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Select Committee on Transforming Health

The Hon. R.L. BROKENSHIRE (16:52): I move:

That it be an instruction to the Select Committee on Transforming Health that, in considering the health impact of Transforming Health, the committee considers quality and safety issues arising from the relocation of the Royal Adelaide Hospital.

The Hon. R.L. BROKENSHIRE: It came to my attention last week—and, again, it was interesting to hear the Hon. Kelly Vincent ask the Minister for Health very detailed questions on issues that have arisen already with the new RAH regarding, effectively, what you could summarise as patient care. I understand that on 6 October the committee will have a witness, a relevant public officer within Health SA, the Department of Health, appearing before the committee. That is why I am asking for the cooperation of this house to move this through with expediency.

I have spoken to an associate professor of medicine whom I have enormous respect for, who has done his homework and advises me—and I put on the public record that it is not the Australian Conservatives' intent at all to have the particular patient named or identified, that would be incorrect. However, it is important that we identify if there is a weakness in the new RAH in any way.

We have seen a lot of glossy expenditure—I think something to the tune of $750,0000—in advertising, painting this as the bee's knees of the health system in the history of South Australia. However, it is no good having that glossy image if there are issues that have been missed or not addressed.

I am not going to go into the details of this particular case, except to say that a patient, I am advised, was admitted. The issue was an issue around gynaecology and was quite a serious issue that needed to be addressed as a priority. I am advised that neither the equipment nor the expertise in this area was available at the new RAH, notwithstanding that, I also understand, it was available at the old RAH. That patient ultimately was transferred to the Flinders Medical Centre where they did receive the treatment.

The problem, I am told, was also the fact that that patient spent about six hours of fairly difficult time waiting at the new RAH to see just what was going to happen to treat them. That would be unacceptable. I believe it would be unacceptable to the minister, based on what he said to this chamber today when he said it was not about funding, it was about the quality of health that counted for the South Australian government. If there is a situation, then it needs to be addressed, because I cannot understand how you could have your number one tertiary hospital not able to deal with issues of priority around gynaecology.

What has happened, just to advise the chamber, is that on two occasions the department has advised that the information the associate professor had was incorrect, that there were no issues around this particular patient or gynaecology and the appropriate care, and that the patient did not have to be transferred to Flinders Medical Centre. Having spoken to the associate professor, he advises me that he has been in contact with two doctors that are specialists in this area at the Flinders Medical Centre. They not only confirm that they had to deal with this particular case for this patient but they actually had to implement the procedures to get the patient transferred.

In these early days of the new RAH, what we need is absolute confidence for the South Australian community. We do not need a snow job, we do not need a cover-up; we need some honesty and transparency. If there are flaws in some areas of what the new RAH provides, then we need to let the public know that. We need to have the debate and we need to fix it. That is all this is about: getting to the truth.

I trust the associate professor. He is highly respected and an incredibly gifted and talented man who speaks up for patients, because, as you would expect from any medical practitioner, they put people before spin. It is important that our parliament actually gets to the bottom of this. Therefore, I am moving this motion as a matter of urgency. I trust the parliament will support this motion and that we will be able to get the committee to get a detailed response from the department when they next have in the right person in October. I commend the motion to the house.

The Hon. K.L. VINCENT (16:58): In a move that I am sure will be of no surprise to anyone in this chamber, I speak on behalf of the Dignity Party to support this motion. Given the concerns that the Dignity Party has raised about the Transforming Health process over the past few years, indeed the 14 questions that I asked today alone would be evidence enough to suggest that we do have concerns about this process and that we think any necessary measure to investigate it should be supported. Of course, we would hope that the welfare of patients was already a matter being considered by the committee, but just to be safe, we are happy to support this particular motion.

The Hon. T.A. FRANKS (16:58): The Greens rise to support this addition to the terms of reference for the Transforming Health select committee. Indeed, as a member of the Transforming Health select committee, I found it an incredibly worthwhile tool for a major overhaul of our health system in this state. To have so many flaws exposed by this select committee, the Greens are happy to continue to shine a light where a light is needed. Nowhere is it more needed than in the health portfolio in this state and indeed with the very lives of those citizens.

We also urge that the borderline personality disorder issue really needs to be taken seriously by the Weatherill government. The parting missive of the outgoing mental health minister to give $1.2 million over two years to a series of disappointing events, where the BPD community and, indeed, groups like Sanctuary have been calling for a substantial unit as exists in Victoria—a unit that will save lives—has been ignored, and it has been ignored continuously now for over five years. BPD can be addressed; it can be treated.

People in this state are needlessly dying or needlessly ending up in our emergency department units and will be ending up at the new RAH and losing their lives and their quality of life. It needs to be addressed. The Greens urge support for this motion. We indicate our support for this motion and we will be taking it further. We will be ensuring that this government is held to account for what it says it is trying to do with Transforming Health. We want to see lives saved and we challenge the Weatherill government to meet that challenge.

The Hon. S.G. WADE (17:01): I rise to support the motion on behalf of the Liberal team. I do so as chair of the committee but, of course, not with the authority of the committee. I note that the member's motion is an instruction, because, as the motion itself clearly implies, the committee already has a responsibility to consider the impact of Transforming Health on the quality of health care, and his motion focuses on quality and safety.

I welcome the motion as an opportunity for members to bring matters to the attention of the committee in a focused way, so that, as we have a witness before us at our next meeting, members of the committee can be aware of concerns of other members of the chamber. In that respect, I particularly thank the Hon. Mr Brokenshire and the Hon. Kelly Vincent for taking the opportunity to contribute to the debate on Mr Brokenshire's motion, and, of course, I thank the Hon. Kelly Vincent for her very detailed set of questions to the minister today, which indicate concerns not just within the disability sector. Many of those concerns were representative of Ms Vincent's constituents, who do not have a lived experience of a disability.

I think this mechanism is novel. That is certainly true, but I think it also does a service to the witness because, effectively, she will have matters brought to her attention on notice. I give an undertaking to the council that I will make a copy of Hansard available to the witness so that she might consider the remarks that have been made today in her preparation for the committee next week.

The Hon. Robert Brokenshire, both publicly and again today, has outlined a very disturbing case, which in the classic jargon of the health sector would be called 'an adverse outcome'. I do not say that to in any way belittle it, but that is how the health sector does tend to refer to these things. I think it is important for us as a committee to ask the CEO of the hospital what safety and quality reports have eventuated from the relocation, both internal and external. Of course, if there is a particularly severe adverse outcome, that may well lead to reporting obligations to entities beyond the health system.

Both in the public domain and in this parliament issues have been raised about the quality of food and the frequency of food. I have had constituents raise concerns with me about the transition from one patient to another patient in a room; in other words, cases where on the way in a patient is receiving food that was ordered for a previous patient, and on the way out their meal is offered to the next patient.

Already, I am getting reports of significant issues in relation to the adequacy of the facility. The AMA in particular has been for years now expressing concern about the lack of space for clinical research and in relation to outpatient facilities. I received constituent representations, in particular in relation to the lack of outpatient facilities, which is affecting whole streams of clinical services. For example, in the area of rheumatology, I am told that in the old RAH there were 20 to 30 seats in the outpatient waiting area. In the new RAH, there are reportedly 10, which are shared with another whole department.

Of course, in the public space we have had a number of concerns raised about car parking. Many nurses and other health professionals have missed out on an unallocated car park. I was disappointed to see that SA Health had to go to two rounds of car parking allocations, and the second was so close to the commencement of the new facility. One of the concerns that particularly relates to the safety of staff is in relation to the way that the car parks are handled for what I would call early starters and late finishers.

The former minister for health, the member for Playford, did give an undertaking while he was still minister for health that no overnight staff member would miss out on a car park. With all due respect, that is not a hard commitment to meet, because particularly outpatients do not turn up in the middle of the night, but staff have raised with me the fact that if a clinic or an operating team starts early, they need to be there well before the clinic starts, well before the first patient is wheeled into the operating theatre. The focus on overnight staff perhaps does not do justice to staff who need to do early starts and late finishes. There have also been concerns raised about the drop-off and pick-up zone.

There is a whole range of concerns. Members have outlined a number here today. I think it is important that we on the one hand accept that any new facility will have teething problems and these do need to be ironed out, but also I think a number of these concerns flag what I would call structural issues. You will not be able to redress the lack of planning for clinical research space and for outpatient facilities overnight. That is a flaw in the government's planning and consultation.

As was highlighted in question time today, this government seems to have an allergic reaction to effective consultation with clinicians. Those chickens are coming home to roost as the clinicians are now trying to make a very complex hospital work. It will be additional stress on the staff. There will be additional costs in terms of modifications and service delivery, and I fear that they will significantly damage the quality and safety of our health care. We as a parliament need to make sure that we highlight the issues early so that they can be resolved early. I support this motion.

The Hon. T.T. NGO (17:08): I rise to quickly speak on this matter as the state government's representative on the committee. The government has nothing to hide and supports these amendments from the Hon. Mr Brokenshire in terms of amending the terms of reference. Providing a safe clinical environment for those staff who work in our public hospitals, not just the new RAH, and the patients who are treated there is of the utmost importance to the government.

I point out to other honourable members that the current terms of reference of the Transforming Health committee already allow members to ask these sorts of questions. I can see the Hon. Stephen Wade nodding his head in agreement. To me, this is really unnecessary, but that is why we have no problem in supporting it. If the Hon. Mr Brokenshire would like to come along to the next meeting where we will be hearing from Jenny Richter, CE of the Central Adelaide Local Health Network, who is in charge of the new RAH, he is more than welcome to attend.

In the past two years, in terms of Transforming Health, it has been open to members to ask all sorts of questions, and the committee has never used the terms of reference to stop members from asking questions outside the terms of reference. To keep it short, we do not have any problem with this, and we are happy to support it because we are an open and transparent government.

The Hon. J.A. DARLEY (17:11): For the record, as a member of the Transforming Health committee, I will also be supporting this motion.

The Hon. R.L. BROKENSHIRE (17:11): I will be brief. I thank all honourable members. This is an important issue. It is a very important committee, and I look forward to being present to observe the committee at work on 6 October.

Motion carried.