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Wednesday 29 May 2019 The Speaker, Ms Hickey, took the Chair at 10 a.m., acknowledged the Traditional People and read Prayers. QUESTIONS Hospitals - Implementation of Recommendations of the Auditor-General Ms WHITE question to MINISTER for HEALTH, Mr FERGUSON [10.02 a.m.] The annual $100 million blackhole in health funding remains and total funding for health services in Tasmania increased by less than $11 million or 0.5 per cent over the next year and just $5 million the following year. You know that the Auditor-General yesterday released an 18-month investigation into emergency rooms at each of Tasmania's four major public hospitals and found an unacceptable and dangerous situation. His most damning finding is that between 2015 and 2018 - on your watch - there was a 60 per cent increase in adverse events in emergency departments. Sick people presenting at EDs are getting sicker and Tasmanians are dying avoidable deaths. The Auditor-General makes a clear recommendation that you sufficiently resource hospital teams urgently. Are you finally listening and will you adopt that recommendation now? ANSWER Madam Speaker, I thank the Leader of the Opposition for her question. Yes, the Government is listening. I am listening and we will never stop listening. I want to say from the outset that there are political points to be made on both sides of the Chamber around funding. We will always stand up for our strong record in providing extra funding into the health system each and every year. Many commentators including members opposite who failed to produce an alternative budget yesterday will have different points of view, which also can be made. On the report from the Auditor-General, the Government welcomes that report. It should be welcomed indeed by every Tasmanian as it has been from across the clinical community. There are lessons that can be drawn from the Auditor-General's very detailed look into the performance of emergency departments. The Auditor-General in his report casts his mind back much further than just five years. He goes back quite a period of time. It is a reflection not just - indeed, he has made this point quite explicitly - it is not just about funding at all. It is about governance and how decisions can be better made. It is about breaking down silos that continue to persist and cultural issues which the Auditor- General has pinpointed in wanting to be constructive. That is where he has placed quite a heavy emphasis. What this represents for us is an opportunity to explore his recommendations. I am all for a thorough look into how we can implement the recommendations of the Auditor- General's report. I welcome it. To that end, even though it is the case that the report was only tabled yesterday, I have requested comprehensive advice from the department so that we know how we can implement those as soon as possible. The Government will continue to work with relevant stakeholders. We have our meeting next month. There is a lot of work going into that. 1 29 May 2019 In advance of the Auditor-General's report, I had already come to the view that we should invite him to the Access Solutions meeting next week. I will ensure his report is provided to all attendees so they can be as informed as soon as possible so that everybody can come to the task with the right mindset. The right mindset is to continue to deal with any bureaucratic obstacles that get in the way of whole-of-hospital solutions to an emergency department access challenge and also, to end the blame game. Members interjecting. Madam SPEAKER - Order. Mr FERGUSON - That is my responsibility, it is your responsibility, it is the Government's responsibility and it is the Opposition's responsibility because the blame game is helping no-one. Members interjecting. Madam SPEAKER - Order. I would prefer that we did not have a repeat of yesterday's behaviour. Please let us get through question time. Mr FERGUSON - The Government is all for helping our patients get better access to our hospitals. Almost for the first time, it seems to have dawned on members opposite that we have hit capacity. We are full. We have opened up all the wards that were closed and we are building more capacity. How can we do better before that capacity comes on line so that the patients get the best possible access? That is what the Government stands for. Also, in line with much of the commentary in the report, which was not mentioned in the question, we acknowledge we need to improve governance and accountability within our health system. It is not a set and forget process. It is a continual need to monitor this and to be willing to change even more, if required, so that we can improve both governance and accountability within the health system. By the way, as the report shows, many of these issues have been around for yonks, indeed over a decade. We have been taking action by bringing in important reforms to clarify and strengthen accountability in our health system. The thing that brought this House together only one year ago, was placing accountability in one place, with the secretary of the department of Health being the single point of accountability for ongoing management and service improvement of health care in our state. Implicitly, this included stronger local leadership for our hospitals. We remain committed to seeking further improvements in that regard. You ought not verbal the Auditor-General in relation to that because he held open the prospect that can, and should, be leveraged to deliver the better outcomes that we want. I will conclude on this point, knowing that there will be more questions and interest in this and that is fair enough. We will act and I have welcomed the report. It is a really constructive contribution to how we can help patients get better access to our EDs. I am all for that and you will see action in this area. 2 29 May 2019 Budget 2019-20 - Health Staff Funding Ms WHITE question to MINISTER for HEALTH, Mr FERGUSON [10.08 a.m.] Together with your colleague, the Treasurer, your incompetence in budget management has resulted in the chronic underfunding of Tasmania's health and hospital system and now you are about to go further. Your latest train-wreck budget acts as a further $450 million cut across the public service. The Australian Medical Association says in the next year alone that can only mean further cuts to health and has pleaded with you to stop. Dr John Saul says: … the Government should cease the efficiency dividend that will see a $14m cut to the health budget. This inevitably will mean around 130 backline staff will go, making it even harder for the front line to do their job or frontline staff not being employed fast enough to end the crisis. Minister, you know this. How much will you slash from hospitals and health to reach your $450 million in new cuts across government? How many staff will have to go or are you prepared to claim that Dr Saul is wrong? ANSWER Madam Speaker, I will answer the question by correcting the Leader of the Opposition. We are increasing the health budget and to correct five years of misinformation from Ms White, we have increased health funding every year we have been in office. We will always look to meet demand and that is exactly why we provided $105 million additional in the current financial year and more funds in the new financial year which is set out in the budget papers. We have taken health funding now to $8.1 billion over four years. That is the biggest increase in health funding but in the question you overlooked that fact. Ms White - It is a sad joke. Mr FERGUSON - This is from the Leader of the Opposition who only goes back to the one shot that she has, which is the blame game. Ms White - Are you not accountable as minister? Mr FERGUSON - We are actually interested in solutions and you have failed to acknowledge that in the Budget there is $30 million specifically to meet demand where we have named up a preparedness to look at funding initiatives that emerge from the Access Solutions meetings which, by the way, is exactly what the Opposition has been calling on us to do and now we are doing it, the Labor Party is not happy. We are bringing together all the experts on an informed basis to create the right environment to make decisions and provide advice to government so that we can help our patients, and the Labor Party does not like it. That is offensive to Tasmanians because every editorial in today's papers has been calling for bipartisanship. We offer that bipartisanship again today but the line of questioning again shows that the Labor Party do not want bipartisanship. They want the blame game. You cannot have it both ways. I again restate that the Government welcomes what is something like a scholarly piece of work by the Auditor-General with constructive recommendations that can support decision-makers to 3 29 May 2019 work together to help provide a stronger and more accessible health system. I hope the Labor Party will embrace the bipartisanship I offer and which the editors and the newspapers and everyday Tasmanians are expecting of us. Budget 2019-20 - Tourism Growth Mr TUCKER question to PREMIER, Mr HODGMAN [10.12 a.m.] Can you outline how the 2019-20 Budget continues to deliver on our goal to transform Tasmania into the tourism capital of the world? ANSWER Madam Speaker, I thank the member for his question and the opportunity to talk about our Budget and the Government's determination to continue the momentum of growth investment and the excellent promotion of our state as the country's premier destination.

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