Liberals promise more money for local hospitals if they gain power

The SA Liberals have promised more money for regional health services should they win power in 2018.

Shadow Health Minister Stephen Wade MLC, current member for MacKillop Mitch Williams and Liberal candidate for the seat Nick McBride addressed a local health forum on Wednesday night

Other talking points at the forum were the resurrection of local health boards, investing in regional skills and health insurance.

The event was organised by Mr McBride, who often took the floor. Federal Member for Barker Tony Pasin also spoke briefly at the end of the forum to support the local Liberal representatives.

Most of the questions on the night were fielded by Mr Wade, who was there to give more details about the Liberals’ plans for their next tilt at controlling the state.

Regarding the current set-up of hospital management, Mr Wade told the audience that the Liberals' plan is to have state, local and regional boards. There would be "decentralised decision-making, local solutions, familiar stakeholders".

Mr Wade compared South Australia to other states that have boards, and said that there was “too much bureaucracy” involved in the decision-making process. The state Liberals wanted to “challenge the big city bureaucrat belief” that the best budget plans had resources go to a central, metropolitan hospital.

A recurring theme among the speakers was frustration at “Adelaide-based bureaucrats” who didn’t prioritise the needs of country hospitals. The one-time closure of Keith hospital was used as an example of this contention. 

Of the Millicent hospital, Mr McBride said: “There used to be 12 GPs and 180 babies born in one year – now that’s all gone.”

According to Mr Wade, there are “no rural Australians in the state Labor party room”, and this was evident by their priorities.

“The Labor government failed to get its plan through for country hospitals in 2007/2008,” Mr Wade said. “Sub-regional hospitals haven’t seen a paintbrush in decades.

“”In the 2017/2018 Labor plan there is $900m for capital works – but not a dollar for country regions. But they could find the money for a major expenditure on the RAH (Royal Adelaide Hospital).” 

Mr Wade gave an example of when he challenged former Health Minister Jack Snelling on his funding priorities, and Mr Snelling had reportedly replied: "The RAH is the state’s largest country hospital.”

This anecdote resulted in a ripple of displeased murmurs from the crowd. Mr Wade followed the anecdote by saying that while the RAH may serve all South Australians, and there is likely a high number of regional patients who are treated there on a daily basis, country South Australians shouldn’t have their hospitals closed or neglected for the sake of saving money for city hospitals.

Mr Wade also said regional South Australians were losing out on vital mental health funding, identifying rural and regional Australians as a “high risk group” for mental illness and mental issues. Reportedly there is currently no resident psychiatrist in the South East.

City-based bureaucracies were also attacked by Mr McBride, who stated: “Mediocrity runs supreme in this state. I have better things to do than be Mr Average.”

Mr McBride expressed support for a higher budget for regional hospitals, and mentioned that he had a personal as well as political investment into making sure that the local populace received high quality healthcare (his wife is a nurse).

Mr Williams – who received a round of applause for his long years of service – spoke in support of local health boards, and health advisory councils.

Mr Williams shared an anecdote about how past systems of communication compare to the present. According to Mr Williams, if he wants to consult with the Naracoorte Hospital, he first has to seek permission from the Health Minister (which is currently Peter Malinauskas). 

In the past, when there were boards, he would simply ask to speak with them.

However, not everyone in the crowd was fully enthusiastic about a return to hospitals primarily being managed by councils and boards.

Des Murray, who is associated with the Bordertown Health Advisory Council, said he was concerned about how much funding would be allocated to smaller towns in the region.

Comparing Bordertown to more populous towns like Mount Gambier and Naracoorte, Mr Murray asked, “What voice will a smaller town have on a board?”

Mr Murray didn’t rule out support for boards, but he did ask the assembled politicians about whether or not there would be “fine print” on board construction and town representation.

Mr Wade answered that boards would be skills-based, rather than town-based, which would help alleviate the problems of some towns receiving more privileges.

He also stated that the boards, while working in the interests of their local region, would still be held accountable by the Health Minister and the Premier to deliver positive healthcare results right across the region.

When Mr Murray later said that Bordertown hospital had not been consulted about health budgets in the past, Mr Wade replied that under a Marshall government, there would be more transparency about costs provided to both boards and individual citizens.

Mr Wade added that while the Liberal party could not guarantee they would provide “largesse”, he assured the crowd that all country hospitals under a Marshall government would be adequately funded.

The audience member who expressed the most skepticism about the idea of a return to boards was Dr Brian Norcock. Dr Norcock also expressed concern for smaller towns, saying, “Mount Gambier, Naracoorte, Bordertown – they’re separate entities.”

Dr Norcock’s suggestion was to sort the towns into sub-groups of geographic sizes across the state, in order for boards to make decisions based on need related to population.

While Dr Norcock’s idea received applause from the crowd, Mr Wade disagreed, saying that an industrial framework was best. This was because services provided by hospitals were often related to each other, with hospitals transferring patients based on their medical need and distance.

“We don’t want fiefdoms who are fighting with one another,” Mr Wade said.

Discussion about the boards dominated the question-and-answer session, with audience members generally accepting and agreeing that regional medical skills in health and medicine would benefit country hospitals. 

The third talking point, between private and public health insurance, received a few questions about coverage benefits. The Liberal party members in the room believed that private health insurance could be both a “public and private good”, with the Keith Hospital being an example of a hospital gaining funding from more and more citizens choosing private health insurance. 

According to Mr Williams this scheme stopped under the former Health Minister John Hill, which resulted in another low murmur from the crowd.