Tuesday, 2 August 2022

Health system

Ms KEALY (Lowan) (16:31): Today I grieve for the state of Victoria and the many Victorians who have declining health outcomes because they simply cannot access the health support that they need when they need it. They are also suffering from a complete restriction of transparency around what the real issues are when you look at Victoria’s health system, including the mental health system.

At the moment we are waiting for the government to release the elective surgery waitlists. There are expected to be 100 000 Victorians waiting for surgery in the state of Victoria—100 000 Victorians who do not know when they will be able to get that surgery that they desperately need. It is very important to note that ‘elective’ surgery does not mean that you have got a choice about it. Elective surgery just means that you need to have the surgery but not as an emergency, it is not at crisis point. So Victorians who are waiting and who desperately need to have surgery—because no-one chooses to have surgery if they do not have to—do not know, under Victoria’s broken health system, when on earth that is going to happen.

But perhaps even worse is that in Victoria we do not know how many people out there have got a cancer that desperately needs surgery but which we have not had the opportunity to diagnose. Over the past three years of lockdowns and restrictions 6500 Victorians have missed their opportunity for cancer screening. This is important screening, whether it is for bowel cancer or breast cancer, having a mammogram done, whether it is about a Pap smear, whether it is about having those lumps and bumps checked out by a health professional or whether you are just not feeling 100 per cent—if you are a bit more tired than usual or are noticing some changes in your weight. They are the things that people should be getting checked out, but they put it off and kick the can down the road either because they have not been able to get an appointment or because they have been too scared to leave their home and enter a health system where they might be at risk of getting COVID. Others have felt that they would just be overwhelming the system and that they would be a burden. The fact that we have come to a point in Victoria’s health system where we are so far in crisis that if people are unwell, they are unwilling to reach out and seek health support is a critical point, because people are getting diagnoses later down the track, they are more sick and they are more likely to need surgical intervention to deal with that issue, which is only going to further compound the elective surgery waitlists in Victoria.

We are going to see catastrophic outcomes for Victorians when it comes to their health needs into the future. This is not something that we are just talking about: ‘COVID’s over. That’s it; we don’t need to put any more money into it, we are at the end of the tunnel. No more masks; we are fine’. That is simply not the case. It is not the case when we look at surgical needs and elective surgical demands. It is not the case when we are looking at mental health and the severe impact that lockdowns and restrictions have had on the mental health of all Victorians but particularly young Victorians, particularly older Victorians, particularly those from culturally and linguistically diverse communities and particularly those who have lost their job or who have had to supervise their kids in homeschooling while balancing their work and have been just unable to do it. Unfortunately we have got a health sector and a mental health sector that cannot see the light at the end of the tunnel. They see that billions of dollars are being thrown at mental health and yet they have not seen any changes on the front line. There are no additional services available to provide support to the many Victorians who desperately need that support.

We are not seeing the release of elective surgery waitlists; instead we are actually seeing threats that there will be further closures to surgery, that these waitlists will continue to grow and that it is going to be an even longer period of time before Victorians can get the elective surgery that they are waiting for and that they need. We heard earlier today during question time that it is expected that over 100 000 Victorians are now on the elective surgery waitlist in Victoria. But this data is being hidden from Victorians in that it should have been published by now; it is well overdue and it should be in the public arena for debate and discussion and so we can hear from the government what they are going to do about it. But not only is this government refusing to be transparent and release that data, it is refusing to release a plan because, put simply, the Andrews Labor government has no real solutions when it comes to dealing with Victoria’s health crisis.

The bigger problem around transparency is that now we expect over 100 000 Victorians to be on the elective surgery waitlist, but it is not the full story. We have also heard today about regional hospitals, hospitals like Bairnsdale in the member for Gippsland East’s electorate. Bairnsdale hospital has about 1400 people on its elective surgery waitlist, but those numbers are not included in the state elective surgery results. So not only are we not seeing the full data and not only is the government covering this up with more secrecy and a lack of transparency, but when we finally do see the data it will not be the full story. We will not have the waitlists included for Bairnsdale or Mildura or Horsham or Hamilton or other important regional hospitals. It is a complete blight on the health system in Victoria when the government cannot even or is not courageous enough to say, ‘This is how many people in total are waiting for surgery in the state’. When you do not know what you are dealing with, there is no way you can come up with an overall solution that is actually going to fix the problem in the first place.

This is not something that is restricted to just elective surgery. We know that there are of course massive shortfalls in support for people in the mental health sector. The government have taken no action at all to release the workforce that is there and waiting and willing to provide mental health support. They just need some financial support from the Andrews Labor government. This is around provisional psychologists, who the government refuse to even acknowledge could be funded, even though a little bit of funding for this group of people—they are fully trained and are ready to go, they just need a little bit of funding—would mean unlocking 2000 additional psychologists for Victoria’s mental health system. We know that counsellors could participate in the mental health practitioners in schools program, but the government are pushing it back until next year. Even the Schools Mental Health Fund should be rolled out now to every single school, but the government are waiting until 2024 to roll it out to metropolitan schools. That is another two years before kids who live in metropolitan Melbourne will be able to access that important mental health support.

There are other challenges we have got that critically hit rural and regional Victoria. We know that there are massive shortages when it comes to accessing your general practitioner. I was speaking to my good friend the member for Ovens Valley earlier today, and he shared with me the issue that the community has in that people can move up to his electorate but cannot go and see a general practitioner in their new community because all of the books are full. This means that you have to go back to where you came from or Melbourne or wherever it might be to actually get in to see your GP. When so much of our medical system relies on having that entry point of seeing a general practitioner, it means that people who live in Ovens Valley are not able to get the health support that they critically need. Again, it means their health needs are not being addressed. It means that there might be a diagnosis later and people getting sicker, and then when they get critically sick they end up in an ambulance and in an emergency department and putting so much pressure on. I commend the member for Ovens Valley because he has been a fierce advocate for better health services in his region. He understands the health system completely, and he will always stand up and find real solutions for his local community to make sure that they can access the health care that they need and they deserve when they need it.

I have also seen doctor shortages in my own electorate of Lowan. Casterton is facing a critical shortage of general practitioners, and while we might hear from the Andrews Labor government, ‘Hey, it’s a federal issue, it’s got nothing to do with us’, it actually has so much of an impact on the state government because it means that people cannot be admitted into the public hospital system. There seems to be just this lack of knowledge of anything that happens outside of Melbourne for this Andrews Labor government. They do not understand that the local GP is the visiting medical officer, is the admitting GP for a hospital, and that actually not a single patient can be admitted to a hospital in country Victoria unless there is a general practitioner to admit them. So this seems to be lost on the government—‘Not our problem’, we hear from the Andrews Labor government. Well, we have got a critical problem in Casterton right now. It is replicated in many of the communities across my electorate, and unless the Andrews Labor government step up and actually put some support in place our hospitals will not have general practitioners to admit their patients. They will not have any doctors to visit their patients. Our communities will not be able to access a GP and the health outcomes will be catastrophic, having a cumulative effect on the ambulance system, on our emergency departments and further up the track if they are referred to, say, Hamilton or Horsham hospital, or Ballarat or Geelong as the next level up, or our metropolitan hospitals. This is a critical issue, and we have just heard utter silence from the Andrews Labor government.

The other thing that we have had in our region are these ridiculous mega mergers of hospitals, which as we thought would happen, has just resulted in a gradual erosion of local health services. In Horsham we now have no paediatric dentist. It means that for our community—and this is what a friend of mine was told—‘No, it’s unlikely we’ll be able to get another paediatric dentist until much, much later in the year’. Now, if it is a year-long waitlist for a child in the public system to see a dentist, that can have catastrophic impacts on not just their physical health but their mental health. To not have good oral hygiene means that you cannot get a filling when you need to, and it means that extra spot that bacteria can enter your body through. It can result in significant problems when it comes to getting sepsis and strep A and other systemic issues. We also have that problem where kids who have rotten teeth are ashamed to smile. It has a massive impact on their mental health and wellbeing. So the fact that Horsham will not have a paediatric dentist for a significant period of time means that our local kids who would need to access the public dental system will not be able to do so. When it comes down to the crunch Labor always look away and try to put out a media release to say, ‘Oh, but we’re doing this’, but when it comes to the crunch in Horsham you cannot access a paediatric dentist and you will not be able to for a long period of time.

We also have issues around access to allied health professionals. There are simply no allied health professionals at Edenhope hospital now. As we expected, all of the money is being siphoned into Ballarat. We have lost our anaesthetist. We have lost some of our surgeons. We have lost key nursing professionals in our hospital. People are feeling dejected. They cannot see a career pathway. It has been catastrophic for our region. Putting everything under Ballarat has just funnelled the money into Ballarat, and our local hospitals are missing out and are being cut off from the health services that they need and deserve to have.

We also have issues around just workforce challenges altogether. We need to see an overall workforce plan when it comes to building that next generation of nurses, of doctors, of allied health professionals, because we know in country Victoria that unless you have got a big supply of doctors and nurses and allied health professionals in Melbourne, then the first place there are shortages is country Victoria. And we have all been suffering for a really long period of time, and that is why there are often worse health outcomes if you live in the country than if you live in the city. We need to see an urgent plan when it comes to growing the next generation of health professionals. We need to look at more funding of students to be able to get them out and onto the ground, because this is at crisis point. The health system is in collapse in Victoria. We need to look in every single corner to make sure we can get as many skilled practitioners as possible out and about and on the ground and providing that urgent support that Victorians need, whether you live in the city or whether you live in the country, but first and foremost we need to get the people on the ground and support them. There are opportunities to do that, and I urge the government to do that, but I know that the Liberals and Nationals are the one group that have got a plan to do this. We have got real solutions that will deliver additional workforces. We will make sure that we have got more people trained up. We know where those opportunities are to pay for provisional psychologists to get them in the system. We have got a fantastic program already announced about Australia’s biggest ever recruitment drive in mental health and health. We have got the solutions to deliver what Victorians need.

In November Victorians will remember. They will remember this November that there have been problems in the health system, that the people who started this health problem, who created this health system mess, are not the ones to get us out of it. They have overseen a disastrous collapse of Victoria’s health system. Nobody can get the health support they need. People are dying waiting for ambulances, waiting to have calls to 000 answered. They are taking their own lives because they cannot access the mental health support they need when they need it. It is absolutely disgraceful to think that we have got—the member for Eureka soon—the member for Buninyong questioning whether that is worthwhile or not. I think it is disgraceful that anyone would ever argue against that.

Victorians will remember this November. They know the damage that the Andrews government have done to their health system. They know that the ones who have created the mess are not the ones to fix it, and they will vote 1 the Nationals and the Liberals this November.