Second reading

Mr D O’BRIEN (Gippsland South) (15:48): I am pleased to rise to say a few words on the Health Legislation Amendment (Quality and Safety) Bill 2021. I also begin, as others have done, by thanking the healthcare workers of our state that have done a magnificent job over the last couple of years. I will include and acknowledge the past history of the member for Melton as a paramedic in our state and the good work that he did. I hope he was a much better paramedic than he is a politician because he has just basically suggested that the notion of a health crisis in Victoria is a fallacy made up by the opposition. The member for Melton should look at some of the statistics, look at some of the cases. He should have been paying attention in question time over the last few days as we have reeled out case after case of people who are struggling with the way the health system is being managed at the moment. I am going to go into some detail in a moment on the report on government services that highlights what a failure our current health system is under this government. This government has been in power for what is it—18 of the last 22 years? The health system has been run by a man who has been either the Premier or the Minister for Health for 11 of those years and we have some significant issues.

That brings us to this legislation. The opposition will not be opposing this legislation, but the more I look at it the more I really question this government’s attitude and motives, process and policy when it comes to not only delivering health care but delivering government in this state, because this is the establishment of yet another new government bureaucracy—a new authority, a new commissioner, a new officer. This happens every time. There is not a problem that afflicts public policy in this state where this government does not see the solution as being yet another government agency. Whether it is the school building authority—I thought the education department built schools—whether it is the level crossing removal authority, the Suburban Rail Loop Authority, the North East Link Program authority, we constantly have a new authority every time. Whenever the government has a new policy idea there is a new authority established for it, and you wonder what some of the departments are left to do because they have got these new authorities being set up left right and centre. And of course we know what happens with each of these authorities: there is a CEO and a deputy CEO and a media team and a comms team and so there are more and more jobs in there, and we have just heard in the other place actually how this government has been stacking those jobs with Labor Party friends.

Anyway, this is the establishment in principle of a new chief quality and safety officer under this legislation. That in itself sounds appropriate. I look at it and I think that we have already got the health complaints commissioner in Victoria, we have already got Safer Care Victoria here in Victoria, we have got numerous other agencies, like the Aged Care Quality and Safety Commission at the federal level, and I do really wonder what it is that we need yet another new officer for. Now, the government will say, ‘Well, those agencies don’t have the power to do the work, particularly what is proposed under this legislation, particularly looking at private hospitals’. Well, why not give one of those existing agencies that power under this legislation? What is the purpose of establishing a whole new system, a whole new bureaucracy, under the chief quality and safety officer? None of us in this place will argue that there is not a need to ensure that bad events, adverse events, in our hospitals and health system more broadly are investigated and that there is a process particularly for patients and their families, but why the need for a new agency all the time? It just beggars belief.

So the new chief quality and safety officer will have a role to conduct quality and safety reviews of both health and ambulance services, and there is also—and it is one of the issues that is being promoted—the new duty of candour that requires health and ambulance services to inform patients and/or their families when harm has occurred to a patient during their treatment and also requires them to apologise to patients or their families for any harm that does occur. We all understand that in any system and any health system there will be occasions of adverse events, and as members of Parliament I am sure we all get those concerns raised with us. Sometimes people come to me directly. Sometimes they have already been to the hospital or the health service and are not happy with the response they get. Sometimes we simply refer them to the health complaints commissioner or to Safer Care Victoria or indeed to the minister. There will always be issues, and it is appropriate that where there is fault, and there will be fault from time to time, even in the closest to perfect system, there is an apology, and often that is all that the patient or the family members of the patient want. They acknowledge something could go wrong, but they just want an apology. So I do not have any issue with that, but as I said, what concerns me is that at a time when our health system is under enormous duress—and it is not just duress caused by the pandemic, it is duress caused by management or mismanagement of the system for some time—we are introducing this legislation with yet another chief quality and safety officer, another bureaucracy.

This is in the context, as others have mentioned, of the recent release of the report on government services (ROGS) by the Productivity Commission. We see in that report a number of tables, and it makes for quite illuminating reading for any Victorians who would like to compare us to the rest of the country. For recurrent expenditure per person on public hospital services for 2019–20 Victoria is eighth on the list of states and territories at $2687 per person compared to the top end, Northern Territory—clearly a higher cost—at over $6000. But the national average is $2971, and Victoria is well under it. New South Wales is $2887—our nearest competitor, so we are considerably behind. Now, in some respects that would be good. If it was that we were efficient, if we were delivering better services for less money, that would be great. I would be the first to applaud it. But when you look at some of the other statistics, that is not necessarily the case. For available beds per thousand people, for example, Victoria is seventh on the list of the eight states and territories at just 2.3 beds available per 1000 people versus New South Wales, our nearest competitor, at 2.6.

Emergency department waiting times—again we can say, ‘There’s been a pandemic’. Well, everyone has had the pandemic. In 2020–21, if you compare our performance in the ROGS data on emergency departments on the percentage of patients seen on time with New South Wales—again our nearest competitor and the one that we need to be comparing ourselves to—for ‘Resuscitation’, those seen on time is 100 per cent for both New South Wales and Victoria. Under ‘Emergency’ Victoria is 17 percentage points lower than New South Wales. In the ‘Urgent’ category Victoria is 12 percentage points lower than New South Wales; in ‘Semi-urgent’, 7 percentage points lower than New South Wales; in ‘Non-urgent’, 5 percentage points lower than New South Wales; and in total, 11 percentage points lower than New South Wales.

Elective surgery is an issue. I started on that and I will continue on it. We have seen the most recent data from this state. We are now up to over 80 000 people on that elective surgery waiting list, and we are still waiting for the government to actually give the okay to fully resume elective surgery in this state despite the fact that the number of people in hospital with COVID has come down considerably in the last couple of weeks.

The ROGS data has ‘Turnover following admissions for surgery’—so basically how many people were added to the hospital waiting list in a year and how many were removed following surgery—and that is following surgery, not just people being taken off the list because they died or whatever happened, but actual turnover. Again, out of eight, Victoria is at number six, with 80.9 per cent actual turnover per annum for elective surgery, compared to New South Wales at 93.4 per cent. So I have got to hand it to this government: we have got regular claims of record spending on the health system and we are constantly told how much focus this government puts on the health system, and yet we have got a health system that is underperforming compared to all of our competitors around the country.

I think the member for Lowan talked about this: the final one I just want to touch on from the ROGS data is ‘Sentinel events’—that is, effectively serious events, in particular causing death or very serious injury, where something went wrong and was caused by the health system—the public hospital in this case. For 2019–20 there were 24 such events in Victoria versus just nine in the next biggest one, New South Wales. There were eight in Queensland, and it was lower in all the other states. Yes, that is a one-off year—the data does not show me the previous years—but it is a significant concern. We do not oppose this bill, because it is important that we have these oversights in our health system, but I do wonder why existing facilities cannot do what they are supposed to do.

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