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Crisis in the Health System

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Wednesday, 17 October 2018

Tags: Health, Ambulance Ramping, Ambulances

That the House -

  1. Agrees with the Premier Hon. Will Hodgman MP's frank admission that the health system is 'not good enough'. 
  2. Congratulates the Member for Clark, Hon. Sue Hickey MP, for her call for an apolitical, long-term approach to fixing the health system. 
  3. Calls on the Premier to include representatives from all sides of politics in a statewide roundtable discussion with health professionals, unions and stakeholder groups between now and the end of 2018. 
  4. Further agrees that the best way to tackle the crisis in the health system is by working together. 


Dr WOODRUFF (Franklin) - Mr Deputy Speaker, I will make a short contribution to give the minister a chance to speak to this motion.

The Greens agree with the general tenor of this motion. It is a bit of a political motion because it has an internal contradiction which does not make sense to me. This is a political issue. It has become a political issue because this Government has failed so consistently to come into office and grapple with what needed to change, given everything the minister said in 2014 and beyond about the things that needed to change in the health system. He has set about doing the opposite of what is needed.

It has become a political situation. We have seen front page news in newspapers, in headlines and on the news at night for years now, far beyond the normal course of events that you would expect to see on health systems in other states.

We all accept that health is a very challenging portfolio, particularly in modern Australia. Nonetheless, the way the minister and this Liberal Government have chosen to prioritise cuts to the budget over the last five years has led to this devastating situation in Health.

It has been hugely exacerbated by the minister hiding information in the last term of government, particularly leading up to and just after the state election. They were not upfront about reports that had been done on the access to emergency care. A report the minister sat on for about five or six months had to be retrieved under a right to information request. The information that was passing within the THS and beyond, formal and informal information, about the real concerns about the CEO of the THS, his terrible performance and the impact it was having. Subsequently, he is no longer in that position.

The restructure of the THS happened after 2014. The minister did not listen to comments from his own health staff about how it was too centralised, too rigid and how it cut the hospitals out of having any voice at all. So the pendulum swung hard over to try to counteract what this Government and other people saw, in their view, problems, in their eyes, in the management of health that was there from the previous period.

In doing that they did not listen to people's concerns along the way. There was an arrogance about how things should be managed. Unfortunately, the chickens came home to roost. They have done so in a very distressing way for people waiting in an ambulance, ramping for hours and hours and hours outside the Royal Hobart Hospital, and sometimes the Launceston General Hospital. Patients in mental health distress are forced to wait for hours or days in the emergency department in places that are clearly unfit for a person in their situation.

The contradiction in this motion, however, is that Ms White congratulates the Speaker, Sue Hickey, for her call for an apolitical approach to fixing the health system but then wants the Premier to include representatives from all sides of politics in statewide round table discussions with health professionals, unions and stakeholders. That is a political response. It is a political situation but I do not believe it demands a political response. In principle, we do not have a problem with that call. I am not sure the Greens would feel the need to be involved in that conversation. We believe we have called for and we ourselves have run a health stakeholder round table because this Liberal Government failed to do that.

We support a call for a statewide round table discussion with health professionals, unions and stakeholder groups between now and the end of 2018. I do not think that it would be an advantage to have all sides of government there. What would be an advantage would be for the minister to clear away the wreckage of his reputation of not listening to stakeholders and start on a new foot.

Let us believe that Mr Ferguson has really grappled with the situation now, we are in a second term and we have four years. It is an opportunity with lots of things changing. Some things are changing for the worse but that is the time to take stock. I hope that the minister has learnt that stone walling, hiding information, refusing to listen to people when they say things that are unpleasant is not the way to run a health department; it is not the way to get people on board, and it is not the way to solve intractable problems.

Having a stakeholder round table, inviting people and making the information about what they say available - Let us face it, this is Tasmania. There is not point hiding it, because it will come out eventually. Stuff comes out. It is much worse when you hide it in the first place. Have confidence in your convictions. If you know where to go, just be proud. You can do it, minister, I know you can.

There is a systemic problem here which is really a difficult one. It is difficult for the Liberals in government to do what needs to be done in this situation. It is not that the minister is not capable. We have a really obvious problem with way too much workload happening in the Liberal Government, and with a Premier who now has 10 portfolios it is a totally ludicrous situation. We have a minister who has too many portfolios. Health is a massive responsibility. Looking from a bird's eye view as though you were an alien looking down, why would you give Police, Emergency Services, Fire and Health to the same person to manage, especially when you have a health system like we do? Clearly that is a problem.

The other problem is the Liberal philosophy, which is that things are individual responsibilities and if people take individual responsibility and we focus on the individual then we can get outcomes. That is clearly going to continue to take us down the path of more ambulance ramping and more money spent in the health system and the acute area. It will prioritise focus on the medical model. It drives the ambulance to the bottom of the cliff and requires us to continue to focus in that way at the acute situations and crises which will continue to get bigger and more extreme.

The minister had an inkling of that in 2014 with the idea in 2013 of having the best health in Australia by 2025, but the issue is you cannot do that without a systemic response. It was not an accident in Australia when we had a Liberal Prime Minister like Tony Abbott refusing to remove junk food advertising from children's television, and John Howard before him said the same thing - 'It is the responsibility of parents to tell their children how they should eat. It is not our job as a government to get junk food advertising off children's television. Parents should just education their children better.' I mean, really? It is not surprising we live in a society with the highest levels of obesity when we have companies like Coca-Cola Amatil and Schweppes coming in and making damn sure we do not introduce container deposit legislation to make sure there is nothing at all that impinges on their bottom line. It is no surprise that we have chronic diseases increasing all the time because of the stranglehold of the big food industry on our labelling and packaging of food at the federal level.

We have a situation where we do not systemically push down on alcohol or talk about the impacts of alcohol and do something about the volumetric amount of alcohol in drinks and price it relative to the percentage of alcohol. We do not do that because we want to allow a free market for the alcohol industry to make as much profit as they can, but it is at our expense and the expense of individuals who, for a whole range of reasons, are not able to control ourselves as much as they would like to.

It is the role of government to put money into health and all policies that go across the whole Government so that when we design roads and footpaths they are designed to make sure they give us the opportunities for exercise as we need it.

It is something that the minister can do in looking at putting the money, over the next couple of budgets, into the amazing voluntary resource that we have in the community of people who work for free to support the people who live with their families who have mental health illnesses, their friends who need to be cared for and all of the organisations that do essentially free voluntary work. They are the backbone of this community. They are the backbone of the tuckshop and fresh food schools movement. They are the backbone of the carers' organisations and they get an absolute pittance out of the Health budget. Typically that money has not even been increased beyond CPI year on year. They are expected to be able to cope. I have been around and talked to them and many of those organisations cannot do it much longer. They may not be able to do it any longer. Some of these people are held together by only one or two amazing people but they are getting burned out. They need a bit of support. Almost all of the work they do is voluntary. It is such an incredible resource relative to the billions of dollars in the Health budget. They do massive lifting and they need that support.

If you were to increase their budget by 100 per cent it would be a tiny part of the budget and make such a huge difference. It would have a multiplier effect which would go a long way to the distributed health system that we need so it is not all focused around the Royal Hobart Hospital, the Launceston General Hospital and the North West Hospital and on a medical model and an acute health model but it is looking at, way upstream, preventative health and community health.

The Greens are happy to support this motion. We do not feel the need to take up a round-table discussion with health professionals, unions and stakeholders. We would be expecting, demanding that the outcomes of those sorts of round-tables be made public and no longer be done behind closed doors. Everyone understands we are on a pathway to increasing the problems we have had in the past and we can turn that around now. We should work together on this issue, as on all issues. We have our state's best interests at heart and we have the people within Tasmania that we all care about in every part of the electorate we represent.