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Legislative Assembly for the ACT: 1999 Week 2 Hansard (9 March) . . Page.. 393 ..

MS CARNELL

The comparatively higher expenditure relates in part to a higher quality of service - something that I am sure nobody would be negative towards - but also in part to a higher cost structure for providing the same level of services elsewhere. For example, across Australia, the ACT is the only jurisdiction which has 100 per cent of its public hospital beds accredited by the Australian Council on Healthcare Standards, compared to a national average of 72 per cent of beds. Mr Speaker, that is a great outcome. However, the recurrent cost per patient in our hospitals, adjusted for the type of illness, is the highest at $3,689 per separation, compared with a national average of $2,496 per separation. The higher cost does not relate to length of stay, which in the ACT is close to the national average.

So, Mr Speaker, we are spending more, but are we getting a better outcome? We have a great health system. There is no doubt about that. But, Mr Speaker, you cannot say that the quite significant increase in cost - more than $1,000 per separation - equates directly to an increased or improved standard of treatment in comparison to other teaching hospitals in other parts of Australia. Mr Speaker, to a large extent, it does come down to our staffing levels, to working conditions, to the sort of way in which we operate. When we have attempted to change some of those approaches in this place, for example in the nursing area, members of this Assembly have yelled in horror. We have had debates in this place: "Shock, horror; we cannot possibly have fewer nurses".

I have to say, Mr Speaker, that if we do not do something - and not just something; if we do not reduce our staffing levels, not just in nursing but also in administration, our work practices across the board amongst our doctors and so on - we will continue to pay more than $1,000 per separation above the Australian average. For what? Certainly not for a demonstrated better level of service. Some of it you can equate to quality. There is no doubt about that. I would have to say that I would leave that in the equation. But, Mr Speaker, there is another big chunk that is simply to do with work practices. This is a minority government, Mr Speaker. These things can only be changed with the support of this place.

For public housing the ACT has the shortest waiting time profile. In fact, 75 per cent of the applicants in the ACT wait less than a year. By comparison nationally, 74 per cent of applicants wait longer than a year. So, in the ACT, 75 per cent of applicants are into a house in less than a year. Nationally, virtually the same number are still waiting for longer than a year. But, Mr Speaker, this comes at a cost. Government expenditure on public housing in the ACT is $338 per person, compared to the Australian average of $106 per person. Public housing comprises 10.3 per cent of total housing in the ACT. By comparison the national average is 5.3 per cent. In addition, Mr Speaker, 13 per cent of dwellings in the ACT are underused, compared to a national average of 9.4 per cent.

In education, it costs 44 per cent more than the national average to educate a primary school student and 8 per cent more than the national average to educate a secondary school student in the ACT. We spend $5,632 per government primary school student in the ACT, compared to the national average of $4,704 per student. We spend $7,101 per government secondary school student in the ACT, compared to the national average of $6,578 per student. The higher costs do not relate to the student-staff ratio, which is

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