Elective Surgery

The Hon. S.G. WADE (14:42): I seek leave to make a brief explanation before asking questions of the Minister for Health in relation to elective surgery.

Leave granted.

The Hon. S.G. WADE: Elective surgery activity is currently facing three significant events reducing activity levels. The window of reduction in elective surgery activity has been compounded by the ramp down of the Royal Adelaide Hospital and now the upcoming closure of the Repatriation General Hospital. The number of people overdue on the elective surgery waiting list has increased sixfold in the last three months. At the end of June, there were 174 people overdue on the list; now there are 1,000. At the Royal Adelaide Hospital, almost half of the 79 urgent elective cases are more than two months overdue. My questions are:

1. When will hospitals return to normal elective surgery workflows?

2. How is the government going to address the backlog, which they have created by their mismanagement of the transition to the new Royal Adelaide Hospital?

3. Does the government accept that its decision to move the Royal Adelaide Hospital at the peak of the flu season is contributing to the unacceptable delays, and will it reassess the wisdom of closing the Repatriation General Hospital next month?

The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse) (14:43): Let me thank the honourable member for his question, particularly the first half of his question. The first half of his question was absent of rhetoric that was inflammatory and lacked fact. The second half of the honourable member's question is harder for me to thank him for because, of course, he couldn't help himself but insert a whole bunch of rhetoric and things that weren't true. So, I am going to deal with the second component first and then I will come to the first component of the honourable member's question.

The second component of the honourable member's question tried to suggest that somehow there was a disaster as a result of the NRAH move. I'm not too sure what NRAH move the honourable member was witnessing because I think the whole of South Australia—including probably the honourable member, in his heart of hearts—witnessed an NRAH move that was largely probably one of the smoothest significant logistical undertakings that this state and this country has ever seen.

I have to say that, at the time of the NRAH move, I was watching it unfold in my capacity as a cabinet minister, having no particular connection to the health system. I was rather anxious about it because I was acutely aware from the briefings we had received at a cabinet level of all the effort and all the work that was associated with such a significant logistical undertaking, vis-a-vis all the risk that was associated with it. I am sure my other cabinet colleagues were watching this with a degree of anxiety as well. When it all happened, and it happened almost—

The Hon. I.K. Hunter: Flawlessly.

The Hon. P. MALINAUSKAS: —flawlessly, it happened in accordance with plans and we saw all the hard work that had been put into that move being realised in an exceptional outcome for South Australians generally. We were all applauding it, but not the Hon. Mr Wade. He was disappointed that he didn't see things going wrong in one of these significant logistical undertakings. So, when I hear the Hon. Mr Wade say things like, 'It was a disastrous move,' or, 'Bad for public policy'—

Members interjecting:

The PRESIDENT: Order!

The Hon. P. MALINAUSKAS: —I think it is quite unbecoming of the opposition to be looking at it this way. The second part of the honourable member's question referred to the fact that it was a bad decision to move to the NRAH. We know what the opposition really think about the NRAH generally: they wish it didn't exist. They wish that the NRAH didn't exist and that everybody there was still currently holed up in a facility that was in excess of 100 years old, not built for the purposes of a modern health system and in rooms where they were sharing with many other patients, as distinct from having their own rooms.

The Hon. J.M.A. Lensink: Sharing a room—oh, my goodness!

The Hon. P. MALINAUSKAS: I'm sure the Hon. Ms Lensink has private health insurance and one of the reasons—

The Hon. T.J. Stephens: I'm sure you do, too.

The Hon. P. MALINAUSKAS: Yes, I do but I'm not complaining about members of the public getting the same level of health care as other people who make a conscious decision to have private health insurance. I believe that members of the public—

Members interjecting:

The PRESIDENT: Order! Minister, take your seat.

The Hon. J.M.A. Lensink: Have you ever worked in a hospital?

The PRESIDENT: The Hon. Ms Lensink, I know you get very passionate about these issues, but I would ask you in question time to allow the minister to answer his question without a tirade across the chamber, and the Hon. Mr Stephens, that does go for you as well. Minister.

The Hon. T.A. FRANKS: Point of order, Mr President: the minister was actually directing accusations and assumptions to the Hon. Michelle Lensink about whether she had private health insurance instead of addressing his response through you.

The PRESIDENT: I will just say that he asked that question during a tirade across the floor, so your point of order is out of order. The honourable minister.

The Hon. T.A. FRANKS: Point of order, Mr President: I dispute your ruling that all speakers do not address—

Members interjecting:

The Hon. T.A. FRANKS: I will come back with a standing order. You know that we address remarks—

Members interjecting:

The Hon. T.A. FRANKS: Mr President, I am trying to address a remark to you and your colleagues are all heckling me.

The PRESIDENT: I like to be consistent—

The Hon. T.A. FRANKS: I will go back and get the number. All remarks are to be addressed to the President, are they not, Mr President? Could you please rule on that?

The PRESIDENT: I'm not going to rule on anything. I told you, I don't accept your point of order. Minister, could you please get up and finish your answer?

The Hon. P. MALINAUSKAS: Mr President, if the honourable—

Members interjecting:

The PRESIDENT: If this keeps going on the way it is going, I will suspend this question time and I will just walk out until you come to your senses. I do not appreciate at all, while I am trying to control some of the behaviour in here, having anyone stand up with a silly point of order. Minister, will you please get on your feet and finish the question.

The Hon. T.A. FRANKS: Point of order, Mr President: I quote:

Every Member desiring to speak shall rise uncovered, in their place or in the place of some other Member who does not object thereto, and address the President; and may advance to the Table for the purpose of continuing the address.

All remarks are to be made through the President. Could you please rule on that, Mr President? If standing order 167 no longer applies, I think this place deserves to know that that is how you are operating.

The PRESIDENT: Minister, continue your answer.

The Hon. P. MALINAUSKAS: Thanks, Mr President. The other issue that was raised in the Hon. Mr Wade's question was the suggestion that the timing of the move to the NRAH was a disastrous one. I think most people have seen this extraordinary spike in demand in emergency departments, not just in South Australia but throughout Australia, as a result of an extraordinary flu season. Everyone who has seen that unfold would be very grateful for the fact that the government did indeed make the decision when we did. If the decision wasn't taken to move from the ORAH to the NRAH when we did, then we would have seen this extraordinary spike occurring with less capacity than what we currently have.

Everybody knows, despite some of the mistruths that have been disseminated from some members opposite, that the capacity of the new Royal Adelaide Hospital exceeds the capacity of the old Royal Adelaide Hospital, including in the emergency department. I, for one, am glad that the government made the courageous decision that we did to move at the time we did, despite interference from the opposition, because that has enabled the state public health system to cope far better than would otherwise be the case with this extraordinary spike in demand that we have seen taking place.

The PRESIDENT: The Hon. Mr Wade has a supplementary.