Bills

Health Care (Governance) Amendment Bill

Second Reading

Adjourned debate on second reading (resumed on motion).

Mr ELLIS (Narungga) (16:05): I was on my feet celebrating the virtue of the government's efforts to improve health care in the regions and the wonderful job the government is doing. I had already touched on the $1 million investment at Yorketown Hospital to revamp the surgery theatre, a wonderful initiative driven by the community after the uproar that came along with Transforming Health and the efforts to take (well, they succeeded ultimately) the surgical services away from Yorketown. There is a brand-new theatre up and running there.

I had begun to touch on the Ardrossan hospital which, as I said, is a wonderful community hospital, one of few in South Australia. Without knowing the ins and outs of the others, I suspect that it is one of the better-run community hospitals in the state. The generosity of donors to the Ardrossan hospital is extraordinary and it leaves them in a position to run a wonderful set-up at that site.

Jodie Luke, the Director of Nursing, does a tremendous job with her staff looking after not only a community A&E but also an aged-care facility, which is tremendously popular and a really positive place to visit. The Ardrossan hospital did have some financial difficulties in servicing its A&E and transferring patients to a public hospital, but the government, thanks to an election commitment, came to the party and offered $720,000 over four years to help mitigate the cost that was having an impact on the Ardrossan hospital.

Since the election, there have been a number of wonderful initiatives to do with health care that I have been pleased to lobby for in the electorate. The one that has perhaps had the biggest impact on our local constituents—it is only recent—has been an X-ray service. For quite some time X-rays at Wallaroo Hospital were available only in working hours. Those who played sport on the weekend were unable to access X-ray services. The wonderful football clubs we have in the electorate were unable to visit the hospital in the event of an injury to get an X-ray to figure out what had happened to them and why they were feeling like they had injured themselves, so they had to shoot off for the long car ride to Adelaide.

A litany of examples came through our office of people who had tried to access X-ray services out of hours and had no luck. The difference this service has made in the electorate, despite being only recently enacted, has been extraordinary. One of the most popular Facebook posts the Narungga electorate office has put up was just about returning X-ray services to Wallaroo Hospital over the weekend. That has been a tremendous upgrade. We have also had $3.4 million invested at the Snowtown Lumeah Homes facility for new kitchen facilities, refurbished residents' rooms and bathrooms, a nurse call system, sprinklers and security systems.

Other speakers have touched on the PATS improvements. Our office is no different from a great many other regional offices, in that we get a lot of calls about PATS. Many people rely on it to get to Adelaide and access their specialist services, so it is pleasing to see the government making efforts to improve it. I will continue to work towards efforts to make sure that sensible and commonsense outcomes can be provided to regional people trying to access specialist services in South Australia.

On the topic of the health network, we have a wonderful organisation for Northern and Yorke: the chair, John Voumard, is doing a wonderful job, and there is Julianne Badenoch from Ardrossan; Glenise Coulthard, Liz Malcolm, John O'Connor and Yvonne Warncken. I would like to also acknowledge at this point the former chair Vanessa Boully. I have worked closely with Vanessa over the last three years. She is active in the electorate in the mental health space on a volunteer basis and did a tremendous job throughout her time as chair, and we would like to thank her for that.

The local health network has had a positive impact on localised decision-making. It has been great to have access to people who actually live in the electorate, live in our part of the world, to talk to them about the issues that we are facing. It has been pleasing, from a principle point of view for myself, to see decentralised decision-making moving away from a large centralised bureaucracy, getting people out to the regions and having people live where they make the decisions that impact the people.

As these boards continue to evolve, we need to ensure that they remain local. That was the benefit we sold to the people upon coming to government: that these would be localised decisions being made by local people. I think we need to prioritise local people when the board positions become available and make sure that they are people living in the electorate, living in the area and living near the hospitals that they are making decisions for.

In my view, we do have an issue in the Northern and Yorke where not many people from the peninsula are actually on the Northern and Yorke Local Health Network. I am on the Yorke Peninsula HAC group, which services the Maitland, Minlaton and Yorketown hospitals. I can tell you that Yorketown is a long way from Pirie, and it feels as though we could do with more people from the peninsula patronising that board to ensure that we at the Yorketown hospital get a fair say in those decisions.

We also need to make sure going forward, as these boards continue to evolve, that the networks are properly funded, otherwise we will have a situation where we are robbing Peter to pay Paul. We cannot have Pirie competing against Wallaroo for funding, which I do not believe to be the case at the moment but, as a matter of ongoing consideration, it is important that there is enough funding for each hospital to provide each service to make sure each hospital is doing the job that we intend it to do.

By way of conclusion, I will be seeking assurances from the minister during the committee stage that local representation will be considered a priority. These are skills-based boards, and they were by design. There are obvious reasons for that. These positions are very important, with high responsibility. We need to make sure that there are people on them with the appropriate skills in order to discharge those responsibilities properly, but it needs to be localised decision-making. That was the benefit of devolving and decentralising it. We need to make sure that that continues to happen.

With those words, I congratulate the government on the work they are doing on health care in Narungga. It has been positive. There will always be more to do, but we have made a great start in three years. I look forward to continuing to work for the residents of Narungga because, as I said, it was one of my primary inspirations for nominating and I think it is one of the primary concerns that voters in Narungga have. I commend the bill and I will consider amendments as they come forward.

Ms LUETHEN (King) (16:12): I rise to support the bill and I thank the Minister for Health for his work on this bill and the Minister for Education, acting for the Minister for Health, in this house. The bill is the second stage of the government's election commitment to decentralise decision-making in the public health system through the establishment of metropolitan and regional boards.

The bill will establish a new governance and accountability framework for the public health system. The governing boards have been operating since 1 July 2019 and are accountable for the delivery of health services within their geographic area. The bill amends the Health Care Act 2008 to revise the functions of the chief executive of the Department for Health and Wellbeing to focus on the strategic direction and performance of the public health system, ensuring that the roles of the chief executive, the governing boards and the local health networks are clear and avoid duplication or omission.

It will provide the CE with the ability to issue binding policies and directives to the local health networks and SA Ambulance Service, setting the required standards for the performance of their functions. It will require the CE to publish service agreements to demonstrate transparency and accountability in how the local health networks are funded and managed. It will provide the CE with the ability to take remedial action when the performance of a governing board or local health network does not meet expected standards. It will make minor amendments to sections of the act to reflect the new governance and accountability framework and/or clarify their intent.

The bill also makes consequential amendments to the Mental Health Act 2009 to align the requirements for the disclosure of personal information with those under the Health Care Act 2008. Wellbeing SA was also established as an attached office on 6 January 2020. Its functions are to oversee community-wide health and prevention services; lead innovative system change to embed prevention across the life course and disease continuum; to improve physical, mental and social wellbeing; and reduce the preventable burden of disease.

Three part-time mental health commissioners were appointed in January and February 2020 pursuant to section 68 of the Constitution Act 1934, with terms expiring on 7 January 2023. The bill includes a broad function for the CE, which was advocated for by stakeholders through consultation, being a requirement to engage with consumer representatives and other interested parties in the development of healthcare policy, planning and service delivery, and this collaboration and community engagement is certainly valued in my electorate. Governing councils are required to have consumer and community engagement strategies in place under the Health Care Act 2008 to ensure the local health networks are appropriately engaging with their communities on an ongoing basis.

Prior to the March 2018 election, the Marshall Liberal team committed to develop a new governance and accountability framework for the public health system that will devolve decision-making in the public health system through the establishment of the metropolitan and regional boards, put responsibility and accountability for health services at a local level with strengthened oversight, improve patient safety and hold governing boards accountable for the performance of their local health network.

Devolving decision-making in the public health system recognises that healthcare needs and challenges can vary between areas within metropolitan Adelaide and across regional South Australia. Decisions that are made as close as possible to the area and people affected and with the full and effective engagement of local health professionals and communities are likely to be better decisions. Governing boards are also required to have consumer and community engagement strategies in place under the Health Care Act.

Our health system should provide the very best care to patients and put the wellbeing of South Australians first. We are not there yet, but I have confidence that we are on our way to deliver better health services. The $97.5 million upgrade to Modbury Hospital is testament to this. We have sought to end the cuts inflicted on Modbury Hospital from Labor's failed Transforming Health policy and instead invest in returning key services to the north-east. I think it is safe to say that health services across the north and north-east are one of the key issues that were raised with me the most.

Whether I am out doorknocking or just out and about in the electorate, it is made to clear to me that the residents of King and the people of the north and north-east in general want better patient care closer to home. This is why it gives me great delight to talk about the upgrade of Modbury Hospital. Several milestones have already been completed, including the completion of an eight-bed emergency extended care unit, an upgraded hospital facade and a refurbishment of the administration area on level 5.

Easing pressure on the emergency department is a key focus of the upgrade, and the completion of a specialised emergency extended care unit goes a good way to addressing this. The new unit allows patients who are assessed in the emergency department to be moved to the new unit for further observation and treatment for up to 24 hours. This frees up emergency beds and improves the movement of new patients into the emergency department.

Construction is also underway on the new 20-bed palliative care unit. The palliative care team at Modbury Hospital receives around 1,200 new referrals every year for both inpatient and community care. The new unit, with private gardens and natural light, creates a more homelike environment with space for families to stay with their loved ones during their end-of-life care. I must say that in the time that I have been the candidate for King and the member for King as well, I have heard so many positive comments and feedback about the staff at Modbury and the palliative care service at Modbury Hospital and now we are backing up that wonderful service with a modern, purpose-built state-of-the-art facility.

There is plenty more to look forward to, with the upgrade works continuing for a new surgical suite, a high dependency unit, a front entrance and the relocation of the outpatient department to allow for more streamlined access in a more efficient location. This is on top of the recent announcement that a further $1.5 million has been invested for lift upgrades. Once completed, these upgrades will deliver, as promised, improved health care for our communities, more beds at Modbury Hospital and fewer transfers to the Lyell McEwen Hospital.

The extensive upgrade and enhancement of Modbury Hospital is not just delivering better healthcare services for the residents in the north and north-east but, importantly, stimulating the local economy at a time when it is most needed. Over 200 construction workers are on site daily and nearly 1,400 people have been involved in the construction so far. Further to this, the upgrade has used over 100 tonnes of reinforced steel that has been processed and manufactured locally in Cavan and 1,100 cubic metres of concrete that has been sourced from companies across South Australia, providing a huge boost to local suppliers and tradespeople throughout this economically challenging period.

I would also like to take this time to thank the staff and patients as well as the volunteers at Modbury Hospital. This upgrade at the hospital in our local health network has no doubt caused some disruption over the last year in what has been a challenging period, so I thank everybody for their patience.

This is indeed an exciting time for residents in the north-east. Modbury Hospital has been an ageing facility that has long been overdue for an upgrade. It had been neglected under the previous government and bits of the facade were even falling off and crumbling to the ground below. I am so proud to be a part of a Marshall Liberal government that has put an end to these cuts and downgrades that had previously been inflicted on people in my local community through Labor's failed Transforming Health plan. Instead, we are investing in world-class infrastructure to deliver better patient care closer to home for people in the north and north-east.

Our health system should provide the very best care and that is what we are aiming to do every day: provide health care and look after people's wellbeing at every stage of their lives. The Marshall Liberal government inherited a financial and organisational mess from the former Labor government. After 16 years of Labor mismanagement, our central health network needed to refocus and rein in.

In 2018, we launched a responsible road map back to stability and excellence. KordaMentha's 2018 diagnostic review identified that CALHN was suffering from a lack of financial control and reliable information, poor processes and poor culture. It confirmed the extent of the dysfunction in performance, monitoring, procurement, planning, improvement capability and risk management. It described an organisation lacking a clear motivating vision or sense of purpose.

A massive overspend of $303 million was forecast in CALHN for 2018-19 unless urgent and significant corrective action was undertaken. This poor performance was systemic and unsustainable. The diagnostic review also reported that anticipated savings from moving the new Royal Adelaide Hospital had not been achieved and, in fact, costs had increased as a result of the move to the new hospital. Since late 2018, CALHN has made huge inroads to becoming a sustainable and accountable healthcare network.

In mid-March, when COVID-19 arrived, CALHN moved into emergency response mode. At that time, administrators KordaMentha and the government agreed to pause the recovery program. While COVID-19 impacted CALHN's recovery, its board and executive team maintained the financial controls and demonstrated the capability and capacity required to successfully manage its financial performance in a post COVID-19 operating environment.

Central Adelaide Local Health Network now has a clear vision to shape the future of health with world-class care and world-class research. It aims to be one of the top five performing health services in Australia and one of the top 50 performing health services in the world within five years. CALHN achieved a successful turnaround and will ensure its patients receive the world-class care they expect and deserve and that the community receives a sustainable service delivery model.

Thousands of South Australians will benefit from better health care closer to home through a $42.8 million infrastructure stimulus package, which has triggered a series of job-creating projects throughout the state. The $42.8 million package includes a new $6 million step-down unit to care for brain and spinal patients at the Marshall Liberal government's reactivated Repat, a landmark expansion of the Gawler hospital emergency department, an extra $10 million for shovel-ready regional health infrastructure works and a series of other projects for rural South Australia.

Premier Steven Marshall said that this $42.8 million funding package is part of the Liberal government's plan to build what matters in communities and create jobs for South Australians. We are committed to keeping South Australia safe and strong. We will continue to do this by creating jobs, backing businesses and building what matters. The Marshall Liberal government will also launch an expansion of the Gawler hospital ED, which will increase its capacity fourfold. These projects will improve the lives of many, and I am proud to be part of this government that is determined to deliver better health care for all South Australians.

As the Marshall Liberal government seeks to avoid repeating Labor's catastrophic transformation of South Australia's health system, it is proceeding with the new Women's and Children's project in a manner that will deliver the best quality hospital for South Australians while being prudent with how it spends South Australian taxpayer money. South Australians, as both taxpayers and health consumers, would expect nothing less.

It has been eight years since Labor announced a new Women's and Children's Hospital and four years since it abandoned yet another project. In 2017, Labor broke its promise and downgraded the project to a women's-only hospital stranded indefinitely at the North Adelaide site. In contrast, the Marshall Liberal government has prioritised the new Women's and Children's Hospital as an important asset with incredibly important services for our South Australian system.

The Marshall Liberal government has been steadily increasing health services capacity since it came to government, and there are now 432 treatment spaces at the current Women's and Children's Hospital. Preliminary planning for the new hospital has revealed 441 treatment spaces and over 1,215 car parks to be provided, increasing from the approximately 900 car parks at present.

The Marshall Liberal government is delivering on its commitment to construct a new Women's and Children's Hospital, and it is delivering better local health services for northern suburbs residents, including those in my electorate with significant upgrade projects underway at Modbury Hospital and Lyell McEwin Hospital.

I still remember a King family pulling over to sign my Fix Golden Grove Road petition and a lady telling me in tears how she had lost her father-in-law after waiting with him in the corridors of Modbury Hospital for 11 hours. She said that, on this occasion, there were spare palliative care beds but not enough staff. This man had little dignity in the last hours of his life. Thank goodness this is changing with our investments and care by the Marshall Liberal government.

When my local constituents raise concerns about health care, I reiterate that I believe that all South Australians, including every person living in the north, are entitled to world-class, accessible and effective health care, and this is what I will fight for every day that I am elected to represent my King community.

My constituents' health care needs to be efficient, effective and sustainable so that services are available when they need them. I thank every constituent for reaching out to me for help when this is not the case. I am committed to advocating for each individual in my community to provide them the health support they deserve. I am here for you. I commend this bill to the house.

Debate adjourned on motion of Dr Harvey.