Question Time

Emergency Departments

The Hon. S.G. WADE (14:31): I seek leave to make a brief explanation before asking the Minister for Health a question, and in doing so I wish him well in his new role. Health services are very important to all South Australians.

Leave granted.

The Hon. S.G. WADE: A fortnight ago today, the then health minister announced a hospital emergency plan to try to deal with acute hospital overcrowding, yet two weeks later the overcrowding continues. In the 24 hours up to 6am this morning, all the metropolitan emergency departments had been subject to Code White overcrowding. Flinders Medical Centre was Code White for 14 hours straight. On average, emergency departments have been operating over capacity for 15 of the last 24 hours. My questions to the minister are:

1. When does the government expect the hospital overcrowding crisis will be dealt with by this government?

2. What measures are the government currently taking to address hospital and emergency department overcrowding?

3. Why were the unions representing nurses and ambulance officers involved in the meeting to agree the measures but not the representatives of the doctors?

The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse) (14:32): I thank the honourable member for his important question. I also thank him for his best wishes. The honourable member has been working hard and assiduously regarding South Australian health policy for a while now, and I look forward to working with him, where I can, on a collaborative basis to ensure that the health needs of South Australians are met as best as possible.

Of course, in recent weeks we have seen an extraordinary amount of pressure put on our emergency departments throughout the South Australian health system. It hasn't been specifically located to one particular hospital more than any other, but it has reflected an extraordinary amount of demand that has occurred within our emergency departments in recent weeks. I think from the outset it is appropriate to acknowledge how much work has been undertaken on behalf of those men and women of both a clinical staffing nature but also support services, including allied health professionals, to ensure that we get through this extraordinary period of demand in a way that South Australians reasonably expect but also in a way that ensures the interests of those people that are suffering from a form of illness are best represented.

The government, in response to this extraordinary period of demand on our emergency departments, put in place a number of measures that were largely led by the former health minister. He worked collaboratively with a number of organisations to come up with a few measures that have been put in place. My advice thus far is those measures appear to be working well. Of course, that is subject to review.

The honourable member is right to mention that the system is still under a large amount of pressure, although I do note that while there are at least three hospitals that, immediately prior to me walking into this chamber, were at Code White, there are a number that are not, and that is positive news.

I have been monitoring the dashboard in respect to emergency departments and demand pretty assiduously since taking on these responsibilities a bit over a week ago. I can say that as I have been observing the dashboard it has been fluctuating from time to time. On Monday (yesterday) there were periods where a large number of hospitals were on Code White but there have also been other periods throughout the course of the last seven days where hospitals have been on Code Green in some instances and that, of course, is good news.

In respect to some of the measures that were put in place, the honourable member would be aware of those. They were announced publicly but I think one of the two most significant is a policy to send community nurses to non-urgent calls. That seems to be working well, from the feedback and the advice that I have received to this point. Similarly, the move to have SAS not attend motor vehicle accidents in some instances also appears to be working relatively well but, again, of course, it is subject to review. The state government has also put in place other measures in conjunction with that. I would like to put on the record my thanks to those elements within the private sector that are making a contribution in these extraordinary times. These are temporary measures, as I said, but, largely, they appear to be working well at this early stage.

In response to the two components of the Hon. Mr Wade's question that were of a more specific nature: when does the government expect this extraordinary period of demand to alleviate? I think it would be a bold person who would try to make predictions around emergency department presentations in coming weeks. Experience tells us that, of course, there are peaks and troughs when it comes to the numbers of emergency department presentations that occur within the system. Typically, around this time of year, we see peaks on the back of the flu season and that is well known. Ordinarily, we would expect emergency department presentation numbers to decline as we exit the flu season and enter into the summer months.

I think it would be inappropriate, indeed dangerous, for me to try to speculate or offer a firm date as to when that number would be expected to fall off so that the system is no longer under the current pressure. Instead, we are just working as hard as we can. The men and women in emergency departments around the state are working as hard as they can. The men and women working in the ambulance service are working as hard as they can to make sure that we deal with the circumstances that have been brought to bear.

The second component of the Hon. Mr Wade's question was with regard to who was present during those meetings while a number of measures were discussed. The honourable member is right to point to the fact that my predecessor, the member for Playford, was working with a number of different organisations to inform the government's response, and that is an approach that I intend to continue for as long as I am lucky enough to hold this position.

I have already reached out to a number of doctor representative organisations, including SASMOA and, of course, the AMA. I am looking forward to meeting with them shortly. Naturally, I have not had the opportunity to do that. I probably would have been meeting them this week if it were not for the fact that, of course, parliament is sitting. I am looking forward to meeting with those organisations, as I am with all other key stakeholders within the health sector.

I want to put one reflection on the record, albeit in my early days in holding this responsibility, and that is the fact that all these key stakeholders, in their own way, have a contribution to make towards policy development around the health system in this state. There is no doubt about that. Often these organisations, whether they be of an industrial nature or otherwise, are making a contribution to the policy debate in the way they think is not just in the interests of their own members but of the system generally, and I think that approach is to be commended.

However, it is important to put on the record that, in my view, there is no one single stakeholder that can lay claim to ownership of the system or ownership of good public policy. Each of these organisations will have a different view and it is my job as health minister not necessarily to serve them per se but to make sure that we are working together to serve the interests of who the health department is here for—and that, of course, is patients. First and foremost, the people that we are here to serve are the patients that present day in and day out to the health system across our great state.

There is an extraordinary number of presentations that occur day in and day out that operate smoothly and effectively through the collaborative effort of all those different interested parties. I want to work with all of them. I have reached out to a large number already and I look forward to meeting many more over coming days, weeks and months.

They all have a valuable contribution to make, but it is important that we all work collaboratively to make sure that we are not just looking out for the interests of one particular stakeholder over another, but rather make sure we are doing everything we can to ensure that the interests of patients in South Australia are best represented with good quality public policy in the area of health.