Health Services

Mr DAVID HARRIS: I direct my question to the Minister for Health. Will the Minister update the House on the Iemma Government's plans to deliver better health services?

Ms REBA MEAGHER: Access to safe and efficient health care is a core responsibility of government. That is what the people of New South Wales expect and that is what they deserve. The community expects continued investment in health to provide better service delivery. This has been a Labor priority ever since taking office—it always has been and it always will be. This budget again delivers on those expectations. Last year the public health system delivered more than two and a half million medical and surgical procedures and more than 2.3 million treatments were provided in our emergency departments—8 per cent more than the figure for the previous year, and well above population growth.

As the Australian Institute of Health and Welfare confirmed last week, our hospitals are performing well in the face of this pressure. The institute found that our emergency department waiting times are the best in the country. No other State came close to our performance on triage benchmarks and elective surgery waiting times. Over the past three years we reduced the average waiting time for elective surgery from 3.6 months in June 2005 to 2.8 months in March 2008. This year the Iemma Government will invest $13.2 billion in the New South Wales public health system—an increase of 5 per cent on last year's budget. That is $36 million each and every day being spent on delivering better health services and infrastructure for the community.

Our budget means more beds, more doctors, nurses and paramedics, new equipment and upgraded facilities across the State. We are adding capacity to the system where it is most needed. An amount of $12.9 million has been allocated for an additional 52 acute hospital beds. Hospitals to receive new acute beds include Campbelltown, Shellharbour, Nepean, Gosford, Belmont, Coffs Harbour, Wagga Wagga and Dubbo. This is in addition to the 180 new acute beds I announced last November to help relieve pressure on our busiest hospitals.

Mr Chris Hartcher: Where are the staff?

The SPEAKER: Order! The member for Terrigal will cease calling out.

Ms REBA MEAGHER: I thank the member for Terrigal for asking. We will also invest $2 million to provide additional senior nursing and allied health staff to better support and treat patients at Temora, Cootamundra, Narrandera and Leeton hospitals. Almost $20 million has been allocated for an extra 160 community-based beds, adding further capacity to treat people closer to their homes. Members will recall that earlier this year I launched medical assessment units as a new model of care in our hospitals. The medical assessment units provide faster, safer and better care for older patients with chronic diseases and are already open at 16 hospitals and underpinned by 224 beds.

The budget will further expand on this new model of care with 72 additional beds this year. New medical assessment units will open at Wyong, Maitland, Port Macquarie, Fairfield, Blacktown and the Children's Hospital at Westmead, bringing the total to 22 hospitals with a medical assessment unit. We will also open four new intensive care beds at Royal Prince Alfred, Wollongong, Nepean and Westmead hospitals, with an additional paediatric intensive care unit bed at Sydney Children's Hospital and an additional neonatal care cot at Nepean hospital. Over the past four years the Government has opened more than 2,000 beds, and more than 600 beds have been opened since May last year.

This year we will also invest $32 million to strengthen statewide services in our acute hospitals, with funding for additional services for bone marrow transplants, spinal injuries and severe burns. We are also adding capacity to cope with a significant increase in birth rates across the State. To build capacity and improve services we will spend $46.4 million over four years to expand maternity services to care for mothers and babies. Our plan will recruit 150 new midwives and 12 obstetricians to work in our busiest maternity wards around the State where there have been increases in births of almost 30 per cent in four years. Other specific workforce initiatives include $7.2 million to recruit an additional 75 full-time ambulance staff.

We will also continue to deliver on our election commitment to fund 80 clinical nurse educator positions by funding 20 of those positions this year. I am also pleased to inform the House that the Government has provided funding for an additional 120 clinical nurse educators, 18 of whom will be funded this year. This means better clinical support and supervision of our nurses, which will have an important flow-on effect for patient safety. The Iemma Government is also working hard to provide patients and staff with state-of-the-art hospital facilities and equipment. This year our capital programs total almost $840 million as part of a four-year $2.3 billion health infrastructure program.

Some of the new infrastructure projects to commence this year include the $27 million Lismore integrated cancer care centre, with $12.2 million provided this year; $5.6 million for the $41.7 million redevelopment of Narrabri Hospital; and $6.9 million for ambulance infrastructure, including new ambulance stations at Byron Bay, Batemans Bay and the introduction of the electronic patient record. Also, $3.5 million will go towards the $10 million emergency department at Maitland Hospital and $18 million will be used to build the new multipurpose service centres at Coonamble, Balranald, Eugowra and Manilla.

The budget includes funding also to continue a number of projects already underway, with more than $106 million for the major redevelopment at Liverpool Hospital, another $50 million for the Auburn Hospital redevelopment and completion of the Queanbeyan hospital redevelopment. The budget also includes an allocation of $37 million to continue mental health capital works projects already underway at Gosford, Wollongong, Sydney Children's and Shellharbour hospitals, and the non-acute mental health units at Sutherland, St George, James Fletcher and Coffs Harbour hospitals. An amount of $15.3 million will be provided for the redevelopment of Auburn, Deniliquin, Liverpool, Nelson Bay and Ryde ambulance stations, and for fleet replacement and new equipment.

This year's budget will enable construction to begin on two vital redevelopments at Orange and Royal North Shore hospitals. This includes $61.5 million to start the redevelopment of Royal North Shore Hospital and community health facility, as well as to complete the Kolling Research and Education building. Work on the new Orange Base Hospital will continue this year. The budget is a responsible investment in meeting the health needs of our community; but more than that, the budget is a significant down payment on the future of our health system. The demand for health services is only going to increase as our population ages. Half of all New South Wales public hospital beds today are occupied by patients aged over 65 years, and the number of people aged 65 years and over will increase by a third in the next 10 years.

In addition to ageing we are beginning also to see the consequences of our unhealthy lifestyles on our bodies. Indeed, an estimated 77 per cent of New South Wales residents live with at least one chronic disease. Unfortunately, the end result of obesity—diabetes, heart and kidney disease, arthritis, and respiratory disease—is mostly a chronic condition with no easy cure. These ailments condemn the patient to a lifetime of hospital visits: we are seeing the effects of this with rapid increases in attendances at our emergency departments.

The SPEAKER: Order! There is too much audible conversation in the Chamber.

Ms REBA MEAGHER: It is so important that we start to manage chronic disease in the community to keep people out of hospital for as long as possible and improve patient care. The Council of Australian Governments has recognised the critical importance of chronic disease and has made it a national priority. The Iemma Government once again is leading the way and taking steps to meet this challenge. This year's budget includes funding to develop and implement an innovative chronic disease management program. The new program will provide coordinated care and support in the community for people aged 65 years and over who suffer from severe chronic disease and who are at high risk of needing hospital care.

Currently, older people may receive care from a range of health service providers including general practitioners, medical specialists, community health services and hospitals. Our program will establish a chronic care service in every area health service to be run in partnership with divisions of general practice and medical specialists. This service will facilitate and coordinate the management of each patient's ongoing care in accordance with a shared care plan and broker services as required. This will support the important relationship patients have with their general practitioners and other medical practitioners. Evidence from the United States and Europe demonstrates that a coordinated care management approach can improve clinical outcomes in the treatment of those with chronic illness.

I will seek to hold further discussions with the Federal Government about establishing a partnership on this important issue. The chronic disease management program complements the introduction of the medical assessment units and our expansion of community-based beds. Our plans are centred on improving the patient journey and clinical care. Treating people out of hospital and helping people lead healthier lives through community support is the best way of delivering health care in the decades ahead. Health will consume 27 per cent of the State budget this year—that is a doubling of the health budget since 1995. We are proud of our record and commitment to public health. With today's budget the Iemma Government is getting on with the job of reforming and shaping a health system to meet the needs of the community now and in the coming decades.