House of Assembly: Thursday, May 17, 2012

Contents

ROYAL ADELAIDE HOSPITAL

Mr HAMILTON-SMITH (Waite) (14:34): My question is to the feeling unloved Minister for Health and Ageing. Will patients moved from the Royal Adelaide Hospital emergency department to his proposed hot floor continue to be counted as emergency department patients for the purpose of federal government records, or will they be deemed to have been admitted to a hospital bed?

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:35): I thank the member for his question. We are doing this in all our hospitals. Royal Adelaide is doing it in the most extensive way, I guess. It brought together as a local board a range of hot areas. The whole thinking behind this is based on the experience in Britain which did move towards—the current government is moving away from it now—a target of 90 per cent of patients being seen, treated, admitted or discharged within four hours.

One of the ways they achieved that was to determine very early on which patients are likely to be admitted and then stream those into a ward, such as an AMU—or as we call it an acute medical unit, or a hot ward, as we have used in popular language—where they can be managed outside the emergency department. They are not in emergency departments in terms of the statistical analysis: they have been moved out —

Mr Hamilton-Smith interjecting:

The Hon. J.D. HILL: I have never pretended otherwise.

Mr Hamilton-Smith interjecting:

The Hon. J.D. HILL: Madam Speaker, this synchronic approach is very interesting, but the member asked a question and I am seriously giving him an answer.

Members interjecting:

The SPEAKER: Order!

Mr Hamilton-Smith interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: The—

Ms Chapman interjecting:

The SPEAKER: Order! You will listen to the minister or move on to the next question.

The Hon. J.D. HILL: The intention is to take the patient—

Mr Pisoni interjecting:

The Hon. J.D. HILL: They have an answer for everything except a policy position. They just do not have any policy positions at all. They know how to be negative but they do not know how to be positive. Madam Speaker, the intention is—

The Hon. I.F. Evans interjecting:

The SPEAKER: Order! The member for Davenport, order!

The Hon. J.D. HILL: —to have the patients who do not need to be in the emergency department taken out of the emergency department and looked after in another part of the hospital. That I would have thought is a very sensible way of managing a group of patients. We are also looking to make sure that some patients who otherwise would go into the emergency department, who only really need GP help, can have somewhere else to go; that is why we are very strongly supporting GP Plus Health Care Centres and GP Super Clinics. They are getting attention outside the emergency department.

If we can build up both those services then we will have fewer people in the emergency department, which means that the emergency department will be able to operate in a more effective way. There are other things that we need to do as well, but all these things fit together. One of the things we want to do is to make sure that senior doctors are on duty over the full cycle of the hospital's operations, because at the moment we tend to have senior doctors operating only during the middle of the day—the normal working hours, rather—and not during the night; so, we want to have senior doctors registered, and that is part of the EB agreements.

That matter is being contested, I have to say, but we want to break through that so that we can have senior doctors on duty who are more able to make quicker and more effective decisions rather than having to have a whole lot of tests done because they are not sure about what is going on. There are a whole lot of measures we are putting in place to make the emergency departments work, but having hot floors, having acute medical units, is one of those ways.