I have previously spoken in this place about the challenges facing our healthcare system, especially in south-west Sydney. With my electorate home to one of the largest trauma centres in Australia, Liverpool Hospital, health care and hospitals are among the issues most commonly raised by my community. As a former healthcare professional, I am acutely aware of the challenges wrought by a system that functions across multiple levels of government. Since COVID, our hospitals and acute‑care services have been placed under exponentially more pressure every week as they have become the default gateway to the State's healthcare system.

Our healthcare system was not designed for our hospitals to be the first port of call should anyone fall ill or need health care. The Australian system is unique in identifying GPs as the gateway to other health services, except in the case of accidents or emergencies, where acute care is required. The modern GP model of care in Australia began with the introduction of Medicare in 1984 by the Hawke Government, which established a universal health insurance system that subsidised GP services through patient reimbursements. However, the foundation for a structured GP training system was laid in 1973, when the Whitlam Government funded the Family Medicine Programme to train GPs. Since then, primary health care has been the remit of the Commonwealth. However, the impact of a global pandemic, a decade of resource cuts to primary care, inadequate transfers from hospitals to aged-care and NDIS programs, and an exodus of bulk-billing GPs, especially in regional areas and Western Sydney, have come home to roost. Our hospitals are at breaking point because they are where people seek care first, regardless of whether they are the most appropriate place for the care they need.

Given the stories I hear and the ways in which I advocate for my constituents, I was flabbergasted to hear that the Prime Minister has written to the States asking them to rein in public hospital spending—especially because, in the words of the Minister for Health, it is not like public hospitals in New South Wales are out there drumming up business. The Commonwealth ignores the critical problem of bed blocking, which occurs when patients who are medically ready to be discharged cannot leave hospital because there is nowhere appropriate for them to go. That is often due to shortages in aged-care placements, disability accommodation, subacute beds or community health support, or delays in NDIS and home care approvals. When patients who are ready to leave cannot be discharged to appropriate aged-care or community placements, that effectively takes beds offline.

The impact of that is felt immediately and acutely in emergency departments. At Liverpool Hospital, the consequences of bed blocking are particularly severe. When patients cannot be discharged, new patients cannot be admitted. That means that the emergency department becomes more crowded, elective surgeries face delays and staff spend hours trying to secure community supports that should be readily accessible, leading to staff burnout and delays in urgent treatment. The problem then flows through the whole hospital system: every department becomes stretched, every clinician is carrying more than they reasonably can and every patient feels the strain. Serving a rapidly expanding population across the broader south-west Sydney region, our hospital is already managing thousands more presentations each year than its infrastructure was originally designed to handle.

In Liverpool there are 50 aged‑care or NDIS patients that have exceeded their estimated date of discharge. There are 150 such patients across the South Western Sydney Local Health District and a whopping 1,100 across New South Wales. They are patients who should not be in our public hospitals, in beds that should be occupied by acute care patients. That is not a reflection on the quality of care offered at Liverpool Hospital. Our nurses, doctors, allied health teams and support staff are extraordinary. They work incredibly hard in challenging circumstances, often going above and beyond to support patients who cannot be safely discharged. The problem lies in the lack of affordable aged-care placements, inadequate transitional care programs, shortages in rehabilitation and subacute beds, and delays in disability and home‑care approvals. Those areas are where State and Federal issues intersect. When gaps appear between systems, hospitals like Liverpool bear the brunt.

We need a more integrated approach between hospitals, aged care, disability services and primary care. We need more subacute capacity and community‑based health care options in south-west Sydney, so patients can recover safely at home or in appropriate facilities without remaining in hospital longer than necessary. And we need strong collaboration with the Commonwealth to ensure aged-care and disability supports are funded, staffed and accessible when people need them. Liverpool Hospital is a cornerstone of our region's health system. Addressing bed blocking will help ensure it can continue providing the timely, high-quality care that our community deserves. I stand by our Premier and health Minister in calling for a better deal when it comes to New South Wales hospitals. I call on the Commonwealth to do its bit rather than cost shift.