Hospital Waiting Lists (06.03.2013)
Written on the 12 March 2013Ms CROZIER (Southern Metropolitan) -- I am pleased to rise to speak to the debate on Mr Jennings motion, which he brought to the chamber earlier this morning. The motion states:
That this house notes --
(1) that when the Baillieu government came to office the waiting list for elective surgery was 38 897;
(2) with dismay, on behalf of Victorian patients, that for the last five quarters in a row, elective surgery waiting lists have been on each successive occasion the highest ever recorded in Victoria with the most recent list showing the number of patients waiting is now at an appalling and unacceptable record high of 47 760;
That brings me to my opening point, which concerns what the coalition did when it came to government in 2010. Health services in this state were left in an absolute shemozzle by the former Minister for Health, the now Leader of the Opposition, Mr Andrews.
I remind the chamber that when we came to government, we found that there was an unfunded completion cost of $44 million for the Olivia Newton-John Cancer and Wellness Centre, which was an extraordinary oversight. I do not know whether this was poor planning, but it illustrates the former Labor government's legacy of the mismanagement of projects.
A fit-out for essential information and communications technology services at the Royal Children's Hospital which cost $25 million were unfunded. IT services were not included in the forward planning for a new hospital costing $1 billion. That was either an extraordinary oversight or mismanagement. As Victorians we are all very proud of the new hospital, and it does an extraordinary job in servicing the needs of Victorian children and those from interstate. However, it is unbelievable that there was no IT component in funding for the hospital.
As we know, there were significant black holes in other government portfolios such as transport. There was HealthSMART in health, there was the myki ticketing fiasco and there were significant blow-outs on projects right across the board.
This government has worked extremely hard to put Victoria back on a sustainable footing to meet commitments such as funding significant infrastructure for the Olivia Newton-John Cancer and Wellness Centre and putting IT systems into our brand-new Royal Children's Hospital.
I also want to refer to other issues that were more well known in the lead-up to the 2010 election. This concerns statistics, so it goes to the heart of Mr Jennings's motion. In the Auditor-General's Access to Public Hospitals -- Measuring Performance report, handed down in 2009, there was an extraordinary finding in relation to data manipulation. The report confirmed that data manipulation occurred. The foreword of the report states that:
... much more worrying were instances of admitted data manipulation to meet indicator targets. This is highly improper ...
On page 5 it states:
These conditions have opened the way for inappropriate practices such as data manipulation, which undermine the integrity of hospital performance monitoring.
In the conclusion, on page 51 it states:
Our conclusion is that data manipulation did occur at this hospital, based not only on the hospital's admission of retrospective changes of data by a few minutes in order to meet the indicator, but also on the results of the medical record audit.
Mr Jennings talks about what this government is doing in relation to statistics and what it has to deal with, but the former government does not have a record to boast about. Unfunded projects and the cover-up and manipulation of data are damning findings. As soon as we came to government we looked at these issues and addressed them. One of the first things the minister did was to create a health services plan. He consulted with people within the health industry, including stakeholders and those at the coalface such as practitioners and clinicians, those in the public health sector and those in community health. The health services plan, whether it concerns the needs of Melburnians or those in regional Victoria, sets out a comprehensive and clear plan to address this state's many needs, which includes new capital programs. I will run through some of those in a minute.
With all due respect, I have to say to Mr Jennings that I am not sure he understands the complexities of how large health services operate and the extraordinary challenges they face not only on a daily or hourly basis but almost on a minute-by-minute basis in many instances in some of these larger institutions. Those challenges are at times critical and very complex. However, I have to give Mr Jennings some credit, because I think he has much more of an understanding of Victorian health services than his federal counterparts, the Prime Minister, Julia Gillard, the federal Minister for Health, Tanya Plibersek, and the Treasurer, Wayne Swan, who, in his appalling and disgraceful manipulation of population data, showed what he truly thought of Victoria and Victorian patients.
Mr Lenders interjected.
This motion talks about elective surgery waiting lists, and it goes to the heart of that issue. Elective surgery waiting lists have been impacted significantly by the federal Labor cuts. It is extraordinary to think that a government could cut a budget after it had been agreed to and signed off on.
Hospitals work within those budget frameworks, and to have the federal government cut that funding midway through its budget is an extraordinary approach to take, and it is one we have seen with the recent announcement of a restoration of about $107 million to Victorian health services, although in a punitive manner, I have to say -- --
Mr Lenders interjected.
Ms CROZIER -- It has been done in a very punitive manner. Mr Lenders knows that the letter the Prime Minister wrote to the Premier in which she talked about the Premier was disingenuous. I do not think she has very much credibility at all in relation to this issue. She and Minister Plibersek have been absolutely shown up. I want to congratulate our Minister for Health for taking the fight up to the Prime Minister and the federal Minister for Health and for arguing for that to be restored -- --
Ms CROZIER -- It is a massive backflip.
Mr Drum -- No help from state Labor members.
Ms CROZIER -- Mr Drum is absolutely right. Those opposite did not argue the case for Victorian patients. They sat there silently. One would have to assume that they supported their federal counterparts in ripping $107 million out of Victorian health services. Victorian Labor members should be condemned for their lack of action in that they did not contact their federal counterparts. It is a disgrace.
While I am on that, I refer to those disingenuous advertisements the federal government wasted taxpayers money on in the weekend papers some weeks ago, and I believe that that advertising is rolling on. That money should have been directed to health services rather than to a blatant campaign that is absolutely untrue. If we are talking about disingenuity, that is a very disingenuous advertising campaign. The federal government is pretty good at wasting money; we have seen what it has done. It has wasted money on pink batts, school halls -- you name it. It loves spending money. It does not know how to save; it has absolutely no idea. It is wasteful in management and wasteful in money matters. Australians and Victorians alike know what the federal government is doing -- --
The ACTING PRESIDENT (Mr Ramsay) -- Order! I ask Mr Lenders to refrain from interjecting and allow Ms Crozier to finish her contribution before lunch.
Ms Hartland interjected.
Ms CROZIER -- I did not hear Ms Hartland's interjection, but I do not think it was favourable.
I will return to the matter. The federal government has been absolutely shown up by its actions. Victorian patients, but more importantly Victorian health services, know what they have done. As I said, budgets had been set. Those health services were working towards those budgets and managing their services, and as anyone who has worked in health services -- --
Mr Lenders -- Your heart is not in this.
Ms CROZIER -- I say to Mr Lenders that my heart is in this, because I have worked directly in health services, and I absolutely understand the difficulties they face on a daily basis.
Sitting suspended 1.00 p.m. until 2.02 p.m.
Ms CROZIER -- I am pleased to be able to return to this very important motion of Mr Jennings.
Mr O'Brien -- As are we.
Ms CROZIER -- Thank you, Mr O'Brien. Before the lunch break I was speaking of the significant legacy left by Labor that we are continuing to deal with.
When we came to office we had to deal not only with those issues but also with the huge $6.1 billion of GST revenue that was ripped out from beneath us by the federal government. We also have a carbon tax; unfortunately Mr Finn is not here, but I am sure he would have something to say about that. Those costs go to the bottom line and affect the running of health services and hospitals, and that goes to the heart of Mr Jennings motion regarding waiting lists and elective surgery. I will return to that in a minute.
Whether it is because of the impost of a carbon tax, the GST revenue being ripped out of the state or, as we saw last November, the reduction of $107 million to Victorian health services, those costs have an enormous impact.
Certainly those clinicians, as well as the staff in the administrative arms of those health services, fully understand what the federal government did. The ads the federal government tried to put in place and the backflips did not cut it, because people knew that the federal Treasurer, Wayne Swan, needed to fix his black hole. The federal government is very good at creating black holes. It wasted an enormous amount of money through various programs and the federal Treasurer needed to find that money. Taking $107 million directly out of Victoria health services was absolutely disgraceful, but I think he has been shown up for the standards that he adopts, along with his colleague Ms Plibersek, the federal Minister for Health.
It is absolutely clear that the state Minister for Health, David Davis, has led the way in fighting for Victorian patients, and many other states have followed his lead and come on board. I know that there was agreement among state ministers that they felt these cuts were extremely unnecessary, and that includes two Labor ministers as well.
Those opposite talk about the Victorian coalition government taking $616 million from health services. There is no doubt that was undertaken, and Mr Davis has been up-front about looking at the readjustment of finances in relation to health, but we must remember that this was done in relation to reducing waste. During the last sitting week I spoke about aspects of Health Purchasing Victoria, which has become more efficient. This government has made headway in improving efficiencies, getting money back into front-line services and supporting clinicians to enable Victorian patients to be treated.
As I said, health is an extremely complex and challenging area -- there is no doubt about that -- but it needs to have some certainty and surety in terms of budgets, and to have money ripped out halfway through a budget cycle is extraordinary to say the least.
I want to make another point in relation to Mr Jennings's motion and to reassure the chamber and any people listening -- I am pleased to see some members of opposition here; after all, it is their motion -- that the Victorian coalition government has increased health funding by $1.3 billion since coming to office to a record $13.7 billion -- --
Ms Mikakos interjected.
Ms CROZIER -- Ms Mikakos, the former member for Lyndhurst in the Assembly pulled the plug a few weeks ago, as you know, so why did he go? You have caused a number of by-elections right across the -- --
The DEPUTY PRESIDENT -- Order! I ask members to reduce the interjections, and I ask the member to stay on the topic.
There is no doubt that state budget funding for hospitals has increased since the coalition government was elected. We are putting more into hospital services and taking note that this state had an increase in population in the period between the former government being elected in 1999 and our coming to office. The preposterous assumption that our population had decreased, as was asserted by the federal Treasurer, Wayne Swan, is just extraordinary.
We have taken note that our population is increasing, and we are working towards managing that in terms of planning in all sorts of areas, of which health is just one area.
There has been significant spending on infrastructure to cope with this population increase. The coalition government is looking at addressing shortfalls in the areas of education and transport. Very little was done by the former government to address an increasing Victorian population which requires services. For those opposite to come in here making demands and saying that this or that has not been done is extraordinary considering the legacy they left us, including a lack of planning, and more to the point, a lack of detail in much of that planning. Victorians should be reminded of these challenges, because they are the ones we faced when we came to government.
Anyone who knows about or who has worked in emergency departments will understand how busy those departments can be. Very often there might also be a lot of minor cases. For example, there could be significant activity on weekend nights due to more car accidents or incidents of alcohol-fuelled violence, or any of those issues that we think as a collective we want to address and reduce in number. However, there are peaks and troughs in emergency departments, and they often find themselves in fluid situations, such as when they deal with critical incidents, minor situations, triaging and sorting matters out when patients present in various areas. Emergency departments are extraordinarily busy areas, and obviously there will be increased demands made of these emergency departments because of an increase in population. Naturally an increase in population is going to mean an increase in activity. I find some of the federal regulations extraordinary, particularly the 4-hour rule -- that is, that patients must be admitted to the hospital or referred within 4 hours of arrival at an emergency department so hospitals can churn people through and out.
Mr O'Brien -- Wayne Swan said the population is decreasing.
Ms CROZIER -- Poor Mr Swan. His figures are pretty questionable at times, and his figures showing a population decrease were an extraordinary presumption.
As I said, the population of Victoria has been increasing for years. The subject of the manipulation of federal funding to Victorian health services using false data reminds me that before lunch I was talking about the manipulation of data under the former state government in 2009 when the then Auditor-General handed down a report on public hospitals. That report showed the manipulation of data by the former government and exactly what members of that government had done. This just goes to show that a leopard does not change its spots, because that is what is happening at a federal level now -- the manipulation of data. Trying to argue that Victoria's population had decreased was just ridiculous.
To return to my point about the national partnership agreement component and the federal Labor government discontinuing a key component of that, at the time that was done the Victorian coalition government warned that the national partnership agreement cut would create a shortfall of over 7000 elective surgeries in Victoria alone. There is no doubt that that is a significant figure. When we think of those 7000 people on waiting lists, we realise it is a significant figure. Patients may be waiting for minor surgery but very often it is major in their eyes. Although it may not have been categorised as major surgery, for many patients their surgery is major. Having some 7000 people on waiting lists is a significant number and we have to face up to and deal with it, and I think the minister is addressing that.
The federal health cuts have impacted on elective surgery waiting lists; there is no doubt about that.
Mr O'Brien -- She does not understand the impact of the carbon tax.
Ms CROZIER -- No. She does not understand the impact of the carbon tax, because the carbon tax goes to costs, including ongoing costs to the bottom line of a hospital's management. Whether it is surgery, doing the laundry, cleaning or running electricity to keep a department open, all services in a hospital use power. Hospitals are enormous consumers of power, and a carbon tax goes straight to the bottom line and increases costs. In my electorate of Southern Metropolitan Region the Alfred hospital will have hundreds of thousands of dollars of carbon tax impost to find, which will directly impact upon services that -- --
Mr Leane interjected.
Ms CROZIER -- Mr Leane, it will affect your area in Box Hill.
The DEPUTY PRESIDENT -- Order! The member, without assistance.
All hospitals have peak times, which can be very busy times, certainly in the winter months; that is well known. There are peaks and troughs that trend throughout a hospital's year.
When I was a manager in one of Melbourne's larger hospitals we used to cater for that. We used to look at what the staffing needs were for those busy times, and we would reduce staffing at less busy times. It was a perfectly practical and common-sense approach to take, but when you have imposts like a carbon tax or you have had money cut out of your budget midway you cannot plan for those things. I imagine that that would be of enormous frustration to those administrators; in fact I know it has been because I still know many people who work in the area and they have told me so. They have said that the demands are greater and it is very difficult. I have to say that I think the demands of the health services are now probably far greater than when I first worked in them in the early 1980s. I know that is some time ago; in fact it is almost 30 years to the day that I first started at the Alfred hospital. I was there just before Ash Wednesday, so I remember that very clearly, and I remember the demands.
Mr O'Brien interjected.
Ms CROZIER -- In earlier debates we had been recalling the effects of Black Saturday, the recent bushfires. When Ash Wednesday occurred I was at the coalface at the Alfred hospital, and I remember clearly those very difficult times for everyone concerned, no more so than those directly affected -- those patients who were flown in or brought by ambulance from country Victoria. As we all know, it was a tragic day, as were the more recent bushfire events. That highlighted to me the importance of our health services. I am very proud to have been working in the industry for as long as I did. It was extraordinary, and it is probably not too different from what we are all trying to achieve here.
That takes me back to my point that we need to be administering taxpayer funds on behalf of all Victorians and that we have to monitor budgets so that health services, which work on behalf of all Victorians, can also achieve what they need to do. What the federal government has done is an extraordinary act. Hospitals, as we know, are under enormous pressure, as I have highlighted. They are working very hard and are unable to cope with such a large reduction in the national partnership agreement funding. As I have said, that is certainly having an impact on elective surgery waiting lists and activity, but despite those pressures hospitals are doing an extraordinary job. All the clinicians working in our health services should be commended and acknowledged for the work they do, and I am very much cognisant of that.
I come back to the point about the aspect Mr Jennings mentioned. He raised a number of things.
This will reverse cuts made by the Victorian government.
That is simply not true. The Victorian government did not cut $107 million from Victorian hospital funding; it was the federal government.
The second point says:... patients will benefit directly from the commonwealth's investment which will see funding grow from $3.6 billion in 2012-13 to $4.5 billion in 2015-16. That's an increase of $900 million.
That advertisement, run by the federal Labor government, was an absolute abuse of taxpayers money, and all Victorians should be appalled at Labor for wasting that money on trying to justify its cuts. To say that we are running a 'mischievous' campaign is extraordinary.
Mr Leane -- You are. Of course you are.
Ms CROZIER -- Mr Leane and Labor members at a federal level have run an outrageous campaign.
Ms CROZIER -- The $616 million has gone from wasted projects, which Labor is very good at doing. Do I have to go through them again? We found black holes. There were wasted projects. We are putting efficiencies back into the health services.
Mr Leane interjected.
The DEPUTY PRESIDENT -- Order! There are constant interjections. This is not a conversation. Ms Crozier has the call. I am tolerant of quick interjections but not a constant set of sentences that would not really form an interjection.
Ms CROZIER -- As I was saying, Mr Jennings made reference to that campaign, and I was just highlighting the campaign that was run at a federal level. Mr Jennings also talked about the statement of priorities with Southern Health. I think he said there was a deteriorating situation with targets and the amount of funding going to that particular health service. The Minister for Health has made it very clear that this year's statement of priorities for individual hospitals did not include $9 million in additional contestable surgery funding this year. Under this initiative more than 2000 additional elective surgeries will take place.
What hospitals need is secure and predictable funding. They do not need decisions made on a whim because black holes need to be plugged. They do not need the opposition's federal counterparts making ridiculous assertions such as those that have been made by the federal Minister for Health, Tanya Plibersek.
I return to some of the points that have been raised by the Victorian Minister for Health in recent days. I refer to a media release from him last Friday, 1 March, which speaks of the federal funding cuts that have hit elective surgery waiting lists at the Alfred hospital. Mr Davis said:
... the performance report shows strong performances by the Alfred hospital in a number of key areas.
Mr O'Brien interjected.
Ms CROZIER -- Mr Koch has been lobbying for that for a long time, as has Mr O'Brien, in relation to their constituents in Western Victoria Region. I come from far western Victoria, and I know how long it takes to get to Melbourne. This is an enormous service for people who may find themselves in the unfortunate predicament of being in a serious accident.
To get back to the performance report in relation to emergency patients, I highlight to the chamber that in this media release Mr Davis also said that:
... even though more people are now waiting for elective surgery, the latest performance report shows that the most urgent category 1 patients all still received their treatment within 30 days, and hospitals were able to maintain an 11-day turnaround as the median time to treatment.
Victoria remains the only state to meet the target for 100 per cent of category 1 elective surgery patients, those who are most urgently in need of surgery.
The Alfred was on bypass for 1.6 per cent of the time in the three months to the end of December, well below the state benchmark of 3 per cent and an improvement on the 1.7 per cent bypass rate in the previous three months. In the three months to the end of December the Alfred treated 100 per cent of category 1 patients immediately on their arrival at the emergency department and it treated 76 per cent of semi-urgent category 4 patients within an hour of their arrival at the emergency department. There are other very good statistics that the Alfred should be very pleased with. It saw 5143 patients arrive by ambulance at its busy emergency department, up from 5082 attendances in the previous quarter.
It can be seen that an enormous amount of activity occurs at that health service, which caters for many Victorians in metropolitan Melbourne as well as many patients from regional Victoria and interstate. I know the Alfred has specialist services which cater for the health needs of patients from Tasmania and South Australia.
Hon. M. P. Pakula interjected.
Ms CROZIER -- As Mr Pakula lives on that side of town, he might need to access the Monash Medical Centre. If he were to be elected as the member for Lyndhurst in the Assembly, it would possibly be even closer for him. He will get to understand that very effective health service, should the need arise. I sincerely hope it does not happen, but his children might need the services of the Monash Children's hospital.
Mr Tarlamis interjected.
Ms CROZIER -- I know that members on both sides of this chamber will be very glad to see the continuation of the services provided by the Monash Medical Centre -- and the children's hospital, which will be built as has been announced -- which assist people in the southern areas of Melbourne. However, I point out that the commonwealth health-care funding cuts would have had an impact of $13.7 million on that health service alone. That is an extraordinary amount of money to be cut, and it would have directly affected services. That amount of money would pay for a lot of operations and a lot of beds -- some might even have not been fully occupied; it is a lot of nurses, doctors and other administrative hours that could have been paid for without that impost. That goes to the heart of what we are talking about today.
Mr Jennings motion refers to elective surgery waiting lists.
Minister Davis should be commended for the work he has undertaken in this area. He has argued very effectively on behalf of Victorian patients; he has led the charge in that respect. Other states have looked to the minister's leadership on this issue and seen the money restored to Victoria, and as a result of this I am sure they also want the money cut from their budgets restored.
Mr O'Brien -- So far they have some of the money; the feds have to give the rest back.
Ms CROZIER -- They do need to give the rest back -- $368 million needs to be restored. That is an enormous amount over the next three years. As I said, this $107 million only takes us to 30 June. On 1 July $368 million in cuts will kick in. The administrators within those health services know the direct impact these cuts will have.
In conclusion, I believe that Minister Davis has argued very effectively to have the $107 million of funding restored, but the government is still arguing for a further $368 million to be restored. We urge those opposite to go to their federal counterparts and argue for Victorian patients. We will not be supporting Mr Jennings's motion. It is a nonsense, as I have highlighted. I reiterate that he should go to his federal counterpart and argue for Victoria's fair share.