Parliamentary Committees

Select Committee on Transforming Health

The Hon. S.G. WADE (15:55): I move:

That the first interim report of the committee be noted.

The Hon. S.G. WADE: I am convinced that the Weatherill government's process to identify the site for the new post-traumatic stress disorder centre of excellence was significantly flawed and cannot guarantee the best outcomes for veterans and other people with mental health issues. The select committee recommendations are a pathway to getting the process back on track and ensuring the best-possible outcomes for veterans. The select committee is of the view that the ministerial expert panel, which was established to consider the model of care and the location of the service, should not have ruled out some public health services remaining at Daw Park.

Similarly, and importantly, the select committee is also of the view that the ongoing expression of interest process for the Daw Park site should also not rule out public health services remaining there. These services could be a public unit co-located with private services or, alternatively, the PTSD centre of excellence could be located in a private facility similar to what happens in other former veterans' hospitals around Australia. These are both viable options that need to be explored.

Further, the select committee has received a staff-initiated proposal for public orthopaedic and neurological services to be provided at Daw Park, either freestanding or as part of a wider health precinct. The committee has also received evidence highlighting opportunities to pursue commonwealth funding to improve health services to both veterans and serving Australian Defence Force personnel.

By making a decision about the location of the PTSD centre of excellence before the future use of the Daw Park site has been determined, the Weatherill government is closing the door on opportunities to significantly improve PTSD and other health services on the Daw Park site as part of a health precinct. An expanded expression of interest process for future uses of the Repatriation General Hospital site could bring forth proposals which significantly change the context of the expert panel's recommendation as to the location of the new centre of excellence.

I hope that members of this chamber and the community might find the report of the select committee readily understandable. Rather than restate it, I would like to focus my remarks on responding to the dissenting statement of the government member, the Hon. Tung Ngo. I acknowledge the diligent and constructive engagement of the honourable member and the work of the committee, but I respectfully disagree with most of his dissenting statement. I am pleased to note that one recommendation has the unanimous support of the committee, including the Hon. Tung Ngo. The first recommendation reads:

1. That a Commonwealth/State task Group be established bringing together SA Health and relevant Commonwealth Government agencies to identify opportunities to improve and better coordinate health services to veterans and serving members of the Australian Defence Force, and to support research related to these services.

Given the unanimous support, I trust that the government will move quickly to establish such a task group. The select committee's second recommendation states:

2. That the expressions of interest process be paused and relaunched once the Commonwealth/State Task Group is concluded, thus allowing time for opportunities with other publicly funded services to be considered.

End of recommendation. The government member has indicated that he does not support this recommendation. The government member says the recommendation for the location of the PTSD centre of excellence was based on the requirements of the model of care, and that the Glenside campus was strongly recommended as the best site.

The government member makes no attempt to rebut the central argument of the report and of this recommendation that we cannot know what we have achieved is the best outcome for veterans' health if we do not test all the realistic possibilities through a robust expressions of interest process, and only then can we decide the location. The expressions of interest process needs to be paused and relaunched with all relevant information on opportunities.

I would highlight these opportunities in terms of three classes: first, there are the opportunities for the commonwealth support for both ADF and veterans' health. These opportunities were highlighted to the committee by Professor Sandy McFarlane, a world renowned expert on PTSD. Secondly, staff-initiated proposals for the future use of the site, presented to us by a senior nurse and heads of the unit from the Repat, demonstrated opportunities to use the site in an ongoing way for both public and other services.

Thirdly, the opportunities include synergies that could be achieved between the new uses for the site and current services. For example, a private hospital, an opportunity affirmed by a number of witnesses to the committee and also in public statements by the Minister for Veterans' Affairs, the Hon. Martin Hamilton-Smith. The third recommendation of the committee is:

That the expressions of interest process for the future use of the Repatriation General Hospital be broadened to encompass proposals, which could involve the continuation of publicly funded services on the site or for currently publicly funded services to be provided on the site for not-for-profit or private providers.

The government member does not support recommendation 3. He says that, as the current expressions of interest process does not limit any proposals being put forward, the recommendation is irrelevant. On this fact the member is not correct. On page 9 the expressions of interest document produced by the government in relation to the Daw Park site states clearly:

That the transition of SA Health services from the site will be completed in late 2017.

A short list of SA Health services are listed as remaining on the Daw Park campus. The vast majority of SA Health services are excluded from it EOI process—they are not on the list. Ward 17 is not one of the services listed.

Contrary to the statements of the government member, the EOI process does limit proposals, it does exclude proposals for Ward 17. If the process can allow for proposals for Ward 17 on the Daw Park site, as the government member suggests, the government should make that clear and accept the committee's recommendation to pause and relaunch the expressions of interest process, with clear information to stimulate the full exploration of the prospects of publicly funded services on the site. The fourth recommendation is:

That SA Health staff be encouraged and supported to develop proposals in relation to the provision of services at the Daw Park site.

The government member does not support the recommendation because he says that staff have been encouraged by the minister and SA Health to put forward any proposals they wish for consideration in relation to Daw Park. If that were true, why is there then no mention of such opportunities in the EOI documentation? If it were true, how do EOI participants become aware of the SA Health staff proposals, proposals which could stimulate and inform their own proposals and highlight the very useful synergies. It is one thing to say that people are free to speak, it is another thing to put in place a process so other people get the chance to listen. The fifth recommendation is:

That the veterans' community and the public be given at least four weeks to assess non-confidential information and comment on the short list of proposals coming out of the expressions of interest process.

The government member says that recommendation 5 is not supported because 'there was public consultation during 2005 that canvassed views about future uses for the Repat site, and this has been incorporated into the EOI document'. I am surprised that the government member opposes consultation on the outcome of the EOI process.

His position is completely at odds with the position of the Hon. Martin Hamilton-Smith, the Minister for Veterans' Affairs who, as both minister for Veterans' Affairs and as acting health minister, in a press release on 21 April 2015 said that, following the conclusion of the expressions of interest process, 'the veterans' community and the public will have the opportunity to have their say about the plans'.

In April the government was committed to consultation after the EOI proposals were in. What has changed, or is it just that the member for Waite is demonstrating yet again his impotence when it comes to standing up for veterans and his electorate? The sixth recommendation is that:

The location of the PTSD Centre of Excellence be revisited following the conclusion of the Expression of Interest process.

The government member says that, 'whilst he supports the intent of the sixth recommendation, he considers it unnecessary'. I respectfully disagree with the member. The recommendation is necessary. His comment is the first indication that the government has given that it accepts that the decision of the expert panel needs to be reconsidered. If the government has accepted that reality I would be delighted, but one swallow does not make a spring. The seventh recommendation is, and I quote:

That, in consultation with the Probity Auditor for the Expression of Interest process, SA Health brief all members of the Veterans Advisory Council, the Veterans Health Advisory Council and members of the oversight panel and working groups on Veterans Mental Health Governance on their responsibilities under the Public Sector Honesty and Accountability Act 1995, in particular in relation to conflicts of interest.

The government member says that he does not support recommendation 7. In his dissenting statement he says:

The select committee admits in section 6 that it 'has no evidence of active misconduct', yet Recommendation 7 implies that there may be inappropriate behaviour.

Firstly, the member misquotes the report. The report states that the committee has no evidence of 'actual' misconduct not 'active' misconduct. The member goes on to assert that recommendation 7 is, and I quote:

…an unacceptable slur on the reputations of the members of the Expert Panel.

I ask: how can it be? It does not mention the expert panel: it talks about the Veterans Advisory Council and the Veterans Health Advisory Council. Further, it talks about people being reminded of their statutory duties. It is no more a slur on anyone on those bodies than a road speed limit on the side of the road is a slur on all road users.

The member then goes on to criticise the committee for the fact that this is an interim report. He is upset that we have not addressed issues which will be considered in a future report, matters related to the probity of the expert panel process. He says that he finds it 'both disappointing and perplexing that this important issue was not included in the interim report'.

The fact of the matter is that the committee was clear in its interim report that this was a narrowly focused, time sensitive interim report tabled to address issues which relate to the expressions of interest process that is scheduled to conclude at the end of November. There is no point in recommending that a process be paused and broadened if it has already been completed by the time the report is tabled.

The committee was simply not in a position to finalise its consideration on all issues such as the robustness of the expert panel process. For one thing, the committee received a folder full of evidence from SA Health only one business day before it finalised its report. I would have thought that the government would want us to consider that information before we finished our deliberations on the broader issues.

With those comments, I commend the report to the council and urge the government to accept the recommendations as a matter of emergency if, indeed, they are committed to the best possible outcomes for the veterans.

The Hon. T.T. NGO (16:08): I rise to speak on this motion, which seeks to move the select committee's interim report. Being a member of the select committee, I consider that the evidence that this committee has heard so far does not support the recommendations currently within the interim report.

Witnesses have described a robust process which resulted in the decision to recommend Glenside campus as the future site for a centre of excellence for post-traumatic stress disorder (PTSD) and the Ward 17 services currently located at Repatriation General Hospital (RGH). This decision was based on the model of care developed by the independent expert panel during 2015 and the resultant requirements, both clinical and nonclinical.

I want to put particular focus on the seventh recommendation of the interim report. The select committee admits in section 6 of the interim report that it has no evidence of actual misconduct, yet recommendation 7 implies that there may be inappropriate behaviour. I consider this to be an unacceptable slur, as the Hon. Stephen Wade said, on the reputation of many members of the expert panel who are well regarded and dedicated advocates for many veterans.

The committee has, so far, spent a considerable amount of time—I repeat, a considerable amount of time—investigating whether the process used by the expert panel in choosing the Glenside site was biased towards a predetermined outcome, and whether all the expert panel members voted for the Glenside site, meaning the decision was unanimous, as stated publicly by both co-chairs of the expert panel.

The interim report has completely left out this part of the investigation. I find it both disappointing—of course, considering we spent so much time investigating these two matters—and perplexing that this important issue was not included in the interim report at all. Instead, a potential conflict of interest that a few witnesses mentioned sparingly and for which the committee found no evidence, featured predominantly in the interim report and was included in the recommendations.

That is what I found strange about this interim report. I do not mind if it mentions that, but it also mentioned the amount of time we spent investigating these two matters and they completely left it out. It is my view, however, that from the evidence provided to the committee so far, for the most part individual members of the expert panel have consistently outlined their full confidence in the robustness and frankness of its deliberations, as well as reflecting on the unanimous decision made in promoting the advice which it subsequently provided to the minister.

It is unfortunate that this has not been reflected in the committee's interim report. The absence of this evidence in the interim report shows that the committee only aims to undermine the credibility of the expert panel's advice to the minister, which was that Glenside campus should be the future site for the Centre of Excellence for post-traumatic stress disorder (PTSD) as well as the Ward 17 services currently located at the Repat General Hospital.

I will take this opportunity to paraphrase some of the comments that various distinguished members of the expert panel have made to the committee about their satisfaction with the process and deliberations of the expert panel. First, there is Mr Chris Burns, the presiding member of the Veterans Health Advisory Council. He has stated his opinion—

The Hon. S.G. WADE: Point of order, Mr Acting President.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): There is a point of order; the honourable member will resume his seat. The Hon. Mr Wade.

The Hon. S.G. WADE: It appears that the honourable member is about to reveal evidence to the committee which has not been brought before the council. I did not selectively quote to support my case; he should do the same. This is not what the interim report is about.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): The honourable member will resume his seat. I am sure the honourable member will not be going into anything that was done in a deliberative sense in private.

The Hon. T.T. NGO: He has not heard my—

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): I ask you to continue your remarks with that in mind.

The Hon. T.T. NGO: I will start again. First, Chris Burns, the presiding member of the Veterans Health Advisory Council, has stated that in his opinion he does not believe that the expert panel process could have been conducted in a better manner. He believed the process to be open, engaging, egalitarian, inclusive and beyond reproach.

The Hon. S.G. WADE: Mr Acting President—

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): Just resume your seat. There is a point of order.

The Hon. S.G. WADE: Clearly, the member is suggesting that Mr Burns conveyed that information within the committee; that is the deliberations of the committee.

The Hon. T.T. NGO: I have not quoted.

The Hon. S.G. WADE: I am sorry, if the honourable member is not suggesting that Mr Burns said that within the committee, he should tell us where he found that, because it is remarkably similar to evidence that has not been brought to this council.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): I think the honourable Mr Ngo needs to be very careful in the way he describes the way in which people have made statements and where they have made statements.

The Hon. S.G. WADE: He might be misleading the house if he suggests they said it elsewhere.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): I am not sure that you have done that, so I think if you are going to continue quoting Mr Chris Burns you probably need to be clear about that, and I ask you to continue.

The Hon. T.T. NGO: I am not quoting Mr Burns. I am paraphrasing what he—

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): You need, I think, to be clear, if you are paraphrasing what he is saying, where he said that. I think that is something that you have not done at this stage.

The Hon. T.T. NGO: I have said it already. I am paraphrasing when he gave evidence.

The Hon. T.A. FRANKS: Point of order: it is disorderly for members to remark on the proceedings of committees still underway, and that is what the honourable member has just done.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): I think the Hon. Mr Ngo has probably got the message that he probably should not proceed any further. This is an interim report. Your committee has not finished. I ask you to continue your remarks, but be very cautious about the way in which you refer to evidence that has been given to the committee that is still sitting.

The Hon. T.T. NGO: Thank you, Mr Acting President. The evidence from various committee members has backed up my argument that the process of that—

The Hon. T.A. FRANKS: Point of order: the honourable member continues to refer to evidence from committee hearings which are not to be commented upon until that committee reports.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): The honourable member has referred to evidence without saying who it is coming from, but it is still not appropriate for this, because your committee is still sitting. I would ask you—

The Hon. T.T. NGO: That's fine. I am not referring to anybody.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): No, I know that, but you are making reference to evidence that could be connected back to various people. I would ask you to continue your remarks—

The Hon. T.T. NGO: I am not naming anyone.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): No, there's no debate; I ask you to continue your remarks without treading that line. The Hon. Ms Franks, on the point of order.

The Hon. T.A. FRANKS: On the point of order, it may be perhaps advisable if the honourable member would refer to standing order 190 and absorb that before continuing his speech.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): We do not really have time for the honourable member to do that now. He can seek leave to conclude if he wishes.

The Hon. T.T. NGO: Alright. I made my points clear, Mr Acting President, so there is no point in going on—I could go on, but there's no point; I've said enough.

Debate adjourned on motion of Hon. T.A. Franks.