MEDICAL EMERGENCIES DISASTER RECOVERY

123 Mr HAMILTON-SMITH (Waite) (17 July 2012). With respect to 2012-13 Budget Paper 4, vol. 3, p. 42—

1. How many presentations of staphylococcus (golden staph) or related illnesses have occurred across the Health system in the past 12 months?

2. Is there an increasing danger of community presentations of golden staph?

3. What budgeted provision has there been made for an epidemic, such as bird flu or some sort of catastrophe like Ebola?

4. What contingency plans have been made to ensure local hospitals can cope in the case of an earthquake?

5. What is the capacity of our hospital system to cope with the surging winter illnesses and what are the trends so far this winter?

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts): I am advised:

1. It is not possible to give an accurate answer to this question as 'golden staph' (Staphylococcus aureus) infections are not notifiable diseases, and can cause a range of conditions from minor skin infections, such as boils, through to serious bloodstream and other invasive infections. It is not uncommon for minor staphylococcal infections, which are extremely common, to be treated empirically with antibiotics and patients not admitted to hospital.

SA Health records Staphylococcus aureus blood-stream infections that are healthcare-associated, acquired during hospitalisation or as a consequence of some medical treatment. Total Staphylococcus aureus bloodstream infections in South Australian hospitals have been stable over the past few years, with about 150 episodes per year, of which about 30 have been due to methicillin-resistant Staphylococcus aureus (MRSA).

2. 'Golden staph', Staphylococcus aureus, is a common pathogen in every community worldwide. There are increasing reports of community infections with types that show resistance to antibiotics, of which MRSA is an example. It is not possible to eliminate Staphylococcus aureus from the community, as up to 50 per cent of the population carry it transiently or permanently at any time. It is part of what is described as the 'normal flora' of our skin and upper airways.

Efforts are being made nationally and internationally to reduce the risk of infections caused by antibiotic-resistant strains through the introduction of antibiotic stewardship programs, which aim to lower the inappropriate use of antibiotics in both hospitals and general practice.

3. No specific budget provision has been allocated for epidemics, such as bird flu or some sort of catastrophe like Ebola. It would be difficult to determine a quarantined budget for events, such as a pandemic. In the last 300 years, on average, three pandemics have occurred each century, and each has varied enormously in severity.

However, SA Health, as part of its core provision of service, has a responsibility to ensure arrangements are in place to manage such events when they do occur. Prevention, preparation, response and recovery arrangements for these and other critical health events have been well developed over recent years, and comply with both national and State planning.

4. Work on this risk area has been in progress for almost two years following Exercise Team Spirit 2010. The State Earthquake Hazard Plan is based on a 1:1,000 year event—Richter Scale 5.5 earthquake and it is recognised that, should this occur, it can be expected to cause considerable damage with the potential for serious human consequences.

A working group of key stakeholders was established in late 2010, which includes representatives with expert knowledge from the Department of Planning Transport and Infrastructure, SA Health and SA Engineering Functional Service. The State Earthquake Hazard Plan has clearly identified the areas that SA Health needs to be able to respond to in an earthquake event, and the scope of the working group is to ensure this can be achieved.

Emergency management arrangements are in place within SA Health based on an all-hazard approach and have been part of the core education and exercise program for nearly two years.

All Local Health Networks have Emergency Management Coordinators who are working in conjunction with the Department for Health and Ageing Emergency Management Unit to embed consistent practices and plans across the system. This means that staff moving across hospitals in South Australia will find that the overarching arrangements will be similar and less likely to cause confusion in an emergency situation.

5. SA Health manages a demand cycle throughout the year. Winter brings influenza and bacterial infections and summer brings allergies and heat related illnesses. The capacity of public hospitals is maintained during the winter period by ensuring effective patient flow by monitoring and managing demand through the Local Health Networks.

Managing local trends and patterns through a 'real time' state-wide emergency department capacity tracking web tool, and by implementing strategies in line with the SA Health Hospital Escalation Policy, supports demand management.