Public Works Committee: The Queen Elizabeth Hospital Transforming Health Project

Ms DIGANCE (Elder) (11:26): I move:

That the 529^th report of the committee, entitled The Queen Elizabeth Hospital Transforming Health Project, be noted.

An honourable member interjecting:

Ms DIGANCE: That's next. The Transforming Health initiative involves a whole-of-system approach incorporating a range of interrelated services being delivered across multiple sites, which I have already outlined with previous projects in the southern region.

The Queen Elizabeth Hospital has also been included as part of the initiative and will be redeveloped. The oldest of the health buildings, the hospital dates back to 1959, with new ward accommodation being completed in 2003 and 2007. The new mental health for older persons building was completed in 2013 and the new allied health building in 2012. This hospital will be a key facility in the South Australian health system and requires further redevelopment, including physical changes, in order for it to meet the requirements of the changing health environment and the new approach to the management of health in South Australia.

Specifically, the role of The Queen Elizabeth Hospital will change to incorporate the provision of spinal and brain injury rehabilitation and general rehabilitation, including orthopaedic and stroke. As such, the redevelopment of the hospital will include the repurposing of 62 existing beds to accommodate rehabilitation services for spinal injury, brain injury and general rehabilitation, and a new ambulatory rehabilitation building for the new hydrotherapy pool and support space, as well as new therapy and staff support areas.

The capital cost for this project is $20.4 million, exclusive of GST. Extensive consultation has occurred at both The Queen Elizabeth Hospital and the Hampstead Rehabilitation Centre. In addition, consultation will occur with the Charles Sturt council and the local community. A local communications work group is to be established to consult with both internal and external stakeholders. Construction is due to commence in January next year, with completion by the end of 2016. 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 KNOLL (Schubert) (11:28): I rise to talk about the QEH redevelopment, not because it has any great proximity to the electorate of Schubert but because over the past 18 months I have heard a lot of stories from members of my electorate finding their way into the Hampstead Rehabilitation Centre and who will, self-evidently, find themselves in the future having to head down to The QEH to receive treatment for spinal and brain injury. I want to talk about a couple of experiences I have had of people coming into my office in response to these proposed Transforming Health changes.

Having moved out to the country about five years ago, and understanding what country life is all about, it is a beautiful environment in which to live and it is a beautiful environment in which to raise a family because of the cleanness of the air and the beautiful green surroundings, especially at this time of year. There is a wholesomeness to living in the country that sustains country people.

When these people have horrific brain or spinal injuries they almost invariably end up in the Royal Adelaide Hospital. After they complete their surgery they then head off (at the moment) to the Hampstead Rehabilitation Centre to rehabilitate. Going from a beautiful, relaxed country environment to a hospital-like environment is not a positive step. I think we can all agree that sitting in hospital is not necessarily the best thing for a person's rehabilitation, in terms of their mindset, especially when they are used to big, wide open spaces. Confined to a hospital bed or inside a hospital ward is not necessarily the best place to rehabilitate, especially when we are talking about weeks, if not months, of rehabilitation.

Obviously, what is being proposed with the transfer of the Hampstead Rehabilitation Centre to The QEH is the closing down of the centre and moving those facilities to a hospital-like environment. We are going to close the Hampstead Rehabilitation Centre, which has access to open areas, to parks, to gardens, to a whole host of services, including gym services and a pool, and move those facilities to a hospital-like environment.

I would like to talk about a gentleman in my electorate who lives out Sedan-Cambrai way, out in the flats. This gentleman is known to me because he is a pig transport carrier. It turns out that he has been carting for many years pigs that end up in beautiful Barossa Fine Foods sausages. He and I had a conversation. I have had cause to meet his son, who is a brilliant artist out in the Barossa, but he really wanted to talk to me about the situation with his daughter.

His daughter was a high school student. She was doing year 11 or year 12 and had a horrific brain injury. She went to the Royal Adelaide Hospital and received treatment and was there for quite a long time. Her father spoke to me about the fact that the entire time she was in the Royal Adelaide Hospital she did not show any signs of improvement. She was fairly non-responsive; she was not able to talk. Her father, who is a pretty gruff sort of guy, was standing in front of me with tears in his eyes because he saw his daughter's pain and suffering and because his whole family was sitting there waiting for things to improve, as they were supposed to.

After about five or six weeks, I think, she got moved across to the Hampstead Rehabilitation Centre and her father said that, all of a sudden, literally within days, they started to see a vast improvement from her, especially when they sat around in the garden areas, smelling the fresh air and looking at the flora and fauna around there and getting involved in what she would have considered her more natural home environment. She started to talk a lot more. She started to rehabilitate in terms of walking and those kinds of things, getting her physical movement back. She improved in leaps and bounds.

Her father was at pains to stress to me that it was only when his daughter was moved from a hospital-like environment to a more relaxed setting, a more comfortable setting, that she started to thrive. His concern is that if the future path is going to be from the RAH to The QEH, it is not going to provide for that more relaxed environment. It is going to go back to being a hospital-like environment.

I also had a doctor in my area who broke his leg in a bicycle accident. From what I understand it was an accident involving a single bicycle. He spent weeks out at the Hampstead Rehabilitation Centre and came home full of praise for what that centre was able to do for him. I have also had discussions with people who are quite familiar with Paraquad SA and their concerns about the fact that this move from the Hampstead Rehabilitation Centre to The QEH is going to result in a loss of square metreage of space for rehabilitation in this area and also that it will not provide the level of gym services that the current centre provides. On all of these things, Paraquad SA's view is vital to being able to rehabilitate their people.

It has been made a lot more clear to us on this side of the house that the smoke and mirrors Transforming Health proposals, which may have some element of trying to improve the efficiency of service, are not about improving the quality of service—and they are about reducing costs. That is, of itself, not necessarily a bad thing, but it is not a conversation that the government has been willing to have; in fact, they have been trying to hide and run away from the idea that Transforming Health is about saving money. Indeed, in this place and outside of this chamber, the Minister for Health, the member for Playford, has not ruled out the fact that we are going to see a significant reduction in bed numbers, somewhere quoted up to around 800 beds, as we understand.

This belies the fact that Transforming Health has been a process that has been designed around trying to deliver an outcome, but the government has not been willing to have an honest conversation with the people of South Australia. There is an argument to say, 'Look, health spending will swallow up the entire budget, we need to have a rethink about the way we do things.' You would have to consider that it is about a $3.5 to $4 billion budget that there are better ways that we can spend that money. I think that is a conversation that the government could have but they have chosen not to; they have chosen to spend $3 million worth of taxpayer money on an advertising campaign, purely designed to try to move away from having an honest conversation about cost.

When we stand in this place, and we are discussing now The QEH proposal, talking about a diminution of services, we are talking about not only cutting costs but also cutting quality, and that is the part that I think South Australians will most baulk at. That is the part of the conversation that I do not think is okay. Certainly, the concerns of people in my electorate that are not being addressed are legitimate concerns and ones that should otherwise be taken into account.

I implore the government to come clean and be honest, help us to understand the true intent behind these proposals, and let's find a way to make sure that we can try to do things better at lower cost but at the same time not reduce the quality of services for the most vulnerable in society for people at a time when they most desperately need their government to stand up for them and deliver for them at those critical junctures post horrific injury.

Mr WHETSTONE (Chaffey) (11:37): I too welcome the 529^th report of the Public Works Committee on The QEH Transforming Health Project. To note, as a committee member, it was a hearing dealing with the four projects that really ended up having a common theme and that was about, as I think the member for Schubert has so eloquently put it, the government hiding behind the smoke and mirrors, reducing bed numbers and, essentially, trying to explain but not explain how they had to reduce their healthcare budget but also uphold the level of care, courtesy and good outcomes, and that is what every person who visits a hospital ultimately is looking for.

The $20.4 million project (GST inclusive) is set to have a primary focus on rehabilitation with the majority of construction expected to take place next year. A new hydrotherapy pool, which I am sure every regional hospital in South Australia wished they had—and I know the member for Schubert would like a new hospital. Of my six hospitals in the electorate of Chaffey, four of them would absolutely die for a hydrotherapy pool—

Mr Pengilly: Absolutely.

Mr WHETSTONE: Of course, the member for Finniss agrees with me. I am sure he is looking for a hydrotherapy pool down at—

Mr Pengilly: The south coast.

Mr WHETSTONE: Down at the south coast.

Mr Pengilly: Kangaroo Island.

Mr WHETSTONE: And Kangaroo Island, of course. I tend to treat myself as a bit of an expert with rehabilitation because, throughout the course of my youth and my early adulthood, which luckily I am still in, I have had to rehabilitate many times sporting injuries, sadly.

Members interjecting:

The DEPUTY SPEAKER: Order!

Mr WHETSTONE: Whether it was through performing above my capacity or capability, it always seemed to put me in hospital in one way, shape or another. I think obviously rehabilitation is something that is critical after you have been fixed up, stitched up, realigned or put back together. Rehab is probably the most important, because getting back into the groove is what life is all about. The 62 existing beds repurposed for rehab services are currently used for the general medical and aged assessment.

One of the other common themes throughout the hearing was the simple questions that I asked, and they were just simple yes or no questions. I asked many times as to whether there will be fewer beds at The QEH. The response was, 'We are going to have the number of beds that we need to deliver care that we need for our population.' Another question was, 'Will we have more or less beds?' and the answer was, 'We have more beds than anybody else in Australia.' I again asked, 'Will there be more or less beds?' The answer:

We have more beds per head of population than anywhere else in Australia, so we are going to aim to end up across the system with the right number of beds for our population...

I imagine that, if we manage all of the reform that we want, we will not need as many beds as we have now.

Again, I asked for that simple yes or no: 'If we are successful with our transformation, we will' have fewer beds. I asked 40 questions and I was only looking for one answer, and eventually I got it: we will have fewer beds, we will have fewer nurses and we will have fewer doctors.

Just a quick note on the state government's upgrade at the Berri Hospital in my electorate: as I have stated, the hydrotherapy pool is one of those assets that the government needs to consider more important than just the bottom line. As I have said, hydrotherapy pools play a significant role in the health, wellbeing and end outcome of all patients. The hydrotherapy pool is something that I will continue to advocate for to this health minister and this government, and hopefully in the not too distant future we will see a change of government and a change of health minister that will be more accommodating when we are looking to justify the needs of regional rehabilitation.

During the hearing, we were told of the extra landscaped area in the therapy spaces. I have said that I think that is very important, and I am sure the member for Schubert would acknowledge that surroundings are very important in rehabilitation. It is not only having good clinicians, doctors, equipment and services, but just the tranquillity and some form of a surrounding there to not only help people rehabilitate but also to help their mind and headspace cope with what they are going through at a time.

We were told that the project does involve the relocation of rehabilitation capacity from the existing Hampstead site and SA Health is working through the consultation. I think it is sad that we continue to centralise, and obviously the philosophy of this current government is to centralise at all costs. We were also told that:

...we have recently constructed quite a bit of new capacity at Lyell McEwin, and we would expect that Lyell McEwin will soon be able to treat more of the northern constituents rather than [having them travel to] The Queen Elizabeth.

I think while that might be good for the people of the north, there are a lot of boxes that will not be ticked once Transforming Health is implemented.

I asked about the clash of the QEH project and the supposed opening of the RAH. I think that really did open up the eyes of most people in the room that, yes, while we are having a transition from the current RAH to the new RAH, we will also be dealing with The QEH as well. That will be interesting to watch in its rolling out. As I have made clear, there were a number of concerns within the project, but nevertheless, it was given the green light and I think the committee did a great job.

Ms DIGANCE (Elder) (11:45): I thank the member for Schubert and the member for Chaffey for their contributions to this debate. I also thank the other hardworking members of the Public Works Committee, the administrative staff and executive officer, and all the witnesses who came before us and I think thoroughly covered this particular project also. I recommend the report to the house.

Motion carried.