House of Assembly Fifty-Second Parliament, Second Session (52-2) 52 2 Parliament of South Australia House of Assembly published Question Time Question Time Health System HEALTH SYSTEM Mrs REDMOND House of Assembly Heysen Leader of the Opposition HEALTH SYSTEM Mrs REDMOND (Heysen—Leader of the Opposition) (14:54): My question is to the Minister for Health and Ageing. Will the minister explain why a reduction of 114 beds in the health system does not mean a reduction in health services, given that the South Australian Salaried Medical Officers Association, the Nursing and Midwifery Federation and the AMA all say that these cuts will mean a reduction of services? 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 HEALTH SYSTEM The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:54): I thank the acting shadow minister for health for her question. It is interesting that at this time when health is such a major issue, the Liberal Party does not have a permanent spokesperson on health at all. There is nobody on the other side who can talk about it. No wonder the Leader of the Opposition— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Mrs REDMOND House of Assembly Mrs REDMOND: Point of order. Standing order 98 requires that the minister's answer not be debate and be relevant to the question. The Speaker House of Assembly The SPEAKER: Thank you. The minister is aware of that. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: She is a bit sensitive, Madam Speaker, and that is why she makes mistakes when she goes onto the radio to make claims about it. Mrs REDMOND House of Assembly Mrs REDMOND: Point of order. The same standing order requires the minister to stick to the substance of the matter raised in the question, not to go off on a debate. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Thank you. If the minister's answer relates to the substance of the question, he can answer as he chooses. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Minister, I refer you back to the question. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: I will deal with the substance of the question. The question was, how can reducing the number of hospital beds equate to no reduction in health care? I will explain that very simply to the house. I will just go through some basic mathematics. We have about 3,000 hospital beds operating in Adelaide on any given day. It does vary a bit, because we flex up and we flex down dependent on seasonal demand, but say we have 3,000 hospital beds. The average length of stay of a patient is around about 6½ days. What we know is that many patients spend about half a day to a day longer in hospital than they ought because they have not been discharged. The reason they have not been discharged is that we have a system in place where doctors do the discharging. Mrs Redmond interjecting: The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Madam Speaker, they ask the question; she interjects; she objects to me saying anything political, yet she reserves the right to interject against me. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Point of order. Mr PISONI House of Assembly Mr PISONI: It is elementary not to address members by their correct title. 'She' is not acceptable. The Speaker House of Assembly The SPEAKER: Sit down, member for Unley. That is no point of order. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! Members interjecting: The Speaker House of Assembly The SPEAKER: Order! We will get some normality in this place. Order! Minister. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Madam Speaker, every time I come in here and try to answer a question which is a sensible question, I answer in a sensible way and I get the same kind of inane interjections— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: —from the other side. They don't like the logic of what I am saying, so they interject. Members interjecting: The Speaker House of Assembly The SPEAKER: Order! What is your point of order, deputy leader? Mr MARSHALL House of Assembly Mr MARSHALL: It's 98: relevance. The minister has been asked to address the substance of the question. He wants to give us a lecture. He wants to give us a lecture on civility, but— The Speaker House of Assembly The SPEAKER: Sit down! Sit down! You have made your point of order. It is not an opportunity for you to debate. Minister, back to the question. The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: To get back to the logic. Thank you, Madam Speaker. I hope to get a bit of time to allow myself to finish this. The point I was making is, there are about 3,000 hospital beds. Patients on average spend longer in hospital than they need to, because the discharge policies we currently have in place, which are led by doctors, mean that doctors often are not available to let people go when they are ready to go. Consequently— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: The same thing happens, Madam Speaker. Why would they get upset when I respond to interjections? The logic is, if you can get patients discharged in a timely way—and this is a recommendation that was made to the government by the nurses union, who— Members interjecting: The Speaker House of Assembly The SPEAKER: Order! The minister is trying to answer the question. Order! The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: This was the logic of the position put to the government by the nurses union, which said that there should be a policy in place, a protocol led discharge policy or a nurse led discharge policy in place, as happens in many other jurisdictions. It is something that we were considering in any event. To do this would mean we could conceivably take about half a day out of the average length of stay of patients in hospitals. If we were to do that, that is equivalent to about a 10 per cent reduction in the need for beds in our system. We are not asking to reduce by 10 per cent; in fact we are looking at less than 5 per cent of the hospital beds across the metropolitan area. It is absolutely achievable to run our system in a smarter way, to get better productivity out of our system and to do things which are better for patients. Mr Pisoni interjecting: The Hon. J.D. HILL House of Assembly The Hon. J.D. HILL: Ask me some questions! Go on; don't interject—ask a question. Have the guts! You be the shadow minister for health for a day. The policy will mean patients will get out of hospitals sooner, not before they need to get out, but in a timely fashion. It will produce a more productive system. This is what the nurses recommended. We have endorsed it; we think it is the right way to go, and I understand that doctors support it as well.