Parliamentary Committees

Public Works Committee: Flinders Medical Centre Transforming Health Project

Ms DIGANCE (Elder) (11:01): I move:

That the 527^th report of the committee, entitled Flinders Medical Centre Transforming Health Project, be noted.

In October 2014, SA Health commenced the Transforming Health initiative. It incorporates a number of reforms, including the establishment of new models of care, changes in clinical service profiles of hospitals across South Australia and the health system, and capital investment into SA Health assets.

As part of the initiative, a number of projects have been proposed, including the redevelopment of the Flinders Medical Centre. The centre is the major tertiary referral facility for acute care and emergency services in the southern region of Adelaide. The hospital manages the majority of major and complex medical and surgical diagnostic and treatment procedures for the southern region and provides services to all types of patients, including those with severe life-threatening disorders or those with limited chance of survival. The hospital is also a tertiary referral teaching hospital associated with Flinders University. Through the Transforming Health initiative, the role of Flinders Medical Centre will be expanded to also create a rehabilitation services hub with new palliative care facilities and new mental health facilities for older persons.

Consultations with an expert advisory panel that included clinicians and consumers identified that the Repatriation General Hospital palliative care service, including Daw House inpatient service, would be better relocated at the Flinders Medical Centre. Previously, this scope of works had been identified for the Noarlunga health service. Following this feedback, the palliative care services will now be provided from the Flinders Medical Centre site.

The full scope of works will provide a new 55-bed rehabilitation building comprising inpatient, ambulatory, research, teaching, consulting, hydrotherapy pool and gymnasiums base; a new 30-bed older persons' mental health unit, including consumer accommodation, administration, consulting, interview and sally port facilities; a new 15-bed palliative care ward with a courtyard garden located within the rehabilitation building; a new multi-deck car park delivering in excess of 1,240 car spaces; enhanced secure bicycle storage; two linkages to Flinders Drive to improve vehicle access and flow; new pedestrian and vehicle linkages to support interconnection of the new facilities with each other and connection with the main hospital building; and site engineering and infrastructure works to provide engineering systems to the new facilities.

The total cost of the works, including the palliative care building, is $170.5 million exclusive of GST. Consultation regarding the works has occurred with the Flinders Medical Centre, the Repatriation General Hospital and Southern Adelaide Local Health Network, clinical and nonclinical staff, and consumer advisory groups. Consultation is ongoing with these groups.

Project construction is due to commence this month with completion of the works by September 2017. Given this and pursuant to section 12C of the Parliamentary Committees Act 1991, the Public Works Committee reports to parliament that it recommends the proposed public works.

Mr WHETSTONE (Chaffey) (11:04): I too rise to speak on the 527^th report of the Public Works Committee, entitled Flinders Medical Centre Transforming Health Project. The Flinders Medical Centre project comes at a cost of $170.5 million and is the largest of the four Transforming Health projects. This work involves constructing a new rehabilitation centre, a new palliative care service, a new aged acute mental health unit and a new, big car park, which does make up about 30 per cent of the cost of the project.

Construction of the facilities is all on the southern side of the site on what is the existing on-grade car parks, and then they will all be linked with covered walkways into the main part of the hospital. During the hearing we were told by architects that there would be a multi-storey car park, which will reproduce about 500 car parks, and they will be in the location which is currently being used with an additional 740 car parks and which covers both the demand generated by new functions, including visitors and patients, but which also adds an additional 250 parks to the capacity of the hospital overall.

The total construction cost to the car park was revealed in the vicinity of $30 million to $34 million. As I said, that is quite a large percentage of the cost, but I guess that all people visiting hospitals would understand that a car park is essential when people come in to visit or for people who are going in there for elective or day surgery.

I also asked whether the new infrastructure spend on this Transforming Health project will mean a reduction in doctors, nurses and beds, and that was quite a contentious issue right throughout the theme of all four of the Transforming Health projects. I do want to note that Professor Keefe stated that there are issues overall across the state in terms of equity of outcomes, and she quoted that we do have more doctors, nurses and hospital beds than any other state in the country and that that puts us in a better position than most other health jurisdictions in the western world.

The aim of the health reform is to firstly improve the quality, and as we improve the quality and deliver the appropriate treatment and care to our patients so the need for certain activities will reduce, and the need for the overuse of doctors, nurses and hospital inpatient stays will decrease.

While talking on the Flinders Medical Centre I would like to touch on the disgraceful decision to close the Repatriation Hospital at Daw Park. In 2010 the current government stated that it would never close the Repat Hospital, and the petition of more than 119,000 signatures tabled in parliament recently is a true sign of the greater anger against that closure and that decision by this current government.

How will the elective surgery load of the Repat be delivered given that the Flinders Medical Centre is overcrowded, and ramping has obviously continued all too often? I note that the state government has announced that a replacement for the Repatriation General Hospital's palliative care unit will be built at the Flinders Medical Centre with a 55 bed rehab centre containing the 15 room palliative care unit on the fifth floor.

SA Health's Chief Medical Officer, Paddy Phillips, has said that the current facilities at the Repat are no longer suitable for modern day palliative care, which has advanced significantly over the past 30 years. Again, I think that most of those 119,000 signatures in that petition indicate that it is a bad decision. It has not been met with any resistance from the local members and, I guess, neighbouring local MPs, which is very, very disappointing. I think that it just shows that those people are toeing the party line to the detriment of those people who have relied on the Repat Hospital over many years. I will just leave it that and support the 527^th report.

Mr DULUK (Davenport) (11:09): I also rise to speak on the Public Works Committee in relation to the Flinders Medical Centre with just a couple of brief remarks. As the local member for the Flinders Medical Centre, I think everyone welcomes an upgrade to the hospital in their electorate. Certainly, the Flinders Medical Centre and the $170 million spend is a welcome spend by the government.

Two things concern me: one, this $170 million spend is at the expense of about $117 million that was promised by the government in the lead-up to the 2014 state election. Whilst it is a wonderful headline figure, I think overall health services in the state are at a loss as a result of the decisions being made by the government. As the member for Chaffey touched on, a lot of the upgrade to the Flinders Medical Centre is at the expense of the Repatriation General Hospital and the closure that has brought, and the tabling of 119,000 signatures against that closure is certainly of concern.

A concern which is often raised with me, and was again raised on Friday by constituents, is about car parking at the new Flinders Medical Centre. At the moment, there is a huge strain on the parking capacity for visitors, users, staff and the like of the precinct, including the university. We have a private hospital there and we have a public hospital there and there is not sufficient parking at the moment. I am concerned, with this current proposal, that those parking needs will not be addressed and there will be car parks lost for staff as a result of the Darlington project.

One of the biggest concerns for me is the ability for users of the centre to have access to the upgraded Flinders Medical Centre. I urge the government and the planners within health and the Department of Planning, Transport and Infrastructure to give due consideration to the planning requirements because I believe it is going to be a dog's breakfast. If we can manage this process then I think it will all be smoother in the long term.

Ms DIGANCE (Elder) (11:12): I would like to thank the members for Chaffey and Davenport for their contributions to this debate. I would also like to note that during the Public Works Committee hearing on this Transforming Health project, I did raise with those present previous promises of funding to the hospital, in particular to upgrade the well utilised and often overcrowded neonatal intensive care unit. The commitment is still there and in place and we were told at the committee meeting that we will see those works start to come to fruition next year. I am personally very pleased about that, given my background and that many of my constituents have used that facility over time with their very sick and small babies. I would also like to thank the Public Works Committee for their hard work on these particular projects and also the administrative and executive officer. I recommend the report to the house.

Motion carried.