Parliamentary Committees

Public Works Committee: Lyell McEwin Hospital Expansion

Mr CREGAN (Kavel) (11:02): I move:

That the 25^th report of the committee for the Fifty-Fourth Parliament, entitled 'Lyell McEwin Hospital emergency department expansion and new mental health short stay unit', be noted.

The Lyell McEwin Hospital is part of the Northern Adelaide Local Health Network and provides a comprehensive range of specialist and diagnostic treatment services. The committee has heard that the project is critical for the Lyell McEwin Hospital to meet the increased demand for services, which has been generated by the population growth in the northern metropolitan areas of Adelaide and the northern region of South Australia.

Further, the expansion of the Lyell McEwin Hospital emergency department has been identified as a key infrastructure requirement to support the transformation of the hospital into a tertiary-level facility. The project is expected to involve a combination of internal refurbishment, new building expansion and a car park extension.

In addition to the extension or expansion to the emergency department, this project will include a new mental health short stay unit. This new unit is expected to enable the assessment of the most appropriate care options for mental health related presentations to the hospital's emergency department. The estimated cost for the project is $58 million and project completion is expected in 2022.

The Public Works Committee has examined written and oral evidence in relation to this project, and the committee has been assured by SA Health officials that the appropriate acquittals for the project have been received. The committee is satisfied that the proposal has been subject to the appropriate agency consultation and meets the criteria for examination of projects as described in the Parliamentary Committees Act 1991. Based on the evidence that we have considered and pursuant to section 12C of the Parliamentary Committees Act 1991, the Public Works Committee reports to parliament that it recommends the scope of the proposed public works, the subject of this recommendation.

Ms LUETHEN (King) (11:04): I want to thank the Public Works Committee for progressing the plans for many projects and certainly the projects that are impacting the delivery of health services in the north and north-east, which is one of the key priorities that have been raised with me over and over again in my seat.

Good health and positive wellbeing are essential for any thriving community. Everyday life is improved by public health systems and services that support a clean, safe and healthy environment. In order to develop a sustainable health system for the future, we need to reduce the burden of disease and associated costs to our community by focusing on protecting and promoting health and wellbeing and preventing illness, and this is certainly a focus of our government.

We are committed to delivering better services, which is certainly what people in King have elected me to advocate for within my party and in this place. In King, I have not only community members who need better services from our local Lyell McEwin Hospital but also many staff and volunteers who live in King who have been generous with their feedback and ideas over the last couple of years about how our health system and services must be improved. We are investing millions in health, including making vital upgrades to the Lyell McEwin Hospital, Queen Elizabeth, Modbury and Noarlunga hospitals, to ensure our health services are of a standard our community absolutely deserves.

I thank the Public Works Committee for their efforts and the progress they have made to support plans for the $58 million major redevelopment of the Lyell McEwin Hospital emergency department and short stay mental health unit. The Minister for Health and Wellbeing has said that the proposed plans will almost double the capacity of the emergency department to help cater for projected population growth in the north and increased demand.

The emergency department activity at the Lyell McEwin Hospital has increased significantly over the past decade, from 42,000 to more than 76,000 presentations last financial year, and activity is projected to continue to increase annually. The plan is to develop a three-storey building development north of the existing emergency department, which will alleviate pressure on the emergency department into the future.

The purpose-built eight-bed short stay mental health unit will provide a more suitable care environment for mental health patients requiring a short stay and improve patient flow throughout the emergency department. The highlights include additional capacity for adult treatment spaces in the ED; a new dedicated eight-bed short stay mental health unit; an emergency extended care unit; a new reception, waiting and triage area; expanded dedicated paediatric assessment and treatment spaces; a dedicated ambulance arrival area for patient transfers; additional resuscitation triage capabilities; a new bulk decontamination unit; new quick access and discharge facilities; and workstations and education spaces for staff.

The minister has told us that the former Labor government had not budgeted nor planned for an increase in car parking spaces at Lyell McEwin as part of their redevelopment plans; however, we are certainly investing money in relocating the car parking displaced by the redevelopment. It is a planning requirement to increase car parking as you expand hospitals, not reduce it, yet the Labor government failed to do this.

We have listened to the feedback from patients, staff and volunteers, and we are committing to an extra $7 million dollar expansion of the five-level, multideck car park at the hospital. Construction of the new car park will begin in coming months to cater for growing demand and to alleviate the loss of around 67 existing car parks from the development. The Marshall Liberal government does not want to cut corners because of Labor's previous poor planning. We have acted responsibly by planning and budgeting for the much-needed extra car parking capacity.

We will now work on finding opportunities to deliver the ED capacity within the project budget, whether that is through construction efficiencies or finding additional money. Northern Adelaide Local Health Network chief executive officer, Maree Geraghty, said that the redevelopment is a major boost for the north. The Lyell McEwin Hospital has continued to grow with the community over the past 60 years, and this expansion will help cater for the future health needs of the growing northern Adelaide population.

The project will be completed in stages in order for the existing emergency department to remain operational. I thank our staff and community in advance for their patience while this project is underway. Construction is scheduled to commence early next year and is forecast to be completed in 2022.

There is further good news this month as well: nurses and other hospital staff in the northern suburbs were pleased to hear that, in addition, they will also have access to an extra 250 spaces in a newly constructed car park opposite the Lyell McEwin Hospital. The Minister for Health and Wellbeing said that the state Liberal government will enter into a new lease agreement with Northwest Healthcare Australian Property Pty Ltd and Perpetual Corporate Trust for dedicated staff car park spaces within a new multideck car park, to be built on Haydown Road.

We are committed to ensuring the community has access to quality health services in a modern hospital setting, and the new car park will support the increase of these future services. Providing a safe environment for our staff, patients and visitors has always been, for us, a very high priority. We have listened to staff concerns and we are working with them to make our hospitals and our surrounds safer.

Due for completion in mid-2020, subject to approvals, the leasing of the 250 new car park spaces will provide better access for staff to the old main entrance of the hospital, which we know is still a well-utilised entrance. The car park will provide secure after-hours access for staff, appropriately lit access and CCTV security camera coverage. I reiterate that this is good news, because the 250 new car parking spaces are in addition to the $7 million multideck expansion within the hospital grounds for staff, patients, visitors and volunteers.

The 250 spaces obtained through this new lease agreement will address the staff car park spaces lost from the sale of vacant land on Mark Road when the lease agreement concludes. A recent Auditor-General's Report showed that the Marshall Liberal government invested more than $5 million extra in security services, predominantly in additional security guards, throughout SA Health sites in the past financial year.

The NALHN chief executive officer, Maree Geraghty, said that it is an exciting time for both the local health network as a whole and the staff based at the Lyell McEwin Hospital. The northern suburbs has the highest population growth in South Australia, with a quarter of the state's population expected to live there by 2026. The new lease will accommodate the long-term requirements for the northern suburbs and will improve accessibility as demand on the hospital continues to grow.

The existing multideck car park has a capacity of 1,227 spaces and, once the new section is complete, there will be a total of 1,432 car park spaces in the existing multideck, plus the 250 new leased staff car park spaces opposite the hospital from July next year. In addition to increasing car parks, we have also taken steps to increase on-site security and we have held staff information sessions on personal and community safety and situational awareness, led by SAPOL, following violent incidents in recent months across public hospitals.

We are certainly committed to providing a safe working environment for staff and have been reviewing lighting, monitoring and functionality of the CCTV, security patrols and duress alarms on the site. We are also in consultation with the precinct partners, which includes the local council, to look at streetscape upgrades, such as increasing the width of footpaths and trimming trees. NALHN's escort service started last month, which provides a vehicle after hours, driven by a guard, to take staff to their car park, for those who park on roads around the hospital within a prescribed radius. We thank our staff and consumers for their patience during the construction of the car parks and also the hospital's upcoming redevelopment.

The good news is that in the north-east the new government is fixing up Labor's mess at the Lyell McEwin and Modbury Hospital. While Labor downgraded services at Lyell McEwin and Modbury as part of their failed Transforming Health plan, the Marshall Liberal government is investing in world-class infrastructure to deliver better patient care closer to home for the residents in the north and the north-east. Because I live in King and grew up nearby, I absolutely understand the importance of these better services and I am pleased to provide an update on the good news with progress taking place.

The Hon. A. PICCOLO (Light) (11:15): I speak in support of this motion and thank the member for Kavel, Chair of the Public Works Committee, and welcome these works. I think investment in our health system is always a very good thing, and that is why the previous Labor government invested hundreds and hundreds of millions of dollars, over 16 years, into Lyell McEwin Hospital and actually made it the tertiary hospital it is today. When it comes to actually caring for the north and Gawler areas, we have an excellent track record, bringing that hospital to a higher standard. If I remember correctly, the only thing the last Liberal government did in the north-east was to privatise the hospitals there, and we brought them back under public control.

We talk about safe working environments for staff, etc., and also mention that staff are very happy. Well, it was interesting—I must have been in a different place because this week I think there were members of staff from the Lyell McEwin Hospital rallying outside the hospital, unhappy with this government.

An honourable member: They didn't look happy.

The Hon. A. PICCOLO: They didn't look very happy at all. Clearly, it is a case of seeing what you want to see and not what is actually happening on the ground. In fact, staff are going to be rallying in my local hospital this week, too, because they are so happy with this government that they are going to take time off and rally against the government about their poor working conditions.

If you actually want staff to be in safe work conditions, an important part is staffing levels—in other words, staff being able to do the work properly and having the time to do the work properly they need to do. Clearly, the nursing staff in our hospital are not happy with that and that is why they are rallying. They also need to be paid a responsible salary to make sure that they are paid for the work they do. According to this government, we care so much for our staff that they actually have to rally and take industrial action to get them to notice, to pay them more money.

This government's commitment to nursing and nursing staff is not that good at all. Rather than the member for King gloss over all the issues—and, as I said, I reaffirm that investment in bricks and mortar is important, and we did that over 16 years—I think we cannot gloss over and ignore the other issues, the other important part of the hospital, which is not just the bricks and mortar but the people who work there.

Unfortunately, I have had quite a few dealings with Lyell McEwin Hospital this year—and this is not a reflection on the staff there, as I think the staff do a wonderful job—because I have a family member who is not well and they have cared for. If the member King thinks that hospital was well staffed and that the staff are well looked after, then she really cannot see what is actually happening there. I can tell you that the staff are overworked. Despite the fact they had poor staffing levels, they did an excellent job.

I can tell you that if you are a patient in the north and you are trying to get some important public health services, you are actually put on a waitlist. You do not get a service really quickly. Unless you go through ED, you are put on a waitlist. To suggest that this will resolve all the health issues in the north and that we have some sort of utopia in the north is just a nonsense. Certainly, the bricks and mortar are welcome, and the things that have been are done are welcome, but for this government to suggest that that has resolved our health issues in the north is just a nonsense.

The only way you are going to resolve those issues is to actually put in more money, not giving contracts to private contractors and millions of dollars of contracts to private accountants just to cut costs, and to bring in people who actually do the work—the doctors, the nursing staff and all the ancillary staff. This government is grinding our health system into the ground. We know it from the amount of ramping done, and we know it from the fact that our ambulance services cannot be met. There is such a crisis in ambulance services, and you hear horror stories, that members across the chamber should be ashamed to stand up and say how this government cares about our health services.

With those comments, I support the motion and welcome the decision to spend more on bricks and mortar, but please spend the money where it is very important. In other words, look after staff in terms of conditions and look after the patients we care for. That requires resources, not cutting costs or giving money to the top end of town and your mates at the Property Council.

Mr BOYER (Wright) (11:19): I, too, rise to speak on the 25^th report of the Public Works Committee entitled, 'Lyell McEwin Hospital emergency department expansion and new mental health short stay unit'. I echo the words of the previous speaker, the member for Light, that we on this side of the house support investment in our public hospitals.

Back in 2017, the previous Labor government committed $52.5 million in the budget for what is a vitally important and necessary upgrade to this hospital. Although the planning and the bulk of the upgrade and commitment of money towards that upgrade occurred under the previous Labor government, I do admit that the current Minister for Health has left his own mark on this project. He has reshaped, to use today's polite bureaucratic term, the project which, from my reading of the committee's deliberations, will result in fewer treatment cubicles, and the money that would otherwise have gone to the bricks and mortar expansion of the emergency department itself will instead be put into building car parks.

Aside from that, the funding that was put in place back in 2017 has survived this new Marshall Liberal government, and that is no mean feat, I might add, given that out in the north and north-eastern suburbs we have seen a succession of broken promises. One I can think of in particular that is causing a lot of grief for residents of the north-east at the moment is the much-needed expansion of the Tea Tree Plaza park-and-ride. There was no mention before the state election that this government was going to do anything other than continue with the bill that the Labor government had basically started, but here we are 20 months on and still there is nothing. I am pleased to see that at least the money towards the expansion of the Lyell McEwin emergency department is still there.

We have heard from both previous speakers that the northern suburbs of Adelaide are one of the fastest, if not the fastest, growing regions in South Australia. The Lyell McEwin Hospital has also grown over the last 15 to 20 years from what was a basic community hospital at the start, which was built in the shadow of what was once the Holden factory, to what is now one of the state's leading tertiary hospitals. The Lyell Mac and the Modbury hospitals, which are not so far apart, work hand in glove across what is referred to as the Northern Adelaide Local Health Network to deliver residents of the north and north-east world-class health care.

The staff, clinicians and volunteers who work in our hospitals, such as the Modbury and Lyell Mac hospitals, deserve world-class facilities. I am sure that is something that everyone in this place can agree on. That is one of the reasons that it is so bitterly disappointing to see that the time frame for this project has so significantly blown out. What was originally a planned completion date of mid-2021 is now mid-2022, so it will not even be in this first term—hopefully only term—of the Marshall Liberal government but will now be outside that four years. It is almost a daily occurrence that we see a story on the TV or an article in the newspaper about the incredible pressures that staff at the Lyell McEwin Hospital face every single day.

A 12-month blowout or a reshaping of an infrastructure project may, for a public servant, just be another bit of paperwork to do, but for those staff who are working in what is already a very cramped, overrun and under-resourced ED for incredibly long shifts every single day, this is heartbreaking. I know because in the last few weeks staff from that hospital have called my office and called me to express their frustration and to impress upon me the pressures under which they are working and how those pressures are affecting patient care and their own lives and their own mental health.

It is not us, nor is it the public servants who make these decisions, who have to work in the emergency department and explain to someone who has been sitting there for hours and hours, waiting to be seen, why there are no treatment cubicles available for them. We do not have to do that; we leave that to the poor staff who are working there every day.

The people who are presenting to an emergency department are often in a state of extreme stress and worried about their own ill health or the health of a loved one. It is a very difficult conversation to have, as a nurse or a doctor, to explain to someone that they are likely to be waiting for hours longer because all the treatment cubicles are full and the hospital does not have the capacity to treat them any sooner.

Earlier this year, we saw photographic evidence of the internal ramping occurring at the Lyell McEwin Hospital—the same internal ramping that this government and this health minister told us is not happening. However, we saw a photo of ambulance staff, with patients lying on gurneys and filling up the corridors inside the Lyell McEwin emergency department. What did the Minister for Health say when he was presented with that photographic evidence of what was happening in his hospitals? This was just a sign of a well-functioning hospital.

At present, I think the emergency department has just over 50 beds, and that is going to increase to just over 70 under these plans. I say 'just over 70' because I think there has been some conjecture regarding the precise number. It seems there is a difference between the submission by Minister for Health to the State Commission Assessment Panel in April of this year, which had 75 treatment bays, and the evidence given by, I think, the executive director of infrastructure for Health SA, who advised there would be 72 bays. Under questioning from the member for West Torrens, I believe SA Health admitted that they had scaled down the number of bays from 75 to 72.

I think one other peculiar inclusion in this plan is that the money that will be, on my numbers, a net gain of car parking of around nine spaces has actually been delivered. The State Commission Assessment Panel submission notes that 81 current car spaces will be lost to accommodate the expanded ED, and a further 115 spaces will need to be provided just to keep up with the expected demand from the new ED build.

You can put aside all those car parks, in terms of saying that there will be new additional car spaces. That is the number of spaces needed to accommodate the piece of land with existing car parks that will be taken up by the newly expanded ED and the number of car spaces needed on top of that to accommodate the extra people and increased demand that will no doubt occur as a result of the expansion.

In total, 196 spaces are needed to replenish what will be lost and maintain the current levels. Here, we have a plan to build 205—nine extra spaces. I admit that parking at the Lyell McEwin Hospital has long been a problem. We need more car parks and something needs to be done, but you would have thought that if you were going to do something about that issue and build new car spaces you would not do it at the expense of expanding the emergency department.

Who in their right mind would think taking money from an emergency department upgrade to fund what in the end is going to be a net increase of nine car spaces is a big win for the community? I can only imagine what Stephen Wade's message to residents of the north is going to be before the next state election: 'It might be crowded in the emergency department, but have you seen our car park?' or, 'If you are tired of waiting in the emergency department, wait in your car instead.' One other thing I briefly want to mention—

The Hon. A. Piccolo: You would pay more for the car park.

Mr BOYER: Exactly right; the member for Light is correct. Let's not forget that the privilege to use these new car spaces that will be built is going to cost staff and patients a whole lot more. I think the increase at Lyell McEwin and Modbury Hospital in terms of what a staff member would pay over a year of car parking is in the vicinity of an extra $700.

You have to understand that not all the people or all the staff using those car spaces are what I will call well-paid nurses or doctors or other medical staff. A lot of the people who rely on those car spaces are the people who are getting there early in the morning and late at night to clean the hospital. They are not earning big money. In fact, they are some of the lowest paid workers in this state, and what have we done to them? If they are lucky enough to even find a car park they are going to pay about an extra $700 a year for the privilege of using it.

I think this is a fantastic window into the priorities of this government. It is incredible to think that we are not going to have this expanded ED until after the next state election, and all I can say is: strap yourselves in—the kind of ramping and overcrowding we have seen under this administration is going to get a whole heap worse.

Mr CREGAN (Kavel) (11:30): May I say that we certainly have benefited today from the remarks made in the house by the member for King. The member for King is a champion for her electorate. She is focused on the needs of her constituents and well recognised in her community as somebody capable of delivering in relation to those needs.

This is a very substantial investment by this government in health services in the north and north-east, and the investment has been made in part because of the advocacy of the member for King. Members will know that she is a champion for her community. She remains in close and direct contact on a regular basis with not just, of course, those of her constituents who closely need health services but also those employees of SA Health who work and live in her community. She has taken on board their feedback and ensured that that feedback has been made available directly to the Minister for Health in the other place, and she certainly should be able to take substantial credit for this very substantial $58 million investment.

Isn't it the case, Mr Speaker, that those on the other side just really hate good news? They are allergic to it. As soon as there is the merest indication that there is a substantial investment or some good news, what do we get? We suddenly get the immediate knocking, the wrecking, the commitment to undermining a project of substantial merit.

Members interjecting:

The SPEAKER: Order!

Mr CREGAN: May I turn to the public value of the proposed project and in so doing address a number of the matters that have been raised by the member for Light and the member for Wright. Of course, in their remarks they neglected to reflect on Transforming Health, the Repat, CALHN and other matters, other atrocities from 16 years. We mention them—

Mr Pederick interjecting:

Mr CREGAN: Of course, EPAS, the member for Hammond reminds the house.

The SPEAKER: Is the member for Hammond interjecting out of his seat? I hope not.

Mr CREGAN: With respect to the public value of the proposed project, specifically it is expected that the Lyell McEwin Hospital ED expansion and the new mental health short stay unit project will deliver an additional 1,900 square metres of emergency clinical floor space. Good news, member for Wright and member for Light: a dedicated ambulance arrival for patient transfers. Good news: additional resuscitation, triage and reception capabilities. Good news—

Members interjecting:

The SPEAKER: Order!

Mr CREGAN: —dedicated paediatric assessment and treatment spaces. Good news: increased short stay and quick assessment capabilities. Good news: increased acute and discharge facilities. Good news: refurbishment of existing emergency treatment spaces. Good news: a total of 72 treatment spaces within the ED and a relocated bulk decontamination unit.

There is a new 642-square metre emergency administration accommodation on level 2 above the new ED providing for education and administrative activities; the development of a new eight-bed facility to provide a purpose-built facility on level 3 for mental health patients requiring short stay assessments after presenting to the emergency department; and, of course, a 205-space extension to the existing 1,227 space multideck car park facility to cater for the increase in demand and existing displaced car parks generated as a direct result—

Members interjecting:

The SPEAKER: Order!

Mr CREGAN: —of the ED expansion. The redeveloped ED is expected to improve the patient journey by reducing unnecessary patient movement and reducing average length of patient stay in the ED. Other expected benefits to the South Australian community include improved safety and quality of care to patients; providing patients with access to definitive emergency care; a more sustainable ED service, with the release of value through significant productivity improvements, savings and efficiencies; and more equitable access to consistent quality of care.

I said at the outset that this is a substantial investment that has come in part because of the excellent advocacy of the member for King. Her community respects that advocacy; they rely on it. They have elected her to represent them in this place, and she continues to do that well. We are certainly very proud that she is a member of our team, and the minister has made claim that he has benefited directly from her advice in relation to this project.

Motion carried.