Public Works Committee: Port Pirie Regional Health Service Emergency Department Redevelopment

Mr BROWN (Florey) (11:10): I move:

That the 98^th report of the committee, entitled Port Pirie Regional Health Service Emergency Department Redevelopment, be noted.

Port Pirie hospital is one of SA Health's key regional facilities, providing a comprehensive range of health services to patients throughout the Southern Flinders and Mid North. These important health services include 24-hour accident and emergency care, patient surgical and medical, obstetrics and gynaecology, chemotherapy, renal dialysis, diagnostic imaging services, respite and residential aged care, allied health and community-based services. Onsite providers also include pharmacy and pathology.

The hospital is vital to providing ongoing care to consumers in the Yorke and Northern Local Health Network, and the current standard and condition of the emergency department (ED) is creating operational, infection, safety and security risks. Additionally, SA Health expects the service demand to significantly grow in the coming years, along with an increase in the age and clinical complexity of consumers. This $15½ million ED redevelopment will not only restore the facility's services to current standards but also expand the hospital's service delivery capabilities.

The redevelopment is part of a wider plan to develop health infrastructure in the Yorke and Northern Local Health Network catchment. In 2020, the local health network commissioned an architect consultant to undertake a hospital site development plan to consider infrastructure development at the Port Pirie, Wallaroo and Clare hospitals. Part of the key recommendations for the Port Pirie hospital was the construction of a new ED, medical imaging facility, and a mental health short stay unit and support services. To meet budget, the ED component has been prioritised as the first stage of the development plan, with the remaining components postponed and forming stage 2 of the planned works.

The concept design considered several options, shaped by constraints that the redevelopment will both replace the still operational existing ED as well as the need to cater for the stage 2 development at a later date. The preferred option was approved because it minimises interruptions to clinical services delivery during construction and will allow more room to optimise functional areas. The design also addresses a requirement that the ED be raised by half a metre, ensuring that the hospital can still operate as a post-disaster health provider in the event of an extreme coastal high tide event.

The redevelopment project will construct a new 700 square metre extension to the northern side of the existing hospital and will be built on the site of an existing car park that will require relocation. The new ED will, in line with current Australian Health Facility Guidelines, include:

one emergency resuscitation bay and one hybrid emergency and procedure resuscitation bay;

seven adult patient treatment bays, including one negative pressure treatment bay;

two rapid assessment treatment bays;

a stimulus room, a patient consult room and a triage examination room;

an external covered ambulance area;

a patient waiting and arrivals area;

a triage zone and ambulant arrival bay;

dedicated clinical support utility rooms;

a central staff station; and

back-of-house staff facilities.

The project has integrated several pandemic management measures throughout the facilities design, including dynamic waiting areas, independent toilet and shower rooms, sanitary stations and the previously mentioned negative pressure isolation treatment bay.

SA Health states the delivery of the project will follow best practice principles for project procurement and management. These principles include extensive consultation to ensure incorporation of new and emerging health strategies, evaluation and review of solutions against the brief, development of formal communications with community and stakeholders, preparation of a program that reflects the project scope, establishing and managing a cost plan, appointment of professional service contractors, and scheduling reviews of design documentation and construction.

Development approval from the State Commission Assessment Panel was received in December 2023. Site mobilisation is anticipated to occur this month, with the project anticipated for completion in November 2025.

The project team is managing risks, and the selection process for the professional service contractors has a strong focus on quality, specialist knowledge and the appropriate management of risk. The project team has identified:

challenges managing the scope of the project within the approved budget, for which the team aims to allow appropriate design and construction contingency allowances;

distinct geotechnical conditions due to highly soft estuarine clay within the site, for which the building will require stiffened raft footing design;

the presence of lead dust in the area, which will require the contractor to follow Environmental Protection Agency standards for soil remediation, dust management and monitoring;

managing construction in proximity to an operational clinical environment and existing helipad, for which the project team will remain in ongoing communication with site management and consumers at the hospital; and

replacing the parking capacity due to the removal of the existing car park, for which the project team are negotiating with the local council for an expansion of car parking infrastructure along an adjacent road. SA Health is also looking into acquiring or leasing adjacent land for dedicated onsite parking.

The project team has established formal processes to ensure ecologically sustainable development (ESD) principles are incorporated into the design, construction and operation of the ED. This includes the engagement of an independent ESD advocate. The building will be adaptable, with flexibility for changing uses and technologies as well as mechanical systems prepared for higher temperatures and infrastructure designed to support installation of solar power technology.

The design has also considered the sustainability and efficiency of air conditioning, building materials, lighting and appliances as well as water usage, rainwater and wastewater. A suite of sustainability rating tools will be in place to ensure the delivery of ESD initiatives and to measure ongoing performance.

There are no Local Heritage Places or items located on the site, and SA Health confirms there are no significant trees within the development zones. The Register of Aboriginal Sites and Objects determined there is no record of Aboriginal sites in the proposed works location.

SA Health will remain in ongoing consultation with stakeholders and the community throughout the design and construction process. This includes user group consultation with clinical and non-clinical emergency staff, as well as specialist and representative medical agencies that have firsthand experience. Further insight about the new facility has been sought from general practice and representative organisations, the Director of Aboriginal Health and the local health network's governing board.

SA Health is also working with the Port Pirie Regional Council to investigate parking solutions as well as coordinating soil stockpiles. The local health network will manage required communications regarding site planning and logistics through newsletters, project information boards and website updates.

The committee examined written and oral evidence in relation to the Port Pirie Regional Health Service emergency department redevelopment. Witnesses who appeared before the committee were Melissa Nozza, Director, Capital Projects, Infrastructure, Department for Health and Wellbeing; Coenraad Roberts, Executive Director, Finance and Corporate Services, Yorke and Northern Local Health Network; Victor Oecker, Project Manager, Department for Infrastructure and Transport; and Jeremy Kelly, Director and Lead Designer, Silver Thomas Hanley Architects. I thank the witnesses for their time. I would also like to take this opportunity to thank the member for Stuart for the written statement he provided supporting this project in his electorate.

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 Hon. G.G. BROCK (Stuart) (11:19): I would also like to speak and thank the Public Works Committee for passing this project through the corporate regional health service. I also want to acknowledge the hard work that has been done regarding this project since the election in 2022.

During that election it was an election commitment by both sides of politics to actually do the improvements to the Port Pirie Regional Health Service. This facility has been in its location for many years, and it has served an ever-growing population and tourism opportunities—not only in Port Pirie but also for visitors from the Copper Coast and Clare Valley, and people travelling through the north.

As the member has indicated, these improvements will provide greater services and facilities for various locations within the hospital. The challenges going forward include communication with the board and professional staff because, as the member has indicated, the facility has to be built to accommodate the 3.4 AHD, which is the issue of being able to raise any buildings going forward above the potential of any flooding from tidal inflows and from the river itself, and also from climate change.

This has been a long, drawn-out process, and I know there have been many discussions between SA Health, the Port Pirie Regional Health Board, the minister's department and the Minister for Health. This project, as I indicated, is well and truly overdue. As the member indicated, this is stage 1 of the project. I am looking forward to stages 2, 3, 4 and 5, which hopefully is in the long-term project.

I want to pay tribute to the staff who have been operating in this facility for many years, not only the ED staff but also the hospital staff, because they do a tremendous job. The facility, as indicated, has been well and truly looking for some vast improvements to modernise it, and also provide the extra facilities for the other services, as the member has indicated, and also to attract more professional services into our regional health service. As I indicated, it not only serves Port Pirie—it is not a general hospital, but it is the major hospital in the region—but also it accommodates people from the Copper Coast and also from Clare Valley and northern areas, and people coming in from other areas, as well as an ever-increasing number of tourists.

As with other locations in South Australia, our community in the last 12 to 18 months has experienced vast improvements in opportunities for people to relocate from the Eastern States, and that is challenging our health services.

The health precinct in Port Pirie is a fairly large complex. It is bound by Florence Street, The Terrace and other streets. Just recently, the Port Pirie Regional Health Service has indicated they have tried to get more money for the helipad, and the member has also indicated that has been approved. I think it is about $2.1 million because of the new contract for the rescue helicopters, which could not utilise the existing pads in Port Pirie and other locations.

I will look very closely at this. I really do appreciate the degree to which the minister has communicated with the staff there. It is very important that we communicate not only with the public themselves about what they want but also with the health sector themselves, the people who actually work in these locations. We have to make it as easy as we can for them. Due to some of my issues—not recently—I and others in my family have had to go to the hospital and some of the areas there are inadequate. This extra $15.6 million—I think that is the project's total cost—will make it a lot more attractive, and it will make it a lot easier to get people through the ED system.

As I have made public before, I believe we need a long-term master plan for Port Pirie and the great opportunities it presents not only for Port Pirie but also for the Upper Spencer Gulf. We need as a state, as a government—on both sides—to look at the long-term potential opportunities for growth in the regional sector through the resource sector, the renewable energy sector and things like that. We need to look at the long term. I understand and I hope that the future direction, facilities and usage of the existing Port Pirie Regional Health Service building, which has been there for many years, is taken into account.

In the long term, we will be pushing as much as we can for a new hospital, as soon as we can. I know that everybody is looking for new hospitals. Certainly, in this one here I am very appreciative of the government. I am very appreciative of the Public Works Committee for allowing this to go through, and I understand that it was bipartisan. There were no arguments regarding the opportunities there.

Again, I want to thank the Minister for Health for his consideration of this. I am looking forward to construction starting on that facility. I know from experience that there are going to be some challenges with car parking, because it is a very small car park. I want to reinforce my real and great appreciation of not only the doctors who go there but also the very dedicated medical staff—nursing, surgery and things like that—and the visiting specialists for what they do there. I take my hat off to them. I am very appreciative of this and am looking forward to the construction and the completion of both this and the helipad.

Mr ELLIS (Narungga) (11:25): I rise to also contribute on this report, and in so doing from the outset congratulate the government on spending money on regional health. It is such an important part of our health system as a whole. Every time we see a story in Adelaide about ramping and whatnot, I think to myself that the easiest way we could fix that would be to improve regional health services and reduce the number of people who are having to be flown to Adelaide, or transported to Adelaide, and increase the number who can be treated locally.

Congratulations to the government on spending money in regional health and further congratulations on spending money in our health network. Our local health network, as the member for Stuart would know, has an incredibly difficult task. It is a big network, with a lot of hospitals and a significant population to serve. They have an unenviable task of prioritising works, and it is pleasing to see the contribution made to the Port Pirie hospital in this setting.

I do not mean to denigrate that effort—this is a complementary effort—but I do want to stress the point that while it is wonderful to see Port Pirie receive some investment we would love to see further investment in our health network, particularly on Yorke Peninsula. Again, I emphasise that it is a difficult job for the health network. There are a lot of hospitals and it is hard to prioritise them, but if I could start at Wallaroo, that is a comically small hospital. We have the Copper Coast region which has probably exceeded 15,000 people now—living there, not travelling there—and we have a 21-bed hospital. It is woefully insufficient in size to service the area that it is tasked with serving.

It is pleasing to hear the member for Florey explain that there have been architectural drawings done in 2020 to investigate what a new facility, or a bigger facility, might look like. I have asked in estimates previous whether there were drawings submitted to Infrastructure SA. The answer, I think, if memory serves, came back no. It would be wonderful to know where those drawings have got to, but it is good to hear that there has been work done on examining what a future Wallaroo Hospital would look like.

I do not mean to, again, contradict the words of the member for Stuart, but on the Copper Coast, on Yorke Peninsula, when we are asking for improved health services and investment, we are often pointed towards investment at Port Pirie as a sign of benefit for our community. I am sure there are some who are transferred to the Port Pirie hospital from Wallaroo or from other hospitals on Yorke Peninsula, but I have to say that the absolute vast majority would choose to go to Adelaide.

If they are at the Wallaroo Hospital, for example, and are told that their ailment is such that it needs to be treated at a higher level and that they should either be referred elsewhere or choose to travel elsewhere, I can tell you that the vast majority would choose to travel to Adelaide for access to the services that are on offer in metropolitan Adelaide.

There would be a small minority, I think, who would choose to go to Pirie because it is closer. It is closer; it would be roughly an hour, slightly less than an hour, from Wallaroo. Adelaide would be two hours, or slightly less than two, so it is closer, but I think the vast majority would go to Adelaide. That is where I live. If you live further south than that—in Maitland, Minlaton, Yorketown or any of those communities around there—I think the odds of you choosing to go to Adelaide or being flown to Adelaide increase dramatically.

When we are pointed to investment in Pirie—this is not necessarily to denigrate that investment; it is welcome and should be congratulated—as a sign that our health needs and our local community are being invested in, I think that is slightly hard for my community to swallow. It is a difficult proposition. We would like to see more localised health spending in the Copper Coast on Yorke Peninsula.

I look forward to trying to chase up the architectural drawings. I would like to see what they look like and what they have come to, and use them to continue to advocate. As members would be aware, and I have talked about it on a number of occasions, at the end of last year we tabled a petition in this place of near on 11,000 people calling for action for our local health services. A key part of that was investment in the Wallaroo Hospital, and it was a re-examination of the boundaries of our local health networks.

They have matured now for a while and perhaps it is worth looking at how we can ensure that each health network has a comparable task ahead of it, each health network is servicing a similar number of hospitals and a similar number of patrons—as we do as members of parliament in this place—so that we can ensure that it is not such a difficult task for some and a slightly easier task for others. That might well then ensure that the Wallaroo Hospital receives the priority that I believe it deserves and that my community believes it deserves, and that it can become the focal point of our health network.

We also heard in the speech argument that the growth in the Port Pirie community and the propensity for tourists to visit there is evidence supporting the fact that that hospital needs investment. This is not to say that it does not but I would argue that both of those factors lend themselves far better to investment at the Wallaroo Hospital than they do at Port Pirie. I imagine, without having the statistics in front of me, that annual visitors to the Copper Coast community might well exceed those who visit Port Pirie, and if they do not then I would be advocating strongly that more people visit our community and enjoy the wonderful beaches, and certainly the growth.

The Copper Coast is one of the fastest growing regions in our state. That is a fact. If you do not believe the stats, you only have to drive between Moonta Bay and Port Hughes to see the number of new houses that are being built and the sheer volume of slabs that are being laid around the community to see that it is a growing community. There are people moving there en masse and it was projected in 2019, in a health services study that I participated in, that Wallaroo would grow by another thousand permanent residents before 2036 to around 5,100 people, an increase of 60 per cent since 2011. That was in a health study that I participated in a few years ago: 60 per cent growth.

That growth is there to justify the services. We currently have only a 21-bed hospital. It is comically small. It is in desperate need of investment. I congratulate the investment in Port Pirie. It will be a wonderful thing—gosh knows that building needs it. It is in a poor state is my understanding, and I am sure it will be money well spent but, hopefully, the next step in our health network will be Wallaroo or on Yorke Peninsula.

I look forward to trying to get hold of those architectural drawings and investigate what they look like. I look forward to advocating as strongly as I can in this place, both through the upcoming inquiry into the petition that I tabled, and in other opportunities, to ensure that we get our fair share of the regional health spend in this state.

Ms PRATT (Frome) (11:32): I rise to speak to the report being tabled by the Public Works Committee in recognition of the Port Pirie Regional Health Service emergency department redevelopment. As with my neighbour, the member for Narungga, and my neighbour, the member for Stuart, we welcome investment by the government in regional health services, and the Port Pirie hospital is no less worthy than any other country hospital around our state.

A significant amount of money, $15½ million, is being allocated to this emergency department upgrade, and every dollar is needed—for those of us who have walked through and visited, supported and understood the ageing infrastructure that is there. To be fair to feedback I have been given about the Port Pirie hospital, certainly comments have been made in the recent past that, in fact, a greenfield site would have been welcomed as well.

I do not stand to advocate for that today but to welcome the investment that we—country people—are going to see in a country hospital. The current state of that ED poses operational infection and control risks, as well as safety and security risks, and the $15 million is going to go a long way toward starting to improve the working environment for our hardworking doctors, nurses and allied health professionals, and certainly to lift the standard for patients who, as the member for Stuart noted, come from not just the Port Pirie township but, of course, the Far North, Mid North and Yorke Peninsula.

Yes, people from my region of the Clare Valley are using the services at the hospital, and I will make my own reflection on Clare Hospital shortly. I note that this report suggests that service demand is expected to increase at the Port Pirie hospital, and I do not doubt that at all. Upgrades to any country hospital are going to attract the locals to have more faith in the system and the standard of care that they are going to receive.

I also draw the government's attention to the Auditor-General's Report that was tabled in the house this week, with a very curious table that the member for Narungga might be interested in as he departs. We have seen a 22 per cent increase in presentations at country hospitals, at country EDs, since 2021 mostly on this government's watch—an increase in country patients presenting to their country hospital. On the face of it, we would say that is reflecting country patients' faith in the hospital that they have access to, but I think that if we scratch the surface we will find something else is going on.

We well know in this chamber the delay that everyone is experiencing in accessing an appointment with a GP. There are long wait times, cancellations and no consistency of care. When immediate and urgent treatment is required, patients in the city and the country are rocking up at the local hospital ED for treatment.

There is also a cost factor, and that grows by the day as we reflect on the cost of living. Bills are going up, households are tightening up and regional South Australia is now facing a drought and frost crisis with impact on harvest and income for the next 18 months. That discretionary money just is not there. We should not be talking about health as a discretionary spend but, where there is a country hospital and an ED available to support someone in the middle of the night when their options are limited, they are going to present to the country hospital.

So I say for the third time that we welcome the investment in the Port Pirie hospital, but we welcome it in every country hospital that exists and operates in South Australia. In my own electorate there are many. Clare Hospital is the biggest in the electorate of Frome and it is also due for an upgrade. While plans are well underway, the budget that the government allocated for the LHN was $4½ million, but the cost of the project is $6 million. So there is already a $1½ million shortfall. There is a collection of volunteers dutiful in their service to their country hospital network, and it has been left to the HAC to find $1½ million and to approve through the LHN the release of those funds that were set aside from an aged-care budget.

The HAC is very comfortable with the decision it has made. I sit on that HAC and we are desperate to see the upgrade to the Clare Hospital proceed. But the idea that $15 million is being spent on Port Pirie hospital, and that service demand is expected to increase, just validates my argument that we want to see continued investment in not just the bigger hospitals in regional South Australia but the smaller ones that are providing life-saving services, whether that is in Burra, Eudunda, Jamestown, Balaklava or Kapunda—and that is just my electorate.

An amount of $15 million for Port Pirie hospital is welcome but the opposition is tracking very closely how the government is spending its health budget. An amount of $1.9 million has just been spent on advertising to voters: the government's agenda on how it is investing in health.

The Auditor-General has outlined a $956 million—let us round it up and call it an even $1 billion—budget blowout in health. I am checking in with health stakeholders and saying to them, 'For that extra billion dollars, can you feel it, can you sense it in the health services you have access to? Is it a faster experience, has the infrastructure improved, is the feedback or the servicing you are experiencing an improved experience?', and the answer is no, it is a resounding no.

The member for Narungga spoke about sustainment works, the Yorke and Northern LHN that we—the three members in the chamber representing regional South Australia, the Mid North, Yorke Peninsula and Spencer Gulf—belong to. There is a frustration of the public servants within the LHN that they have a finite budget, a diminishing pool of money—as I understand it, about $800,000 of sustainment works available to them for the entire LHN—which is why the government is scrounging around trying to find other sources, including looking very closely at money that HACs are holding.

The government's report to the chamber today made mention of the helipad upgrade that will take place at Port Pirie. The member for Stuart and I are in concert, we agree: we welcome that at Port Pirie. That enormous concrete behemoth that sits out in the car park is a critical life-saving piece of infrastructure for the Spencer Gulf and surrounds, as it is at every other country hospital around the state where a helipad exists.

I note, with no dissemblance, that the government have genuinely invested in upgrading helipads around the state, and they have gone further than what must be noted in this chamber was a Liberal commitment to country regions: where a helipad was at a hospital, that those upgrades were critical and they were tied to compliance through CASA, the civil aviation authority, that stipulated, with changes coming to helicopters and a weight loading compliance issue, that those upgrades were required.

The minister laughed at me two years ago when it was first put to the government whether they would honour that commitment, yet here we are, a quiet backflip. We welcome it, but I am calling out what was an investment that had to happen that was not the brainchild of this government.

The member for Stuart concluded his remarks by sincerely thanking the workforce who are dedicated to the Port Pirie hospital, and I echo his sentiments but I send that right around the state to every other region in South Australia. Our doctors, nurses and allied health professionals work very hard and they deliver an excellent standard of care.

Mr BROWN (Florey) (11:43): I take this opportunity to thank members who have contributed to the debate. It is always pleasing to hear from the member for Stuart; he is a passionate advocate for his area, as is the member for Narungga. I also take this opportunity to thank the member for Frome for her contribution.

Motion carried.