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Grievance debate on the lack of public healthcare in Mackellar

I rise today to express my deep concern at the state of public healthcare services in my electorate of Mackellar, on the Northern Beaches of Sydney.
Over the last decade, Mackellar has seen our public hospital placed under the management of a private company in a public-private partnership arrangement, the withdrawal of drug and alcohol rehabilitation and the withdrawal of public dental services, a critical lack of both local hospital and community-based mental health services, a paucity of specialist medical outpatient services and a shortage of healthcare workers.

The Northern Beaches have a population almost the same size as Canberra, yet we only have half a public hospital run by a private provider. In 2018, the two local public hospitals on the Northern Beaches, Mona Vale Hospital in the Mackellar electorate and Manly Hospital, were closed and replaced with the Northern Beaches Hospital, which is administered by a private company under a public-private partnership. The Northern Beaches Hospital is the only surviving hospital in the state under a public-private partnership. This follows the buyback of the Port Macquarie Base Hospital after a series of failures. It too was under a public-private partnership.

After a very troubled start, a New South Wales state parliamentary inquiry into the Northern Beaches Hospital was conducted. The key recommendation of this parliamentary inquiry was handed down in February 2020. The key recommendation was that the New South Wales Government not enter into any public-private partnerships for future public hospitals.

Our local doctors, nurses, admin and support staff at the Northern Beaches Hospital do incredible work every day and I only have the highest praise for them. However, the hospital has been managed by its private operators in such a way that constituents have felt compelled to raise an alarm with me. There are stories of staff being overworked, assigned to roles they don't have adequate training for and being exposed to unsafe work conditions. It's claimed that this is leading to an exodus of nursing staff, with others taking early retirement. As a former GP in the area, I also have long held a deep concern over the paucity of public specialist outpatient medical services at our local Northern Beaches Hospital. This has meant that those without private medical cover have had to travel to neighbouring electorates to get their care.

Another issue that is causing great concern in our community currently is the lack of mental healthcare services on the Northern Beaches. We are facing a crisis. In 2022, the former New South Wales Government allocated $11 million to improve youth mental health services on the Northern Beaches. This money was allocated by the New South Wales state Government in response to a growing adolescent mental health crisis in the community which was worsened by the pandemic and was also triggered by a specific tragedy that led to an inquiry into what was happening at the hospital and with mental health services. Of this total funding amount, $7.5 million was allocated to establish a specialised adolescent mental health unit to help address this desperate need for acute youth mental health care. However, nearly 18 months on that money is yet to be spent as intended and the four beds we were promised are nowhere near being delivered.

There was also $365,000 allocated for the employment of a full-time additional adolescent psychiatrist. Again, I'm told that there is still only one adolescent psychiatrist working part time, only 2½ days a week. There are times, also, when there is no psychiatry registrar cover. This leaves specialist psychiatric care to nursing staff. For nurses both in emergency and on the ward who do not have specialist adolescent mental health training, this is often extremely stressful and is contributing to nursing staff burnout, sleeplessness and distress.

If the promised acute mental health unit had been in operation now, it would mean these patients would remain admitted and receiving the necessary care, rather than having to repeatedly present to the emergency department. Their families in crisis would be better supported, confident that their acutely unwell children were being adequately cared for. I currently have a petition circulating the electorate, calling for the urgent establishment of these four adolescent-mental-health beds. Already, nearly 1,000 locals have signed it. Our children and our families of the Northern Beaches deserve to know that in a time of crisis our local hospital is there to help.

There are a number of other issues of concern among my constituents. One of these constituents, Simon Lewer, is from Life Returning. Life Returning is a local community drug-and-alcohol support organisation. Simon founded Life Returning in 2008 after he experienced a serious lack of support services for individuals recovering from drug or alcohol dependency. Simon came to me recently to express distress at the sudden and unexplained closure of the only public drug-and-alcohol rehab facility in Mackellar. The facility, Kedesh Treatment, which was managed within the former Mona Vale Hospital site, had been operating for only a year before it was closed without warning or consultation with the community. This state-of-the-art facility offered a publicly funded nine-week rehabilitation program. The sudden closure of Kedesh has left a significant gap in the provision of drug-and-alcohol treatment services on the Northern Beaches. Simon has told me that, as a result of the closure of Kedesh, his team at Life Returning now has no other option than to drive people seeking rehab to the Central Coast—over an hour and a half away—for residential rehabilitation services.

It's not just drug-and-alcohol rehabilitation services that have disappeared. Constituents have also told me that a new public health dental clinic at the site of Mona Vale Hospital was opened with much fanfare in 2022, but after less than a year of operation it has stopped treating patients owing to a chronic lack of staff. Julie Kelpsa, the oral health consumer coordinator for the Northern Sydney Local Health District, told me that because there has been extreme difficulty in recruiting and retaining staff, particularly for auxiliary roles such as dental assistants and receptionists, the clinic was forced to close.

It's not just a lack of funding impacting our local health services; it's also the availability of housing. I've had meetings with local healthcare professionals who say that unaffordable house prices and rising cost-of-living pressures mean they cannot afford to live locally. This is depriving Mackellar and the Northern Beaches of the precious health workforce that we desperately need. Many of our local healthcare workers have been forced to move out of the area and must commute for hours a day, spending hundreds of dollars a week on petrol and tolls, just to get to work.

As somebody who worked as a GP and as an emergency medicine specialist in the area, I have deep concerns over the public health services in Mackellar. We've been promised a ward for adolescent mental health, and that has not yet appeared—and we haven't got a good reason as to why that hasn't happened. We've also lost a number of other public health services—the public dental health service, the drug-and-alcohol rehabilitation service—and the people of Mackellar are asking why. We have questions, and I will seek to meet with the New South Wales Government to see what can be done to re-establish these services.