Mr BELL - 1996-08-14
The budget cuts hospital expenditure by $7m. It cuts family and aged care services by $0.5m. It cuts public health services by more than $1m. How can the minister support yesterday's statement by the Treasurer that we have `a comprehensive health service no matter where Territorians go'. Does he support that statement?
ANSWER
Mr Speaker, the budget papers show a reduction in expenditure in hospitals of about $1.7m. The budget papers also show that the allocation for the delivery of community health services has been increased by $3.3m and the allocation for primary health care has been increased by $6.7m. Rosanne Brennan was on the radio this morning criticising us for the appointment of a sixth Supreme Court judge. She said that the effort should be directed towards the prevention of crime. That is exactly what we are doing in terms of the delivery of health services in the Territory.
It is very easy to sit and criticise Royal Darwin Hospital. I want to explain this. Surgery interceptions at Royal Darwin Hospital have improved by 47% from 1994 to 1996. It is very easy to criticise Royal Darwin Hospital. Fourteen medical specialists have been successfully recruited. A full rehabilitation service is established at the hospital. The inpatient renal service is now in place. A same-day operating facility was opened in November 1995. The clinical school is under way and postgraduate clinical training is evolving. The surgical waiting lists have been reduced from 2200 at the beginning of 1996 to 1440 in July 1996. Royal Darwin Hospital and its staff are doing a superb job.
Members interjecting.
Mr SPEAKER: Order!
Mr BURKE: The efforts of the staff in the children's ward are absolutely superb.
Royal Darwin Hospital is unlike any other hospital in Australia. If you want to cut expenditure at any other hospital in Australia, you can divert people to hospitals in other suburbs. This is the only major hospital in the Northern Territory. To a large degree, it has no option but to attend to accident and emergency cases and deliver acute health care. It simply cannot turn those cases away.
At the beginning of 1994-95, it had a budget of $72m. It absorbed costs of around $3.2m for the establishment of the renal service at the hospital. It also absorbed about $5m in cross-border charging. There is $9m immediately. The budget then was determined at $80m and the hospital staff themselves made an undertaking to reduce their own expenditure by around $2.2m. They did not achieve that objective. That $2.2m was absorbed last year within the Health Services budget, but the Health Services budget came in on target.
Ms Martin: You are not waiting for an operation.
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Mr Stirling: What about our outpatients at Gove?
Ms Martin: You are not tackling the waiting list.
Mr Reed: We have halved it.
Mr SPEAKER: Order!
Mr BURKE: Let us talk about waiting lists. If you are looking at cutting budgets at a hospital such as Royal Darwin, you must recognise that it does not have the ability to divert patients, as other hospitals have. It also has the problem that it is dealing with acute cases. Have a look at the babies in the neonatal ward. There are about 7 of them. By the time those premature babies leave hospital, they will have cost the health system around $200 000. What do you do? Do you refuse that care at a hospital? Royal Darwin Hospital does not have the ability to divert patients.
The major cost imposts lie in clinicians' decisions. They make those decisions, as they rightly should, in terms of their wish to deliver excellent health care. Do you want to stop them from doing that? The clinicians are setting themselves, as they did last year, clear objectives for reducing their costs. One of the things that will assist is the Casemix measurement system. That enables clinicians to measure their own health service delivery against that of another doctor in the Territory, and benchmark against the delivery of that service in other places in Australia. That is the way we will reduce expenditure at Royal Darwin Hospital. That is how we will be approaching it over the coming 12 months. In any case, we must recognise that, if the budget blows out at Royal Darwin Hospital, there are clear reasons why it is extremely difficult to manage. Nevertheless, it is being managed as well as is possible. Where savings are made in the acute delivery area at Royal Darwin Hospital, or at any other hospital in the Territory, the Northern Territory government will direct that money towards primary health care delivery.
As I said before, we can spend a fortune until the cows come home ...
Mr Bailey: We spend proportionately less than the 6 states do on health.
Dr Lim: We do not. We spend more than Queensland.
Mr SPEAKER: Order!
Mr BURKE: We can spend a fortune at the back end of the line, in hospitals and in clinics, but the real effort must go into educating Australians about lifestyle, and particularly into educating and helping Aboriginal people in communities, who account for 52% of our health budget, to improve their health at the primary level. If that can be done, if we can reach a position where all babies are born at the right birth weight, we will save a fortune in terms of renal failure and diabetes problems later in life.
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ANSWER
Mr Speaker, the budget papers show a reduction in expenditure in hospitals of about $1.7m. The budget papers also show that the allocation for the delivery of community health services has been increased by $3.3m and the allocation for primary health care has been increased by $6.7m. Rosanne Brennan was on the radio this morning criticising us for the appointment of a sixth Supreme Court judge. She said that the effort should be directed towards the prevention of crime. That is exactly what we are doing in terms of the delivery of health services in the Territory.
It is very easy to sit and criticise Royal Darwin Hospital. I want to explain this. Surgery interceptions at Royal Darwin Hospital have improved by 47% from 1994 to 1996. It is very easy to criticise Royal Darwin Hospital. Fourteen medical specialists have been successfully recruited. A full rehabilitation service is established at the hospital. The inpatient renal service is now in place. A same-day operating facility was opened in November 1995. The clinical school is under way and postgraduate clinical training is evolving. The surgical waiting lists have been reduced from 2200 at the beginning of 1996 to 1440 in July 1996. Royal Darwin Hospital and its staff are doing a superb job.
Members interjecting.
Mr SPEAKER: Order!
Mr BURKE: The efforts of the staff in the children's ward are absolutely superb.
Royal Darwin Hospital is unlike any other hospital in Australia. If you want to cut expenditure at any other hospital in Australia, you can divert people to hospitals in other suburbs. This is the only major hospital in the Northern Territory. To a large degree, it has no option but to attend to accident and emergency cases and deliver acute health care. It simply cannot turn those cases away.
At the beginning of 1994-95, it had a budget of $72m. It absorbed costs of around $3.2m for the establishment of the renal service at the hospital. It also absorbed about $5m in cross-border charging. There is $9m immediately. The budget then was determined at $80m and the hospital staff themselves made an undertaking to reduce their own expenditure by around $2.2m. They did not achieve that objective. That $2.2m was absorbed last year within the Health Services budget, but the Health Services budget came in on target.
Ms Martin: You are not waiting for an operation.
Page 1480
Mr Stirling: What about our outpatients at Gove?
Ms Martin: You are not tackling the waiting list.
Mr Reed: We have halved it.
Mr SPEAKER: Order!
Mr BURKE: Let us talk about waiting lists. If you are looking at cutting budgets at a hospital such as Royal Darwin, you must recognise that it does not have the ability to divert patients, as other hospitals have. It also has the problem that it is dealing with acute cases. Have a look at the babies in the neonatal ward. There are about 7 of them. By the time those premature babies leave hospital, they will have cost the health system around $200 000. What do you do? Do you refuse that care at a hospital? Royal Darwin Hospital does not have the ability to divert patients.
The major cost imposts lie in clinicians' decisions. They make those decisions, as they rightly should, in terms of their wish to deliver excellent health care. Do you want to stop them from doing that? The clinicians are setting themselves, as they did last year, clear objectives for reducing their costs. One of the things that will assist is the Casemix measurement system. That enables clinicians to measure their own health service delivery against that of another doctor in the Territory, and benchmark against the delivery of that service in other places in Australia. That is the way we will reduce expenditure at Royal Darwin Hospital. That is how we will be approaching it over the coming 12 months. In any case, we must recognise that, if the budget blows out at Royal Darwin Hospital, there are clear reasons why it is extremely difficult to manage. Nevertheless, it is being managed as well as is possible. Where savings are made in the acute delivery area at Royal Darwin Hospital, or at any other hospital in the Territory, the Northern Territory government will direct that money towards primary health care delivery.
As I said before, we can spend a fortune until the cows come home ...
Mr Bailey: We spend proportionately less than the 6 states do on health.
Dr Lim: We do not. We spend more than Queensland.
Mr SPEAKER: Order!
Mr BURKE: We can spend a fortune at the back end of the line, in hospitals and in clinics, but the real effort must go into educating Australians about lifestyle, and particularly into educating and helping Aboriginal people in communities, who account for 52% of our health budget, to improve their health at the primary level. If that can be done, if we can reach a position where all babies are born at the right birth weight, we will save a fortune in terms of renal failure and diabetes problems later in life.
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Last updated: 09 Aug 2016