Paul Starick: Health wounding Labor after crisis at Women’s and Children’s Hospital

Labor sowed the unrealistic expectation it would fix the health system and this is coming back to bite the government, writes Paul Starick.

The impossibility of “fixing health” is hitting a Labor government that was propelled to power having sowed this unrealistic expectation into the electorate.

The Malinauskas government is becoming a victim of its own success at the March 19 state election, weighed down by the huge public expectation fuelled by its own future-focused health reform agenda.

This was starkly demonstrated by Premier Peter Malinauskas’s flat-footed response to The Advertiser’s revelation that the flagship Women’s and Children’s Hospital had lost accreditation for its Paediatric Intensive Care Unit as a training centre.

Usually a confident and assertive public speaker, Mr Malinauskas was left clutching for answers. Labor’s promised 48 extra doctors for the WCH was being rolled out, he declared, but he was unable to explain why this had not staunched the accreditation wound.

Premier Peter Malinauskas on June 4, when he spent a night with paramedics in an ambulance. Picture: Brenton Edwards

“That’s an excellent question that we’re actively examining. Well, I know (Health) Minister (Chris) Picton is all over this like a rash since this has been drawn to his attention,” he told ABC Radio on Thursday.

The reality of governing is mugging Labor in this regard. The WCH is in trouble now. The flagship hospital has been struggling along for years. Sick kids won’t be in a new one for almost a decade. The new hospital on the Thebarton Police Barracks site will cost up to $3.2bn and won’t be finished until 2030-31.

It’s the modern-day South Australian version of the oft-repeated quote from UK Prime Minister Harold Macmillan about the greatest challenge facing political leaders: “Events, dear boy, events.”

Fixing health is Labor’s central mission. It’s the reason Mr Malinauskas is Premier. He made big promises, particularly “a positive plan for the future, including our plan to fix the ramping crisis”.

An artist impression of the planned new Women's and Children's Hospital (WCH). Picture: SA Government

A big-spending agenda created the impression that problems in the health system would be solved. Labor ministers will point to the specific promise of bringing ambulance response times to acceptable levels. But Labor fuelled lofty expectations during the election campaign and now must deal with the consequences. Voters are not interested in the fine print or an election promise with an asterisk and escape clauses.

As I observed in June, a future-focused agenda takes some time, energy and considerable amounts of money to implement, as the Premier tacitly acknowledged by deciding on an earlier-than-expected June 2 state budget. Like the famous London Tube announcement, it’s a case of mind the gap. In this case, though, it’s the gap between promise and delivery of public health system improvements.

This is even more true now, six months later, when ramping has worsened rather than got better and a humbled, tepid Liberal Opposition has gained some rare traction by seizing upon Labor’s failure to fix the system.

As Health Editor Brad Crouch pointed out on Thursday, we’ve been here before, with multiple Labor and Liberal health reform plans dating back to 1999.

Cost pressures have risen amid ever-increasing demand for services in an ageing population. The futility of believing that throwing more money at the health system would fix all problems was nailed by respected public and private sector veteran John Menadue in his 2003 Generational Health Review, commissioned by the new Labor government.

John Menadue, chairman of the Generational Health Review, in December, 2002.

He gained a striking impression of the implicit view in some quarters that SA had unlimited health dollars, imposing continual pressure and demands for better equipment, more drugs, more beds and more surgery. “Even if the government doubled the numbers of hospital beds, they would quickly be filled, with further demands for new beds,” Mr Menadue said.

This is a quagmire into which the Malinauskas government risks sinking. But the health issue is highly unlikely to be as decisive at the next election as it was in March, when it was fuelled by the state’s most severe Covid-19 wave.

The-then Opposition Leader Peter Malinauskas promised 24 new dedicated paramedics and ambulance officers to the Limestone Coast if elected. Picture: Arj Ganesan

Even the Liberal Opposition recognises that it must be careful not to fight the 2026 election on the same battleground as the 2022 poll. But the Liberals believe failure to fix health does Labor tremendous damage and is starting to drive a truck load of cynicism through the electorate.

There is one crucial distinction. The ambulance union was Labor’s lieutenant ahead of March’s election. Ambos chalked their vehicles and waged a tireless campaign to defeat Steven Marshall’s government. It’s nigh-on impossible to believe health unions will wage a relentless campaign against Labor to install the Liberals.

But health was supposed to be Labor’s strength and it’s now becoming an exposed wound.