Repatriation General Hospital and the Southern Adelaide Local Health Network

In Parliament - Thursday, 19 May 2016

Mr DULUK (Davenport) (12:44:27): I would like to thank the member for Morphett for moving this important motion that he has today and has spoken to. Of course, the Southern Adelaide Local Health Network delivers public hospital services to more than 350,000 people living in the southern metropolitan area, including those in my electorate, and of course in the electorate of Waite.

The Flinders Medical Centre, Repatriation General Hospital and Noarlunga Hospital are the bedrock of this network, yet this government is committed to removing an entire hospital from the network. We are not talking about closing a few beds or even shutting down a ward; no, we are talking about removing an entire hospital from the network. The government is intent on destabilising the very foundation of the health network in southern Adelaide by closing the Repat. The effect on South Australia's public health services will be significant and longstanding, not just for veterans but for thousands of South Australians, and especially for residents in Adelaide's south.

The Repat currently plays a critical role in the state's health system, providing specialised services in urology, vascular surgery, respiratory medicine, cardiology, ophthalmology, diabetes and rheumatology, just to name a few. There are around 140,000 outpatient attendances each year at this hospital, 2,000 transfers from the Flinders Medical Centre for overflow and convalescing patients, and almost 200 beds for general medicine, surgery, palliative care, mental health and rehabilitation services.

I suppose the question that goes to the core of this motion is: what will happen to all these services when the Repat closes? What happens to the 1,341 orthopaedic procedures, 1,353 urological procedures, 604 general surgeries and 665 plastic procedures that the Repat handles in most years? Of course, these are the numbers that were handled in the 2013-14 year. Where will the residents of southern Adelaide go for these services? Surgical services in southern Adelaide will take a massive hit due to the loss of beds, operating theatres and day surgery facilities.

No replacements and no alternatives have been announced by the Labor government: no announcement on how the government plans to deliver these essential services currently provided at the Repat, no announcement on how the government will meet the future health needs of 90 per cent of Repat patients who are civilians, and no announcement on how the already stretched Flinders Medical Centre will meet the surge in patient numbers that will follow the closure of the Repat.

Earlier in the debate, the member for Waite indicated that his residents support the closing of the Repat. Can I say, my office is constantly contacted by people in his constituency who are concerned by the closure of the Repat and how the services that are currently being provided at the Repat will be provided going forward. The announcement this week that the RSL will be the new caretaker for the Repat site masks the reality of Transforming Health and its debilitating impact on public health services, and especially its impact on patients and their families in Adelaide's south. Here, we talk about what the role of government is. The role of state government is to provide public health services. It is not to privatise those health services: it is to provide health services for the public.

Public protests and ongoing community opposition have made no impression on this state government in relation to the closure of the Repat. The petition opposing the closure of the Repat has attracted more than 120,000 signatures, and yet the government still refuses to budge. As the Save the Repat campaigner and veteran Augustinus Krikke said, 'For the government to ignore a petition of that size says something about the mindset of a government that has been in power for 14 years.'

The proposed RSL-led transformation of the Repat site will not provide the medical facilities that the community need in southern Adelaide. There will be no medical and no surgical facilities at that site anymore and no patient facilities for what is proposed within the new RSL-led transformation. The Save the Repat campaigners did not spend five months protesting on the steps of parliament to deliver a retirement living centre with a general medical clinic on the side. Whilst this, seen on its own, may be a good thing, it is not what southern Adelaide needs in terms of health treatment.

To lose a complete hospital leaves a significant hole in South Australia's health system and a giant chasm in the Southern Adelaide Local Health Network. At a time when our population is ageing and demand on hospital services is ever-increasing, the government has taken a razor to the state's health system. Indeed, the proposal by this government, in terms of the renewal of the Repat, fails to capitalise on over $40 million of government funding spent on the Repat Hospital in the last 10 years, and may I add that the vast majority of that federal coalition spending money is now wasted.

This government is very good at wasting money. After all, this is a government that has spent $3 million of taxpayers' money spruiking its changes to the health system and trying to sell the virtues of its debilitating Transforming Health policy; changes that of course include the closure of the Repat. Under the government's Transforming Health changes, those suffering from post-traumatic stress will no longer benefit from specialist services at the Repat and, instead, will be sent to a new facility at the Glenside Health Precinct, a precinct unable to deliver medical care for any physical problem that veterans may have in addition to PTSD.

The Repat at Daw Park has played a critical role in delivering vital healthcare services to war veterans for 74 years. It has helped countless veterans, whether they have required medical treatment for physical ailments or assistance with mental health problems. Veterans have been able to receive help in one place. Now this Labor government is fragmenting those services and sending veterans to other sites across metropolitan Adelaide to receive clinical services previously provided at the Repat.

The 15 palliative care beds at the Daw Park Hospice will transfer to a new 15-bed facility at the Flinders Medical Centre; the new facility forming part of the new $170 million building. That is $170 million of new money for a building that only includes 15 palliative care beds—no more—the same number that is being provided at the Repat. There will be no net gain in palliative care service in southern Adelaide, as confirmed by the health minister in his answer to the question yesterday.

An honourable member interjecting:

The DEPUTY SPEAKER: Order!

Mr DULUK: That is despite the government's own palliative care services plan for 2009‑2016 stating that facilities at the Repat would be expanded to a 22-bed unit and despite the palliative care service plan also highlighting the need to develop a hospice at Noarlunga Hospital with a base capacity of 10 beds by 2016. That is 32 beds that the government identified as being required by 2016 to meet hospice care needs in the southern suburbs; 32 beds the government outlined as a commitment to providing for the South Australian Adelaide areas as well. Of course, the former health minister, the Hon. John Hill MP, at the time said:

SA Health's Palliative Care Services Plan 2009-2016 outlines the South Australian Government's plan to expand and reshape services, in light of increasing demand for end of life care across the health system.

I ask the current Minister for Mental Health and Substance Abuse: was former minister Hill wrong? Is there new funding for palliative care and in-home care services available? No, of course not. They are simply just not meeting what is in their own plan. They say they are looking at more stay-at-home facilities for those in need of palliative care—we will see what is in the budget coming up.

The Hon. S.E. Close interjecting:

Mr DULUK: We will see what is in the budget coming up to see if those services have actually been funded.

The SPEAKER: Order! The minister is called to order.

Mr DULUK: But they are not and, of course, the minister is agitated.

The DEPUTY SPEAKER: Sit down. The minister is called to order. The member is allowed to be heard in silence.

Mr DULUK: Thank you, Deputy Speaker, for your protection, as well.

The DEPUTY SPEAKER: No further remarks are necessary; just carry on.

Mr DULUK: The 15-bed Daw Park Hospice that is currently located at the Repat is closing and any funding for a new palliative care unit at the Flinders Medical Centre only provides for 15 beds. These are the facts, yet as I said our population continues to age and the southern suburbs continue to swell and the demand for palliative care service will always continue to grow.

The new $170 million facility at the Flinders Medical Centre will be immediately inadequate, providing only 15 of the 32 beds the government identified as being required for southern Adelaide. There is another failed plan, another broken promise and another wasted opportunity and the healthcare needs of southern Adelaide, once again, are ignored.

The state Labor government must stop blaming the federal government for its financial mismanagement. It must stop passing the buck and shirking its own responsibility for health policy in the state. Health services are, of course, the core responsibility of any state government. It was the state Labor government's decision to adopt Transforming Health, it was the state Labor government's decision to butcher our health network and, of course, it is the state government that is intent on closing the Repat Hospital.