Public Works Committee: Southern Fleurieu Health Service (Victor Harbor) Emergency Department Redevelopment

Mr BROWN (Florey) (11:40): I move:

That the 66^th report of the committee, entitled Southern Fleurieu Health Service (Victor Harbor) Emergency Department Redevelopment, be noted.

The Department for Health and Wellbeing (SA Health) proposes to construct a new emergency department for the Southern Fleurieu Health Service at Victor Harbor. This will comprise a new on-grade contemporary and expanded single-level emergency department to address existing capacity challenges and deliver a facility layout that improves workflows, egress and clinician-patient interactions.

The Southern Fleurieu Health Service is operated by the Barossa Hills Fleurieu Local Health Network and provides a comprehensive range of medical and surgical services to patients across the Fleurieu Peninsula and surrounding communities. As one of the key peri-urban facilities in the state, it plays a critical role within SA Health's regional facilities in treating patients, stabilising those requiring higher acuity care and reducing patient flow to Adelaide's metropolitan area.

This Victor Harbor health service currently comprises a 31-bed facility, including a 24-hour emergency department and acute medical and surgical accommodation as well as obstetric, palliative care, chemotherapy and renal dialysis services. The current emergency department was last developed in 2010 and requires further redevelopment to meet projected activity growth and to address existing problems with layout and functionality.

In 2020, SA Health undertook acute inpatient modelling to project future presentations to this emergency department. Modelling predicted total hospital presentations would significantly increase by 2026-27, with 43 per cent being geriatric presentations, with further increases expected by 2031-32, with 46 per cent being geriatric presentations.

The proposed redevelopment aims to deal with this expected activity growth. It will also address current capacity pressures and will maintain a high-quality and contemporary health service for the growing community in the Southern Fleurieu region. The redevelopment will include:

12 patient treatment bays, inclusive of one negative-pressure treatment bay, five enclosed treatment bays to support paediatric patients and six open bays;

two patient emergency resuscitation bays and three emergency extended care unit short-stay beds;

patient admission and consulting areas, including a new emergency department entrance, triage area with examination bed, interview room, low stimulus room and two consulting rooms;

clinical support and utility spaces and new staff facilities;

an external ambulance canopy and lobby area separate to the main public emergency department access, with enabled ambulance thoroughfare from Bay Road, Victor Harbor;

construction of an additional car park adjacent to the emergency department entry; and

construction of new roadways, car parks and landscape works to support the emergency department.

The total investing budget for the project is $16.8 million, with joint funding from the commonwealth via the Community Health and Hospitals Program initiative and from a state-funded regional Asset Sustainment Program. Site mobilisation activities have commenced, with project completion anticipated in May 2025.

The new emergency department will be located adjacent to the footprint of the current administration building and will see part of this existing administrative building demolished. This will be close to other clinical hospital functions and accessible via a new entry on Bay Road. This was the preferred option as it will minimise disruption to clinical services at the existing emergency department, which can remain operational until the completion of the new facility and transition of services.

Pandemic management has been considered as part of the new facility's design and includes several control measures such as cluster chairs in waiting areas that can enable social distancing, a negative-pressure isolation treatment bay with an independent mechanical ventilation system, a patient bay special room with ensuite bathroom for isolating patients and handwashing basins throughout the facility.

The best practice guidelines for project procurement and management as advocated by the state government and construction industry authorities will be followed throughout the project. Part of this process is risk management, and it is integral that risks are identified and assessed, with mitigation measures incorporated where necessary.

Risks identified include construction works being carried out in proximity to an operational clinical environment, which requires clear, ongoing communication with site management and attending patients; the removal of asbestos under controlled removal conditions; and careful management of the project to align with the approved budget. To manage these risks, a two-tier governance structure has been established, with an executive leadership team responsible for strategic oversight and an integrated management team responsible for overall day-to-day operational management.

SA Health has incorporated ecologically sustainable principles into the scope of the project. The department notes that facilities with good environmental qualities are essential to achieving a good value-for-money solution, which will assist in creating a positive workplace, reducing energy and water consumption, reducing the consumption of renewable and non-renewable resources and minimising recurrent costs associated with the project. These measures include:

the use of energy-efficient heating and cooling;

energy-efficient lighting;

a mechanical system designed to deal with increases in adverse weather conditions;

an environmental management plan to effectively manage construction waste, air, water and noise pollution;

the use of water-efficient sanitary and tap-ware fixtures; and

the collection of rainwater for landscape irrigation.

In addition to those stated, incorporated design measures will increase adaptability and allow changes of use with minimised impact to ensure the building is adaptable and futureproofed.

Engagement and consultation have been key themes throughout the design phase of the new emergency department. Consultation has occurred with clinical and non-clinical staff, specialist agencies, the South Australian Ambulance Service, the Director of Aboriginal Health at the Barossa Hills Fleurieu Local Health Network and the Southern Fleurieu Health Advisory Council.

The Register of Aboriginal Sites and Objects determined that there are no registered or reported Aboriginal sites, objects or ancestral remains within the project area. There are no state, local or contributory non-Aboriginal heritage-listed places expected to be directly impacted by the project.

The committee examined written and oral evidence in relation to the Southern Fleurieu Health Service (Victor Harbor) Emergency Department Redevelopment. Witnesses who appeared before the committee were: Melissa Nozza, Director, Capital Projects and Infrastructure, Department for Health and Wellbeing; Bronwyn Masters, Interim Chief Executive Officer, Barossa Hills Fleurieu Local Health Network; John Harrison, Director, Building Projects, Department for Infrastructure and Transport; and Dennis Tapp, Associate, Wiltshire Swain Architects. I thank the witnesses for their time.

Based upon the evidence considered and pursuant to section 12C of the Parliamentary Committees Act 1991, the Public Works Committee reports to parliament that it recommends the proposed public work.

The SPEAKER: The member for Florey can go and get a drink after almost 45 minutes of nonstop talking because he is about to be provided with some respite in the form of the member for Finniss.

Mr BASHAM (Finniss) (11:47): It is a privilege to rise and thank the Public Works Committee for their work in considering such an important project in my community. The Southern Fleurieu Health Service, or the South Coast District Hospital as it is also known, is such an important part of the community structure in Victor Harbor and the surrounding areas. My father was born there, I was born there, two of my three children were born there, my wife was born there; it is certainly a big part of our family, and it even goes back to my great-aunt, Aunty Edith.

In the area where the ED is proposed to be built, or where work has already started, Aunty Edith was a nurse in the hospital in the 1930s, in its first 10 years of operations. Her medical equipment is, or was, on display in the entrance hall to the old entrance of the hospital, which is actually where this new ED is being built. It will be fascinating to see what happens to that historical display. Hopefully it is not lost because it certainly is something that I was very proud of, to be able to walk in and see Aunty Edith's syringes, etc. The needles were about the size of my little finger. It is quite extraordinary, the advances we have seen in medicine over that time, and I am really pleased that history has been there and hopefully is retained.

Interestingly, at this time of the year, it also reminds me there was an article in the local paper about Aunty Edith, who, after leaving the South Coast District Hospital, went to England. She was in England from 1938 for a few years. The day that the war broke out, on 1 September, she enlisted in the Queen Alexandra nursing service and started serving in England from day one, right through to the end of the war. She was there the whole time, serving in places like France, Malta and the Middle East. It was quite an amazing thing for a lady in her 40s to be serving in a part of the world so foreign.

She then hopped on a plane and flew back to Australia only weeks after the end of the war. It was apparently one of the first times that that had been orchestrated as well. The agent-general at the time was able to get her on a flight because her mother was unwell, and got her back to Australia. That is just a bit of family history tied up with where this ED is going.

Regarding the importance of the ED, personally I have not needed the ED for my health care, but many members of my family have. Unfortunately, both my wife and one of my daughters are anaphylactic to nuts and seafood. Both of them have had different occurrences over time and ended up in the ED, including not long after my daughter turned 18 in January. She must have eaten something that had some nuts in it. She was not aware of what it was and she had an anaphylactic reaction. I cannot fault the staff and the team at the South Coast District Hospital and the way that she was treated in the ED there.

To get in there, she was rushed into the resus room. I was there with her. Evie is actually just starting medicine, so she was quite intrigued at the whole process once she got herself settled down and relaxed and back in control of her immune system, once the adrenaline had been injected. The intriguing thing was that the medical student who tried to put the line in left a puddle about the size of two dinner plates on the bed, not getting the line quite right. It was good to see the team just say calmly, 'Don't worry about that. That's just a little bit of blood. It doesn't matter. Blood makes a big mess.' It was really pleasing.

It certainly highlighted to me the need for the new ED. We were in the resus room. Once Evie was stabilised, we needed to be moved out of the resus room, because it was needed again for another emergency. Sadly, this was very much on view to all of us in there; it is a very tight space. A poor gentleman came in for some standard treatment. He was on holidays. They did some tests and in a very short period of time realised his body was in complete shutdown and gave him hours to live.

Sitting there with your 18 year old, it is quite emotional listening to the family having to ring people and tell them that their loved one only has hours to live. It will be so nice to have a private space in the new ED where people will actually be able to do that without the world listening. I thought that was extremely challenging for my daughter. There was a 10 year old next to us. Likewise, it would have been extremely challenging for that family to have been listening to this going on, but it had to be the way it was because there was no other space available.

I think it is such an important thing to see this ED space certainly increase in size. It is more than doubling, so it is going to be great to have that extra space to be able to make sure that we do not see that crowding. I think it will make a big difference to the community. My only fear is that the local community is growing faster than the numbers that were forecast a few years ago. The number that the community is getting to is actually about the size that it was forecast to get to in about 2035, about 10 years early, so hopefully, this ED will not be at capacity almost the day it opens.

We certainly do need a bit of ability to grow. It is only 10 years or so since the previous ED was opened, so we do need to keep monitoring the growth that we are seeing on the southern Fleurieu and make sure that we keep the medical needs at the right level across that region. It is a particularly strong growing region, and hospital needs are higher in our region, particularly with the demographic. It intrigues me that of the people eligible to vote in my electorate the average age is 66. It is certainly an older community than most in South Australia, let alone Australia, so it is an extra challenging space, and the ED is such an important thing.

I get a close-up view of this space. I see it from my front door. I literally live across the road from the hospital, so I see a lot of what is going on. And certainly, through this build there are going to be some challenges. One of the biggest challenges I see is that the helicopter is not going to be able to land onsite during this time, because they are worried about flying debris from the construction process, which means they have to find another site.

My understanding is they are going to be using one of the town ovals. That is fine most of the time; the only problem is if it happens to be 2 o'clock on a Saturday afternoon when the football is on. That is not going to be so easy for it to be managed to make sure that the helicopter can sit there for three hours. It is not going to be that easy in the middle of a football game having a helicopter land on the oval.

So there are things that will need to be managed through this process. We will wait and see how it all goes, but I certainly am really pleased to see this spend going forward. It goes back to the commitment by Greg Hunt as minister federally, putting money into this during the by-election where Georgina Downer was involved. So it has certainly been a while before we have actually seen action on the ground, but there is certainly action there right now. It is fantastic to see, and hopefully we will see a new ED open soon.

The SPEAKER: Thank you, member for Finniss. Great story about Aunty Edith too. What a great pioneering story and putting herself out there to help others and having a great adventure at the same time.

Mr BROWN (Florey) (11:56): I would like to take the opportunity to thank the member for Finniss for his contribution to the debate. It is always, I find, pleasing to hear from local members about their particular views on this project. I am sure not only the department but the government as a whole will be grateful to have the support of the member for Finniss for this particular project.

I would also like to take this opportunity to thank the members of the Public Works Committee for their diligence in not only this project but other projects we have considered. I think it would be remiss of me not to point out that the member for Schubert, who has resigned from the committee, has done a sterling job in contributing to the committee. I would like to thank her for her contribution. During the relatively brief time that I have worked with her on Public Works I was very impressed by the way in which she diligently did her job but also did so not in an overly partisan way.

I know we are all politicians, and we all have our jobs to do, and I can certainly respect that from everyone who is a member of the Public Works Committee, but I think it is appropriate for me to say that the member for Schubert has certainly done her job as a member of the committee in a way that shows that she is committed to getting good reports through and has not been overly political. So I wanted to take this opportunity to thank her for her service and to put on the record how much I am looking forward to working with the member for Chaffey as a member of the committee.

Motion carried.