Southern Suburbs Health Care

Ms COOK (Fisher) (15:10): I rise today to talk about health care in the south. I started my career working in health care in the mid-1980s, amidst the biggest reforms in the career structure of nurses that SA had ever seen. Nurses were concerned, other healthcare workers were worried about their own positions within the health system and patients became nervous as they saw rolling work bans, strikes and rallies, but the nurses led the negotiations systematically, using evidence as their base. Clinicians supported the changes as the evidence was placed in front of them. The confidence of the patients increased, and the challenges facing our healthcare system, while highlighted in the past two years, are not new.

There have been a number of changes made within the system over the past three decades. There have been processes, such as Redesigning Care. No bells and whistles or noises have been made, just a concerted effort made by clinicians and administrators to improve the patient journey within hospitals. We saw changes made within the emergency department, which stopped patients from lining the corridors on barouches. We saw the emergence of transit, or discharge lounges, and we saw the arrival of more complex electronic systems, including patient dashboards and ambulance journey boards.

All of these and more made inroads into reducing the length of stay and improving patient outcomes. None of these reforms was as complete, integrated and complex as the current changes occurring, which take the acute-care pathways across the entire metropolitan area and address patient outcomes, length of stay and the use our resources in a targeted, systematic and evidence-based way. This is a sustainable reform.

As a clinician, I am challenged by many of the changes. I know the way change worries healthcare workers and consumers, but I know that the only way we can provide the best healthcare services in the most expert way moving forward is this way. The false and twisted information being put out into the public sphere is a disgrace. The voice being given to people on the opposing side of the change outcome, in particular people not working the system or considered as leaders in health, is worrying.

As I said before, I am challenged by many of the changes, and I have been working with hundreds of healthcare colleagues and constituents to ensure their voices are heard in the process. With the support of the members for Reynell and Kaurna, the Noarlunga Hospital emergency department was given a voice. Amongst several changes to the plans proposed, we now see the emergency department remain under the main roof of the hospital, rather than its proposed move to the separate GP-Plus area. An upgrade, including a specialised paediatric section, was also secured.

As well as this, I worked with the community to present a voice to the minister regarding the downgrading of neonatal services at Flinders Medical Centre. This made no sense to me, to force vulnerable families further apart as they travel to the city for the only level 6 care in this state. The decision to downgrade this service was reversed. I also questioned the move of our PTSD unit to Glenside, but the evidence was in opposition to the position I put forward.

I also put forward a position regarding maintaining palliative care services at Daw House Hospice. Again, the evidence, as well as my own lived experience with my mum as she passed away, and the position of experts were not in line with position I put forward. I will speak more on the work I am doing in this space soon.

I am excited about the realignment of the acute and subacute services in the state, but those particularly in the south. I am also very proud of the work of many of my colleagues as they lead the movement of clinical services. With further confusing reporting and messaging coming to light this week, I want to place on the record some of the facts about the southern health services.

Between 19 April 2017 and 2 May 2017, it is proposed that Noarlunga's Whittaker ward will transfer its inpatient beds to 4GS at FMC (an existing upgraded 18-bed medical ward) and will be combined with existing general medical services, which can also flex up an additional eight beds if needed. There will be no impact on patient care during this reconfiguration. Whittaker currently only has three to four admissions a day, and it ran at 50 per cent capacity over January due to the reduced demand and successful strategies to reduce length of stay.

FMC is the safest and most appropriate place for patients with acute medical conditions who require admission because it has a much wider range of specialties and diagnostic services. If you doubt this, ask the doctors, the clinicians, who have been working in the south and driving this for decades. They are happy. The Medical Ambulatory Care Service (MACS) has been established in the GP-Plus clinic, and this allows for patients to stay in contact with medical specialists down south. It helps them to avoid an admission to hospital and being seen in the emergency department. It has been a huge success.

The clinicians are implementing clinical improvement initiatives to reduce length of stay, improve patient flow and create capacity. We have seen an eight-hour reduction in length of stay in the south. The state government is building nearly $200 million in new infrastructure and Noarlunga Hospital will have inpatient beds. There will be two medical wards focused on world-class care for the elderly as well as overnight surgical beds available for those who need to stay. Facts are vital and, unlike those who wish to politicise the advancement of health care in this state, I will not stop laying the facts in front of our community.