13th May, 2026.
Public-private partnerships in health over the past decade have been increasingly used to deliver infrastructure, clinical services and health promotion by leveraging private sector expertise and capital. That is because of many factors, including the choice of private partner and stakeholder interest. Private partners cite improved hospital efficiency and patient satisfaction statistics but face challenges regarding high bid costs and potential conflicts of interest, especially in health promotion. I preface my speech with a genuine in-principle acknowledgement of the role of the private health service in Bowral. It provides the community with an alternative choice of medical care and specialist care for an extensive list of diseases, and it reduces waiting lists for care in the public hospital. Many people using the private hospital report high patient satisfaction.
In the electorate of Wollondilly, Ramsay Health Care—Australia's largest private hospital operator and an ASX-listed company—operates Southern Highlands Private Hospital in Bowral. Ramsay's private hospital is next door to the Bowral and District Hospital; it is literally on the same block. The South Western Sydney Local Health District is the governing body responsible for the public hospital. What is little known about those two organisations is that Ramsay Health Care has an arrangement in place to provide cancer and infusion services for both private and public patients at Southern Highlands Private Hospital. That is an exclusivity agreement. I raise that in the House to bring attention to the still-trending privatisation of public health services to Ramsay Health Care. That trend is because of growth in Australian Competition and Consumer Commission merger, acquisition and divestment notices involving Ramsay.
The previous Government, in concert with—although to a lesser extent than—the Australian Government, transferred services and staff responsibilities to the private sector, possibly eroding diversity of choice and value in public health care. Bowral hospital is not an isolated case study. It is reported in Ramsay Health Care's annual reports that it operates private hospitals in Western Australia, Queensland, Canberra, Victoria and globally. While patients report that they appreciate the service in our community, there is minimal evidence-based data in the public domain to explain how, when, why and who implements, monitors and evaluates the private hospital cancer services to our public patients in Bowral. I raised that with our Government to ask about its intentions to establish cancer health services at Bowral and District Hospital and the future of public services within Southern Highlands Private Hospital.
In 2022 and 2025, New South Wales parliamentary inquiries and reports found that remote, rural and regional communities were paying more out-of-pocket expenses for health care. Government responses to those inquiries referred to the growth of public-private partnerships to increase the extent of healthcare access in selected rural and regional communities. It is the appropriate time to conduct an independent audit to ensure that public moneys are spent appropriately and to review the opportunities, risks and sustainability of continuing or expanding cancer health service options in the Southern Highlands region.
While the service is provided, some of my constituents continue to present at Campbelltown Hospital and Liverpool Hospital and claim financial subsidies from the Isolated Patients Travel and Accommodation Assistance Scheme to access cancer health care more than 100 kilometres from home. I question whether the sole use of the private hospital has abated or lessened or is abating or lessening those environmental and social concerns. I ask the Government to confirm its intentions to continue to expand or augment the public cancer patient model at the Southern Highlands Private Hospital or indicate whether it will eventually transfer patients to a specialised public cancer treatment centre.
Notwithstanding the fact that the Government has heavily invested in the Bowral and District Hospital, with stage one costing $68 million and a further $55 million pledged for stage two, no cancer health services to improve access to, affordability of and equity of services were committed to by the Government. The public deserves to know the implications, for better or worse, of resourcing public cancer health in Bowral through a private health corporation versus delivery in the public hospital. We need to understand the use of the public purse. It should provide an evidence base to confirm whether public-private partnerships add tangible cost efficiencies to the public health system, improving patient access and affordability of public health services in the Wollondilly electorate.