Parliamentary Committees

Public Works Committee: Mount Gambier and Districts Health Service Redevelopment

Mr BROWN (Florey) (11:02): I move:

That the 81^st report of the committee, entitled Mount Gambier and Districts Health Service Redevelopment, be noted.

The Department for Health and Wellbeing (or SA Health) proposes to significantly expand the service capabilities and capacity of the Mount Gambier and Districts Health Service, commonly known as the Mount Gambier hospital, to provide effective care for consumers in the Limestone Coast Local Health Network.

Mount Gambier is South Australia's second largest city. The Mount Gambier hospital delivers health services for the South-East and Limestone Coast region of our state as well as customers living in western Victoria. The hospital currently has 113 multiday beds and provides care to a catchment of over 36,000 people. In 2021-22, the emergency department received over 22,000 presentations. Of these presentations, 20 per cent were admitted, with over 2,300 admitted patients having a length of stay exceeding 24 hours. Furthermore, 650 patients had an average emergency department stay of between four to eight hours.

Endorsed SA Health modelling anticipates that by 2032, presentations will increase to nearly 29,000. Additionally during this time, there were over 1,000 mental health presentations assessed at the hospital, with 278 admitted to the inpatient mental health unit and 103 patients admitted to beds elsewhere within the hospital. This redevelopment project will deliver a new six-bed emergency department short stay unit with potential for future expansion, a six-bed mental health subacute unit and a two-bed drug and alcohol unit.

The new emergency department short stay unit, located adjacent to the existing emergency department, will have six treatment bays—inclusive of one bay that will be able to accommodate mobile bariatric patient lifters—as well as a staff station, amenities and consult room. This will provide short-term care for emergency patients who require observation, specialist assessments and diagnostics and whose length of stay is deemed to be limited—for example, less than 24 hours. This will be supported by two new workstations in the emergency department office.

The new mental health subacute unit will have six beds in a homelike, non-institutional setting, each having its own ensuite. Two bedrooms will focus on more independent facilities, including a kitchenette in the rooms. The new unit will support the therapy program's needs, with a lounge room, kitchen, dining area, activity area, smaller meeting areas and an outdoor courtyard. It will be located next to the existing inpatient mental health unit as a standalone new build with a separate dedicated entrance as well as maintaining direct links to the wider Mount Gambier hospital. Consumers will be free to move through the new unit and wider hospital campus but with no direct linkage or connection to the existing inpatient mental health unit.

The new drug and alcohol unit repurposes two medical ward rooms so that this unit can be accessed directly from the medical ward while still being a separate unit. Both bedrooms will operate under a closed quarantine model and will provide a medically managed drug and alcohol withdrawal service. This will be targeted at consumers wishing to plan for drug and alcohol withdrawal who require medically managed inpatient services. Like the mental health subacute unit, the drug and alcohol unit will resemble a homelike, non-institutional setting, with each room having its own ensuite as well as a lounge, kitchen and dining area, multipurpose activity room and enclosed courtyard.

The project has a proposed $20 million budget and forms part of a state government election commitment to expand the Mount Gambier hospital's emergency department. Construction is expected to begin in September of this year, with an expected completion date of November 2025. This redevelopment will provide modern, fit-for-purpose facilities to meet operational needs with modern clinical standards as well as enabling the provision of appropriate levels of care to the surrounding communities.

The entire program of works will deliver 14 additional beds at the hospital and will support improved patient flow and deliver improved patient outcomes. It will allow patients to be reviewed in dedicated areas, freeing up space in the emergency department and improving triage flow whilst also providing safe care of emergency presentations and mental health consumers. It will increase the capacity to provide urgent mental health care in the emergency department and more generally support the projected presentation increases.

The safety of staff, consumers and visitors has been considered across the proposed works, with the design form generally open plan to maximise sightlines throughout. Within the mental health subacute unit, controlled access will be applied to bedroom doors for personal operation, with staff override. Furthermore, staff assist call duress buttons will be provided in both fixed wall and mobile pendants, in review with the Office of the Chief Psychiatrist.

The project will follow the best practice principles for project procurement and management, as advocated by the state government and construction industry authorities. Risk management will form an integral part of this process to identify and assess risk and ensure appropriate management or mitigation measures are incorporated into the project delivery. A key risk is ongoing capital pressures and supply chain delays, alongside continued inflation of prices and general wage increases within the construction sector. Another risk is that the site has possible hazardous materials.

The project team have reviewed site and geotechnical information and will conduct destructive tests and ground boreholes to identify any potential risks. To manage these risks, an integrated management team has been established with executive-level membership from across SA Health, the Limestone Coast Local Health Network, the Department for Infrastructure and Transport and the lead professional services contractor. This integrated management team will be supported by a project management group who are responsible for overall day-to-day operational management.

SA Health has incorporated sustainable development 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 that will assist in creating a positive workplace, reducing energy and water consumption, reducing the consumption of renewable and non-renewable resources, and minimising recurrent project costs. To help achieve these aspirations, integrated sustainable development measures include:

the use of energy-efficient heating, cooling and lighting, with increased outdoor air provision and a design that encourages a high level of daylight while mitigating for solar glare;

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

provisions for full electricity use, including an electric heat pump for water and preparations for future electric vehicle charging;

a rainwater tank to provide a source of sustainable water for toilet flushing and landscape irrigation; and

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

Furthermore, incorporated design measures will increase adaptability and allow for changes of use with minimized impacts to ensure the spaces are adaptable and futureproofed.

SA Health states that engagement and consultation has occurred with clinical and non-clinical staff, consumer reference groups and industrial bodies, as well as various units and agencies within SA Health and the Limestone Coast Local Health Network. Throughout the project, the Limestone Coast Local Health Network and the SA Health Media and Communications Unit will manage external communications, media inquiries and press releases. The local community has been consulted through an ongoing two-way process of engagement at various levels, with public notices and key stakeholder group consultation.

The committee examined written and oral evidence in relation to the Mount Gambier and Districts Health Service redevelopment project. Witnesses who appeared before the committee were: Melissa Nozza, Director, Capital Projects and Infrastructure, Department for Health and Wellbeing; Tjaart Van Der Westhuizen, Principal Project Manager, Limestone Coast Local Health Network; John Harrison, Director, Building Projects, Department for Infrastructure and Transport; and Rachela Snewin, Senior Architect, GHD Design. 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.

Motion carried.