The Hon. R. D. DYER: I ask the Minister for Health and Community Services a question without notice. Will the Minister confirm that his department, in its radical plan "Strategic Issues for Acute Hospital Services" recommends that about 50 hospitals be closed by the end of the century? Does this represent about 20 per cent of the 254 public hospitals in New South Wales? Will the Minister inform the House which hospitals are to be closed?
The Hon. J. P. HANNAFORD: The Government does not have any plans for the closure of hospitals. As I have said to honourable members many times before, hospitals open and hospitals close. I have listed all the hospitals that were closed during the former Labor Government's administration. When that Government was in office it closed hospitals without considering the total direction of health care services. This Government has sought to prepare an overall program for the direction of health care services. That is why a number of discussion papers have been circulated. If a discussion document has identified issues for discussion, that is no more and no less than what the Federal health Minister, Brian Howe, has done with the Macklin inquiry papers which dealt with health issues for the future.
As I said in answer to a question from the Deputy Leader of the Opposition, Brian Howe has indicated, as has his department, that the trend is towards fewer beds. At present the average bed stay per patient is about seven days. About 10 years ago the average bed stay in hospital was about 12 days. In the United States at present the average bed stay is about three days. With the new technology available, patients do not have to remain in hospital as long and thus there is a lesser need for the vast number of available beds. At present in some hospitals in this country patients undergoing a certain procedure may be in hospital for eight to 10 days and may be unable to return to work for three to six months. With a new procedure being trialled in the United States, it is hoped that patients will be in hospital for two days at most and be able to return to work within eight days. That is one result of new technology. As a consequence fewer hospital beds will be required for the current population levels. That trend will have to be balanced against increasing population.
The Hon. R. D. Dyer: And an ageing population.
The Hon. J. P. HANNAFORD: And a massive ageing population, which is an issue I have had to address on several occasions since becoming a Minister. Until now the trend has been for many of the ageing population to be kept in hospitals. That is not a desirable situation. The whole purpose of the Federal and State HAT program, which came into place during the administration of the Hon. Virginia Chadwick as Minister for Youth and Community Services, is to keep people in their own homes, being supported in their own homes.
The Hon. R. D. Dyer: People with acute illnesses need to be in hospital.
The Hon. J. P. HANNAFORD: Those people will be treated in hospital, but the question is whether they are kept in hospital for unnecessary periods.
The Hon. Virginia Chadwick: Age is not an illness.
The Hon. J. P. HANNAFORD: As the Minister for School Education and Youth Affairs said, age is not an illness. What we should be doing is looking after patients in hospital during the acute stage of their illness. There may be a need to concentrate resources into significant hospitals, putting many of the costly services into those hospitals so that hospitals will be used for different purposes and different specialties. The Government is aiming at assisting people in the various nursing and medical categories to be looked after in their own homes. More consideration must be given to the total continuum of care and better targeting of health resources to ensure that the maximum number of people are able to be nursed in acute care hospitals.
With that approach, support and the appropriate level of care will be provided to people in their own homes. The honourable member knows full well that it is misleading to run with the line that hospitals are going to close. Concentration must be given to the provision of care for those who need it. That is the target of this Government and will continue to be the target of future governments. It is not known whether hospitals will maintain their present roles. In some instances hospitals will not continue their existing roles. Some roles may be enhanced and some may be altered to more appropriate levels of care. When it is necessary for such decisions to be made they will be made. No one knows what will happen during the next 10 years. One thing certain is that governments must ensure that patients in need are given the appropriate level of care.