HEALTH DEPARTMENT BUDGET

Mr HAMILTON-SMITH (Waite) (14:50): My question is to the Minister for Health. How and when does the minister propose to achieve the $424.2 million budget cuts over the estimates period? The Auditor-General's Report tabled this week indicated that the Department for Health and Ageing must find savings for the two years remaining in the 2010-11 budget initiative of $240.2 million and savings identified in the 2012-13 budget of $184 million over the estimates period.

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:50): I thank the member for Waite for his question. The challenge facing the health budget is a very difficult one, it is fair to say. The way that we are approaching this is to ensure that we provide the services to the public of South Australia in the most efficient way that we can, that we focus on continuing to provide the very best services to the public of our state. So we are proud, for example, of the elective surgery and the emergency department stats which were published in the last month or so which showed we are one of the best performing health services in Australia. We can do better at ensuring that we use our resources more efficiently.

To that end, we asked KPMG and Deloitte to review the operations of our metropolitan hospital systems and we are considering the public and institutional responses to those reports and I will be making some announcements shortly about what measures we will be adopting. We are also looking at the out of hospital services that we run to see what is still relevant and what is still current. Some of those services have been around for 30 or 40 years and probably haven't been reviewed in that time and I flag that some of those services will no longer be delivered. We will make a judgement as to whether or not they are providing good clinical health services to people, hospital avoidance services and we are also going to look at the relations, as has been flagged in the last few days, with the organisations which are not government which we fund to deliver particular services. We are expecting value for money from those as well, and we will do that in a strategic way.

In addition to that, of course, we will try to ensure that as few people as possible go to hospital who do not need to go to hospital because there are other places they can go and that is where our GP Plus strategy comes in, so we have other options for people so that they do not have to go into the hospital system. In fact, South Australia had the lowest increase in attendances at emergency departments in the last year (0.3 per cent) largely because of the other hospital strategies that we have in place. So, we will continue investing in those strategies.

Finally, we will try to make sure that when a patient does go into a hospital they move through the hospital as quickly as possible. Sometimes there are logjams in place in a hospital to get a person into a bed and that means the tests that are required might take longer than they need to take, that means we need to have doctors who are senior doctors who are on duty around after hours, so we want a rostering system and we are involved in enterprise bargaining discussions at the moment with SASMOA, the union which represents doctors, because we want to have more doctors available to work extended hours. At the moment only the emergency department and the ICU doctors work in that way, so we have been in negotiations with the union now for about a year over this very point, and we absolutely have to make that work. Once patients have been admitted into the hospital, we want to make sure that once they have had whatever they need to have and they are better, they no longer need an acute hospital, they can be moved somewhere else.

Part of the reforms that are required is to have discharge arrangements in place. At the moment a lot of patients will spend time in hospitals longer than they need because the discharging is always done by the doctor. We want a move to have protocol-led discharges so that nurses can discharge patients once they have satisfied whatever the requirements are. So, there are a whole lot of reforms in that area that we are working on.

Can I say, this is not going to be an easy task and every time Health tries to reduce expenditure in almost any field whatsoever, other than in very minor areas, but whatever field we try to reduce expenditure in we get a reaction from—

Mr WILLIAMS: Point of order, Madam Speaker. I was looking forward to learning how the minister was going to manage his substantial budget but he has gone four minutes and still has not explained very much to us.

The SPEAKER: I am not sure what your point of order was, but minister your time—

The Hon. J.D. HILL: Madam Speaker, I take absolute objection to that comment. I gave a very serious answer to what I thought was a serious question. I was explaining to the house how I was going about the task that I have, and to have it trivialised by that clown over there I find completely objectionable.

Members interjecting:

The SPEAKER: Order! There was no point of order in that one.