing about this broken promise is that vis-a-vis the Labor Party it remains broken. It remains broken in that the Labor Party does not support the repeal of the carbon tax. Members opposite could be on the phones right now -- and one would think by some of their absences from the chamber they are on the phones right now -- seeking the repeal of that carbon tax they promised would not be introduced under a government that Ms Gillard led.

Mr Leane -- That is what Mr Davis is doing.

Mr D. R. J. O'BRIEN -- I hope Mr Davis is trying to do that, because he works very hard to deliver for Victorian hospitals. One can see this with the Victorian budget, and this builds on previous budgets that have delivered $90 million of capital investments into Barwon Health and similar investments into Ballarat Health Services, including a helipad that I know Mr Koch lobbied for and worked with the community extensively in a committee to achieve. As anyone who has dealt with rural health and rural life-saving situations would know, the role of helipads and helicopter life-saving services is critical. I recall the campaign led by the member for South-West Coast, the now Premier, the Honourable Dr Denis Napthine, which for many years pursued and eventually obtained a south-western Victoria helicopter.

However, with its next budget the commonwealth government has got to deal with the legacy of the previous federal government, and we are still dealing with our legacy from the previous state Labor government.

Nevertheless, we have invested in builds of more than $4.5 billion in existing health projects that are under way in Victoria -- for example, we will invest $73 million in this budget in a new redevelopment of Latrobe Regional Hospital and $28 million to build Barwon Health North in Geelong's northern suburbs. This is another fantastic initiative championed by Western Victoria Region MPs, including Mr Koch, Mr Ramsay and me, and by the member for South Barwon in the other place, Mr Katos. The coalition government is also investing in a major redevelopment of the Boort hospital and in major works at Moyne

Health Services in Port Fairy. Further, the coalition government's capital funding for the expansion and redevelopment of hospitals will cater not only for Victorians in this generation but for Victorians into the long term.

Some of these projects include the build of one of the biggest regional hospitals in Australia, the $630 million Bendigo Hospital. Mr Drum is not in the chamber yet, but I believe it is the case that one of the members for the Bendigo region from the Labor Party is still calling for a smaller hospital for Bendigo. You would be surprised that someone would do that, but that is what they seek. There is also the $1 billion Victorian Comprehensive Cancer Centre project; $46.4 million for the expansion of the Ballarat hospital with the David Koch-led helipad; and $65.6 million for the Echuca hospital redevelopment, championed for a long time by many members for Rodney, including the one with the loudest voice in the Parliament, Mr Paul Weller, who has championed that cause amongst others in the northern region for a long time.

Mr Ramsay interjected.

Mr D. R. J. O'BRIEN -- He is still working on that bridge, and I can hear him from here calling for that, but that would probably not be relevant to this motion. What is relevant is there has been $10 million delivered for the Castlemaine hospital and there is funding for the redevelopment of the Victorian Eye and Ear Hospital and hospital developments in Mildura, Swan Hill, Kerang, Charlton, Numurkah, Geelong and Kilmore. I commend members from all those areas for their advocacy and this government for responding and delivering. There is also $40 million to expand and reconfigure the Frankston Hospital emergency department, and there is funding for the new paediatric facility at Monash Children's hospital and for investment in new world-class research at the Peter Doherty Institute. Also in relation to regional Victoria in particular there will be $3 million for a major redevelopment of the community health facilities at Moyne Health Services, including a new community health building.

In relation to the south-west, I had the privilege and honour along with Mr Ramsay of witnessing the final community contribution to Peter's Project on Thursday of last week. The member for South-West Coast, the Premier, who had been on the advisory committee together with many other active community members, has delivered a significant project for that community. The project was completed as a result of the community raising in a very short time, and ahead of time, the $5 million for its contribution, but also the significant contributions of the state government and federal government through the federal member for Wannon, Dan Tehan. It is a fantastic facility that will service people not only in Warrnambool but many other people in western Victoria.

I am personally aware of the battle of one of the longstanding friends of our family, our shearer, who shore until he was nearly 68 but who unfortunately got cancer.

He found that the treatments in Geelong were too far for him to travel to and effectively elected to see out his days in a lot of pain rather than receive the treatment that he could have received. His name was Paddy Trigger. I and many other people in the south-west are familiar with people who would have benefited from the radiotherapy services that have now been delivered by this government and by this member for South-West Coast, this Premier, with the support of this health minister, to ensure that Victorians get a better deal for health than they will ever get under the fiscal irresponsibility and hypocrisy of successive Labor governments.

What we see with this motion is another attempt by the shadow minister -- --

Honourable members interjecting.

Mr D. R. J. O'BRIEN -- Yes, they must try whatever they can to muddy the waters. It is a very difficult exercise, counting beds, as was recognised by the Australian Medical Association when it effectively noted the change in the way hospital beds have been counted. I think all members of this chamber will have witnessed the frequent exchanges on this issue that have occurred from time to time between the health minister and the shadow health minister. What is absolutely clear is this government's commitment to responsible financial economic management. There were the Cain-Kirner and the Bracks-Brumby governments, which never delivered the expenditure within what was budgeted for, and then there was the disgrace of the Rudd and Gillard governments.

There is one truth, which is that Labor cannot manage money, and if you cannot manage money, you cannot manage health.

Labor members talk about health cuts and other things that are actually not occurring, but even if there is financial responsibility, it is always the case that coalition governments have to come in and clean up the mess that Labor has left this state in. That is something that the Victorian community ought to be reminded about when they contemplate what to do in November, because if this record $27 billion commitment is to be carried out without mismanagement -- --

The PRESIDENT -- Order! I thank Mr O'Brien. It was the longest 2 minutes in history. He has rewritten Greenwich Mean Time.

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