Question Time

EATING DISORDER SERVICES

The Hon. S.G. WADE (14:38): I seek leave to make a brief explanation before asking the Minister for the Status of Women a question about eating disorders.

Leave granted.

The Hon. S.G. WADE: After a massive community backlash, the government was forced to initiate a review of eating disorder services in South Australia. The report was released yesterday. I am reliably informed that it has a number of good ideas in it. In a letter to me the minister claimed that the 17-member project reference group has 'approved the release of the final report'.

From a medical perspective, however, concern has been expressed that the government model focuses on each end of the spectrum—acute services and community services—with no credible transition path between them. Vulnerable young women coming out of an acute phase of anorexia typically need weeks of subacute care. This service was offered by Ward 4G at the Flinders Medical Centre. There will be no such focus in the proposed model.

The minister's letter exacerbates the concerns when he says that the model will include 'a residential program with clinical input'. The phrase 'with clinical input' suggests that the facility will not have on-site medical supervision, meaning that a client will need to get a relatively high level of recovery before they can be placed there. I ask the minister:

1. Given her failure as Minister for the Status of Women to realise the significant threat to vulnerable young women in the original proposal, what steps will she take to consult with women on the proposed new model?

2. Did the 17-member project reference group endorse the recommendations of the final report as claimed by the minister?

3. Will the minister guarantee that vulnerable young women will have access to medically staffed transitional services?

The Hon. G.E. GAGO (Minister for Regional Development, Minister for Public Sector Management, Minister for the Status of Women, Minister for Consumer Affairs, Minister for Government Enterprises, Minister for Gambling) (14:40): I thank the honourable member for his questions. Indeed, I have spoken on this issue on a number of occasions in this place, and I have put on record a number of times some of the concerns that I have around the services being provided by Ward 4G. I do not think I need to go over those again, but I have made it very clear in this place that I believe it is not the most optimal of environments for the treatment of women for this particular disorder. I believe we can do better than that, and that is exactly what the Minister for Health intends to do.

This issue is obviously a matter for the Minister for Health; however, as the Minister for the Status of Women, I have obviously sought advice on this. I have been advised that services for individuals with eating disorders are currently predominantly provided through the Children, Youth and Women's Health Service, and obviously the Flinders Medical Centre as well. Weight disorder beds on Ward 4G—

The Hon. R.L. Brokenshire interjecting:

The PRESIDENT: Order! The Hon. Mr Brokenshire should not be on the phone in the chamber.

The Hon. G.E. GAGO: Ward 4GP at Flinders Medical Centre is currently co-located with other psychiatric beds, and I have talked about that before. I have already put on the record that this is obviously a location that is not the most conducive to recovery, nor the most conducive therapeutic environment. I do absolutely respect and acknowledge those people who have received treatment at Flinders on this particular ward. I can understand that the services, the treatment and support they have received there has saved the lives of many, many young women in particular, but also young men, and I can understand the attachment that those people and also their families have for that service.

It is completely understandable why these people would feel such a sense of loyalty to this facility and gratitude for the services that it has provided in the past and a sense that they do not want to give that up. So, I do acknowledge that; however, as I have said in this place before, I think we can do better than that. As our knowledge and understanding of models of treatment and care develop over time, it is important that we continue to develop our services to keep in step with that, and that is exactly what the Minister for Health is currently attempting to do. I congratulate him on that and I congratulate him on his preparedness to go out and genuinely consult and listen to people and then to take back those points of view and to consider and incorporate those points of view.

SA Health commissioned an independent consultant to develop a statewide model of care, working closely with a reference group that included clinicians, non-government and university representatives, consumers and carers. I think there has been extensive consultation right throughout. Over 150 people, I am advised, were consulted as part of the development of the new model.

The Hon. S.G. Wade interjecting:

The Hon. G.E. GAGO: It is just nonsense what the honourable member is saying. They were consulted as part of the design of this new model. I was pleased to be informed that the service model is now complete and will be released to stakeholders—

Members interjecting:

The Hon. G.E. GAGO: They are complaining, Mr President, because the Minister for Health listens. They complain when people are not consulted, then when ministers do go out and consult, when they do go out and flag a particular view or a particular position, they flag it, and then consider the views that come back. When they do that and then incorporate those views, they are damned again. It is absolutely outrageous.

The development of the model of care involved examination of national and international best practice models. The new model of care, I am advised, advocates increased community-based options for people with eating disorders and will have a hub-and-spoke structure with outreach for country patients. The hub of specialist clinicians will work with other services, including GPs, community, mental health and other agencies to offer clinical advice and guidance to manage eating disorders. So, the best expertise will be involved in this service design.

I am advised that services will include both residential and day programs and will expand the range of prevention, intervention and treatment services available across the state. The model of care at the start of the process of reform and the implementation committee, including clinicians, consumers, carers, NGOs and other key stakeholders will be established. I understand that the implementation committee will determine priorities for development and implementation, and I have been advised that it is anticipated that the full implementation will occur over a period of one to two years. So, that is the level of detail and thoroughness that is going into this.

I have been assured that there are no plans to move the eating disorder patients from Ward 4G to the Margaret Tobin Centre. The Minister for Health has made that very clear. The six eating disorder beds on Ward 4G—

The Hon. S.G. Wade: That was your key decision before. That was the key element.

The Hon. G.E. GAGO: Well, the minister has listened. Instead of thanking the minister for listening, what do they do?—criticise him. It is just outrageous. The six eating disorder beds on Ward 4G at Flinders Medical Centre will remain open while the implementation committee considers the best location for the provision of residential and community services. The Women's and Children's Hospital will continue to provide eating disorder services for children under 16 years of age, and these services will be included in the model of care.

I am also advised that the cost of the new integrated and expanding model of care is expected to be more than $1 million per annum, and the government is committed to ensuring that services for this vulnerable group are provided with the best care options possible and appropriate to suit the particular stage of their illness and disorder.