Ambulance Ramping

Mr MALINAUSKAS (Croydon—Leader of the Opposition) (14:10): My question is to the Premier. Why has ramping increased by 576 per cent under the Premier's watch? With your leave, sir, and that of the house, I will explain.

Leave granted.

Mr MALINAUSKAS: In 2021 year to date, ambulance ramping has increased by 576 per cent when compared with the same period in 2017. Why?

The Hon. S.S. MARSHALL (Dunstan—Premier) (14:10): I thank the Leader of the Opposition for his question and we have been through this on a number of occasions here—

Members interjecting:

The SPEAKER: Order!

The Hon. S.S. MARSHALL: —in the parliament. I'm happy to go through them again, although it seems to me that they are more interested in yelling rather than actually listening. The reality is that there has been a very significant move right around the country in terms of ramping and that is for a number of reasons. The first is because there has been increased presentation. Probably—

Members interjecting:

The SPEAKER: The Premier has the call.

Members interjecting:

The SPEAKER: Order! The deputy leader is called to order. The member for Playford is called to order. The member for Wright is warned. The Premier has the call.

The Hon. S.S. MARSHALL: As I was pointing out to the chamber and, of course, to yourself, there has been an increase in ramping around the country and there are a number of reasons for this; one is increased presentation. Some of this is because many patients who would be typically treated in a primary healthcare setting—for example, at their local GP—are now being precluded because of arrangements that specific surgeries have with regard to excluding patients who have respiratory complaints or symptoms. This is driving more people to our emergency departments. Also, the presentation is with a higher level of acuity. We also have people who have longer length of stay.

There are a number of reasons why we are seeing this situation exist right around the country. But, as I was saying to my previous answer, I think South Australia is in a unique position to be able to deal with this effectively as quickly as possible, because many of the strategies that other states are now adopting we are well down the track of here in South Australia.

Sir, you would be more than aware that we have currently underway more than a billion dollars' worth of expenditure in our health system at the moment. A large amount of that is upgrading the capacity of the emergency departments we inherited from those opposite. The Leader of the Opposition loves to ask questions and shout across the chamber, but it actually was the Leader of the Opposition, in his role as the health minister in South Australia, who presided over downgrading our hospital system in South Australia and actually closing the Repat.

Members interjecting:

The SPEAKER: Order!

The Hon. S.S. MARSHALL: So he downgraded these hospitals and of course—

Members interjecting:

The SPEAKER: Order!

The Hon. S.S. MARSHALL: —closed the Repat. He wants to know which one. Well, I can tell you: it's the Repat. I can take you down there. It's now a thriving centre and has a great future down at the Repat. One of the things that the Repat is doing is taking patients that would normally go to the Flinders Medical Centre and being able to triage them down at the Flinders Medical Centre and provide a great service. But there is still much more work to be done.

I am very pleased and proud that this state has done a lot in terms of the urgent mental health care centres. In fact, we were the first state that actually trialled this. It's up and running, the trial was successful, it's been further expanded. Not only has that central urgent mental health care centre been expanded 24 hours a day seven days a week but it is also being the pathfinder, if you like, for other centres similar that will stand up around the state. The first one was included in our most recent budget, which was adjacent to the Lyell McEwin centre, and of course we will have others to announce as suitable sites are found.

There are many things that are being done. One of the critical things we are doing to get ready for that time when we do take the state borders up is to create more bed availability in our hospitals by taking some of our longer term patients who were there awaiting an aged-care bed or an NDIS placement and remove them. In fact, in the most recent $120 million-plus COVID-ready package, we have created the equivalent of around 400 beds. Much of that is about taking people out of our major teaching hospitals and putting them into a more appropriate level of care so that we can be ready for the inevitable cases that will come post 23 November this year.