Minister for Health (5.02.2014)

Written on the 28 February 2014

Mr JENNINGS (South Eastern Metropolitan) -- President, I thank you for the opportunity to speak on behalf of the Labor Party, the Parliament of Victoria and the people of Victoria. I move:

That this house expresses no confidence in the ability of the Minister for Health, Mr David Davis, MP, to acquit his responsibilities to manage and improve health services in Victoria and notes that despite the election promises made by

Mr Davis on behalf of the coalition to improve Victorian health services, the community has witnessed the following deterioration in health care --
(1) 10 000 more Victorians are on the surgery waiting list than when the government came to office;

(2) there were 4157 fewer surgeries performed in 2012-13 than had been performed in 2010-11;

(3) statewide response times for ambulance code 1 emergency callouts have worsened in each year of this government;

(4) the most recent evidence shows that adult cardiac survival rates have worsened;

(5) ambulance ramping at hospitals delaying patient transfers into emergency departments rose to 13 178 per month in 2012-13;

(6) during 2012-13, 29 per cent of Victorian patients were not treated within required times in emergency departments with one in three patients staying longer than 4 hours and more than 2000 people staying longer than 24 hours; and

(7) as highlighted in a recent survey by nurses into available beds, which corroborates national reports by the Australian Institute of Health and Welfare, the number of Victorian hospital beds has gone down.

It is with a heavy heart that I move this motion and speak to it.

I will call on facts embedded within the motion that can be corroborated by data available primarily in sources provided by the Victorian government and that demonstrate that our citizens are suffering at the hands of a hospital system and ambulance service that continue to be in crisis, notwithstanding the significant promises made by the coalition in coming to government and particularly the personal commitments made on behalf of the coalition parties by the then spokesman for health, David Davis, who is now the Minister for Health.

Those promises, most disappointingly and distressingly for Victorians, have not been delivered. Those promises gave some sense of optimism to the Victorian community that the health system would get additional resources at an escalating rate. It was going to receive additional support from the incoming coalition government that would improve the outcomes of our hospital system, but the opposite has occurred.

The facts clearly demonstrate that the rate of growth in hospital expenditure has deteriorated from what was inherited by this government, and it has deteriorated ever since. The performance of the hospital system continues to deteriorate by virtually every significant measure, and the community is suffering.

There is potential within today's debate for the Parliament and politicians to lose sight of the pain and suffering of members of our community. I will contribute to this debate many budgetary and statistical facts about the overall performance of the hospital system, but I want to pause for a minute to remind all members and anybody who notes today's debate that we are talking about the wellbeing of Victorian citizens -- families, communities and individuals -- and their pain and suffering. We should never lose sight of the burden being borne by patients in Victoria, where the system is failing.

I want us to continually remind ourselves of the unfortunate circumstances of individual citizens across the state. They are at the heart of my concern, the Labor Party's concern and the concern shared by the community across Victoria. We want that pain and suffering to end and our health services to rise up and meet the needs of the citizens of the state, who are currently being let down by the hospital system.

In terms of personalising this issue, at one level I am distressed to move a motion such as the one before the chamber today. It is quite personal. I am drawing attention to the failures of the Victorian health minister and his inability to deliver on his promises and to deliver a system that is growing in accordance with community expectation and demand and the needs of citizens. The system is falling further and further behind. It is a system in which conflict prevails in the workplace of Victorian hospitals and the ambulance service.

To this very day it is a system that is in crisis, and the health minister perpetuates that crisis through his interventions by creating conflict and refusing to accept responsibility for better outcomes across the system. His standard method, which I am sure will be replicated by members of the government benches who rise to support him today, is to distract and confuse the facts of the system that the minister inherited and the budget settings that the minister has delivered during the term of this government. But it is inescapable that the underlying structure of the budget and the growth in the hospital system that was developed by Labor during our term in office has been reversed by this government. Those facts are unassailable, and I will outline for the house in my introductory comments why that is the case.

On behalf of the Labor Party and of the community, we say that the health minister has failed to enable the system to deliver on a number of key indicators. Code 1 ambulance response times have worsened.

Our community is suffering because performance targets for semi-urgent and non-urgent elective surgery patient treatment times are not being met across the system. There is a failure in emergency department treatment times. Ambulance transfer times into emergency departments continue to be a failure. Very significantly, the transfer of mental health patients to a bed within a required time is another measure on which this government has failed. We take the opportunity to remind the government and the community that the government has comprehensively failed to deliver on its promise to increase the number of hospital beds that are available to our citizens within the hospital system. On every one of these measures, every single one, there has been a pathetic performance by this minister, a pathetic performance by the government and a pathetic delivery of quality of care in our state. On every measure there is a complete failure -- --
Honourable members interjecting.

Mr JENNINGS -- Regardless of the tawdry interjections that may come from the other side, the measure -- --

Honourable members interjecting.

Mr JENNINGS -- I did not use the word 'grubby', Mr Finn. I have not used the word 'grubby' once in my contribution until now.

I draw attention to the fact that I do not need to drop into hyperbole; I am sticking with the facts. That is something that this government and this minister want to deny -- the facts. There will not be many facts in the contributions we hear from government members today. There will not be much reference to budget papers or targets or hospital performance details. There will not be many contributions that go in-depth on any of those, because the truth hurts. It is clear that the truth hurts because when I scope out my presentation I see I am generating some degree of agitation from government benches. The truth will hurt, just as the truth hurts Victorian citizens, because this government has failed.

One of the first myths that we need to address in this debate, and one of the myths that I anticipate will be perpetuated by government members, is what was inherited within the hospital system when this government came to office. The health minister continues to perpetuate myths and to deny responsibility for the hospital system that he inherited. But what is the truth about the hospital system that this minister inherited? The truth is that during the period 1999-2010 there was a 153 per cent growth in expenditure in our hospital system by the Labor administration. The fact is that during that period in office we employed an additional 10 944 nurses from the situation that we inherited from the Kennett government, and added 3549 doctors to the system. At the end of our term in office an additional 1.4 million people were receiving elective surgery, compared to the number in 1999. In terms of our capital expenditure -- --

Mrs Peulich -- What about the bed count? Tell us.

Mr JENNINGS -- We will get there. We will get to bed numbers. That supports my argument; it does not support hers, so Mrs Peulich should just sit and wait. Just like Victorian citizens who are waiting for the promised beds, perhaps Mrs Peulich should wait to have some facts outlined to her before her contribution. I would encourage her to understand the facts of the situation in health, an issue that she seems to be blithely ignorant of.

The last budget of the outgoing Labor government in Victoria made commitments for $2.3 billion worth of capital spending in the health portfolio. That brought in total $7.5 billion worth of investments made during the term of the Labor government. Extraordinarily that $2.3 billion, which was in the 2010-11 budget that was delivered by Labor, contributes the vast majority of the capital program in health by the current government. It is extraordinary that this minister relies on budget commitments that were put in the forward estimates by Labor as the major contributor to his capital program.

When this minister claims credit for Bendigo Hospital and Box Hill Hospital, members should ask themselves, 'Which budget did the projects appear in?'. Both those projects occurred in the budget prior to the current government coming to office. Labor had rebuilt not only the Austin and Mercy hospitals, it had rebuilt Maroondah, Angliss, Northern, Sunshine and Dandenong hospitals, it had rebuilt Kyneton, Stawell, Ararat and Geelong hospitals and it had returned the Latrobe Regional Hospital to public hands.

In fact it had rebuilt the Royal Children's Hospital, the major project that this minister has been associated with opening, which was in fact from the budget that had been totally funded and delivered by the Labor government. We had redeveloped the Royal Women's Hospital and the Casey Hospital and, as I indicated, we had commenced the Bendigo and Box Hill hospitals, the Victorian Comprehensive Cancer Centre and the Olivia Newton-John Cancer and Wellness Centre. All of those projects had been commenced and completed by Labor.

That is one piddling -- --

Ms CROZIER -- That is not true. You had not even started Bendigo. You said you completed the projects.

Mr JENNINGS -- It is an extraordinary contribution of a member of the government, who actually seeks to interrupt my flow. Members opposite may be having a bit of difficulty themselves because they are trying to immediately reinterpret what I have said. I actually said that the Bendigo and Box Hill hospital projects were in the forward estimates and had been committed to by the Labor government. That is clearly what I said. Government members who by interjection suggest that I said something else may be able to reflect on those facts in their contributions.
There is another significant fact about which government members who contribute to this debate by interjection -- and probably by their contributions to the debate as well -- are blissfully ignorant. They are blissfully ignorant of the budget papers their own government brings to the Parliament of Victoria. In the various debates on health we have had in this Parliament in the last three years I have not heard a government member -- perhaps that will change today -- refer to the page numbers, the table numbers and the financial details that are included in the Victorian budget.

I will be amazed if today any government member talks about the Victorian budget. I am happy to talk about the Victorian budget. But when I say I am happy to talk about it, at one level I am very sad to talk about it because clearly the government does not understand its own budget papers. Many stories that are peddled by government members are blissfully ignorant of the facts.

Let us get on the table a few facts compared to the myths. One fact compared to the myth is that the current government in Victoria has tried to indicate that commonwealth revenues to support health have diminished over time. However, the fact is that they have increased significantly during the course of this government. If members actually looked at the government's budget papers, they would note the trend in commonwealth funding in the health portfolio. If you look the government's budget papers for 2011-12, in budget paper 5 at page 161, you will actually see that the commonwealth contribution in 2010-11 was $3240.5 million.

For the following year, page 185 of budget paper 5 shows that for 2011-12 the commonwealth contribution was $4139.1 million, in 2012-13 the commonwealth contributed $4034.4 million, and in the current financial year, 2013-14, on the same page in the same budget paper, the commonwealth contribution is shown as $4261.1 million. In fact the commonwealth contribution has risen significantly -- by more than $300 million over that four-year period. That is $300 million more than it was when the government came to office. The government in Victoria is trying to con the Victorian public. To say that the commonwealth's revenues were reduced over that period of time rather than increased is a flagrant lie, and a lie that is exposed by the Victorian government's own budget paper.

Mrs Peulich interjected.

Mr JENNINGS -- Page 185 of budget paper 5, the government's budget papers which were presented to this Parliament by the government, indicates that commonwealth funding for the health portfolio has risen significantly over the last four years.

There is another lie that is perpetuated by the health minister in Victoria and supported by government members. I am not quite sure why, and I am not quite sure what level of detail and understanding government members have in relation to budgetary issues, but a lie that we hear time and again relates to the $107 million that was adjusted in commonwealth revenues in the last financial year and the impact that had on the health system. Most Victorians recognise that the removal of that $107 million was a bad move by the federal government.

In fact, despite the way the story is told, I think everyone in the Parliament of Victoria understood that it was a bad move and, from our various vantage points, everyone in the Parliament who had an interest in health probably played a role in restoring that $107 million. It was restored within three months. That $107 million was taken out but put back three months later by the federal government, because it recognised it was an error. The fundamental difference between the commonwealth government in relation to that $107 million -- --

Mr Leane interjected.

Mr JENNINGS -- That is a very good interjection from Mr Leane. His question was, 'What has happened to the savings that have consistently been made by the state government?'. Has any of the $826 million taken out by the Victorian government over the last three budgets come back? Not one penny of it has come back.

This is the extraordinary myth that has been perpetuated by the Victorian government. It applied one standard to this $107 million from the commonwealth to say, 'That money was inappropriately withheld by the commonwealth; it has to give it back'. Fair enough, but in successive budgets the Victorian government has taken out $826 million -- and I can prove that, as distinct from the assertions of government members. If you have a look at the very first budget introduced by the then Treasurer, Kim Wells -- --

Mr Leane -- Wells?

Mr JENNINGS -- Yes, he was Treasurer that day. On page 112 of budget paper 3 relating to the 2011-12 budget, it can be seen that $481.9 million worth of savings was taken out of the health portfolio by the Victorian government. On page 23 of budget paper 3 of the 2012-13 budget -- I am not sure who the Treasurer was then, but whoever that Treasurer was -- --
Honourable members interjecting.

Mr JENNINGS -- Mr Wells survived that year! The Treasurer reduced the health budget by $134.1 million. Within the first two years of the election of the coalition government $616 million was taken out of the health budget. Has one penny of the money taken out by the Victorian government been restored to the health system? Not one penny. And what happened in this year's budget? Who delivered this year's budget?

Honourable members interjecting.

Mr JENNINGS -- It was delivered by Mr O'Brien on this occasion. Mr O'Brien -- an excellent Treasurer, according to Ms Crozier -- took $210 million from this year's budget. That is recorded on page 17 of budget paper 3. That brings the total to $826 million that was cruelly ripped out of the health budget going forward by the Victorian government. That is $826 million all gone, never to return. That money is at the heart of the reason this government has failed the people of Victoria in delivering its promises, because it actually pretends that it has grown the budget. It pretends that commonwealth revenue is the reason it has not delivered, but the sorry truth is that the investment made by the Victorian government for the last three years over the last three budgets has not kept up with demand. The government has fallen behind demand, and in addition to that, $826 million has been ripped out and never returned to the system.

But members do not need to take my word for it, because as recently as last week the Australian Productivity Commission published a national report on expenditure in health and other government services. Quite extraordinarily the fact that the opposition has been drawing attention to the last three years and that government members have blithely ignored is outlined very starkly in the Productivity Commission report. Within its health analysis the report clearly indicates that in the last four years of the Labor government there was an average increase of 6.1 per cent in the recurrent budget of the health portfolio, and in the first year of the coalition government it dropped to 0.3 per cent.

Mrs Peulich -- So inputs are the be-all and end-all, are they?

Mr JENNINGS -- Inputs are a major problem, but outcomes for Victorians is where the malady and the failure of this government is.

Do not distract me about that. I am talking about inputs at the moment, but I am going to get onto outcomes again in a second.

The Productivity Commission report published last week shows that in the last four years of the Labor government Victoria's recurrent expenditure per person in public hospitals increased by an average of 3.2 per cent, and this was nearly halved in the first year of the coalition government to 1.6 per cent. The Productivity Commission has again demonstrated a number of facts that government members in Victoria may be blithely ignorant of or choose not to talk about. According to the Productivity Commission report, there were fewer medical practitioners employed at a full-time equivalent rate per head of population in the last 12 months in Victoria, and there were fewer nurses employed per head of population than in the previous year.

Beyond inputs, participation in the system -- that is, the number of staff employed in critical areas within our public hospitals per head of population -- has actually been reduced during the life of this government in terms of the demand pressures within the Victorian hospital system. As reported on a consistent national basis by the Productivity Commission, the growth rate in Victoria has been half what it was under Labor, and that is half of what it should be. As a consequence, every outcome for patients in the Victorian hospital system -- the key measures -- is going backwards. Those are undeniable truths.

Let me quickly run through the facts, as distinct from the government's fiction, in relation to each of the points listed in the motion. I will run through the issues in the order they are listed. The first point is that there are now 10 000 more Victorians on elective surgery waiting lists than when the government came to office.

For this fact I rely on hospital performance data released by the government. At the last count, in September 2013, there were 48 363 Victorians on elective surgery waiting lists. It had been higher during the course of the previous financial year when the number was 50 000. For the first time in Victorian history 50 000 people were waiting on elective surgery waiting lists.

Mr Leane -- They promised to slash waiting lists!

Mr JENNINGS -- Mr Leane, they had promised to slash waiting lists. I am sure this will be a sorry fact for you to fully understand and appreciate, Acting President. When the government came to office there were 38 000 people on the waiting lists, and now there are over 48 000. That is according to the government's own figures.

Again according to the government's figures in 2012-13 there were 4157 elective surgeries -- fewer than had been funded and delivered in the last year of the Labor government. This trajectory is consistent under the Liberal government. According to government data there were 153 415 elective surgery admissions in Victoria in 2012-13, which was down 665 from the year before and 4157 from the year prior to that. Members can look for themselves at the health performance data on the government-sponsored website.

Another fact in relation to elective surgery is that the government's figures for 2012-13 show that more than 5000 people had waited longer than a year for elective surgery in Victoria. Five thousand of our citizens suffered in pain for longer than a year before they received their surgeries. Patients are waiting longer.

One of the things recorded on the government website is the 90th percentile, which is an indication of how long it takes the hospital system takes to get through the waiting lists -- that is, how long it takes for 90 per cent of patients to get through the system. The website shows that 90 per cent of people on waiting lists wait 223 days to receive their surgery, which is up from 189 days when the government came to office. This is a significant increase.

Some people become confused about the direct causal effect of this, but I am not overreaching by saying that the causal effect is that people are dying on the waiting lists, nor am I overreaching by saying that it is in fact the blow-out in the waiting lists that has caused the deaths.

What is consistent with what I have described about people waiting longer for surgery is that the number of people who have died whilst they are on the waiting lists continues to rise, and the most recently available data obtained under freedom of information is that under this government in Victoria 2253 people have died whilst they have been waiting for surgery.

As you would expect, as the waiting lists get longer and as people wait in pain and suffering, their quality of life deteriorates. Many of them experience the end of their lives, and that is something the government must -- --

Mr Leane -- Admit.

Mr JENNINGS -- Unfortunately it must accept the truth of these facts. It must continue to focus on the reality that it should be delivering better outcomes for Victorian citizens.

The system is clearly not delivering what the government expects of it.

One of the ways in which the outcomes for Victorians have clearly floundered under this government, despite the promises made by the then incoming Minister for Health, is the deterioration in ambulance response times and the effective delivery of patients to hospitals by our ambulance system. The health minister, David Davis, made a lot of promises about how ambulance service delivery was going to improve, but what is the situation we have seen reported in the budget papers? The government has no option, given the performance measure is in the budget paper, but to record it. It is also recorded in the annual reports of the Department of Health.

The data shows that in 2010-11 the proportion of ambulance call-outs in emergency situations where the response time target of 15 minutes was met was 77.1 per cent; it had gone down from the year before.

In the last full year of the Labor government ambulances had responded to an emergency within 15 minutes on 81 per cent of occasions. However, in the data from 2012-13, that number is now as low as 73 per cent, so clearly it is heading in the wrong direction. That means that not only are the lives of patients right around Victoria at risk but members of the community are anxious that if they need an ambulance in a timely way an ambulance may not come.

One of the indicators that the health minister has relied on is not true. What is important to Victorian citizens is survival rates for cardiac arrest, which is one of the most significant reasons why an ambulance is called out. If someone has a cardiac arrest, their life is immediately in jeopardy. The minister has claimed in Parliament on a number of occasions that that measure is improving. Unfortunately in its report on ambulance services across the nation the Productivity Commission last week demonstrated that this statistic is deteriorating in Victoria.

According to the report, whereas during the previous year more than half of Victorian patients who suffered a cardiac arrest had survived that experience due to the support of the ambulance service, in the last reporting period that number was reduced to less than half. The one kernel of good news that the health minister has attempted to rely on has been shown by the Productivity Commission to not be true. In fact the trajectory of cardiac survival rates has deteriorated in Victoria, which is totally unacceptable to Victorian families and certainly unacceptable to the state opposition.

Apart from the emergency response times and cardiac arrest rates, the next measure of the effectiveness of ambulance services is transfer times from ambulances to hospitals. What do the facts say about this? When the coalition government came to office it drew attention to failures in the system, including ambulance ramping in Victorian hospitals. Despite the investments made by the previous Labor government and the growth in ambulance services that occurred while we were in power, we recognised that ramping was a problem. At that time on average about 7000 hours per month of ambulance ramping was occurring in Victorian hospitals. We, as an outgoing government, recognised that we needed to do more work on that issue; 7000 hours was not good enough for us, and we wanted to improve that situation.

What does the latest data say? It shows that the figure has increased from 7000 hours per month to 13 178 hours per month. The number of hours that patients are waiting outside Victorian hospitals has virtually doubled under this administration. Despite the incoming government's promises and what the minister has said has been an increased effort in ambulance services, the performance has deteriorated.

There are a number of reasons why that is the case.

One of the reasons is that this minister continues to see the ambulance service and its workforce as the enemy. At every turn this minister blames paramedics for the deterioration in service and adverse impacts upon patients. He blames them for poor outcomes for transfer times, poor outcomes for cardiac arrests and poor performance for emergency response times. However, these outcomes are due to the government's failure to support the ambulance service in terms of resource allocation, governance and the management systems and dispatch systems of Ambulance Victoria, and to the fact that investments in ambulances have not been met by corresponding growth in emergency departments and bed numbers within the hospital system. The system has not grown or been managed in a consistent, coherent way, and as a result the performance of ambulance services for Victorian patients continues to deteriorate.

As recently as yesterday, when I asked the minister a question about the performance, scope of practice and delivery of ambulance services in Victoria he not only took the opportunity to abuse me but also again abused paramedics and the union. Rather than recognise the significance of those issues, he attributed the concern I expressed on behalf of Victorian patients to me being a puppet of the union. This is a minister who continually refuses to take responsibility for better performance -- -

Ms Tierney -- He just wants to play politics.

Mr JENNINGS -- Exactly -- play politics, play an industrial trump card, find conflict, always blame somebody else, and never, ever take responsibility for delivering outcomes.

When I ask him a question and encourage him to take responsibility, he goes back to the previous health minister or the intervention of the commonwealth or the unions, or he somehow blames me, shooting the messenger for having the audacity to ask him a question. I am holding the mirror up and asking him to look at his own performance.

How short of community expectations has he fallen in his ministerial responsibility? This is a minister who flagrantly does not understand the concept of ministerial responsibility. Ironically he calls on me to take responsibility for these matters. We have somewhat different roles. I would be happy to take responsibility on behalf of the Victorian people. I am currently not in a situation to do so, but given the opportunity, maybe the people of Victoria will want to give the opposition that opportunity in the not-too-distant future.

Mrs Peulich -- I think the Victorian public will see through that.

Mr JENNINGS -- I was waiting for that brilliant interjection to roll out.

An honourable member interjected.
Mr JENNINGS -- That is right. I think my knees started knocking! The chattering that we heard was my knees knocking. I was quaking under the assault of government interjections.


The ACTING PRESIDENT (Mr Ondarchie) -- Order! Mr Jennings will not respond to interjections.

Mr JENNINGS -- That is right. You know, Acting President, that I will not be distracted because the facts are on my side in this debate.

It always helps if the facts are on your side.

The next set of facts I want to draw attention to are those contained in the health performance data released by the government. Again, I do not need to spend a lot of time on these facts because not only are they evident to anyone who looks at the data but they are very evident to anybody who turns up to a hospital emergency department in Victoria. If anyone wants to get into an emergency department by ambulance, by just walking in or by being taken in off the street, it is very obvious that in fact they are waiting longer. What the data released by the government as recently as September 2013 -- which is the latest data that has been released by the government on its own website -- shows is that 29 per cent of patients in emergency departments have not been treated within the required times that would be expected of those emergency departments. In fact one in three patients stays longer than 4 hours without necessarily being sent home, being cared for or being admitted to hospital and more than 2000 patients are staying longer than 24 hours.

Mrs Peulich interjected.

Mr JENNINGS -- Acting President, you can hear that I am being baited in relation to the performance under the Labor government. My response to the interjection is that the performance was better. At the time it was not seen as good enough by the then opposition and in some media commentary. Indeed many members of the community did not think our performance was good enough. People were entitled to form that view. In fact now the situation is worse and getting worse. The last issue I refer to, which I have been invited to refer to on a number of occasions, is beds.

Mrs Peulich interjected.

Mr JENNINGS -- I am happy to talk about beds, because it is a sorry truth that today there are fewer beds operational in Victorian hospitals than there were in the last year of the Labor government. Members do not have to rely on me for that information; they can go to the source. They can go to the Australian Institute of Health and Welfare report which shows that in the last year of a budget funded by the Labor government there were 13 254 beds operating in Victoria.

Mrs Peulich interjected.

Mr JENNINGS -- That is the benchmark that Mrs Peulich's government inherited: 13 254 beds.

Ms Tierney -- And it promised?

Mr JENNINGS -- And it promised 800 more beds. What does the latest Australian Institute of Health and Welfare report show on how many beds have been delivered?

Mr Leane -- Plus 800?

Mr JENNINGS -- No. The number has gone down by 36 -- minus 36.

Mrs Peulich interjected.

Mr JENNINGS -- Under the current government the number that was inherited, 13 254, should be 800 higher. It should be 14 054.

That is the number that will be the measurement of the delivery of the 800-bed promise made by the then incoming government. An increase on 13 254 of 800 means that the benchmark for this government will be 14 054 beds by the end of this term. How is the government going? On the last measure the government has gone backwards on its promise by 36 beds.

When the nurses union not only reported on the 800-bed shortfall but looked at the number of beds that were operating within the system over summer, it identified 1116 beds of those 13 254 beds as not even being used. The government is 800 down on the promise and 1116 down on the number of beds that were being funded and operational within hospitals.

Mr Leane interjected.

Mr JENNINGS -- Exactly.

We are in the ballpark of 2000 beds down on the expectation set by the then incoming government. Members of the opposition have sat here and copped a modicum of abuse. It is okay; I can bear it. Apart from the knee knocking that you, Acting President, heard before, I think we can bear it.

Members of the opposition will be fascinated to listen to the contributions of government members and hear how many facts they can point to. We will be interested to hear from them facts, as distinct from the facts that I have outlined in my contribution, which rely on budget papers, the government's own report on hospital performance, an Australian Institute of Health and Welfare report, a report of the Productivity Commission and freedom of information documentation that the opposition and members of the community have gathered. Opposition members rely on all those sources of information and report back to the government on them. It will be fascinating to hear from government members what datasets and facts they rely on.

How many references will there be to the budget, an Australian Institute of Health and Welfare report, a Productivity Commission report and other documentation that is available in annual reports of hospitals and the Department of Health?

On 31 October last year I laid myself somewhat open by asking the Minister for Health, 'What was the highlight of your health department's report? Here you are, open slather: what are you proud of, what have you delivered?'. The minister said, 'Hand hygiene compliance'. That was the fact that he was most proud of. He was scrabbling through his own department's report, looking as if it was the first time he had ever seen the report.

Mr Lenders interjected.

Mr JENNINGS -- In fact he was giving the impression that he had not seen the report before. He was going through the pages -- page after page after page -- and he said, 'Oh, hand hygiene. I'm pretty proud of that'. He also said he was proud of the participation rate, the number of people who go into hospitals. All you had to do was turn up as a patient and you were included in the participation rate. That was a pretty important measure!
The minister has no information to rely on to show that the situation is getting better. When he was asked an open-ended question, 'What are you proud of?', he could not identify anything more significant than the participation rate and hand hygiene compliance in the hospital system. That is a pretty clear measure that you are not doing well.

An honourable member interjected.
Mr JENNINGS -- There is a bit of an alliance of views between the nurses, the nurses union, the paramedics, the paramedics union and the opposition. We share a view that the system is not working well.

We share a view that the system is under great stress because it is not being provided with enough resources. The delivery in the hospital system is not good enough. We agree that this minister has set himself up to fail by promising much and delivering little. Not only has he delivered little, he has delivered bad outcomes. The performance of the hospital system has deteriorated under his watch. He continues to refuse to take responsibility for the system. He is a sorry excuse for a minister not only because he does not have any facts that he can rely on to say that the system is getting better but also because he does not demonstrate any compassion for the Victorian community and individuals in our community who want a better ambulance service and a better hospital system. He has no compassion for their pain and suffering. In fact at every turn he will try to absolve himself of responsibility and attempt to blame others. The minister cannot continue to blame others; he must take responsibility.

I find it extraordinary that in my contribution today I have not necessarily called on the arguments of others to support the idea that this minister should be sacked. The facts speak for themselves, and the minister deserves to be sacked. The Herald Sun newspaper is not necessarily my first, second or third port of call when I am looking for a reliable authority, but nonetheless it does its best to be fair and reasonable in its commentary. As far back as October 2013, four months ago, the Herald Sun editorial said that there must be an end to the ambulance dispute. It highlighted the conflict and the trench warfare that has been generated by this minister in ambulance services. The editorial of 5 October concluded by saying:

It is sick Victorians who are paying the price in an argument where both sides have become entrenched in their views. Dr Napthine must be the circuit breaker.

As far back as four months ago the Herald Sun was calling for the intervention of the Premier to remedy this solution, and by implication the Herald Sun has editorialised and said that the minister should be sacked because he is not up to it. That was the view expressed, and it is a view that is shared by the opposition. It is at the heart of our moving the motion of no confidence in the minister. It would be best for him to do the responsible thing and leave, or alternatively the Premier should sack him.


Ms CROZIER (Southern Metropolitan) -- I am very pleased to rise this morning and speak to Mr Jennings's motion -- --

Mr Lenders -- Misleading the house now?

Ms CROZIER -- I have not even started my contribution and Mr Lenders is saying that I am misleading the house -- --

Mr Lenders -- You said you were pleased!

Ms CROZIER -- I am pleased to speak to Mr Jennings's motion because I want to talk about the issues that Victorian patients in Victorian health services are facing today. Throughout his contribution Mr Jennings consistently talked about the facts, calling on the facts contained in his motion. It is a lengthy motion and there are a number of elements in it, which I will not repeat at this time, but I will go through a number of them and highlight to the chamber some of the points where I think Mr Jennings has misled the house.

First and foremost, when we are looking at the first part of the motion we see that Mr Jennings has said that there are 10 000 more Victorians on the surgery waiting lists than when the government came to office.

In relation to the statistics about where Victoria sits, it is performing equal to the national median waiting time and performing better than the national performance when measuring a number of 90 percentile days. That is in accordance with statistics for previous years, when Labor was in power.

Let us look at the facts in relation to the data. This government has been very up-front about releasing data, which was something Labor in government failed to do.

Mr Lenders -- There is a powerful argument in Bentleigh and Prahran.

Ms CROZIER -- Mr Lenders can interrupt and talk about health in Bentleigh. Mr Jennings asked for reports, but I remind him of the report entitled Your Hospitals -- A Report on Victoria's Public Hospitals July 2009 to June 2010. That report contains a lot of information, including information on various hospitals and their data, but there is no data for the Peter MacCallum Cancer Centre. I would like to know why there is no data for the Peter MacCallum hospital listed in this report. I have no idea why it was not included in that report or why the previous government hid data at all. We know it did that, and there were numerous reports. If members recall when the former Minister for Health, now Leader of the Opposition and the member for Mulgrave in the Assembly, Daniel Andrews, was responsible for -- --
Mr Lenders interjected.

Ms CROZIER -- Yes, Mr Lenders, we have been in for three years, but I think it is important to point out the situation we inherited, particularly in the context of what we are discussing here. What I am trying to say is that we came in with a commitment to highlight to the Victorian public the hospital data, and that is exactly what we have done, which is in direct contrast with what Mr Lenders's government did when it hid data. I ask why the Peter MacCallum data was not included in that report and why it was hidden. There are numerous newspaper reports to back up what was going on at that time. I remind members that there were secret waiting lists. An article in the Age of 18 November 2010 states:

More than 26 000 Victorians were not included on official elective surgery waiting lists last year and instead were classified as 'not ready for care' ...

Those were secret waiting lists that Mr Lenders's government presided over. It is wrong to say that the data we provide is inaccurate and that there are blow-outs in waiting lists. There is far more transparency in relation to what is going on under this government than took place under your government. Effectively what was happening under that regime was that patients were not being added to those waiting lists. There were, as I said, secret waiting lists, and article after article condemned the then Minister for Health, now the Leader of the Opposition, Mr Andrews, in relation to his -- --

Mr Lenders interjected.

Ms CROZIER -- I will get to that, Mr Lenders. I am putting this into context and saying that this is our government's commitment. When we came to government and said we would release the data -- --

Mr Lenders interjected.

The ACTING PRESIDENT (Mr Finn) -- Order! I ask Mr Lenders to refrain from interjecting, but I also request that Ms Crozier address her comments through the Chair so that we do not have a conversation across the chamber, as I am feeling a little left out and my feelings could be hurt. I ask Ms Crozier to follow the standing orders with regard to that.

Ms CROZIER -- Certainly, Acting President. Thank you for your guidance. Through you I will return to my contribution. Mr Jennings is no longer in the chamber to rebut what I am going to say about a number of other issues, but I wanted to take him to task in relation to the facts.

Again through you, Acting President, the facts are that during the 2012-13 financial year he spoke a lot about budgets, and I remind the chamber that when we came into government in 2010 we had to find money to support a number of projects that had been pursued through the former government. Through my interjections during his contribution I reminded Mr Jennings that this government needed to find $55 million to pay health workers for the 2010 Christmas and New Year period. I have actually worked in hospitals over the Christmas period -- --

Mr Lenders interjected.

Ms CROZIER -- I am not sure if Mr Davis has worked in a hospital over the Christmas period in recent years, and I must admit it has been a while since I have. However, workers expect to be paid when they work through the Christmas and New Year period. That is the normal process.

When we came into this office we had to find $55 million to fund those health workers' salaries in December 2010. Mr Lenders was the Treasurer at that time, and that was money we had to find. Mr Jennings talked about the Royal Children's Hospital, a magnificent facility with terrific workers that provides an amazing service to the Victorian public as well as to children from interstate at times. Again, there was no IT system funded and this government had to find $26 million. Mr Jennings talked about budgets and budget responsibilities, but this government had to foot the bill for the mismanagement of various projects.

We also had to find $44 million for the Olivia Newton-John Cancer and Wellness Centre. There was a lot of fanfare and discussion about that magnificent centre, but all that was funded was a shell. It needed $44 million to have a fit-out. As we know, when you are processing patients through a health-care service you have to have equipment, beds and resources. The government had to find $44 million. Mr Jennings talked about budget responsibility and what we were doing, but these are the facts.

Mr Lenders interjected.

Ms CROZIER -- Mr Lenders has interjected, but I want to go back to the 2012-13 financial year, when the Gillard government used incorrect population figures to rip $107 million from our health services. The Victorian public understood exactly what was going on; Victorian health services understood exactly what was happening. I remind Mr Jennings that he did not support a motion in this house that expressed concern about those cuts. I want to remind him of exactly what was said. It was moved that the house:

(3) calls upon the heads of treasuries to convene urgently to discuss the commonwealth Treasurer's determination and report on the basis of this decision, noting that the reductions in commonwealth funding for public hospitals will, unless reversed, be implemented in early December 2012 in the form of a $39 million clawback of funding to Victoria from the 2011-12 financial year and a $67 million reduction in the 2012-13 financial year for Victorian hospitals and large reductions in forthcoming financial years bringing the total commonwealth funding reductions of the health and hospitals funding through the health-care SPP and national hospital agreement to $475 million since the announcement of the commonwealth's 2012-13 budget; and

(4) further notes that six state health ministers expressed concern about the announced reduction in commonwealth health funding at the recent Standing Council on Health meeting.


You did not support that motion, so you effectively agreed with what was occurring at a federal level, which was putting health services at great risk. You talked about budgetary management -- --

The ACTING PRESIDENT (Mr Finn) -- Order! I ask Ms Crozier to direct her comments through the Chair, for there could be some confusion as to whom she is referring when she says 'you'.

Ms CROZIER -- In his contribution Mr Jennings suggested that this government did not understand the budgetary management of our health services. I remind Mr Jennings that he voted in favour of the $107 million cut through that financial year. Hospitals and health services have budgets in place, as members would understand, and based on an expectation that money will be delivered they manage their hospital and health services.

When they have money ripped out halfway through a financial year, it creates a large degree of uncertainty, and that is exactly what this cut did.

It was an unprecedented move that caused a huge amount of uncertainty for health services. They had to readjust and replan a whole range of services that they provide, whether it was elective surgery, outpatient services or other resourcing. That is how health services operate, and when they do not have money coming in, or when it is effectively taken away from their budget, it makes it very difficult for them to operate. That caused a huge amount of disruption to elective surgery and hence some delay in various elective surgeries and other health service care delivered through those health services. Therefore it is disingenuous to say that -- --

Mr Lenders -- There is no correlation between the data and the rise.

Ms CROZIER -- I make the point again that that had a direct impact on the delivery of health services and compounded upon and created issues for elective surgery and data figures in relation to that particular year. Those hospital services have had to play catch-up, and they have done a magnificent job. The Victorian health services are under constant pressure, with an ageing population that is experiencing more chronic disease and more complex health outcomes in many instances. We understand that and are planning for it, and that is why the government has undertaken a number of initiatives that are addressing those very points.

I commend the minister for what he is doing in tackling some of those complex issues in relation to chronic disease, and I further point out that those challenges were partly caused by the Gillard government ripping $107 million out of the hospitals, as I said.

That placed uncertainty on Victorian health services, which have had to manage a very complex health delivery service at times. I again commend the minister for some of the initiatives he is undertaking to tackle some of those areas, including chronic disease. Issues were raised in relation to heart attacks and the response times to them, and there have been some very good announcements through the delivery of new treatments through our ambulances, and we are receiving very good figures in that area.

I also direct the attention of the chamber to the Department of Health Annual Report 2012-13, and specifically the figures for acute health services in Victoria 2011-12 to 2012-13, which highlight the numbers of emergency presentations. In 2011-12 that number was 1 506 828, and in 2012-13 it had increased to 1 526 628, which is an increase in emergency presentations in that acute setting. In terms of admissions from elective surgery waiting lists, in 2011-12 the figure was 153 316 and in 2012-13 the figure was 153 076. This data is all available and out there in the public domain, and it is reporting on what is actually happening within our acute hospital systems.

The third point of Mr Jennings's motion states that the 'statewide response times for ambulance code 1 emergency callouts has worsened in each year of this government'. He talked about the facts constantly, but the facts are that the government has injected additional funding into this area. It has increased ambulance funding by 17 per cent, to $662 million a year, and it has delivered an additional 465 paramedics throughout the state. Some of those paramedics are based in regional Victoria and some are based here in Melbourne. Mr Jennings is blind to the fact that an increase in numbers has occurred, but that increase is reassuring for the Victorian community.

Obviously some industrial issues are occurring in relation to the current pay negotiations. It is disappointing that we cannot get a resolution of that matter. I think the Victorian community supports and identifies the very good work that paramedics do, and we have added 465 paramedics, which means they have a greater presence across the state, they have more shifts and there are more vehicles and more ambulance stations. In relation to the response times, the Victorian health services performance data shows significant improvements in timely transfers of patients from ambulances to hospital emergency departments, with the statewide proportion of ambulance patients seen within 40 minutes improving from 76.1 per cent in the December year to date figures for 2012-13 to 80.9 per cent for the same time in 2013-14.

This data is made public, which is far from what the previous Labor government did, which was to hide the data. Victorians were well aware of the fudging of the figures. Our emergency departments are under a great deal of pressure.

They always have been, whether it be from an increase in alcohol and drug-affected cases that present or other issues. We have had a rise of those instances over the last few years, and the government is looking at tackling the very alarming effects of the increased use of methamphetamines, and again I congratulate the Minister for Health, David Davis, and the Minister for Mental Health, Mary Wooldridge, for addressing those issues. They are alarming for Victorians and for the young people who will be severely affected by the abuse of such substances.

That is just one area I have highlighted, but of course our emergency departments treat a whole range of emergency admissions, whether it be due to heart attacks, car accidents or other problems. The government was seriously concerned about the issues in the emergency department and so introduced a task force to examine those transfers, under the guidance of Andrew Stripp.

There is no doubt that with the report that he has handed to the government there have been great improvements in a number of hospitals right across the metropolitan area. For instance, at Frankston Hospital, there has been a 24 per cent improvement in patient transfer times; at Dandenong Hospital, 30 per cent; and at Casey Hospital, 15 per cent. These positive statistics show that the task force of health workers looked at those issues and wanted to get improvements. Health workers in those areas have undertaken these improvements, and they are making a huge difference.

The Report on Government Services 2014 released by the Productivity Commission in January shows that Victoria has more paramedics than the national average, with 49.3 equivalent full-time ambulance officers per 100 000 people. To go to the claim of Mr Jennings that we are not basing our arguments on reporting, I draw his attention to what the Stripp report and the Report on Government Services say.

It is disingenuous for Mr Jennings to say the government is not relying on accurate reporting.

In addition to the 465 extra ambulance officers and paramedics who have been put in place, Victoria now has more ambulance stations. The total revenue for ambulance services was $681.5 million in 2012-13, which was an increase of over 10 per cent from the previous year. We know our paramedics do a great job, and they are not, as some have claimed, leaving in droves. The attrition rate for paramedics in Victoria is no greater than the national average. We regard our ambulance service and our paramedics very highly, and it should be noted that the government is addressing some of their concerns about the issues they face.

The fourth point in Mr Jennings's motion says:

- the most recent evidence shows that adult cardiac survival rates have worsened;

That is incorrect.

Ambulance Victoria has reported to the Department of Health that out-of-hospital cardiac arrest survival rates in Victoria are among the best nationally and internationally. Ambulance Victoria has advised that the difference in outcomes for patients in shockable rhythms in 2012 is not statistically significant. Labor is misleading and putting fear into the Victorian community, but its claims are not entirely correct.

I remind the chamber that cardiac disease is a chronic disease and that the last state government budget committed an additional $21.9 million over four years to a range of strategies to improve outcomes for people experiencing cardiovascular disease. Heart disease has been the leading cause of death for Victorians and Australians for a long time, although it was recently reported that cancer has overtaken heart disease. Obviously some of these initiatives and strategies in relation to heart disease are making an impact. We need to do more in relation to cancer treatments and cancer prevention, and over many years governments of all persuasions have done a lot.

Looking at chronic disease, one of those initiatives is the Healthy Together Victoria program, which is running very effectively in a number of local government areas across the state. The program aims to tackle obesity at a young age and to get people to understand health and wellbeing. Hopefully, over a number of years -- it will not happen overnight -- it will have an impact on the rates of chronic diseases, such as heart disease and diabetes, and lead to better health outcomes for individuals.

That is an example of the on-the-ground grassroots-level type of initiatives that are having a positive impact on the Victorian community. The additional $21.9 million in funding has been widely supported and is being used to look at a number of ways we can identify people who are at risk of developing heart disease and how we can better manage that.

The fifth point of Mr Jennings's motion says:

... ambulance ramping at hospitals delaying patients transfers into emergency departments rose ...

I again refer to Andrew Stripp's report which looks at congestion in emergency departments. It will go a long way towards relieving a lot of issues in our emergency departments. There is no doubt that issues in emergency departments fluctuate.

Friday nights, Saturday nights and post-weekend days are usually busy. Emergency departments can become very busy at certain times of the week and the year.

What we are talking about here is emergency patient transfer times. I reiterate that Labor did not release the data. When Mr Andrews, the Leader of the Opposition and member for Mulgrave in the other place, was the Minister for Health, Labor hid the patient transfer times. Labor cannot disguise the fact that Mr Andrews was responsible for the data, but he did not allow the public scrutiny that should have occurred. Releasing the data was a government commitment, and that is what we have done.

The September 2012 quarter recorded 665 patients staying longer than 24 hours; by the September 2013 quarter this had dropped to 94 patients, so there have been improvements in a number of areas across a number of hospitals in the metropolitan area.

The department and health services are all working closely together to look at how to improve the situation, and the health workers in those areas have done a magnificent job in catering for demand that is at times complex.

There are more improvements the government has made. I am reading through Mr Jennings's rather long motion. There has been a significant amount of capital investment in our health services. Mr Jennings read out a number of capital investments that Labor undertook during its 11 years in government, but I remind members of what we have undertaken over 3 years. Bendigo Hospital received $630 million and an additional 252 beds. It is the biggest regional hospital in Australia, and it will cater for -- --

Mr Lenders interjected.

Ms CROZIER -- That is a fact. It is a $630 million capital investment.

It will be absolutely advantageous for the northern parts of Victoria -- --

Mr Lenders interjected.

Ms CROZIER -- Hopefully members up there will be supportive of Bendigo Hospital. The Box Hill Hospital redevelopment received $447.5 million. There has been $76 million to redevelop Frankston Hospital, $29 million to expand Northern Hospital and an $11 million expansion to the Austin Hospital short-stay unit. We are building the Monash Children's hospital, which came to Labor's notice in 2002 but it did nothing about it. Labor did not plan for population growth expansion and the needs of families in the south-eastern suburbs of Melbourne and other southern parts of Victoria. This government is doing that. Mr Lenders has asked, 'What have you been doing?', and that is exactly what we have done. We have put a huge amount of capital investment into hospital infrastructure, and I am pleased to say that Victorians understand that.

Mr Lenders's and my constituents will be grateful for the building of the Monash Children's, and I have no doubt they look forward to that coming online within the agreed times.

Mr Lenders interjected.

Ms CROZIER -- The Monash Children's may actually have an IT system. It will not be forgotten, like it was with the Royal Children's Hospital. We are looking at what is needed for the proper functioning of a hospital.

I want to make a point about targets in emergency departments, and this is fairly obvious for workers in emergency departments. The federal target of 4 hours to get people in and out of an emergency department is in many instances completely unrealistic, and quite frankly it is unfair on those workers who move people through emergency departments. That target showed a lack of understanding by the former federal government, which did not fully understand or appreciate the complexities of what occurs in an emergency department. Many emergency departments have had to meet that target to get various bonuses or whatever they needed, but unfortunately it has put them under enormous pressure.

The statistics for emergency department patients regarding length of stay greater than 24 hours have improved greatly over a number of years. I will look at hospitals in the area that Mr Lenders and I represent.

At the Alfred hospital in 2005-06 there were 687 patients with a length of stay greater than 24 hours; in 2006-07 there were 418; in 2007-08, 300; in 2008-09, 727; in 2009-10, 11; in 2010-11, zero; in 2011-12, zero; and in 2012-13, zero.

At the Monash Medical Centre in 2005-06 there were 13 patients; in 2006-07, zero; in 2007-08, 79; in 2010-11, zero; in 2011-12, 11; and in 2012-13, 2.

At Sandringham Hospital in 2005-06 there were 48 patients; in 2006-07, 32; in 2007-08, 9; in 2008-09, 2; in 2009-10, 2; in 2010-11, 1; in 2011-12, zero; and in 2012-13, zero.

These are significant improvements in the data that is available.

Statewide in 2005-06 there were 4852 patients; when we came to government in 2010-11 there were 1877; in 2011-12, 1799; and in 2012-13, 2088.

Those statistics show that there are improvements within emergency department transfers. Many initiatives are being undertaken, and again I commend the Stripp task force for undertaking work with various emergency departments to get better outcomes for patients.

Paragraph (7) of Mr Jennings's motion mentions a recent survey by nurses into available beds.

I cannot recall whether he explained how many nurses there were, where they were or how that survey was conducted. He mentioned corroboration of national reports and that the number of Victorian hospital beds has gone down. Members have to understand that when we came to government the appropriate starting point for measuring an increase in hospital beds was quite different. When we were elected there were a number of beds, but bed numbers are not static. They go up and down, and they always have. In busy winter months, when there is an increase in the number of patients with the flu, the number of hospital beds needs to be increased. When there are quieter times, beds will close. That has always been the case. Health services need to manage those beds, and it is too simplistic to say that bed numbers should stay the same and that they are fixed. Members need to understand how that works.

The government is committed to delivering hospital beds.

The Australian Hospital Statistics 2011-12 report demonstrated that the average available bed count in Victorian public hospitals rose from 13 186 in 2009-10 to 13 370 in 2011-12, which is an increase of 184 beds. I know Mr Jennings had that big rant and said that government members were -- --

Mr Lenders -- He was very measured.

Ms CROZIER -- He was quite condescending, actually, and patronising.

This is a nonsense motion. I know that there is a longstanding procedure to never amend an opposition motion, but if I were to amend it I would move:

That all the words after 'That' be omitted with the view of inserting in their place -- 'this house --

(1) condemns the opposition for bringing a baseless motion into the house attacking the Minister for Health which diminishes themselves and this house;

(2) strongly supports the Minister for Health, Mr David Davis, MLC, noting --

(a) improvements in the Victorian health system since 2010;

(b) the admission by the Leader of the Opposition, Mr Daniel Andrews, MP, that while in government prior to December 2010 he and Labor failed to plan for the growth of Victoria, quoted in the Herald Sun on 4 December 2010 stating, -- I think it's fair to say that in the face of unprecedented growth, we struggled to keep up ... I think we could have done more, we could have done better--;

(c) the flawed record of Mr Andrews which consists of systematic data manipulation of health data and statistics;

(d) Labor's botched merger of the ambulance service and failing to properly resource Ambulance Victoria; and

(e) Labor's failure to build the Monash Children's hospital despite knowing for eight years it was needed, to build the Royal Victorian Eye and Ear Hospital and to plan and build Bendigo Hospital of a sufficient capacity;

(3) condemns Victorian Labor for its failure to stand up for Victorians when the former federal Labor government cut funding to Victorian hospitals from December 2012 by voting in this chamber to support the cut;

(4) supports the coalition government's record of $14.3 billion in health funding, which is $2 billion greater than what it was under Mr Andrews; and

(5) supports the massive $4.5 billion health capital works program currently under way, including hospitals that Labor failed to build in metropolitan and country Victoria'.

They are the facts and that is what this government has done in three years. When we came into government we had to fix those problems that were highlighted to us, that were disclosed and that were unfortunately discovered. Some of those health workers were put under great stress and strain.

Health services would have had to close down if they could not, for instance, have had their Christmas and New Year holiday pay. That would not have done anything for the Victorian community.

In conclusion, I will not be supporting Mr Jennings's motion. It is flawed in all of those elements. I have pointed out why. I again congratulate the coalition government on the delivery of health services and the continuing work it is doing in health on behalf of the Victorian community.


Ms HARTLAND (Western Metropolitan) -- After almost eight years of being in this Parliament I feel like I have listened to this debate roughly 12 times. It was one that happened on a number of occasions when the government was in opposition, when basically the same things were said about the Labor government. The problem is that we are now three years into this government and there are serious problems.

Some things were inherited from the previous government, and there are clearly projects that were never carried out, such as the Western Hospital emergency room. Because I am somewhat accident prone -- I have broken an ankle, I have broken a finger, I have done all kinds of things -- I am a bit of a regular at the Western Hospital emergency room. It has fantastic staff and the most disgusting building of any hospital I have ever seen. It should have been redeveloped under Labor, but this government has been here for three years. What about fixing Western Hospital? What about the expansion of Sunshine Hospital? It is clear that with growth in the outer west, medical facilities that are currently there are not coping. There needs to be a major expansion. Maybe that is something the government should be talking about as well.

Let us have a look at the other things that are happening. One thing that really concerns me is the ideological hatred of unions that is coming from this government. Let us look at a few examples.

Of course there was the nurses dispute. Then there was the dispute with the medical physicists, a dispute that the government would not resolve with a fairly small workforce of, as I understand it, about 40 people. Rather than resolving it, the government was using fly-in, fly-out medical physicists to travel from New South Wales to Traralgon because they no longer had a medical physicist there. These are the people who calibrate various X-ray machines, magnetic resonance imaging machines et cetera. In New South Wales they were being paid $35 000 more a year. The government would not settle with a very small group of workers because, as far as this government is concerned, you have got to drive the unions into the ground.

There is also the current ambulance dispute. How much longer do we have to go on with the government completely intransigent on the issue of negotiating with the ambulance union? I do not see any progress in this dispute, which has been going on for months and months.

Clearly there is a major problem that this government will not deal with. This is about a pathological hatred of unions. The government does not understand that people have rights to decent pay and decent conditions. Whenever you voice these kinds of concerns in this Parliament it is all about, 'You are taking orders from your masters'. The Greens do not have any masters in the unions. We support them because we think their claims are justified.

Mr Jennings in his contribution talked about the issue with ambulances in particular, and I appreciate the fact that he acknowledged that there was a problem under the previous government. But he also pointed out quite clearly the extraordinary number of hours that ambulances are now ramping at hospitals. Is that a system that is working well? Is that a minister who is dealing with these issues well? I do not think so.

Yesterday I asked the minister a question about heatwaves, and I found his response interesting. I will quote from what he said so I am not misrepresenting him:

I do not necessarily accept that these events will be occurring in the way the member has outlined and, as I said ...I think there are heatwaves from time to time and they are dealt with. But I think it is important that the esoteric debate about climate change is not confused in this way.

If a health minister who is dealing with heatwaves -- and the fact is that people die during heatwaves -- is a climate change denier and does not believe that heatwaves are going to happen anymore, they cannot set up the mechanisms by which they can deal with them.

Maybe the minister could read from the Victorian Climate Change Adaptation Plan on this issue, which states:

CSIRO and Bureau of Meteorology projections for future climate indicate that the average number of days over 35 degrees centigrade in Melbourne may increase from 9 days in 1990, to 11-13 days ... by 2030 ...
The Greens are not saying this; it is the Bureau of Meteorology and CSIRO. If he cannot plan for this because he refuses to acknowledge that there is a problem, does that mean he cannot do his job as health minister?

Many of the things Mr Jennings has said today are quite reasonable. The motion and debate are reasonable because they are about all the things we see currently not working in the health system. It is time that the minister acknowledged that there is a problem and got on with the job rather than blaming the unions and the previous federal government -- blaming this person, blaming that person. He should have a serious look at what is happening in health and fix it -- now.


Mr LENDERS (Southern Metropolitan) -- I rise to join this debate. In doing so I will make an observation. This is a motion of no confidence in the minister, which is a particularly serious motion in this house. In his motion Mr Jennings outlined seven sound reasons for this house not having confidence in the minister. I open with a broad discussion of what is expected from a health minister and, in that context, why this house should not have confidence in this Minister for Health.

The starting point, whether it be from the minister himself or from Ms Crozier, who stoically accepted the barrister's brief to defend the indefensible in the house today -- --

Mr Jennings -- She's no Robert Richter.

Mr LENDERS -- No Robert Richter, no. The first thing you would hope from a minister is that they have some vision, some passion and some view as to how to improve the system. In the end if you come to government and the best you can do after three years and two months is extend a litany of blaming someone else for a system, it begs the question, why are you even in the job?

From what we have heard through this entire debate it is as if the minister has gone back 20 or more years in his life to when he was an undergraduate student politician in university and it was all about debating, criticising others and finding blame. The central premise in all this is that this is a health system that is big -- depending on how you measure between the two departments, it is either the biggest or the second biggest expenditure item in the state of Victoria -- but more significantly, it delivers key services to hundreds of thousands of Victorians on a regular basis. The central and driving point surely must be that the role of the minister is to deliver the services, improve and enhance the services, make them better services and have some empathy for the people who use those services.

In the debate today we have heard statistics mentioned.

Mrs Peulich was interjecting during Mr Jennings's contribution saying, 'Don't talk about inputs, don't talk about inputs, don't talk about inputs', and then Ms Crozier got up and talked about inputs, inputs and inputs. Nowhere in that was there empathy. Nowhere in that was there a discussion about there being people who are in pain and who are waiting in ramped ambulances trying to get access to services in the emergency department at Frankston Hospital, in the emergency department at Monash Medical Centre, in the emergency department at Sunshine Hospital, in the emergency department at -- and we could insert other hospitals. There has not been a discussion of things being tough, that they should be better, that this is how we can make them better and that this is what we want to do. Even in the opening remarks of Ms Crozier's contribution to the debate, she had within about 2 minutes turned the discussion to what the health statistics in Victoria were in 2009.

As Mr Leane so often brings up in this house, if we go back to November 2010 and look at what was on the how-to-vote cards handed out at every polling booth in this state, we see that an item listed on those cards was that 800 new hospital beds would be delivered in Victoria, including 100 in the first full year of a coalition government. I have paraphrased the Liberal Party how-to-vote card. However, that was the commitment.

Mr Jennings very eloquently and dispassionately went through the data from the Australian Institute of Health and Welfare, which is on the public record. There are figures from the 2011-12 financial year, and there are figures from the 2010-11 financial year. What we see is that in 2011-12, which was the first full year of this government, there were 13 218 average acute beds. I am using that as a statistic, but I will get to how that affects people. That was down from 13 254 the previous year. I raise this not because it is a statistic, but because this government went out to the electorate and said, 'Our measure of how we are going to make this health system better for citizens of the state who want action, for citizens of the state who want treatment, for citizens of the state who want assistance when they need it, will be the increase in hospital beds'.

The one bit of objective data that is not locked away in the minister's man safe or hidden from the public -- objective data -- actually shows that the number of hospital beds has gone down. That in itself is a problem. If there were a good reason for that, if there were a debate around that and the minister was open and transparent about it, my view on whether or not we should have confidence in him might be different. But there has been denial. From day one there has not been an acknowledgement of any of that; from day one we have heard that there has to be somebody else to blame.

This characterises how this minister operates as a minister. I will articulate the pattern that we find here. The starting point, if we go to service delivery, is that for people in pain who need a service -- whether it be something as basic as a hip replacement, which people queue up for in hospitals, or something far more immediate, like an emergency department admission; no matter what it is -- the problems have not been addressed by the addition of 800 new beds. The problems have been made worse by, amongst other things, the $826 million in cuts over three budgets from this government that have resulted in our emergency departments being clogged up and an increase in those on the waiting lists. Rather than addressing this, the government always finds someone else to blame.

The historical fact is that the now Leader of the Opposition, Daniel Andrews, was the Minister for Health for three years. David Davis has been the Minister for Health for three years, but whenever there is a discussion about where the health system is now, it is as if the last three years never happened.

This minister's focus is perpetually on the three years before that. There is always someone else to blame. I remember quite clearly when this minister came into this house boasting of how he had sacked the ambulance board, employed a new board, made the ambulance system his own and had fixed the problem. Now, after three years, what do we see? It is a bit strange to be blaming someone else for this when the minister took the ambulance service as his own. He sacked the board and made it his own, and yet today we find an ambulance service where the minister cannot even negotiate with his own workforce. We have a minister who has politicised this matter beyond end.

Again, we see that the minister is incapable of even negotiating with the workforce. As he did with the nurses and as he is doing with the ambulance employees, he demonises the workforce and its elected representatives and he uses the power of government to add to that propaganda war.

To deal with the current situation where almost $500 000 has been spent on government advertising to deal with an enterprise bargaining agreement for a small workforce, if the minister's objective -- and it would be a laudable objective -- is to communicate with the members, it would not be rocket science to actually send them all a letter; there are not a lot of them. As Mr Jennings said to the minister yesterday in his question without notice, $450 000 would actually get three or more mobile intensive care ambulances in ambulance stations across Victoria today. But in the so-called interests of communicating with ambulance employees, this minister has actually chosen to communicate with ambulance employees and 5.3 million other people when a letter to a few thousand people would have equally got his message out.

The minister's spin and inattention to detail is fascinating.

If members were to look at today's notice paper they would see that notice of motion 534 calls on the federal government to reverse cuts that were reversed a year ago, or almost a year ago.

Business interrupted pursuant to standing orders.


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