Health Care (Governance) Amendment Bill 2019

June 5, 2019

The Hon. J.A. DARLEY (17:10): I rise to speak on the Health Care (Governance) Amendment Bill. The bill makes a number of changes to the act, in line with the government's commitments to reform South Australia's health system. Among other things, the bill outlines the role of the chief executive. I understand the chief executive and local health network boards will enter into service agreements, and the chief executive will be responsible for ensuring that the obligations under the agreement are met.

 

I, like many others in this place, received a joint statement signed by a number of authorities, including SACOSS, SANDAS, the AMA, Health Consumers Alliance and the Aboriginal Health Council of SA. This joint statement outlined a number of shared concerns. One of the concerns that was outlined was the issue of a silo mentality that may arise if local health networks are operating completely independently of each other. What provisions are there to ensure that, if you attend the Queen Elizabeth Hospital's emergency department, the experience you have will be much the same as if you attended the Royal Adelaide Hospital?

 

I organised a briefing with the minister a few weeks ago to address these issues and was assured that it was the role of the chief executive to ensure that the health system as a whole worked cohesively, notwithstanding the autonomy of the local health networks. That is to say that, even though the local health networks are responsible for what happens in their areas, the chief executive will have oversight of the system as a whole and will address issues with local boards that are not meeting the performance standards as outlined in their service agreements.

 

There was also great concern that the Health Performance Council would be abolished and a commission on excellence and innovation in health would be established. Whilst the government has not said that the commission will directly replace the Health Performance Council, the commission will take on many roles that are currently undertaken by the council.

 

Part of this concern was that the bill lacks the provision of independent oversight of the health system. Understandably, many people are sceptical of a Caesar under Caesar approach, whereby an internal body is charged with oversight. Again, I have raised this with the minister and I understand that the commission will have statewide clinical networks that will help drive policy and direction for the health system.

 

For example, I understand there will be a cardiac clinical network that will comprise clinicians and practitioners, as well as consumers, who will be charged with looking at cardiac-related health services. If a particular problem is identified, the clinical network will be able to investigate further and provide recommendations. These investigations can be self-instigated or come by direction.

 

In essence, the minister advised that there will still be oversight available through these statewide clinical networks under a commission on excellence and innovation in health. I would be grateful if the minister could confirm my understanding of these networks and add any additional details on how they will operate in order to ensure that there is transparency and independent oversight on the health system.

 

Whilst I have been largely satisfied with the responses the minister has given to me regarding the concerns raised in the joint statement, I understand there are a number of amendments that have been filed that will address some of the matters. Given they were only filed today, I have not yet had time to consider them but, on looking at them briefly, I believe there may be some merit to them. Whether we need to legislate for everything that the amendments address is a matter that needs further consideration. I support the second reading of the bill.

 

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