Health Services Amendment (Ambulance Services) Bill 2015
My speech opposing the Health Services Amendment Bill which allows non-government organisations to provide non-emergency patient transport services. I believe it is merely an attempt at privatisation by stealth of a crucial aspect of public health infrastructure.
I oppose the Health Services Amendment (Ambulance Services) Bill 2015 on the grounds that it is merely an attempt at privatisation by stealth of a crucial aspect of public health infrastructure. In a briefing with the chief of staff of the Minister for Health last week we discussed provision of the non-emergency patient transport [NEPT] service. I had received representations from my constituents regarding this matter, which I had forwarded to the Minister but had not had a response at that stage. There were concerns about the efficiency of the program since its centralisation from John Hunter Hospital to Parramatta at the end of 2014. Prior to 2014, patients experienced an efficient service. They were transported to and from health facilities without delay as a result of the proficiently coordinated service provided by Hunter New England Health. The centralised booking system, on the other hand, has severely affected the manner in which patients are transported, particularly in the Hunter area. In many cases, patients are experiencing inadequate service, with drivers failing to arrive on time to get them to appointments or, in some instances, not arriving at all. I was quite horrified to hear of an incident involving an elderly female patient who was transported to a Cardiff medical practice from Maitland Hospital for an appointment at 9.00 a.m. The driver, who was organised by the centralised booking hub at Parramatta, informed the patient that he would return to collect her within the hour and transport her back to Maitland Hospital. At approximately 7.00 p.m.—10 hours later—staff at Maitland Hospital received a call to say the elderly woman was still in Cardiff because the driver had not returned to collect her. This is unbelievable and unacceptable. I am told that this sort of situation never occurred under the transport system managed by Hunter New England Health. I have heard of another incident where two patients were required to be transported from John Hunter Hospital to Sydney Hospital. The centralised booking system sent two transport vehicles, each with a driver and a nurse, to transport the patients even though they were going to the same location. It was not until they arrived at Sydney Hospital that the drivers realised the mistake that had been made by the system. This miscalculation by the centralised booking system meant that a vehicle, a driver and a nurse were taken out of the local Hunter transport pool for an entire day. Despite repeated assurances from the Department of Health, there are concerns that the centralisation of the NEPT program has failed to reduce delays or improve coordination of the transport fleet in the Hunter region. Since its inception, patients and staff have suffered. They have experienced inadequate service, which has led, in many cases, to prolonged treatment and increased hospitalisation as patients have had to return for appointments. The number one priority of our health service should be to provide high-quality service and care while ensuring that patients are treated with the respect and courtesy they deserve. However, it would seem that the move to the centralised booking system is failing; it is proving to be an inadequate transport system for many patients. What is the Government's response? When I raised this matter with the Minister's chief of staff I was advised that they are aware of this issue and they are working to resolve it. I was very excited to hear this news. Unfortunately, the commitment by the Minister's chief of staff did not go beyond blaming union rostering for all the problems. I worked in logistics and transport for 17 years and it is clear to me that the problem is with the centralised computer system. There are teething problems but when I raised this with the chief of staff I was told, "We have a system that has the capacity to deal with these multiple issues of coordinating patients, doctors, hospitals, drivers, vehicles and nurses but we have not been able to implement it." The Government is implementing a system that does not work and is not fit for the purpose. All the people involved—the patients, the doctors and the hospital staff—are wasting their time. The lack of a clear solution is evident when we examine the Health Services Amendment (Ambulance Services) Bill 2015. Instead of adequately delivering an efficacious computerised booking service, the Government has chosen to blame the unions, evade its moral obligation and introduce a bill that will enable the privatisation of this service. Let us have a closer look at the bill. The bill creates two definitions: "emergency ambulance services" and "supported non-emergency transport". The Government has been crafty in the language it has chosen for this bill. Object (a) of the bill proposes to "make it lawful for non-government organisations and private operators to provide supported non-emergency transport … without the consent of the Secretary of the Ministry of Health." Object (b) tries to reassure the people of New South Wales by stating it prohibits "emergency ambulance services … from being provided by non-government organisations and private operators for fee or reward" but then it adds the seven crucial words, "without the consent of the Health Secretary". And there we see the Coalition's ideology at work. The Coalition pretends to care about maintaining the quality of an essential public health service but is sure to add an escape clause—an opportunity for the health secretary to give consent for private operators to provide emergency ambulance services, not just occasionally when there is no other choice or when lives are at risk but regularly and, eventually, permanently. If the Government leaps at the opportunity to privatise ports and electricity networks, why will it not also privatise ambulance services? If that is not worrying enough, the Government has seen fit to introduce a bill that changes the essential nature of the Ambulance Service without putting in place any new quality regulations. The Minister said:
The bill adds proposed new sections designed to provide light-touch regulation of supported transport.
Light-touch? When the public's health and safety is at stake the Government chooses "light touch regulation". Let us return to the Minister's speech to learn a bit more about this. She continued:
Organisations providing supported transport will be obliged to ensure that the vehicles used are equipped in a manner that ensures patient safety.
In other words, the Government will leave it up private operators to let the Government know that they are doing everything correctly. The Minister went on:
Similarly, hospitals, aged care facilities or other organisations that contract or engage service providers will be obliged to take reasonable steps to assure themselves the transport provided is safe and appropriate.
In other words, the Government is saying, "Just sort it out amongst yourselves; leave us out of it." If members are not alarmed by what I have read from the Minister's speech so far, consider this comment from her:
It is important to note that New South Wales does not have a well-established market for supported transport. Therefore the bill anticipates standards being assured through other mechanisms. These will be developed through further consultation with the community, health service providers, aged care providers and support transport providers.
Should the Minister not have done that before introducing the bill? This goes to the heart of the issues I have raised. Why is the consultation taking place after the bill has been introduced? Why is the cart being put before the horse? The Minister is concerned about not imposing rules on the sector. Just last week the Government made a big performance about making it illegal to call yourself a paramedic without appropriate credentials. Labor supported that move. I struggle to reconcile this show of support for the integrity of our first responders with the Government's stripping so many resources from paramedics that many people now believe it is faster to attempt to make their own way to hospital. I note the Government has told journalists that the new Lower Hunter hospital will not contain cancer services as they will be provided at the tertiary hospital at Mayfield, which is not well connected by public transport for patients who live in Maitland. I note also that the Government has closed the rail line into Newcastle, which transported many Maitland and Upper Hunter residents to health specialists in Newcastle. I note the Government has stopped the free shuttle service for the John Hunter Hospital that offered transport from free parking. Transport is a major social determinant of health and this Government is attacking the ability of people on low incomes, with less mobility and access to transport, to access quality health services and now it is seeking to privatise non-emergency patient transport. I am so sick of this Government saying one thing and meaning another. I am concerned that by giving a statutory value to the name "paramedic" one week and the following week throwing open the possibility of privatisation, it will change the discussion about first responders altogether. I urge the Government to put its money into the public provision of health and of patient transport and to support individuals in our community who need help to access quality health care.