House of Assembly: Thursday, September 09, 2021

Contents

Regional Health Services

Mr ELLIS (Narungga) (16:11): I rise today on behalf of the health professionals in my electorate, who I believe are struggling under the burden of bureaucracy and mismanagement. I have had contact from numerous health professionals who live and work in Narungga and who report to me that the situation is becoming increasingly dire. From the outset, and to be abundantly clear, I do not believe that any blame lies at the feet of the current government, nor at the feet of the current minister. This is a problem that has been entrenched for almost 20 years and will now require a significant change to the way in which we do things. Transforming Health created this problem and now we need to fix it.

The AMA and the Rural Doctors Association continue to await outcomes from continued contract negotiations, and I have to say I find this quite disappointing. I do not think it is an exaggeration to say that the attraction and retention of doctors in regional South Australia is the single biggest issue we face. Without health services within an achievable distance for people to access, towns will wither and die—it becomes inevitable. Regional people, through their representatives elected by them, need doctors a lot more than doctors need government.

While I am not privy to the contract negotiation details, I do know that something needs to change. We cannot continue to maintain the status quo, with the gradual reduction of doctors and no obvious stream of replacement, and expect things to improve. We need to change the way regional hospitals are staffed and, while local health networks have been a great start, it is not enough by itself.

There have been some harrowing stories related to me by health practitioners in my electorate, recently by people at Maitland Hospital, who have been without a doctor staffing the hospital on multiple occasions recently. There have been at different times either a nurse practitioner or a paramedic acting as the on-call doctor. I am led to believe that, on at least one occasion when the nurse practitioner, who did a fantastic job and certainly filled it to the best of her ability I am sure, was acting as the locum, her provider number had not transferred with her and thus she was unable to prescribe even a basic dose of antibiotics.

That meant that a patient who had presented to the hospital with a basic infection faced having to be driven by volunteer ambulance, taking up the valuable time of volunteers, to Wallaroo Hospital and back for a relatively simple prescription. Thankfully, in that case the Maitland Medical Clinic, sitting adjacent, stepped in and prescribed the required dose, but the pressure being put on Michelle Nelligan and her staff at the clinic is significant. Unfortunately, they are the ones who face community unrest, thanks to decisions made elsewhere. They are the ones who are left to find doctors at short notice and they are the ones who find themselves under continued pressure.

I have received anonymous correspondence from a nurse at Maitland Hospital who reports that the 'never-ending overworked environment with little to no support is creating a pressure cooker at work' and that a particular shift left her 'feeling panicked and like her registration might be at risk' and finally 'that the working environment is becoming worse by the day'.

Maitland Hospital is an example I have heard about recently. Similar problems have been happening across the board, including at the wonderful community-run hospital at Ardrossan, and at Wallaroo Hospital where I regularly hear about stressed, overworked staff and concerns about the delivery of services. Minlaton accident and emergency has started to close intermittently on weekends when locum staff cannot be sourced. Most recently, I have corresponded with the minister in relation to the Minlaton medical clinic. All of this is happening as our health professionals also deal with COVID vaccinations, testing responsibilities and associated inquiries.

I am doing my best. I am looking into the Independent Hospital Pricing Authority funding model and potential changes there, proper apportionment of the teaching and training grants that come from the federal government, ways to create more rural generalist pathway training places, potential changes to Local Health Network boundaries and improvements to doctor entitlements. These are potential avenues towards a fix, and I reiterate that this rural medical workforce crisis is not the current minister's fault.

I believe that this government has made genuine improvements to regional health care, but we were starting from so far back. Thanks to the unmitigated disaster that was Transforming Health, there is a lot of work to do. I have to say, also, that those people who presided over Transforming Health are now pretending that they care about regional health care. It is so incredibly offensive to my community that they now present themselves as some sort of compassionate leaders. It goes down like a lead balloon in the regions, I can assure you.

All that said, it does not matter where the problem started or who is responsible—we only need a solution. The solution cannot be the status quo. We cannot allow this gradual decline to continue while we build big hospitals in the city and pretend they are hospitals for all South Australians. A simple initiative to ease ramping in Adelaide would be to empower regional hospitals so that they do not have to fly so many people out.