House of Assembly: Wednesday, May 12, 2021

Contents

Motions

International Midwives and Nurses Days

Debate resumed.

The Hon. C.L. WINGARD (Gibson—Minister for Infrastructure and Transport, Minister for Recreation, Sport and Racing) (11:51): I rise to support the motion as well and note that my wife, too, is a nurse. We celebrated the International Day of the Midwife on 5 May and today we are celebrating International Nurses Day. Among many others here, I value the opportunity to say thank you to our capable and hardworking nursing staff. Furthermore, I want to recognise the immense contribution of our nurses and midwives to our community. They work day and night, they tend to the sick, they advocate for better health and wellbeing, they administer medication and treatment and they take on the special responsibility of helping to deliver new life into this world. If I have time, I will come back to that in a personal reflection on my granddaughter being born at my house.

With the declaration of a global pandemic last year, nursing staff embraced new roles. Their importance here and around the world, then and now, cannot be underestimated. Locally, South Australian nurses have been involved with airport screening, contact tracing and the repatriation of international travellers, among many other important tasks, to protect our community during the COVID-19 pandemic.

Nurses in our community have a long history of supporting the health and wellbeing of South Australians. In my own electorate, I have been privileged to hear from many nurses and past nurses. Wendy Murphy from Marion, for example, told me that she has been a nurse for more than 50 years—that is half a century and how long I have been alive. Wendy wrote to me to share some of her observations and insights during her time in this profession. I am grateful to Wendy and the other nurses just like her who have dedicated their lives to providing quality care.

Another example of the outstanding local nurses is Helen Wright, who worked at the Repat, where she spent 20 years as a registered nurse and 10 years managing five specialised clinics, including a dementia clinic. Helen's voice is one of the many that I have heard in support of the Repat. Of course, the Marshall Liberal government has been committed to revitalising this health precinct, which was closed by the disastrous decision of the former Labor government as part of their Transforming Health program, despite their promises that they would never close the Repat. Thankfully, the Marshall Liberal government was elected, and now we are investing in this site to provide South Australians with better care closer to home.

Earlier this year, we opened the Neuro-Behavioural Unit, featuring 18 beds. It is an Australian-first specialised unit to care for people living with the severest dementia symptoms. Next to it is the Specialised Advanced Dementia Unit. Patients with complex dementia and medical conditions will be able to access this 78-bed dementia care facility to receive the quality care they need. I was lucky enough to tour there just recently before it opened and I can say it is a wonderful facility, designed impeccably well, and I thank everyone for their involvement with that project.

The Repat's Bangka Strait Ward, a 26-bed ward, opened earlier this year, and cares for patients awaiting services such as NDIS, equipment and housing or other rehabilitation services. Of course, the Repat's 48-bed brain and spinal injury rehabilitation facility provides a patient and family-centred service that includes exercise physiology and a sports gymnasium to support rehabilitation and I thank all the workers there. In fact, that is my area of study as well and I know how important that facility is.

Our Veteran Wellbeing Centre was also opened earlier this year to integrate veteran community services with government support. So again you can see that we are revitalising that site that, as I mentioned, was going to be sold off by the previous government. As veterans transition to civilian life, they will be able to access a range of services at the centre, including advocacy, education, employment and housing support. These upgrades are vital to supporting our local veterans.

There are several groups in my electorate that I know welcome the support and assistance we can offer veterans: the Marion RSL, the Brighton RSL and the Vietnam Veterans' Federation, currently led by Ken Parnell, Jim Nicholson and Bob Ellis respectively. They are among the local community groups benefiting from our support for this vital health precinct at the Repat hospital. I thank each of these groups for their support that they provided directly to their members, local veterans and families. They do an outstanding job.

The investment into the Repat also complements the investment we are making into the Flinders Medical Centre in my local community. At the Flinders Medical Centre, construction is underway to build the largest emergency department. This expansion is part of the $86 million Southern Health Expansion Plan, with $8.5 million being invested directly into the emergency department. Previously, it was 56 beds, but under our expansion there will be another 30 beds, taking it to 86, which I think is absolutely wonderful. I know that a number of the other hospitals are being expanded, but in my area that expansion of the Flinders Medical Centre is greatly appreciated.

As we continue to roll out state-of-the-art infrastructure across the state, we are supporting our health professionals, including our fantastic nurses and midwives, to deliver quality care. Nurses and midwives make a real difference in our community. They so often bear enormous responsibilities with optimism, expertise and energy, having a positive impact on their patients.

The Marshall Liberal government is committed to supporting nurses and midwives as we develop our health system and to ensuring equitable quality access to health care for our local community. We are committed to undoing the damage done by Labor's ill-fated Transforming Health debacle. I am grateful to all nurses and midwives for their work day in, day out in service of our state's health system and for their ongoing support for the physical and mental wellbeing of South Australians.

I will now share a personal story of the wonderful experience I witnessed in my own home when my granddaughter was born. The midwives and the healthcare professionals who helped were outstanding and I was very lucky to have that experience. It was during COVID, when it was hard to get into hospitals and there were a number of things that were going on. My daughter elected to have a homebirth. Unbeknownst to me, she decided that it would happen at my home. I thought a homebirth always happened at your home. It was a wonderful experience.

She rang when her waters broke and told me she was coming to have the homebirth at my home. Clearly this was orchestrated with her mother and I was left out of the loop. I was then very much brought into the equation of having to move the dining table. I asked why we were moving the dining table. My wife said, 'Because we are going to put a pool here.' I thought, 'We have just finished building a brand-new home and a pool in my dining room was not in the plans,' but we built a pool in our dining room and our beautiful granddaughter was born there.

I thank the team that was there. They did an absolutely outstanding job. My granddaughter was actually taken to hospital at the end and had exceptional care at Flinders, where the team was outstanding as well. The note I make to everyone is that if your child says they are having a homebirth check that they are doing it at their home because otherwise you could be duped like me. My granddaughter's name is Olive and we have a little olive tree by our front door. Thank you again to all the wonderful nurses and midwives. In fact, I have to mention that it was a good friend of ours who actually delivered the baby too, so it was very special. Thank you, all.

Mr PICTON (Kaurna) (11:59): Firstly, can I acknowledge my good friend and colleague—

Ms Cook: And nagger.

Mr PICTON: —and she says nagger—the member for Hurtle Vale, Nat, who has moved this motion over a number of years. Thankfully, today we actually got it on International Nurses Day, which is the luck of the parliamentary draw.

As Nat says, she is very good at making sure that I as the shadow minister for health am across every single thing that nurses in South Australia want and need at every minute of the day. That is an incredible asset for me to have and it is an incredible asset for the nurses and midwives of South Australia to have Nat in the parliament and so strongly advocating on behalf of nurses. Nat has said on a number of occasions that she would like to see parliament filled with nurses—no doubt we would be a better state—but, certainly, I think our parliament is well served by having Nat here, particularly with her longstanding experience as a very senior intensive care and retrieval nurse at Flinders Medical Centre before she was elected here.

Can I acknowledge your acknowledgment of the people here, Deputy Speaker. It is fantastic to have so many nurses and midwives in the chamber today to hear this motion being debated. We thank you for your hard work and for your many years of experience serving the people of this state. We know that nurses and midwives are really the backbone and probably the heart of the healthcare system in terms of making sure people can get the care and compassion they need as part of health care, and we also know that it is an incredible professional service to be a nurse or a midwife.

The list we had of a number of professors, doctors and people like that really speaks to the high professionalism and high education that nurses and midwives in South Australia have. I particularly thank all those people who work as part of our three university programs and who are training and researching for the future as well.

As other speakers have said, we all have personal experiences of the benefits and impacts that nurses and midwives have had on our lives. Just last week, I made a post on my social media acknowledging international midwives' day. Rather than just posting the usual graphic or whatever, I posted a picture we took after my son Alex was born of the midwife Emily. She was really the spearhead of giving birth to Alex. She was paid a lot less than the obstetrician but certainly did a lot more work, as good as the obstetrician was.

Ever since, we have just been in awe of the care and professionalism that Emily gave to us and particularly to Connie, my wife, that night. Connie to this day still cannot speak highly enough of her, so I gave a little tribute to Emily. I was very touched the other day when I then received an email from Emily's dad, Greg, who said:

Dear Mr Picton,

Yesterday you posted on Facebook an image of your newly born son Alex and my daughter the midwife. It was a thoughtful and affirming gesture. Thank you. My heart burst with pride. My eyes filled with tears. I was so proud. Emily was my baby once, and now she lives such significant life. How did that happen? Thank you for the support and the public recognition of a group of nursing practitioners who make such a difference to people's lives. I trust that Alex is well and that you spend many hours with a heart flushed with pride and tears in your eyes. They grow so quickly and so does love. Well done Mr Picton.

Regards

Greg Hay

I think that just shows how proud families and the community are of our nurses and midwives, the work that they do and the impact that they have upon people's lives. We do know that there have been significant challenges, as this year we have obviously faced the pandemic and that has presented additional challenges and strains.

We know about the issues with PPE. We know about the issues when casuals in our state health system were not supported through the elective surgery shutdown and lost significant income. We know about the huge number of hardworking nurses working in our hotel quarantine program who put themselves at risk through being part of that very important program.

We know about the huge challenges in aged care. It is good that there is some additional money, but I do not think it goes nearly far enough to addressing the problems in aged care and making sure that we can provide enough nursing care and provide the care that we all know is needed. We know there are huge challenges in regional health care in making sure that we have enough nurses across the state in enough places, and we know that those nurses who are there are under additional strain and pressure.

We know that mental health care is a continuous crisis, where we see patients not getting the care they need because there are not enough resources, not enough mental health resources and not enough mental health nurses. That leaves patients in desperate situations and puts outrageous pressure on the staff we do have.

Clearly, we are in the midst of a ramping and hospital overcrowding crisis at the moment. We absolutely hear you very clearly about the impact that that is having every single day on our healthcare system and our hospital system. We hear you about the pressure that the administration is putting on about budgets rather than patient care. We hear you about the threats to security at work that you face on a day-to-day basis.

We hear you about the shortage of staff that you face in our healthcare and hospital system. We hear your concerns about job security. We hear you about the concern that you have primarily for the patients who are suffering and cannot be helped because of the outrageous strain staff are under in situations where there is not enough staff, there is not enough budget and there are wrong priorities. And the government is not listening to any of those concerns.

We see that even just looking at the last official statistics in the Auditor-General's Report, which shows that usually the number of nurses goes up every year. Last year, even during the pandemic, the number of nurses in South Australia working in our healthcare system went down by 112 nurses overall. This was at the same time the government was putting out calls for redundancies, not for back office workers but for frontline nurses and midwives, 120 of whom had their positions made redundant. Those positions were abolished, which then put more pressure on everybody else. There are still more calls from the government for more people to take redundancy packages. That is only making the situation worse. We need more staff, not less.

I would like to acknowledge the hard work and the importance of the Australian Nursing and Midwifery Federation and acknowledge Associate Professor Elizabeth Dabars AM, who is here today, and thank her and the federation for their advocacy on behalf of nurses and midwives in this state. On this side of the house, we believe in the importance of unions and we believe in the importance of workers having strong representatives and strong advocates to make sure that their pay and conditions are as good as they can be.

Certainly, through the ANMF there is a very strong voice on behalf of nurses and midwives in this state. We have seen that through the concerns raised about safe staffing, ramping and overcrowding. We have seen that through the concerns raised about the security of staff getting to and from hospitals as well as inside hospitals. We have heard concerns raised about the privatisation of services across the board. No doubt, the ANMF will continue to strongly raise these concerns going forward to make sure there is a strong voice for nurses and midwives in this state.

Lastly, we heard, largely in the notes no doubt prepared for the previous speaker by the minister's office, about a litany of infrastructure upgrades and things like that. Fundamentally, this motion and our healthcare system are about people, about hardworking women and men who are nurses and midwives in this state and for whom we should be so thankful. We should acknowledge the pressure they are under.

We should be making their lives easier, not harder, but unfortunately we are now faced with a crisis situation where so many people are under an outrageous level of pressure. We will continue to fight for you. The member for Hurtle Vale and I, the Leader of the Opposition and all of us will continue to stand up for the nurses and midwives in this state, but particularly today we say thank you for the work that you do every single day on behalf of the people of this state.

Mr PEDERICK (Hammond) (12:10): I rise to speak on this motion moved by the member for Hurtle Vale:

That this house—

(a) recognises both International Nurses Day and International Midwives Day;

(b) notes their key themes, 'Nurses: a voice to lead—a vision for future healthcare' and 'Midwives: changing the world one family at a time';

(c) notes that International Nurses Day is celebrated all around the world every year on 12 May;

(d) notes that International Midwives Day is celebrated all around the world every year on 5 May; and

(e) sincerely thanks all nurses, midwives and care assistants for the important work that they do in our communities, hospitals and homes.

I rise today to speak in support of this motion and to express my heartfelt thanks to our dedicated and remarkable nurses and midwives in South Australia. This year, 2021, has been designated by the World Health Organization as the International Year of Health and Care Workers, in recognition and appreciation of their unwavering dedication in the fight against COVID-19.

In South Australia, like our European counterparts we have extended our acknowledgement and recognition of our nurses and midwives as part of the international year of the nurse and midwife 2020 celebrations. It is very important for us to take the time to recognise both International Nurses Day and the International Day of the Midwife. It gives us an invaluable opportunity to celebrate the achievements and to recognise the contributions that all nurses, midwives and carers make in ensuring South Australians are receiving high-quality and safe care.

I recognise the contribution and how hard all our nurses and midwives work and realise how important it is for us to honour our entire nursing and midwifery workforce. They are to be acknowledged for their efforts and their significant contributions enabling the improvement and effectiveness, efficiency and quality of actions that support and promote public health and wellbeing. Certainly, during last year I needed to have some elective surgery—it became a bit less elective as it got closer. I had my right hip replaced, and I just want to acknowledge the excellent care that I had at Flinders. The nursing staff were absolutely fantastic.

Every year, on 5 May, the International Day of the Midwife is celebrated around the world. The theme for this year's International Day of the Midwife is 'Follow the data: invest in midwives'. It is significant in highlighting the wonderful work midwives do to ensure the women in their care have a positive birth experience. Midwives play a critical role in promoting healthy women and in ensuring the health and wellbeing of women and babies and the family unit.

Midwives also have a key role in health counselling and education, not only for women but also for those within the family unit and the community. So 12 May is International Nurses Day, an annual celebration to commemorate Florence Nightingale's birthday. The focus for this year's theme is 'Nurses: a voice to lead—a vision for future healthcare'.

I would like to take this opportunity to commend the nurses and midwives in South Australia and across the world for their understanding and caring, their selflessness, their patience and their dedication. They are the people whom we depend upon at some of the toughest times we all experience in our lives. They are the people who are there for us and those closest to us in the most difficult of times.

Every year, as an important part of the week of celebrations for International Day of the Midwife and International Nurses Day, we have the SA Health South Australian Nursing and Midwifery Excellence Awards. Once again, this year we want to pause and pay tribute to South Australian nurse Kirsty Boden, the recipient of the Australian Bravery Decorations Bravery Medal, the Queen's Commendation for Bravery and the Red Cross Florence Nightingale Medal in recognition of what happened in the 2017 London Bridge terrorist attack. Kirsty, without hesitation, ran into danger offering her nursing expertise and qualities to save others. She truly put herself before others. Kirsty's courage, dedication and her strong will to care for the injured as a nurse and as a caring person will be remembered.

To our nurses and midwives, on behalf of the South Australian government, and all South Australians, I thank you all for the dedication, compassion and commitment to making a difference every day to the lives of the South Australian community and beyond. I thank our nurses and midwives who lead, innovate and care for our South Australians, demonstrating their values of generosity, empathy and integrity but, importantly, the value and art of the human touch which, as has been mentioned before, was so sadly missed at times over the last 12 months and ongoing. I acknowledge the art of the human touch in caring for the South Australian community. I commend the motion.

Mr HUGHES (Giles) (12:16): I also rise in support of this commendable motion. It is entirely appropriate that the motion has been moved by the member for Hurtle Vale, with such a background—so many experiences in the nursing profession. We on this side are incredibly fortunate to have such a member, and a member with such a huge amount of lived experience. It is always good to have someone with lived experience, and not just relying upon abstract knowledge to make comment on some of the most important issues that we face.

I am sure many of us in this chamber have met midwives and nurses, often in not great circumstances, but I have to say that the most profound and happiest days of my life were in the company of midwives, with the premature birth of our twins. An obstetrician was involved—and he had to do some heavy-duty work because it was a caesarean—but there was a midwife there. The obstetrician was fantastic, but the degree of human warmth during that process was not exactly as great as it was with the midwife who, with skill, experience and warmth, brought something else to that particular experience.

It is worth reflecting on as a country member with a vast electorate. The challenging births that used to take place as a matter of routine in country hospitals are now much rarer. I come from Whyalla, one of the larger regional communities. The delivery of our twins could no longer happen in a place like Whyalla. You would have to go either to Port Augusta or to Adelaide for a birth of that nature.

Indeed, someone with relatively minor complications—they might be overweight; there might be a number of other factors—would now have to go to Port Augusta or to Adelaide for that birth. Whereas once upon a time we did have resident obstetricians in communities like Whyalla, that no longer occurs, but we still have midwives and we still have midwives capable of doing amazing work in the absence of obstetricians.

When it came to our third child, the obstetrician only turned up right at the last minute when all the work had been done. The midwives did all the work and that was a long birth. I remember that incredibly well. It was not a caesarean. It was a very long birth, and my partner at the time was very annoyed with us because we were already quaffing champagne and eating pizza while she was in the process of giving birth. The language she used was incredibly abusive—and understandable. But that is reflecting upon the way the delivery of health in country communities has changed.

One of the things about having such a large electorate is that there are a number of nurses who live and work in very remote communities, and they serve those communities incredibly well. Their level of dedication is something to behold, but it does carry risks. Back on 23 March 2016 there was the brutal death of Gayle Woodford, someone who was incredibly dedicated and who ended up losing her life in a very remote community in the APY lands.

The things nurses are exposed to at times in remote communities are deeply concerning. It is important that in this place, with the introduction of Gayle's Law, we need to ensure it is properly managed. We need to ensure that people in remote locations, doing outstanding and very necessary work, are looked after. Even in our larger communities there have always been issues, and it is usually in relation to alcohol.

Alcohol is still one of the big contributors, and in our hospital up at Whyalla, a large hospital, there is exposure to violence. At times it is not the fault of the person who is putting people's safety at risk—it can be the result of trauma or mental health conditions or psychotic episodes—but we do have our unfortunate share of people who are off their faces on this or that and who are directing violence against people who are there to help them.

That was one of the really concerning things in the hospital in Whyalla, that we did not have 24-hour security for a long time, despite all the Code Blacks, so I was proud to be involved in the campaign to get that changed. Once again, we saw the incredible worth and power of unions, of people collectively organising to try to get a result. There is now going to be 24-hour security at the hospital, but we just need to make sure it is appropriate and skilled security, with the capacity to protect people and de-escalate situations when needed. As I said, it is a large electorate, with nurses at Whyalla, Roxby Downs, Coober Pedy, Quorn, Hawker, Cowell, Kimba, the APY lands and Marla, and people working through that vast electorate to deliver essential services.

The issues we have in aged care and the role nurses play in that sector have also been touched upon by our shadow minister. There are insufficient nurses in aged care. I have not yet been through the detail of the budget announcements, but we clearly need to bring back staffing ratios in terms of both nursing and the general workforce in aged-care facilities. The fact they were even removed all those years ago—under the Howard government, I think—was a disgrace, and the consequences of that have been very serious at a number of facilities.

In common with all other members here, I commend the work done by nurses and the work done by midwives, incredibly essential work by incredibly valued members of our community. They should be treated with respect. I will just touch on the difficulties now with accessing GPs, which is extending beyond the smaller regional communities. I think that whole idea of having additional trained nurse practitioners—I know GPs hate this and I know doctors hate this, in the main—means they could play an even bigger role than they are playing now.

Ms LUETHEN (King) (12:25): I rise today to speak in support of this motion from the member for Hurtle Vale and to express my heartfelt thanks to our dedicated and remarkable nurses and midwives in South Australia. This year, 2021, has been designated by the World Health Organization as the International Year of Health and Care Workers in the recognition and appreciation of their unwavering dedication in the fight against COVID-19.

It is very important for us to take the time to recognise both International Nurses Day and International Day of the Midwife. It gives us an invaluable opportunity to celebrate the achievements and to recognise the contributions of all nurses, midwives and carers in ensuring South Australians are receiving high-quality and safe care. I recognise the contribution and how hard all our nurses and midwives work.

Furthermore, it is significant in highlighting the wonderful work midwives do to ensure women in their care have a positive birth experience and outcome. I remember, when I had one of my two children, the obstetrician accidentally cut me in a very painful way in the process of giving birth and the midwife pushed him aside, took over and sent him away. My husband said he could smell alcohol on the obstetrician and I am very glad the midwife was there to safely deliver my child and keep me well. Midwives also have a key role in health counselling and education, not only for women but also for those within the family unit and the community.

Both International Nurses Day and International Day of the Midwife have intriguing histories. While International Nurses Day has been celebrated since 1974, the story of its observance stretches back to the Crimean War in the 1850s. International Nurses Day is celebrated in honour of Florence Nightingale whose work as a nurse during the war led her to becoming the foundational philosopher of modern nursing. Appalled by the conditions of the facility she worked in during the conflict, Nightingale spearheaded an assiduous campaign for health and nursing reform and established several nursing schools across the world, including in Sydney, London and New York.

In contrast, the idea of an international midwives day was initially floated by an Australian delegation to the 1987 International Confederation of Midwives in the Netherlands. In Australia, the importance of midwives is recognised each year with the Walk with Midwives celebrations nationwide. I understand this event is scheduled to occur in Glenelg for this Saturday morning and I hope there is fine weather.

I take this opportunity to sincerely thank all nurses, midwives and other health professionals who have reached out to me to have their say, sharing their experiences over the past six years about our health system and how it needs to be improved to offer better patient care. Locally, I remember visiting the Lyell McEwin Hospital part way through the pandemic just as some of our nurses had volunteered to go to Victoria to help out when their COVID cases were high. I asked a nurse about this decision and whether they were scared and she said she was committed to a belief that it was just part of the job to care for our whole community.

This year, when the vaccine was being rolled out to frontline staff, our nurses again were at the front of the queue, bravely rolling up their sleeves. Throughout the countless hours I have spent hosting listening posts and doorknocking, I have been touched by the stories of hundreds of nursing staff working in our local hospitals. In particular, I can recall a nurse who visited one of my listening posts in The Grove SA shopping centre in 2017 actually crying to me about the lack of resources that made her job so painfully difficult under the previous government.

When I doorknocked and listened to my community in 2017 and 2018, other nurses sat me down in their lounge rooms—one for over an hour—to give me countless examples of Labor's torrid management of our health system. All these stories I relayed to our extremely hardworking Minister for Health. It is these stories from my constituents, our nurses, who, like Florence Nightingale, inspire me to advocate for a better healthcare system, a better Modbury Hospital and a better Lyell McEwin Hospital.

We are seeing promised improvements and milestones delivered locally, and that is why I am proud to be a part of the Marshall Liberal government delivering what matters not only to all constituents but also to these hardworking nurses. We acknowledge that there is a lot more to do, but we are absolutely committed to better health services.

As part of Modbury Hospital's $98 million redevelopment, residents and staff in the Adelaide's north-east recently got access to a brand-new state-of-the-art outpatient building. Designed over two levels, the new outpatient department at Modbury Hospital will provide more streamlined access for people visiting the hospital for treatment or diagnosis. A nurse at Modbury of over 30 years recently told me that the new facilities had greatly improved patient flow, making her job better.

I am also proud to be delivering with my colleagues the $58 million expansion and refurbishment of the Lyell McEwin Hospital's emergency department. Additionally, I was pleased to hear about the hospital's new pharmacy robot last month, which will give nurses more time for other tasks, such as educating and supporting patients regarding their medicines.

I thank health and medical professionals in my electorate for raising their concerns with me over the years, as this is absolutely critical in helping me understand what I should be advocating for, how I should advocate for better outcomes in health. It also gives me better questions to ask of my colleagues, and I urge these health and medical professionals to keep their feedback coming because I am certainly listening. One ex-nurse, Ellen Gilespie, has been particularly vocal at the three health forums we have held in our local community, and this has been incredibly helpful.

At a recent Modbury Hospital community forum we held at the Modbury Bowling Club many recent positive experiences at our local hospitals were shared by my local community members. My constituents provide me good feedback about nursing staff all the time, and I pass this great feedback on to the CEO of the northern alliance each time I see her, which is often because we have been delivering so many milestones in our local hospitals, and this is great because we are taking a step towards better health outcomes. I urge constituents to tell more of the positive stories of the great care that our local nurses provide. These hardworking nurses and midwives deserve to be acknowledged, and I hope the good stories I pass on to the leadership are getting back to the nurses.

Every year, as an important part of the week of celebrations for International Day of the Midwife and International Nurses Day, we have the SA Health Nursing and Midwifery Excellence Awards, and once again this year we want to pause and pay tribute to South Australian nurse Kirsty Boden, the recipient of the Australian Bravery Decorations—Bravery Medal, the Queen's Commendation for Bravery and the Red Cross Florence Nightingale Medal. In the 2017 London Bridge terrorist attack, Kirsty, without hesitation, ran into danger, offering her nursing expertise and qualities to save others. Kirsty's courage, dedication and her strong will to care for the injured as a nurse and as a caring person will be remembered.

There was good news for our hardworking nurses in the federal budget today. Tradies, teachers, truckies, farmers and nurses on low and middle incomes will score a $1,080 tax cut in the budget. In addition, it was great to hear that in aged care the government will invest in training and upskilling aged-care workers and introduce retention bonuses for nurses to ensure that the workforce of 366,000 can meet the growth in demand.

In South Australia, there is no denying that more capacity is needed in our emergency departments, and that is why we are in the midst of delivering a landmark hospital build program, which will see a substantial increase in treatment spaces. We inherited a health system where hospital emergency departments had been downgraded and the Repat closed. In contrast, we are implementing a comprehensive plan that not only increases beds and treatment spaces but reduces the number of people needing hospital admission.

We have more budget, more doctors, more nurses, more midwives and more ambulance officers in South Australia than ever before in the state's history. Yesterday, we were told that since the government came to office in 2018, in the period 2018-20 there was an increase of 286 nurses and midwives. Today, I thank our nurses and our midwives. I thank them for the care they provide and the amount of times they go above and beyond. You really deserve this recognition. Thank you.

Mrs POWER (Elder) (12:35): I stand today to support this motion and acknowledge the exceptional work of nurses and midwives everywhere on the frontline of caring for our community, never more so than in the last 12 months, when they have been part of the front line in the fight against COVID-19. Whether in hospitals, clinics, schools, visiting homes, rural communities or the outback, being a nurse is much more than simply carrying out health care. Being a nurse is understanding a patient—getting to know them and their needs, talking to them—and alleviating their fears. It is picking up the things others might miss. It is comforting and encouraging. It is professional, and it is personal.

I know this because I am surrounded by so many incredible nurses in my own life. My mum is a registered nurse. She works in Alice Springs. She came to Australia from Canada and fell in love with my dad in Alice Springs and has had some incredible times nursing in Indigenous communities. She still works as a public health nurse with the Central Australian Aboriginal Congress there.

My sister-in-law, Leslie, is in Canada, and she has shared with me her stories as a nurse and carries out her care in the same way that I know nurses do in our own country. A very good friend of mine, Shelley Fox, works as a neonatal nurse at the Flinders Medical Centre, and I am always in awe of and inspired by the work she does and the things she faces in her everyday work.

So to all the nurses, we do see you, we do hear you, and I can assure you that you do have the backing of this government. I would like to call out some of the comments the member for Kaurna made. I think that they are absolutely outrageous—to suggest that those on this side of the house do not equally acknowledge and care and fight for our nurses and midwives. To suggest this is just hypocritical. I know all too well that people in my community remember Labor's failed Transforming Health, and I can assure you the nurses who worked at the Repat certainly have not forgotten what happened there.

But, unlike some of those opposite, I do not think today is about playing politics. I really want to focus on this important occasion to recognise and commend the work of all nurses and midwives across the world but particularly the amazing ones we are lucky to have here in South Australia. I say thank you to all the nurses and midwives in our state for your dedication, your professionalism and your understanding as you care for us all during our times of need. Unfortunately I have had quite a few experiences in hospital, from third-degree burns as a child to a spinal fusion and all sorts, and I know I would not have got through those times if it were not for the nurses. For your efforts, your courage and your hard work during the pandemic today and every day, we say thank you.

These international days are also an opportunity to pay tribute to the nurses and midwives who have been heroes throughout our history. With the recent ANZAC Day services, it is timely to remember those in this profession who went above and beyond, those nurses in war, many of whom made the ultimate sacrifice to care for injured and dying soldiers in horrendous conditions. More than 3,000 Australian civilian nurses volunteered for active service during the First World War, and around 1,500 nurses across a number of countries lost their lives. We pay our respects and give our greatest thanks to the nurses past and present.

This is an issue that is very important and close to my heart, particularly in my local area where we hold the annual Bangka Day Memorial Service, held at the Women's Memorial Playing Fields. It is held in recognition of the 22 Australian Army nurses who were gunned down during the Bangka Island massacre in World War II. A special service is rightly held in their honour. Each year, I am so moved by the courage of those nurses and that courage that remains in nurses who work today. Sadly, these times are not entirely passed. As some of my colleagues have mentioned, it was only a few years ago in 2017, more than 70 years after the Bangka Island massacre, that a South Australian nurse was killed in her selfless act of caring for others.

Our nurses who work every day on the frontline are courageous, dedicated and selfless. There is no doubt that in the past and today nurses and midwives are the people whom we depend upon at some of the toughest times we experience in our life. They are the people who are there for us and those closest to us in the most difficult of times. I would like to acknowledge all the members on this side and the other side who have shared some of their personal experiences with nurses they have had that have touched their lives.

They are without a doubt our heroes, particularly during the pandemic. I celebrate their success and I extend deep thanks for their hard work in caring for all of us. As the member for King mentioned, you do inspire us. You do drive us to want to work harder, to fight harder and to make sure that you have the resources you need.

As a government, we will absolutely continue to invest more in health as required. I would like to acknowledge the Minister for Health in the other place, who I know is undertaking an incredible body of work, upgrading every metropolitan hospital in our state. In my local area, the Flinders Medical Centre emergency department is almost about to double in capacity. He is not only undertaking upgrades across metropolitan hospitals but also overseeing a range of initiatives that can ensure that people get the right care in the right setting, and that may or may not be at a hospital.

With all this investment, whether that is expanded emergency departments or piloting the priority care healthcare centres or the My Home Hospital program, at the end of the day it is the nurses who really determine the quality of care that South Australians receive. We take this moment to acknowledge you, to say thanks, to reassure you that, whilst we have done so much in the last three years and sometimes we cannot make the concrete dry any faster, as the Premier often says, we are doing all that we can to ensure that you have a better setting, more support and more resources to continue the great work that you do. We have done a lot, but there is certainly more to do, and we are here to do it with you. Thank you so much for all that you do.

The Hon. D.G. PISONI (Unley—Minister for Innovation and Skills) (12:42): Firstly, I stand in support of the motion. International Nurses Day does give you reason to pause and think about experiences that you may have had with nurses and midwives in your life. Fortunately, I have not had a lot of them, except of course the two times I accompanied my wife during her birthing of our two children. The first birth was a very, very long labour, and there is no doubt that the support she had in hospital from the several shifts of midwives during her labour helped her to get through that process. We have never forgotten the support that we received during that process.

We also know that it is one of those areas over various specialities of nursing where it has been predominantly feminised. Because of that, I think we have seen that the pathways into nursing are not perhaps as broad as they are for some other areas. I was surprised when I started in this role, first as the shadow minister in skills training and then as the minister, to have it confirmed how much of that allied health support in aged care and disability care is delivered almost entirely institutionally.

Those students are then expected to work basically for free for up to eight weeks, in what they call a placement, in order to get their on-the-job training or their real-life experience to combine with classroom training, whether it be a Cert III in Individual Support or enrolled nursing. Of course, these are very good pathways into other areas of registered nursing and midwifery.

I am very pleased to say that as a government we identified that it was not satisfactory that that be the only way to enter the care sector and we started almost immediately to develop paid pathways where enrolled nurses would have an opportunity to be paid over a 12-month period in order to combine their on-the-job training and their classroom training. Certificate III in Individual Support was another area where we were able to run some pilots. I think there are about 1,000 successful paid traineeships in that space at the moment.

This is a philosophy and a practice that we have seen in many male-dominated industries for a very long time, where people are actually paid to learn. The ambition of this government is to ensure—and I am very pleased with the additional funding that was announced in the federal budget yesterday—that we work with the federal government to deliver more paid training pathways in the care sector.

The fact that there is now a 50 per cent subsidy on the first year of a traineeship is a tremendous hook, if you like, for employers who are not used to the paid traineeship model to give it a go. I know that those who have used the paid traineeship model will not return to other models as they have found it very beneficial. I know that they will continue working together with industry and working together with the ANMF.

We have had a very successful relationship in expanding services through the registered training organisation that is run by the Australian Nursing and Midwifery Federation. I think one of the reasons that we have been successful is that they are connected with the industry and practices that happen within the industry. I think our relationship has grown from just over half a million dollars in paid training in the financial year ending 2018, to more than $1.3 million in training nurses, or enrolled nurses with individual support. A special shout-out to Rob Bonner, who runs that organisation for the federation, for his passion and commitment in nursing.

We have an ambition in the government to see many more paid training opportunities and stackable skills. I recall that there have always been periods while I have been in politics when there have been shortages of qualified nursing. I remember one scheme that was announced by John Hill, probably around about 10 or 12 years ago, where the state government was going to train nurses in Vietnam and bring them out to work in our hospitals in South Australia. I remember the press release. I remember the discussion at the time, but I am not quite sure that I am aware of any of the outcomes of that.

Our view is that we have people here who would like to enter the care sector and may have ambitions to be registered nurses. We would like to see those pathways developed through paid traineeships, stackable paid traineeships. There are a couple of universities in Australia that have come up with generic models of stackable qualifications where you start as a cert III or cert IV, jump out at that level and work at that level, or continue on to another paid traineeship and a diploma in that particular area, and then jump out at that level if you wish and work at that level, or then go on to complete a bachelor's degree in that related area. Of course you are getting credits right the way through while you are being paid to learn in that sector.

This is a very exciting change to the way in which you can start a career in nursing and in the care sector, and it is that very word—it is not just a job, it is a career—and having those career pathways that can support predominantly women in the workforce who want to continue advancing their careers, being able to support them to do that through paid traineeships, paid diplomas and supporting them to go on to get their bachelor degree or working in management through this process.

I am very pleased with all the partners we have been working with in this place, whether it be the ANMF or many of the private providers and TAFE, which will also continue to offer these services in regional South Australia. There are now pathways into nursing through our vocational pathway program in schools that the Minister for Education has been building since coming to office. Next year, grade 7 will be in high school. In that year, students will be introduced to a program called The World of Work, where they will have 100 hours of exposure to industries and opportunities for careers, in which the care sector and nursing will play a critical role.

By the time those students get to year 10, they will be in a position to decide what interests them and what pathways are available to them, whether it is through a vocational pathway that could also end up in a university degree or, alternatively, going straight to university after finishing year 12. We even have situations where in year 12 people could do a Cert III in Individual Support or enrolled nursing while they are completing their high school certificate.

It is a very exciting time for careers right across South Australia, and the allied health career area is one we have a very strong focus on. Again, congratulations and a big thank you to nurses and midwives for what they do for us every day, even though many of us are not exposed to it personally on a daily basis.

The Hon. D.C. VAN HOLST PELLEKAAN (Stuart—Minister for Energy and Mining) (12:52): I will be quick for a few reasons—because a lot has been said already and because the member for Hurtle Vale tells me that the nurses are getting hungry and looking forward to some lunch. Given that my wife is a nurse, I understand exactly how difficult it can be to squeeze in a meal break or a tea break and how often you go without them, so I will make sure that does not happen today.

I wholeheartedly support the member for Hurtle Vale's motion for International Nurses Day and International Midwives Day and wholeheartedly support the key themes: for nurses, 'A voice to lead: a vision for future healthcare', and for midwives, 'Changing the world one family at a time'. Let me say, through you, Mr Deputy Speaker, to the people in the gallery that it is a pretty special mark of respect when one of these motions continues on for the whole 90 minutes of time that is allowable. Normally, we get through three, four, five or six motions. When you have this many members of parliament wanting to speak and wanting to contribute, you know that a good motion has been brought to the house and that a lot of MPs feel strongly about it.

My main contribution is to share an opinion that nurses are the glue that holds the whole healthcare system and the health industry together. There is an enormous range of professions other than nursing in health care and an enormous range of subprofessions, I suppose, within nursing. My wife is a theatre nurse. She loves her work; she has been doing it for over 30 years and every day she thoroughly enjoys her work. She often likes to say that she is one of the old guard who is hospital trained and that they are much better than any of the newer ones coming through these days, but I know that—

The DEPUTY SPEAKER: Be nice there, minister.

The Hon. D.C. VAN HOLST PELLEKAAN: —there are some outstanding nurses coming through these days as well. As a particularly strong advocate for country health services throughout South Australia, nurses play a huge role. I am especially keen on doing what our government and our parliament can to support the ongoing development of nurse practitioners and extending the practical hands-on professional role nurses play through a wide range of opportunities, which in my observation typically exist more in the country than they do in the city, as it is for GPs.

A wider range of work is available to a GP in the country than in the city because a specialist is not necessarily right there on hand, so GPs—sometimes because they want to, sometimes because they have to—learn to do a wider range of things and become comfortable doing a wider range of things, and it is exactly the same for nurses. Nurses are the glue that holds together health care and the health industry.

Finally, it dawned on me while listening to this range of speeches that, certainly in this chamber and certainly on this side of the chamber, there are a significant number of MPs whose partners are nurses. I know that we are all very proud of what they and all their colleagues throughout the state do.

Ms COOK (Hurtle Vale) (12:55): Thank you very much to everybody who contributed. I also acknowledge the member for Torrens, who really did want to make a contribution, but we are running out of time. I am sure you appreciate that she supports you as well. Thank you very much to the Speaker for his kind words and words of guidance. Thank you to the members for Gibson, Kaurna, Hammond, Giles, King, Elder, Unley and Stuart for their contributions. There are differences in opinion across the chamber and I appreciate—as I am sure the nurses and midwives in the audience appreciate also—that we come from different philosophical bents but that we want the very best for the workforce and the outcomes.

I do not deny that nurses and midwives have reached out to people across all parties within the parliament to express their concern for the patients they care for and the families they look after, and they have done that in the best and strongest possible language. I think that the way the interpretation has been made may differ from one party to another. My very clear message is that capital is not everything, infrastructure is not everything and concrete is not everything.

The issue that we have right now is about the people, about the workforce and about how we support them and truly listen to and address the concerns they are expressing to us over and over again. That should not always translate to a new building. Collectively, the people in here have centuries of experience. They saw the upgrades to the Flinders Medical Centre, they saw the upgrades to the Lyell McEwin and they saw the building of the new Royal Adelaide Hospital, so they will not be lectured to by anybody who alleges that new concrete and new walls and changes to infrastructure will change their world. They just want people to listen and to invest in the people.

I want to make a couple of quick points regarding that; one is that the unions are doing an incredible job to raise awareness around some of the staff disputes and contradictions that are going on. I acknowledge the ASU for their support, particularly for the disability workforce. I support the United Workers Union, which is currently running a campaign to try to raise awareness of their workers who have been trying to negotiate to get some certainty for their future and some decent conditions for some of the lowest paid workers in our healthcare sector for the last three years. Enough is enough—get on with it, get to the table and give them some certainty. Then there is the ANMF—

The DEPUTY SPEAKER: Member for Hurtle Vale, I do not mean to interrupt, but do you wish to have this passed?

Ms COOK: Yes, I do. I will get it done really quickly now. Head to www.anmfsa.org.au for their campaign. Unlike the Minister for Health, who made you bring your own cuppa for midwives day, I will supply the pies and pasties for you today. I commend the motion.

Motion carried.

Sitting suspended from 12:59 to 14:00.