Parliamentary Committees

Public Works Committee: Flinders medical centre neonatal unit redevelopment project

Ms DIGANCE (Elder) (11:02): I move:

That the 568^th report of the committee, entitled Flinders Medical Centre Neonatal Unit Redevelopment Project, be noted.

The Neonatal Unit was established at the Flinders Medical Centre over 30 years ago. Since then, there have been significant changes in technology and the provision of models of care Australia-wide for neonates. In particular, and in addition to medical advances, there has developed with time the recognised value of support and encouragement by family members of those in need, which has led to a natural increase of family involvement in the care of these high-needs babies. This, in turn, means that we need extra space for every crib, not only to accommodate supportive family members but to ensure privacy at this very stressful time.

While highly experienced and skilled clinicians and management have ensured these advances in technology and caregiving have been retrofitted into the current facility with due care and professionalism, necessary changes to the footprint of the nursery must be made to continue to facilitate the best possible care.

The current Neonatal Unit is located over two floors. The main unit is on level 3, with a 12-bed satellite overflow nursery established on level 4. This has resulted in neonatal staff and resources being shared between the two floors. While they have always made this work, the opportunity has arisen, with this proposed upgrade, to consolidate services onto one floor, bringing with it efficiencies recognised and identified by the clinical staff and management. This redevelopment is in line with the revitalisation currently occurring at the Flinders Medical Centre. It is now an appropriate time to co-locate the clinical neonatal services in one area and upgrade the facilities.

The upgrade to the Neonatal Unit will deliver a 50-cot unit over approximately 1,700 square metres, all located on level 3 of the hospital. The redevelopment will provide for family-centred care and the level of acute care facilities will increase, with 16 neonatal intensive care unit cots including four negative pressure and/or isolation cots. These are all level 6 acuity care cots for the more seriously ill infants. In addition, there will be 10 high-dependency cots, including two physical isolation cots, and 24 special care cots, making 34 level 4/5 acuity care cots.

The neonatal clinical care area on level 3 will also provide baby treatment spaces; consultation, counselling and support spaces for parents and families of admitted babies, as well as three overnight rooms for parents; clinical work and support spaces including medication, equipment stores, milk storage and utilities; and reception and public waiting facilities. This clinical unit has been specifically designed with multiple zones to best manage infection control, privacy and safety. The most acute care cots will be placed farthest from the entrance to minimise foot traffic that can cause disruption to patient treatment and patients' families and minimise infection for the most seriously ill babies.

The neonatal administrative and clinical support unit, that is, the non-clinical neonatal activities, will be located on level 4. This will include workstations for clerical activities, non-clinical work areas for senior clinical staff and clinical research staff, training facilities and meeting and seminar facilities. This area is located within a 45-second walk of the clinical area, should an emergency arise requiring additional staff.

To accommodate the Neonatal Unit on level 3, the Department of Anaesthesia non-clinical support unit will be relocated to the newly refurbished accommodation on level 2, where doctors can undertake non-patient activities associated with patient care, including training in clinical skill development. The department will maintain its telemetry connection with the operating theatres, an important aspect of this move, as clinicians will be able to monitor the theatres and respond promptly, should the need arise. The department is located within the critical travel distance to the operating theatres, being within a two-minute walk.

The committee was informed that there has been extensive consultation with clinical and non-clinical staff. A working group has been established to ensure the design of the new units meets the needs of the staff, as well as the support services and those they are taking care of. Consultation will continue with both staff and other stakeholders throughout the construction phase of this facility to ensure the best possible outcome.

The total cost of this project is $17.5 million (GST exclusive), with works due to commence this July. The construction will be staged in order to manage the ongoing operations of the unit and should be completed by September 2018. These works are in addition to the Flinders Medical Centre upgrade health project that is continuing at the moment.

As a local member of parliament with constituents who utilise the Flinders Medical Centre services, I have been and will continue to be a strong proponent to ensure this nursery at Flinders Medical Centre, catering for all levels of neonatal care, will not only endure but in fact receive this much welcome upgrade. During the hearing of this project, some committee members raised the previous misinformed discussion on the relocation of level 6 services, which they confused with the apparent total closure of the entire neonatal nursery. This was simply a falsehood and a fearmongering campaign—nothing else. I repeat that at no stage was closure part of the plan of this much-needed and loved neonatal nursery.

As the local member for Elder, and a former practising midwife, I enthusiastically welcome the reconfiguration and upgrade of this very important nursery to those in the south and also country patients. I wish to thank my fellow committee members for considering this project and the due diligence that we all undertook: the members for Colton, Torrens, Finniss and Unley, and I also thank the staff for their assistance.

Before I finish, I would like to say special thanks to the member for Finniss for his work on the committee. For those of you who are not aware, the member was appointed to the Public Works Committee on entering this house in 2006 and has been a member of this committee ever since. That is 11 years of continuous service with one committee. It must be a record. He has considered nearly 330 projects over this period, been on countless site visits—and I have to say is always enthusiastic for site visits and I am grateful for that—and has outlasted several executive officers.

The committee is generally a very harmonious committee that progresses projects with bipartisan support. However, there have been times when we do have disagreements and the member has prepared a number of minority reports over the years. I thank him for his passion in recent times for the Kangaroo Island airport project, keeping us abreast of what is happening there and ensuring good governance of that project.

With that, and pursuant to section 12C of the Parliamentary Committees Act 1991, the Public Works Committee reports to parliament that it recommends the redevelopment of the Flinders Medical Centre Neonatal Unit and associated works.

Mr DULUK (Davenport) (11:10): I also rise to speak to this report. As the Flinders Medical Centre is in the heart of my electorate, I support the works that are going on at the moment. Better late than never. It is 15 years in the making, but it is good to see some progress happening. It is a wonderful investment in the Flinders Medical Centre. Of course, we have seen the government make a few announcements this week in regard to further upgrades at the Flinders Medical Centre with the creation of two new operating theatres for about $3.5 million, taking the number of theatres from 10 to 12. This is part of the $1 billion investment in public hospitals announced in the state budget. It is good to see some really good investment in the Flinders Medical Centre.

As the member for Elder talked about in her report, it is good to see the local MPs getting behind projects. I see the member for Fisher is really proud of the $12 million proposed to be spent in Noarlunga and I know the member for Lee is very excited about the investment in The QEH. Obviously, he was a bit worried about what was happening with The QEH in terms of his community and polling and he convinced the government to spend some money.

Members interjecting:

The DEPUTY SPEAKER: Order!

Mr DULUK: Investment in local hospitals is most important and it is very important that we are investing in the Flinders Medical Centre. We have seen an upgrade to Modbury Hospital, Deputy Speaker, through your hard work. There is one hospital in my community that is not receiving any money, and that is the Repat. The Repatriation Hospital in my community is not receiving any money in this budget at the moment.

Ms DIGANCE: Point of order: we are actually talking about the Flinders Medical Centre, specifically the neonatal nursery unit.

Ms Chapman: You talked about the Kangaroo Island airport.

The DEPUTY SPEAKER: Order! I am going to listen very carefully to the member for Davenport and I am trying to be very fair. Happy birthday, member for Bragg.

Mr DULUK: Thank you, Deputy Speaker, for your protection. I am talking about my role as the local MP, as the member for Elder talked about in her contribution in her role as the local MP. The Flinders Medical Centre is a fantastic hospital in my electorate. When the Flinders Medical Centre is at capacity and overcrowded, it sends the bulk of its patients down Ayliffes Road to the Repat. On Monday, there were about 206 inpatients at the Repat.

Ms DIGANCE: Point of order: relevance.

The DEPUTY SPEAKER: I do not think we went into numbers.

Mr DULUK: Numbers are—

The DEPUTY SPEAKER: We do not need to know numbers.

Mr DULUK: Numbers are very important when it comes to public works, Deputy Speaker.

The DEPUTY SPEAKER: Yes, but not daily figures.

Mr DULUK: Of course, in terms of investment in the Flinders Medical Centre, which is most important—and we are seeing an extra $3.5 million to deal with the operating theatres—and the expansion of the Flinders Medical Centre and with the Neonatal Unit at the moment as well, the question is: where is capacity going to be generated at that site to deal with what is happening at the moment with the closure of the Repat? I suppose I can say that I know my community is very concerned—

Ms DIGANCE: Point of order: neonatal care is not performed at the Repatriation Hospital. I think we need to be clear on that. We are talking about the Flinders Medical Centre neonatal nursery care unit.

The DEPUTY SPEAKER: I am going to suspend ruling up the book and listen to you full time now.

Mr DULUK: If the member for Elder is unhappy—

The DEPUTY SPEAKER: No, get back to the report.

Members interjecting:

The DEPUTY SPEAKER: Order! Get back to the report.

Mr DULUK: At the moment, we are seeing a fantastic investment in the Flinders Medical Centre and we are seeing an upgrade of the Flinders Medical Centre. As part of the government's $180 million spend over the last couple of years in the Flinders Medical Centre, they are talking about increasing parking. A huge issue at the moment for many of my residents is access to the Flinders Medical Centre, as the member for Ashford knows, getting around.

One thing people love about the Repat is that it is very easy to get a park, and my constituents are saying to me, 'Sam, what is going to happen when the Repat closes? How am I going to get a park at the Flinders Medical Centre? How am I going to get around? What is the mix going to be between Flinders Private and the Flinders Medical Centre?' Another really big issue people come to me with and say is, 'Sam, they are closing Ward 17 at the Repat—

Ms DIGANCE: Point of order: this is a public works project on the Neonatal Unit at Flinders Medical Centre. No neonates are treated at the Repat.

Mr Knoll interjecting:

The DEPUTY SPEAKER: Order! The member for Elder is raising relevance. I must admit, listening closely to you, that parking at the neonatal centre might be the issue, but let's try to focus on the neonatal centre.

Mr DULUK: Point of order: the member for Elder in her contribution talked about the new upgrade of the Flinders Medical Centre, as am I.

The DEPUTY SPEAKER: True, but I am not sure—

Mr Pengilly: Talk about Modbury. You would be allowed to do that.

The DEPUTY SPEAKER: Order! That is just 'she said, you said' dobbing. Part of your problem, I suppose, is that the member for Elder's contribution was not quite so wideranging.

Mr Knoll: What? Because it wasn't attacking the government?

The DEPUTY SPEAKER: She covered areas, but I think you have had a fair bash at that bit. Move on to the next bit you are going to have a go at. I think that is part of your problem.

Mr DULUK: Thank you, Deputy Speaker, for allowing me to move on to talk about older person's mental health at Flinders which—

The DEPUTY SPEAKER: No.

Mr DULUK: As part of the current development—

Ms DIGANCE: Point of order: when I spoke about the Flinders Medical Centre, I did a generic—

Mr Knoll: What is the point of order?

The DEPUTY SPEAKER: Relevance, again.

Ms DIGANCE: The point of order is relevance. This is about the neonatal—

The DEPUTY SPEAKER: Sit down. Everybody just take a break. We are still going to listen very carefully. Try to focus on this report, if that is possible. That would be good.

Mr DULUK: Of course, the member for Elder in her report talked about consultation with clinicians and obviously how it is very important to work with clinicians to get the right footprint at the Flinders Medical Centre. We are seeing some of the services move from different levels, which is most important and of course, in a more broader sense, there would have been consultation across the board with other clinicians and other areas of the hospital to make movements for the changes to accommodate the new neonatal centre.

One thing I would like to put on the record is the consultation between government and SALHN. The Flinders Medical Centre is within SALHN and the Neonatal Unit is obviously within the Flinders Medical Centre. The Repatriation Hospital is another hospital that is in SALHN. Recently, in evidence given to the committee into Transforming Health, which is to do with SALHN and the Flinders Medical Centre and the Neonatal Unit within that, was the future use of Ward 18, which of course is the geriatric unit within the Repat, which is within SALHN, which is within Flinders Medical Centre with the neonatal centre right there.

Ms DIGANCE: Point of order: relevance. No neonates go to Ward 18. They never have.

Mr Knoll interjecting:

The DEPUTY SPEAKER: Order!

Mr DULUK: Thank you, Deputy Speaker. If the member for Elder will listen to me then she will—

The DEPUTY SPEAKER: Order! I have not said anything yet. It is only 20 past 11. It is going to be a very long day if we have to keep stopping every five seconds for a discussion on a report like this. Please keep concentrating on the actual report, which is on the neonatal care unit.

Mr DULUK: Thank you, Deputy Speaker. If the member for Elder is listening, I was talking obviously about relocating services across the Flinders Medical Centre, which has happened as part of this public work inquiry into neonatal services, so there had to be some rejigging of services and where they were located. As part of the relocation, we are seeing some new investment at the Flinders Medical Centre for an older persons mental health service within that. I am not sure what levels were being switched—levels 4 or 5—but I am sure that the member for Elder will be able to tell me if I am wrong.

In terms of making room at the Flinders Medical Centre for the new neonatal centre, discussion with SALHN would have to have occurred with regard to what is happening in Ward 18 at the Repat. Recent evidence to the select committee on 9 June 2017 states:

ACH to date has had no discussions with government about potentially using Ward 18 post-settlement as the facility—

Ms DIGANCE: Point of order.

The DEPUTY SPEAKER: Order! Sit down. Member for Davenport, point of order on my right.

Ms DIGANCE: ACH do not care for neonates.

The DEPUTY SPEAKER: Relevance. Before you keep going, it would be best to perhaps realise that my role in the house is to prevent arguments between members, within standing orders of course, but it would be fair to say perhaps that you are going out of your way this morning to perhaps not concentrate as much as we would like on the Neonatal Unit. Is there going to be any part of your contribution about the Neonatal Unit?

An honourable member: Probably not.

The DEPUTY SPEAKER: Probably not? No, I did not think so. Let's hear you out. You might say something about the Neonatal Unit in a minute. Off you go.

Mr DULUK: Deputy Speaker, this is all about the Neonatal Unit. Actually, this is about where, two years ago—

The DEPUTY SPEAKER: You are being very naughty, now.

Mr DULUK: —the government actually wanted to close the Neonatal Unit at the Flinders Medical Centre. This is all about the Neonatal Unit, this is all about a huge hospital in my electorate. This is all about health care in South Australia. This is all extremely relevant, and if those opposite do not want to hear about what they have been doing across the board to destroy health care and the provision of health care, especially in my community—

The DEPUTY SPEAKER: But, you see, within your contribution now you are not actually talking about the Neonatal Unit at all.

Mr DULUK: I am coming back to the Neonatal Unit.

The DEPUTY SPEAKER: Great, let's hear it.

Mr DULUK: Two years ago, the government wanted to close the Neonatal Unit, as you well know, Deputy Speaker.

Ms DIGANCE: Point of order.

The DEPUTY SPEAKER: Order!

Ms DIGANCE: No, the government were not going to close—

Members interjecting:

The DEPUTY SPEAKER: Order!

Members interjecting:

The DEPUTY SPEAKER: Listen! The member for Elder did cover part of that in her contribution, which is on the record, so we are going to listen to what the member for Davenport has to say and then we will see.

Mr BELL: Can I get a point of clarification, Deputy Speaker?

The DEPUTY SPEAKER: Yes.

Mr BELL: In October last year, when the Natural Resources Committee handed down a finding on fracking in the South-East, the Treasurer came in here and deviated wildly from the substance of that report. You ruled, I think quite correctly, that there was a broad scope within the report to make comment on it, so if the scope is health—

The DEPUTY SPEAKER: Okay. Sit down now. I am sure that on that day I took advice as well, and I am taking advice this morning. Let's move back to the report. I am sure other members have other things to say as well. I am trying to be as fair as I can.

Mr DULUK: Thank you, Deputy Speaker. I would have finished by now if I had not been interrupted so much by the member for Elder. Two or three years ago, the community rallied to keep services at the Flinders Medical Centre. I recall being there on a Sunday with the leader, the member for Mitchell and the member for Bright. I did not see the member for Elder there at the community protest, but the community in southern Adelaide, in SALHN, which includes the Flinders Medical Centre, the Repatriation Hospital and Noarlunga Hospital at the moment, was disgusted about what the government wanted to do to the neonatal services at the Flinders Medical Centre. That is a fact.

It is a disgrace that those opposite even contemplated reducing services at that site, as it has been a disgrace that they have been reducing services across the board, across all South Australia, in recent years, only then to reinstate them and build them back up as they are at the moment. This is the cynical nature of the government at the moment when it comes to health care. What we saw in the way they were treating the neonatal facility two or three years ago at the Flinders Medical Centre we have seen repeated across the board. We have seen it with cardiology at The QEH and we have seen it in the hospital in your area.

The neonatal centre at the Flinders Medical Centre is a very important, much-loved part of the Flinders Medical Centre. Obviously, there have been adjustments at the moment in terms of its positioning, and it is fantastic to see that in my community the neonatal services will continue through the hard work of the community lobbying, and keeping this government accountable, and of all of us on this side of the house.

The DEPUTY SPEAKER: It reminds me a bit of the time when we were discussing the privatisation of the Modbury Hospital, but I wouldn't say that, would I? The member for Finniss.

Mr PENGILLY (Finniss) (11:24): I will try not to be too controversial.

The DEPUTY SPEAKER: It is your last contribution as a member of the committee.

Mr PENGILLY: Well, that is right. We could get back to that. I might do that later on today, actually. This indeed is a much-needed project, but it is worth noting that, yes, the government was going to close it down and degrade it; there is no question about that whatsoever. The member for Davenport is quite right. I also hope, with the introduction of this new facility, that the member for Davenport might work quite hard to fill it up.

Members interjecting:

The DEPUTY SPEAKER: What? Hang on. Is that in the biblical sense?

Mr PENGILLY: We are still waiting and it is too much information. The opposition members were supportive of this project, as indeed they were of the KI airport project, which the member for Elder raised during her speech. It is a much-needed project. It is a major concern, with the declining population in the state, that we wonder where we are going to have to go with all these medical facilities, but the neonatal unit that was presented by government officers was a well put forward project.

I know that the member for Davenport pushed very heavily and lobbied to have it done, so congratulations to him on that. He is an outstanding local member up there and in due course he will make a good local member for the seat of Waite, I hope, but that is another story. There was not any great degree of opposition from anyone on this. Indeed, a number of questions were asked from across the committee and we supported the project.

Ms DIGANCE (Elder) (11:26): I would like to thank the members for Davenport and Finniss for their contributions, but I do want to highlight the fake news they have talked about, that the unit was going to close, because it never was going to close. There was discussion about the level 6 part of the care of that unit, but it was never going to close, so that was fake news over there. Bipartisan support was unanimous on this project. It is seen as a very valuable project for those in the southern area and also for country members. I recommend the report to the house.

Motion carried.