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Tasmanian Health Service Bill 2018 (No. 3)

[11.18 a.m.]

Ms ARMITAGE (Launceston) - Mr President, I thank the Government for bringing forward this bill as it returns our Tasmanian public hospitals to a form of self‑control, under the direct umbrella of the secretary for the new Department of Health. The Department of Health under the leadership of the secretary is best placed to support statewide consistency and best practice in public acute, subacute and primary health facilities. I accept it is better to build a new act fit for purpose with one local hospital network under the national requirements and that it meets the requirements of activity-based funding under rules between the Commonwealth and the state.

I am pleased the bill provides a framework that supports local decision-making. Local communities led by local doctors are in the best position to make decisions about their healthcare and will spend more money on beds and less on desks. I agree that where we spend money and where we direct money needs to be balanced. It is also hoped that we will now be less reliant on locums and agency nursing. Locally based accountability and authority for delivery of hospital‑based patient care should be promoted by this bill and the related health service restructure. Localised where possible, centralised where necessary. Healthcare should be provided in, or as close to, people's homes as possible, but some specialist care needs to be centralised in fewer locations to ensure better outcomes. Our hospitals require onsite, engaged and empowered clinical teams, which are essential if we are to achieve best results in acute healthcare.

I fully support removal of the Tasmanian Health Service governing council and the current statewide THS executive as proposed by this bill. Our state naturally falls into three population centres and each has significantly different challenges in healthcare delivery.

On 1 July 2015 the Tasmanian government established the Tasmanian Health Service by amalgamating the three Tasmanian health organisations. At the time I stated I believed the change was being made with no evidence, just generalisations, not facts - that there should be one THS and that one THS would be more efficient.

The three Tasmanian health organisations had not had the time to be proven one way or the other. Efficiencies aside, and I am not sure there have been many, our Launceston General Hospital has lost accreditation in emergency medicine and had accreditation reduced in other specialities.

This has affected our ability to recruit, particularly with regard to registrar training. Many of Launceston's long-term specialists completed their registrar training at Launceston General Hospital and decided to locate permanently to our city. It is therefore imperative we have a hospital with the necessary accreditation to continue to attract these doctors and their families.

It is hoped with the changes in this bill that our public hospitals can regain their Australia‑wide status as centres of excellence. We cannot go backwards and must always be looking forward. While I appreciate there is still one local hospital network with the Department of Health and Human Services secretary being the one and only person who takes responsibility for things that happen within the THS, I am pleased to see the establishment of the local advisory groups with initially one in the north, north-west and the south. I also note everyone currently on the consumer reference groups will transition to the new body.

As mentioned previously I am pleased to see the tide turn. Unfortunately damage has already been done in our public hospital system, particularly with regards to morale, and it is hoped it will be onward and upward from here.

I note there is an anticipated $4 million in expected savings over the next four years and trust they are invested into frontline health services, as suggested in the second reading speech.

Our hospital staff perform incredibly well under often great duress. It is because they regularly go above and beyond that our hospital system continues to care so well for our community.

Regionally based northern and southern hospital executive management teams need to be empowered to leave their regional services with statewide processes overseen by the Department of Health and the Department of Health secretary. Patient outcomes are what is important, and while this bill is the first step, more work will be needed on the ground once the legislation is passed.

I support the proposed bill and the fresh start to organisation of the Tasmanian Health Service it will deliver.

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