Bills

Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill

Introduction and First Reading

Ms DIGANCE (Elder) (16:41): Obtained leave and introduced a bill for an act to amend the Health Practitioner Regulation National Law (South Australia) Act 2010. Read a first time.

Second Reading

Ms DIGANCE (Elder) (16:42): I move:

That this bill be now read a second time.

I rise to introduce the Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill 2017. This bill is in response to the terrible tragedy, being the murder of Mrs Gayle Woodford, a dedicated nurse whose life ended in tragic circumstances on 23 March 2016. Mrs Woodford responded to a late-night call-out for an apparent medical emergency, and in responding to this call Mrs Woodford was subsequently abducted and murdered.

I welcome today to parliament, albeit with mixed emotions and in mixed circumstances, Mr Keith Woodford, husband of Gayle, and their son, Gary. Welcome. I would also like to acknowledge Alison, their daughter and sister, also a nurse, who is not present today. On behalf of the government and all in the South Australian parliament, I offer our deepest condolences for the sad loss of your wife and mother, Gayle—an exceptional person, a much loved wife, mother, friend and nurse.

Today, the introduction of this bill is to place into law protections relating to after-hours call-outs for those healthcare professionals practising in isolated and remote areas of South Australia. Understandably, Mrs Woodford's murder brought outrage from the community and professional bodies, such as the Australian Nursing and Midwifery Association and the Council of Remote Area Nurses of Australia, as well as nurses themselves, including the member for Fisher, on my left, and myself. We, with the health minister, were determined to amend this situation.

Health practitioners working in remote areas already face a number of challenges in the environment, being the first responder for emergency issues, living in small or very small communities that are often only accessible by four-wheel drive vehicles, and travelling on unsealed roads that at times may be impassable because of heavy rains and flooding. Under these conditions, our health practitioners do not also need to be concerned about their own physical and personal health and safety.

The amendment bill before the house today provides protection to the safety of health practitioners working in health services in the remote areas of the state that are funded by the South Australian government or contracted by the government to provide health services in these areas. When responding to out-of-hours or unscheduled call-outs for emergency medical treatment, these health practitioners must be accompanied by a second responder. The second responder will serve the role of accompanying the health practitioner on emergency call-outs to reduce the chances of personal attack. These second responders may be local community members, another staff member from the health service or a person from another government agency.

Second responders are already in effect in remote areas of the Northern Territory and Queensland to accompany remote area nurses on emergency call-outs. When we met with the APY council, they were keen to reassure us and reassure me that they have already put this into practice in their area. The arrangements in these jurisdictions are by policy and not by legislation, so what we are doing today is very different. While this provides additional security for remote area nurses, it has raised other issues.

A review of remote area nurse safety in the Northern Territory following this occurrence found that practices had not been formalised or documented in relation to staff safety. Staff surveyed stated that they usually considered the clinical needs of the client before their own safety, which is no surprise and highlights the dedication of our healthcare workforce. This government recognises the urgency and need to make provision for the safety of our health workers at risk.

The Northern Territory survey also found that remote area nurses were concerned that if they did not attend an emergency call-out they could be legally liable or their registration could be put at risk. This legislation addresses this issue by providing, in the event that a second responder cannot be found and the health practitioner is unable to attend an emergency call-out, that they cannot be subject to any disciplinary action by a regulatory body.

I am told, in the experience of the Northern Territory Department of Health, that in most emergency call-outs a second responder can be found. I am hopeful that the same can be achieved in this state, as the prospect of not attending an emergency call is not one that is taken lightly by this government and does not sit very well with health practitioners.

I know that the Northern Territory survey highlighted that remote area nurses and managers were worried about client outcomes and community responses if the client deteriorated because the nurse did not attend or if there were delays while contacting a second responder. This legislation will apply to all health services provided in the remote area of South Australia comprising the APY lands, the Maralinga lands and those areas that fall outside a council area, more commonly known as unincorporated South Australia.

Should a health practitioner receive an out-of-hours or unscheduled call-out for emergency treatment, they will be required to go through a risk assessment to determine whether the service needs to be provided now or whether it can in fact wait until the clinic is open the next day or in clinic hours. Should the health practitioner confirm that attendance is required on an emergency basis, then a second responder will be contacted to accompany the practitioner. The second responder will arrange to meet the health practitioner at a designated point and accompany the practitioner until such time that the call-out is completed. At times, the second responder may have to meet the health practitioner prior to actually getting to the scene, but they will not meet at the scene; they will meet prior to that.

In the Northern Territory, most second responders are persons from the local Aboriginal communities. The persons are able to provide further information to health practitioners about the local communities, which over time increased the knowledge of the practitioners working in the remote areas and allowed them to manage community relationships. This model is attractive for implementation for remote areas in South Australia and, as part of the implementation of this legislation, a process will be undertaken to engage with local Aboriginal communities to identify individuals to serve as second responders.

I know that many of the Aboriginal community groups were dismayed with what happened to Mrs Woodford and are concerned about what this may mean for the health service delivery to their communities. Given this, I anticipate that the government will be able to work closely with these communities to ensure the health practitioners will be able to provide services without fear for their own safety and security.

Where second responders are unable to be provided for local communities, the role will be taken up by other health service providers or staff from other government agencies. Health service providers in remote areas will also be required to have policies and procedures in place to ensure the safety and security of health practitioners. Many government health services already have policies in place for persons working alone or in isolation in remote areas. The legislation will require these policies to be reviewed at least every five years. Where the state government has contracted with another provider to deliver the health services in the remote areas, the provider will be required to comply with all requirements of this legislation.

The work of health practitioners in remote areas can be both rewarding and very challenging. These practitioners are responsible for providing essential primary healthcare services and are the first point of contact for emergency medical issues. They will deal with everything from antenatal care to end of life care and everything in-between.

Working in remote areas is not inherently dangerous; however, there are a number of factors, such as isolation, that can contribute to increased risks to health practitioners working in these areas. For those dedicated practitioners who are currently working in the remote areas of this state, and for those future practitioners who may work in these areas, this legislation allows them to work without fear that they may be harmed, assaulted or, worse, lose their life. This legislation will be underpinned by regulation that ensures its workability.

As I mentioned at the outset, this legislation has been called for by the community and professional bodies following this terrible crime towards Mrs Woodford. There has been no greater advocate than Mrs Woodford's husband, Keith, who has asked governments and health authorities to implement Gayle's Law. I thank you, Keith, for your continued advocacy and commitment to this change. I know we have not finished yet because we still need to tackle it on a federal level as well. I would like to quote Mr Keith Woodford, who said:

We must act to adequately protect nurses and medical staff in remote areas to ensure the crime that took Gayle away from us will never be allowed to happen again.

With this simple, but very powerful, request, I commend the bill to members. I seek leave to have the explanation of the clauses inserted in Hansard without my reading it.

Leave granted.

Explanation of Clauses

Part 1—Preliminary

1—Short title

2—Commencement

3—Amendment provisions

These clauses are formal.

Part 2—Amendment of Health Practitioner Regulation National Law (South Australia) Act 2010

4—Insertion of Part 5A

This clause inserts new Part 5A into the Health Practitioner Regulation National Law (South Australia) Act 2010 as follows:

Part 5A—Restrictions on single person attendances in remote areas

Division 1—Preliminary

77A—Interpretation

This clause defines terms and phrases used in the proposed Part.

77B—Interaction with other Acts

This clause clarifies that the proposed Part is in addition to, and does not derogate from, the provisions any other Act or law.

Division 2—Restrictions on single person attendances in remote areas

77C—Application of Division

This clause describes the health practitioners, and callouts, to which the proposed Division applies.

77D—Second responders

This clause sets out how a health practitioner engages a second responder, and makes procedural provisions in relation to second responders, including a power to make regulations regarding second responders.

77E—Health practitioner to be accompanied by second responder

This clause prevents a health practitioner to whom the proposed Division applies from attending a callout to which the Division applies unless they are accompanied by a second responder. The clause sets out what it means for a health practitioner to be accompanied by a second responder.

77F—Limitation of liability

This clause limits liability arising out of the operation of the proposed Part.

Division 3—Providers of health services in remote areas to have policies and procedures to ensure safety and security of health practitioners

77G—Application of Division

This clause sets out persons and bodies to whom the proposed Division applies.

77H—Providers of health services in remote areas to prepare or adopt policies and procedures for the safety and security of health practitioners

This clause requires persons and bodies to whom the proposed Division applies to prepare or adopt policies and procedures designed to ensure the safety and security of health practitioners providing health services in remote areas on behalf of the State authority.

77I—Policies and procedures to be reviewed

This clause requires persons and bodies to whom the proposed Division applies to review the policies and procedures required under new section 77H in accordance with the regulations. A review must be conducted at least once every 5 years.

77J—State authorities not to contract etc with non-compliant providers

This clause prevents a State authority from contracting with providers of health services who are not compliant with the proposed Division, and requires contracts and agreements to contain provisions ensuring the provider will comply with proposed Division 2.

77K—Power of Minister on refusal etc to comply with Division

This clause sets out steps the Minister can take if a State authority refuses or fails to comply with the proposed Division, including reporting the refusal or failure to Parliament.

Division 4—Miscellaneous

77L—Exemption

This clause provides the Minister with the power to exempt a specified person, or a specified class of persons, from the operation of a provision or provisions of the proposed Part.

Mr VAN HOLST PELLEKAAN (Stuart) (16:52): I advise that I am not the opposition's lead speaker on this issue, but I do appreciate the opportunity to say a few words at the start of this debate. This is an issue that is dear to my heart for quite a few reasons. My wife is a nurse. My wife has worked in a remote Aboriginal community for a couple of years in Western Australia. She has explained to me some of the challenges and dangers.

I myself have worked in outback South Australia. I spent a lot of time at Marla and gained a lot of friendships and connections with a lot of people through that time, so this issue is very dear to me. But, of course, there is nothing that I can know, nothing that I can think, nothing that I can understand or that any of us here can understand compared with what Gayle's family would understand about this issue.

We disagree on a lot of things in this chamber, but this is not one of them. Mr Woodford, you and your family, and others no doubt who have supported you, have got your message through loud and clear, and there is genuine bipartisan support for Gayle's Law. I am very pleased that this is one of those issues that is beyond politics, beyond dollars and beyond a lot of the things that we debate and discuss and disagree on in this place.

This is an issue of principle. This is an issue that must be fixed. This is perhaps an issue that should have been addressed earlier, and I am sure that plays on your mind a lot, but we are doing the very best that we can at the moment. For many of the reasons that the member for Elder just outlined, this is incredibly important.

I know that when living and working in remote communities, people form different bonds in a good way. In the city, you have your core friends. I have not lived in Adelaide for a very long time now, but you have your core friends, and you do not often know too much outside of that. In smaller, more remote places, everybody knows everybody and everybody is connected in some way. It is not to say that everybody desperately loves each other, but you do find a way to get on.

There are people who have been supporting this sort of outcome at a personal level for a very long time, but it has not been legislated and it has not been mandatory. We want to contribute to make it legislated and to make it mandatory. This is incredibly important. There are a lot of things that affect all of us in our lives, but nothing could be more devastating than the type of impact upon a family that has come with Gayle's death. I put my personal apology on the table that this has not happened before today, but certainly the opposition and the government are at one in making it happen today.

Ms COOK (Fisher) (16:55): I speak in support of the Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill 2017. Gayle Woodford was a dedicated nurse who lost her life on 23 March 2016. She was one of hundreds of nurses working across Australia in our remote communities. Health practitioners, just like Gayle, respond to calls for help, never imagining that some day there could be somebody with an ulterior motive calling her out of her house. A late-night call-out for emergency medical treatment saw Gayle abducted and lose her life. I will not repeat the name of the person who took her life. I do not think that needs to be tabled in this place.

Gayle's murder brought outrage from the community and it brought outrage across Australia from her nursing family and from professional bodies, such as the Australian Nursing and Midwifery Federation and the Council of Remote Area Nurses. All of us grieve with the family and are outraged at what happened.

First responders work in all manner of roles in remote circumstances but also in the city. Many of them are now on notice that they are at risk whenever they offer help as part of their work. We, as legislators, are on notice that we must act to protect all people working in vulnerable situations.

However, some of the conditions in rural and remote services are quite unique. People who put their hand up—and I have many friends who have done that—face extraordinary challenges and risks. Some of these relate to the lack of available peer support in the area, the environment itself and the types of infrastructure in place—for example, the roads leading to some of these very remote settlements are dangerous in themselves—but, sadly, the biggest risk clearly can be the person the responder is there to help.

The bill seeks to protect first responders working in these health services in the remote areas of our state, providing services for us, and it could well be one of us who is out travelling with our families in remote parts of South Australia who need help. The bill is demanding that all first responders are accompanied by a second responder when responding to out-of-hours or unscheduled calls for emergency medical treatment, and this will most definitely reduce the chances of a personal attack upon a first responder.

I am very pleased that the second responder can be a local community member, because not only does that provide the support for the first responder but it builds capacity within the responders' team, local knowledge and understanding about that community, and also builds the capacity of the community, as carers themselves, to provide support.

I was interested to read the Remote Area Services review from the Northern Territory and Queensland because they already operate with this second responder service, but I note that the member for Elder has discussed limitations they have identified around that. I believe that our bill does seek to remedy some of that by insisting that this happens, that there is always a second responder and that the person who is in the position of first responder, should they not be able to get the assistance of somebody to attend with them, will be protected from any potential professional implications or fallout.

However, that does not protect the first responder's heart because, when you are working in a situation like this, you would feel incredibly guilty if you did not respond to the call for help. Even knowing that you are protected from some litigation does not help your heart or your head because you have said no if the person calling for help actually does come to some form of grief because you have not gone. However, that is up to us as a community of healthcare workers to educate and support our colleagues. It is up to us as a government to provide the resources to educate and support, and it is up to us as a government to provide the processes to ensure that there are people available.

I have many friends who are currently working in rural and remote. I know that they are watching this legislation as it develops and the ensuing changes in practice that will come. I congratulate my parliamentary colleague and friend, fellow registered midwife nurse in this place, the member for Elder, on her work on this and acknowledge the current and previous health minister in the other place, minister Malinauskas and in this place, of course, the member for Playford, Jack Snelling and his staff for supporting the work in this very important area.

The member for Elder and I have both been rocked to the core by this terrible tragedy, a real waste of a soul who was dedicated to working and caring for some of the most vulnerable Australians out in rural South Australia. I know personally the deep pain that is felt when a loved one is taken in such futile circumstances. What a terrible waste—so unnecessary.

To Gayle's husband, Keith, and her son, Gary, and daughter, Alison, (Gary and Keith are here today in the gallery), I know the pain and frustration you are feeling as a result of this terrible, terrible tragedy. It is just the worst loss, but I hope that, like me and my family, you are able to find some recompense and some sort of relief with time as you move forward. I hope that the dedication of this legislation to Gayle's work, and the work of many thousands of health practitioners, does provide some comfort to you and to your friends and the rest of your family. Some people do leave this earth in such tragic circumstances for a reason. May this legacy for Gayle be the reason. I commend the bill.

Mr KNOLL (Schubert) (17:03): I indicate that I will be the lead speaker on this Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill 2017. This bill has become known as Gayle's Law as the impetus for it was the tragic murder of Gayle Woodford, a dedicated nurse who lost her life on 23 March 2016 on the APY lands.

I just want to say that, having researched this bill, some of the details that have come out of the resulting court case and the conviction of the perpetrator were really quite harrowing and difficult to go through. To reflect upon what happened on that awful night, as someone who has been married for 10 years I can only imagine the difficulty the family has gone through. I commend them for everything they have done in coming to terms with what has happened and trying, in some small way, to find a positive way forward.

Gayle was skilled in her profession. She was committed to her patients and she was proactive in her care. Gayle Woodford was born on Eyre Peninsula and married Keith Woodford in 1980. Her nursing career took the couple around Australia, to New South Wales, Queensland and back to regional South Australia. She was recognised as an intelligent and capable health professional. She was a diabetic educator and a graduate of the Centre for Remote Health at Flinders University.

Gayle had been working for the Nganampa Health Council for five years before her death. Since that time, I want to acknowledge that the Centre for Remote Health and CRANAplus have dedicated a memorial scholarship in Gayle's name. The scholarship is jointly sponsored by CRANAplus and the Centre for Remote Health and covers all course fees for the Graduate Certificate in Remote Health Practice offered through Flinders University.

One scholarship is awarded annually for study to commence the next year. The scholarship will be awarded and based on the likelihood and level of contribution the recipient will make to remote and Indigenous health, and it is a real testament to what has come out of this tragedy. A scholarship like this seeks not to run away from helping those who need health care in remote areas, but instead tries to strengthen that bond, indeed, as we try to strengthen the ability of those nurses to go out and do their jobs safely through this legislation.

Gayle's influence in this community and each one in which she worked was profound. She devoted her time and energy to caring for those who needed her help. A dear colleague, a caring nurse, a loyal friend, a cherished wife and mother, Gayle Woodford touched everyone around her both in the medical community and more widely. I turn now to the bill itself.

Whilst the opposition has had a briefing, our party room has not had a chance to consider the second reading and tabled bill, so our comments therefore reflect the fact that we have a common desire to see this bill become law and offer in-principle support. If there are any issues that arise in relation to ensuring that the proper application of this bill comes into force, they will be addressed in the Legislative Council discussion on the bill. In saying that, I do not want in any way to suggest that we are going to do anything to hold up this bill. We want to make sure that the provisions in here achieve what they set out to achieve and to make sure that we do get the outcomes sought out in this bill.

Nobody should go to work concerned for their welfare, let alone their life. Nurses and other first responders are particularly entitled to protection. Society has a moral obligation to protect health workers as they attend the health needs of the wider community. We ask our first responders to put themselves in danger to meet the healthcare needs of others. We owe it to them to minimise their danger. I note that this bill essentially requires that a first responder must be accompanied by a second responder in responding to a call-out after hours in remote areas of South Australia as they have been designated. Second responders may be local community members, other staff members or someone from another government agency; it is quite broad.

Essentially, it is recognition of the fact that we need somebody to accompany those people. It is not necessarily about the health skills, although that may be an advantage. It is more about there being safety in numbers and safety in case something goes wrong, as it did so tragically for Gayle Woodford. Second responders are already in use in the Northern Territory. I understand that they have a policy around that, and what we are seeking to do here is to actually take it one step further.

We are taking it one step further by ensuring that any sort of legal liability that may be placed upon a health professional in failing to respond to an emergency call-out is covered and that a health practitioner, if they are unable to attend an emergency call-out, cannot be subject to any preliminary action by a regulatory body. I note that this legislation applies to all health services, including those provided in the remote areas of South Australia comprising the APY lands, the Maralinga Tjarutja lands and those that fall outside a council area, what we understand to be unincorporated South Australia.

The bill talks about and makes sure about the broader level of people who can be engaged as second responders. The bill was modelled on the policy in the Northern Territory and seeks to minimise the danger and to protect regional health workers. The second responder needs to meet requirements set up by regulation and will be a second responder from the time he or she is engaged to act as a responder until the end of the call-out.

The government proposes that these second responders could also be people from local Aboriginal communities, who may also have a familiarity with the areas that these health professionals are going into. Again, that is something that could be quite positive. The opposition welcomes the opportunity to discuss actions to look after those who look after us.

With those words, I commend the bill to the house and support the bill through its second and third readings. I also say that we will work constructively to ensure that this legislation achieves the outcomes it seeks to achieve and that we can into the future ensure that the horrific things that happened on 23March 2016 never happen again.

Mr SNELLING (Playford) (17:10): I also add my support to this bill. Delivering health services in the APY lands is extremely challenging. The nurses, in particular, who provide those health services in the APY lands truly are heroic. Of course, the first principle in any health care or any area where you are delivering services is in the first instance to keep yourself safe, and this bill certainly provides for that. It provides for better protection for nurses, particularly when they are called out after hours to deliver health services. Gayle Woodford was a truly heroic person, and this bill is a fitting legacy for the work she did in providing important health services to the most vulnerable of South Australians.

I would like to thank all those who have worked to bring this bill together in a very, very short period of time. I would like to pay tribute of course to the officers in the Department for Health and parliamentary counsel as well and to the various groups, in particular the nurses federation, whom we consulted in drafting this bill to make sure that it did what it was seeking to achieve. I would also like to thank Mr Woodford, who is here in the chamber today, for his prompting of the need for this bill and for his presence here today. Mr Woodford, you and your family have made a terrible sacrifice, but this will be a lasting legacy to Gayle Woodford of which you and your family can be truly proud. Thank you.

Mr HUGHES (Giles) (17:12): I rise to say a few words, partly as the member who covers the area where these tragic circumstances occurred. I cannot imagine what the Woodford family have gone through and are going through with the loss they have experienced in those particular circumstances. I know that in country and remote areas people do look out for each other, but there is sometimes the need, and the need in this case, to formalise that to ensure that, as much as we can, we provide the protection that is needed.

I was elected only at the last state election. My relationships in the APY lands are still at an early stage. The people I have met up there have been good people and, like communities everywhere in the state, most people are decent and do the right thing and do the right thing by others. Unfortunately and tragically, whether it is in remote areas or metropolitan areas, there are those who transgress, and transgress in an incredibly horrendous fashion.

This bill will go some way to providing additional protection. When you look at the remote areas, the APY lands is such a vast area, with a population of 3,000 people scattered over an area the size of England in landmass. That is not counting the rest of the remote areas in South Australia. Delivering services and doing the right thing by people presents some very particular challenges. There are those particular challenges in the APY communities and some of the other communities in our state where we have people who experience a very significant degree of disadvantage, and that is often reflected when it comes to morbidity and mortality.

It is incredibly essential that we have people like Gayle providing those much-needed services. Those people are respected and those people are cared for in those communities, which is not to say that there are not at times profound challenges. Sometimes, this house operates in a way that is deeply partisan in a very, in my view, unconstructive way and it is gratifying that there are sometimes issues that bring us together. The thoughts that have been expressed by the opposition and the bipartisan approach that has been taken to this bill are gratifying. I think that in some ways it would be worthwhile seeing that on a raft of other issues that are also deep in nature.

The number of nurses I have met in our unincorporated areas who really go out of their way to provide a service, often way above what you will see in the metropolitan area, and the number of people who intimately know many people in the communities they service is something incredibly special, but in providing that work we need to ensure that people are protected to the highest degree they can be. Hopefully, this legislation will go some way to addressing some of those needs. My heartfelt condolences to the Woodford family.

Dr McFETRIDGE (Morphett) (17:17): I rise to support the bill before the house and I do so having had many years of experience working in association with people on the APY lands, both Anangu and piranpa, the white people who work on the lands. The problems, the challenges and the opportunities that exist in South Australia in that remote region called the Anangu Pitjantjatjara Yunkunytjatjara (APY) lands, you have to see them to believe them. I have said many times in this place that members should go up there with the Aboriginal lands committee or just organise to go there and have a look at what is one of the most beautiful parts of South Australia. Mount Woodford, the highest peak in South Australia, is there.

You will only really understand the remoteness of that country and the difficulties faced by the Anangu and all the people who are working up there with Anangu, who want to help them to progress, to close the gap, to achieve their wants, their hopes and their future, if you actually go there and see those people and talk to those people. I have met hundreds of white people who have gone up there to assist the Anangu—doctors, nurses, healthcare workers, bureaucrats, engineers, road workers, all sorts of people. The list is too extensive and I will not be able to name them all. They all go up there with the best of intentions, but many of them come back jaded, disillusioned and angry, with many other emotions and quite disparaging views on what is going on up there.

One thing that I have never done, that members I have worked with on the Aboriginal Lands Parliamentary Standing Committee have never done and that I hope other members in this place have never done is give up on making sure that we give those South Australians up there and the Anangu the opportunities that we all enjoy in South Australia in metropolitan Adelaide and in the other great parts of our state.

Unfortunately, there are some significant challenges, as the member for Giles said. It is in his electorate, and I know he is a very proud and hardworking member up there. We know, through the many reports that have come through here from the Aboriginal Lands Parliamentary Standing Committee and the other reports that have been put before this parliament, that there are significant issues on the APY lands that cannot be tolerated and must be dealt with, and unfortunately a lot of those involve alcohol, drugs, pornography, gambling and domestic violence.

Fortunately, it is just a small sector of the community who are the worst perpetrators. The issues are widespread, but the worst perpetrators are an isolated few. The legacy of some of the substance abuse is no more evident than in the numbers of individuals who are now, in some cases, wheelchair bound or severely disabled as a result of petrol sniffing. Unfortunately, I have had evidence given to me that some of those individuals are now sexual predators of some of the young people up there. There is a real need to make sure that the legacy and hard work of the nurses of this world, the Gayle Woodfords of this world, is rewarded by support from this place. This legislation will do some of that.

The heartache and worry people have when their family and friends are in these situations is very close to me. My daughter was working in a remote Aboriginal community and was threatened and attacked. She was forced to drive out into remote communities with no contact whatsoever, with a very reluctant police force that would come and help occasionally. This is not South Australia: this was in the Northern Territory. She was working on Groote Eylandt. She was helping in a public health program up there as a veterinarian, yet she was on her own, a young woman out there. My wife and I really worried about her safety.

When I see what has been happening on the APY lands, personally my heart just bleeds for Gayle's family and all who knew her because it is something that should never have happened. We like to think it will never happen again. If this legislation goes some way to protecting those people from that small group of people who do not understand, value or appreciate the opportunities and help they are given, then I think we really need to make sure we do that. Those people need to get the message very strongly that they cannot act with any impunity, and they will be dealt with very harshly.

I think that the legislation may need to be extended to other people besides nurses and first responders up there because there are many others who are required to go out there at extraordinary times to do extraordinary things. It is with strong support that I hope the bill goes through this place expeditiously and through the other place and then provides the support that we here all want to give to those who are helping those who are helping us.

Ms WORTLEY (Torrens) (17:23): I rise to support the Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill 2017. When enacted, this amendment bill will provide a significant level of protection for nurses and other health practitioners working in the remote areas of the state, those funded by the South Australian government or contracted by the government. It will see health practitioners in these areas responding to out of hours or unscheduled call-outs for emergency medical treatment accompanied by a second responder. They will no longer go it alone.

It means the health practitioner will be accompanied by another, reducing the chance of personal attack. Second responders will be a local community member, a person from another government agency, or a staff member from the health services. As outlined by the member for Elder, herself a former nurse, the legislation before us today will apply to all of the health service providers in remote areas of South Australia that fall outside of a council area. Importantly, remote area health service providers will be required to have policies and procedures in place to ensure the safety and security of health practitioners.

The Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill 2017 is before us today in response to the tragic death of a dedicated nurse, Gayle Woodford, and the commitment of her husband, Keith, who has called for the adequate protection of nurses and medical staff in remote areas. The community and professional organisations representing nurses and other health practitioners, including the Australian Nursing and Midwifery Association and the Council of Remote Area Nurses of Australia, have also made it clear that measures must be put in place to help protect nurses and other health practitioners who provide these much-needed and often life-saving services in the APY lands and other unincorporated areas of our state.

I acknowledge the presence here today of Gayle's husband, Keith, and their son, Gary, and also acknowledge their daughter, Alison, who is unable to be here. I extend my sincere condolences to you. I understand it has been a very sad and difficult journey that has brought you to where we are today: introducing legislation that will significantly reduce the chance of such a tragedy occurring again. I commend the bill to the house.

Mr PENGILLY (Finniss) (17:26): I wish to make a small contribution. I have absolutely no hesitation in supporting this bill. I think the fact that we have to put retrospective legislation into place after such a tragedy is very sad; however, I believe that, in responding to the request of Gayle Woodford's family, we are doing the right thing. Even if it is too late, we are doing the right thing. If it stops something like this from happening ever again, we will have done useful work in the chamber this afternoon and this evening.

My wife and I were absolutely staggered when we heard the news of what happened. My wife is a nurse as well. I guess it was exacerbated for me, insofar as I had actually toured the APY lands on a Public Works Committee trip, and I know that some members in here were there as well. I had never been up there before. I acknowledge the vast distances that have to be travelled and the difficulties in which professionals have to carry out their work in the region. The difficulties that are imposed on them are just different to anywhere else. They are entirely committed to the people who live up in those lands. The people in the lands were devastated when this tragedy occurred.

It is a small step forward. It is too late for Gayle, but it will hopefully fix the situation in the future. I am very supportive of this bill, and I look forward to its speedy passage through this house and an equally speedy passage through the upper house so that it can be put into effect. Thank you.

Ms DIGANCE (Elder) (17:28): I thank all the members in this house who have spoken in support of this legislation: the members for Stuart, Fisher, Schubert, Playford, Giles, Morphett, Torrens and Finniss. While I am thanking people, I would also like to thank Kathy Ahwan and Prue Reid from SA Health for their help, parliamentary counsel, Simone McDonnell, the previous health minister (member for Playford) and the current Minister for Health, and of course Keith Woodford and his family.

The safety of any health practitioner performing their duties is of paramount importance, but none more so than health practitioners working in the remote areas of South Australia. While the work can be very rewarding, these practitioners face a number of challenges working in isolated and small communities, such as being the first line of response for emergency issues and travelling on unsealed roads that may be impassable because of heavy rains and flooding. Given these challenges, they do not also then need to be concerned for their own personal safety and security.

Of course, remote areas are not inherently dangerous, but the isolation, coupled with societal problems, can expose these practitioners to greater risks than those in other geographical areas. Sadly, while abuse and violence are experienced by many nurses in many health settings, it is amplified in isolated, remote and rural areas. It can be terrifying and very confronting, as I know only too well myself.

Those who have found this particular issue unacceptable have opted to leave rather than to put up with it, which is understandable. However, for too long nothing has been done, and it is tragic that it has taken this crime against Gayle Woodford—a wife, a mother and a dedicated nurse—for this action to be taken. I am hopeful, through this very sad event, that only good will come from this legislation and that we will care for those who care for us.

I have spoken with a number of groups about the bill, including CRANAplus, which represents remote and isolated health workers; the Australian Nursing and Midwifery Federation; the Aboriginal Health Council; and the APY Aboriginal communities, and they were all supportive of the government bringing this legislation to parliament. While some health practitioners may question some aspects of this legislation, which they may interpret as telling them what they can and cannot do after hours in the provision of assistance if a second responder is unavailable to accompany them—and I can understand that—they can rest assured that the focus is to ensure that their healthcare organisations put their safety first and that we put their safety first.

I know that these practitioners dedicate their lives to helping others, but it is important that we also protect their lives. That is why I am really pleased that this house has united to honour the memory of Gayle Woodford in unanimously passing this bill—I hope unanimously passing this bill; we have had unanimous support, so I predict that is what is going to happen—which we have all come to fondly know as Gayle's Law, to give the assurance that our nurses and health practitioners so deserve.

Bill read a second time.

Committee Stage

In committee.

Clauses 1 to 3 passed.

Clause 4.

Mr KNOLL: Proposed section 77A(2) provides:

For the purposes of this Part, a reference to a remote area will be taken to be a reference to the following areas of the State:

(a) the lands within the meaning of the Anangu Pitjantjatjara Yankunytjatjara Land Rights Act 1981;

(b) the lands within the meaning of the Maralinga Tjarutja Land Rights Act 1984;

(c) an area outside of a council area under the Local Government Act 1999;

(d) any other area declared by the regulations…

I want to ask how the decision was arrived at to choose these three and whether other remote areas were considered to be included as part of this legislation.

Ms DIGANCE: In this particular case, we firstly wanted to address the actual issue at hand that had happened in the Aboriginal communities. We recognise that there may be other situations that arise, and they can be addressed in the regulations.

Mr KNOLL: I have just one simple follow-up on that. I agree that the APY lands and Aboriginal lands are intended to be covered here, and I assume that there are some Aboriginal communities that live in the unincorporated areas of South Australia. We have seen, for instance, the tragic death recently at Manna Hill, which is a pretty remote station. Is it that it is too difficult to ascribe certain areas and that this was neater, or is it a case where in the regulations we may have to go to prescribing coordinates on a map or something like that?

Ms DIGANCE: There are a number of definitions when it comes to remote areas. As time goes on and we look at the regulations, we certainly can consider and include what is necessary.

Mr KNOLL: On page 6, new section 77E—Health practitioner to be accompanied by second responder, states:

…a health practitioner to whom this Division applies must not attend a callout.

Obviously, there is no penalty or offence. You do not want to charge a nurse for having gone out there. Really, I am just trying to understand what sort of thought processes were gone through in assessing the risk when a nurse chooses to still go out there and do that. I know that in her contribution the member for Fisher talked about nurses having that desire still to go out there. Is there any sort of impetus? It is not a criminal offence, and I am not in any way suggesting that it should be, but is there any sort of other method by which health practitioners can be discouraged from essentially not complying with this clause?

Ms DIGANCE: I thank the member for acknowledging that in this legislation the nurse or health practitioner will not be jeopardised as far as their registration goes, but what will also accompany this will be education and reinforced risk assessment of those call-outs. From the employers' point of view, they will need to take the responsibility to make sure that they have a robust organisation and good relationships with the health practitioner and be able to talk through those situations as well.

Mr KNOLL: If I can go down to new section 77E(3), it states:

(3) Subsection (1) does not apply—

(a) if the place at which health services are to be provided in relation to the callout is prescribed premises; or

(b) in any other circumstances prescribed by the regulations...

Let's say that there is some sort of remote health clinic where the first responder agrees to meet the person if it is something that is only open during certain hours. Is this a clause to exempt certain buildings or certain premises within these remote areas?

Ms DIGANCE: What this is doing is giving us options, but it is also encouraging the meeting to happen where there may be more people around, so that if there are police nearby, or what have you, the second responder will automatically be in place.

Mr KNOLL: Just for the sake of clarity, this is potentially around down the track. I suppose I can ask if there are any premises that you have identified and that you would identify in the regulations. Would it be, for instance, a police station that may be prescribed by the regulations as being where this clause is exempted from?

Ms DIGANCE: The member is quite correct. When the regulations are being discussed and identified, there could be police stations involved and other such buildings as well.

Mr KNOLL: New section 77I—State authorities not to contract etc with non-compliant providers, is obviously in relation to those providers preparing or adopting policies and procedures for the safety and security of health practitioners. I think that makes perfect sense, that we want to make sure that those contracted health providers out there have these policies in place before we give them any sort of contract to go out and provide these services. That potentially, I suppose, deals with some of the issues that happen in the Northern Territory in trying to enforce compliance. It states:

(b) the contract or agreement contains provisions ensuring that the provision of health services pursuant to the contract or agreement will comply with any requirements under Division 2.

Is this saying that if a healthcare professional does not comply with division 2, which includes the fact that a health practitioner must not attend a call-out unless they have a second responder—that is, if one of your healthcare professionals who is contracted to work for a firm that has a contract does not abide by this requirement to have a second responder—this may risk their contract

Ms DIGANCE: Let me see if I have this straight. You are actually talking about an actual health service provider and an individual health practitioner as well?

Mr KNOLL: Yes.

Ms DIGANCE: We see this as a really good way to, in effect, do an audit of all healthcare providers in these remote areas to ensure that they are in fact providing the appropriate risk matrix and safety care to their workers. I think that I have your question clear. If the health practitioner does go to a call-out without a second responder, that will be a matter between them and their healthcare provider—their employer, if you like—to discuss that, and the outcome of that will remain to be seen. They could well be reprimanded. It would depend, but this will also be teased out as well. At the end of the day, this is to make sure that employers are actually doing the right thing by their employees.

Mr KNOLL: Certainly I understand that they have to have these policies and procedures in place. I agree that with the relationship between the employer and the employee or the contractor and the subcontractor, however that arrangement works, there will be an industrial response, I suppose. The point I am trying to make is that the state government contracts this nursing company to provide out-of-hours nursing care. Is the healthcare service provider's contract potentially in jeopardy if one of their subcontractors or employees does not comply with the requirement to take a second responder with them?

Ms DIGANCE: I think, really, in all fairness, that these types of situations will have to be assessed case by case. I am hopeful that with this legislation and then with the regulations that come from this legislation, there will be clear guidelines on how people need to perform and operate.

Clause passed.

Title passed.

Bill reported without amendment.

Third Reading

Ms DIGANCE (Elder) (17:45): I move:

That this bill be now read a third time.

Bill read a third time and passed.