Select Committee on Transforming Health

The Hon. S.G. WADE (17:48): I move:

That the fourth interim report of the committee be noted.

I would like to take the opportunity to highlight some of the issues raised in the fourth report. The fourth interim report is a report that is focused on the Modbury Hospital. The Transforming Health select committee has in this report condemned the Weatherill government's failure to inform local residents about the significant downgrading of the Modbury Hospital emergency department as part of the Transforming Health changes. You will note that it is a unanimous report.

The select committee found that communication with local residents had been completely inadequate and that any statement implying that it is business as usual at Modbury entirely overlooks the fact that there has been a significant downgrade of its emergency department. In my view, the Weatherill government has not clearly communicated to local residents that, if they are suffering from a heart attack or a stroke, Modbury Hospital is no longer the place to go.

The committee also found that recent changes to both Modbury and Lyell McEwin hospitals had not been well planned and that there was ongoing confusion as to when emergency surgery could be performed at Modbury Hospital. That compounded the challenge faced by nurses, doctors and other health professionals. In my view, the powerful evidence of health professionals cuts through the spin that all is well at Modbury and Lyell McEwin. The fact is that front-line staff provided the committee with a harrowing picture of a hospital system under pressure. Patient safety is being undermined by the refusal of hospital administrators to put clear surgical protocols in place.

The parliamentary committee report contains strong criticism of the way the Weatherill government's Transforming Health changes are being rolled out and its recommendations are unanimously endorsed by all members of the committee, including the government member. The committee's nine unanimous recommendations include the ones calling on SA Health to (1) undertake a public information campaign clearly explaining under what circumstances a patient should present at the Modbury Hospital Emergency Department.

At this point I pause and express my horror that the government, in spite of that unanimous recommendation provided to this chamber weeks ago, dared to put very similar information out to the western suburbs and the southern suburbs—

The Hon. R.I. Lucas: Surely not.

The Hon. S.G. WADE: They did. The honourable member shares my horror. Let me give an example of the appalling communication included in that document. In a letter, signed by Professor Dorothy Keefe, the Clinical Ambassador for Transforming Health, it says words to the effect: in an emergency, ring an ambulance; if you need urgent medical attention, go to the emergency department. What sort of mumbo-jumbo is that from a person purporting to be speaking on behalf of the government and giving clear clinical advice? Of what use is that to a person in terms of deciding whether they should present at a downgraded emergency department or whether they should traipse across town to go to a so-called super ED?

The Hon. R.I. Lucas: It sounds dangerous.

The Hon. S.G. WADE: Patients have the right to have clear information about their responses. As the Hon. Robert Lucas rightly points out, to give them anything less than clear information is dangerous.

The PRESIDENT: He should not point out anything while you are on your feet.

The Hon. S.G. WADE: I can appreciate, in the context, that he is just so zealous, overzealous perhaps, perhaps a bit robust, and he just cannot contain himself; but at least he is not slagging off women.

The Hon. K.J. Maher: So, you appreciate his humour, do you?

The Hon. S.G. WADE: No, I do not.

Members interjecting:

The Hon. S.G. WADE: My colleagues have been very helpful.

Members interjecting:

The PRESIDENT: Order!

The Hon. S.G. WADE: Just as the Hon. Ian Hunter should not distract from the water debate by using offensive language, likewise, I will not allow the Hon. Rob Lucas to distract me from the horrors of Transforming Health.

Let's be clear, this is a very serious matter. We have South Australians in the north and now in the west and the south, who are being told, through Transforming Health propaganda into those three regions, vague information as to where to go if they are facing a medical emergency. If the government wants to downgrade the emergency departments, which is what it is doing, it has a moral obligation to make sure that patients are fully informed in terms of making the choices that they need to make in a medical emergency.

The fact that we had a unanimous report from a select committee highlighting the dangers of the information they had already put out and then within weeks they compound the error by putting similarly confusing information into two other regions is beyond belief.

The Hon. J.S.L. Dawkins: Did you say 'deliberately confusing' or 'similarly confusing'?

The Hon. S.G. WADE: Did I say 'deliberate'? It was both similarly and deliberately. Recommendation 7 highlights that the government needs to—

Members interjecting:

The PRESIDENT: Order! Will the Leader of the Government please desist. The Hon. Mr Wade has the floor.

The Hon. S.G. WADE: Thank you, Mr President. Again, the wisdom of your advice to ignore interjections has been proven yet again. Recommendation 7 of the committee said that the government should immediately issue a clear, unequivocal written directive to all clinical staff about the circumstances under which emergency surgery can be performed at the Modbury Hospital. We were gobsmacked, as a committee, that a senior public servant came before our committee and told us the reason why she had not put in writing that clinicians could undertake emergency surgery was because it was so patently clear that it did not need to be put in writing.

Within a week a letter was provided to the committee which showed that she had written to clinicians saying, 'Don't do emergency surgery.' We believe that it is a risk to patient safety that there is not clear advice to clinicians and that when emergency surgery is available to deal with patient issues it should be provided. To suggest that a bureaucrat's directive should override the clear ethics of a medical practitioner to respond to patient need, as and when required, we believe is dangerous and offensive. Certainly, it was a view that was shared to the committee by the President of the Australian Medical Association.

The committee, in recommendation 4, urged for immediate discussions with emergency department clinicians at the Modbury Hospital to determine the back-of-house clinical resources required to maintain a safe and effective emergency department. A series of health professionals, including the local President of the Royal College of Surgeons, highlighted that you cannot have a fully fledged emergency department without appropriate back-of-house services. The committee is very concerned about the downgrading of services at that hospital.

The committee has called on SA Health as a matter of priority to ensure that the Lyell McEwin is properly resourced. If you are going to downgrade the Modbury Hospital, you cannot leave the Lyell McEwin not only with no additional beds built into that facility but a clear lack of clinical resources. The health minister needs to stop the downgrade of Modbury Hospital and instruct SA Health to deal with critical issues and concerns highlighted in the select committee report.

If the minister's statement in the parliament on 17 November is anything to go by, he is ignoring those alarm bells. His comments were a poor attempt to spin a report that was unanimous in its criticism of his health agenda and demonstrated his unwillingness to face up to the grave concerns and the lived experience of our front-line health professionals. I commend the report to the parliament. I believe it is a very useful insight into the impact of this government's appalling policies on the people of the north and the north-east.

Debate adjourned on motion of Hon. J.M. Gazzola.

Sitting suspended from 17:58 to 19:47.