This speech is in relation to the Statutes Amendment And Repeal (Institute Of Medical And Veterinary Science) Bill, which will repeal the IMVS Act and transfer its functions to the Central Northern Adelaide Health Service, which has become one of the great monoliths within our health system, carrying a huge responsibility in terms of health services across the state.
Adjourned debate on second reading.
(Continued from 30 April 2008. Page 2541.)
The Hon. J.M.A. LENSINK (17:17): Our position has been stated very clearly in the other place by the shadow minister for health, the member for Bragg and deputy leader, Ms Vickie Chapman, who spoke for several hours on this particular bill on 29 April. Being a non-lawyer and, I say in jest, a non-serial offender in terms of lengthy speeches, I do not intend to speak for several hours on this bill, but I will restate a few very important points in relation to this particular proposal.
This bill will repeal the IMVS Act and transfer its functions to the Central Northern Adelaide Health Service, which has become one of the great monoliths within our health system, carrying a huge responsibility in terms of health services across the state. It is centralisation. It goes hand-in-hand with the actions of this government, as we have seen in its most recent budget, in relation to not only country health, where our country hospitals will be absolutely gutted, apart from the four major centres, but also the non-spine (I think that is the language that the government uses) metropolitan hospitals, which will also be dumbed down in the effort of centralisation.
There can be no more obvious proof in the pudding of how this government is managing our health system than the actions of well over 100 doctors to date who have simply had enough of the way they have been treated. This is a government that believes in buildings and not the people who work in them. It is all very well to make great announcements about infrastructure, but if you do not look after the people who work in your system you do not have a system at all.
In relation to this particular bill, the pathology services, which are currently provided by the IMVS, SouthPath and the women's and children's department, which have all evolved separately along their own lines into a single pathology service entitled SA Pathologies, are merely a smaller part of the picture but nevertheless a very important part of our health system.
I declare an interest in that my sister was an employee of the IMVS a few years ago as a research scientist. The people whom I know who work there these days are really quite fed up with the way they have been treated by this government. They are treated like mice in a running mill and have their particular skills and expertise dismissed as if they are all just numbers that can be pushed around in some grand plan by this centralist government.
The IMVS has a very good reputation. I am pleased that at least the government has seen fit to allow the title of the IMVS and Medvet Sciences to be carried forward so that those reputations may continue to attract research funding. We see this as a means by which the government will take over all of these pathology services so that it can get its hands on the funding that they raise. Rather than respecting the particular models that may have developed historically, they will be rolled into one homogenous system regardless of whether that is the best way to proceed going forward.
There are a number of issues in relation to staff. I understand that the IMVS lost its FBT status three or four years ago and was grandfathered until recently. We were told in a briefing—and I am grateful to the minister's staff for the information that they provided—that when staff becomes part of CNAHS they will be able to salary sacrifice again. There are also, I understand, some contract issues in terms of the transfer that still need to be approved. The new entity will need to become an approved pathology provider in order to receive commonwealth funding.
I think it also needs to be highlighted that, because of its reputation, the IMVS undertakes a significant number of tests from private GPs. It will be interesting to see whether that, in fact, continues.
I note that the government assumes that it will actually be undertaking more tests. I think that is optimistic. It also claims that there will be some cost savings of $2.177 million over two years. I think that is probably rather optimistic as well; possibly it is part of some illusion that is part of the vision of the shared services which has occurred in a lot of government departments but which really is not coming to fruition.
We are not sure where those savings of $2 million plus will come from. I also understand that there are 'fee for service' funding model issues that are still to be worked through. I note that the cost per test on average for the IMVS is $25, SouthPath $31 and the Women's and Children's $71, so one would have thought that, if one wanted to amalgamate them, the intelligent thing would be to keep the IMVS and make it the lead agency for pathology testing in South Australia.
Another disappointing thing about what happens when these entities are all rolled into one service is that the expertise of the board is lost, and I note that the CEO Professor Brendan Kearney has a great deal of experience in the health field. Once these entities are rolled into one under CNAHS, we will see the lack of transparency continue, with much less public information being made available.
When one looks at budget papers or annual reports these days, the funding, the number of patients and the number of tests and so forth, are all aggregated, so it is very hard to actually work out what is really happening in the service, which I suspect is part of the design of this proposal in that it reduces transparency. As we know, our health system is in crisis, and the government would rather that the real world should know as little as possible about what is really going on.
I would like to place on the record a question: does the government have any intention of selling any of the assets of any of those three services as this goes through? We have been given reassurances in the past, along the lines of, 'We're from the government; we're here to help; trust us.' As I said earlier, we were given those assurances in relation to Country Health and now look at what is happening there, where the services will be so minimal that, to be quite honest, speaking as a health professional myself, nobody will really want to go there to work, because the work is just not particularly challenging.
That equates to training places and so forth. It really is pulling apart the fabric of a health system that has taken decades to develop, and those communities within the health system that have developed and have been self-sustaining are being pulled apart. I fear that the same will happen with our pathology services in this state which have had such an excellent reputation to date. So, I seek an assurance from the government that no assets will be sold as a result of this within the next two years and, with those remarks, I indicate that we will be calling for a division on this bill in opposition.