House of Assembly: Wednesday, February 27, 2008

Contents

HEALTH REFORMS

Ms THOMPSON (Reynell) (14:27): My question is to the Minister for Health. How are the state's doctors and nurses getting involved in South Australia's health reform process?

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:27): Last year, the state government launched South Australia's Health Care Plan, which is a blueprint for reform and change within our health system. I have spoken a lot about it. An essential part of this plan is to prepare our hospitals for the growing demand that we face in the future. Increasing demand is already being felt in emergency departments in our public hospitals. Over the past five years, admissions at South Australia's public hospital emergency departments have jumped by 25 per cent. That is 25 per cent over five years. Sir, to deal with this—

Ms Chapman interjecting:

The SPEAKER: I warn the deputy leader!

The Hon. J.D. HILL: To deal with this massive increase, the state government is employing more ED staff and we are expanding ED capacity. We are also, of course, rolling out our GP Plus health care structure to provide more services closer to where people live. The role of emergency department staff is vitally important in providing the very best emergency care to all South Australians. The government values the passion, dedication and care of staff who work in our emergency departments.

As part of our development and implementation of the health care plan, we are learning from other jurisdictions which have reformed their health systems. This month, the government arranged for a delegation of physicians and nurses to travel to the United Kingdom to look at how that country is working to improve its public hospitals, in particular, the performance of their acute medical services. Six delegates in total from Flinders Medical Centre, the Royal Adelaide Hospital, and the Queen Elizabeth Hospital visited hospitals in London and Edinburgh to observe the treatment of acute medical patients within emergency departments and inpatient wards.

They also studied different models of care and looked at the emerging roles of advanced nurse practitioners and admission and assessment processes. In particular, the clinicians have studied the UK system to see how emergency care can be better delivered, waiting times reduced and patient outcomes improved.

I refer to some of the interesting features of the UK system and the reforms that have occurred there. First, there has been a focus on acute medical care that integrates the role of the emergency department with medical inpatient units. This has improved times to admit medical patients. A system has been devised of dividing patients into three specific groups that are related to the potential time a patient requires clinical care. This means that long-stay patients are targeted earlier to move into an appropriate inpatient ward. A strong multidisciplinary approach is now taken to the acute medical unit, which allows for all the patient's needs to be accommodated and appropriate arrangements for community support when they are discharged. And in some acute medical units, GPs can make a direct admission to the unit rather than go through the emergency department system.

Of course, in Britain there is a strong focus on patients seeing the clinical decision maker so that care can be put in place as soon as possible and patients do not have to repeat their condition and medical history several times with various clinicians. The team of doctors and nurses will report back to the Department of Health on what they have found and how South Australia can learn from the UK experience.