2023 NSW Election: Orange candidates on healthcare

Doctor shortages, palliative care, maternity facilities, and a lack of specialist infrastructure including CT PET scanners were flagged as the primary areas of need for our region.

Every candidate endorsed investigation construction of a mental health 'Safe Haven' in town, and three-of-four said they would lobby for government funding if elected.

Responses from incumbent independent Phil Donato, National Party candidate Tony Mileto, Greens' David Mallard, and Labor's Heather Dunn are attached below.

Shooters, Fishers and Farmers candidate Arron Kelly did not provide a response. The Legalise Cannabis Party says it plans to run in the Orange electorate but is yet to confirm a candidate.

Each Friday in the election lead up the Central Western Daily will cover an issue of local concern, including: Cost of living, roads, transport, disaster prevention and relief, and housing.

The 2023 NSW election is scheduled for March 25. An in person Q&A has been confirmed for March 8 at the CWA Building in Robertson Park.

If there is an issue you believe Orange election candidates should discuss, comment below.

How would you rate the availability and provision of health services in the region as they stand today - what are your primary concerns?

When you look across my electorate - we're quite lucky in some regards in Orange itself - but you don't need to go very far and outside Orange and the health services completely fall off.

Only today [Thursday] I was talking to women who are waiting months for their kids to see paediatricians. Trying to see a psychologist or a psychiatrist is very difficult. Trying to see GPs in some parts of my electorate is very difficult.

So you know, it's difficult to put a figure across the region but I think from what we've seen - from my experience and from speaking to constituents is that there's lots to be done in the health space.

And really, health should be the number-one priority of any government. The welfare of its people, its citizens, its communities should be the forefront ... it's a $33 billion dollar budget, the health budget takes up about a third of the total overall state budget.

Certainly in regional New South Wales we've seen from the Regional Health Inquiry that much more needs to be done. We're lagging behind in terms of when we look at our city counterparts and people in metropolitan areas of Sydney and I think we need to do more.

We need to do more and we need to get more emphasis on getting the staff, medical professionals, specialists, doctors, GPS, and allied health professionals into regional New South Wales and across the Central West to really make the lives of so many people better. That we're not requiring people to travel hundreds of kilometres to access health professionals and to spend days away from their home at huge expense.

So we certainly need to do a lot more than what we're currently doing in terms of regional health.

If elected, what measures would you take to improve access and quality of health services for your constituents?

I think we've got to work collaboratively with communities, depending on who's in government whether it's a Liberal-National government or whether it's a Labor government, I think more needs to be done to attract medical professionals to the regions and provide incentives for relocation opportunities and showcasing our region as being a terrific place to live, work and raise a family. Providing job opportunities for spouses, excellent schools for children to attend, and a great quality of life.

So we really need to showcase something better than what we presently do, I believe. We need to continue working with communities to showcase what we need.

Palliative care is obviously a big issue in this region. The palliative care hospice is something I've been campaigning now for a while. We've pushed for a while now - we've got the two dedicated beds, but that was a struggle to get that and we want to continue ensuring that we don't miss out on our fair share here in Orange.

It's about working with communities, working with community groups and stakeholders to ensure that we highlight what needs to be done in areas that we're falling short of and putting pressure on the government of the day by lobbying, by calling out where there's deficiencies by raising matters in Parliament, by asking questions, by meeting with ministers ... to really ensure that our voices are heard and attention to affecting change in areas that we need to see more resources put into like mental health, paediatrics, and maternity. Parkes and Forbes paternity for example - Lachlan Health Service - if you're an expectant mother in those areas you've got to either go to Dubbo or Orange to deliver a baby.

To some extent ... the level of health services in some of our smaller communities actually decreased compared to what it was 40 years ago, when you could have a baby at your local hospital and when they could fix fractures at your local hospital. Now, many of those hospitals don't offer that service.

Do you believe the existing services are able to cater for a growing population, and why?

We've got an aging population so I think we need to look at providing facilities and resources and medical professionals for that aging population ... a lot of things are being diverted out of telehealth. That's all well and good if you've got internet connectivity but a lot of places in regional New South Wales and even our electorate don't have that level of connectivity and sometimes you need to see a doctor or a medical professional - you can't just do it over the screen.

There needs to be a lot more emphasis also placed in terms of mental health and the child mental health unit out of Orange. We really need to look at - and the government needs to invest more in - those areas.

I think the local health district ... is very top heavy. There's a lot of bureaucrats in those positions - high-paid bureaucrats - but sometimes I feel that the rubber is not hitting the road where it needs to. Whether there's streamlining that needs to take place or whatever sort of review or structural review processes need to occur, we really need to ensure that the money is best spent and that it's getting to those people most in need in our communities and that it's not getting tied up in bureaucracy.

What are your thoughts on the findings of the recent parliamentary inquiry into rural and regional health - and will this be factored into your plans for health services?

I think the Regional Health inquiry demonstrated that people in regional NSW are at a disadvantage when it comes to the quality of health care than those people in the city face or encounter. We need to look at closing that gap. I appreciate It's difficult to get staff to come to the regions but you know, there needs to be some sort of system put in place where maybe HECS debts are waived for medical professionals moving to the country and committing to doing a tenure in the country. offering those levels of incentives to attract medical professionals ... entice and attract those people to the bush and set up base and practice in the bush. I mean, that's probably the biggest thing is the quality of service or then inequality of service.

People in regional areas statistically aren't living as long as people in metropolitan areas of Sydney or the metropolitan areas of the state. One of the reasons is that we don't have the level of health infrastructure in the bush that it really needs to be so they're probably the two biggest things we really need to look at.

It's stuff that we probably already knew anecdotally but it reaffirmed that. We don't want to see the Regional Health inquiry just being a talk fest though. We want to actually see it have some meat and have some teeth and be able to achieve change. We don't want it to just be a talk fest where the conversation goes on for months or years and not many of the recommendations are made, or governments of the day come and go and very little changes.

We need to ensure that doesn't occur and that the recommendations that come out of that regional health inquiry are implemented by the government whoever it be, come the 25th of March and the people of regional New South Wales are put first and foremost in their decision making process.

Do you support construction of a Mental health 'Safe Haven' in Orange - and if so, how would you go about securing this?

I've been a passionate advocate for a mental health Safe Haven to be located here in Orange.

Unfortunately, we see suicide in our communities happening all too often and we need to do more to prevent that and to drive the government's initiative toward zero suicides - that's their ultimate objective. And having these safe havens has demonstrated that it provides a fairly relaxed, informal setting.

A Safe Haven is a facility that's a very homely-like setting ... Parks has one, Dubbo has one - they're scattered throughout our towns in regional New South Wales. And they've proven to be quite effective for people who may be suffering from a mental illness or mental disorder or might be feeling down, depressed, anxious, whatever the case may be. It's an opportunity they can drop in, there's no appointment required.

It's run by people with lived experience in terms of mental health issues, problems, and support. I was only at the Parkes facility last week - it's only been open for about 15 months - and they've already had over 1000 People use it coming and use that facility.

It's taken a lot of pressure also off the emergency hospital emergency department at the local hospital where people were those people are not presenting at the hospitals.

It's non judgmental is quite homely in its surrounds and settings, and the people who work there are wonderful people with lived experience so I've been pushing for one in Orange. I've been lobbying with Minister Bronnie Taylor a number of times.

We're hopeful there may be an announcement in the lead up to the election by the government to place one here in Orange, and we remain optimistic about that. I've had a number of meetings with Bronnie Taylor to discuss this issue and made numerous representations to her that there's an overwhelming support in the community for it.

So let's hope the government listens and delivers on this - hopefully we can get a commitment to come as the election approaches.

What health projects or policies would you deliver to the electorate and are any of these projects achievable in the next term of government?

restoration of full maternity services for Lachlan Health Service, a CT PET scanner available to public patients in Orange, and hospice palliative care for Orange - similar to what was just announced in Tamworth ... there's three things first off the bat.

Obviously more medical professionals, more allied health professionals, more GPs across the regions as well. I think the medical school is a good thing. But that's going to take a few years for the students to graduate and come through but it's a start, which is terrific.

It's all about showcasing the region and providing that level of incentives. Look at waving HECS debts, for example, for doctors or nurses to spend a tenure of their training or time where they stay here. A lot of those medical professionals might decide to stay here permanently after they finish the four or five years, they might have to stay in a region to pay off their HECS debt. I think that would get a lot of support from medical professionals because they rack up a fairly significant extent during the course of their long study.

So we need to think of those things because money that you put in the system now for prevention and for care and treatment is money you save at the back end when people are suffering from numerous illnesses or comorbidities, or whatever the case maybe. Where they're choking up the health system and there's a huge financial cost to the state.

If we can have that level of care, treatment, and support for people during the course of the journey from children into adults through their working life by having that continuity of care and by having the medical professionals here in our town and available - it should deliver better health outcomes in the longer term as well which ultimately will save the government towards the latter stages of a person's life.

Like I said at the beginning, health should be the number one priority of any government whether it be State or Federal. That should be the biggest commitment because ultimately the health of our communities is the most important priority. So we want to ensure that we have those facilities and resources and personnel in our communities to be able to achieve that.

How would you rate the availability and provision of health services in the region as they stand today - what are your primary concerns?

Our region's health services aren't adequate. In the public health system, our nurses, midwives, paramedics and other professionals are understaffed, overworked and their working conditions are deteriorating. Mental health, dental and allied health services are too often unavailable or unaffordable for many in our region. The recent NSW Parliamentary Inquiry into Rural and Regional Health made clear that we don't have fair and adequate access to health services and this affects the wellbeing of our communities and can have disastrous consequences. We need to fix the public health system, expand public and accessible general and specialist health services, and look after our health workers.

If elected, what measures would you take to improve access and quality of health services for your constituents?

The public health system is losing workers due to burnout, poor pay and unsafe working conditions. With the Greens in the balance of power, we'll push the next government to abolish the public sector wage cap, give nurses, paramedics and midwives a pay rise, implement safe nurse-to-patient staffing ratios, hire more paramedics for regional NSW and introduce a 24/7 patient transport service to decrease delays and free up ambulances.

We need to remove the barriers that prevent junior doctors from considering a career in general practice, and we want to establish outreach programs so that more people can see a specialist close to home.

We want to establish 12 public primary care services (one per Local Health District, including our Western NSW LHD), managed at a local level, where you can see a GP and allied health professionals like a physiotherapist, speech pathologist or dietician for free, including home visits for people with a disability or limited mobility and outreach services into local communities.

This can be funded within the existing NSW Health budget by redirecting the over $200 million wasted in NSW every year by the inefficient system of filling staff shortages through expensive private locum agencies. The savings from improved health outcomes and reduced hospital admissions over time will then be re-invested into more public primary care clinics.

Do you believe the existing services are able to cater for a growing population, and why?

Our services are already stretched and we need to plan for future growth as well as an ageing population. We need to invest in preventative health, retain our invaluable public health workforce, and ensure the next generation of health professionals are being trained and supported to enter these professions and work in the regions.

What are your thoughts on the findings of the recent parliamentary inquiry into rural and regional health - and will this be factored into your plans for health services?

The Parliamentary Inquiry heard directly from regional health workers and community members as well as experts, and its findings were clear and scathing about the inadequate resources, poorer services and worse health outcomes that regional areas have been faced with. Its recommendations should be implemented urgently, and an independent Rural and Remote Health Commissioner should be appointed to monitor and report on progress in fixing the regional health system and its outcomes.

Disappointingly, the Liberal-National Coalition and Labor members on the Inquiry united to prevent some important recommendations being put forward by Greens MP Cate Faehrmann, including requirements for safe staff-to-patient ratios and minimum staffing levels. The Greens in the balance of power will push whoever forms the next government to implement these requirements to address the chronic understaffing in our health services.

Do you support construction of a Mental health 'Safe Haven' in Orange - and if so, how would you go about securing this?

The early reports from the initial Safe Haven sites such as Dubbo sound promising, and they look to provide a way for people with mental health issues and potential suicide risk to access support and a safe space within the community, hopefully reducing demands on emergency departments and other services.

I would advocate looking at the outcomes and lessons learned so far with a view to expanding the model into Orange. But while Safe Havens may be one part of the solution, we also need to address the challenges people with mental health issues face in accessing and affording ongoing support and treatment services from allied health professionals, and providing the working conditions that allow public mental health services to offer appropriate care when needed.

What health projects or policies would you deliver to the electorate and are any of these projects achievable in the next term of government?

I would advocate for abolishing the public sector wage cap and providing wages for nurses, midwives, paramedics and others in the public health system that can keep up with the cost of living. Along with that, we need to urgently implement safe staffing levels in the health system.

We can deliver the first 12 public primary care clinics in the next term of government and I would advocate for one to be in Orange, to provide access to public GP and allied health services as well as outreach to surrounding towns, villages and rural communities.

I'd also push for government funding to deliver vital services that currently aren't adequately available locally and leave vulnerable patients and their families facing travel away from home and related challenges - this includes specialist services as well as palliative care. We need to ensure our region's people are cared for, supported and able to have the best possible quality of life at all stages while at or close to home and loved ones.

How would you rate the availability and provision of health services in the region as they stand today - what are your primary concerns?

I think we should all be incredibly proud of the health services in our region. We have an incredibly dedicated workforce and some of the newest health facilities in the state but there's always more that needs to be done.

Earlier this month Orange Health Service welcomed another 14 graduate nurse and two graduate midwives, and later this year we'll be welcoming more.

However, there is no doubt that there is a medical workforce shortage right across Australia - even in our big cities - so Orange, Parkes, Forbes and our other smaller communities are no exception. But the Central West is a beautiful part of the world. People are moving here in droves and we need to capitalise on that by making sure that: Health workers are enticed here, they're welcomed with open arms, and we give them the resources they need to stay.

If elected, what measures would you take to improve access and quality of health services for your constituents?

If elected, my focus is 100 per cent on workforce. We are lucky that our main hospitals of Orange, Parkes and Forbes have been redeveloped alongside an upgraded ambulance station and Multipurpose Service in Molong - so the infrastructure is there. What we really need is the workforce to make sure the services we've got are staffed and delivered to our community. I want to see babies being born at Parkes again, more specialists across our region and improved palliative care.

The Government's $883 million incentives package has already made inroads here. Across the Western LHD 58 new staff have already been attracted and its helped retain a whopping 644 people across health facilities. The Orange electorate has been a major beneficiary of this - with over 200 health staff having moved or staying in our communities. And this isn't just in our major centres, but staff at Bloomfield, Cudal, Eugowra and Molong are benefitting too.

It's a fantastic start but there's more that needs to be done. I want to work with the Minister for Regional Health and other regional Ministers on trying more unique and innovative ways to incentivise staff here to fill and expand our hospitals.

Do you believe the existing services are able to cater for a growing population, and why?

For the moment. But with our region growing we need to be on the front foot to ensure our population doesn't outstrip our services. Again, I think workforce is our Achilles heel and that will be my number-one focus.

What are your thoughts on the findings of the recent parliamentary inquiry into rural and regional health - and will this be factored into your plans for health services?

The Inquiry shone a light where it needed to, hearing directly from rural and regional communities, patients, their families and healthcare workers and I was pleased to see the Deputy Premier create a dedicated Minister for Regional Health to tackle this.

There have been some really big wins in regional health over the past 18 months, including the transformation of the way health clinicians are incentivised to work in the bush, more nurse practitioners, pharmacists' scope changing, and massive changes to the Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS) with a $149.5 million investment that means subsidies are doubled.

I have already spoken to the Minister for Regional Health about what continued improvements our community expects, and if elected, I'll be knocking on her door daily to make sure they happen.

On other hand, Labor don't even have a Regional Health Minister, have said they won't be building any new hospitals, and have made it clear they are not interested in looking after the people of rural and regional NSW.

Do you support construction of a Mental health 'Safe Haven' in Orange - and if so, how would you go about securing this?

Absolutely. We've seen how well the model is working in other parts of the state, including Parkes, so it's a no brainer to secure one in Orange too. They've already had over 300 people walk through the door.

I do a lot of community work in the mental health and suicide prevention space, and even when I was police officer, the thing that comes up a lot is people just needing someone to talk to. That's what is so fabulous about a service like this. There's no referral from a doctor or pre-scheduled appointment needed.

If elected, being part of a team in Government would mean I have a direct line to the Mental Health Minister Bronnie Taylor. I want to work with her to get the funding but most importantly, I want to work with the community to ensure we have the best location possible and a service that is going to reflect our region's needs.

What health projects or policies would you deliver to the electorate and are any of these projects achievable in the next term of government?

Improving palliative care services in the region will be a focus of mine. It is important that we not only focus on expanding services at Orange Health Service, but also ensuring that if people choose to die at home that they can get the care they need. It is great that the NSW Liberal and Nationals Government's secured $743 million for its End of Life Care program, and I will fight to ensure that the Orange Electorate gets its fair share.

And as I said earlier, workforce, workforce, workforce. I want to see more doctors, nurses and allied health professionals calling the Central West home so we can re-start and expand the amazing services we already have.

How would you rate the availability and provision of health services in the region as they stand today - what are your primary concerns?

There is a critical shortage of health professionals across the region. There has been a failure by the state government to attract, support and retain health professionals. My primary concerns are that people in Orange are twice as likely to die prematurely than those who live Sydney, and that the rate of suicide within the regional is trending up. There is inadequate funding for services.

If elected, what measures would you take to improve access and quality of health services for your constituents?

I would work with the government to implement the recommendations from the Rural Health Inquiry. Support the funding of an additional 500 regional paramedics across NSW. Support the introduction of minimum and enforceable safe staffing levels to public hospitals. Support the addition of 1,200, above those included in the current government's budget, nurses and midwives. Support the boosting of access for mental health services for young people through the additional funding of Kids Helpline.

Do you believe the existing services are able to cater for a growing population, and why?

There is a significant investment needed to service the growing needs of the Orange population and address the inequity of health outcomes between regional and metropolitan residents.

What are your thoughts on the findings of the recent parliamentary inquiry into rural and regional health - and will this be factored into your plans for health services?

It is concerning and shameful. It puts the people within the Orange electorate at great risk. Labor will appoint a Deputy Secretary for Rural Health who is accountable for implementing all recommendations from the rural health inquiry and will be tasked with driving reform and improving the health outcomes for rural and remote communities across NSW. I will support and advocate for this.

Do you support construction of a Mental health 'Safe Haven' in Orange - and if so, how would you go about securing this?

I support a mental health 'safe haven' in Orange. I would advocate for the funding.

What health projects or policies would you deliver to the electorate and are any of these projects achievable in the next term of government?

Labor will have a fresh start for rural health care, with announcements so far including:

Regional Health:

Implement Rural Health Inquiry recommendations

Fund an additional 500 regional paramedics in Labor's first term.

Pressure on health system:

Introduce minimum and enforceable safe staffing levels to public hospitals, starting with emergency departments.

Additional 1,200 nurses and midwives recruited into the system (above the government's additional recruits outlined in 2022-23 NSW State Budget) within the first four years of a Labor Government, at a cost of $175 million.

Women's Health:

Boost funding for Women's Health Centres to $100 million over five years to ensure the 20 centres across the state can operate sustainably and deliver health services that meet the needs of the community.

$19.5 million over three years to fund an additional 29 McGrath Breast Care nurses to support people right across New South Wales.

Mental health:

Boost access for mental health services for young people in New South Wales by committing $17 million to the Kids Helpline over four years to increase their capacity to respond to a rising number of calls.

A Minns Labor Government will establish legislation to enshrine a whole-of-government approach to suicide prevention.

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