Extract from Hansard [ASSEMBLY — Tuesday, 22 May 2012] p2940a-2989a Mr Christian Porter; Mr Roger Cook; Ms Rita Saffioti; Mr John Kobelke; Mr Fran Logan; Mr Peter Watson; Mr Chris Tallentire; Mr David Templeman; Dr Tony Buti; Mr Andrew Waddell; Mr Paul Papalia; Mr Peter Tinley APPROPRIATION (CONSOLIDATED ACCOUNT) RECURRENT 2012–13 BILL 2012 APPROPRIATION (CONSOLIDATED ACCOUNT) CAPITAL 2012–13 BILL 2012 Declaration as Urgent On motion by Mr C.C. Porter (Treasurer), resolved — That in accordance with standing order 168(2), the Appropriation (Consolidated Account) Recurrent 2012–13 Bill 2012 and the Appropriation (Consolidated Account) Capital 2012–13 Bill 2012 be considered urgent bills. Cognate Debate Leave granted for the Appropriation (Consolidated Account) Recurrent 2012–13 Bill 2012 and the Appropriation (Consolidated Account) Capital 2012–13 Bill 2012 to be considered cognately, and for the Appropriation (Consolidated Account) Recurrent 2012–13 Bill 2012 to be the principal bill. Second Reading — Cognate Debate Resumed from 17 May. MR R.H. COOK (Kwinana — Deputy Leader of the Opposition) [4.19 pm]: I am very pleased to be the first member on this side to respond to the Treasurer’s speech on the Appropriation (Consolidated Account) Recurrent 2012–13 Bill 2012 and the Appropriation (Consolidated Account) Capital 2012–13 Bill 2012, but I note that I am not the lead speaker. That will in fact be the Leader of the Opposition, who will address the chamber tomorrow as he advised earlier. I would like to make some comments about the health component of the state government’s budget and reflect, time allowing, on some of the deficiencies that I see in this budget with respect to my electorate of Kwinana. This health budget can be characterised by disappointment, delays and deficiencies—disappointment in its capacity to respond to the demand on our health system to date and to properly allow for the cost increases; delays in the infrastructure and cancellation of much-needed health infrastructure; and deficiencies in the response to some of the key policy issues confronting our health system today. The minister might be able to stand and quote the Western Australian Council of Social Service regarding some of the broader issues of the budget brought down by the Treasurer, but he cannot quote any of his own health stakeholders in their commentary on the health budget. Indeed, I want to quote the Australian Medical Association from last week. It stated — The Government has missed the opportunity to future proof WA by failing to provide adequate funding increases, it has missed the opportunity to prepare for a fast growing and ageing population and it has missed the opportunity to provide adequate research funding. The AMA went on to state — This is a treading water budget as the health system shows signs of drowning under increasing demand. The proposed overall spending increase of 7.3% will only barely cope with health inflation and will not come close to meeting the massive increases in demand. These comments really summarise the difficulties that confront this health budget. It has not confronted the issues associated with demand. The 7.3 per cent increase in expenditure that the AMA identifies simply will not adequately provide for the health system into the future. In the out years the government has provided for a 4.1, 4.1, 4.1 increase and then a 4.7 per cent increase in the health budget. This is, quite frankly, inadequate. It is an inadequate response for what will be a tsunami of demand—a demand that the minister himself knows will be forthcoming in the future years. Let us look at the nature of some of that demand. If we look at the health department’s quarterly performance report from January to March this year, we get a snapshot of the sorts of issues impacting on the department. For instance, 10 296 patients were discharged and 133 841 separations took place from January to March this year. That is an 8.3 per cent increase over the same time last year, at a time when this government is providing a 7.3 per cent increase in funding to the health department. There were 17 123 emergency department attendances in the last quarter. That is a 7.5 per cent increase over the same time last year and an 11.6 per cent increase in the metropolitan hospitals alone. Admissions from emergency departments grew by 9.1 per cent, and 10.5 per cent in the metropolitan area alone. Those figures are, in particular, from those hospitals participating in the four-hour rule. We see the same trends happening in Western Australia as happened in the United Kingdom; that is, we are seeing a spike in admissions from EDs as hospitals move to accommodate the demands of the four-hour rule. There was a 9.1 per cent increase in ED presentations for those hospitals undertaking the four-hour rule. [1] Extract from Hansard [ASSEMBLY — Tuesday, 22 May 2012] p2940a-2989a Mr Christian Porter; Mr Roger Cook; Ms Rita Saffioti; Mr John Kobelke; Mr Fran Logan; Mr Peter Watson; Mr Chris Tallentire; Mr David Templeman; Dr Tony Buti; Mr Andrew Waddell; Mr Paul Papalia; Mr Peter Tinley One would think that the minister, when confronted with these sorts of demand figures, would go to the Treasurer and say, “We cannot have a business-as-usual approach to health.” We cannot tread water, as the AMA has accused the minister of doing on this occasion. We need to bring extra resources to bear to make sure that our hospitals, and the doctors and nurses who work in those hospitals, have the resources they need to meet demand. But the government’s response has not been to meet that demand with extra resources. In fact, there will be cuts to current health programs right across the forward estimates. There will be cuts of over $100 million in 2012–13, and $716.4 million over the full budget cycle to 2015–16. That is through the efficiency dividend. However, there will be a further $32.5 million in extra cuts over the budget cycle. We are seeing the continuation of staff working in a health system with fewer resources and being required to do more with those fewer resources. The experience of Western Australian families who go to hospitals for services is very different. At the same time as we are seeing this increase in demand, we are seeing a corresponding decrease in the level of services. There has been an increase of only 0.7 per cent in admissions from the elective surgery waitlist. There has been a 3.2 per cent increase in waiting times on the waitlist in the metropolitan area, with a 1.7 per cent increase overall. There has been a corresponding decrease in the number of available active overnight beds—a 7.7 per cent decrease in that area—with a corresponding increase in occupancy rates of 0.8 per cent, taking the figure up to 86.2 per cent. In particular, one of the statistics that is most disturbing is that there has been a huge increase of five per cent in the number of visitations to dental clinics, and the number of people on the dental clinic waitlist has grown by a massive 24.4 per cent to 24 856. The performance in relation to hospital services is very disturbing. I mentioned the elective surgery waitlist. It is interesting to note that under current performance levels across the first quarter of this calendar year, the government has failed to meet any of the national health partnership targets that it will be measured against at the end of this year for the reward payments for the health system. It is a long way short. If the health department cannot increase its elective surgery performance, we will again lose out with reward payments. The other area of concern in the health budget is the delays in and the cancellations of health infrastructure. The most notable disappointment that must be felt by the electorate is that once again the government is watering down its commitment to the people in relation to Royal Perth Hospital. The minister has already said that there is a future for Royal Perth Hospital, despite his reluctance to progress the legislation through this place. In particular, we have seen a betrayal of the commitments that those opposite made during the last election campaign to redevelop Royal Perth Hospital as a 400-bed tertiary facility. In this budget we see a delay of the redevelopment in that the eventuation of the commitment of $22 million towards Royal Perth Hospital will not be until 2014–15—well after the election. The minister often gloats that the commitment to the people regarding Royal Perth Hospital achieved a healthy return for the government at the last election. The sense of betrayal amongst the people in the community who put their faith in this minister that he would redevelop that hospital must be felt quite acutely. There is a whole range of delays in health infrastructure right across the portfolio; $229 million in health infrastructure has either been delayed or cancelled. Stage 1 of the reconfiguration of Osborne Park Hospital has been put off to 2014. I think it was first in the 2009 budget estimates hearing that the minister and I asked questions about the redevelopment of Osborne Park Hospital. The Armadale–Kelmscott Memorial Hospital upgrades have been delayed. Harvey Hospital, again, is one of the original hall-of-famers from that first year that the government took a red pen right across hospital infrastructure.