Department for Health and Wellbeing, $5,413,286,000

Commission on Excellence and Innovation in Health, $5,930,000

Wellbeing SA, $16,772,000

Membership:

Mr Picton substituted for Ms Hildyard.

Mr Brown substituted for Ms Wortley.

Ms Luethen substituted for Mr Whetstone.

Minister:

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

Departmental Advisers:

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

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

Mr D. Frater, Deputy Chief Executive, Department for Health and Wellbeing.

Ms J. TePohe, Deputy Chief Executive, Department for Health and Wellbeing.

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

Mr J. Logie, Executive Director, Corporate Communications, Department for Health and Wellbeing.

Mr J. Woolcock, Executive Director, Finance, Department for Health and Wellbeing.

The CHAIR: Welcome to Estimates Committee B. The estimates committees are a relatively informal process 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 on 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 the timetable for today's proceedings, previously distributed, is accurate?

The Hon. S.G. WADE: Yes.

Mr PICTON: Only in the sense that we do not have any choice in the matter, but apart from that, yes.

The CHAIR: I will take that as a yes. 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 24 September 2021.

I propose to allow both 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 for asking questions. A member who is not a member of the committee may ask a question at the discretion of the Chair. All questions are to be directed to the minister, not to the minister's advisers. The minister may refer questions to advisers for a response.

Questions must be based on the lines of expenditure in the budget papers and must be identified and/or referenced. Members unable to complete their questions during the proceedings may submit them as questions on notice for inclusion in the assembly Notice Paper. I remind members that the rules of debate in the house apply in committee. Consistent with the rules of the house, photography by members from the chamber floor is not permitted while the committee is sitting.

Ministers and members may not table documents before the committee. However, documents can be supplied to the Chair for distribution. 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. The committee's examinations will be broadcast in the same manner as sittings of the house are broadcast 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.

The proposed payments to be examined during this session relate to the portfolio of SA Health. The minister appearing today is the Minister for Health and Wellbeing. I declare the proposed payments open for examination. I call the minister to make an opening statement, if he wishes, and to introduce his advisers.

The Hon. S.G. WADE: I would like to introduce my department executive to the committee, Dr Chris McGowan, Chief Executive, Department for Health and Wellbeing; deputy chief executives of the department, Ms Lynne Cowan, Mr Don Frater and Ms Julienne TePohe; Mr Jamin Woolcock, the chief financial officer; and Mr Brendan Hewitt, the executive director for Infrastructure.

Since I was before the committee in November last year, South Australia has continued to do remarkably well in response to the COVID-19 pandemic. However, the events of this month have shown that COVID-19 continues to present a real and present threat to the public health and wellbeing of the South Australian community. I thank South Australians for their efforts in following the public health advice so we could get through the Modbury cluster without an extended lockdown. Of course, we are still within the incubation cycle, so it is important that we all continue to make ourselves aware of the current restrictions and comply with them, in particular for those in quarantine to remain in quarantine and for those who have testing requirements to fulfil them.

This year has also seen us commence the biggest ever peacetime operation with the rollout of the COVID-19 vaccine, commencing late February. Soon after we launched the Pfizer vaccines at the Royal Adelaide Hospital, the nation watched as Dr Caroline Phegan was the first person in the country to receive the AstraZeneca vaccination at the Murray Bridge Soldiers' Memorial Hospital. SA Health has continued to lead the way with a vaccination rollout with our rate of vaccination consistently being above the national average.

We have also continued to demonstrate the innovation that helped keep us safe earlier in the pandemic. The Wayville mass vaccination clinic was the first dual clinic in Australia, both offering Pfizer and AstraZeneca in one facility. We have progressively boosted vaccination capabilities across the state, while recalibrating and pivoting the program in line with ATAGI advice. To date more than 830,000 vaccinations have been administered in South Australia as part of our rollout.

The pandemic response in keeping South Australians safe has been of the utmost priority for SA Health over the past 18 months. At the same time, the health system has continued to provide invaluable services to the people of South Australia. We have not lost sight of our commitment to improving the health system. Health and wellbeing touches everyone, and we recognise the importance of delivering a healthcare system that is focused on prevention and out-of-care options, such as My Home Hospital and our priority care centres.

We are delivering on our promise to build a new Women's and Children's Hospital for all South Australians. The $1.95 billion facility, with 500 treatment spaces, is an increase of 13 per cent on the current hospital, with a capacity to treat approximately 21,000 additional patients in a year. The recent release of the master plan has outlined our unwavering commitment to building a hospital of which all South Australians can be proud. The hospital is only a part of our record investment across our metropolitan and regional hospitals to improve patient flow and stop ramping. There are now more doctors, nurses, midwives and ambulance officers in South Australia's public health system than ever before in the state's history.

Our record $7.4 billion spend in this year's budget is ensuring the delivery of better health outcomes in the short, medium and longer term for all South Australians. The investment is almost $900 million more than was spent in the final year of the former government and builds capacity in our hospitals and health services, keeps our state safe and strong through the pandemic and supports a better health system for all South Australians.

I conclude my remarks by once again paying tribute to the staff of SA Health. These health professionals work tirelessly. They give their time to ensure South Australians stay safe and receive quality treatment and to delivering innovative solutions to health care. As the pandemic has demonstrated, South Australia is at the forefront of health care. We would not be in such a position without the ongoing commitment and dedication of the doctors, nurses, midwives, paramedics, allied health professionals, pathologists and other staff right across the system.

Ms LUETHEN: Point of order, Chair.

The CHAIR: Point of order, member for King.

Ms LUETHEN: I thank the minister for his opening update. I would like to call a point of order: in your opening, Chair, you talked about the rules of debate of the house applying in here. One of those rules of debate in our normal sitting is that props are not allowed. I take offence to the labels directed to the video camera in front of the member for Kaurna and ask that he turn these labels away from the video, or otherwise allow us to have a label up that says, 'Disastrous Transforming Health'.

Members interjecting:

The CHAIR: Members! There is precedence that if there is a public display that public display be removed from the chamber. Member for Kaurna, from my position I cannot see the offending material, but if you are happy to move those folders it would be much appreciated. Lead speaker for the opposition, did you wish to make an opening statement?

Mr PICTON: Thank you very much, Chair. The government is really focused on the big issues, as always. Firstly, I would like to thank all the frontline health workers in this state, both the people who work in our public health teams, Professor Spurrier and everybody in her teams, for the amazing work they have done to keep South Australia safe, but also everybody in our hospitals, our community health services and our Ambulance Service, those frontline heroes, for the work they have done in very trying circumstances over the past year since we last met.

The CHAIR: With the completion of opening statements, I call the member for Kaurna.

Mr PICTON: My question is to the minister, in relation to Budget Paper 4, Volume 3, page 60, SA Ambulance Service. The minister has previously revealed that in April there was a record 2,281 hours of delays for ambulances, otherwise known as 'ramping hours' or 'transfer of care delay hours'. What were the equivalent figures for May and June this year?

The Hon. S.G. WADE: I do not have those figures.

Mr PICTON: Why do you not have those figures?

The Hon. S.G. WADE: The data the honourable member is referring to is issued by the South Australian Ambulance Service. The data is not published on a regular basis. It was not published on a regular basis under the former government or under this government.

Mr PICTON: But you released that data yourself in May for, I believe, February, March and April. So why do you not have access to that data for May and June this year?

The Hon. S.G. WADE: The honourable member's question validates my answer. The fact that in May, which I think the honourable member refers to, there were three months' data released highlights the fact that the periodic data is not released on a regular basis. In that context, I would like to make the point to the committee that this data is no secret.

Mr PICTON: Release it then.

The Hon. S.G. WADE: This data is reflected on a day-in day-out basis by real-time data on at least two SA Health dashboards, which indicate both the state of the emergency departments and also the waiting time for ambulances. This government has never denied that there is increased pressure on our emergency departments and increased hours lost in transfer of care in the first half of this year. In that regard we are not unique. Right around Australia there has been increased pressure on our emergency departments, particularly related to higher acuity cases. As I said, periodic data has not been regularly published by the former government or by this government.

Mr PICTON: Could you ask any of your advisers here today whether they have that data?

The CHAIR: Member for Kaurna, sorry: I have just been alerted to the fact that the display is still within view of the camera, so if you could please remove the display.

Mr PICTON: The big issues. Minister, can you ask whether any of your advisers have this information available today?

The Hon. S.G. WADE: I am the only witness here. I have already given an answer to the honourable member.

Mr PICTON: Minister, can you commit—

The CHAIR: Member for Kaurna, you will wait for the call before proceeding.

Mr PICTON: Minister, can you commit to coming back to the committee before the end of the day with that data?

The Hon. S.G. WADE: No.

Mr PICTON: Minister, when will that information be released?

The Hon. S.G. WADE: I am happy to approach SAAS and inquire as to when that data will be released. Considering the honourable member's interest, I imagine it will be released shortly.

Mr PICTON: Minister, do you believe that the public has a right to know this information?

The Hon. S.G. WADE: As I have already indicated, this is a very transparent issue. We have daily data, hourly data, minute—in fact, minute by minute might not be true; I think the Ambulance Service dashboard is only refreshed every seven minutes—so people have very good line of sight about the performance of our emergency departments and ambulance ramping. Certainly, the data in relation to monthly data is released from time to time. I am more than happy to let the South Australian Ambulance Service know the member for Kaurna would be interested in a copy.

Mr PICTON: Minister, have you yourself released that data on a number of occasions over the past two years?

The Hon. S.G. WADE: With all due respect, I do not publish the data. I have a day job. The honourable member would—

Mr PICTON: You put out media releases with the data.

The Hon. S.G. WADE: The honourable—

The CHAIR: The member for Kaurna! Minister, if you could just pause your answer. In this chamber, member for Kaurna, we have had a very cordial debate through the estimates process. When questions have been asked, they have been given in silence; when answers are being given by the minister, they will be given in silence.

The Hon. S.G. WADE: As I said, I am more than happy to pass on the request of the honourable member, and I am sure that data will be released shortly.

Mr PICTON: Are you going to take it on notice at least?

The CHAIR: Member for Kaurna, you will wait for the call.

The Hon. S.G. WADE: The honourable member has my answer, which is that I will pass on the request to SAAS. I have no doubt that it will be released shortly.

Mr PICTON: What is the breakdown of the transfer of care delays over the past financial year by hospital?

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

Mr PICTON: Is it correct that yesterday afternoon a mental health patient required an ambulance at 3.20pm; however, the ambulance did not arrive until 13 hours later, at 4.04am this morning? Do you believe that is acceptable?

The Hon. S.G. WADE: The fact that mental health patients endure inappropriately long delays in care, whether that is ambulance responses or within the EDs, is a reason why this government is investing in innovative solutions to provide better care for people with mental health challenges.

In relation to the transfer to hospital stage of the journey, one of our key investments has been in mental health co-responders, where a qualified paramedic is working with a qualified mental health clinician in a dual discipline response, responding to what is identified as a potential mental health pick-up. That has been a very welcome improvement in the transfer of care for people accessing the Ambulance Service.

Another key initiative in terms of delivering more timely and appropriate urgent mental health care support has been the Urgent Mental Health Care Centre, Australia's first adult mental health centre, a centre which has been so successful since it was opened in March that we have already, through the most recent budget, extended it to a 24-hour service. So of course the government is determined to bring down the waiting times for mental health patients to get the care they need, and we are investing to deliver that improved outcome.

Mr PICTON: So why did all of that fail—

The CHAIR: Member for Kaurna, you will wait to be given the call.

Mr PICTON: So why did all that fail the patient last night who waited 13 hours for an ambulance?

The Hon. S.G. WADE: I do not know the circumstances of the case to which the honourable member refers.

Mr PICTON: Is it correct that on Wednesday an ambulance call for a suspected stroke at Seaford Rise was responded to from an ambulance that had to come all the way from Fulham Gardens, a 38-kilometre drive away?

The Hon. S.G. WADE: I am not aware of the case to which the honourable member refers.

Mr PICTON: What do you have to say to people in the southern suburbs who are nervous in terms of the fact that ambulances are having to come from the other side of town to respond to their cases?

The Hon. S.G. WADE: I think the honourable citizens of the southern suburbs are well aware of the havoc caused by the former Labor government's Transforming Health. They saw the Noarlunga Hospital—

Mr PICTON: Point of order: this is debate.

The Hon. S.G. WADE: —downgraded.

The CHAIR: Member for Kaurna, the question asked was the minister's opinion. That is a very wideranging question; the minister is entitled to provide a wideranging answer—

Members interjecting:

The CHAIR: —and he will be heard in silence, member for Hurtle Vale.

The Hon. S.G. WADE: When I talk to the people of the southern suburbs, which I do often, they have not forgotten. They have not forgotten that a so-called assistant minister for health stood by, as did the member for Hurtle Vale, while their government trashed these services in the southern suburbs through Transforming Health. They downgraded the Noarlunga Hospital, which put added pressure on the Flinders Medical Centre, which was already—

Members interjecting:

The CHAIR: Members!

The Hon. S.G. WADE: —under pressure.

The CHAIR: Minister, please stop there. Members on my left, the member for Kaurna, in asking his questions, has been heard in silence. The minister's response and answer to that question—

Mr PICTON: Point of order, Chair.

The CHAIR: I am not taking a point of order on relevance.

Mr PICTON: Point of order for debate.

The CHAIR: The question was wideranging, asking the opinion of the minister.

Mr PICTON: Point of order for debate. When you start talking about the opposition, that is debate. That is the precedence of the house.

The CHAIR: There is no point of order.

The Hon. S.G. WADE: So what would the citizens of the southern suburbs think?

Mr PICTON: An ambulance is coming from Fulham Gardens.

The Hon. S.G. WADE: They would think that they have elected a government—

Mr PICTON: An ambulance is coming from Fulham Gardens.

The CHAIR: Members! So far today, this debate has been entirely respectful through this process in this chamber. That will continue.

Mr PICTON: Why do you not tell the minister that?

The CHAIR: Members will remain silent while the minister is providing his answer.

The Hon. S.G. WADE: I appreciate the embarrassment of the honourable members on the opposition benches, but let me assure you that this government is addressing the concerns of the citizens of the southern suburbs.

Mr PICTON: You do not even know what the ramping figure is.

The Hon. S.G. WADE: This government is undoing the damage of Transforming Health. We are doing that in particular through the Southern Health Expansion Plan, which is investing $86 million. In particular, that plan is focused on easing the pressure on the emergency departments and stopping ambulance ramping. The Flinders Medical Centre is our busiest emergency department and through that plan it will become our biggest, with up to 30 more treatment bays.

In terms of reactivating the Repat, which is another part of the Southern Health Expansion Plan, we are undoing the damage of Transforming Health, which put added pressure on the Flinders Medical Centre and on Noarlunga when that facility closed. We are also undoing the damage of Transforming Health by enhancing the clinical capacity at Noarlunga. A new 24-bed general medical ward was established at Noarlunga in late 2020.

I am sure the citizens of the southern suburbs are just as keen as I am to see the Southern Health Expansion Plan being completed. My understanding is that the final steps in the Flinders Medical Centre works are just across the horizon, but we look forward to a significant strengthening of the southern health services, which were degraded by the previous government.

Mr PICTON: How many cases involving SA Ambulance are currently being investigated by the Coroner?

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

Mr PICTON: Have there been any deaths associated with ramping or ambulance delays in the past financial year, and, if so, how many?

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

Mr PICTON: How many Safety Learning System reports were made about ramping in the past financial year?

The Hon. S.G. WADE: I am not willing to take that on notice because that term 'ramping'—there could be numerous cases where there are issues in relation to the delay of care. I am happy to seek a response from SAAS in relation to that question, but to claim that SAAS could, without an inappropriate diversion of resources, identify every case where ramping or transfer of care delays may have been a factor, I think would be an inappropriate diversion of resources.

Mr PICTON: Only because there are so many. Can you confirm that in the past financial year the budget papers reflect that only 69 per cent of category 2 SA Ambulance cases which involve lights and sirens were seen on time, and is that the worst figure in the state's history?

The Hon. S.G. WADE: The honourable member raises an interesting matter. There was a deterioration in priority 2 response times in the last financial year, but one of the factors in that, in my view, is the archaic rosters that the Ambulance Service works within.

Mr PICTON: It is the paramedics' fault.

Mr Brown interjecting:

The CHAIR: Member for Playford!

The Hon. S.G. WADE: Roster reform is all about ensuring that more ambulances are available to respond to calls for assistance when we need them and, over time, give us better access to data that truly reflects SAAS's response times. At the moment, SAAS is unable to dispatch an ambulance to a priority 3 case in the last hour of a paramedic's shift. That is a part of the industrial arrangements under which SAAS operates. This leads to a build-up of overdue priority 3s and priority 4s at particular times of the day.

In some cases SAAS may decide that they need to upgrade the case—in other words, reprioritise it—so that an ambulance can be dispatched. When that happens a patient, who SAAS believes is a priority 3 and who has been waiting let's say an hour while more pressing cases are attended to, is reclassified as a priority 2. When that happens they have already been waiting a significant amount of time. In the case that I have just used of an hour, that is clearly going to be above the response time for a priority 2, which is a 16-minute target. So I believe there is reason to believe that the deterioration in the KPI performance may well be related to the roster reforms.

We, as a government, are determined to reform the rosters. It does not help ambulance paramedics and it does not help the patient to have such a preponderance of shift changeovers at the same time of the day. Two-thirds of our metropolitan day crews are attempting to finish work at the time that demand is often high and increasing and that will contribute to delays in response times.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 28, CALHN. On 17 May 2021, a CALHN spokesperson advised of a document prepared for CALHN by KordaMentha to consider various opportunities for savings. This has been referred to as the tranche 2 report. Has the minister been briefed on this report, has he or his office been provided with a copy of this report, and has he read this report?

The Hon. S.G. WADE: The report has certainly not been given to me, but the honourable member's question is very broad and I will need to take it on notice because the honourable member refers to my office and there are a number of people in my office.

Mr PICTON: But just from your perspective, you have not seen the report or been briefed on the report.

The Hon. S.G. WADE: I have not seen the report, no. If it is the one that the honourable member described as 'secret plans to axe doctors, nurses from Adelaide hospitals', the same report that he put his leader in the position of having to make a public retraction, no.

Mr PICTON: When will this report be released?

The Hon. S.G. WADE: My understanding is that the report that the honourable member refers to is an internal working document of a local health network.

Mr PICTON: Has the chief executive of the Department for Health and Wellbeing seen or been briefed on the report?

The Hon. S.G. WADE: I have no idea.

Mr PICTON: Can you ask him? He is right next to you.

The Hon. S.G. WADE: I am the witness and I have given my answer.

The CHAIR: Member for Kaurna, you need to wait for the call, as you are well aware.

Mr PICTON: Does this report recommend any budget cuts or savings?

The Hon. S.G. WADE: As I said, I have not seen the report.

Mr PICTON: What does the report that has been produced by Gloria Wallace from the HardyGroup for CALHN refer to?

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

Mr PICTON: This is the first question I have asked about this.

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

Mr PICTON: Have you been made aware—

The CHAIR: Member for Kaurna, you will wait to be given the call.

Mr PICTON: Have you been briefed in relation to a report from Gloria Wallace from the HardyGroup in relation to CALHN?

The Hon. S.G. WADE: I do not know the report to which the honourable member refers.

Mr PICTON: How much was Gloria Wallace paid, or the HardyGroup paid, in relation to the report for CALHN?

The Hon. S.G. WADE: As I said, I am not aware of being aware of that report. I have nothing to add to my previous answer.

Mr PICTON: Will you take it on notice?

The Hon. S.G. WADE: No.

Mr PICTON: Such transparency.

The CHAIR: Member for Kaurna, off-the-cuff comments are not necessary. Please refrain from making them. I give you the call to ask a question of the minister.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 13, workforce summary. What was the total number of redundancies offered and accepted via voluntary separation packages last financial year across the department and all local health networks?

The Hon. S.G. WADE: Would the honourable member mind repeating his question?

Mr PICTON: What was the total number of redundancies offered and accepted via voluntary separation packages across the department and all local health networks last financial year?

The Hon. S.G. WADE: I do not have information as to the number offered, but I do have information as to the number accepted. This is last financial year, 2020-21?

Mr PICTON: Yes.

The Hon. S.G. WADE: And it was in relation to the department and each of the local health networks?

Mr PICTON: Yes.

The Hon. S.G. WADE: I am advised that during the 2021 financial year, to June 2021, a total of 93 separation packages were accepted. I remind the committee that SA Health in its broader sense has more than 44,000 employees. In terms of the Department for Health and Wellbeing, 27 separation packages were accepted; in relation to SALHN, 14; in relation to the Northern Adelaide Local Health Network, 22; and in relation to the Central Adelaide Local Health Network, 24. In relation to the Barossa Hills Fleurieu Local Health Network, there were five, and in relation to the Riverland Mallee Coorong Local Health Network, there was one.

Mr PICTON: How many of those were nursing or midwifery staff?

The Hon. S.G. WADE: I do not have the numbers broken down by profession within entities, but across all of those entities, 13 of the 93 were either nurses or midwives.

Mr PICTON: Which local health networks have open offers for further voluntary separation packages?

The Hon. S.G. WADE: I do not know the answer to that question.

Mr PICTON: What was the total amount spent on voluntary separation packages for each of the past two financial years?

The Hon. S.G. WADE: I do not have the answer to that question.

Mr PICTON: Can you take it on notice?

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

Mr PICTON: I refer to Budget Paper 5, page 43, the COVID vaccine rollout. For the most recent figures that you have available, what percentage of medi-hotel private security guards have been vaccinated with two doses?

The Hon. S.G. WADE: I have a broad number. In other words, there are almost a thousand people who currently work in the medi-hotel pathway. I am advised that 83 per cent of those are fully vaccinated and that there are employees even today who have been vaccinated from the medi-hotel pathway. I would remind honourable members that the medi-hotel pathway is obviously a workplace where there is a constant turnover of staff and so staff may well have received their first vaccination but not be fully vaccinated, as per the honourable member's question.

Mr PICTON: Why, when we are now many months since the vaccine program started—and these are category 1a workers—do we still have 17 per cent or approximately 170 staff who work in our high-risk medi-hotel environment who are unvaccinated or not fully vaccinated?

The Hon. S.G. WADE: I have already given part of the answer to the honourable member, and part of the answer may well be that some of the employees will be recently recruited employees and either have not had their first dose or, in accordance with the honourable member's question, have not had their second dose, because, I stress, the honourable member asked me how many were fully vaccinated. One of the other factors is that vaccinations are voluntary.

Mr PICTON: What percentage of local health network employees have been fully vaccinated?

The Hon. S.G. WADE: There is a range of vaccination rates. You asked for all health employees. In terms of the local health networks, the advice we have received—the information that is available to them—is it varies between 47 per cent and 82 per cent. I would hasten to add that not all SA Health employees may choose to have their vaccination done through a workplace immunisation clinic. Many presumably would avail themselves of the services of their GPs.

Mr PICTON: Those people are presumably still required to inform the department or their LHN that they have been vaccinated, are they not?

The Hon. S.G. WADE: There is no direction on that. The employers, including LHNs, may well do that.

Mr PICTON: Which LHN was the one at 47 per cent?

The Hon. S.G. WADE: The Flinders and Upper North Local Health Network.

Mr PICTON: Do you have an overall figure across all the LHNs?

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

Mr PICTON: What percentage of disability workers have been fully vaccinated?

The Hon. S.G. WADE: That would have been a question for the Minister for Human Services at estimates this morning.

Mr PICTON: I thought you were in charge of the vaccine program. What percentage of aged-care workers are fully vaccinated?

The Hon. S.G. WADE: Under the national vaccination program, the vaccination of aged-care workers is the responsibility of the commonwealth government.

Mr PICTON: Do you have access to that information?

The Hon. S.G. WADE: I am happy to seek the information from the commonwealth, or the member might.

Mr PICTON: What percentage of Aboriginal and Torres Strait Islander people in South Australia have been vaccinated?

The Hon. S.G. WADE: Again, we are happy to make inquiries of the commonwealth. My understanding is the Aboriginal and Torres Strait Islander identification is a factor that is recorded by AIR, the Australian Immunisation Register.

Mr PICTON: According to the most recent statistics you have, how much stock of both Pfizer and AstraZeneca is on hand in South Australia?

The Hon. S.G. WADE: In terms of Pfizer, I am advised that there is no stock of Pfizer in our SA Health warehouse because we distribute it as soon as we receive it. In terms of what we believe are the stock holdings of Pfizer across the network, we think that by the end of Sunday there will be around 29,000 doses, which is less than one week's supply, so that highlights the supply issues that all states and territories have been highlighting.

Obviously, the situation in relation to AstraZeneca is significantly more comfortable. There will be some in the warehouse and some in the networks, but our understanding is that by the end of Sunday our holdings should be around 57,000.

Mr PICTON: In terms of Pfizer, you said as of Sunday. How much is on hand as of today?

The Hon. S.G. WADE: These are all estimates. With all due respect, we might have known how much we delivered at the beginning of the week but we do not know on each day how much of the stock was used, so this is our estimate.

Mr PICTON: If you do not know that, who would know that?

The Hon. S.G. WADE: I do not think anybody would know that.

Mr PICTON: Why is the Riverland vaccine clinic—

The Hon. S.G. WADE: Just wait a second. The member is helping me be educated. Apparently we do have stock systems that would mean that at the end of each day we could seek a daily update—it is not something I do, with all due respect—but we certainly could not do it at 2.15 in the afternoon.

Mr PICTON: As of yesterday, at the end of the day, how much Pfizer stock was available?

The Hon. S.G. WADE: I do not have the information.

Mr PICTON: Why has the Riverland vaccine clinic, which I believe is based at the Berri hospital, said that they are not going to be able to have Pfizer on stock until September, which is what Mr Champion said to The Murray Pioneer this week, I believe.

The Hon. S.G. WADE: I have no means of confirming what the honourable member claims.

Mr PICTON: What percentage of SA Ambulance staff are fully vaccinated?

The Hon. S.G. WADE: I am advised that 35 per cent of SA Ambulance staff are fully vaccinated.

Mr PICTON: What percentage of them have partial vaccination?

The Hon. S.G. WADE: I am advised 41 per cent.

Mr PICTON: Are you concerned that 59 per cent of SA Ambulance workers have not even had one vaccine yet?

The Hon. S.G. WADE: As the Premier has repeatedly said, we want all South Australians to be vaccinated.

Mr PICTON: These workers have been priority 1a or priority 1b since the beginning of the program. Why has it been so difficult to get vaccines to them?

The Hon. S.G. WADE: I cannot recall the month, but I suspect it was April, when it was my good fortune to be at the Oakden ambulance station for the launch of the South Australian Ambulance Service workplace immunisation program. I know that SAAS is continuing to offer vaccinations to its employees. I am confident that they will continue to work with their employees to provide opportunities to vaccinated. Of course, some SAAS employees, like any other SA Health employee, may choose to go to their GP. I do not have line of sight as to how many people have been vaccinated through their GPs and have not notified their SA Health employer. As I said, SA Health and SA Ambulance Service are very keen to make it as easy as possible for employees to be vaccinated.

Mr PICTON: Have there been any approvals for people to be vaccinated outside of their eligibility, under the official guidelines in South Australia, and, if so, how many people?

The Hon. S.G. WADE: I am not really sure which framework the honourable member is referring to. For example, some might say that the Marshall Liberal government's provision of vaccines to South Australians over the age of 16 in regional South Australia is outside of the guidelines.

Mr PICTON: That is not what I mean, but if you do not want to answer, that is fine. Are you aware that there is a COVID vaccine candidate from a team at Flinders University? Have you received any request to meet with that team, and, if so, have you done so?

The Hon. S.G. WADE: I presume the honourable member is referring to Professor Nik Petrovsky. It is my understanding that both members of the department and members of my office have either received presentations from Professor Petrovsky or met with him, but if I am mistaken I will correct the record.

Mr PICTON: Has any funding or support been provided to that team, and are you aware that they are considering moving out of the state, citing the lack of support they have received from the state government?

The Hon. S.G. WADE: I remind the honourable member that the vaccination program, in terms of the development of vaccine candidates and the procurement of vaccines, is a matter for the commonwealth, and I am confident that Professor Petrovsky would have engaged the commonwealth. In terms of the Marshall Liberal government's support for economic development opportunities, that is a responsibility of a different minister.

Mr PICTON: In relation to the new direction covering red zone and mandatory vaccination for people working there, which I believe is coming in in a couple of days on 4 August, how many people in the system will be covered by that and what percentage of them are partially vaccinated?

The Hon. S.G. WADE: Red zones are not a standing zone in that sense. They basically follow the patient in quarantine. Basically, the direction will require that a patient in quarantine, as they enter a health facility, only has contact with vaccinated clinical staff. Local health networks are working through how they can ensure that. As a result, it is not possible for us to estimate the number of employees who may be impacted.

Mr PICTON: I refer to Budget Paper 5, page 46, protecting SA from COVID. Is the minister aware of the circumstances of, I believe, a professional basketball player, Mr Daniel Cioffi, who was working in Spain and has been attempting to return to Adelaide to see his mother, who has terminal cancer?

The Hon. S.G. WADE: I am not clear whether that might have been a case that was raised with my office, but I am happy to make inquiries.

Mr PICTON: Is the minister aware of the current status of his attempt to see his mother, who has terminal cancer?

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

Mr PICTON: Is the minister aware that the Premier personally wrote, I understand, a letter advocating for Mr Cioffi to receive an exemption for travel to Australia?

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

Mr PICTON: Is the minister aware that Mr Cioffi has made his way back to Brisbane, I understand, but has been unable to come back to Adelaide?

The Hon. S.G. WADE: As I said, I am not clear whether or not the case the honourable member refers to is one that has been raised with my office, so I am not really in a position to play 20 questions when I do not have the facts.

Mr PICTON: I will ask a question in relation to the same budget line. In relation to the cost of the hotel quarantine program, including all costs—hotel staff, health, police, etc.—what has been the total cost of the program since the beginning, or in the last financial year, if that is helpful?

The Hon. S.G. WADE: My understanding is that the information I have before me is only in relation to the costs of the Department for Health and Wellbeing. In relation to the 2020-21 estimated result, the net cost of the medi-hotel program is $85 million.

Mr PICTON: That is the net cost, taking out, I presume, the fees paid for by people.

The Hon. S.G. WADE: Yes.

Mr PICTON: In relation to the fees, how much has been recovered from people and how much is sitting there in unpaid bills today?

The Hon. S.G. WADE: I am advised that for the last financial year there was 18—let's say $18.5 million of payments received by SA Health in relation to medi-hotel programs, and there is still $17.9 million outstanding.

Mr PICTON: How many breaches have there been by any staff involved in the program over the past financial year?

The Hon. S.G. WADE: I do not have that information, but I am happy to take it on notice.

Mr PICTON: How many staff have faced warnings, disciplinary action or suspension over the past financial year?

The Hon. S.G. WADE: I am also happy to include that in the answer.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 15, where it refers to the new Women's and Children's Hospital. When will construction on the new hospital start?

The Hon. S.G. WADE: I am advised that there will be some preparatory works in early 2022, and there will be construction work later in 2022.

Mr PICTON: When do you anticipate that contracts will be signed with the lead constructors for the project?

The Hon. S.G. WADE: I am advised that we are planning for a tender for the managing contractor later in 2022 and that an appointment of a managing contractor is expected in early 2022.

Mr PICTON: Sorry, you said the tender was going to be after it was signed?

The Hon. S.G. WADE: Sorry. Just to clarify, the tender will be later this year, and we expect the contract for the managing contractor to be finalised in early 2022.

Mr PICTON: Do you anticipate that before the government goes into caretaker mode in February?

The Hon. S.G. WADE: It is our intention that that would be the case.

Mr PICTON: Is the business case for the new hospital complete?

The Hon. S.G. WADE: The business case is complete and, as the Treasurer indicated in the budget papers, it has gone to Infrastructure SA for analysis.

Mr PICTON: When will that business case be released to clinicians?

The Hon. S.G. WADE: After it has been through the Infrastructure SA process.

Mr PICTON: What is the cost-benefit ratio in the business case that has been sent to Infrastructure South Australia?

The Hon. S.G. WADE: As I said, the report will be released after it has been through the Infrastructure SA process.

Mr PICTON: Have you had any meetings with potential developers for the new hospital, i.e., construction firms, or have people expressed interest in the early tender stages?

The Hon. S.G. WADE: Considering that the managing contracted tender has not even gone out and the member's question was extremely broad as to, as I understand, the potential participants, I would not be in a position to answer that, but let's put it this way: I am not aware of having met with anybody in the context of them seeking to do work on the Women's and Children's Hospital since the government's announcement in the budget.

Mr PICTON: Have there been any meetings with either yourself, your office or departmental staff about the hospital with potential people who would be willing to apply without probity advisers present?

The Hon. S.G. WADE: Obviously, the honourable member knows that question cannot be answered by me from my knowledge.

Mr PICTON: I believe you have said that there will be capacity to expand the hospital in the future. What is the extent of that expansion capacity, i.e., how many square metres?

The Hon. S.G. WADE: I am advised that the expansion capacity of the new Women's and Children's Hospital will be finalised through the concept development process, which is currently underway.

Mr PICTON: Is there a need to seek approval under the Aboriginal Heritage Act for the new hospital, and has that process started?

The Hon. S.G. WADE: I am advised that section 23 approval under the Aboriginal Heritage Act will be required. That process has commenced and the department is not aware of any issues at this stage.

Ms LUETHEN: I refer you to the clinical services plan, Budget Paper 4, Volume 3, page 20. This year, the department is developing a 10-year clinical services plan. How will this plan be developed and how might it take into account the particular needs of the people living in Adelaide's northern suburbs?

The Hon. S.G. WADE: I thank the honourable member for her question. I propose to ask the deputy chief executive, Mr Don Frater, to give an answer.

Members interjecting:

The CHAIR: Member for Kaurna, you do not have the call to ask a question, nor are interjections in order. The minister.

The Hon. S.G. WADE: Mr Frater.

Mr FRATER: Thank you for the question. The clinical services plan enables the state to identify the future capital needs of the sector and it identifies the services that we require to deliver according to the changes that are occurring in both population, due to population growth, and ageing.

The government's principle, that it is operating under, is to attempt to deliver services closer to the community; therefore we are looking at how we manage improvements and increases in activity to the north through NALHN, and particularly in paediatrics. It is a high population growth area with lots of children, and children's services are required into the future. It is part of the drive to create a more service-orientated delivery in a local area. It is population based, so it is seeking to deliver to the community in that area services that they require, and to improve delivery to their population needs.

There are a number of areas across the state that this will impact. It is a 10-year plan. It permits us to calculate a three-year commissioning strategy which will enable LHNs to identify services that they can expand over a longer period, and moves them away from a 12-month commissioning process. It also helps us to deliver our workforce strategies and our capital works needs into the future.

The key areas that we think are going to need to be driven are in the south, in particular, for aged care and the elderly, in the north with paediatrics and for people who are disadvantaged, an increase in activity, and of course Mount Barker where we are seeing a significant growth in both ED and other service requirements. It is a significant piece of work which we have commenced. We will probably finish later this year and it will be utilised to then drive a whole heap of additional work which will identify what is the future of our health system in the state.

The Hon. S.G. WADE: If I may add to the comments by Mr Frater, it actually does relate back to the question from the honourable member for Kaurna in that one of the areas where the Northern Adelaide Local Health Network is not self-sufficient is particularly in those lower acuity paediatric areas.

I just want to pay a tribute to the strong collaboration between not only the Northern Adelaide Local Health Network management and the Central Adelaide Local Health Network management but also the respective boards. They have each been in very collaborative discussions about how best to deliver services to both the statewide constituency of the Royal Adelaide Hospital—sorry, what I meant to say was the Women's and Children's Hospital board and the NALHN board—the statewide responsibility of the Women's and Children's Hospital and the more geographically-defined focus of the NALHN board.

The NALHN board has been extremely focused on the broader health needs of their community. They have a community which has lower socio-economic indicators, and that board is very keen to make sure that they respond in a sensitive way both culturally and to the different cohorts which they serve.

Mr PICTON: My question is in relation to Budget Paper 4, Volume 3, page 16, the Women's and Children's Hospital sustainment. Is it correct that there is only $4.4 million of sustainment works left to spend at the current Women's and Children's Hospital site? Will there be any additional funding to be spent on the existing site between now and I believe seven years' time when the new hospital is scheduled to open?

The Hon. S.G. WADE: I do not have the figure for the residual, but it certainly is the case that we are coming to the end of the $50 million sustainment works budget that this government committed to. It is certainly the expectation of the government that there will need to be further investment in terms of sustainment. I have had discussions with the Treasurer, and my department is doing work on that.

Mr PICTON: What is the total medical equipment backlog at the current Women's and Children's Hospital?

The Hon. S.G. WADE: I should clarify: I am advised that the bid for sustainment works is likely to include some equipment expenditures. That is just to clarify that fact. In terms of the question about the outstanding requests for medical equipment, I am happy to take that on notice.

Mr PICTON: In relation to the Women's and Children's Hospital Local Health Network, Budget Paper 4, Volume 3, page 39, what is the scope of the investigation currently underway in relation to the Women's and Children's Hospital emergency department? When is that investigation expected to report and will that report be made public?

The Hon. S.G. WADE: Just a point of clarification: that review was initiated by the Women's and Children's Hospital Local Health Network, so I will need to take that on notice and refer that question to them.

Mr PICTON: So you have not been briefed in relation to that investigation at all?

The Hon. S.G. WADE: I have certainly had briefs in relation to the fact that the Women's and Children's Hospital has commissioned a review. I welcome that. I welcome the fact that our local health networks are always looking to improve their services.

Mr PICTON: What is the scope of that review?

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

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 28, Central Adelaide Local Health Network. It has been publicly reported that the Department of Human Services is running a service based out of SA Health's Hampstead hospital site. Is there a contract in place in relation to that? If so, what are the financial terms and what is the length of time?

The Hon. S.G. WADE: I am happy to take the question on notice and seek information from the Central Adelaide Local Health Network.

Mr PICTON: What assurances have been sought and received regarding the safety and quality of services to be provided in that area of Hampstead, which is now being run by DHS?

The Hon. S.G. WADE: As I said, I am happy to take this question on notice, but my understanding is that the patients the honourable member refers to are not clients of SA Health.

Mr PICTON: I believe they were previously. It is on SA Health's site. It has been reported that the Health and Community Services Complaints Commissioner is conducting an investigation. Is the minister aware of that, and has SA Health or CALHN been asked to provide any information as part of that investigation?

The Hon. S.G. WADE: In terms of CALHN, they can provide information in the context of the answer that I have already proposed that they provide.

Mr PICTON: Are there any adverse outcomes and reports of poor treatment that the minister has been briefed in relation to?

The Hon. S.G. WADE: Certainly, there have been public reports of patient care concerns in relation to Hampstead. As I said, it is a relationship between CALHN and the Department of Human Services, and my understanding is they are not SA Health patients.

Mr PICTON: What action has the minister taken since becoming aware of those concerns about patient care?

The Hon. S.G. WADE: As I said, my understanding is that these are not SA Health patients.

The CHAIR: I will shift to my right, as we have not had one for a while. The member for Newland.

Dr HARVEY: Thank you very much, Chair. My question relates to Budget Paper 4, Volume 3, page 32. Could the minister please provide an update on the upgrades to the Modbury Hospital and how they will impact on the delivery of health services for Adelaide's north-eastern suburbs?

The Hon. S.G. WADE: I thank the honourable member for his question. The state of the Modbury Hospital was one of the issues that confronted the Marshall Liberal government on its election. The downgrading of the Modbury Hospital under the Transforming Health experiment was very damaging to the provision of care services closer to home, so we were very keen to deliver on our commitment to invest in the Modbury Hospital.

In terms of the redevelopment, in the broader sense I will ask the executive director for infrastructure to address that in a moment, but I would just reiterate that this government in this budget is going above and beyond its election commitments. It is going above and beyond its election commitments because in this budget we are investing substantially in mental health services.

As the honourable member knows, Woodleigh House and the mental health services at the Modbury Hospital site are well past their use-by date. In fact, in the very early years of this government, the Premier and I both accompanied honourable members from the local community to inspect the facilities at Woodleigh House. It was very clear then that this was not the place to provide mental health care to South Australians, so I am delighted that this government is investing even more money in the Modbury Hospital on this occasion in relation to mental health services. I will ask Mr Hewitt to put that investment in the context of the whole redevelopment.

Mr HEWITT: The South Australian government has committed $98.1 million to the Modbury Hospital redevelopment project, delivering an exciting transformation to the hospital through the investment of world-class infrastructure. As the minister has mentioned, there is now a further investment into the replacement of the Woodleigh House project of $48 million.

The scope of the works of the Modbury Hospital upgrade work included construction of a new emergency extended care unit; an upgraded surgical unit, including additional procedural spaces; a new four-bed high dependency unit; a new outpatient department; a new administration area in order to create the capacity for a new palliative care unit; improvements to the building facade; and a whole range of engineering works to enable the hospital to be fit for purpose moving into the future.

Delivering a major upgrade to an operational hospital is a very challenging process, and the hospital, the project team and the builder, Built Environs, have done an extremely good job in delivering quality construction while the health services have been underway. It has been achieved through careful planning, a staged approach to ensure that the effective clinical functions are safe and ensuring that the broader environment can continue to operate appropriately.

We have made substantial progress. We completed the emergency extended care unit back in August 2019. We have replaced the masonry facade. We have relocated administration to pave the way for palliative care. We have completed the development of a new outpatient department and, importantly, provided new accessible car parking improvements, including an additional six disabled car parks with really appropriate access into the front door of the hospital. We have done engineering upgrades. We have completed the four-bed high dependency unit and we have now completed the operating theatres and two new procedure rooms and completed that component of the project eight months in advance of its schedule.

So we are now into the final phase of this current work where we are underway on the 20-bed palliative care unit, which is at ground level, and also completion of the short stay general medicine unit. Following those works being completed early in 2022, we will then complete works with an upgrade of the lifts on site before then moving into the next phase of works, which would be the redevelopment of Woodleigh House.

The CHAIR: The member for Frome is seeking the call. I use my discretion, although he is not formally part of the committee, to recognise the member for Frome.

The Hon. G.G. BROCK: I refer to Budget Paper 4, Volume 3, page 14. For the Leigh Creek health clinic you have an estimated completion date of June 2023 with a budget of $1.8 million but only $270,000 for this budget coming forward. Can you give us an update on where that is and how that is going to progress, and also how the people of Leigh Creek will be able to access services during the interim period?

The Hon. S.G. WADE: I thank the member for Frome for his question. As he says, the budget papers report that $270,000 of the project will be spent this financial year. The total budget is $1.8 million. It is proposed to be completed in the June quarter of 2023. I am advised that $1.5 million will be spent in the next financial year. As part of the COVID-19 economic stimulus package, the government committed to the construction of a new health clinic at Leigh Creek to align with the government's strategy for the township.

The Department for Health and Wellbeing infrastructure branch is currently undertaking a planning and feasibility study in consultation with the Flinders and Upper North Local Health Network and the South Australian Ambulance Service, interfacing with the Department for Infrastructure and Transport on township and property matters. Sorry, honourable member, what was the element in relation to community consultation?

The Hon. G.G. BROCK: I asked the minister: in the interim period, will there be any impact on the residents or travellers through Leigh Creek going to the outback because this may not be fully completed at this particular point?

The Hon. S.G. WADE: I will take that on notice, if you do not mind. My understanding was that there are interim arrangements in place. My understanding was that one of the medical practitioners who has been involved in the Leigh Creek township is working with the local health network to maintain not the full services that served the township in the past but some services. I will certainly get details from the network and get back to the honourable member.

The Hon. G.G. BROCK: I refer to Budget Paper 4, Volume 3, page 15. We have psychiatric intensive care beds. We have a budgeted estimated completion date of 22 June for $12 million. Can the minister advise whether any of those intensive care beds will be for regional South Australia?

The Hon. S.G. WADE: The honourable member's question relates more to the next set of officers.

The CHAIR: The expenditure line quoted sits in the portfolio that we will address at 4.15, so unfortunately it is out of order to ask the question, but I will leave it in the minister's hands, if he does want to provide an answer.

The Hon. G.G. BROCK: I will come back later on, Mr Chair.

The Hon. S.G. WADE: If the member is not able to do that, I will certainly correspond with him.

The Hon. G.G. BROCK: Sorry, I am going between two estimates committees, Mr Chair. If you could perhaps take that on notice, minister. On page 16 you have SA Ambulance Service vehicle replacement. I know this might not be the right session, but are any of those vehicle replacements under the $8 million and then $13 million for the next year in regional South Australia?

The CHAIR: That question is in order and relevant to this session.

The Hon. S.G. WADE: I will certainly take the honourable member's question on notice, but in relation to the most recent distribution of ambulance vehicles—I seem to recall there were 42—my understanding is that a significant portion of those went to country South Australia. It has not been the practice of the Ambulance Service over the years, but it has certainly been recognised by the Ambulance Service that to put, shall we say, an ambulance into country service towards the end of its useful life is a big ask—the asset is already tired. My understanding is that that is one of the reasons the Ambulance Service had a particular focus on country South Australia in the last round, and I will certainly seek an indication of their intentions in relation to this current round.

I also make the point that this government has a keen interest in the delivery of ambulance services in country South Australia. I know the honourable member would be aware that the government is investing more than $4 million in a new ambulance station at Port Augusta. In terms of the 74 additional paramedics budgeted in this budget, I think a third of them are destined for country service, particularly, as I understand it, where an ambulance station has an on-call element and has a level of activity that is beyond what is normally expected for an on-call site, to relieve them of the on-call work.

It was my pleasure, when I visited Whyalla recently, to visit the Whyalla ambulance station, which is a shared facility with the fire service, and talk to them about the work being done in that region to withdraw on-call rosters. That is an initiative that is strongly welcomed by the Ambulance Service, because on-call rosters are very tiring. We appreciate that, in many country towns, the Ambulance Service has significant demands, and to have an on-call roster on top of a busy ambulance station is not good for the ambulance crews and not good for those they seek to serve.

Mr PICTON: In relation to Budget Paper 4, Volume 3, page 28, CALHN, is the pool at Hampstead hospital closed permanently and, if not, when is it scheduled to be closed permanently?

The Hon. S.G. WADE: Due to COVID-19 restrictions, and following expert advice from the Central Adelaide Local Health Network's infectious diseases unit, the Hampstead Rehabilitation Centre hydrotherapy pool is currently only available to patients who require hydrotherapy for their rehabilitation. This is consistent with practice at the pool since its opening, with access to the pool prioritised for patients. I am advised that no decision has been made by CALHN about the long-term future of the pool.

Mr PICTON: The same budget line: when is the government scheduled to close the St Margaret's site?

The Hon. S.G. WADE: I presume the honourable member is referring to the former government's decision to close St Margaret's Hospital?

Mr PICTON: I understand you are continuing with that, are you not?

The CHAIR: Member for Kaurna, as we have said through this process, and as you have adhered to most of the time, when the minister is providing an answer he will be heard in silence.

The Hon. S.G. WADE: Currently, the government is actually investing in St Margaret's Hospital. I am advised that works to address the collapsed sewer pipe at St Margaret's Hospital are progressing and that patients continue to be admitted from the Central Adelaide Local Health Network to the St Margaret's Hospital program, located at Lourdes Valley.

The St Margaret's multidisciplinary team continues to work with patients and their families to access a permanent residential aged-care placement or placement through the Transition Care Program, which focuses on an improvement of the functional independence of patients. I am advised that it is not yet determined when the St Margaret's site will be ready for use.

Mr PICTON: So there are no plans to close St Margaret's.

The Hon. S.G. WADE: The government is looking at the long-term capital needs of CALHN—I should say that CALHN is looking at the long-term capital needs of CALHN—and I remind honourable members that it was the former Labor government that decided that St Margaret's should close.

Mr PICTON: Is that the policy of the government?

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

Mr PICTON: Budget Paper 4, Volume 3, page 25, refers to revenue associated with parking. What was the total revenue received from the general public for all public hospital car parks over each of the last two financial years?

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

Mr PICTON: When do the state budget's estimates presume that the free parking for hospital staff will end?

The Hon. S.G. WADE: Committee Chair, I almost fear that I might tread into the domain of the Treasurer, but if I can do that tentatively. My understanding is that Treasury, for the purposes of budgeting, assumed that the declaration came off on 1 July past and that it is proposed that, if the declaration is taken off during this financial year, an adjustment will be made for the intervening period.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 13, your ministerial office. What is the role of Kathleen Bourne in your ministerial office? Is it correct that Kathleen Bourne is a Liberal candidate for the Legislative Council at the next election?

The Hon. S.G. WADE: Kathleen Bourne is a ministerial adviser, and she has a particular responsibility in relation to COVID pandemic matters.

Mr PICTON: Is it correct that your ministerial adviser has nominated to fill the casual vacancy of David Ridgway?

The Hon. S.G. WADE: I am not in the practice of commenting on the personal affairs of my staff.

Mr PICTON: Has your ministerial adviser Kathleen Bourne ever used any government resources to further her prospect as a candidate for election, either at the state election or for internal party contests for the casual vacancy?

The Hon. S.G. WADE: I am very confident that she has not.

Mr PICTON: Did your ministerial adviser Kathleen Bourne accompany you on a visit that you undertook to the Mid North on 6 June this year?

The Hon. S.G. WADE: My recollection is that she may have received a lift home with me, but she is a resident of the Mid North and was in the Mid North. Sorry, I should clarify that: she is not a resident of the Mid North now, but she is a former resident of the Mid North, and my understanding is that she was already in the Mid North for other matters.

Mr PICTON: So she was not working for you as your ministerial adviser when she was photographed in TheFlinders News for a meeting with the Liberal Party's Stuart electoral council on that day?

The Hon. S.G. WADE: It is not my practice to travel with a ministerial adviser in terms of supporting me at functions, and I did not have a ministerial adviser supporting me at that function.

Mr PICTON: But you did have a ministerial adviser with you, because you were photographed with her in the Flinders News.

The Hon. S.G. WADE: As I said, it is not my practice to take ministerial advisers to functions, and Kathleen Bourne was not at that function as my ministerial adviser.

Mr PICTON: Is it correct that your ministerial adviser Kathleen Bourne has taken one month's leave to campaign for the casual vacancy in the Legislative Council?

The Hon. S.G. WADE: Again, the honourable member has erred into the area of asking me to comment on the personal affairs of my staff, and that is not a matter that is dealt with in this budget.

Mr PICTON: Well, the ministerial office is in the budget. In any case, Budget Paper 4, Volume 3, page 27, Health Services. Earlier this year, it was reported in The Advertiser that there was a $7 million tender for a patient feedback mechanism that you had launched. Has that tender been awarded?

The Hon. S.G. WADE: I may need to verify what the honourable member is referring to. I presume it is the statewide patient-reported measurement system. The Commission on Excellence and Innovation in Health, which is an attached unit to the Department for Health and Wellbeing, is driving, delivering and successfully achieving the business case for a statewide patient-reported measurement system, which is intended to provide real-time engagement on experience on outcomes at micro and macro levels. I am advised that the implementation commenced on 1 July 2021.

So that it does not get confused with, shall we say, public opinion data, I wonder if I might ask the chief executive of the department to explain about patient-reported measurement.

Dr McGOWAN: Thanks, minister. This is a very important part of designing a system that is continually informed by the results of patient outcomes and patient experience. This is a project that has been led out of the Commission for Excellence and Innovation in Health. The process seeks to build a continuing database of the results—physical results, biological results—of people who enjoy our health services and complement those with the patient experience. This whole process goes towards trying to calibrate the system so it is informed by the fundamental prospect of patient experience times patient outcomes over cost to the community. That is the value proposition.

We believe that over time, as we start to calibrate the system, identify the patient outcomes and patient experience relative to the cost of delivering the services, we will continually drive the system to be more and more valuable and focus on the value it generates to the public. We think this is a very important strategic platform for health services. It has been adopted around the world. My understanding is, if indeed we are referring to the PREMs and PROMs project here, it is well developed in other parts of the world and is increasingly becoming a part of the health system planning architecture.

Mr PICTON: Thank you, but my question was: has the tender been awarded?

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

Mr PICTON: What is the value of the tender?

The Hon. S.G. WADE: I am not aware of that.

Mr PICTON: Can you take that on notice?

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

Mr PICTON: I refer to Budget Paper 5, page 43, Additional support for the SA Ambulance Service. The four-year cost next year is $11.5 million. Does that represent solely the employment of the additional 74 SA Ambulance staff and therefore is that approximately $155,000 each, or are there additional training onboard costs? Can you essentially breakdown what that $11.5 million is going to be spent on?

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

Mr PICTON: Are there any offsetting savings as part of this, i.e., reductions in overtime expenditure, and, if so, what are those offsetting savings?

The Hon. S.G. WADE: I am certainly happy to seek a response from SAAS. I suppose going back to my answer to the question of the honourable member for Frome, of course there would be offsetting savings in terms of no longer needing an on-call allowance for country crews that currently run on call.

Mr PICTON: There is also $1.956 million for investing. I understand it is reported in the budget that there will be six additional ambulances and also the fit-out of ambulance stations. Can you break that down in terms of how much is for the extra ambulances and how much is for the fit-out of the stations?

The Hon. S.G. WADE: I am happy to do that.

Mr PICTON: Which stations are being refitted?

The Hon. S.G. WADE: Again, my understanding is that the ambulance station refit relates at least in part to the crews that I was referring to. My understanding is that as you go off an on-call roster, you have more need to provide in-station accommodation and services for ambulance officers and paramedics. In fact, when I was at the Whyalla station, they were talking to me about how they might be able to accommodate their withdrawal from the on-call roster.

Mr PICTON: When are the 74 additional staff expected to start work?

The Hon. S.G. WADE: My understanding is that the first cohort of FTE, which will be around 20 FTE, are employees finishing their internship. My understanding is that if they have not started now, they are expected to start shortly.

Dr HARVEY: My question relates to Budget Paper 4, Volume 3, page 16. Can the minister please provide an update on the changes to the scope of the stage 3 redevelopment of The Queen Elizabeth Hospital, following consultation?

Members interjecting:

The CHAIR: Members, there is no need to interject.

The Hon. S.G. WADE: The QEH stage 3 redevelopment includes the following elements:

an upgraded cardiac catheter laboratory;

a new multilevel car park;

a new clinical science building—in particular, the clinical science building involves the emergency department;

operating theatres and day surgery;

an intensive care unit;

a new cardiac catheter laboratory;

a central sterilising services department;

the relocation of general rehabilitation services from Hampstead;

a rehabilitation centre; and

associated site infrastructure upgrade works.

Through the concept development process for The Queen Elizabeth Hospital significant work was done in terms of the appropriate facilities to be housed in the new clinical services building. That work was led particularly by Rachael Kay and Paul Lambert. The feedback I received was that it was extremely positively received, to the extent that people involved in the new Women's and Children's Hospital engaged with the CALHN team in terms of their experiences of consumer and clinician engagement.

Again, it was my pleasure to be at the opening of the new multilevel car park in December 2019, and to meet with some consumer representatives who were extremely positive about their engagement in that project. I am confident that has continued through. As a result of that concept development work and other work by both the department and the Central Adelaide Local Health Network, an additional $50 million was approved for the clinical services building.

The Treasurer does not like the pattern here: when the Minister for Health and Wellbeing goes to consult clinicians and consumers, somehow the cost goes up. The same thing happened with the new Women's and Children's Hospital. Because we are actually genuine, unlike the former Labor government which thought it was sensible to build a new Royal Adelaide Hospital without effectively engaging consumers and clinicians, we have—

Members interjecting:

The CHAIR: Member for Hurtle Vale, member for Kaurna—minister, if you could please pause. Both the member for Kaurna and the member for Hurtle Vale, and the member for Playford, will not interject. The minister will be heard in silence. He is very capable of answering, and happy to answer in any way he so wishes.

The Hon. S.G. WADE: I actually think there is a political science thesis in this. The Hansard will show that whenever Labor Party members get embarrassed, the interjections increase dramatically.

Mr PICTON: Point of order: there was a very specific question about The Queen Elizabeth Hospital. The minister talking about the opposition is debating the answer.

The CHAIR: The minister is providing a level of preamble around this question. He has the call.

Members interjecting:

The CHAIR: Member for Hurtle Vale, you will not interject.

Ms COOK: I withdraw the word 'lie'.

The CHAIR: Nobody asked you to withdraw, but if you are happy to withdraw, let the Hansard show that that comment was withdrawn by the member for Hurtle Vale.

The Hon. S.G. WADE: In spite of the embarrassment of Labor members, this government is proud of its achievements in consulting with consumers, consulting with clinicians and delivering quality health infrastructure.

The CHAIR: Given that the time has expired for the examination of payments in relation to the portfolio of SA Health, there are no further questions and I declare the examination of the portfolio SA Health complete.

Sitting suspended from 16:15 to 16:30

Departmental Advisers:

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

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

Mr D. Frater, Deputy Chief Executive, Department for Health and Wellbeing.

Mr J. Logie, Executive Director, Corporate Communications, Department for Health and Wellbeing.

Mr J. Woolcock, Executive Director, Finance, Department for Health and Wellbeing.

The CHAIR: We will get underway for the afternoon session in Estimates Committee B. The next lot of proposed payments relate to the portfolio of SA Health, mental health and substance abuse. The minister appearing is again the Minister for Health and Wellbeing. The estimates of payments are those referenced earlier for the Department for Health and Wellbeing, the Commission on Excellence and Innovation in Health and Wellbeing SA. I advise that the proposed payments remain open for examination and call on the minister to make an opening statement in regard to this portfolio, should he wish.

The Hon. S.G. WADE: I may, for the information of honourable members, advise that Ms Lynne Cowan and Ms Julienne TePohe have left us, and I have been joined by Dr John Brayley, the Chief Psychiatrist.

The Marshall government has a strong commitment to and record of investing in and supporting mental health services, including launching the Mental Health Services Plan, the first time this state has had such a plan in a number of years. The 2021-22 state budget continues the delivery of that plan with a number of initiatives supporting South Australia's mental health system. Funding of $163.5 million has been provided to strengthen the state's mental health system, providing additional support services and investing for the future with the aim of creating a more resilient and flexible system.

Elements of the package include a new crisis stabilisation centre in the northern suburbs; the creation of additional psychiatric intensive care bed capacity; a new older persons mental health facility; an increase in community mental health services; a continuation of time-limited COVID supports; additional support for the delivery of urgent mental health care; additional housing for people with a mental health disability; and supporting immediate staffing, training and recruitment needs.

The Marshall government also recognises the significant mental health challenges presented by the COVID-19 pandemic and has worked to support South Australians affected with a $15.1 million plan, which has been allocated across a range of mental health initiatives and drug and alcohol services in response to the pandemic. An additional $5 million has also been invested over the 2021-22 financial years in response to the bushfire crisis through the increase of mental health clinical services in impacted areas. Finally, the new $14 million Urgent Mental Health Care Centre, which has been established on Grenfell Street in collaboration with the commonwealth government and Neami, will be expanded to a 24-hour service through this budget.

The government is also committed to reducing the harms of alcohol, tobacco and other drugs in the South Australian community, including health, social and financial impacts. South Australian population survey and wastewater data indicates that the use of alcohol and illicit drugs has shown some decline in recent years. The use of methamphetamines, pharmaceutical opioids and heroin has reduced. Average levels of alcohol consumption have reduced, with average levels in 2020 the lowest since sampling began in 2016.

We know that the COVID-19 pandemic has been difficult for many South Australians. To support the community during this time, additional funding has been extended to increase access to alcohol and other drug treatment and support. It is important that individuals and families can easily access information and support for substance misuse. To facilitate this, SA Health manages the Know Your Options website.

I would like to sincerely thank our frontline staff, the doctors, nurses and midwives and allied health professionals, along with our administrative staff, who work within our mental health services and our Drug and Alcohol Services, for their commitment and dedication, working tirelessly every day to deliver quality and safe care to our clients.

The CHAIR: Member for Kaurna, do you wish to make an opening statement?

Mr PICTON: No.

The CHAIR: There being no opening statement, I call for questions.

Mr PICTON: My question is in relation to Budget Paper 4, Volume 3, page 27, Health Services. Over the past financial year, what was the funding that was spent under the Individual Psychosocial Rehabilitation and Support Services and GP Access program?

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

Mr PICTON: For the same two programs, what was the funding for the previous financial year?

The Hon. S.G. WADE: I am happy to take those on notice as well.

Mr PICTON: For the same two programs, what is the funding in the budget for this coming financial year?

The Hon. S.G. WADE: Sorry, I thought that was question number 1.

Mr PICTON: No.

The Hon. S.G. WADE: I am happy to consult Hansard so that it might be clearer.

Mr PICTON: The first question was about the past financial year, the second question was the one before that and the third question was the coming financial year. Are you happy to take them all on notice?

The Hon. S.G. WADE: I am happy to take all three questions on notice.

Mr PICTON: How many clients have been assisted by both the IPRSS and GP Access programs over each of the past two years?

The Hon. S.G. WADE: And number 4.

Mr PICTON: Number 4, what?

The Hon. S.G. WADE: And question number 4 I also take on notice.

Mr PICTON: Has there been a 25 per cent cut to the IPRSS and GP Access funding?

The Hon. S.G. WADE: As I needed to take the first four questions on notice, I will take the fifth question on notice.

Mr PICTON: Was the decision to cut funding from these mental health programs imposed by Treasury? I refer to emails released under FOI, including from your advisers here today. The first is from Dr Brayley on Thursday 23 May 2019 at 11.25pm, when he said:

Mental health NGOs are very concerned that 25% of the NGO budget will be t/f to the NDIS in 19/20...

We had a number of NGO reps at our task force this afternoon and they were arguing the reduction should be delayed for a year. Treasury has already made this decision to reduce the SA Health NGO budget.

Dr McGowan then said the next day, Friday 24 May 2019 at 7.10am:

Hi John—I am not surprised. I actually don't know how this decision was made.

After the difficulties with other areas of the NDIS/NDIA and acknowledging that they are still getting on their feet with the process etc, I would support the NGO sector. But, I assume the decision was made in DPC?

Lyn Dean then said, 21 minutes later, on the same day:

The decision was made by Treasury. We raised all the issues that John identifies however Treasury took the view that the NGO sector has had year…to get ready for this...

It's a challenging space and Chris raised a good point with NDIS about sharing risk and being more responsible.

The Hon. S.G. WADE: Sorry, was there a question there?

Mr PICTON: Yes, the question was: was the decision made imposed by Treasury?

The Hon. S.G. WADE: I might totally reject the premise of the honourable member's question. This was a transfer of funding to the federal government under an NDIS transition arrangement, signed off by the former Labor government.

Mr PICTON: As Dr Brayley said in his email, 'People are concerned that 25 per cent of the NGO budget will be transferred to the NDIS,' to which your chief executive, Dr McGowan, said, 'I don't how this decision was made,' and then Lyn Dean, who was in the department at that stage, said that the decision was made by Treasury. Was Lyn Dean correct that the decision was made by Treasury?

The Hon. S.G. WADE: I am really surprised that the honourable member would take this line of questioning, considering that earlier this month his leader had to make a public retraction for misstatement of facts.

Mr PICTON: Are you going to answer the question?

The CHAIR: Member for Kaurna!

Mr PICTON: Point of order, this is debate.

The CHAIR: Member for Kaurna, there is no point of order at this stage. The question that was asked was broad in nature, there was insertion of facts contained in the question—

Mr PICTON: Was Lyn Dean's statement correct?

The CHAIR: Member for Kaurna, I do not need to hear the question again. I was well and truly listening to the question.

Mr PICTON: I am not sure you listened to it the first time.

The CHAIR: As I have said so far today, as has been adhered to so far today, the minister will be able to provide his answer in silence.

The Hon. S.G. WADE: Just as the honourable member has run a misinformation campaign about—

Mr PICTON: Oh, come on—that is against standing orders, Chair. You are not allowed to impute improper motive by a member. Maybe you can in the Legislative Council, but not here in this house. I ask you to stop the minister from raising such points in this debate.

The CHAIR: I was not able to hear the conclusion of the minister's comment.

The Hon. S.G. WADE: That is because I was not allowed to conclude.

The CHAIR: I am happy for him to start again. Unfortunately, the cut in to the minister's answer was so quick that I was not able to hear it. Perhaps we will give the minister an opportunity to provide his answer.

The Hon. S.G. WADE: The honourable member's question reminds me of the constant misinformation that was put into the public domain by the opposition and advocates, asserting that—

Mr PICTON: This is their email.

The Hon. S.G. WADE: —there had been a cut to mental health services. That is a distortion—

Mr PICTON: I can table it.

The CHAIR: Member for Kaurna, again, the minister is able to provide his answer in silence.

Mr PICTON: He is doing so out of order, sir. It is simply debate.

The CHAIR: There is not debate in the answer that is being provided.

The Hon. S.G. WADE: Clearly, the honourable member is not confident that he has enough questions to get through this session. He wants to—

The CHAIR: Minister, I will call you up there—

Members interjecting:

Mr PICTON: I am happy to move for an extension of two more hours for estimates today if the minister would like.

The Hon. S.G. WADE: I just wonder why he is filibustering in his own estimates' time.

Members interjecting:

The CHAIR: Members, enough, member for Playford, member for Hurtle Vale, member for Kaurna! I will ask the minister to stay on track. The last point made was perhaps veering into the territory of being debate. If he could continue. Minister.

The Hon. S.G. WADE: I am sorry, Chair. Let me come back to the facts. The facts are that the honourable member's question seeks to rerun arguments that the opposition ran in the public domain, asserting that this government had made cuts to mental health services when all this government was doing was implementing legally binding agreements with the commonwealth, signed by the former Labor government.

Mr PICTON: A question in relation to Budget Paper 4, Volume 3, page 27, Health Services: what was the average amount of time per mental health patient that a patient spent in metropolitan emergency departments over the last financial year?

The CHAIR: I also remind the member for Kaurna that this is not question time; this is a committee of the whole. There is the ability for the minister to answer as he wishes, provided it has a degree of relevance.

The Hon. S.G. WADE: I do not have a figure for the full financial year. The most recent data I have relates to May 2021. What I am advised is that the average waiting time for adults and older mental health patients in metropolitan hospital emergency departments was 12.8 hours. I am advised that in October 2014 it was 18.5 hours.

Mr PICTON: Is that one month in time or for the year to date to May?

The Hon. S.G. WADE: It was the month in time.

Mr PICTON: What about the year to date to May? Do you have that figure?

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

Mr PICTON: How does that compare to the previous financial year?

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

Mr PICTON: Can you also provide on notice a breakdown of that by local hospital network?

The Hon. S.G. WADE: No, because six of our 10 local health networks do not have metropolitan emergency departments.

Mr PICTON: Can you provide a breakdown by the metropolitan local health networks?

The Hon. S.G. WADE: Yes.

Mr PICTON: What is the total number of mental health patients who waited more than 24 hours for a bed in emergency departments over the past financial year?

The Hon. S.G. WADE: I am advised that the number of episodes was 1,446.

Mr PICTON: How does that compare to the previous financial year?

The Hon. S.G. WADE: I do not have that data.

Mr PICTON: Can you take that on notice?

The Hon. S.G. WADE: Yes.

Mr PICTON: How many mental health patients have waited more than two days in emergency departments for a bed?

The Hon. S.G. WADE: I do not have that information.

Mr PICTON: Can you take that on notice?

The Hon. S.G. WADE: I will inquire as to how easily it can be obtained. Not every permutation of data is easily obtained.

Mr PICTON: For those 1,446 patients, what does that represent as a percentage of all mental health patients over that financial year?

The Hon. S.G. WADE: I will see if a comparator can be provided.

Mr PICTON: What was the longest time a mental health patient waited in an emergency department for a bed in the past financial year?

The Hon. S.G. WADE: I do not have that data.

Mr PICTON: Can you take that on notice?

The Hon. S.G. WADE: Yes.

Ms LUETHEN: My question is from Budget Paper 4, Volume 3, page 14. Could the minister please outline what services and level of care the new $20.4 million capital build for a 16-bed crisis stabilisation centre will provide to the people of the north-eastern and northern suburbs of Adelaide?

The Hon. S.G. WADE: I thank the honourable member for her question. The question does take us to the positive way forward in terms of the honourable member for Kaurna's questions in relation to unnecessarily long waits. We are very determined to provide more timely mental health care, and one of the key ways we are doing that is by establishing adult mental healthcare centres.

Everybody appreciates that a busy emergency department is often not a good therapeutic environment for a person with mental health challenges to receive diagnosis or treatment. That is why this government, in partnership with the commonwealth, established the Urgent Mental Health Care Centre in Grenfell Street. The crisis stabilisation centre in the northern suburbs builds on that concept, not only by providing a facility where people can come to receive counselling and support but also where people might be admitted into an overnight facility.

The initiative provides $20.4 million in investing funding over three years and operating funding of $4.2 million in 2023-24, growing to $8.5 million per annum from 2024-25, to build and operate a new 16-bed crisis stabilisation facility in the northern suburbs to support the mental health needs of the community. The 16 beds will be provided for patients who otherwise would have required inpatient care and should be considered as equivalent to 16 inpatient beds.

The service will aim for a three-day length of stay and provide an appropriate therapeutic environment for people to stabilise in a period of mental health crisis and then return to the community. I might ask the Chief Psychiatrist whether he would like to provide more detail on the service.

Dr BRAYLEY: The crisis stabilisation centre is also called a 'crisis retreat' in the Mental Health Services Plan. People will be able to go there for urgent mental health care, basically hospital triage level 3 or below. They can self-present or be taken there by ambulance or police. In addition to having a living room environment with chairs and a comfortable homelike or therapeutic space for people to be assessed—certainly lower stimulus than an emergency department—the crisis stabilisation centre has beds well. So it will be able to accept more people than the Urgent Mental Health Care Centre can, simply because of the bed capacity.

It still combines a focus on having technical expertise from professional workers with a peer workforce. Because of the model that has beds as well, the number of peer workers is likely to be around the 20 per cent to 30 per cent mark, which is not as high as it is at the Urgent Mental Health Care Centre. It is an engaging therapeutic environment but deals with significant levels of acuity. This is described in the plan.

Last year, the Substance Abuse and Mental Health Services Administration in the United States produced crisis guidelines for all aspects of a crisis response system. It goes into some detail about what a crisis stabilisation centre should deliver and has been able to deliver in places overseas. When I started, there was concern from people in NALHN (Northern Adelaide Local Health Network) that they did not have an intermediate care centre, which in the past was the community model for providing care for people in crisis.

This more modern version basically has more staffing, a design that is comfortable but with good lines of sight and an ability to take involuntary clients as well as voluntary ones and is therefore not a step-up step-down from inpatient care but the equivalent of inpatient care for this group of people.

It will meet a gap that has been there in the north, but critically, in terms of ED and hospital diversion, we would like to think, just as it is with the Urgent Mental Health Care Centre, that people will want to go there earlier rather than staying back and waiting until a time when they are more unwell and then possibly needing admission or a longer admission. Also, the centre will clearly be providing extra bed capacity, which is needed as well. So first and foremost addressing the needs of the people who will use it, but also assisting emergency departments and our hospital system.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 28, Central Adelaide Local Health Network. The former executive director of mental health in CALHN, Professor John Mendoza, has reported publicly that his area was given a $5 million savings task last financial year. How much of that $5 million savings task was achieved in CALHN mental health services?

The Hon. S.G. WADE: I can advise that the June interim actual expenditure for CALHN for mental health in 2020-21 was $154.4 million. The actual in 2019-20 was $144.2 million, which is about a $10 million increase in expenditure.

Mr PICTON: Is there a savings target for mental health services at CALHN this year, and, if so, what is that target?

The Hon. S.G. WADE: That is a question for the Central Adelaide Local Health Network.

Mr PICTON: That expenditure is under review by this estimates committee.

The Hon. S.G. WADE: It is still a matter for the Central Adelaide Local Health Network.

Mr PICTON: So do they have a savings task for mental health services at CALHN?

The Hon. S.G. WADE: I do not know whether they have a savings target.

Mr PICTON: Can you take that on notice?

The Hon. S.G. WADE: Yes.

Mr PICTON: Are there any other savings targets for mental health in other local hospital networks, and, if so, how much?

The Hon. S.G. WADE: I think it is important to appreciate that local health networks can receive funding to fund mental health services in more than one way. If they are an activity-based funded service then they will receive activity through activity-based funding. They may receive funding through the Office of the Chief Psychiatrist and also what is commonly called block funding, which is commissioning by the Department for Health and Wellbeing.

The decisions in relation to how the budget is managed within the local health network are a matter for the board and for management, but one does need to be mindful that the Chief Psychiatrist, who is with us today, is only one source of potential funding to local health networks.

Mr PICTON: That was an answer to some question; it was not an answer to my question. What is the breakdown in terms of savings tasks that LHNs have set in their mental health areas and, if you do not know, can you take it on notice?

The Hon. S.G. WADE: I suspect that the answer could not be obtained today because we are only less than one month into this financial year and presumably a lot of local health networks are still setting their budgets. To be clear, there are no centrally mandated cuts to mental health services.

Mr PICTON: That is not what I asked.

The Hon. S.G. WADE: In terms of the local management of budgets, that is a matter for local health network boards and management.

Mr PICTON: All of those budget lines are before the committee right now. Can you take on notice to get an answer?

The Hon. S.G. WADE: Yes, I will, but I would hasten to add that each local health network will be developing its own budgets, its own plans, so that may take some time.

Mr PICTON: How much in terms of expenditure of the COVID mental health package is yet to be spent?

The Hon. S.G. WADE: The hallmark of Premier Marshall's response to COVID-19 has been his strong conviction that we do not face merely a health crisis but we also face an economic crisis. In terms of the health response, the Premier has also been clear that it is not merely a physical challenge to people's health but also a challenge to their mental health and wellbeing.

Consistent with that early realisation by the Premier and his government, the first COVID-positive case identified in South Australia was identified on 1 February, yet it was less than two months later, on 31 March 2020, when the first instalment of the COVID-19 mental health support package was put in place.

That stage 1 has been followed by two further stages, and this current budget, the budget that is before the committee this afternoon, announces a fourth stage. So obviously in relation to the fourth stage, which involves $7.3 million expenditure in July 2021-22, it is far too early to talk about carryovers. In relation to stages 1 to 3, I will need to take that on notice.

Mr PICTON: How much of last financial year's projected expenditure in the budget was underspent?

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

Mr PICTON: In relation to Budget Paper 5, page 47, and the creation of an additional psychiatric intensive care bed facility, can you confirm that the commitment so far in the budget is only to the capital works, with no funding for the recurrent operation of these beds?

The Hon. S.G. WADE: The allocation in the budget is for capital, but the commissioning process of the department will provide the resources for the recurrent.

Mr PICTON: What will be the operating cost of these beds?

The Hon. S.G. WADE: It has certainly been calculated. I will take it on notice and provide the honourable member with that figure.

Mr PICTON: When are these beds expected to open?

The Hon. S.G. WADE: As indicated on page 15 of Budget Paper 4, Volume 3, the current estimated completion for the psychiatric intensive care beds is the June 2022 quarter, but it is hoped that we may be able to have some services operating in current capital facilities earlier than that.

Mr PICTON: I understand this is being accomplished by essentially building something, I believe, at Glenside for a service that is currently there to move to and then moving those beds into an existing site. Is that correct? Can you step us through exactly where these beds are going to go and what movements need to happen for that to happen?

The Hon. S.G. WADE: In reflecting on my previous answer, part of the Psychiatric Intensive Care Unit bed project is for the modification of the rural and remote facility located on the Glenside campus. The facility is operated by Barossa Hills Fleurieu Local Health Network and the project will be undertaken in conjunction with the department's Infrastructure Unit.

The $12 million in capital funding has been allocated in 2021-22 to facilitate the relocation of the Tarnanthi forensic mental health facility from the Glenside campus to another site to enable the return of the Psychiatric Intensive Care Unit beds to the Glenside site.

Mr PICTON: What will the site be that those services will be transferred to?

The Hon. S.G. WADE: In terms of the shuffling of services, it is a bit like a piece of string when you start pulling it. The former Labor government opened the new Royal Adelaide Hospital without being able to open the Psychiatric Intensive Care Unit (PICU). That meant that the services continued on the Glenside site for some time. When the PICU did relocate to the new Royal Adelaide Hospital, it provided an opportunity, which this government took, to provide an additional 10 forensic mental health beds at the Tarnanthi site. Where the Tarnanthi unit is located had been operating as a Psychiatric Intensive Care Unit and substantially retains the attributes that are necessary for a Psychiatric Intensive Care Unit.

The $12 million in capital funding is likely to be used not on the current Glenside site but on the site for the, if you like, next home for the Tarnanthi forensic mental health facility. The identification of potential sites is currently being undertaken by the infrastructure branch, but it is likely that that will be on the James Nash campus.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 27, Health Services. Was there a contract offered to mental health organisation Talk Out Loud last year, I believe perhaps by the Office of the Chief Psychiatrist, to provide them with funding which was then subsequently rescinded?

The Hon. S.G. WADE: I am advised that whilst Talk Out Loud may not have been successful for a particular grant round we understand that they may have been successful in another round, so I will make inquiries. It may not have been a grant round, but it relates to potential alternative funding.

Mr PICTON: Were they offered funding and then had that funding offer rescinded?

The Hon. S.G. WADE: As I said, I am happy to provide an answer.

Mr PICTON: Were there any other organisations that had funding offers made to them that were then rescinded?

The Hon. S.G. WADE: Not that we are aware of, but we are happy to take that on notice.

Mr PICTON: Thank you. I refer to Budget Paper 4, Volume 3, page 39, Women's and Children's Health Network. What is the current waiting time for an assessment or an appointment with Child and Adolescent Mental Health Services?

The Hon. S.G. WADE: The initial triage of children and adolescents is undertaken by the CAMHS Connect team within the Women's and Children's Hospital network, the CAMHS network. Certainly, there has been a recognition that there has been a surge in demand for their services, and it is in that context that the COVID response includes an increase of funding to increase the capacity of CAMHS Connect clinicians to respond to referrals for services across CAMHS. Whilst I have that information, I do not have the current wait time, so I am happy to take that on notice.

Mr PICTON: How many young people are currently waiting to be seen at CAMHS?

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

Mr PICTON: How many individuals and families are currently seen by the individual and family therapy program at CAMHS?

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

Mr PICTON: How many individuals or families are on the waiting list for therapy through that program?

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

Mr PICTON: What is the average wait between a referral to CAMHS Connect and a client's initial mental health assessment?

The Hon. S.G. WADE: I think that is problematic because a lot of people would contact CAMHS Connect direct. They would not be referred.

The CHAIR: The member for Newland has been patiently waiting.

Dr HARVEY: Thank you very much, Chair.

Mr PICTON: It is a surprise to him that he was waiting.

Dr HARVEY: I have been waiting. This is a very important question, so thank you very much, Chair, for the opportunity to ask it. It relates to Budget Paper 4, Volume 3, page 14. Could the minister please explain what the new $48 million capital build for a 20-bed acute older persons' mental health facility at Modbury will mean for families of the north-eastern suburbs living with severe dementia or other enduring mental illnesses?

The Hon. S.G. WADE: I thank the honourable member for his question and I also acknowledge, delightfully, in their presence—because it is very rare for me to be able to welcome members of the other place into this place—both the member for Newland and the member for King for their advocacy for services close to home for people in the north-east, and that is exactly what this investment is about.

This initiative provides $48 million in investing funding over four years to construct a new 20-bed older persons' acute mental health unit at Modbury Hospital. This will allow for the decommissioning of the current Woodleigh House site at Modbury Hospital.

The new facility is part of a growing network of dementia services. Members of the house do not need to be reminded about the shameful saga of Oakden which was closed in the term of the last government without alternative facilities being available. This government made an election commitment to establish dementia facilities for people with more severe forms of behavioural and psychological symptoms of dementia, in particular people with more extreme forms of dementia. We are delighted with the progress thus far of the neurobehavioural unit on the Repat site.

As part of that steady, planned development of older persons' mental health facilities, the government is committing to this new older persons' mental health facility at the Modbury site. As I mentioned earlier, it will give us the chance to decommission a facility that is well past its use-by date. However, very importantly, it will provide an opportunity for people in the north-east, the north and, for that matter, beyond, to receive care for the more extreme forms of behavioural and psychological symptoms of dementia. I might ask the Chief Psychiatrist perhaps to tell us more about the development of those services.

Dr BRAYLEY: Currently, the older persons' mental health ward of 20 beds is based at the Lyell McEwin Hospital. The creation of this new unit is an opportunity to design something to meet the needs of older people who need acute mental health care, whether they have cognitive problems or other mental illness. The design is going to attend to key elements: it will be more homelike with a focus on the flow of people around the unit because when there are people who experience dementia sometimes they can wander and you can have incidents if you do not have well-designed flow. Some of the same principles are used in places like the neurobehavioural unit, so it will be purpose-built.

In terms of the rest of Modbury Hospital, given the fact that there are geriatric and palliative care services being developed on site, there will be a natural synergy. This is a site for an acute ward for older people and for the community team to relocate. There will also be site works so in the future, should there be funding to move to Northgate, that could then occur in a further stage. It will link in with the dementia care units that are being developed, two of them subsidised by the commonwealth. One, it is expected, will be subsidised by the state.

As part of the move there will also be an opportunity to solve a problem with Modbury at Woodleigh House, which is an old and outdated unit. People who are currently admitted there for adult mental health care would instead be admitted to the Lyell McEwin Hospital as part of this move. That will be in the vacated space currently being used for older persons at Lyell McEwin.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 25, where it refers to the establishment of an enhanced Statewide Eating Disorder Service for the Repatriation Health Precinct. When will that new service be fully operational?

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

Mr PICTON: Is it confirmed that that site will definitely be established at the Repat site?

The Hon. S.G. WADE: My understanding is that the current intention is that the service be established at the Repat site consistent with the negotiations of the former government.

Mr PICTON: Can the minister confirm that he was given advice to the effect that the Statewide Eating Disorder Service may have an actual or perceived conflict of interest?

The Hon. S.G. WADE: The honourable member has raised this issue before. He knows that I received advice on that matter.

Mr PICTON: Have you delegated your authority in relation to the Statewide Eating Disorder Service or just the paediatric eating disorder service?

The Hon. S.G. WADE: The matters in relation to eating disorder services are handled by the Minister for Human Services.

Mr PICTON: Is the day clinic at Brighton currently fully operational?

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

Mr PICTON: Have any staff been reallocated from the Brighton day clinic to Flinders Medical Centre or Noarlunga Hospital, either temporarily or permanently, in the past 12 months?

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

Mr PICTON: Can you also take on notice the number of days in the last financial year that the Brighton day clinic was not fully staffed and operational?

The Hon. S.G. WADE: Yes.

Mr PICTON: I refer to Budget Paper 5, page 47, Supporting South Australia's mental health system. Part of this is an $8.4 million per year package. The description then breaks it down between drug and alcohol services, child and adolescent mental health services, forensic mental health services, support for adults with severe mental health conditions, and mental health ambulances. Can you provide a breakdown of that funding across all those different elements that are set to receive funding from it?

The Hon. S.G. WADE: The information I have available to me is broken down by service rather than by theme. I can advise that in terms of ongoing funding CAMHS is budgeted to receive $1.522 million, CALHN is budgeted to receive $2.366 million, NALHN is budgeted to receive $1.009 million and SALHN is budgeted to receive $362,000. The regional LHNs will collectively receive $439,000.

There is also an element of a network managing an allocation within the CALHN allocation because they will be receiving the mental health co-responder funding on behalf of participating LHNs and will distribute that funding to the LHNs and to the Ambulance Service.

Mr PICTON: How much of the component is for that co-responder model?

The Hon. S.G. WADE: It is $1.827 million.

Mr PICTON: I am trying to get my head around this. All those LHNs have been broken up for a piece of the pie. There is clearly a segmented part of it for the co-responder model and there is a segmented part for CAMHS. For the remainder of the services, is it for the LHNs to determine how they wish to best spend that best, or is it segmented between drug and alcohol, forensic mental health, people with severe mental health conditions?

The Hon. S.G. WADE: It is true to say that the allocations to the local health networks have been allocated within broad themes, but the Office of the Chief Psychiatrist wants the LHNs to be flexible to meet their local needs, which brings to mind the exemplary work being done by the Northern Adelaide Local Health Network with the establishment of a northern mental health forum.

It brings together both SA Health providers and NGO providers, consumers and carers, and is led, or is chaired, by Anne Burgess, one of the board members, a person with great expertise in the mental health area. It is yet another example, I think, of the strong community connected nature of board governance, particularly as it is demonstrated in the northern region. These allocations are done within broad themes, but there is flexibility so that LHNs can work with their communities to deliver services that best meet their needs.

Mr PICTON: Can I just clarify: does the $1.009 million for NALHN include a segmented proportion that goes to forensic mental health services, given the role that NALHN usually provides in forensics?

The Hon. S.G. WADE: Yes, it does. The element that is allocated to NALHN includes $770,000 for forensic services.

Mr PICTON: Similarly, is there a segmented proportion of the SALHN funding that will go to DASSA?

The Hon. S.G. WADE: Yes. Sorry; thanks for the question, because it does help me clarify. The LHN programs were the ones I identified. They total $5.698 million. The total DASSA programs within the ongoing services are $2.7 million, so they are not included in the LHN aggregation in this context.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 27, Health Services. The Mental Health Services Plan states that a progress report will be published 18 months after the release of the plan. I understand it is now 21 months since the plan was released. What is the status of that progress report being published?

The Hon. S.G. WADE: It is an interesting point, really, the timely production of plans. I remember the seven-year hiatus between the last Mental Health Services Plan by the former Labor government and the release of the Mental Health Services Plan under this government in November 2019. The progress report the honourable member refers to is currently being developed and, whilst its production has been delayed by COVID, we hope to be able to release it in the not too distant future.

Mr PICTON: Following the mental health in SA workshop that was held famously on 28 April, the minister wrote to participants advising that the Mental Health Services Plan's advisory group would be expanded. Has the broader membership of that group since been implemented?

The Hon. S.G. WADE: I am advised that the group the honourable member refers to is now called the Mental Health Services Plan implementation steering group. The expansion of the group was in two senses, firstly in terms of its terms of reference—my understanding is that the expanded terms of reference have been confirmed—and work is currently underway to expand the membership.

Mr PICTON: At the time the Mental Health Services Plan was published, it was reported that South Australia had less than half the national average of non-acute beds. How many extra public mental health beds, acute or non-acute, have been added to the system since that plan was brought in?

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

Mr PICTON: Perhaps take on notice as well how many extra child and adolescent, older persons and forensic public health mental beds have been added to the system since the plan was released.

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

Mr PICTON: Budget Paper 4, Volume 3, Central Adelaide Local Health Network. Have all the recommendations arising from the Glenside Inpatient Rehabilitation Services review now been fully actioned?

The Hon. S.G. WADE: Sorry, could you repeat the question?

Mr PICTON: Have all the recommendations arising from the Glenside Inpatient Rehabilitation Services review now been fully actioned?

The Hon. S.G. WADE: In terms of the very specific question the honourable member asks, I will need to take that question on notice, but I would ask the Chief Psychiatrist to give the honourable member an update.

Dr BRAYLEY: As a result of that review, gazettal conditions had been placed on the Inpatient Rehabilitation Services. We can provide the specific dates when the gazettal conditions were lifted. There was a significant amount of work, significant areas of improvement, including a noticeable reduction in the use of restrictive practices. It was very positive work by the staff and all those involved in responding to the recommendations from that report and the concerns that had led to our gazettal.

We would have to go through each of the recommendations to just double-check the status of them, but I know that the final model of care has still not been implemented. There are some limitations in implementing the model of care related to the layout of the building, but there are other aspects of the model of care that can still be implemented. That is a particular piece of work that we are checking on. The fact is that has not occurred—I guess it would be desirable if it had—nevertheless, the significant good work and improvements of the team down there should also be noted.

Mr PICTON: Over the past year, have there been any subsequent complaints or concerns raised about that service at Glenside to the Chief Psychiatrist or to SA Health?

Dr BRAYLEY: I will respond to that. I would need to properly check what complaints may have been lodged regarding IRS. I am aware that there are still concerns from practitioners in other local health networks apart from CALHN about their ability to access the IRS, and that was a particular issue to be addressed in the model of care.

Mr PICTON: What is the average occupancy rate of the IRS?

The Hon. S.G. WADE: We will provide an answer to that question on notice.

Mr PICTON: Perhaps you could also take on notice what is the total staff FTE and the total expenditure per annum on the IRS.

The Hon. S.G. WADE: I am happy to do that.

Mr PICTON: Budget Paper 4, Volume 3, Page 27, Health Services. On 13 October last year, the minister posted a graphic on his Twitter account for the total funding for mental health in three years, 2014-15, 2018-19 and 2019-20, in which he claimed he had increased funding in mental health by $20 million. What is the source of that information in terms of the mental health total funding that he used?

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

Mr PICTON: By the same metric, therefore, what was the total mental health funding for last financial year—i.e., 2020-21—and the budget for this financial year 2021-22 and also for the missing years in his graphic, 2015-16, 2016-17 and 2017-18?

The CHAIR: Member for Kaurna, please be aware that the lines of expenditure are relevant to this budget paper and forward estimates, of course, and the previous year. I will provide the minister an opportunity to respond, but that is outside the scope of this budget document.

The Hon. S.G. WADE: I agree, Mr Chair. I think those questions are better asked of the History Trust.

Mr PICTON: Chair, actually it is totally appropriate for the parliament to examine what the funding is compared to previous years' funding, which is totally within the bounds of what this committee is to do.

The Hon. S.G. WADE: 2015-16 is not the previous year.

Mr PICTON: Of previous years.

The CHAIR: Member for Kaurna, there are ample opportunities within the parliament to raise these questions that would be more appropriate perhaps than estimates examining a particular budget line relevant to a particular budget period.

Mr PICTON: Since it is so difficult to answer this, what is—

The CHAIR: Member for Kaurna, your commentary is not helpful.

Mr PICTON: Neither is ruling out perfectly legitimate questions but, in any case, I will ask—

The Hon. S.G. WADE: The member is reflecting on the Chair yet again.

Mr PICTON: —what is the total funding along the same measure as the minister used for last financial year 2020-21, and the budget for this financial year 2021-22?

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

Mr PICTON: In relation to the SA mental health service and mental health ambulances—Budget Paper 4, Volume 3, SA Ambulance Service—how many co-responding mental health ambulances are currently in operation?

The Hon. S.G. WADE: Whilst there may well have been discontinuity of service as the funding was confirmed, the confirmation of ongoing funding of the mental health co-responders program will facilitate the recruitment and retention of officers for the long term, so I will certainly seek advice as to how many teams will be funded out of the mental health co-responder component.

Mr KNOLL: I draw the minister's attention to Budget Paper 5, pages 47 to 49, something that is a bit dear to my heart. Can the minister please outline how the record additional investment of $163.5 million in mental health supports regional South Australians living with mental illness?

The Hon. S.G. WADE: I thank the honourable member for his question. I will ask the Chief Psychiatrist to address the honourable member's question but, as I do, I just want to reiterate that both the Chief Psychiatrist and I are very committed to making sure that rural and regional South Australians access the statewide services that they are entitled to in the city.

For example, some of the high level of acuity services that regional and rural South Australians need are based in the city. When it comes to specialist services like older persons' mental health services, forensic mental health services and the like, specialist statewide services cannot be provided within every region, but there certainly is a determination to fund mental health services for all South Australians, and I will ask the Chief Psychiatrist if he could explain how this budget will assist.

Dr BRAYLEY: I can provide some figures but there are services, as the minister was stating, that are based in Adelaide, and then there are the regional ones, so the additional psychiatric intensive care unit beds, even though they are going to be based at Glenside Hospital, are going to be under the governance of the Barossa Hills Fleurieu Local Health Network, the rural and remote unit there. That enables people, when they are flown or driven to Adelaide, to be admitted to a PIC unit under the governance of rural and remote. That is of benefit to the continuity of care for those people because the rural and remote service has good links and knowledge with rural South Australia. Its staff provide a particular service for country SA.

At the same time, we are also looking closely at people who are transferred into the city for PICU care because there may be some opportunity to support those people in rural locations. That is an alternative piece of work, not part of the budget funding, that we are looking at with MedSTAR. The minister previously, in answering a question about the community funding, indicated that some of the funds that were due to go to Barossa Hills Fleurieu, which then go to all of the regional local health networks, is retained to support the Emergency Triage and Liaison Service (ETLS), which takes calls from all over regional South Australia.

So extra funding, because you can see the significant increase in demand in calls that they have received related to COVID in our weekly dashboards that come through. Other funding will be delivered locally in terms of supporting older persons and supporting the services in their delivery of care. That is part of both the ongoing funding that will be distributed but also COVID-specific funding for this financial year.

That describes some of the key initiatives. Of course, people from country areas will be also admitted to the new unit at Modbury. There is always a certain percentage of country people particularly going to the older persons' service currently at the Lyell McEwin and at Flinders Medical Centre, so there will be benefits in that new service at Modbury as well.

Mr PICTON: I refer to Budget Paper 4, Volume 3, SA Ambulance Service, again. The minister mentioned just before that question from the member for Schubert that there was a break in service. How long was that break in service?

The Hon. S.G. WADE: I do not have the detail. It was brought to our attention that there may have been a discontinuity, so I will check that. My understanding is that because it relates to the start of a new funding year it would only be a matter of weeks.

Mr PICTON: Have those staff been moved to other areas or are they still there ready to restart the program?

The Hon. S.G. WADE: As I said, I have only had some information and I need to seek more. It may be that not all of the mental health co-responder units were affected by that.

Mr PICTON: This is one you might want to take on notice: how many hours per day are each of the co-responder ambulances running for and what is the cost of those, broken down by local health networks?

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

Mr PICTON: In relation to Budget Paper 4, Volume 3, page 18, Health Regulation and Protection, what is the status of the government's planned major revision of the tobacco control act that you announced on 16 September 2018?

The Hon. S.G. WADE: I will need to seek an update on notice for the honourable member.

Mr PICTON: Is it still the government's intention to strengthen outdoor dining restrictions, as you said in your 2018 media release, when you said:

A key issue for these discussions will be ensuring that outdoor dining areas are fully protected from tobacco smoke.

While many local businesses do comply with current laws, it is clear there are a number that are ignoring no-smoking regulations.

The Hon. S.G. WADE: I will make sure the update addresses that issue.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 27, CALHN. How many calls were made to the Mental Health Triage Service last financial year and the year prior to that?

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

Mr PICTON: What percentage of those calls in those years were answered and what was the average response time for those calls?

The Hon. S.G. WADE: I am happy to see if that information is available.

Mr PICTON: What is the FTE that was working on that service last financial year and what is budgeted for this financial year?

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

Mr PICTON: How many calls from the triage service were referred to emergency departments and how many were referred to ongoing community mental health support?

The Hon. S.G. WADE: I will see whether that information is available.

Mr PICTON: It has been raised as an issue by the former executive director of mental health at CALHN that there were significant issues in terms of the facilities for the mental health triage team. Where are they now located?

The Hon. S.G. WADE: My understanding is that the service the honourable member refers to was located in the Ambulance Service building at Eastwood, the main administration building, and that it has since been relocated to the Glenside site.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 27, Health Services. What is the total FTE in the past financial year for community mental health teams and how many vacancies are there currently for staff in community mental health teams?

The Hon. S.G. WADE: I think it might be better if we take it on notice. It is likely that the LHNs are the employing authority.

Mr PICTON: If you are happy to take it on notice, could you also take on notice a breakdown of those vacancies by psychiatrists, psychologists, nurses, social workers and OT?

The Hon. S.G. WADE: I should not use the words 'employing authority'—that has a special meaning for the Treasurer. I should say the LHNs coordinate the mental health teams.

Mr PICTON: Dr McGowan employs everybody still.

The Hon. S.G. WADE: That is right.

The CHAIR: With that answer, the time allocated for examination of payments in relation to the portfolio of SA Health, mental health and substance abuse, has expired, and therefore I declare the examination of the portfolio of SA Health, mental health and substance abuse, completed.

Departmental Advisers:

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

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

Mr J. Woolcock, Executive Director, Finance, Department for Health and Wellbeing.

The Hon. S.G. WADE: I advise the committee that Mr Don Frater and Dr John Brayley, the Chief Psychiatrist, have excused themselves, and I would like to introduce Ms Cassie Mason, the Director of the Office for Ageing Well in SA Health.

The CHAIR: Member for Kaurna, I am sure you are well aware that this is the last opportunity for omnibus questions during this period.

Mr PICTON: I have them ready to go.

The CHAIR: The final session runs until 6.30 and will examine the portfolio of the Office for Ageing Well. The minister appearing is the Minister for Health and Wellbeing. I advise that the proposed payments remain open for examination. I call on the minister to make an opening statement in relation to this portfolio, if he wishes.

The Hon. S.G. WADE: The Office for Ageing Well develops and implements a range of social policies and programs at the individual, community and system level, in line with the Marshall Liberal government's Plan for Ageing Well 2020-25. That plan has three key priorities: home and community, meaningful connections and navigating change. Those themes have never been more relevant than in the context of ageing well in a global pandemic.

To deliver on the Marshall government's election commitment to increase the use of advance care directives in South Australia, the office partnered with the City of Onkaparinga to create a locally driven model to increase the completion of advance care directives in four local government areas over the next two years.

The Office for Ageing Well also partnered with the Office of the Public Advocate to develop an educational tool and workshops to support substitute decision-makers under an advance care directive in their role. Additionally, in 2020-21, the office continued to support the eight ageing well community networks, with a focus on CALD, Aboriginal, and LGBTI+ communities. These networks are facilitated by organisations in local communities to promote safeguarding strategies.

The Age Friendly Services pilot was held in May 2021, delivering on the Marshall government's election commitment to combat ageism by challenging the way ageing is framed in the language and structure of the services the government delivers.

COVID-19 and the associated restrictions imposed on the community has had an intense impact on older Australians, particularly those living in residential aged care. The Marshall government has implemented a wide range of measures to reduce the spread of COVID-19 into residential aged care, and to keep members of our community well.

I would like to particularly pay tribute to the work done by Ms Mason as the director, and also as a key liaison with the aged-care sector and her key role in helping to keep residential aged-care facilities safe during the COVID pandemic.

SA Health has maintained a strong focus on communicating with older people directly and keeping them in touch with information to assist them to stay informed and resilient. This included regular public health and other community messaging via the Seniors Card Facebook page and to more than 90,000 subscribed Seniors Card members through electronic direct mail-outs.

The Office for Ageing Well has met regularly with the aged-care sector since the beginning of the pandemic to discuss the implementation of restrictions in residential aged care and any other COVID-related matter.

The Adult Safeguarding Unit, a commitment of the Marshall team before the 2018 election, is the first of its kind in Australia and it has a legal mandate to respond to reports of abuse and neglect of adults who may be considered vulnerable. The unit commenced operations on 1 October 2019 to respond to abuse of older South Australians. On 1 October 2020, the unit expanded to include adults living with a disability who may be vulnerable to abuse.

Whilst it is primarily a matter for the commonwealth government, the Marshall government is also considering the final report of the Royal Commission into Aged Care Quality and Safety and will respond as required to deliver improved outcomes to older South Australians and their families.

I would like to take this opportunity to thank the Office for Ageing Well team and our partners in the ageing well space for the work they have done, particularly in this pandemic year, to support older South Australians to age well.

The CHAIR: Lead speaker for the opposition, do you wish to make an opening statement?

Mr PICTON: No, thank you.

The CHAIR: Feel free to jump in, member for Kaurna.

Mr PICTON: I will try to do this as quickly as I can to ask some omnibus questions.

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

What is the actual FTE count at 30 June 2021 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; and

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

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

How much is budgeted to be spent on goods and services for 2021-22, and for each of the years of the forward estimates period;

The top 10 providers of goods and services by value to each agency reporting to the minister for 2020-21;

A description of the goods and/or services provided by each of these top 10 providers, and the cost to the agency for these goods and/or services; and

The value of the goods and services that was supplied to the agency by South Australian suppliers?

3. Between 1 July 2020 and 30 June 2021, 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 (1) been abolished and (2) which has been created?

4. Will the minister provide a detailed breakdown of expenditure on consultants and contractors above $10,000 between 1 July 2020 and 30 June 2021 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?

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

How many FTEs were employed to provide communication and promotion activities in 2020-21 and what was their employment expense;

How many FTEs are budgeted to provide communication and promotion activities in 2021-22, 2022-23, 2023-24, 2024-25 and what is their estimated employment expense; and

The total cost of government-paid advertising, including campaigns, across all mediums in 2020-21 and budgeted cost for 2021-22?

6. 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 contractors between 1 July 2020 and 30 June 2021.

7. What is the title and total employment cost of each individual staff member in the minister's office as at 30 June 2021, including all departmental employees seconded to ministerial offices?

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

How much was spent on targeted voluntary separation packages in 2020-21;

What department funded these TVSPs (except for DTF estimates);

What number of TVSPs were funded;

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; and

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

9. For each department and agency reporting to the minister, how many executive terminations have occurred since 1 July 2020 and what is the value of executive termination payments made?

10. For each department and agency reporting to the minister, what new executive appointments have been made since 1 July 2020, what is the annual salary and total employment cost for each position?

11. 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?

12. In the 2020-21 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 2021-22?

13. In the 2020-21 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 2021-22? How much was sought and how much was approved?

14. For each grant program or fund the minister is responsible for please provide the following information for 2020-21, 2021-22, 2022-23, 2023-24 and 2024-25 financial years:

Name of the program or fund;

The purpose of the program or fund;

Balance of the grant program or fund;

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

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

Carryovers into or from the program or fund; and

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

15. For the period of 1 July 2020 to 30 June 2021, 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.

16. For each year of the forward estimates, please provide the name and budgeted expenditure across the 2021-22, 2022-23, 2023-24 and 2024-25 financial years for each individual investing expenditure project administered by or on behalf of all departments and agencies reporting to the minister.

17. 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.

18. For each department and agency reporting to the minister, what is the total cost of machinery of government changes since 1 July 2020 and please provide a breakdown of those costs?

19. For each department and agency reporting to the minister, what new sections of your department or agency have been established since 1 July 2020 and what is their purpose?

20. 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; and

What is the estimated FTE impact of these measures?

The CHAIR: Member for Kaurna.

Mr PICTON: I refer to Budget Paper 4, Volume 3, page 24, Corporate and System Support Services, line 13, aged care. How many state-run aged-care facilities have failed to meet any accreditation standards over the past financial year?

The Hon. S.G. WADE: I am advised that in 2021 there were three notices of noncompliance issued in relation to South Australian government-operated residential aged-care facilities, and all three of them are still current.

Mr PICTON: Which were those three centres or sites, and what were the reasons for failing to meet the accreditation standards?

The Hon. S.G. WADE: The three centres are Bonney Lodge, which is operated by the Riverland Mallee Coorong Local Health Network; Hawdon House, which is operated by the Riverland Mallee Coorong Local Health Network; and the Ira Parker Nursing Home, which is operated by the Yorke and Northern Local Health Network.

Following an audit in September 2020, Bonney Lodge and Hawdon House were issued with noncompliances on 27 and 28 January respectively. These related to care planning and risk management, implementation of best practice with regard to care planning, demonstrated timely response to functional decline, staffing, staff training and organisation-wide governance systems.

In relation to Ira Parker Nursing Home, on 8 June 2021, the Aged Care Quality and Safety Commission issued a notice of noncompliance on Ira Parker Nursing Home for three not met criteria. Firstly, standard 3, personal care and clinical care, requirement (3)(b); standard 7, human resources requirement (3)(a); and standard 8, organisational governance, requirement (3)(d).

Mr PICTON: Were there any sanctions imposed by the commonwealth in relation to those facilities?

The Hon. S.G. WADE: No.

Mr PICTON: As I understand it, those three facilities previously had issues raised with them in their audits. Why has the situation not improved at those sites?

The Hon. S.G. WADE: I do not agree with the implication of the honourable member's question that things are not improving at each site. I think the fact that things are heading in the right direction is reflected in the fact that both Bonney Lodge and Hawdon House, and separately Ira Parker Nursing Home, have received accreditation—they are both fully accredited.

On 19 February 2021, Bonney Lodge and Hawdon House were accredited by the commission for a period of 18 months to July 2022. In relation to Ira Parker Nursing Home, the commission has provided three years' accreditation to 5 April 2024. There are issues that the commission wants the facilities to address, but both are fully accredited.

Mr PICTON: Have all the recommendations from the Standards Wise aged-care individual site reviews now been implemented across all sites?

The Hon. S.G. WADE: I stress that the Office for Ageing Well is not the operator of LHN-based residential aged-care facilities. The regional LHNs operate the services, but I am advised that all regional LHNs have completed their six LHN-specific recommendations. There are also 14 across regional South Australia recommendations: a number of them have already been completed and the remainder are still in progress.

Ms LUETHEN: My question is on Budget Paper 4, Volume 3, page 20, the Retirement Villages Act. Can the minister provide an outline on the cost and time line for completing a review of the Retirement Villages Act 2016 and what steps the Office for Ageing Well is taking to ensure the experience of people who live in the retirement villages is collected and properly considered as part of the review process?

The Hon. S.G. WADE: On the point the honourable member raises in terms of the importance of engaging residents of retirement villages, the government is determined to make sure that all stakeholders, including residents of retirement villages, have ample opportunities to express their view to the review. The review is in line with the legislative requirement to review the act three years after its commencement, and a review of the act is being undertaken in 2021.

A discussion paper has been distributed, which includes an overview of the act, the regulatory changes it brought and the legislative and regulatory framework in other jurisdictions. It also posed a range of specific questions and sought to understand the views of residents and operators. The discussion paper was released for public consultation on the YourSAy website on 29 January 2021, concluding on 16 April 2021, with 187 responses received. These were both written and online. Around three-quarters of the responses were from residents.

The Retirement Villages Unit has engaged an independent consultant, and I might ask the director of the office to tell us about the process: where to from here and particularly the issue the honourable member raised in terms of the resourcing of the process.

Ms MASON: Thank you, minister. The Office for Ageing Well has engaged an independent consultant, Peg Consulting, to undertake the independent review and the analysis of the feedback. As the minister pointed out, three-quarters of the feedback received was from residents, so that was really pleasing to see. The funding for that independent consultant was $42,600; that was the contracted amount for that review process. A report will be provided based on all that feedback to the minister later in the year.

Mr PICTON: What is the estimated time when the report will be released?

The Hon. S.G. WADE: Whilst the length of time allowed for the review is not set out in the act, it is expected that Peg Consulting will provide me with the final report later in the year, and under the legislation I am required to table the report in both houses of parliament within 12 sitting days.

Mr PICTON: In relation to Budget Paper 4, Volume 3, page 27, Health Services, obviously the minister is aware that during the first wave of the pandemic there were a number of hospital sites where, because of co-located aged-care facilities, the emergency department was closed. Is it correct that Strathalbyn emergency department is the only site that is yet to reopen?

The Hon. S.G. WADE: I think we might need to take this on notice because in the turbulence of the Modbury cluster, my understanding is that some facilities that had previously reopened have closed again. So I think it would be prudent for me to seek an update and provide it to the committee.

Mr PICTON: Is it envisaged that the Strathalbyn emergency department will at some stage reopen?

The Hon. S.G. WADE: I am happy to provide an update.

Mr PICTON: I refer to Budget Paper 4, Volume 3, Program 1.4, page 24, in relation to aged care. Last year, in estimates the minister took on notice a question in relation to whether the Adult Safeguarding Unit was made aware of the death of Ann Marie Smith. He subsequently provided a question on notice which stated, 'The department's Safety and Quality Unit became aware of the death on 7 April 2020. The matter was then included in a report to the SA Health chief executives weekly executive meeting.' Was the chief executive present at that weekly executive meeting? Did he read the document in relation to the death of Ann Marie Smith? If so, what action did he take upon learning about that?

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

Mr PICTON: Was that information circulated to anybody else in the department at that time?

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

Mr PICTON: Did the chief executive or any other executive make the minister aware of that matter after it had been raised on 7 April before the matter was made public on 25 May 2020?

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

Mr PICTON: In relation to the CCTV trial, how many sites is the trial now operational at and how many patient rooms is it installed in?

The Hon. S.G. WADE: The pilot is operating at Mount Pleasant aged care and Northgate House. It currently involves 26 residents across those two sites.

Mr PICTON: Is that the full extent that will be provided with the funding from the trial?

The Hon. S.G. WADE: The current funding is focused on those two sites.

Mr PICTON: Who is undertaking a review of the outcomes of the trial and when is that expected to be provided?

The Hon. S.G. WADE: A select tender process was undertaken for the independent evaluator. PricewaterhouseCoopers has been appointed to independently evaluate the pilot.

Mr PICTON: What is the value of that procurement for PwC?

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

Mr PICTON: Are there any investigations underway in relation to the procurement process that led up to the implementation of the trial?

The Hon. S.G. WADE: Not that I am aware of.

Mr PICTON: In relation to the Adult Safeguarding Unit, how many complaints were received by the Adult Safeguarding Unit in the past financial year?

The Hon. S.G. WADE: Just to clarify, the unit receives a whole range of calls and people may be seeking confidential advice and information that may not lead to a report. To provide the data in relation to calls, I am advised that from 1 July 2020 to 30 September 2020—sorry, to more directly address the honourable member's question, of the 1,885 total calls received during the 2021 reporting period, 963 resulted in a report which required the unit to take action.

The CHAIR: With that response to the question, the time assigned to examination of payments in relation to the portfolios of the Office for Ageing Well has expired; therefore, there are no further questions and I declare the examination of the portfolio of the Office for Ageing Well complete and the estimate of payments for the Department for Health and Wellbeing, the Commission on Excellence and Innovation in Health and Wellbeing SA closed.

At 18:30 the committee adjourned to Monday 2 August 2021 at 13:00.