House of Assembly Fifty-Second Parliament, Second Session (52-2) 52 2 Parliament of South Australia House of Assembly published Question Time Emergency Departments EMERGENCY DEPARTMENTS Mr HAMILTON-SMITH House of Assembly Waite EMERGENCY DEPARTMENTS Mr HAMILTON-SMITH (Waite) (14:30): My question is to the Minister for Health and Ageing. What action has he taken in regard to the Coroner's 3 June 2010 report into the death of Ms Aileen Promnitz? In recent weeks, doctors have raised serious concerns about overcrowding in emergency departments across Adelaide hospitals. In this report, the Coroner determined that 79-year-old Ms Aileen Promnitz was found to be deceased in the waiting area of The Queen Elizabeth Hospital emergency department after being left for six hours without being seen by a doctor. The Coroner found that a bed was not available and that Ms Promnitz was placed on a waiting room trolley at 8pm, where she remained until her death to be found by a member of the public at 2am. The Hon. J.D. HILL House of Assembly Kaurna Minister for Health and Ageing Minister for Mental Health and Substance Abuse Minister for the Arts EMERGENCY DEPARTMENTS The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:31): I thank the member for the question and, obviously, the loss of any life under the circumstances that have been described is a tragedy for the family involved. Can I say, generally, that our emergency departments in South Australia are now working at a very high level indeed and, in fact, the improvements that are being seen in our emergency departments, and their capacity to treat patients and deal with patients, continues to improve. For example, to April this year, for 50 per cent of people, the median wait time for attention in emergency departments was 16 minutes and, at the 90^th percentile mark, it was 104 minutes. That is the very best in Australia. We have the very best performance in emergency departments in terms of seeing people, according to those stats. So, 76 per cent of people, for example, to April, have been seen in time. What we are doing in response to that is improving our emergency departments. We are making sure there are more resources and there is more capacity to deal with people, and that is why we have just recently refurbished and expanded the Flinders Medical Centre. We have done work at Lyell McEwin, we are doing work at all of our major hospitals to expand our capacity. There is an issue in relation to emergency departments, and I raised this yesterday, I think, in answer to another question. There is an issue in transferring patients out of the emergency department into a bed in the rest of the hospital, and that requires a great deal of reform. We are working on that, and one of the stumbling blocks to that is the difficulty in getting the medical association, the union that represents doctors, to agree to having senior doctors put on duty around the clock. They do not want to be on duty over the later hours in the night. We want them to do that and we are in long discussion with them in terms of the current enterprise bargaining agreement. We want the senior doctors to be available on duty across the calendar so that they are able to make decisions about which patients can be put into which places. That is one of the problems that we have. We also want to change the way in which patients can be discharged. At the moment only doctors can discharge patients. Sometimes doctors do not come in to do the rounds until later on in the day, which means patients can be sitting in beds for many hours waiting to be discharged when they are ready to be discharged. What we would like to do is to move to a protocol-based discharge system, so once the patient has reached the appropriate level of readiness, a nurse can discharge the patient. So, there is a whole range of reforms that we are working on. It is in my view, and in the view of my department, that we have sufficient beds to manage this if we can get those cultural changes in the workforce, and that is what we are focusing on, member for Waite, trying to change the way we run our hospitals so that we can transfer patients through. It is easy, I guess, to point to a particular case and then try to dramatise it, and say that that is an indication of something going wrong. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: And it is easy for oppositions— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: —and it is always something that oppositions want to do, to make politics out of particular cases. What I am saying— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: If they want to ask more— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Making a loud noise is not the same as making sense, Madam Speaker, that is all I'd say. What I am saying to the opposition, what I am saying to the public: we recognise that from time to time things don't go the way we'd like, and I apologise and I always say sorry to the families who have not got the service that they want. However, what we are doing is building a very strong hospital service. We have the best performing emergency departments in Australia. We have the best performing hospitals, in my view, in Australia. We have a world-class health system in our state. The other side continues to knock it because that is the only policy that they have.