Mr DEAN - The member for Murchison covered a lot of the problems across the hospital system and I just want to touch briefly, as might the member for Rosevears, on some of the issues currently surfacing at the Launceston General Hospital. I think that the Launceston General Hospital is in a mess and some press releases tell the story. The one dated 27 June 2007 had two very eminent medical professors in Berni Einoder and Rob Fassett make a number of claims in relation to what is happening in that system. They say it is in such turmoil that it is costing the lives of people. That is a pretty tragic situation. That assertion comes from people who ought to know, who are in a hospital, understand the system and understand it very well. Very clearly these people are becoming frustrated with the situation. It is in such a state that they are prepared to put their positions in the public arena.

The first question is, what is being done to address the recent concerns raised by professors Rob Fassett and Berni Einoder at the Launceston General Hospital? Is anything being done or is it falling on deaf ears? Are people sticking their heads in the sand and just hoping it blows over? I am not sure what is happening, and it is not surprising that these people are very concerned.

Another issue they raised is how difficult it is for the Launceston General Hospital to provide the level of service expected and required by the people and meet the demand for services when the budget is deliberately set much lower than the projected amount required to run that hospital for 12 months. That was one of their huge concerns. They raised it in 2006 and I am plucking figures out of the air but I understand that the under-budgeted amount that year was about $6 million to $8 million. I understand it is similar this year. They just cannot run the hospital on that budget. They say it is physically impossible to do it unless beds are closed, wards are closed and people are not being attended to when necessary, et cetera.

They also said there is a discrepancy between the budgeted amount for the running of the Launceston General Hospital and that of the Royal Hobart Hospital when you compare the services and the amount of work done within these organisations. It really is very very concerning. They said that hospitals should be funded, need to be funded, on activity. That was where funding should start, the basis for funding.

Mr Parkinson - It is probably not fair to compare one hospital with another because the buildings differ so much - age and all that sort of thing.

Mr DEAN - Granted. I accept that and I am only really repeating what these professors who work in the Launceston General Hospital said. I suspect they know what is happening at the Royal Hobart Hospital as well and they simply use that as a measuring device when they look at the two facilities' budgets.

In the same press release, Professor Einoder said, and I quote, 'The 28 bed closures were part of an agenda to diminish the hospital's capacity. There are no plans to increase nurse numbers so we can open those beds again'. How many beds have been closed in the Launceston General Hospital; how many more will be closed through this winter; how long will they be closed for; and when will they be opened again?

Another question is about the nurses. As I understand, there was to be an increase of eight or nine nurses, I could have that wrong, in the Launceston General Hospital. I am advised that has not occurred. Is it going to occur? If it is going to occur, when is it going to occur? I am frustrated by what is happening. I have a document I want to read but I am not sure whether to do it.

Mr Parkinson - I will see if I can get you some answers in relation to those bed questions in a moment.

Mr DEAN - Yes. As I understand it on the advice I am receiving, there is no hope of opening any more of the 28 beds unless we have more funded nursing positions.

Who suffers as a result of this? Very clearly, the staff suffer because they want to do what is required of them. They want to provide the service that is necessary to the people who are sick and who are calling on them for treatment, so they get frustrated -

Mr Parkinson - There's something funny going on in the system. My father recently had to be hospitalised and he has private health cover so he went into the Hobart Private. He had a lovely holiday in there for a week and did not want to come out and they did not want to let him go. I did not get the impression that they were after a bed in there. I kept asking him when he was coming home because I had to go around and feed my mother every night, which I enjoy doing by the way and I don't mind that.

Mr DEAN - It is interesting that you should raise this because I have a question I am going to ask tomorrow in this House in relation to exactly that situation. In Launceston, a private patient tried to get into a private hospital and was refused because they did not have enough beds. This person then sought assistance from the public system but was having difficulty there also. I will ask that question in a better form tomorrow, hopefully.

Mr Parkinson - I am not suggesting my father did not need to go there. He was sick and he was very well looked after and he did not want to leave.

Mr DEAN - There are so many issues coming up. There are plenty of nurses in Launceston but they do not want to work under the restrictive conditions such as double shifts, extra hours, et cetera. The root cause of the current problem is the Federal Government promised people free treatment and the Federal Government has not kept face with funding to enable the State to provide free treatment. The State Government needs more Federal funding.

I just go back to the position that I raised earlier. These professors putting forward these suggestions, putting forward the current predicament surrounding their workplace, are to some extent putting their positions on the line. That is also a very hard and very difficult position they are in and I wonder what the repercussions might well be to these people. I admire them because they are prepared to do that for the benefit of the people, for the benefit of and purposes of improving the situation as it currently exists at the Launceston General Hospital. They are prepared to do that so I commend them and I would hope that they would be supported because we know both of these people are absolutely the best that one could get in their profession.

It is false economy too. If people cannot be treated when they should be treated then their situation normally worsens. So when they finally can be treated it takes a lot more treatment to get them into a reasonable condition so that they can have a reasonable standard of life and a reasonable quality of life.

Mr PARKINSON - In the Budget the Government has shown its commitment to the LGH . There has been a 36 per cent increase in the budget over the past four years. That is for the LGH alone. Staffing increases are 57 doctors, 223 nurses and 335 overall, that is nurses, since 1998. Despite this, we recognise that all of our health services are stretched. That is why the minister has recently released the Clinical Services Plan, which looks at how we manage the increasing demand for services over the coming 10 to 15 years. So it is not as if these things are not being worked on.

In relation to beds, I understand your frustration and appreciate where you are coming from but it is so difficult to answer a question like how many more beds will be closed? I understand that has arisen out of your frustration but these things are organised on the basis of need and safety issues within staffing arrangements and so on within a hospital.

Mr DEAN - The need is there. The demand is there.

Mr PARKINSON - Yes. The figures fluctuate from to time. As to when beds are closed and reopened, it just depends on availability, demand et cetera. It has to be managed on site within the resources they have. I guess it comes down to resourcing in the end, and how much you can throw at it by way of resources. In 1997-98 the department's share of the Consolidated Fund was 28.9 per cent. In 2007-08 it has shot up to 36.1 per cent and rising. Hence the need for the Clinical Services Plan to try to turn the ball around. But do not let me stop you. Keep going.

Mr DEAN - They might well be able to get some money from the fox-free organisation but I probably ought not say that. Although, I believe, that that is where they ought to be going to get some of it.

I want to make one or two other comments. There has been an increase in acute operations from 30 per cent to 50 per cent. Many of these are out of hours, which have become emergencies due to delays in receiving treatment. It is now much more stressful for these people, for the medical staff, for the patients and for everybody concerned.

I referred previously to the budget of the Launceston General Hospital where budgets have been prepared but yet the budgets provided are well and truly underneath the amount that has been sought. Well and truly under the amount being sought. In one instance, I understand it was this year, the budget was somewhat $10 million underfunded. There are not too many organisations now that can set a budget that is unreasonable or unrealistic; in other words, one whereby they are going to have an adequate amount of money to throw it out all over the place to exist on. They now budget according to their specific needs to allow them to do the work that must be done, without too much spare.

Mr Parkinson - You reckon there is no ambit in there?

Mr DEAN - No, there is no change now normally.

Sitting suspended from 4 p.m. to 4.30 p.m.
Mr DEAN - I was just going through the Hawthorn itinerary for Aurora Stadium but I do not need that now for a while. The member for Huon, cost of entry, $1 000.

Mr Harriss - Everybody else, $1 200.

Mr DEAN - Mr Chairman, I was talking about how there are no surpluses now in the setting of budgets so that when you have a hospital that sets the budget for that year and they are then deliberately underfunded by some large amount on what they are asking for then, very clearly, they have to restrict the services that they were wanting to provide in that year. Obviously that comes down to bed closures, staff cuts and a lot of other things that are budgeted for. In this instance we know that the Launceston General Hospital has closed a number of beds and we know that there are a lot of staffing problems as well.

Mr Parkinson - The other point I was advised on that I did not mention was the fact that there are a number of flexible beds at that hospital. They come in and go out depending on demand.

Mr DEAN - It is impossible to operate on an amount that is set far too low. In the meantime nurses' salaries have increased 3 per cent and doctors', 4.2 per cent. Yet whilst doctors' had increased 4.2 per cent, they received only 3 per cent extra, which did not even cover the cost of their increase. Therefore this would need to come out of a budget that had already been set as well and that resulted in further cutbacks. What the Launceston General Hospital needs is to get exactly the amount that has been budgeted for so that the hospital can be run in the way that it should be.

There are two or three other interesting statistics I want to refer to. The Department of Health and Human Services have agreed to the Launceston General Hospital employing 1 350 staff. However, the total salaries budget only covers the salaries for 1 289 staff. So immediately we have a huge problem as to how those extra staff might be funded. Where does the money come from? Or are they required to sack or rid themselves of 61 staff members? The total salaries budget of the Launceston General Hospital is $106 million. Total known salary expenditure will be $111 million. This stems from the underbudgeting processes from a number of years ago. Of course, we all realise and know since those original budgets were set that there have been many pay increases and award changes and other costs that have impacted negatively on those budgeted amounts.

I understand that the next pay rise is likely to be in the vicinity of 4.5 per cent. It will be interesting to see how much money is released from Treasury to cover that amount. Will the full amount of 4.5 per cent be made available? One would hope so. If not, it is simply putting the hospital in an even worse position than it is already in. Interestingly, on my advice and it concerns me somewhat, that $1.1 million paid to creditors last financial year was taken from this year's budget. This is last year's creditors taken from this year's budget; $1.1 million. Once again, that creates an even greater difficulty for this hospital to get through.

Ms Forrest - That is the creative accounting I was talking about.

Mr DEAN - Is that the creative accounting? It is a deplorable situation. I am looking in from the outside at this stage. Working in an organisation like that would be extremely frustrating. I just wonder what the result will be at the end.

Medical and surgical consumables will be overspent by $2.4 million this financial year because of the 10 per cent increase in activity and 3 per cent inflation plus 11 per cent increase in imported goods. They spent $13.4 million in 2005-06 and will spend $15 million in 2006-07 with no provision made for it. It is not surprising that these people in these organisations are really getting to a stage where they are pleading for help, pleading for support, and they are certainly pleading for the support of their politicians and to the members in this House. Particularly, I suppose, to the members in the north of the State.

I have a concern for the medical situation right throughout the State but clearly in this instance I am keeping most of my discussion directly to the Launceston General Hospital. That is the one I understand best and that is the one that I have some detail in relation to. I listened the other night to an interview with the minister, Lara Giddings, where there was discussion about the hospital and the predicament that hospitals are currently confronting. The minister indicated that there was a gross underfunding from the Federal Government and that was one of the causes of the predicament that the hospitals were currently in.

A short time after that interview they then interviewed the Federal minister. The Federal minister made it plain in that interview that the States were adequately funded as far as hospitals and medical circumstances were concerned and that it was a matter for them as to how they spent it and how they apportioned their money. So we have the Federal Government on one hand saying that the States are adequately funded, the States are saying no we are not. From the public's point of view they do not care how the funding occurs provided they are adequately provided for within the hospital system.

There is a strong argument for the fact - and it has often been raised - that there should be one organisation only responsible for hospitals in this country. We will always have this problem. We are always going to be exposed to it whilst we have a State government on one hand with responsibility and a Federal government on the other hand with responsibility. It is a fairly ordinary situation and I am not quite sure where we go or how this problem is going to be remedied. It is a sad situation because at the end of the line it is the people that will suffer as a result of this continued problem within the system.

There has been information provided also that the hierarchy within the hospital system is far too high - too many within that part of the hospital and not enough working at the coalface, at ground level, doing the work that needs to be done. The number of staff has been raised on many occasions. Does the black line relate to administration, does it and the red line -

Mr Parkinson - That is the Tasmanian Government's contribution to acute health funding, that is the Federal Government's contribution over the same period from 1997-98 to 2007-08. The State's share is increasing rapidly relative to the Federal Government's share.

Mr DEAN - Has that been tabled?

Mr Parkinson - The honourable member for Huon should look at that. He keeps telling us how good we are doing on the GST but he forgets they are ripping us off in other areas.

Mr DEAN - I just raise that last point, Mr Leader. I am not quite sure whether you are able to respond to the concern over the senior levels and administration continuing to rise at the expense of those people working at the coalface, as it were, who are actually doing the work within the hospitals, as opposed to the administrative work.
That is all I need to say at this stage. I have shown my frustration. I have shown the frustration of people working within the system up there. I speak with a number of people who work in the system and it is unfortunate that not too many of them speak well of what is happening within the system right at this very moment.

It is pleasing to read in the paper from time to time about people who have been treated at the Launceston General Hospital and who speak very highly of the service they have received. That is because the staff are dedicated; that is because the staff want to make sure that the right thing is being done and that they provide a high level of service. It is good to read those reports, it is good to see that that is happening, but as far as those people being supported within the organisation goes there is a lot to be desired. I would hope that a lot of these issues can be sorted out and that we can move forward with our hospitals and get them right, but I think we are a very long way away, which is most unfortunate.