Department for Health and Wellbeing, $4,175,879,000

South Australian Mental Health Commission, $2,102,000

Membership:

Mr Picton substituted for Ms Michaels.

Mr Boyer substituted for Ms Stinson.

Minister:

Hon. S.G. Wade, Minister for Health and Wellbeing.

Departmental Advisers:

Dr C. McGowan, Chief Executive, Department for Health and Wellbeing.

Ms J. TePohe, Deputy Chief Executive, Corporate and System Support Services, Department for Health and Wellbeing.

Ms L. Cowan, Deputy Chief Executive, Commissioning and Performance, Department for Health and Wellbeing.

Ms L. Dean, Chief Executive Officer, Wellbeing SA, Department for Health and Wellbeing.

Mr J. Woolcock, Chief Finance Officer, Department for Health and Wellbeing.

Prof. P. Phillips, Commissioner, Commission on Excellence and Innovation in Health, Department for Health and Wellbeing.

Mr B. Hewitt, Executive Director, Infrastructure, Department for Health and Wellbeing.

Mr A. Knez, Manager, Executive Services and Projects, Department for Health and Wellbeing.

The CHAIR: The estimates committees are relatively informal procedures and, as such, there is no need to stand to ask or answer questions. I understand that the minister and the lead speaker for the opposition have agreed to an approximate time for the consideration of proposed payments, which will facilitate a change of departmental advisers. Can the minister and the lead speaker for the opposition confirm that the timetable for today's proceedings previously distributed is accurate.

The Hon. S.G. WADE: Yes.

Mr PICTON: Grudgingly.

The CHAIR: It is the same as every other year, member for Kaurna. Changes to committee membership will be notified as they occur. Members should ensure that the Chair is provided with a completed request to be discharged form. If the minister undertakes to supply information at a later date, it must be submitted to the Clerk Assistant via the answers to questions mailbox no later than Friday 5 September 2019.

I propose to allow the minister and the lead speaker for the opposition to make opening statements of about 10 minutes each, should they wish. There will be a flexible approach to giving the call to ask questions based on about three questions per member, alternating each side. Supplementary questions will be the exception rather than the rule.

A member not on the committee may ask a question at the discretion of the Chair. Questions must be based on lines of expenditure in the budget papers and must be identifiable or referenced. Members unable to complete their questions during proceedings may submit them as questions on notice for inclusion in the assembly Notice Paper.

There is no formal facility for the tabling of documents before the committee; however, documents can be supplied to the Chair for distribution to the committee. The incorporation of material in Hansard is permitted on the same basis as applies in the house, that is, that it is purely statistical and limited to one page in length.

All questions are to be directed to the minister, not the minister's advisers. The minister may refer questions to advisers for a response. The committee's examination will be broadcast in the same manner as sittings of the house are broadcast, that is, through the IPTV system within Parliament House via the webstream link to the internet and the Parliament of South Australia video-on-demand broadcast system.

I will now proceed to open the following lines of examination: the portfolio of SA Health, estimated payments being for the Department for Health and Wellbeing. The minister appearing before us today is the Minister for Health and Wellbeing. I declare the proposed payments open for examination and refer members to the Agency Statements, Volume 3. Minister, could you please introduce your advisers and make an opening statement if you have one.

The Hon. S.G. WADE: I would like to advise the committee that the advisers with me today are, to my left, Lynne Cowan, Deputy Chief Executive, Commissioning and Performance; Dr Chris McGowan, Chief Executive, Department for Health and Wellbeing. To my right is Julienne TePohe, Deputy Chief Executive, Corporate and System Support Services. The other advisers with me are Lyn Dean, the Chief Executive Officer of Wellbeing SA; Jamin Woolcock, the Chief Finance Officer of the Department for Health and Wellbeing; Paddy Phillips, the Commissioner, Commission on Excellence and Innovation in Health; Brendan Hewitt, Executive Director, Infrastructure; and Andrej Knez, Manager, Executive Services and Projects. I do not propose to make an opening statement.

The CHAIR: Member for Kaurna, do you have an opening statement or will you go straight to questions?

Mr PICTON: I will start with questions. I refer to Budget Paper 4, Volume 3, page 52, regarding SA Ambulance Service. Minister, while I understand local hospital networks are reporting now to governing boards, is it correct that the SA Ambulance Service (SAAS) CEO is responsible to the CEO of SA Health?

The Hon. S.G. WADE: Yes, it is.

Mr PICTON: Excellent. Minister, this week the Chief Executive of SA Health made comments on radio following a ride along he did on an ambulance in which he said that he left the ambulance when it was ramping at Flinders Medical Centre. He said he was very bored. Has the chief executive issued an apology to paramedics and other clinicians for these comments?

The Hon. S.G. WADE: Dr McGowan has provided a statement. I consider that Dr McGowan should be commended for getting out of his ivory tower to get an insight into the challenges faced by our front-line paramedics every day. Neither Dr McGowan nor I deny ramping. We are committed to eliminating it. Dr McGowan should be commended for the initiatives that he and his team are putting in place to eliminate ramping, and in my view actions speak louder than words.

Mr PICTON: Minister, on the same budget line, has the minister seen comments from SA Health's staff online expressing no confidence in the Chief Executive of SA Health?

The Hon. S.G. WADE: The union called for an apology on Tuesday. A statement from Dr McGowan was given in response on the same day. Three days later, Labor is making belated calls. That, to me, seems contrived and hollow. This is old news.

Mr PICTON: Sorry, sir, the question I am asking is: have you seen comments from your own staff online saying that they have no confidence in your chief executive?

The Hon. S.G. WADE: I refer to my previous answers.

Mr PICTON: So you have seen those comments or you have not seen those comments?

The Hon. S.G. WADE: I refer to my previous answers.

Mr PICTON: Is the chief executive apologising?

The Hon. S.G. WADE: Mr Chairman, I refer to my previous answers.

The CHAIR: Member for Kaurna, I think the minister has provided a statement to the house. We could repeat the 45 minutes of time wasted this morning in this session here, or we can continue and ask some questions about Health, which I really want to hear about.

Mr PICTON: Thank you for your commentary, sir.

The CHAIR: Thank you.

Mr PICTON: We are trying to get some answers here. Minister, same budget line: previously, on 30 April, Mr Paul Lambert, the executive director of operations at CALHN said on ABC radio, and I quote, 'Ramping over the last 100 days has decreased…it’s a significant number of hours decreased.' If that is the case, why does the SA Ambulance data show that ramping has increased over that period and in fact is at record highs now of over 2,000 hours per month in both May and June?

The Hon. S.G. WADE: The situation that we have experienced since this government came to power has been extremely unusual. Obviously, we were encountering the first year without the Repatriation General Hospital. In the first year of operation of the new Royal Adelaide Hospital we experienced a heavy winter last year and quite exceptional summer demand. It is obviously also noteworthy that there has been an unprecedented early and heavy flu season.

The health system has had a lot to cope with in the last 12 months. I consider that real progress is being made on dealing with the underlying demand. Ambulance ramping did see a reduction as we went into winter, but, as I said, we have experienced a very heavy flu season. In this context, it is pleasing to see that in recent weeks we have had some of our best weeks of the year in terms of transfer of care. I also note that emergency department wait times for mental health patients are the best they have been for eight months.

Mr PICTON: Minister, same budget line: how are you or the chief executive advised and how regularly in terms of the situation of ramping in our hospitals?

The Hon. S.G. WADE: My department—myself and my office—are in daily contact with people throughout the system.

Mr PICTON: Minister, on the same budget line, are hospitals ramping right at this moment?

The CHAIR: Member for Kaurna, surely by 'at this moment' you mean as at 2.10pm. I am not sure that that question is relevant to the budget paper.

Mr PICTON: Why is that, sir? I think South Australians want to know.

The CHAIR: Because the minister cannot be responsible for what is happening right now at 2.10pm for anything outside of this budget estimates hearing.

Mr PICTON: I am happy to rephrase. Is the minister aware if hospitals were ramping today?

The Hon. S.G. WADE: I have been aware of high levels of demand today.

Mr PICTON: What hospitals is ramping occurring at today?

The Hon. S.G. WADE: With all due respect, I doubt whether I am able, without notice, to recount the status of each of the hospitals and the status of the time at which I last viewed them. The honourable member has access to our public dashboards—they are available to every South Australian.

The CHAIR: Member for Kavel, seeking the call.

Mr CREGAN: Minister, I take you to Budget Paper 4, Volume 3, page 33. Can you inform the committee about the steps the government has taken to reactivate the former Repatriation General Hospital site that was closed, decommissioned and earmarked for sale by the previous Labor government?

The Hon. S.G. WADE: I thank the honourable member for his question. The house would be well aware that Labor broke its promise to 'never, ever close the Repat', and in doing so cut off more than 100 beds from the health system. This has directly contributed to the pressure the health system faces today, and this government is determined to fix Labor's mess.

The government made a clear commitment to reactivate the Repat site as a genuine health precinct and to work with the community in doing so. As minister, one of my early actions was to stop Labor's sale of the site and to secure it for public health services going forward. We reopened the hydrotherapy pool and began the community engagement process we had promised. We have engaged the community, clinicians, veterans and other key stakeholders to determine the best use of this valuable and much-loved community asset.

The final concept master plan of the Repat site, developed on the results of public and stakeholder feedback, has received strong community endorsement, and we have also continued this government's strong record in working collaboratively with our federal colleagues, securing a joint investment of $80 million in the Repat health precinct. I would now ask the executive director for infrastructure to provide some updates on recent activity on the Repat site.

Mr WOOLCOCK: Since March 2018, the government has successfully reopened the hydrotherapy pool and opened a further 20 new beds to add capacity to our health system and accommodate long stay patients with complex needs, some of whom have been waiting for up to six months in hospital for commonwealth supports. It has also retained 20 beds within the ViTA precinct, due for closure in December 2018.

SA Health is continuing to progress discussions with key stakeholders to deliver the master plan. The first stage of Repat reactivation building works are expected to commence later this year with the refurbishment of C Block. This early milestone will see the southern community Older Persons Mental Health Service relocating into a redeveloped C Block building.

Mr PICTON: On the same budget line that the other member used, I am wondering what is option 4 for the Repat precinct governance that was recommended for approval to the SALHN board by the CEO as listed in the agenda for its first meeting?

The Hon. S.G. WADE: I do not know to what the honourable member is referring.

Mr PICTON: I am happy to furnish you with a copy of the agenda for the SALHN first meeting that was held, which says:

Repat Health Precinct governance, recommendation: the CEO recommends the board endorse option 4 as the preferred transitional arrangement over the next two to three years, subject to ongoing review.

What does that mean?

The Hon. S.G. WADE: I take it that what the board is discussing is how the Repatriation Health Precinct should be governed in terms of the local health networks. In that context the Repat site is becoming analogous to the Glenside site in that it will be hosting services provided by more than one LHN. In the context of the Glenside site, there needed to be discussions between local health networks about how do they govern a site that is not exclusively in their control. Without having access to those papers, I presume it is referring to similar discussions in the Repat context.

Mr PICTON: You said you do not have access to the papers. Would that not be something that the Minister for Health would be briefed about?

The Hon. S.G. WADE: Just to clarify: I was not saying that I do not have access to the papers. What I mean is, I do not have those papers; I have not tried to access them. As minister, I would be entitled to access those papers. I presume the SALHN discussion is a discussion that feeds into broader discussions within the portfolio. The discussions that SALHN is having through their board, and I am sure through their management, will feed into a broader discussion. As I said, unlike when Labor closed the Repat, the Repat will no longer be only the custodian of SALHN assets, it will also be sharing the site with other networks.

Mr PICTON: A further question on the same budget line: when will the operating theatres open at the Repat site, bearing in mind that you promised before the election that that would be happening swiftly? Is there a particular date that you have in mind?

The Hon. S.G. WADE: The reactivation of the Repat site—as I indicated in my answer to the member for Kavel—is already progressing extremely well. We are delighted to have reopened the hydrotherapy pool within months of being re-elected. We are delighted with the progress and particularly the partnership with the commonwealth government in reinvesting on that site.

One of the precincts within the Repatriation General Hospital site is a site that is dedicated to services such as surgical and care transition. On 11 March 2019, SA Health released a request for information seeking insights on how interested developers, private health service providers and local health networks could collaborate with SA Health in the provision of facilities and services relating to the surgical and procedural services within the reactivated Repat site.

The RFI closed on 3 April 2019, and SA Health has shortlisted the 10 submissions to four and will shortly commence discussions and negotiations to determine how future surgical and procedural services at the Repat can be designed to best meet the needs of the community.

Mr PICTON: I have another question on the same budget line: what is the year-by-year operational expenditure budget for the Repat precinct over the next four years?

The Hon. S.G. WADE: That clearly cannot be determined at this stage because we are in the process of finalising the partners on the site.

Mr PICTON: So nothing has been provisioned in the budget?

The Hon. S.G. WADE: I think it would be fair to say that there would be provisions already, for example, the Older Persons Mental Health Service, when Labor closed the Oakden facility in September 2017. I might seek some more information. As I was saying, the former Labor government closed the Oakden facility in late 2017. I think there was a net loss of 64 beds, or something in that order, with the closure of that facility.

The recurrent funding that is associated with those beds would transfer. Likewise, we are committing the transfer of the brain and spinal services that are currently at Hampstead and their recurrent funding will come with them. As each piece in the Repat health precinct falls into place, the capital funding and the recurrent funding will be part of that process.

Mr PICTON: On the same budget line—just to confirm, minister: obviously, this process is to examine the budget and budget figures. You do not have a figure that you can furnish before the committee as to what the budget for the Repat is over the next four years?

The Hon. S.G. WADE: I am surprised that the honourable member is asking me to tell him how much it is going to cost to fund the services on the Repat site when the government is still in the process of determining what services will be on the Repat site. Clearly, that is a question almost in the nature of hypothetical. Let's put it this way: it is going to be a lot more money than when you planned to close it.

Mr PICTON: On Budget Paper 4, Volume 3—

The CHAIR: Member for Kaurna, before you go on, would you mind if I flick to the member for Florey? I notice you are moving from the Repat.

Ms BEDFORD: Moving north. I refer to Budget Paper 4, Volume 3, page 30, under the NALHN heading. Is the minister satisfied with the progress of the clinical working party's work on the re-establishment of the level 1 ICU/HDU at Modbury Hospital? Why is the unit not already in place, given its return was an election promise?

The Hon. S.G. WADE: If I could start with the second part of the honourable member's question first, the election promises are for the term of the parliament. We are determined to deliver on our commitment to undo the damage from Transforming Health and that is exactly what we are doing right across the hospital network.

In terms of the Modbury site, as the honourable member rightly highlights, one of the key commitments that we made is that we will restore our high dependency unit at the Modbury site. In that context, we have had a clinical working party, co-chaired by Professor Andrew Bersten and Ms Alison Hodak, to develop a plan to establish the high dependency unit and enable Modbury Hospital to take more complex patients.

Following the initial planning work undertaken by the clinical working group, a high dependency unit steering committee has now been formed to oversee the implementation and delivery of the HDU. I am pleased with the progress being made and I look forward to that team delivering a high-quality high dependency unit at Modbury Hospital.

Ms BEDFORD: We now have an HDU steering committee. When is that next going to meet?

The Hon. S.G. WADE: The HDU steering committee has oversight of an HDU implementation and planning committee, which will lead four work groups. Updates will be provided to the steering committee in addition to the quarterly steering committee meetings. Each group, with its own lead, will articulate a facet of the development process.

There are four working groups: the clinical services work group, the workforce work group, the corporate and finance work group and the infrastructure work group. Key priorities for the next phase of the project include the appointment of an HDU medical clinical lead, which is expected by 1 January 2020, the refining and finalising of the model of care and extensive stakeholder engagement, including with industrial bodies.

Ms BEDFORD: That is some very thorough work. Has the level 1 ICU/HDU actually been allocated a physical space on the redevelopment plan and, if so, where?

The Hon. S.G. WADE: Yes, it has been. The location of the HDU has been established on level 1. If possible, it will be fast-tracked within the overall project program, but at this time NALHN expects the HDU to become fully operational in early 2020.

Ms BEDFORD: Level 1 is a pretty big level. Is there any specific space on level 1 that they are talking about? The last plan we saw did not have a space for it.

The Hon. S.G. WADE: I know the honourable member is a frequent visitor to the Modbury Hospital.

Ms BEDFORD: Only in my professional capacity, sir.

The Hon. S.G. WADE: Sorry, I meant as a—

Ms BEDFORD: Not as a consumer.

The Hon. S.G. WADE: Anyway, all I was adverting to is that there is a plan up in the Modbury Hospital at the moment which indicates the location of the HDU.

Ms BEDFORD: I am not sure of that. Anyway, I will go and have a look tonight. When can the residents of the north-east expect to see the eight-bed EECU functioning—again, part of the election promise that has blown out somewhat?

The Hon. S.G. WADE: I am sorry. It has just been brought to my attention that I misstated. When I said the HDU would become fully operational, I apparently said 2020; I meant to say 2021.

Ms BEDFORD: We think it will be a bit later than that, but go on, yes. We will give you that.

The Hon. S.G. WADE: We as a department live in hope.

The CHAIR: Member for Florey, could you please listen?

Ms BEDFORD: Well, I am thinking closer to the election in 2022, but I am just back to the EECU. When will that be functioning? I am a patient woman.

The CHAIR: We look forward to you being here in 2022, 2023, 2024 and 2025 estimates.

Ms BEDFORD: Well, the stress of today might preclude that, sir, and then I can be a consumer.

The Hon. S.G. WADE: In relation to the EECU, I am advised it will be later this year.

Ms BEDFORD: Up and running later this year?

The Hon. S.G. WADE: The EECU. The extended—

Ms BEDFORD: It is nearly August, and you are going to have it up before Christmas. Fantastic. So will the minister release the salary packages of individual executives, or details of the dollar cost per position, within the Department for Health and Wellbeing and the local health networks?

The Hon. S.G. WADE: I am happy to take that on notice.

Mr BOYER: On Budget Paper 4, Volume 3, page 30, Sub-program 2.2: Northern Adelaide Local Health Network, and just to build on the questions asked by the member for Florey about Modbury Hospital, have you received yet any clinical advice from those working groups and committees you referred to in your earlier answer that state that the proposed four-bed HDU will be safe?

The Hon. S.G. WADE: The HDU steering committee, I am advised, reached in-principle agreement for the HDU model of care, including that the HDU will have critical care oversight with a hybrid surgical/medical model aligned to the broader principles of a level 1 ICU. Level 1 east has been confirmed as the most appropriate site for the HDU.

Mr PICTON: To go back to Budget Paper 4, Volume 3, page 52, SA Ambulance Service, why is there a reduction of seven FTEs for SA Ambulance Service over the forthcoming year at a time when urgent responses have decreased by 7 per cent over the past 12 months?

The Hon. S.G. WADE: I will take the detail of the honourable member's question on notice but I am advised that part of the impact is likely to be the conclusion of time-limited projects. In relation to recruitment, in the last two financial years, the Ambulance Service has employed another 148 paramedic interns and 84 qualified paramedics.

Mr PICTON: But the actual staff members were down by five over the past year. That is what the budget papers say.

The Hon. S.G. WADE: I have undertaken to take the details of that on notice.

Mr PICTON: Same budget line: has the minister or his department received any advice or any reports that outline for him a need to increase the number of paramedics working for the SA Ambulance Service?

The Hon. S.G. WADE: From opposition, the Marshall Liberal team made a clear commitment to support the continuation of the SSWG. Consistent with that, the government is working with the Ambulance Service to look at the new operational model for SA Ambulance Service, and I certainly appreciate that my honourable colleague the Treasurer is also discussing operational issues with the Ambulance Employees Association in the context of enterprise bargaining discussions. Right throughout the Ambulance Service, its employee organisations and the department, there is an interest in developing new ways of delivering paramedic services. There is no doubt that paramedics going forward are going to be a very agile and key element of our health service.

Mr PICTON: Have you received any report that outlines the need to increase the staffing for SA Ambulance Service?

The Hon. S.G. WADE: I have explained the discussions that are going on. Those discussions will flesh out not only the workforce needs of the Ambulance Service but also more effective ways of utilising the workers that we already have.

Mr PICTON: So these have just been discussions? There have not been any reports or consultancies done in terms of the staffing?

The Hon. S.G. WADE: I did not say that, Mr Chair. I would suggest that the honourable member might stick to asking questions and I will stick to answering them.

The CHAIR: Thank you, minister. Once again, as we traversed these issues this morning, I will determine what gets asked and answered but we will go from there. Member for Kaurna, do you have anything more on this topic?

Mr PICTON: I absolutely do.

The CHAIR: Well, we will see how we go but I think the minister is well within his rights.

Mr PICTON: Thank you for your immense fairness, as always. Can the minister confirm that a report has been received that outlines the need to increase staffing in SA Ambulance Service?

The CHAIR: I think the minister has already answered that in previous questions.

Mr PICTON: With fairness, I think he has been trying to avoid answering that question. Maybe if he had another opportunity, he might outline whether a report has or has not been received that outlines that.

The Hon. S.G. WADE: As I said, the work of the SSWG was specifically looking at the resource needs of the Ambulance Service. My understanding is there were consultancy reports linked to that. There is no doubt a lot of work being done in my department, Treasury and the Ambulance Service as we all work together to have a highly effective and sustainable ambulance service going forward.

Ms LUETHEN: I also have lots of questions because health is very important to people in the north and north-east. Budget Paper 4, Volume 3, pages 13 and 25: could the minister please outline any action he is taking to ensure the transition out of hospital for people eligible to be NDIS participants?

The Hon. S.G. WADE: I thank the honourable member for her question. I appreciate the opportunity to explain the work of the Hospital Discharge Project pilot which commenced on 1 April 2019 and which will be running for a period of six months. A commitment between SA Health and the commonwealth Department of Health in March 2019 facilitated an $8 million project to deal with the long-stay transition to discharge project to assist in transferring long-stay patients in acute beds to alternative non-acute care options while longer term supports are confirmed. This may include some NDIS-eligible patients who are awaiting NDIS confirmations.

To date, 53 patients have been discharged from hospital, with a further three patients due to be discharged by early 2019. SA Health and local health networks have identified a further 35 long-stay patients for this project with the aim to discharge by October 2019. Of the 35, 12 patients are currently being considered by providers to determine their discharge support needs. The project is funded for two years and will improve patient flow from hospitals to communities. I will ask the Chief Executive of Wellbeing SA, Lyn Dean, to add to that.

Ms DEAN: Thank you, minister. The SA Hospital Discharge Project is a collaboration with the National Disability Insurance Scheme to streamline discharge processes within our hospital system. To date, the project has resulted in some key improvements, including the appointment of three health liaison officers from the National Disability Insurance Agency, and agreeing to trial improvement in equipment and home modification assessment processes, with hospital occupational therapists, to assist more timely discharges. A data tool to track NDIS participants' progress through the hospital to community is also in development.

Alongside this, there is a hospital discharge framework, which is, in effect, developing policies and principles that are drafted with South Australia to guide how Health and NDIS will work together to discharge patients. This framework will be taken forward on a national level once it is fully implemented.

In addition to that, recent interjurisdictional discussions have taken place in resolving boundary issues between the NDIS and the health system. From an historical perspective, there has been disagreement from the NDIA and Health as to what would be funded in regard to nursing supports. It is recognised by the NDIS that some people will need nursing support to be discharged and cared for in the community, and now this will be funded by NDIS. The aim is to implement this change from October of this year.

The CHAIR: Member for Kaurna.

Mr PICTON: Budget Paper 4, Volume 3, page 52, SA Ambulance Service: I am wondering if the minister is concerned about late meal breaks for SA Ambulance staff and if you have any response to concerns that are being raised in the Industrial Relations Commission today about SA Ambulance not meeting its requirements for staff breaks, as set out in the enterprise bargaining agreement?

The Hon. S.G. WADE: I am surprised that the honourable member thinks it is appropriate for a minister of the Crown to comment on matters that are actively being considered by an industrial tribunal, particularly when that particular minister is not the Minister for Industrial Relations.

Mr PICTON: So you do not have any response to concerns raised about your staff in SA Health not receiving their entitlements under the enterprise bargaining agreement under your management of the health system?

The Hon. S.G. WADE: I remind the honourable member that I am neither the Minister for Industrial Relations, nor, as a minister, do I intend to comment on industrial matters before an industrial tribunal.

Mr PICTON: Who is the minister who is responsible for running the SA Ambulance Service?

The Hon. S.G. WADE: I refer to my previous answer.

Mr PICTON: You cannot confirm to this committee who the minister is in charge of running the SA Ambulance Service?

Mr CREGAN: Point of order, Mr Chairman.

The CHAIR: Yes, member for Kavel?

Mr CREGAN: The member has his answer and he understands the standing orders, and he can put the question to the appropriate minister.

The CHAIR: Thank you, member for Kavel. I will uphold the question.

The Hon. S.G. WADE: I am the minister responsible for the Ambulance Service. I am not the minister responsible for the negotiations in relation to the enterprise agreement, nor am I the Minister for Industrial Relations, nor do I intend, even if I was the Minister for Industrial Relations, to ventilate in this forum matters that are before that tribunal.

Mr PICTON: On the same budget line, what are you doing as the minister, as you say, in charge of running SA Ambulance Service, to ensure that SA Ambulance staff are getting their meal breaks?

The Hon. S.G. WADE: I have put in place an extremely able management team led by David Place that is working with the employees to deliver a high-quality ambulance service.

Mr PICTON: Last month, what percentage of staff in SA Ambulance were unable to receive their meal breaks—either late or at all?

The Hon. S.G. WADE: I am happy to take that on notice.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 16, annual programs, SA Ambulance Service—Vehicle Replacement. The minister said, in a question taken on notice last year, that SA Ambulance Service places regular orders each year. What is the minister's answer as to why the government has underspent on ambulance vehicle replacements by $2.6 million?

The Hon. S.G. WADE: At a departmental level we are not aware of the factors behind that change. We will take it on notice and come back with an answer for the honourable member.

Mr PICTON: Thank you, minister. The minister, in questions on notice last year, also said that SA Ambulance is in the process of procuring a replacement contract which was at the evaluation stage then. Has that contract now been signed?

The Hon. S.G. WADE: Replacement contract for?

Mr PICTON: For ambulances, flashing lights.

The Hon. S.G. WADE: I will take that on notice.

Mr PICTON: Is the minister aware of a document that was prepared in June 2018 titled 'A consultation paper for support services model corporate services', which outlined under 'fleet services' significant concerns raised about the fleet. It stated:

Demand for fleet services now exceeds current physical and human assets. An additional investment and a revised service operating model will be required to continue to support front-line service delivery at expected performance and compliance levels.

This investment is currently part of a review. At the current levels, fleet is unable to meet all current servicing needs and this is reflected in some instances of non-urgent servicing exceeding recommended intervals.

In the light of the above there is both an immediate and future need for additional assets and resources to accommodate increased workloads and specifically address country ambulances.

Is that something that was brought to the minister's attention, and what action has he taken in regard to the ambulance fleet?

The Hon. S.G. WADE: I will take on notice whether that document was brought to my attention. In terms of the work that I have already referred to there is work being done for a new operational model for the Ambulance Service. In recent years, there has been a fundamental shift in the services provided by SAAS and the use of those services by the community.

The historical model of ambulance officers providing first aid and transporting patients into a hospital ED has evolved into an increasingly sophisticated out-of-hospital healthcare provider model. The Ambulance Service is keen to implement a new operational model that will assist local health networks to manage patient flow by reducing ED presentations and support the management of patients outside the hospital environment in line with proposed health alternative care pathways.

The introduction of a revised clinical response model which utilises an increased use of single responders to create a more targeted see-and-treat model where complex patients can be assessed and treated, referred to alternative care pathways or transport by lower clinical-level crews are all matters under consideration. The Ambulance Service has evolved dramatically over its history, but particularly over recent decades. I am sure that it will continue to evolve. These factors all impact on the staffing and the resourcing.

Mr PICTON: Given that these concerns were raised, minister, back in June last year and then over the subsequent 12 months, $2.6 million was underspent in terms of vehicle replacement. Is that something that is disappointing? Is that potentially going to make the situation of the ambulance fleet worse?

The Hon. S.G. WADE: I do not accept the implication of the honourable member's question which is that nothing has happened in the last 12 months.

The CHAIR: The member for Florey has been waiting very patiently. I will come back to the member.

Ms BEDFORD: I refer to Budget Paper 4, Volume 3, page 26. Where are women able to access a full range of safe and respectful specialised health care and advice on unplanned pregnancy and abortion services within our state's health system?

The Hon. S.G. WADE: Can I clarify? Is the honourable member talking about services for women before they are pregnant or in their pregnancy?

Ms BEDFORD: Both. Unplanned pregnancy and abortion services, so it is pre and post pregnancy. I am specifically looking for a full range of safe and respectful services, not piecemeal services where you visit one site and then pop over somewhere else.

The Hon. S.G. WADE: The honourable member suggests concern that she does not want piecemeal services. I suggest that SA Health is determined to provide women's health services to South Australian women no matter where they live. To the extent possible, that will be physically and geographically dispersed. I have seen or visited a range of women's health services in our hospitals and in our networks, so we will continue to provide services in a devolved environment.

In terms of pregnancy services, there is a particular centre, the Pregnancy Advisory Centre (PAC) at Woodville, which is run by the Women's and Children's Health Network (WACHN), which particularly has responsibility for abortion-related services. But we certainly have no intention to move away from devolved services.

Ms BEDFORD: I accept that but I am advised that there is nowhere now where you can gain a full range of services either at the PAC or the WCH, so there is nowhere for anyone to go to access a full range of services. I think that is the trouble in part because anyone facing this situation needs to be in a respectful and understanding setting and not moved from site to site having to repeat the story several times for people who have not read the notes. That is the difficulty.

The Hon. S.G. WADE: I think part of what the honourable member is asking me is about transfer of services from the Women's and Children's to the Pregnancy Advisory Centre. But given the importance of the honourable member's question, I propose to take it on notice so that I can give her a clear answer.

Ms BEDFORD: That would be great. Also, why were services at the Women's and Children's Hospital dropped, and what consultation took place before those services were moved to The QEH? If you need to take that on notice as well.

The Hon. S.G. WADE: My understanding is they were moved to the Pregnancy Advisory Centre.

Ms BEDFORD: Again, there are some services, according to my information, at The QEH that were moved.

The Hon. S.G. WADE: I will certainly come back with a full answer.

Ms BEDFORD: That would be good.

The Hon. S.G. WADE: If I can explain, my understanding is that there are two things that have happened. There have been some services transferred from the Women's and Children's Hospital to the Pregnancy Advisory Centre and because of some capital issues with the Pregnancy Advisory Centre there are some services that are currently being delivered at TQEH, but I will certainly come back with as much detail as I can.

Ms BEDFORD: And around the consultation process.

The CHAIR: Member for Kaurna.

Mr PICTON: Thank you. I will add to that. Budget Paper 4, Volume 3, page 26, Central Adelaide Local Health Network: what is the current waiting time for women to obtain a termination in CALHN? Is that within clinically recommended times?

The Hon. S.G. WADE: I am advised that the current wait times as at 30 June 2019 are an accumulative wait time, that is, consultation and procedure of 16 days, which compares to 15 calendar days in 2018.

Mr PICTON: Following that, are terminations that are surgical terminations being performed at The Queen Elizabeth Hospital? How long has that been occurring? When will they return to the Pregnancy Advisory Centre?

The Hon. S.G. WADE: The client theatre component of the Pregnancy Advisory Centre was transferred from the Pregnancy Advisory Centre at Belmore Terrace to The Queen Elizabeth Hospital at the end of January 2019 due to an infrastructure failure at the Pregnancy Advisory Centre site. As a matter of priority, the Pregnancy Advisory Centre leadership team is working through immediate issues to ensure an appropriate pathway for clients, while the theatre component is located at The Queen Elizabeth Hospital. A plan for a permanent solution for both its procedural and ambulatory components of care is being developed, with constructive input from both staff and community stakeholders.

Mr PICTON: On the same budget line, is it correct that the contract for the KordaMentha recovery plan implementation contract is being investigated by the Auditor-General?

The Hon. S.G. WADE: It is my understanding, from comments to an estimates committee earlier this week, that the Auditor-General is reviewing these contracts. It would be hardly surprising considering they are significant contracts within Health. Health contracts are reviewed all the time

Mr PICTON: Have there been any requests to SA Health from the Auditor-General for documents to be obtained from the department?

The Hon. S.G. WADE: Reviews are constant, requests are constant, and I am advised we have received requests.

Mr PICTON: Have all those requests from the Auditor-General for documents from the department been complied with?

The Hon. S.G. WADE: Reviews are constant, requests are constant and responses are constant. We continue to comply with requests from the Auditor-General.

Mr PICTON: So just to confirm, that is a yes, that all requests from the Auditor-General have been complied with?

The Hon. S.G. WADE: I cannot confirm that the responses to the requests have been fully completed. We always respond to requests. A response will go to this one. Whether the response has been dispatched, I will take that on notice, but you can be assured there will be a response.

Mr PICTON: Have any health staff been interviewed by the Auditor-General in regard to this matter?

The Hon. S.G. WADE: I would suggest that was a question for an estimates committee two days ago.

Mr PICTON: Sorry, was SA Health up two days ago?

The Hon. S.G. WADE: The Auditor-General—I am not aware of any questioning of SA Health staff. The honourable member could have asked the Auditor-General.

Mr PICTON: Is it correct that KordaMentha was originally hired by CALHN to be headhunters to find an expert to reform CALHN?

The Hon. S.G. WADE: Could the honourable member repeat his question?

Mr PICTON: I am very happy to. Is it correct that KordaMentha was originally hired by CALHN as headhunters to find an expert to reform CALHN?

The Hon. S.G. WADE: My understanding is that KordaMentha was not hired as headhunters, as the honourable member puts it; there may well have been discussions at the time we were trying to identify the resources that we needed. I will provide any further information on notice.

Mr PICTON: Thank you. Given that, why does the acquisition plan for the CALHN turnaround team dated 1 August 2018 say that:

SA Health discussed other alternatives to attracting the right candidate to the role. The group decided to approach KordaMentha about assisting to recruit an appropriate person to the role. KordaMentha was known amongst the group for their executive search function and their success and experience in finding and recruiting experts in different fields, including business turnaround.

The Hon. S.G. WADE: I cannot see what the honourable member's point is. What the honourable member just read out seems completely consistent with what I said: they were not contracted, is my advice.

Mr PICTON: But they did provide advice as a headhunter or executive search provider, but without a contract?

The Hon. S.G. WADE: I can only reiterate what I have already said, which is that I am advised that KordaMentha was not contracted as the headhunters, and what the honourable member quoted seemed to me to be consistent with that advice.

Mr PICTON: Minister, did KordaMentha recommend that CALHN and SA Health should go down the path of hiring somebody as a short-term consultancy, and put a proposal to the government to do that, instead of recruiting a person, as had been the government's original intention?

The Hon. S.G. WADE: I am advised that there was an unsuccessful attempt to recruit for a limited term an executive role within CALHN to determine a way forward and implement sustainability programs. As I said, that attempt was unsuccessful.

Mr PICTON: Was it KordaMentha who recommended hiring somebody rather than going down the executive search function?

The Hon. S.G. WADE: Sorry, if KordaMentha was recommending that we hire someone, they might have been suggesting we go through an executive search. I cannot see how the two suggestions are conflicting, but I will certainly take that on notice and, if I can add to the answers I have already given, I will do so.

Dr HARVEY: My question relates to Budget Paper 4, Volume 3, page 25. What funding has the government provided to support increased services in hospitals downgraded under Transforming Health?

The Hon. S.G. WADE: I thank the honourable member for his question, and I particularly appreciate why he is asking it. The honourable member and his colleague the honourable member for King are acutely aware of the damage done to their communities by Transforming Health. The damage was particularly felt at Modbury, The Queen Elizabeth Hospital and at Noarlunga where services were downgraded or, in some cases, shut down completely. Of course, we know from the Auditor-General's report on Transforming Health that this reduction in services came at a cost to the taxpayer of $47 million.

The Marshall Liberal government has committed to rebuilding services at these hospitals. In the first year, we have made tangible progress. We have opened a 12-bed acute care unit at Noarlunga, we have begun the work on the TQEH stage 3 redevelopment, as well as returned 24/7 cardiac services and established a clinical working group to ensure the safe return of an HDU to Modbury. This year's budget is building on the work of the first year at Modbury where the government has committed $96 million for the redevelopment and $18 million over four years to establish an HDU.

An amount of $32 million has been committed in this year's budget, continuing work towards the HDU opening at TQEH where I recently delivered on another of the government's election commitments and opened the refurbished cath labs; $63 million of the stage 3 redevelopment has been allocated to continue the work there. At Noarlunga, the 12-bed acute medical unit has opened with funding allocated to support its ongoing operation to provide better care at the hospital and ease the pressure on Flinders Medical Centre, particularly reducing the need for diversion.

The Marshall Liberal government is delivering on its commitments, and this budget demonstrates that we are putting in the funding necessary to clean up the mess left by the former Labor government.

Mr PICTON: I refer to the same budget line in Budget Paper 4, Volume 3, page 26, CALHN. Is the minister aware that the acquisition plan for the KordaMentha original contract says that KordaMentha provided CALHN with feedback similar to other recruitment companies; however, they suggested a model which would meet CALHN's needs and allow for the capabilities relating to turnaround in CALHN to be built up over this time? This model was based on a short-term consultancy. So is it not the case that KordaMentha were asked to hire somebody, they did not do that, they said they could not find somebody and recommended that they themselves be hired as a consultancy to do the work?

The Hon. S.G. WADE: The honourable member persists in suggesting that KordaMentha was under contract to recruit an executive. I have already indicated that the advice I have been given is that is not the case. The line of questioning does draw to the house's attention the question that persists: why does Labor hate KordaMentha? What they are—

Mr PICTON: To be honest, Chair, that is not the question at all. I think we asked a very clear question in terms of whether it was KordaMentha who recommended their own appointment.

The CHAIR: Member for Kaurna, I think the answer is highly in order.

The Hon. S.G. WADE: To be clear to the honourable member, I was not seeking to reframe his question; I was suggesting the question that comes to mind as people hear you ask those questions—

Mr PICTON: Do you have an answer to the question?

The CHAIR: Order!

The Hon. S.G. WADE: Time and time again, South Australians say to themselves, 'KordaMentha helped saved Whyalla. Why does Labor want to stop them trying to clear up the mess that Labor left behind under Transforming Health?'

Mr PICTON: It is under investigation by the Auditor-General. You have just admitted that the Auditor-General is investigating it.

The Hon. S.G. WADE: Let's look at the progress that KordaMentha has made in spite of—

Mr PICTON: No; point of order, Chair: I asked a very specific question in terms of the appointment process. I was not asking for an update on the work of KordaMentha. This is about the appointment of the contract. This is budget estimates to examine the expenditure—

The CHAIR: Yes, I understand it is about the appointment of the contract. The contract has been awarded to KordaMentha and the minister is, in my mind, replying appropriately.

Mr PICTON: He is actually talking about a different contract that happened months later. I am talking about a contract last year.

Mr CREGAN: Point of order, Mr Chairman: the member has his answer and I have a supplementary question to the answer.

The CHAIR: Well, member for Kavel, we do not allow supplementaries, per se. At the discretion of the Chair, I am happy—

Mr PICTON: It is a bogus point of order.

Mr CREGAN: The morning was rather more successful, may I say. Thank you for your assistance.

The CHAIR: —to hear your supplementary, member for Kavel, but then the member for Florey has a question before she needs to leave to Committee A and then we can continue. Your supplementary, member for Kavel.

Mr CREGAN: Thank you, Mr Chair. Minister, perhaps you can give an overview or outline of KordaMentha's work so far and some of its successes?

The Hon. S.G. WADE: A very pertinent question, because in spite of the resistance of the former government members to the attempts by this government to clear up their mess, progress is being made. The financial position of CALHN, in partnership with KordaMentha, has improved from a forecast deficit to budget of $274 million for the year ended 2019, as outlined in the diagnostic, to a revised management forecast deficit to budget of $224 million. This is a forecast improvement of $50 million and well ahead of the KordaMentha contractual KPI of $41 million.

Honourable members would be well aware of the government's concern at the relative inefficiency of the Central Adelaide Local Health Network hospitals compared with their sister hospitals right around Australia. In the period from 1 July 2017 to 30 June 2018, the estimated cost of running the central hospitals was 32 per cent above the national efficient price. Encouragingly, there has been substantial progress in dealing with inefficiencies. The indicative cost of activity for the six months to 31 December 2018 is 21 per cent above the national efficient price.

One of the most tangible demonstrations of efficiencies in our central hospitals is the reduced use of agency staff. It is now down 90 per cent, from 7.7 per cent in January 2019 to a low of 0.7 per cent in March 2019. In this and so many other ways, KordaMentha, the CALHN management and the CALHN board are working together to restore sustainability to the services in the local health network.

Ms BEDFORD: I refer to Budget Paper 4, Volume 3, page 30 and the Lyell McEwin Hospital. While I acknowledge and welcome the announcement of the additional car parking planned for the Lyell McEwin Hospital, will the $7 million come from the existing $52.5 million previously budgeted to extend the Lyell McEwin Hospital emergency department or will this now create a $7 million shortfall in the current budget?

The Hon. S.G. WADE: I am advised at this stage that it is intended to deliver within the core project.

Ms BEDFORD: Will the $7 million impact of the promise to build the hospital have any impact on the $5.5 million Mental Health Short Stay Unit at the Lyell McEwin Hospital? Will that be pushed back as well?

The Hon. S.G. WADE: In terms of the time frame for the project, my understanding is that it is already on the public record that the time frame has been adjusted, but I will seek advice.

Ms BEDFORD: Because it is going to be very hard to ask the mental health patients.

The Hon. S.G. WADE: Sorry, I am asking capital, not mental health. Just to clarify the history there, the former Labor government closed the Mental Health Short Stay Unit at the end of 2017 and did not have plans for a new unit, certainly at least not—

Ms BEDFORD: I do not think anyone is disputing that, minister, but we elected you—

The Hon. S.G. WADE: Sorry, Mr Chair, if I—

Ms BEDFORD: —because we believed you were going to be different.

The Hon. S.G. WADE: If I could continue with my answer.

The CHAIR: I am listening, minister. You are in order.

The Hon. S.G. WADE: What I think is important for you and your constituents to understand is that this government did not regard it as acceptable to allow that hospital to operate without some form of unit. A unit was opened in 2018, last year, and planning is going ahead with the new unit.

The whole project has been damaged by the lack of proper planning by the former Labor government. There was not adequate allowance for the car parking needs. The new redevelopment effectively decommissions a whole series of car parks, so the $7 million investment that was announced this week will lead to a 205 car park extension to the current facility, which will help alleviate the loss of the previous car parks and add to the further needs.

In terms of the Mental Health Short Stay Unit, the long-term location for that unit is on top of the ED redevelopment. It is an upper level development. We will continue to work through with clinicians and with management how we can best deliver that project. Certainly, we are being forced to reassess the plans and reassess the funding of those plans because of the poor planning of the former government.

Ms BEDFORD: When will the new redevelopment be completed at the Lyell McEwin Hospital, the emergency department?

The Hon. S.G. WADE: I am advised that it is currently anticipated in mid-2022.

Mr BOYER: I refer to Budget Paper 4, Volume 3, pages 14 to 16, investing expenditure. Just to clarify, the $7 million that you announced, I think it was in the last week, for the new car park at the Lyell McEwin Hospital, that is coming out of the $52.5 million that was set aside to expand the emergency department at Lyell McEwin Hospital?

The Hon. S.G. WADE: Yes.

Mr BOYER: In the same budget paper and the same line: how will that affect the expanded emergency department that will be delivered there, given that it will have $7 million less to put towards it?

Members interjecting:

The CHAIR: Order! I know it is late in the day, but if everyone could please focus. Minister.

The Hon. S.G. WADE: Planning in relation to the project continues. The government is committed to completing the expansion of the ED and the short stay mental health unit. Considering the poor planning that we have inherited, we may need to reconsider some of the final refurbishment works of the original facilities. The expanded redevelopment will deliver important expanded capacity for the suburbs of the north.

Ms COOK: You took that long to get that answer; seriously.

The CHAIR: Order! Member for Wright.

Mr BOYER: Thank you, Chair. Budget Paper 4, Volume 3, pages 14 and 16: can the minister confirm that the number of acute assessment cubicles at the expanded ED will still be doubled as per what was announced by the previous government, or will the number of acute assessment cubicles be reduced?

The Hon. S.G. WADE: Sorry, is the honourable member asking me: does the Marshall Liberal government commit to delivering twice as many assessment units as the former government was planning to? That seemed to be what the honourable member was saying.

Mr BOYER: No. My question was: what was announced by the previous government was a doubling of the number of acute assessment units in the Lyell McEwin emergency department.

The Hon. S.G. WADE: Is that still our intention?

Mr BOYER: Yes.

The Hon. S.G. WADE: Yes. I am advised that the potential reconsideration of some of the final refurbishment works of the original ED may have a limited impact on capacity.

Mr BOYER: Chair?

The CHAIR: Yes.

Mr BOYER: On the same budget line, minister: can the minister confirm that the expanded ED will still have a dedicated room for children and families, as was announced by the previous government?

The Hon. S.G. WADE: I am not aware of any change in that context, but I will take that on notice.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 25, health services. Have any local hospital networks signed off on their service level agreements for 2019-20?

The Hon. S.G. WADE: No, they have not.

Mr PICTON: On what date were the draft agreements given to the local hospital networks?

The Hon. S.G. WADE: There have been a number of drafts and discussions are continuing. I am happy to take that question on notice.

Mr PICTON: Have any board or board chairs raised concerns with you or the department regarding the funding to be allocated under the draft service level agreements?

The Hon. S.G. WADE: The nature of negotiations is that there is more than one perspective. I am sure that, just as there were robust discussions with LHNs, CEOs and the department when the service level agreements were discussed under centralised management, I have no reason to think there will be any less robust discussions under decentralised management.

Mr PICTON: As part of these negotiations, as the minister has characterised them, will there be any additional funding that is available to negotiate with as part of those service level agreements?

The Hon. S.G. WADE: The honourable member tries to lay another trap for me. Earlier today he wanted me to be in contempt of industrial tribunals, now he wants me—

Mr PICTON: I am sorry; I would just like an answer to the question.

The Hon. S.G. WADE: —to impose myself.

Mr PICTON: Is there funding or not? This is the budget estimates. Is there more funding or not?

The Hon. S.G. WADE: If the honourable member is asking me if there is more money in health under the Marshall Liberal government—

Mr PICTON: No, is there more money than what you have offered in the draft service level agreements?

The Hon. S.G. WADE: Chair, I do not know whether this is a conversation or a series of questions. I am trying to answer the honourable member's question.

The CHAIR: Minister, it is entirely appropriate for you to answer how you see fit. It is not for you necessarily to need to—

The Hon. S.G. WADE: My understanding was that the honourable member was asking me in relation to negotiations between the board chairs and the department. Just as I do not intend to interfere in the proceedings of the Industrial Tribunal, likewise I am intending to let the board chairs and the department assistant manager have discussions about the appropriate level of resourcing for the networks.

Mr PICTON: Is there a deadline by which the service level agreements need to be agreed?

The Hon. S.G. WADE: As I understand it, just as under this government and under the previous government, there is no deadline as such. It was certainly not uncommon under the previous government for service level agreements to be signed off in the last quarter of the year.

Mr PICTON: Has each board established a register under the Health Care Act section 33D of board members' interests, and how are these registers accessible by the public?

The Hon. S.G. WADE: I am happy to take the honourable member's question on notice.

Mr PICTON: Can the minister assure the house that no member of any board has been appointed in breach of section 33B(5), which says that people cannot be employees or provide services to the LHN and be a member of the board?

The Hon. S.G. WADE: Certainly, I can assure the house that the department and myself did our best to ensure that the eligibility criteria of the act were respected.

Mr PICTON: Is it true that the presiding members panel, which brought together presiding members of all the heath advisory councils, has been discontinued?

The Hon. S.G. WADE: It is not clear to me that it has been, so I will take that on notice and seek further advice.

Mr CREGAN: Minister, I take you to Budget Paper 4, Volume 3, page 13. Can you outline to the committee the recent restructure of the Department for Health and Wellbeing subsequent to the government's reforms?

The Hon. S.G. WADE: I thank the honourable member for his question. The Marshall Liberal government was elected with a commitment to devolve governance and responsibility in the health system away from a centralised bureaucracy to local health networks. The whole raison d'être is: local decisions for local communities.

The former Labor government abolished local boards in 2008, centralising decision-making. As part of their disastrous Transforming Health experiment, Labor continued this centralising trend with the abolition of statewide clinical networks, shutting out clinicians and the community with ever-growing centralisation of decision-making. The end result was that the South Australian community lost touch and lost faith in Labor's ability to deliver health services.

The Marshall Liberal government is determined to turn the ship around. To support the devolution of governance and the refocusing of health, my department has been undergoing a restructure to reflect its place in a changed health system and its place in a devolved, decentralised health system. I will ask the chief executive of the department to give the committee more information about the process of renewal of his department.

Dr McGOWAN: As the minister said, after the devolution out to the regions, we thought it was opportune to look at the department. It was left a very different department wanting to do different things. We are no longer a deliverer of service and a micromanager of services. We had to be very clear about what our role was going forward, so we engaged quite heavily. We engaged with our staff and we also engaged some of the best bureaucratic minds in health from across the country, previous DGs who are highly respected and who gave their time freely, by the way, with some excitement.

We came up with four core roles. They have turned into the pillars of the department and we have structured accordingly. They are to make sure that, as the government came in and made its policy about a focus on prevention, the public health role was elevated to be reporting to the chief executive—a critical part of a very preventative focus—and that division is called the division of health regulation and protection.

The second division is, if you are stepping away from being the provider and direct manager of services and becoming a commissioner of services, we wanted to be excellent at commissioning and design and bring all the functions of commissioning into one division where they could focus on that, and so we have created the commissioning and performance—so commission, performance, monitor, support and plan.

If there is one role the department needs to do and has not really done to its degree in the past, it is to be the steward of the health system in respect of knowing how the health system is unfolding, where is the national agreement going, what is happening with private health insurance, what is happening with genetics and epigenetics and how we position the department for the next decade or two. That long-term view of the stewardship of the department is very important, so we created the system leadership and design. Then, of course, the department itself needs to be managed as a corporate function.

We also, at the minister's instigation, created two new fundamental pillars, attached offices, that of Wellbeing SA to make sure that we do not go through the abandonment of our primary care, and to have a strong, dedicated focus on prevention and hospital substitution. That is beginning to materialise now.

The second key issue was to make sure that, in this devolved region, the clinicians had a mechanism by which they could cross the regions and still connect around clinical domains such as cardiology, respiratory, or whatever. So we have created the Commission on Excellence and Innovation in Health, which will not only provide the mechanisms to re-establish clinical networks and capitalise on the research and opportunities which are coming with continuous development but also will make sure the regions are quite harmonised across the regions. The commission is also focusing on the opportunities that come with digital health.

A couple of other things we have done in this structure are that we have essentially made sure that the critical role of the Chief Psychiatrist and director of mental health services reports directly to the chief executive so that the fundamental importance of mental health is recognised. I would put it to you that there is probably not much redefining society today more than technology, yet technology was buried down in the organisation, so we have elevated the head of digital health to be a direct report to the chief executive as well. That, I hope, creates a department that is well positioned to deliver the health services we need in the future in line with the government's priorities.

Mr PICTON: I refer to Budget Paper 5, page 52, regarding the public car parking fee structure. Minister, how many staff of the Department for Health and Wellbeing, as opposed to the LHNs, have a car park included as part of their salary package?

The Hon. S.G. WADE: I need to take that question on notice.

Mr PICTON: How many of your staff, minister, have access to a car park as part of their salary package?

The Hon. S.G. WADE: I need to take that on notice.

Mr PICTON: Is it true that the Gazette lists James Murphy, Greg Westenberg, Narelle Hards, Karen McColl, Anna Tree, Jonathan Nicholls—members of your staff—as having access to a free car park?

The Hon. S.G. WADE: The honourable member refers to a document. From past experience, I have no reason to believe what he says, so I will need to take that on notice.

Mr PICTON: Minister, do you pay for your car park in the city?

The Hon. S.G. WADE: I am not aware that I pay for my car park in the city.

Mr PICTON: You would know if you were paying for it, would you not?

The Hon. S.G. WADE: I refer to my previous answer.

Mr PICTON: Does the chief executive pay for his car park in the city?

The Hon. S.G. WADE: I will take that on notice.

Mr PICTON: Do any Department for Health and Wellbeing staff, or do your ministerial staff, undertake any night shifts?

The Hon. S.G. WADE: I am well aware that my staff and I and members of the department work long hours.

Mr PICTON: Do you believe that it is more deserving of people who are executives in the department or ministerial advisers to have access to free car parks at the same time that you are putting up car parking rates by 130 per cent for nurses, cleaners and other hospital staff?

The Hon. S.G. WADE: What I am aware of is that under this government there are fewer ministerial staff than there were under the former government. The honourable member's line of questioning highlights yet again the shameless hypocrisy of the current opposition. They do one thing in government and then criticise this government for continuing practices that they started. What I can assure the honourable member is that there will be fewer ministerial car parks under this government because there are fewer ministerial staff.

Mr PICTON: Minister, is it not true that, according to the budget papers, you have increased the staff in your own office from 12 FTEs last year to 17 FTEs this year?

The Hon. S.G. WADE: My ministerial office has had an increase of two FTEs this financial year as a result of the redistribution of our staff within ministerial offices within the Marshall Liberal government. In that process, there has not been an increase in ministerial staff.

Mr PICTON: Minister, do you still stand by your comments in February 2018 that hospital car park fees represent 'a significant financial burden on many patients, carers and relatives at what is often a very difficult time', an 'unnecessary stress' and your concerns about, 'Trying to complete a hospital visit within a strict time line can interfere with a person’s capacity to support a loved one'? You would know. You do not need to check a briefing if you still agree with that statement, do you?

The Hon. S.G. WADE: The Marshall Liberal team in opposition was very concerned about the lack of sensitivity of the former Labor government, particularly to long-stay patients. You saw that most starkly at the Royal Adelaide Hospital, where weekly car parking fees at the RAH had been $65 per week. For people making regular lengthy visits to family or friends or for patients who needed to make repeated visits, that was a real impost.

The government, on its election, undertook a review. One of the things that this review highlighted was that exemptions did not apply at the Women's and Children's Hospital. As a result of the review that was undertaken, the Women's and Children's Hospital has commenced to implement car parking exemptions for eligible consumers. Also, the government reduced the weekly car park fees at the Royal Adelaide Hospital, the weekly pass, to that comparable with other hospitals.

Consistent with our concern for long-stay repeat patients and people who are visiting them, existing exemption arrangements at all metropolitan hospitals have been broadened to include not only patients but also parents or carers of a baby or a young child patient. Patients or parents or carers of a baby or a young child patient who are required to attend the hospital for clinical reasons at least once a week for a period of at least four weeks are eligible for exemption. This includes patients in palliative care, paraplegic, quadriplegic, chemotherapy, radiotherapy and renal patients.

Other patients, relatives or carers may be eligible for car parking exemptions, subject to the approval of the Health facility manager (or delegate). Volunteers approved by the health facility manager are also exempt. These are important expansions of exemptions to make car parking more affordable to those on whom it falls most heavily.

Mr PICTON: Minister, did you consult with any nurses, cleaners or other staff before you decided to increase their car parking costs by 129 per cent?

The Hon. S.G. WADE: I think the committee would be well minded to remember that the former government—

Mr PICTON: I am sorry, I was not asking about the former government. I was asking if you consulted with anybody.

The Hon. S.G. WADE: The former government established the car parking rates and failed to increase them in relation to public car parking since 2011.

Mr PICTON: So we should have hiked up parking rates, you think?

The Hon. S.G. WADE: In relation to staff car parking, it is the government's view that we need to ensure that we properly balance demand in supply in car parking so that it makes good sense to have well-functioning precincts and to make sure that public transport is a viable option, too, for access. Staff car parking fees have been aligned more closely with the cost of public transport. The government needs to continue to raise revenue to invest in car parking facilities. We saw that commitment in the Lyell McEwin Hospital announced this week.

Mr PICTON: You just took that out of the $52 million for the ED upgrade we just heard—there is no extra money.

The CHAIR: Order!

The Hon. S.G. WADE: The government will continue to fund car parking, and for that matter the ongoing operation of those car parks through sensible revenue measures, both in relation to public car parking and in relation to staff car parking.

The CHAIR: The member for Newland has the call.

Mr PICTON: He wasn't even seeking it—you startled him.

The CHAIR: He was seeking the call.

Dr HARVEY: I have a very important question relating to Budget Paper 4, Volume 3, pages 13 and 25. Could the minister update us on the progress that has been made to provide more people with care closer to home and ease pressure on our busy emergency departments?

The Hon. S.G. WADE: I certainly will. The Marshall Liberal government is committed to providing South Australians with care closer to home and to provide more support for people to stay well and out of hospital. Earlier this year, we launched three innovative home hospital pilot programs in the northern, southern and central local health networks.

These three pilot programs have helped free up hundreds of hospital bed days by providing home or community care to a total of 660 patients. The programs have prevented dozens of presentations to emergency departments and hospital admissions, providing much-needed relief for our busy hospital staff and busy EDs. The pilots have shown that receiving care at home or in the community is embraced by patients and delivers high-quality sustainable care.

For older patients, a hospital stay often worsens their overall condition. It may disrupt their routine and sleep, reduce access to family and friends and involve prolonged bed rest, which can rapidly decrease muscle strength. Receiving care in a familiar and comfortable surrounding benefits a patient's wellbeing.

The South Australian health system is currently one of the most expensive systems in Australia, on average operating above the national efficient price. In order to create a more sustainable health system, we need to move towards a system that provides safe, high quality but lower cost alternatives to hospital care. I would ask the CEO to give us advice on the progress of the pilot projects.

Dr McGOWAN: I thank the minister. There are three major projects we are running, which are quite exciting. In the north we have a program run by a group called Pop-Up, and it has essentially found the frequent flyers or frequent presenters to the emergency department. These are often people with very complex needs and they often have not had a general practitioner to support them. Essentially, they work with those people to connect them with a general practitioner and to provide them with the support they need.

So far they have 216 patients enrolled, 153 actively today; 63 of those patients have been discharged, but there is a lot of evidence to indicate that maybe up to 45 presentations a day might be avoided by that service alone. We are continuing to do an evaluation of all of these, but particularly of that one to validate that. But it seems like a pretty important role in helping people keep away from the hospital and getting the primary and preventative care they need.

In the south, RDNS is working with the Southern Adelaide Local Health Network to again connect with people who have either been in hospital too long and cannot get out without support, or get people from the emergency department straight into the community. As of Wednesday, 434 patients had received care under that pilot, most of them aged over 65; 230 of those referrals having come straight from the emergency department, so you can pretty much assume that those people are saved admissions; and 204 referrals from the inpatient unit, again indicating that they probably got out earlier. With these programs, 85 per cent of them have indicated that they prefer to get that care than be admitted to hospital. It is saving pressure on our hospitals and giving people better care.

Mr PICTON: On the same budget line, Budget Paper 5, page 52, minister, do you have any sympathy for nurses or cleaners facing this extra $725 a year with your car park fee increase?

The Hon. S.G. WADE: The honourable member continues to highlight the impact on staff—

Mr PICTON: Yes, get used to it; we are going to do a lot of it.

The Hon. S.G. WADE: —and what I think staff appreciate is that they want to have affordable car parking, but they also need to have it accessible. If the government does not maintain management of the car parking which balances supply and demand, what will happen is that the car parks will be overwhelmed by other users. Let's remember where some of our facilities are. The Royal Adelaide Hospital is a relatively short walk from the CBD. If we do not maintain a credible pricing structure for the hospital, staff and patients will not—

Mr PICTON: You are increasing the other hospitals more than the RAH.

The Hon. S.G. WADE: —be able to get access to car parks when they need them. Likewise, the Flinders Medical Centre is going to be the beneficiary of the Flinders Link facility, which is going to make it extremely convenient for people to access that precinct. There is real concern that, if we do not maintain proper arrangements for our car parking, people will not be able to get car parks when they need them.

Mr PICTON: Do you think that a nurse who finishes a night shift at 11 o'clock at night at the Lyell McEwin Hospital or Modbury Hospital has any other choice but to get home by driving their car that they have parked in the car parks that you operate where you have increased the fees by $725 a year—a real wage cut for those low-paid staff?

The Hon. S.G. WADE: The government and the local health networks will continue to work with their employees to make sure that there are transport and car parking arrangements that meet their needs. When I was at the Lyell McEwin on Wednesday, I discussed with staff then the arrangements that are in place to make sure that staff can access the car parks safely. There are arrangements such that security guards can accompany staff when needed. So we are mindful of the fact that health does involve shift changes in the after-hours context, and that will be part of local health network planning—as it always has been, it always will be.

Mr PICTON: Minister, previously you said that the new car park at The QEH would open mid-2019. I would say it is now past mid-2019. When will that open and when will the change to the two hours free end at The QEH?

The Hon. S.G. WADE: The honourable member's question reminds me again of the shameless hypocrisy of the Labor government. It was the—

Mr PICTON: Maybe you could just answer the question.

The CHAIR: The minister is answering the question, member for Kaurna.

The Hon. S.G. WADE: It was the former Labor government that established the practice of not having the first two hours free in multideck car parks. That is a practice that has continued under this government. I do not—

Mr PICTON: When is it opening?

The Hon. S.G. WADE: I do not think it is completely correct to say that all car parks at The QEH—the at-grade car parks—will be removed, but I will take that on notice. I think there is a relatively small number of at-grade car parks which, on my understanding, would continue to be free. I am advised that the opening of The Queen Elizabeth Hospital multideck car park is scheduled for September.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 13, ministerial office. Can the minister advise whether Ms Georgina Downer ever wrote to him advocating for an upgrade to the Mount Barker emergency department prior to 1 February 2019?

The Hon. S.G. WADE: My office and I spoke with the candidate for Mayo and, for that matter, local state members in the area in the context of the Community Health and Hospitals Program. That was announced by the Prime Minister on 11 December. The commonwealth formally wrote to SA Health on 24 December and the submissions were due on 31 January. As I said, my office and I had discussions with the local Liberal members, the priority projects were then incorporated into the draft grant application and the submission was made on 31 January.

Mr PICTON: So there was no letter from Ms Downer; it was just a discussion that your office had with her?

The Hon. S.G. WADE: As I said, my office and I spoke with the Liberal candidate for Mayo, Georgina Downer, and local state members. That was very useful and our submission to the program was very successful.

Mr CREGAN: If I can take the minister to Budget Paper 4, Volume 3, page 39, Sub-program 2.5: Barossa Hills Fleurieu Local Health Network. Can the minister outline to the committee the scope of services to be provided for dialysis patients at the Mount Barker District Soldiers' Memorial Hospital?

The Hon. S.G. WADE: I thank the honourable member for his question. The government is delighted to be improving the services at the Mount Barker District Soldiers' Memorial Hospital with the installation of three haemodialysis chairs. This will mean that local renal dialysis patients have access to life-changing services closer to home.

I was delighted that the honourable member was able to join me in visiting the hospital recently. The community is excited that local patients receiving dialysis treatment in the Hills area will be able to get that at Mount Barker, rather than needing to travel to Murray Bridge or Adelaide. Up to 12 patients each week will be able to receive the treatment in the dual-purpose chemotherapy and haemodialysis unit. The unit will be delivered with an $800,000 investment. We know that treatment for kidney failure is a stressful time for patients and this new service removes the added pressure for treatment and enables them to receive their care closer to home.

In terms of services to the people of Mount Barker, we certainly appreciate the growing demands on the area and are working to expand the paediatric services provided at that hospital in accordance with our election commitments. Mount Barker is the third largest birthing hospital in country South Australia, with more than 500 births annually.

We are continuing to work with the local hospital network and the hospital in a service planning process with input from local general practitioners, the health advisory council, staff and stakeholders. The service planning process has identified paediatric services as a priority for expansion.

Mr PICTON: Same item as before: page 13 of Budget Paper 4, Volume 3. As the minister was the decision-maker in relation to the FOI in relation to correspondence with Georgina Downer, why did you decide to omit large portions of the document that had been sent by your chief of staff, Mr James Murphy, to Ms Georgina Downer?

The Hon. S.G. WADE: A number of the elements of the document related to unsuccessful projects that we are continuing to advocate for. It is in the interests of this state that we maintain good relations with other governments, so in accordance with the FOI Act those decisions were made.

Mr PICTON: Minister, if the document is so sensitive that there would be issues for the state with its release, have you or your office now asked Ms Downer to return the document to your office?

The Hon. S.G. WADE: The honourable member fails to appreciate the different contexts in which the two documents were provided. One was to a Liberal candidate when an active grant round was underway. We provided her with a letter—a copy of a letter that had already gone to her federal ministerial colleague—and it was in South Australia's interests that I would seek the support of a member of the Liberal team to advocate for those grant bids. She had lobbied for a number of the projects. We wanted her continued support to secure the money. Having a federal Liberal lobby a federal Liberal minister makes strategic sense.

It makes no strategic sense to now provide in an FOI and therefore put into the public domain the details of projects that we are trying to work with the commonwealth to fund. We believe that the FOI Act was appropriately applied.

Mr PICTON: I am sure that was the answer to some question, but it was not an answer to my question. My question is: given that Ms Downer was not elected; she is no longer a candidate in the Liberal team, as though that has some particular status; she is a private citizen, with no attachment, no potential of being elected anytime soon; and the minister has outlined that these are particularly sensitive documents and that it is in the state's interest that they not be disclosed, has the minister now asked Ms Downer to return the documents to his office?

The Hon. S.G. WADE: I have nothing to add to my previous answer.

Mr PICTON: So you have not asked her to do that?

The Hon. S.G. WADE: I have nothing to add to my previous answer.

Mr PICTON: Was the same document or any other cabinet documents or cabinet submission attachments sent to Mr James Stevens?

The Hon. S.G. WADE: I refute the implication in the statement, which is that this was a cabinet document. What was sent to Ms Downer was a letter with two attachments that were—

Mr PICTON: Listed as cabinet submissions.

The Hon. S.G. WADE: The letter had already been provided to the federal Liberal minister. The documents were not cabinet submissions. The whole purpose of the cabinet submission was to sign off on my grant application. The cabinet submission included attachments that were destined to be attachments to the grant application. The letter that was provided to Ms Downer, as I said, had already been sent to the commonwealth minister.

Mr PICTON: My question is in relation to Budget Paper 4, Volume 3, page 26, Central Adelaide Local Health Network. I refer the minister to the CALHN organisational and financial recovery documents, particularly the January activity summary which lists that KordaMentha during January—

The CHAIR: Sorry, Member for Kaurna, I am just try to find it—page 26?

Mr PICTON: Sorry, yes, page 26, Central Adelaide Local Health Network.

The CHAIR: Which dot point?

Mr PICTON: Sub-program 2.1.

The CHAIR: Wonderful, thank you.

Mr PICTON: One of the listed highlights or key activities in January for KordaMentha was discussions with Treasury regarding the TVSP program. What is the nature of the TVSP program that is discussed in this document?

The Hon. S.G. WADE: This is a matter that is in the hands of the Central Adelaide Local Health Network rather than the department, but our understanding is that CALHN management and the board, in discussion with KordaMentha, are looking at separation options that are available to them.

Mr PICTON: How many separations are being foreshadowed as part of that?

The Hon. S.G. WADE: I am happy to take that on notice, but I would be very surprised—

Mr PICTON: I have another question. Budget Paper 1, page 3, $550 million for the new women's and kids: what is the outline of that funding over the forward estimates?

The CHAIR: Alas, minister, the time has expired for the answering of questions. Perhaps you could take that on notice and reply to the house. There being no further questions, I declare the examination of proposed payments for the portfolio SA Health completed.

Sitting suspended from 16:00 to 16:14.

Departmental Advisers:

Dr C. McGowan, Chief Executive, Department for Health and Wellbeing.

Ms M. Bowshall, State Director, Drug and Alcohol Services SA, Department for Health and Wellbeing.

Dr J. Brayley, Chief Psychiatrist, Department for Health and Wellbeing.

Ms L. Dean, Chief Executive Officer, Wellbeing SA, Department for Health and Wellbeing.

Mr J. Woolcock, Chief Finance Officer, Department for Health and Wellbeing.

Mr B. Hewitt, Executive Director, Infrastructure, Department for Health and Wellbeing.

Mr M. Bandick, Director, Drug Policy and Population Health, Drug and Alcohol Services SA, Department for Health and Wellbeing.

Mr A. Knez, Manager, Executive Services and Projects, Department for Health and Wellbeing.

The CHAIR: Noting the time, we will finish at 6.14. I would like to move to SA Health, Mental Health and Substance Abuse. The minister appearing is the Minister for Health and Wellbeing. The estimated payments are for the Department for Health and Wellbeing and the South Australian Mental Health Commission. I declare the proposed payments open for examination and refer members to Agency Statements, Volume 3. Minister, if there has been a change of advisers, could you please reflect that for the committee?

The Hon. S.G. WADE: Thank you, Mr Chair. I am happy to do so. To my left is Dr Chris McGowan, Chief Executive, Department for Health and Welling; and Ms Marina Bowshall, State Director, Drug and Alcohol Services SA. To my right is Dr John Brayley, the Chief Psychiatrist.

Also with me today are Lyn Dean, Chief Executive Officer, Wellbeing SA; Mark Bandick, Director, Drug Policy and Population Health, Drug and Alcohol Services SA; Jamin Woolcock, Chief Finance Officer; Mr Brendan Hewitt, Executive Director, Infrastructure; and Mr Andrej Knez, Manager, Executive Services and Projects.

The CHAIR: Thank you, minister. Do you have an opening statement?

The Hon. S.G. WADE: No.

The CHAIR: Then I will call on the member for Kaurna.

Mr PICTON: My question refers to Budget Paper 4, Volume 3, page 22, the South Australian Mental Health Commission. Minister, where is the Mental Health Commissioner, whose budget is subject to this hearing of estimates?

The Hon. S.G. WADE: There is only one witness appearing here today and that is me. I bring some advisers. I do not bring all my advisers.

Mr PICTON: Is it not pretty important to have the commissioner when the commissioner's actual budget is up for debate and scrutiny by this committee?

The Hon. S.G. WADE: There are a lot of officers, a lot of executives right through the health network who are also not here today.

Mr PICTON: Did you ask the Mental Health Commissioner to not come to estimates today?

The Hon. S.G. WADE: No, I did not.

Mr PICTON: Did the Mental Health Commissioner volunteer not to come to estimates today?

The Hon. S.G. WADE: I will have to take that on notice. My understanding is that the commissioner might well be interstate on other duties, but I am happy to take that on notice.

Mr PICTON: Is there a representative from the commissioner's office here today?

The Hon. S.G. WADE: Mr Chair, I would like to remind the committee that ministers are entitled to bring advisers to these meetings. Of the 40,000 employees I have, I certainly do not bring them all. I have brought those who might assist. As in the previous session, from time to time I will have to take questions on notice, but I am happy to answer questions on the budget. I thought this was an opportunity to ask questions on the budget, rather than asking questions on how I organised my day.

Mr PICTON: Why did you invite the Mental Health Commissioner not only to come to last year's estimates—

Mr CREGAN: Point of order.

Mr PICTON: —but to give evidence—

The CHAIR: Order! There is a point of order. Member for Kavel.

Mr CREGAN: The question is in the nature of argument. It is also repetitive, and it is possibly not relevant to any budget line item.

Mr PICTON: Point of order: the Mental Health Commissioner—

The CHAIR: Member for Kaurna, I actually have not ruled on the member for Kavel's point of order before you raise a point of order. I was probably going to rule in your favour, but because you interrupted my deliberations, I am going to throw to the member for Kavel, who probably has a question.

Ms Cook interjecting:

Mr CREGAN: Thank you, Mr Chair.

The CHAIR: The member for Hurtle Vale, you can have an early minute if you keep that up.

Mr CREGAN: I take the minister to Budget Paper 4, Volume 3, pages 30 to 33. Could the minister please explain what the fixated threat assessment centre initiative is?

The Hon. S.G. WADE: I thank the honourable member for his question. The Marshall Liberal government has funded the establishment of a fixated threat assessment centre to mitigate mass casualty terrorism events by lone actors and others, mass casualty events in schools and assassination attempts on dignitaries. Whilst these are low likelihood events, they can be catastrophic events.

The South Australian fixated threat assessment centre will provide a coordinated evidence-based approach, using agreed assessment tools and the input of forensic psychologists, forensic psychiatrists and specialist mental health nurses to support sworn police officers.

The initial focus will include the following groups: firstly, persons fixated with undertaking terrorist acts but without that threat being linked to an underlying ideology; youths fixated with undertaking mass casualty attacks on schools; and persons who may pose a fixated threat to South Australian dignitaries. Considering the Chief Psychiatrist's involvement in this work, I will ask Dr Brayley whether he had any thoughts to add.

Dr BRAYLEY: The minister has referred to the professional composition of the team: the half-time forensic psychiatrist, there is a full-time forensic psychologist, and two specialist mental health nurses. The funding also supports an analyst for SAPOL. Given the significance of the initiative, the decision was to establish a centre rather than a panel. Originally, we were going to have a virtual panel but it has become a centre. The most recent planning discussions have had the centre to be located with sworn officers from the state protective security branch within SAPOL, so it would be based with them.

Back on 16 July, the Department of the Premier and Cabinet organised a fixated threat assessment capability round table with representatives from WA, Northern Territory, ACT and Tasmania, and they heard work that Victoria was presenting, because Victoria has had a leadership role in this area. The budget for this in 2019-20 is $602,000.

Mr PICTON: Same budget line, Budget Paper 4, Volume 3, page 22: South Australian Mental Health Commission: how much of the Mental Health Commission's $2.1 million budget will be transferring to the Department for Health and its subset of Wellbeing SA?

The Hon. S.G. WADE: The honourable member's question is based on a misnomer. First of all, Wellbeing SA is not part of the department. Over the next year, it will be an attached unit. The Mental Health Commission is also an attached unit. I want to make it clear that the reorganisation of mental health services, as a result of the governance review earlier this year, will see no diminution of investment in mental health. The government commissioned a mental health governance review by Aspex Consulting, from which the government prepared an interim government response.

The review and the response went out for community consultation and there was significant feedback in relation to the proposals in relation to the Mental Health Commission. It would be fair to say that the primary concern was about the engagement of lived experience. In terms of the health promotion and preventive elements, it makes eminent sense that Wellbeing SA, which is a whole-of-person prevention and primary health agency, was a logical location for mental health prevention and primary care, and that, as proposed by the review, it made sense for those services to be delivered in concert with Wellbeing SA.

Mr PICTON: Point of order, Chair: my question was very specific in terms of the $2.1 million budget. This is budget estimates. I am wondering if the minister can turn to what is happening with that $2.1 million?

The CHAIR: Member for Kaurna, I am listening to the minister. It is very germane. He is talking about the issues that you have asked and, as far as I am concerned, he can continue.

The Hon. S.G. WADE: The other elements of the consultation response, which the government has responded to, are the need to strengthen the lived-experience focus of the commission and to maintain a mental health lived experience and peer worker focus, the codesign capacity within the Mental Health Commission, and so on.

In response to community consultation, the government's final response amended our response to recommendation 5. It saw the health and preventive elements going to Wellbeing SA and the lived-experience element being strengthened in a Mental Health Commission that will be expanded. It will now include three commissioners—a full commissioner and two part-time commissioners—and there will be an open call for positions. People with lived experience of mental health, as either a consumer of services or a carer, will be encouraged to apply.

Primarily, the resources that are currently budgeted to go to the Mental Health Commission will be primarily allocated between the Mental Health Commission and Wellbeing SA. There may well be some resources that are transferred to the Office of the Chief Psychiatrist, but, as I said, the resources will continue to be dedicated to mental health. The final budget allocations between those three agencies will become clear, particularly as the future shape of the Mental Health Commission and the future shape of Wellbeing SA are clarified in the months ahead.

Mr PICTON: On the same budget line, has the minister been satisfied with the performance of the Mental Health Commissioner, Mr Chris Burns?

The Hon. S.G. WADE: I have huge respect for Chris Burns. Not only is he a highly regarded veteran but the work that he has done in the commission, particularly in developing the strategic plan, have been important milestones in our journey. I particularly appreciate the environment he was working in. He had a government, when he was first appointed, which had let the previous Mental Health Services Plan lie unresponded to. In other words, basically there has now been a seven-year hiatus between the last Mental Health Services Plan—

Mr PICTON: Don't worry, we are getting to that.

The Hon. S.G. WADE: —and the one that is currently under development. So I appreciate the commissioner had a hard context environment in which to operate.

Mr PICTON: Given the minister's respect for the Mental Health Commissioner and the work that he has done, will he be continuing in the role as the South Australian Mental Health Commissioner?

The Hon. S.G. WADE: It is completely up to the commissioner to decide whether he wants to be part of the new Mental Health Commission. As I said, there will be an open call for positions and I would be pleased if Mr Burns wanted to put his name forward.

Mr PICTON: Why will he not just be reappointed?

The Hon. S.G. WADE: This is a government that respects due process.

Mr PICTON: Will the new Mental Health Commissioner, whoever he or she may be, continue the same status as a senior member of the executive service, that is, with a contract with the Premier of South Australia?

The Hon. S.G. WADE: I must admit that I have not turned my mind to the contract. What was more important to consumers and carers in the feedback I was getting was their reporting lines, and one thing that was clear in the consultation was that the community wanted the Mental Health Commission to have a direct reporting line to the minister and that will happen.

Mr PICTON: So the Mental Health Commissioner will not report to the head of Wellbeing SA, but will report to the minister?

The Hon. S.G. WADE: I was saying the Mental Health Commission collectively. I would like to stress that this is an expanded and enhanced commission that the government will be establishing. As a commission, they will have a direct reporting line to the minister. In terms of the secretariat function, the secretariat function will be based within Wellbeing SA, and my understanding is that the officers of the secretariat would answer to the commission on commission matters and answer to Wellbeing SA in relation to other matters.

Mr PICTON: Who will the commissioner report to? To the minister or to the CEO of Wellbeing SA?

The Hon. S.G. WADE: My understanding is that as the head of an attached unit, the Mental Health Commissioner would not report to the head of another attached unit, which is Wellbeing SA. I have nothing more to add.

Mr PICTON: So the Mental Health Commissioner is reporting to the minister or to the CEO of Wellbeing SA?

The Hon. S.G. WADE: I have nothing to add to my previous answer, which is that the Mental Health Commission will report to me; they do not report to the head of Wellbeing SA.

Mr PICTON: Last year, the minister indicated that there would not be any changes to the Mental Health Commission. What has changed his mind over the past 12 months?

The Hon. S.G. WADE: I have no intention of answering that question because it is a direct misrepresentation of the statement I made.

Mr PICTON: In terms of the governance report that the minister outlined, which South Australian stakeholders were consulted during the consultant's drafting of the mental health governance review?

The Hon. S.G. WADE: Consultation is very important in mental health reform. That is why the government released the review, with its draft interim response, and undertook consultation on that. The government responded to the consultation in the final response. South Australian mental health consumers can see the sincerity of the government in terms of community engagement because we have substantially revised recommendation 5 in response to the community consultation.

Mr PICTON: Over the past nine months, has the Mental Health Commissioner given you any advice about his concerns about your proposed changes to the Mental Health Commission?

The Hon. S.G. WADE: Yes, the Mental Health Commissioner was clear that he did not support recommendation 5. As it went out to consultation, it was clear that he was not alone.

Mr PICTON: Since your revised changes to that plan to keep it but connect it to Wellbeing SA, has the Mental Health Commissioner raised any concerns with you about that proposal?

The Hon. S.G. WADE: I do not recall the Mental Health Commissioner communicating with me on the final response, other than in broad terms, which is that he welcomed the continuation of the Mental Health Commission. In detail, I will need to take that on notice.

Mr PICTON: Are you aware of anybody who has expressed concerns regarding the poor consultation following the release of that Aspex Consulting report into mental health governance?

The Hon. S.G. WADE: I am not sure which period the honourable member is talking about. Is the honourable member talking about the consultation—

Mr PICTON: After the report was released.

The Hon. S.G. WADE: There were certainly concerns about the consultation method, but there are a lot of opinions about consultations. I find a lot of people are frustrated about consultations that lack a focus. One thing that can be clear from this consultation is, by having a mental health governance review report and the draft interim response, the community was able to clearly express its views because it had a clear proposal to respond to.

I believe the fact that the government engaged the community, listened to the community and responded to the community means that we will have a better, more robust mental health governance framework going forward.

Mr PICTON: Minister, are you aware of an online video called How to Spot a Bad Consultation, which was shared in April 2019?

The CHAIR: Member for Kaurna, I have given a lot of latitude; I am just not quite sure in which budget paper and line item that appears.

Mr PICTON: It is the same line item, in terms of the Mental Health Commission.

Ms Cook interjecting:

The CHAIR: Thank you for your assistance, member for Hurtle Vale, but I am not sure if it does.

Mr PICTON: I am sure the minister is happy to answer.

The CHAIR: The minister can answer if he chooses, but that question is very out of order.

The Hon. S.G. WADE: I would make the comment I made before, which is that there are lots of opinions about consultation. The proof of the pudding is in the outcome. In spite of some scepticism that the government was willing to change its proposal, the fact that we have substantially reformed the original model demonstrates that that scepticism was unfounded.

Mr PICTON: Minister, are you aware that the video How to Spot a Bad Consultation references the consultation organised—

The CHAIR: Member for Kaurna, I have already ruled on that.

Mr PICTON: If you let me finish the sentence, Chair—

Ms COOK: You let him go.

Mr PICTON: —you will find that it has direct relevance to the budget papers.

The CHAIR: Member for Hurtle Vale, you really want to go home early, don't you? Then we all have to come back at 9.30 on Monday. It would really annoy your shadows on Monday if they could not participate fully in estimates.

Mr PICTON: We can come back tomorrow.

The CHAIR: No.

Mr PICTON: It says 'the next day' in the standing orders so that would be tomorrow, Saturday.

The CHAIR: Monday is the next scheduled day of sitting. What is your question, member for Kaurna?

Mr PICTON: My question is: in regard to the consultation held about the Mental Health Commission and its abolition following the release of that consultants' report, are you aware that concerns were raised online that SA Health staff, executives and policy officers were there to set up but then left and did not actually participate in the consultation itself?

The Hon. S.G. WADE: If the honourable member is concerned that some staff were involved in preparation for the meeting but did not stay for it, I am happy to take that on notice, but it sounds rather petty to me. The fact of the matter is that lots of people in SA Health have lots of different roles. SA Health and, for that matter, other members of the department and the wider portfolio were engaged in the consultation. I believe that it was a robust consultation. The fact that the government substantially reformed its position demonstrates that it was a successful consultation.

Mr PICTON: My question relates to Budget Paper 4, Volume 3, page 25, health services. How closely do you as minister or the department monitor the number of mental health patients waiting over 24 hours for a bed in emergency departments?

The Hon. S.G. WADE: I thank the honourable member for his question. The department, and particularly the Office of the Chief Psychiatrist, monitor such indicators. I must say that it is very pleasing to see that the latest rate for the proportion of mental health patients who were waiting longer than 24 hours has fallen. In June, it was 8.5 per cent, which is in fact the lowest rate in eight months. That is particularly pleasing considering the high demand that we have been experiencing through summer and with the large flu season.

We are determined to continue to see improvement in that important area of timely delivery of care. In that context, we are hopeful and optimistic that the opening of the 10 forensic mental health beds at Glenside will help to continue that positive trend. I am sure that part of the positive trend is related to the work of the court diversion service strategy. Considering his key role in rolling that out, I ask the Chief Psychiatrist to explain how the court diversion service strategy has helped improve the reduction in the number of mental health patients staying for more than 24 hours.

Dr BRAYLEY: Certainly, minister. Regarding the court diversion strategy, the concern had been the number of forensic outlier patients in community beds. The community bed number is modelled on the needs of the community. Back in February of this year, we were up to 15 forensic patients who were either in an ED or in an acute community unit. The forensic court diversion began in March and since then, through to June, the figure dropped to 7.8 forensic outlier patients. This reflects the number of orders that are avoided when people are assessed and referred to mental health teams and information is given to the court.

This reduction is important because 10 new forensic beds were opened with the aim of addressing this overflow of people who are forensic patients into the community beds. If it was not for the initial reduction calls by the court diversion service, we would not have had enough capacity with our 10 beds to be effective. In the last week, there have been four forensic overflow patients in community beds.

Mr PICTON: On the same budget line, given that the minister gave the stats before for June, I am wondering if you can outline how many patients in the calendar year 2019 have waited over 24 hours for a bed in emergency departments, and what proportion is that?

The Hon. S.G. WADE: Is the honourable member asking me the number of patients from 1 July 2018 to 30 June 2019 and what proportion of patients that is?

Mr PICTON: If that is the format in which you have it, I am happy to have it. If not, then the calendar year 2019.

The Hon. S.G. WADE: I was trying to understand the honourable member's question. I presume, therefore, that you have confirmed that and I will take that on notice.

Mr PICTON: So you do not have that information in front of you? There is not a table in front of you with that information on it?

The Hon. S.G. WADE: I said I would take that on notice.

The CHAIR: The member for King is nodding at me intently.

Ms LUETHEN: I refer to Budget Paper 4, Volume 3, pages 19 and 20. Could the minister explain what he has done to improve services for older South Australians living with enduring mental illness following the shameful legacy left behind by the former Labor government?

The Hon. S.G. WADE: I would like to thank the honourable member for her question. Honourable members will recall that there were two significant reports into older persons mental health services in response to Oakden. One was by the Chief Psychiatrist and one was by the Independent Commissioner Against Corruption. The South Australian government is implementing a number of measures to protect our most vulnerable people. We are reforming the state's mental health services for older people and making improvements to governance, monitoring, infrastructure, safety and quality and the mental health workforce.

The state government is committed to protecting South Australia's most vulnerable by strengthening powers to investigate allegations of abuse or neglect and restoring open and accountable government. Primarily, we are doing it through the changes to the Independent Commissioner Against Corruption legislation. The state government accepted all six of the Chief Psychiatrist's recommendations and all 13 of the commissioner's recommendations, and SA Health has taken on oversight of the implementation of the recommendations. I will ask the Chief Psychiatrist whether he might elaborate on that.

Dr BRAYLEY: Thank you, minister. In terms of the initial recommendations coming out of former chief psychiatrist Aaron Groves' report, that of course is leading to the older persons mental health reform currently underway. We have work underway for the 18-bed tier 7 dementia unit at the Repat site. There is a committee that I am chairing that is developing the model of care for that new facility.

It will also consider how it interfaces with other specialist dementia care units for people with tier 5 and 6 dementia and issues of staffing, culture and standards of care. That work is currently underway. We also have a rollout of rapid access teams, psychogeriatric teams that will go into residential aged-care facilities to provide assessment, advice and support. That is basically starting in 2019-20.

In terms of commissioner Lander's ICAC report, a preliminary response was published in March of this year and we are about to present a completed report to the minister. This work will address governance roles, responsibilities and local health network training for SLS. Already there has been an increase in the number and frequency of Chief Psychiatrist inspections and a particular focus on unannounced inspections.

A review of community visitor training and qualification requirements will be included in that report. Mr Julian Gardner from Victoria, the inaugural public advocate from Victoria, was asked to do that work, as well as looking at our functions and resources and assets generally, amongst other recommendations that were in the ICAC report. There is a range of specific actions involving our systems generally but also particularly the Office of the Chief Psychiatrist and the Community Visitor Scheme.

Mr PICTON: In relation to the same budget line, Budget Paper 4, Volume 3, page 25, health services, the same subject: the report that was just mentioned by the Chief Psychiatrist was previously due to be delivered to the chief executive before 30 June. Was that delivered to the chief executive before 30 June and, if so, will it be made public? Also, the preliminary report said that a review of the use of restrictive practices would be completed in early 2019 and an updated policy to be published in June. Has that occurred and, if not, why?

The Hon. S.G. WADE: If the honourable member is referring to the specialised aged-care reform program report which was due to be issued by the end of June, the answer is yes, it was delivered and it is available on the SA Health website.

Mr PICTON: No, that is not what I was referring to actually. I was referring to the final report following the Chief Psychiatrist's response report which he mentioned earlier this year. He said that he was due to give it to the chief executive soon but that previously it was promised before 30 June. The preliminary report from the Chief Psychiatrist also talked about a restrictive practice review which would be completed in early 2019, with an updated policy published in June, and that appears to not have occurred either.

The Hon. S.G. WADE: I understand that the ICAC update report will be provided to the chief executive most likely by the end of next month.

Mr PICTON: Question following Budget Paper 4, Volume 3, page 25, health services: has the government now established a plan for the rollout of the reduction in funding to mental health NGOs of $6.8 million this year?

The Hon. S.G. WADE: SA Health has commenced the process of meeting with all current non-government organisations providing psychosocial services to negotiate funding agreement extensions to 30 June 2020, with a further option to extend services to June 2021. All NGO agencies have received their service agreements for the first quarter of 2019-20 for signing, with 93 being executed as at mid-July.

Mr PICTON: When will the next quarter contracts be arranged?

The Hon. S.G. WADE: The department is engaging BDO advisory to help develop a pricing framework and model to support the transfer of funds as mental health consumers transition to the NDIS. As part of this process, BDO advisory will be consulting with a number of NGOs. I am advised that a meeting is scheduled in that context for early August.

Mr PICTON: When are you expecting a report from BDO in terms of what the funding for the next quarter should be, presumably the second quarter of this coming financial year?

The Hon. S.G. WADE: It is hoped that the BDO work might be completed by the end of August. Obviously, that would need to be considered.

Mr PICTON: Will that BDO report be made public?

The Hon. S.G. WADE: I doubt it. We do not normally make consultancy reports public.

Mr PICTON: Will that BDO report be shared with the NGO providers?

The Hon. S.G. WADE: I would just like to reiterate what I said in my earlier remarks, which is that SA Health has commenced the process of meeting with all current non-government organisations. I highlighted that BDO is consulting with a number of non-government organisations. The department has funded the Mental Health Coalition with, I think, two separate significant grants to help the transition, so we certainly intend that the BDO work will be a collaborative effort with the NGOs.

Mr PICTON: Minister, what is your response to the comments from Catherine House CEO, Louise Miller Frost, to the Social Development Committee, who said that she was assured by the Chief Psychiatrist that their existing level of funding would continue until June 2020?

The Hon. S.G. WADE: I am happy to take the question on notice. I have not read those remarks.

Mr PICTON: Minister, were any of the mental health NGOs advised at the beginning of this year by the government, by the Chief Psychiatrist, or anyone else in the department, that their funding would be continuing in the 2019-20 financial year?

The Hon. S.G. WADE: Anyone else in the department? With 40,000 staff, I will need to take that on notice.

Mr PICTON: What about the Chief Psychiatrist? Did he advise any of the NGOs?

The Hon. S.G. WADE: I am happy to take that on notice.

Mr PICTON: He is sitting right next to you.

The Hon. S.G. WADE: Mr Chair, there is only one witness here today.

The CHAIR: Indeed, and I will remind the committee of that.

Mr PICTON: How does the minister respond to the fact that Catherine House CEO, Louise Miller Frost, found out about the three-month contract when she opened the contract offer?

Ms COOK: Oops!

The CHAIR: Member for Hurtle Vale, no need to interject.

The Hon. S.G. WADE: The process of the rolling out of these contracts is challenging. There is no doubt about that, but this is a process that is the subject of a signed agreement between two governments, and one of the governments was a Labor government in South Australia that signed a bilateral agreement to fund the NDIS by providing for funding to be transferred from the state government to the NDIS to cover the services for those clients who are eligible to transfer to the NDIS.

Mr PICTON: Not many of them at Catherine House.

The Hon. S.G. WADE: It is shamelessly hypocritical for the Labor Party to brand this transition of funding as cuts because they are transitions that are laid out in a bilateral agreement that they signed. We appreciate that this is challenging. It is challenging for consumers, it is challenging for providers, it is challenging for the department, but it is completely unhelpful for the opposition to persist in fearmongering when what they should be doing is working with stakeholders and the government to make sure that this transition is as smooth as possible.

I welcome the commitments given by the Chief Psychiatrist in particular, and his team, to work with mental health organisations and with consumers to facilitate continuity of support. The process is, as I said, not without its challenges, but it offers in the long-term significant benefits for Australians living with psychosocial disability. We want to work with them to help them make the most of the NDIS to pursue their life goals.

Mr PICTON: Can you guarantee that no existing mental health clients or organisations like Catherine House will be left unsupported when these full reductions take place in the second quarter of this financial year?

The Hon. S.G. WADE: I reiterate what I just said, which is that the Chief Psychiatrist and his team have made contact with mental health organisations assuring them that SA Health will continue to work closely with providers to ensure that no South Australian is worse off as a result of the transition to the NDIS.

Mr PICTON: Are there any further funding reductions planned in the 2020-21 financial year?

The Hon. S.G. WADE: The advice available to me is that there will be the transition of funding this year. I am advised that we are not aware of further transition of funding in the next financial year—that is, 2020-21—but I will take that on notice and seek confirmation, because these are matters that also engage the Department of Treasury and Finance.

Mr PICTON: Are there any other mental health programs that are likely to be subject to reductions in funding over the next 12 months?

The Hon. S.G. WADE: I am not aware of any other reductions, but I will take that on notice.

Dr HARVEY: My question relates to Budget Paper 4, Volume 3, page 30. Could the minister outline any recent reforms to forensic health services?

The Hon. S.G. WADE: I thank the honourable member for his question. It highlights the importance of tackling forensic mental health as a particular cohort. As the Chief Psychiatrist mentioned in his earlier remarks, there was a significant increase in forensic mental health patients that was having a knock-on effect, if you like, on the broader health system. It was impacting on length of stay for other mental health consumers, and it was adding to the stress on emergency departments.

The honourable member's question highlights the importance of the changes to actually deliver appropriate mental health care to people with forensic mental health issues. The commissioning of the 10-bed secure inpatient forensic unit at Glenside, of course, will increase capacity but, very importantly, it will give us an opportunity to have a much better flow between the emergency departments and the other parts of the forensic mental health network.

The 10 forensic and Department for Correctional Services subacute rehabilitation patients have now moved from James Nash House into that 10-bed unit. Prior to opening the unit, minor capital works were completed and the Chief Psychiatrist's office inspected and approved the facility. I might ask the Chief Psychiatrist, who I know would do a much better job of explaining it to the committee, how the forensic mental healthcare pathway is improved by adding the Glenside campus facility.

Dr BRAYLEY: Currently, in South Australia, the forensic bed capacity is 70 beds, with 50 inpatient beds at James Nash House, the 10 inpatient beds at Glenside Hospital which have just been opened which will cost $4.9 million this year to operate—$20.35 million has been allocated over four years for their operation—and 10 residential step-down beds at Ashton House.

It has been a particular benefit because our Forensic Mental Health Service also caters for people who have a forensic disability, people with intellectual disability, brain injury and other disabilities that might have led to offending where people have been found not guilty by reason of mental impairment or unfit to plead. They are looked after in a unit called the Tarnanthi unit. Eight of the beds of these 10 beds bring together the forensic disability client cohort.

This then frees up beds at James Nash House for acute admissions which may be prisoners who have a mental illness or other forensic patients who need acute care. These people might otherwise have been going to emergency departments or into other wards. We have seen a link between the forensic outlier numbers and waits in emergency departments, so this is good for the patient group who are now at Glenside, with a particular focus on forensic disability. It creates more beds for forensic patients and has benefits for the community as well.

Mr PICTON: My question is in relation to Budget Paper 4, Volume 3, page 25, regarding health services. On what date, minister, did you delegate your responsibilities over services for eating disorders?

The CHAIR: Member for Kaurna, eating disorders? Where would I find that on page 25?

Mr PICTON: It is a health service that is provided to people.

The CHAIR: Within SALHN, I assume?

Mr PICTON: Largely in SALHN but not exclusively.

The CHAIR: Perhaps you would just want to say that as well.

Mr PICTON: Yes, I am happy to—SALHN.

The Hon. S.G. WADE: My understanding was that the gazettal was on 6 June.

Mr PICTON: Did the minister receive any advice that prompted him to make this delegation?

The Hon. S.G. WADE: In the conduct of my ministerial duties I have discussions both within the department and with the Cabinet Office. As a result of those discussions and my own consideration, the delegation was made. I think it is worth highlighting that that is—and I am not sure what the word is. The honourable member for Kavel might help me. It is a concurrent delegation. In other words, minister Lensink has the functions and powers pursuant to the Health Care Act 2008 and the Mental Health Act 2009 with respect to eating disorder services but I continue to have those powers, too.

Mr PICTON: Was there any conflict of interest that arose between the election and when the delegation was made that prompted that delegation to be made?

The Hon. S.G. WADE: The delegation was made, particularly in the context of the Marshall Liberal government delivering on its commitment to paediatric eating disorders. The Marshall Liberal team went to the election with that commitment. A report on the governance of the services was commissioned by the chief executive of SA Health. I have made the ministerial delegation on eating disorders to minister Lensink, particularly so that she might be able to take forward the government response to that report.

Mr PICTON: So was there any particular conflict that arose between the election and when you made the delegation?

The Hon. S.G. WADE: The delegation was made in the context of my wife's role in eating disorder services. Let me stress that the delegation is concurrent. In other words, I still have the functions and powers pursuant to the Health Care Act 2008 and the Mental Health Act 2009. As the paediatric eating disorder service issue was considered, I decided that it was appropriate to make the delegation because I thought that that report raised an issue of conflict of interest in relation to me making the decision because of my wife's involvement in eating disorder services.

Mr PICTON: Minister, did you make any decisions or consider any advice regarding that paediatric eating disorder clinic before you made the delegation?

The Hon. S.G. WADE: I certainly received advice, but the decisions in relation to that report and the way forward will be made by minister Lensink under the delegations.

Mr PICTON: Is that limited to the paediatric eating disorder clinic, or is that in relation to all eating disorders services?

The Hon. S.G. WADE: I will continue to refer issues to minister Lensink or, for that matter, to any other minister who I choose to delegate from time to time. In relation to eating disorders, if I think that that raises issues of conflict of interest—as I said, I retain powers in relation to eating disorder services.

If I could give the honourable members a suggestion on that, the Chair quite rightly asked the question, 'Where does the money for eating disorder services go?' In relation to the Statewide Eating Disorder Service, that is a statewide service that is hosted by the Southern Adelaide Local Health Network. Therefore, the standard funding allocation to the Southern Adelaide Local Health Network, some of that will go to fund the Statewide Eating Disorder Service. In my view, there are issues in relation to eating disorders that will not represent a conflict of interest. In this context I formed the view that there was an issue in relation to paediatric eating disorder services, so that is why a delegation has been made.

Mr PICTON: Minister, do you regard that you have any conflict in relation to the Statewide Eating Disorder Service that is planned for the Repat site?

The Hon. S.G. WADE: No, I do not.

Mr PICTON: On the same budget line, Budget Paper 4, Volume 3, page 25, my question to the minister is: where is the Mental Health Services Plan?

The Hon. S.G. WADE: During the 2018 state election, the government made mental health and wellbeing in our communities a top priority and committed to the development of the Mental Health Services Plan. The government sees the plan as an important part of rebuilding our mental health services in South Australia. The plan responds to a seven-year hiatus in planning for the mental health system since the Stepping Up report, 2007-2012. That report effectively expired some seven years ago.

The Mental Health Commissioner and the Chief Psychiatrist worked together with extensive community consultation. Of course, that built on the Mental Health Strategic Plan 2017–2022. The report itself has been given to the government, and we are working through it. I intend to take it to cabinet in the not-too-distant future.

Mr PICTON: Did you not promise to deliver that plan within 12 months of coming into office, which would have been 18 May 2019, some four months ago now?

The Hon. S.G. WADE: I just make the point that we might be four months late—the former government left a seven-year hiatus.

Mr PICTON: It is more than four months because it is not being released today. When is it likely to be released?

The Hon. S.G. WADE: These matters are matters for cabinet.

Mr PICTON: So you do not have the revised deadline, after the 12-month deadline has now well and truly passed, of when this plan is going to be released?

The Hon. S.G. WADE: It will certainly be less than seven years.

Mr PICTON: I thought you thought that this was a very urgent plan that needed to be dealt with immediately. Why do you not have a deadline for when you would release this plan?

The Hon. S.G. WADE: I appreciate the honourable member may well be running out of questions, but I have nothing to add to my answer.

Mr PICTON: I have a lot more, do not worry about that. Have you seen a draft of the Mental Health Services Plan?

The Hon. S.G. WADE: Yes.

Mr PICTON: Has cabinet seen a draft of that plan?

The Hon. S.G. WADE: I imagine that is wandering off to cabinet matters. I thought I was telling the committee earlier that I was working on the plan with a view to taking it to cabinet.

Mr PICTON: Has any provision been made in the budget for funding allocation to deliver what will be in the plan?

The Hon. S.G. WADE: That goes to the content of the plan and cabinet consideration. I will wait for that consideration.

Mr PICTON: Well, it actually goes to the content of the budget papers that we have been presented with.

The Hon. S.G. WADE: I have nothing to add to my answer.

Mr PICTON: So there is no money that we can identify in the budget for this plan?

The Hon. S.G. WADE: No, that was not my answer.

Mr PICTON: Where is the funding for it?

The Hon. S.G. WADE: I have nothing to add.

Mr PICTON: Is it true that community consultations on the mental health plan were booked for country venues and then cancelled and not rescheduled?

The Hon. S.G. WADE: I am happy to take that on notice.

Mr PICTON: I have a question in relation to Budget Paper 4, Volume 3, Central Adelaide Local Health Network. Are all action items from the Glenside Inpatient Rehabilitation Services report being met inside the time frames outlined in the CALHN action plan? If not, what action items have fallen behind?

The Hon. S.G. WADE: We do not have that level of detail. I am happy to take the question on notice.

Mr PICTON: When was the minister first made aware of complaints about the Inpatient Rehabilitation Services at Glenside?

The Hon. S.G. WADE: I will need to take that on notice.

Mr PICTON: Did any patients meet with you about that service?

The Hon. S.G. WADE: Not that I recall.

Mr PICTON: Did any staff members raise complaints with you about that service?

The Hon. S.G. WADE: Primarily, the issue was raised with me by the Chief Psychiatrist.

Mr PICTON: Did the minister or SA Health notify the Office for Public Integrity with concerns regarding this service?

The Hon. S.G. WADE: Mr Chair, I would hope that members of parliament would appreciate our need to respect institutions. I have no intention of answering that question.

Mr PICTON: You have already made clear on previous occasions that you have referred matters to the OPI. Why would you not make it clear in this regard?

The Hon. S.G. WADE: I have nothing to add to my answer.

Mr CREGAN: I take the minister to Budget Paper 4, Volume 3, pages 39 to 41. Could the minister outline to the committee what the Borderline Personality Disorder Collaborative run by the Barossa Hills Fleurieu Local Health Network is?

The Hon. S.G. WADE: I thank the honourable member for his question. The Borderline Personality Disorder Collaborative is a new service that is implementing a statewide model of stepped care in partnership with all local health networks. It is responding to a significant service gap in relation to people with borderline personality disorders. It commenced operations on 1 July 2019, and I was pleased to officially launch the BPD Co hub on 7 June at 100 Greenhill Road, Unley. I acknowledge the fact that the shadow minister for health and wellbeing also joined me for that event.

The Barossa Hills Fleurieu Local Health Network is hosting and leading the development of a statewide borderline personality disorder centre of excellence, which will be called the Borderline Personality Disorder Collaborative, or BPD Co for short. I am very pleased that this initiative is finally underway after years of lobbying by consumers and carers.

People with BPD often find themselves misunderstood and marginalised by the broader health system and within EDs more broadly, and funding this service will go some way towards supporting up to 68,000 South Australians living with BPD and their family carers. I wonder if the Chief Psychiatrist might want to add anything on that service?

Dr BRAYLEY: Yes, certainly. Currently, the service is providing advice and consultation, but it will be offering a range of services—a hub-and-spoke type of model—so training, research, early brief psychological therapies, working in partnership with people in local health networks, individual group programs, and then people with high needs or people who have complex needs would be receiving services directly from the BPD Co clinic, which is on Greenhill Road.

Currently, the advice and consultation services have been operating. We are booked to do a gazettal inspection. We understand that they are going to be ready for a gazettal inspection on 2 August and then, after that, the full range of services will be provided by BPD Co.

Mr PICTON: I refer to the same line item in Budget Paper 4, Volume 3, page 26, CALHN, in relation to Glenside again. Has the audit of nursing staff been completed and, if so, what were the findings of that audit?

The Hon. S.G. WADE: That is even more detailed than the previous question so I am even in a greater need to take the question on notice.

Mr PICTON: Has any disciplinary action been taken against any staff member since the release of the report?

The Hon. S.G. WADE: Again, I will need to take that on notice.

Mr PICTON: Are any of the original staff members still working in the unit?

The Hon. S.G. WADE: It is my understanding that there are.

Mr PICTON: How many would be working there?

The Hon. S.G. WADE: I will take that on notice.

Mr PICTON: A question in relation to Budget Paper 4, Volume 3, page 41, Eyre and Far North Local Health Network: has the minister been advised of a lack of mental health services to cover Eyre Peninsula?

The Hon. S.G. WADE: There are certainly ongoing discussions about the needs for mental health services on Eyre Peninsula. For example, I am aware of concern that the inpatient mental health beds at the Port Lincoln hospital are not open. My understanding is that they have never been open since the former government built them.

Mr PICTON: How many psychologists are practising on Eyre Peninsula?

The Hon. S.G. WADE: I am happy to take that question on notice.

Mr PICTON: How many psychiatrists are practising on Eyre Peninsula?

The Hon. S.G. WADE: I am happy to take that question on notice.

Mr PICTON: Did the minister see reports in the Port Lincoln Times where concerns were raised by the presiding member of the Mid West Health Advisory Council that there were no psychologists on Eyre Peninsula?

The Hon. S.G. WADE: I have already given an undertaking to get back to the honourable member with the answer. I will deliver on that commitment.

Mr PICTON: Have you had concerns raised with you about mental health services on Eyre Peninsula by the member for Flinders?

The Hon. S.G. WADE: Yes, he has.

Mr PICTON: What were those concerns that he raised?

The Hon. S.G. WADE: In particular, he has discussed with me the inpatient beds at Port Lincoln hospital, but I would suggest that honourable members might try to be the best MP they can be without trying to coach others.

Mr PICTON: Do you have plans to open those inpatient beds at the Port Lincoln hospital?

The Hon. S.G. WADE: The government will always be alert to the level of demand or unmet need for services and, to the extent that resources are available, we strive to meet them.

Mr PICTON: What is the make-up of the Child and Adolescent Mental Health Service staff on Eyre Peninsula?

The Hon. S.G. WADE: I will have to take that question on notice.

Mr PICTON: I refer to Budget Paper 5, page 53, youth treatment orders. Does the funding outlined in the budget for youth treatment orders represent the full amount of funding required to implement the detention orders?

The Hon. S.G. WADE: Mr Chair, although I am in a familiar place, I am not familiar with your standing orders. Considering that youth treatment orders is on your Notice Paper in the House of Assembly, I wonder if the member might be more within standing orders if he asked his question in the context of that bill.

The CHAIR: I am glad you raise that, minister, because it allows me to reflect on your comment about the role of members of parliament. I wonder what that would be like, coming from the upper house.

Mr PICTON: They are long three-hour days in the upper house, sir.

The CHAIR: Member for Kaurna, if you could indulge the other place and rephrase your question, that would be wonderful.

Mr PICTON: Have you been given advice in relation to what funding is going to need to happen for youth treatment orders?

The Hon. S.G. WADE: I just regard this line of questioning as anticipating the debate on the bill. In our house, our members would raise this in the context of the consideration of the bill. If we want to run two considerations of the bill, then I will get my advisers to—

Mr PICTON: Point of order: we are here to examine the budget. There is a specific line in the budget about this matter.

The CHAIR: On which page, member for Kaurna?

Mr PICTON: It is Budget Paper 5, page 53, line 13, youth treatment orders. If you accept what the minister from the other place is suggesting, then this house is unable to examine this section of the budget, which I think is completely unacceptable for our role in examining the contents of the government's budget.

The CHAIR: Member for Kaurna, I uphold the point of order. Minister, youth treatment orders is in the budget, and parliament is not sitting as a committee stage of parliament. We are looking at the estimates budget process.

The Hon. S.G. WADE: I would make the point that the youth treatment orders funding in the budget papers is actually from the Attorney-General's Department.

Mr PICTON: So that does not provide you, in health, with the funding necessary to undertake any actual youth treatment for people.

The Hon. S.G. WADE: The funding for treatment will become clear as a model of care is developed.

Mr PICTON: Has that funding been allocated, or is that a further request that needs to be made?

The Hon. S.G. WADE: The only funding for youth treatment orders that has been allocated in this budget is what is shown on page 53.

Mr PICTON: Have you received any preliminary estimates about what funding is going to be required?

The Hon. S.G. WADE: The model of care working party is continuing to work through the model of care. Once that is settled, we will be able to get a better idea of the costs involved.

Ms LUETHEN: I refer to Budget Paper 4, Volume 3, page 22. Could the minister please provide advice on how the state government is working with our federal colleagues to deliver improved alcohol and other drug treatment services across South Australia?

The Hon. S.G. WADE: I thank the honourable member for her question. As part of our commitment to reducing alcohol and other drug harms, the state government continues to work collaboratively with our commonwealth colleagues and with states and territories to address and reduce supply, demand and harms under the National Drug Strategy 2017-2026 and its substrategies. Our strong partnership with our federal colleagues continues to pay dividends for all South Australians and demonstrates the benefits of a positive and respectful relationship with Canberra.

I particularly welcome the commonwealth government's $20 million investment in South Australian alcohol and other drugs sectors as part of the South Australian alcohol and other drug treatment grant opportunity. This funding is for 2018-19 to 2020, to support substance misuse treatment services in South Australia. In addition, the federal Minister for Health, the Hon. Greg Hunt, has announced a further $3 million in funding for alcohol and other drug treatment services in the South-East region of South Australia. South Australia is also one of only three jurisdictions to be included in the commonwealth's take-home Naloxone project pilot.

I will ask Marina Bowshall, the Executive Director of DASSA, to outline the organisations and communities that will benefit from some of these investments.

Ms BOWSHALL: Thank you, minister. There are nine organisations that have received funding from the Australian government as part of the $20 million package. The Aboriginal Drug and Alcohol Council has received funding for a set of outreach services and diversionary activities in Ceduna region, and the Aboriginal Health Council of South Australia has received funding for alcohol and other drugs sector, workforce development and capacity building across many regions of the state.

Baptist Care has received funding for a residential rehabilitation program for young people from across the state to access. Country and Outback Health Incorporated has received funding for outreach services, counselling and case management for the Mid North and Peterborough region. Mission Australia has received funding for a youth-focused case management, prevention and early intervention pilot for the Fleurieu Peninsula region, Murray Bridge and also for the Playford council region.

The Murray Mallee General Practice Network has received funding for counselling and case management in the Murray Bridge area. The South Australian Network of Drug and Alcohol Services has received funding for workforce development and capacity building for the training of the sector, again to support services across many regions of the state. Sonder has received funding from the Australian government for in-home withdrawal management for the Port Adelaide region and also for the Playford council region.

I should add that Drug and Alcohol Services was also fortunate to receive some funding through this initiative. We have received funding to pilot an assertive outreach program, and we are currently negotiating with the Southern Adelaide Local Health Network and also the Flinders and Upper North Local Health Network to establish those assertive outreach programs.

The focus is on accessing and supporting health services, GPs, justice and other sectors when they come across young people who are treatment resistant and need to be assertively managed and supported to access treatment services, and also supporting the families of those young people to give them access to the various support services and skills they need while they are going through that particularly difficult time with the young person in their family.

Mr BOYER: Minister, on Budget Paper 4, Volume 3, page 20, grants for suicide prevention, I want to ask about the Suicide Prevention Community Grant Scheme. The SA Health website states that the 2019-20 grant applications have closed and that the successful grant recipients were to be announced, I think, in June of this year, but I cannot find any mention of them on the SA Health website. Can you advise us of the recipients?

The Hon. S.G. WADE: I do not have that level of detail with me; I will take that on notice.

Mr BOYER: On the same budget line, minister, it is my understanding that Talk Out Loud were, for the first time in a number of years, unsuccessful for a grant that they had used in the past for conducting their empowerment camps for young people; is that true?

The Hon. S.G. WADE: I will need to take that on notice.

Mr BOYER: On the same budget line, who signs off on the suicide prevention community grants? Do you do that, or does the Chief Psychiatrist do that?

The Hon. S.G. WADE: Sorry, if you could ask the question, and we do not need multiple choice, we can answer the question.

Mr BOYER: Well, you have failed at that for most of the day today.

The Hon. S.G. WADE: To be frank, they are not the only two options.

The CHAIR: Order! Come on, we have been pretty good so far.

The Hon. S.G. WADE: Fortunately, I am not constrained by the multiple choice from the honourable member and I can give a completely different answer—

Mr BOYER: Just an answer would be fine.

The Hon. S.G. WADE: —that being that these grants are considered by a selection panel. In the 2018-19 financial year, the selection panel made a recommendation to the Chief Psychiatrist, which was then submitted to a deputy chief executive within the department. Under the new governance arrangements, the selection panel will make the recommendation to the Chief Psychiatrist and the Chief Psychiatrist will sign off on it.

Mr BOYER: Same budget line, minister: is the Chief Psychiatrist able to tell us if Talk Out Loud were successful or otherwise?

The Hon. S.G. WADE: I have no intention of allowing direct questioning. I am a witness. If the honourable member wants to ask me a question, feel free. If not, I am sure other members have questions.

The CHAIR: The member for Wright should know better than that.

Mr BOYER: Same budget line: minister, how many unsuccessful applications were there for funding in the 2019-20 community grants scheme?

The Hon. S.G. WADE: I will take that on notice.

Mr BOYER: On to Woodleigh House. Actually, I might ask some questions first about the establishment of a peer mental health workforce. This is Budget Paper 4, Volume 3, page 24, targets. I refer to the establishment of a peer mental health workforce cooperative model and embedded guidelines for the peer mental health workforce and ask: is this the mental health priority care centre that is going to be located in the CBD that you announced with Senator Birmingham in May this year?

The Hon. S.G. WADE: Could the member give us the page reference he is referring to?

Mr BOYER: Budget Paper 4, volume 3, page 24, targets.

The Hon. S.G. WADE: No, it is not.

Mr BOYER: Same budget line, then: when will the priority care centre you did announce with Senator Birmingham in May this year be operational?

The Hon. S.G. WADE: I appreciate that the terms might have had more clarity as we move forward, but as of today I am using the words 'priority care centres' for enhanced GP-type services in the community, and I am tending to talk about the federal funding relating to mental health urgent care centres.

I thank the honourable member for highlighting the commonwealth government's commitment to invest $14.7 million to establish a mental health urgent care centre in the Adelaide CBD. It is our view that this will help ease pressure on our hospital systems, including the Royal Adelaide Hospital emergency department. The investment will mean that many people with mental health conditions will be able to get the services they need without going to an emergency department. It is our expectation that the centre would be operational next year.

Mr BOYER: Same budget line: what was the state government's financial contribution to the establishment of that centre?

The Hon. S.G. WADE: The commonwealth and the state will have discussions about the final model of care and the capital costs and so forth, so those details will only be settled once those negotiations are finished.

Mr BOYER: Same budget line, Chair: minister, are you saying that you committed to this without knowing how much it would cost the state?

The Hon. S.G. WADE: The commonwealth government has made a commitment to invest $14.7 million. The Marshall Liberal government is going to partner with them to deliver a mental health urgent care centre. The full capital and recurrent costs will be subject to negotiation between the commonwealth and the state.

Mr BOYER: Same budget line, Chair: can you give us any indication of what the cost might be? Had you been furnished with any detail of what the cost might be before you partnered with Senator Birmingham and the federal government to deliver this?

The Hon. S.G. WADE: I have nothing to add to my answer.

Mr BOYER: You do not know?

The CHAIR: The minister has completed his answer.

Mr BOYER: I refer to Budget Paper 4, Volume 3, page 30, Sub-program 2.2: Northern Adelaide Local Health Network. Is the upgrade of Woodleigh House going ahead?

The Hon. S.G. WADE: There has been some capital investment in Woodleigh House the financial year that has just passed, and there will be further capital investment in the current financial year.

Mr BOYER: Same budget line, Chair: have the works that were tied to the capital investment you refer to that was set aside for the previous financial year commenced or been completed?

The Hon. S.G. WADE: No. Just to reiterate, I said there had been further capital works this financial year and to be doubly clear, the works that started last year are continuing this year.

Mr BOYER: Same budget line, Chair: when do you think that all those upgrades to Woodleigh House will be complete?

The Hon. S.G. WADE: I am happy to take that question on notice.

Mr PICTON: Same budget line, Chair: is the minister but also, particularly given his role under the act, the Chief Psychiatrist satisfied with the treatment at Woodleigh House currently and are there any conditions currently on the treatment under the Mental Health Act at Woodleigh House?

The Hon. S.G. WADE: There are limitations in place in relation to Woodleigh House.

Dr BRAYLEY: Following inspections last year, gazettal conditions were put in place either in late December or early January that are still in place. Those conditions that limit the acuity of patients who can be admitted to Woodleigh House will remain in place until current capital works that are underway are complete. There has also been work on clinical systems in Woodleigh House that NALHN have undertaken and, at times, a member of my staff. We had also arranged some input from a senior interstate psychiatrist who supported those works to develop clinical systems further at Woodleigh House.

Mr PICTON: To clarify, does that mean that, when the current capital works are underway, as just mentioned by the minister, the conditions that the Chief Psychiatrist has on Woodleigh House will be lifted?

The Hon. S.G. WADE: I stress to the committee that the need for improvement highlighted by the Chief Psychiatrist is not limited to capital works. By the time the capital works are completed, it is expected that that will meet the capital works elements of the Chief Psychiatrist's concerns. The other concerns are a matter for him.

Mr PICTON: Has there been any consideration by the government of moving the older persons' mental health unit from the Lyell McEwin Hospital to Modbury Hospital?

The Hon. S.G. WADE: There is the ongoing consideration of how we can best respond to older persons mental health services and needs, particularly considering that we are still dealing with the impact of the loss of 64 beds with the closure of the Oakden facility, only partly offset by beds made available at Northgate. Certainly, the Chief Psychiatrist's limitations placed on Woodleigh House indicate what we all know, which is that Woodleigh House is a very tired facility.

Mr PICTON: At what stage are those considerations about moving services from Lyell McEwin to Modbury Hospital for older persons mental health?

The Hon. S.G. WADE: I have nothing to add to my previous answer.

Mr PICTON: The minister was saying that obviously there is an issue in terms of capacity for older persons mental health. How would it help that capacity to move services from one hospital (i.e. Lyell McEwin where they are established) to another hospital in Modbury?

The Hon. S.G. WADE: It is a hypothetical question.

Mr PICTON: So it is not being considered by the government?

The Hon. S.G. WADE: I have nothing to add to my previous answer.

Mr PICTON: Is the government still committed to three different older persons mental health facilities?

The Hon. S.G. WADE: What we are focused on at the moment is reopening Ward 18. Work on that is progressing well. We have identified a preferred partner for the dementia village adjoining it. As I mentioned earlier, the outreach team will also be on the Repat Health Precinct. The work is continuing not just in relation to facilities, because I think we can often get overly focused on buildings and beds.

With the work in relation to aged-care service reform, in the context of the needs of people with dementia, it is not just going to be Ward 18, it is not just going to be the specialised dementia care unit that will be placed on that site and in partnership with the commonwealth government, it will not just be the cottage-style dementia village that we will be delivering in partnership with a non-government provider. We are very much looking forward to the impact of the rapid access service, which will provide specialist in-reach support into mainstream residential aged care.

One of the really important initiatives that the government has underway under this reform program is to work collaboratively with the aged-care sector to share innovation in continuing to provide high-quality person-centred care for people with dementia. There has been a lot of focus on the needs of people, in particular in tier 7, in terms of tier 7 behavioural and psychological symptoms of dementia. There has also been a lot of work done on tiers 5 and 6.

There is an increasing prevalence of dementia in our community at the same time that we are experiencing an increase in the ageing population, so we need to have a broad-based strategy to both strengthen residential aged-care facilities in dealing with their clients with BPSD as well as developing specialist services. We certainly are keen to build on the establishment of the 18-bed neurobehavioural unit at the Repat site and we will be looking at adding to that tier 7 bed stock as we are able.

The CHAIR: Sorry, gentlemen, time has expired. There being no further questions, I declare the examination of the proposed payments for the portfolio of SA Health, Mental Health and Substance Abuse and the estimated payment for the South Australian Mental Health Commission completed.

Departmental Advisers:

Dr C. McGowan, Chief Executive, Department for Health and Wellbeing.

Ms J. Walters, Acting Executive Director, Hospital Avoidance, Department for Health and Wellbeing.

Ms C. Mason, Acting Director, Office for Ageing Well, Department for Health and Wellbeing.

Mr J. Woolcock, Chief Finance Officer, Department for Health and Wellbeing.

Mr A. Knez, Manager, Executive Services and Projects, Department for Health and Wellbeing.

The CHAIR: The portfolio is Office for the Ageing, and the minister is the Minister for Health and Wellbeing. I declare the proposed payments open for examination and refer members to Agency Statements Volume 3, noting that this session will finish at 6.14pm. Who is reading the omnibus questions?

Mr PICTON: The member for Wright; he is very excited.

Mr BOYER: Thank you, Chair:

1. For each department and agency reporting to the minister:

What is the actual FTE count at 30 June 2019 and the projected actual FTE count for each year of the forward estimates?

What is the total employment cost for each year of the forward estimates?

What is the notional FTE job reduction target that has been agreed with Treasury for each year of the forward estimates?

Does the agency or department expect to meet the target in each year of the forward estimates?

How many TVSPs are estimated to be required to meet FTE reductions over the forward estimates?

2. Between 1 July 2018 and 30 June 2019, will the minister list the job title and total employment cost of each position with a total estimated cost of $100,000 or more which has either (1) been abolished and (2) which has been created.

3. Will the minister provide a detailed breakdown of expenditure on consultants and contractors above $10,000 between 1 July 2018 and 30 June 2019 for all departments and agencies reporting to the minister, listing:

the name of the consultant, contractor or service supplier;

cost;

work undertaken;

reason for engaging the contractor, and

method of appointment?

4. For each department and agency for which the minister has responsibility:

How many FTEs were employed to provide communication and promotion activities in 2018-19 and what was their employment expense?

How many FTEs are budgeted to provide communication and promotion activities in 2019-20, 2020-21, 2021-22 and 2022-23 and what is their estimated employment expense?

The total cost of government-paid advertising, including campaigns, across all mediums in 2018-19 and budgeted cost for 2019-20.

5. For each department and agency reporting to the minister, please provide a full itemised breakdown of attraction and retention allowances as well as non-salary benefits paid to public servants and contracts between 1 July 2018 and 30 June 2019.

6. What is the title and total employment cost of each individual staff member in the minister's office as at 30 June 2019, including all departmental employees seconded to ministerial offices?

7. For each department and agency reporting to the minister, could you detail:

(a) How much was spent on targeted voluntary separation packages in 2018-19?

(b) What department funded these TVSPs? (except for DTF Estimates)

(c) What number of TVSPs were funded?

(d) What is the budget for targeted voluntary separation packages for financial years included in the forward estimates (by year), and how are these packages funded?

(e) What is the breakdown per agency/branch of targeted voluntary separation packages for financial years included in the forward estimates (by year) by FTEs?

8. For each department and agency reporting to the minister, how many executive terminations have occurred since 1 July 2018 and what is the value of executive termination payments made?

9. For each department and agency reporting to the minister, what new executive appointments have been made since 1 July 2018, and what is the annual salary, and total employment cost for each position?

10. For each department and agency reporting to the minister, how many employees have been declared excess, how long has each employee been declared excess, and what is the salary of each excess employee?

11. In the 2018-19 financial year, for all departments and agencies reporting to the minister, what underspending on operating programs (1) was and (2) was not approved by cabinet for carryover expenditure in 2019-20?

12. In the 2018-19 financial year, for all departments and agencies reporting to the minister, what underspending on investing or capital projects or programs (1) was and (2) was not approved by cabinet for carryover expenditure in 2019-20? How was much sought and how much was approved?

13. For each grant program or fund the minister is responsible for please provide the following information for 2018-19, 2019-20, 2020-21 and 2021-22 financial years:

(a) Name of the program or fund;

(b) The purpose of the program or fund;

(c) Balance of the grant program or fund;

(d) Budgeted (or actual) expenditure from the program or fund;

(e) Budgeted (or actual) payments into the program or fund;

(f) Carryovers into or from the program or fund; and

(g) Details, including the value and beneficiary, of any commitments already made to be funded from the program or fund.

14. For the period of 1 July 2018 to 30 June 2019, provide a breakdown of all grants paid by the department/agency that report to the minister, including when the payment was made to the recipient, and when the grant agreement was signed by both parties.

15. For each year of the forward estimates, please provide the name and budgeted expenditure across the 2019-20, 2020-21, 2021-22 and 2022-23 financial years for each individual investing expenditure project administered by or on behalf of all departments and agencies reporting to the minister.

16. For each year of the forward estimates, please provide the name and budget for each individual program administered by or on behalf of all departments and agencies reporting to the minister.

17. For each department and agency reporting to the minister, what is the total cost of machinery of government changes since 1 July 2018 and please provide a breakdown of those costs?

18. For each department and agency reporting to the minister, what new sections of your department or agency have been established since 1 July 2018 and what is their purpose?

19. For each department and agency reporting to the minister:

What savings targets have been set for each year of the forward estimates?

What measures are you implementing to meet your savings target?

What is the estimated FTE impact of these measures?

The CHAIR: Minister, would you like to introduce your advisers for the record, please?

The Hon. S.G. WADE: Yes, I would. I would like to introduce Dr Chris McGowan, the Chief Executive of the Department for Health and Wellbeing, and Ms Jeanette Walters, Acting Executive Director of Hospital Avoidance. Also with me are Cassie Mason, the Acting Director of the Office for Ageing Well; Mr Andrej Knez, the Manager of Executive Services and Projects; and Mr Jamin Woolcock, the Chief Finance Officer of the Department for Health and Wellbeing.

The CHAIR: Thank you, minister. Member for Kaurna.

Mr PICTON: Thank you very much. I would like to commend the member for Wright for his excellent reading out of that and taking one for the team.

The Hon. S.G. WADE: Without taking a breath.

Mr PICTON: That is right. There has to be a better way, surely. I refer to Budget Paper 4, Volume 3, page 25, health services. Has the minister received the audit report into state-run aged-care facilities?

The Hon. S.G. WADE: No, I have not.

Mr PICTON: Has the department received that report?

The Hon. S.G. WADE: My understanding is that they have.

Mr PICTON: When was that report received by the department?

The Hon. S.G. WADE: I will take that on notice.

Mr PICTON: Will the government be accepting all recommendations contained in the report that the department has received?

The Hon. S.G. WADE: As I said, I have not received the report. Once I have received a briefing from the department on the report, I will consider both any recommendations in the report and the department's advice on those recommendations.

Mr PICTON: Given the importance of this issue, will you be asking the department for an urgent briefing on the report that they have received?

The Hon. S.G. WADE: I do find it somewhat galling that a member of the former government would—

Mr PICTON: I did not ask if you found it galling.

The CHAIR: Order!

The Hon. S.G. WADE: —assert to me the urgency of this matter. This government went to the election committing to do an audit of facilities that are not audited or accredited under the commonwealth residential aged-care facilities arrangements. Not only did we deliver on that commitment in government but we also broadened the scope of that audit to include an audit of facilities that are also audited by the commonwealth.

We addressed a major gap in the quality assurance framework of the previous government and, if you like, took the opportunity to test the quality of our facilities that were already being accredited under the commonwealth regimes. We are determined that we will raise the standards in terms of aged-care quality and safety.

Mr PICTON: How many state-run aged-care facilities have failed to meet accreditation standards over the past year?

The Hon. S.G. WADE: I will offer preliminary advice, but take on notice and correct the information if I need to. My understanding is that there were six sites that had advice from the accreditation agency that there were standards not met. One of those sites had two elements to the one site, but my understanding is that only one site received a sanctions notice. But, as I said, I will take on notice to confirm that.

Mr PICTON: What are the names of those six sites?

The Hon. S.G. WADE: Renmark Nursing Home, the Ira Parker Nursing Home, Melaleuca Court Nursing Home, Loxton nursing home, Riverton aged care and Bonney Lodge.

Mr PICTON: Has action now been taken to address those standards, and are they all now meeting accreditation?

The Hon. S.G. WADE: Each of them are at different stages in the process.

Mr PICTON: That is the answer?

The Hon. S.G. WADE: Yes.

Mr PICTON: Which ones have not actually implemented changes to address their accreditation issues?

The Hon. S.G. WADE: Following an unannounced assessment visit on 7 November 2018, the Renmark Nursing Home received advice that they were two not met outcomes. An action plan was developed and a revised plan for continuous improvement was submitted to the Australian government compliance centre. On 8 February 2019, the commission determined that all improvements had been completed and no further action was required.

In relation to the Ira Parker Nursing Home at Balaklava, the nursing home was issued with a notice on 21 February 2019. On 20 March 2019, the nursing home received advice that it had 19 not met outcomes and a sanctions notice was issued for a period of six months. Immediate corrective actions were undertaken, including the appointment of an administrator and a nurse adviser and regular meetings with the Australian government compliance branch. The Ira Parker Nursing Home received the commission audit report on 11 June 2019. The report noted that the initial 19 not met outcomes had now been met in terms of requirements under the standards.

This report requires review by the compliance branch and they will confirm the next steps for the Yorke and Northern Local Health Network. A meeting with the compliance branch was held on 24 June. Following the meeting, the compliance branch informally advised the Yorke and Northern Local Health Network that they can now apply for the sanctions to be lifted. The Yorke and Northern Local Health Network will now undertake this work.

In relation to Melaleuca Court, on 28 and 29 May 2019 the commission conducted a site visit. The audit report was received on 5 June and two not met outcomes were identified. The report highlighted two recommendations that required a response from Yorke and Northern Local Health Network. In relation to the Loxton nursing home, it underwent a full accreditation audit on 6 May to 8 May 2019. The audit reported noted six outcomes not met. The audit report is available on the website.

The site provided a response to the audit report. A decision was received on 13 June 2019, with the outcome being re-accreditation for two years until July 2022; however, the site has a timetable for improvement until 9 September 2019 to ensure that all 44 outcomes are fully met. The site currently meets 38 of 44 outcomes and a review will occur in September.

In relation to the Riverton aged-care facility, an unannounced visit was undertaken by the commission on 15 May 2019. The audit report highlighted one not met standard. The report is not yet publicly available. The commission determines when reports are published. The site provided a response to the audit report, and the commission referred the audit report to the aged-care compliance centre within the department for risk assessment and action. The compliance centre conducted a risk assessment and found that the risk to care recipients at the service was low, as the evidence from the commission did not identify current risk to care recipients and Riverton had commenced a comprehensive review in order to create a plan to address the noncompliance that mitigated any potential risk to care recipients.

In relation to Bonney Lodge Hostel at Barmera, it underwent a full accreditation visit from 25 to 28 June 2019. The report highlighted 21 not met outcomes. The facility has until 1 August 2019 to provide a full response for each outcome to the Aged Care Quality and Safety Commission. Hawdon House nursing home, which is also at Barmera, which I understand is co-located, underwent a full accreditation visit on 25 to 28 June 2019, and that audit report also highlighted 21 not met outcomes; likewise, that facility has until 1 August to provide a full response to the commission.

Mr PICTON: Can the minister advise whether the government has any plans to outsource any of the government-run aged-care facilities?

The Hon. S.G. WADE: There are no current plans for changes in the delivery of residential aged-care services in country South Australia.

Mr PICTON: Can you rule out any plans to outsource—

The Hon. S.G. WADE: That sounds like a hypothetical question to me.

Mr PICTON: What has been the government's rollout of the flu vaccine this year in state-run aged-care facilities?

The Hon. S.G. WADE: My understanding is that it is the practice of the department to offer residents of state-run residential aged-care facilities the flu vaccination and that that occurred this year.

Mr PICTON: Do you know when that occurred this year?

The Hon. S.G. WADE: I will take that on notice.

Mr PICTON: Were any state-run aged-care facilities put in lockdown because of influenza outbreaks within the facilities this year?

The Hon. S.G. WADE: I will have to take that on notice. We have the Office for Ageing Well with us, not the public health division.

Mr PICTON: Has there been any investigation into the over-reliance of sedatives in aged-care facilities in South Australia?

The Hon. S.G. WADE: The honourable member is asking a general question. That issue in that context is part of the regulatory oversight of the commonwealth in terms of residential aged-care facilities.

Mr PICTON: So it is not something, even within the state-run aged-care facilities, that the government is looking at?

The Hon. S.G. WADE: I thought the honourable member was asking generally. We always strive to maintain and improve the quality and safety of our facilities. I am sure that, through the accreditation processes that I have just outlined for the honourable member, issues such as the appropriate use of medication would be under constant review.

Mr PICTON: When the minister visited Ira Parker Nursing Home on 27 March this year, was he aware that sanctions had been put in place in terms of that aged-care facility?

The Hon. S.G. WADE: I will take that on notice. I certainly was aware that accreditation issues had been raised.

Mr PICTON: Given the minister's commitment before the election to always be open and transparent about failures within the health system, if he knew of it then why was it only days later that news emerged—

Ms LUETHEN: Point of order.

The ACTING CHAIR (Dr Harvey): Member for King, point of order.

Ms LUETHEN: I was wondering whether the member can indicate the budget reference line he is referring to.

The ACTING CHAIR (Dr Harvey): Member for Kaurna, are you able to reference the budget line?

Mr PICTON: Yes: Budget Paper 4, Volume 3, page 25, health services.

The Hon. S.G. WADE: I will certainly take the details on notice. In relation to the management of not met outcomes and sanctions, Country Health SA works with the commonwealth so that, in an orderly way, the patients and their families can be advised. We will continue to do that because the welfare and care of those residents and their families is our top concern.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 22, Sub-program 1.4: Corporate and System Support Services, which is where, I believe, OFTA, or whatever the acronym is now, sits. Given the minister has raised concerns in the parliament regarding Lifestyle SA retirement villages and a dispute with residents around food and alcohol services, what has OFTA done to end the dispute between residents and Lifestyle SA?

The Hon. S.G. WADE: I have discussed these issues with the Attorney-General. It is my understanding that a licence is not required to sell liquor at a retirement village by the committee association or operator. The intention of the liquor licensing laws is to regulate the location of the sale and consumption of liquor and to ensure that liquor is not sold to or by minors. A residents' committee, the operator or a resident can sell liquor within the village without requiring a licence.

I am advised that residents' committees will be able to operate the bar and run events in their villages going forward. I am advised that Lifestyle SA is currently working on operational guidelines for functions in the villages, including the sale of alcohol, where any profits are to be used for the benefit of the residents of the village. In the meantime, it is business as usual, with residents' committees continuing to operate the bar and hold functions.

Mr PICTON: Has the minister met with residents regarding their concerns on this matter?

The Hon. S.G. WADE: I have certainly met with residents' representatives and, I suppose in that sense, I have met with residents, yes.

The ACTING CHAIR (Dr Harvey): The member for King is seeking the call.

Ms LUETHEN: I refer to Budget Paper 4, Volume 3, page 19. How is the government improving the customer service experience for older South Australians accessing government services?

The Hon. S.G. WADE: I thank the honourable member for her question. Creating an age-friendly South Australia is a critical element to ensure that older South Australians feel valued and can participate in all aspects of life, including into old age. The government is committed to supporting South Australians to age well and identify opportunities to combat ageism, including challenging the way that ageing is framed in the language and structure of the services our government delivers.

We want to ensure that government customer service settings provide a quality customer experience for older South Australians. I am very pleased that in 2018-19 the government, through the Office for Ageing Well, allocated $15,000 to deliver the age-friendly customer services rollout project across South Australian government customer service settings. I will ask Ms Walters to provide more information about this important project.

Ms WALTERS: The age-friendly customer services rollout project aims to improve the customer experiences of older people who access a range of government services, supporting older people to feel valued, listened to and respected when accessing government services. To develop the project the Office for Ageing Well worked with a group of seven older volunteer age-friendly advisors and staff from a range of customer-facing areas across the South Australian government on an age-friendly customer services pilot project in 2018. This has informed the larger scale rollout project.

The age-friendly advisors discussed their own experiences when accessing government services, as well as the experiences of their peers, and described their age-friendly customer service ideals. They told us they want government services that respond to the diversity of their needs and interests, are easily accessible, treat them with dignity and respect, encourage their participation in service design and review, and are supported to be age-friendly.

The Office for Ageing Well used these priorities and the South Australian Charter of the Rights and Freedoms of Older People to develop and test a suite of age-friendly customer service guidelines and resources. To ensure their relevance across a range of customer service settings, key South Australian government stakeholders helped co-design and test the guidelines and resources, including within SA Health in the Royal Adelaide Safety and Quality Unit, the Central Adelaide Aged Care Assessment Team, the Office for Ageing Well, the South Australia Police, the Public Library Network, Service SA, Housing SA in the Adelaide and Marion offices, the Women's Information Service, the Public Trustee, and the Justice of the Peace service.

Mr PICTON: In relation to Budget Paper 4, Volume 3, page 25, health services, does the government track the number of people waiting to be assessed for home care packages? If so, do you have the updated figures on how many South Australians are waiting?

The Hon. S.G. WADE: That is commonwealth data. It is released from time to time. We do not have the latest figures, but I am happy to take that on notice.

Mr PICTON: Have any concerns been raised with you or the Office for Ageing Well about South Australia not getting its fair share of home care packages in South Australia?

The Hon. S.G. WADE: Yes, indeed there have been. I should say that we want to acknowledge the commonwealth investment in home care packages. Earlier this year, a commitment to another 20,000 home care packages was made by the commonwealth. However, I am concerned that the data indicates that older South Australians are not getting an equitable share of the available home care packages.

South Australia has 8 per cent of Australia's population aged over 65 yet only 6.4 per cent of new home care entries were South Australian. This is a reduction from 7.7 per cent in 2018. One of our concerns is that South Australia may be suffering because of our attempt to respect the commonwealth performance expectations on Aged Care Assessment Teams. Because of my concerns I have written to my federal colleague on that issue.

The ACTING CHAIR (Dr Harvey): The time for questions has expired I am sorry, member for Kaurna. There being no further questions, I declare the examination of the proposed payments for the portfolio of the Office for Ageing Well and the estimate of payments for the Department for Health and Wellbeing completed.

At 18:15 the committee adjourned to Monday 29 July 2019 at 13:00.