Stroke Service

Mr MARSHALL (Dunstan—Leader of the Opposition) (14:22): My question is to the Minister for Health. Did SA Health assess the capacity of the Royal Adelaide Hospital's neurointerventional radiologists before centralising stroke services in March as part of Transforming Health?

The Hon. J.J. SNELLING (Playford—Minister for Health, Minister for the Arts, Minister for Health Industries) (14:22): It is important to note that this matter has nothing to do with the reforms we have made with regard to stroke services; they are completely separate issues. Interventional neuroradiology is a highly specialised procedure; in fact, not only are there not many people in South Australia who are credentialed to do the procedure but there are not many people in all of Australia who are credentialed. It involves inserting a wire, for want of a better word, into the brain of a patient in order to clear out a block. It's a procedure I have seen done with patients suffering heart attacks, but not something I have ever seen done on a stroke patient, and I don't think members would be surprised to understand that inserting anything into a patient's brain is extremely dangerous and not something which is undertaken lightly.

The circumstances where it is undertaken are where the usual treatment for stroke, using the clot-dissolving drugs, has failed, and it's only under those circumstances that this procedure is undertaken, and even then it is not necessarily, I understand, in all cases. It is a relatively rare procedure which is undertaken. At the moment, there are two doctors who are credentialed at the Royal Adelaide Hospital to perform the procedure.

My understanding is that there is some disagreement among clinicians about what are the appropriate qualifications a clinician needs, a doctor needs, in order to undertake this procedure, that it is not a clear-cut matter with regard to who should be allowed to do it. There is some disagreement among clinicians about the sorts of qualifications and how qualified a person should be, given how relatively rare it is compared to other procedures that we do in our health system and the highly dangerous nature of the procedure.

Certainly, I have impressed upon the department the importance of having more appropriately credentialed doctors able to perform this procedure. I think there can be little doubt that only having two to cover a roster, given that strokes present at all times of the day or night, is insufficient. My understanding is that the department is addressing that matter to see how quickly we can get some additional doctors appropriately credentialed and able to do this procedure as soon as possible, because there is no doubt that only having two able to do it is not sufficient to cover a roster.