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Legislative Assembly for the ACT: 2014 Week 12 Hansard (28 October) . .

Page.. 3670..

So there is some uncertainty. I do not disagree with the need to shift more money into early intervention and prevention, but that is very hard when you have got bed occupancies and people flooding to your emergency departments. It is very hard to start saying. "We won't put any more investment into that because it is expensive; we will put it into encouraging people to look at diversions, eating more healthily or doing more exercise." Those are the areas that the Medicare Local submission went to.

MADAM SPEAKER: A supplementary question, Mrs Jones.

MRS JONES: Minister, is it time for a whole-of-system strategic leadership change to address the critical issues facing the ACT health system?

MS GALLAGHER: The whole-of-system strategic leadership is exactly pulling those different segments of the health system together. It is not talking about beating up the public system necessarily, but I would agree that there is more we can do with Calvary. With the Canberra Hospital and Calvary, again we are going to have to have some very difficult discussions there. To run them as a one-system hospital rather than two operators running two mini systems, there will need to be some pretty difficult conversations.

One of the issues that we have to pick through more in terms of the emergency department presentation—and we heard a bit on talkback last week, when people rang in—is the concern with paying so much to go and see your GP, and that genuinely drives people to the public system, for people who cannot afford it. That is a real issue in Canberra. So, yes, there is a lot more that needs to be done. Once the primary healthcare network is resolved—there is this uncertainty with the Medicare Local, as its funding ends. There is no certainty that it will continue in the same form, and if it does it is definitely not going to be a service provider, which is different to the role it plays now. We need to make sure that, as much as we can, we are pulling together in the same way. That means the private hospitals, the public hospitals, the GP community and the primary healthcare system all pulling together.

MADAM SPEAKER: A supplementary question, Mr Hanson.

MR HANSON: Minister, why is TCH 25 per cent more expensive to run than other like hospitals across Australia?

MS GALLAGHER: There are issues in terms of the incomes that we pay to staff to work at the hospital, traditionally our medical staff. Also our superannuation arrangements contribute millions of dollars every year or higher than other state jurisdictions. Then there is the level of care provided in terms of the scope of services. When you are running a lot of services with very low volume your costs are greater. You cannot do the volume that you need to run it in an efficient way. That is a decision we have taken.

I have answered questions in this place about people being sent to Sydney when they feel that they should not be sent to Sydney. We have taken a decision to offer a very

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