Hospitals: Government Performance

Written on the 24 October 2012

I am pleased to be able to rise and speak this morning on Mr Jennings's long-winded motion. It is, I would have to say, quite extraordinary in its detail, and there are certain elements in it that I am looking forward to addressing, because I sat through his contribution which lasted for some time. While there was lots of talk about figures and things, he failed to address some of the facts that this government inherited.


Mr Jennings spoke at length about the fact that we talk about the inheritance from the former Labor government even after being in government for almost two years. However, the Victorian public knows that he did, and still does, refer to the Kennett government years for the entire 11 years of Labor government, which still amazes me. I am glad that his federal colleagues have taken up some of the health reforms of the Kennett government in the 1990s in relation to casemix funding. Those reforms were entirely necessary at the time given the poor state the health system was in when the Kennett government came into power.


Let us get back to Mr Jennings's motion. I will just address the first point of his motion, which talks about disastrous impacts inflicted on the Victorian hospital system, and I say to him that I think in recent days, with the commonwealth decisions, they certainly are disastrous impacts for the Victorian hospital system. However, some of these claims that Mr Jennings has put to the house through his motion are completely unfounded and not true, I would have to say. I will come back to that in a moment.


Just to get on the record some facts in relation to some of the figures Mr Jennings was tossing around, there has been an increase in health spending to $13.7 million in 2012-13, which is a record 4.7 per cent increase. The cuts announced on Monday by the federal government will have a huge impact on front-line and other health services that members of the opposition talk about continually. There is no question that they go to the heart of the delivery of health care in this state.


Members must remember the position that the government inherited. Mr Jennings talked about various capital projects that were undertaken. I have to remind him that there are many terrific world-class health facilities in this state. I am well aware of that, having worked in a number of them from a clinical perspective. As someone who understands the complexities of the clinical setting and the changing dynamics of acute and chronic health settings, I suggest that the challenges posed by those two issues are huge. There is also no doubt that the state is facing challenges of one form or another. The commonwealth government's decisions on its cuts to the health spend should not go unmentioned. As Mr Davis said just recently, cuts by the federal government have resulted in federal funding for public hospitals falling from 44 per cent in 2008-09 to 39.1 per cent. They are pretty alarming figures in relation to what is happening, given the population growth in this state. That was not acknowledged at all by Mr Jennings.


A number of other things have affected the government's operating budget, including the cut in GST revenue, which I think is well known by members of the Victorian public.


They know Victoria has been hit extensively by a $6.1 billion cut in GST revenue. Mr Jennings might be shaking his head, having thrown around facts and figures -- --


Mr Jennings -- That is not true.


Ms CROZIER -- They are the facts. The federal government has cut $6.1 billion from GST revenue for the state of Victoria, despite the fact that we have an increasing population and an increasing challenge in our hospital system. I will go back to some of the aspects of what actually happened, which Mr Jennings failed to address or ignored in his contribution.


Mr Jennings -- You can't actually lie about things, can you?


Ms CROZIER -- Mr Jennings, I will just go back to some of those facts and figures, because you did talk about data in relation to what is actually happening. I remind you that there was an enormous amount of hidden data -- --


Mr Jennings interjected.


Ms CROZIER -- The data that was hidden under the administration of Mr Jennings is quite breathtaking. There are numerous press releases and media articles on that. One article, of March 2009, is headed 'Hospital lied over waiting lists' and has the subheading 'Minister forced into backflip over funding'. Another article, headed 'Hospital waiting lists scandal grows', states:


More Victorian hospitals have been dragged into the waiting list rorts scandal, after government records revealed suspicious anomalies across many health services and a whistleblower described how the Austin Hospital was allegedly falsifying data.


Another article is headed 'Hospital audits tipped amid claims of waiting list fraud'. Yet another is headed 'Health boss has to go' and states:


The bandaid approach to our hospital system is simply not good enough. Patients are suffering while Daniel Andrews dithers.


Yet another article is headed 'Scandal nets second hospital' and states:


As revealed in the Australian yesterday, health minister Daniel Andrews has been forced to commission a system-wide audit of hospital figures after the Auditor-General found waiting lists and emergency ward performance date in Victoria was dodgy.


If Mr Jennings is talking about data, what happened under his regime and what in contrast is happening under the current administration, those articles show what the coalition government inherited. It was an absolute mess. What happened in our hospitals was an absolute disgrace. As I said, as somebody who understands the clinical aspect of how hospitals work, I can say these are damning accounts of what happened under the regime of the then Minister for Health, who is now the Leader of the Opposition. There has been a vast improvement in data statistics. A whole range of measures have been put in place by this government to fix up the mess that it inherited.


Mr Jennings also spoke of ambulance waiting times. He acknowledged his unfortunate episode when he suffered a heart attack, I think he said, which is obviously very concerning. However, not to dwell on his unfortunate situation, I have to point out that in 1999 then Premier Steve Bracks said Labor would ensure that ambulances responded to code 1


emergencies within 10 minutes. In 2002, after failing dismally, the Bracks government set 13-minute code 1 response times. That did not work either, and by 2007 the then Minister for Health, Bronwyn Pike, had to concede, as she realised she had failed again, and she quietly relaxed code 1 responses to 15 minutes. Poor thing; I can see that myki ticketing system falling on her toe.


Mrs Petrovich interjected.


Ms CROZIER -- That was Lynne Kosky, was it? I get them confused. Are they still both here?


Mrs Petrovich interjected.


Ms CROZIER -- Yes, they have all gone.


Mr O'Brien interjected.


Ms CROZIER -- Daniel Andrews has not gone, and he still dithers.


To get back to the point, Bronwyn Pike, the then failed Minister for Health, then had to concede that ambulance response times had to blow out to 15 minutes, so ambulance response times were not glowing under Mr Jennings's regime. On a serious note, that was another issue that the government had to look into and address. Nobody denies that there are exceptional challenges in our health system, and I think Mr Jennings acknowledges that.


Mr Jennings also makes mention of private health in the last point in his motion, which states that the house:


expresses support for the statewide provision of public health services staying in public hands and opposes the attempts of the Baillieu government to privatise the hospital system by stealth.


We all know Mr Jennings does not agree with private health insurance. What has happened at the federal level is absolutely disgraceful for the hundreds of thousands of people who pay their own way through private health insurance. Putting more pressure on those people will only put more pressure on our public health system. It is absolutely disgraceful that he has not argued the case for Victorians by supporting a robust private health system to enable people to have choice and use the private health system if they want to do so.


We know that as people are ageing and the incidence of chronic disease is increasing there are complexities in relation to health outcomes and patients will be seeking more complex health treatments.


We are very fortunate in this country to have an exceptional health system that enables people to treat many complex diseases. We have that growing pressure. There is no question that there are increased expectations, and so there should be in a society such as ours that can address those issues. That is another area that creates additional challenges for our health system.


One final point which I have raised in this house before and have to raise again is the effect of the carbon tax on our health system. As has been pointed out time and time again, the carbon tax, which is set to start at around $13 million and increase to $19 million by 2020, is an enormous impost on our health system. That equates to being able to treat fewer patients and train fewer doctors and nurses. Ms Hartland brought up the issue of maternity services and spoke of midwives being trained. I remind her that there has been a damning report on maternity health services under the previous Labor government.


I am pleased that the Minister for Health is addressing many of those concerns and taking up a lot of the recommendations in that report, including supporting additional postgraduate scholarships for midwives and encouraging them to take them up in rural settings.


I know that Ms Hartland was referring to her region, which covers the western suburbs, but areas in regional Victoria where patients need to travel long distances to get to hospitals and health practitioners should not be neglected. This government has introduced many initiatives which recognise health services in rural and regional Victoria. The Minister for Health should be congratulated on his advocacy for these people who were neglected under the previous regime.


I also refer to Mr Jennings's comments about savings. A lot of figures were floating around, but I remind him that a question was asked of the minister just over 12 months ago about secret or undeclared savings in the health portfolio.


I quote from Mr Davis's answer at the time:


The Labor Party, under the then Minister for Health, Daniel Andrews, instituted savings of a very significant order but did not declare those savings. In this financial year $283.4 million of savings were ordered by Labor, and they are embedded in our system.


That is what we inherited. Mr Davis continued:


It was $336.4 million in the 2012-13 budget year, $336.4 million in the 2013-14 budget year, and $336.4 million in the 2014-15 budget year.


These are savings that have never been declared fully to the Victorian community, savings that were not declared as being applied to the health portfolio, savings that will have some impact on the health portfolio.


... These are savings in the portfolio that were not declared openly or honestly, savings that in the period I have outlined


add up to $1292 million. These are significant savings that Labor applied and that were put into the budget we inherited. These are significant savings that are a challenge in the portfolio of health, and I have to say that honesty is an important point here. The previous government refused to declare the savings it had applied in the portfolio.


Talk about fudge, hide and be tricky! That is a true illustration of the former government's practice of not declaring figures. I have talked about that data. These are significant figures from the health portfolio that were never declared by the previous government. It is absolutely shameful that this practice applied under the former Labor government.


Much has been done for front-line services by the Victorian coalition government. However, what the federal government has done in propping up its health bureaucracy is astounding.


In relation to the national institutional framework, the federal government has created 10 organisations: the Independent Hospital Pricing Authority, the National Health Performance Authority, the Australian Commission on Safety and Quality in Health Care, the Australian Health Professionals Registration Agency, Health Workforce Australia, the Australian National Preventive Health Agency, the National E-Health Transition Authority, a national funding body to administer the national funding pool, local hospital networks and Medicare Locals. Which one of these organisations actually delivers health care? How many patients will be treated under this bloated bureaucracy, which the federal government is so good at creating? It is extraordinary.


The federal government's bureaucracy just gets larger and larger. The spending gets bigger and bigger. This spending does not go to the front line, and Victorian patients are ultimately the ones who suffer in this scenario. Money is misspent in so many ways.


It is disgraceful that the federal government has further cut funds and inflicted challenges for the Victorian health budget.


I am pleased that the Baillieu coalition government is addressing those front-line services. Those opposite possibly do not understand the realities of hospitals. They say they know a lot about budget papers and figures, but I am not sure that they understand the inner workings of a hospital setting, which is very complex. I am pleased to say that as a result of this government's initiatives, as of June 2012 there were 8599 doctors working wholly in the Victorian public hospital system, up from 8207 doctors the previous year. Over this period the number of nursing staff has also increased from 34 034 to 34 568. Hospitals admitted 402 257 patients in the three months to the end of June 2012, up from 388 123 in the same period a year earlier.


Hospitals went on to treat 375 526 patients in emergency departments across the state in the June quarter in 2011-12, which is over 4000 more than in the June quarter the year before.


They are the facts that Mr Jennings needs to respond to. They are an endorsement of the improved efficiency across our health system under the coalition government and this government's improved commitment to ensuring that health services are delivered in this state under challenging circumstances. The task of Mr Jennings's side should be to ask its federal colleagues for a better go for Victorian patients, Victorian nurses and doctors and Victorian health services, instead of allowing the federal government to rip money out from this state and not put its support behind Victorian patients. Its lack of support should be condemned.


In conclusion, I will not be supporting Mr Jennings's motion, which has no foundation or weight. I again congratulate the Minister for Health on what he is doing in delivering health services to the state of Victoria. I ask that Mr Jennings speak to his federal colleagues and support Victorian patients by averting any further cuts to the Victorian budget.


Debate interrupted.

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