Legislative Council Fifty-Third Parliament, Second Session (53-2) 53 2 Parliament of South Australia Legislative Council published Bills Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill Second Reading Second Reading The Hon. I.K. HUNTER Legislative Council Minister for Sustainability, Environment and Conservation, Minister for Water and the River Murray, Minister for Climate Change The Hon. I.K. HUNTER (Minister for Sustainability, Environment and Conservation, Minister for Water and the River Murray, Minister for Climate Change) (17:54): I move: That this bill be now read a second time. I seek leave to have the second reading speech and explanation of clauses incorporated in Hansard without my reading it. Leave granted. I rise to introduce the Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Bill 2017. This Bill is in response to the murder of Mrs Gayle Woodford, a dedicated nurse whose life ended in tragic circumstances on 23 March, 2016. Mrs Woodford responded to a late night callout from Dudley Davey for emergency medical treatment. In responding to this call Mrs Woodford was subsequently abducted by Davey and murdered. Understandably Mrs Woodford's murder brought outrage from the community and professional bodies such as the Australian Nursing and Midwifery Association and the Council of Remote Area Nurses of Australia. Health practitioners working in remote areas already face a number of challenges in the environment being the first responder for emergency issues, living in small or very small communities that are often only accessible by four-wheel drive vehicles, and travelling on unsealed roads that at times may be impassable because of heavy rains and flooding. Under these conditions our health practitioners do not also need to be concerned about their own physical health and safety. The Amendment Bill before the House today provides protection to the safety of health practitioners working in health services in the remote areas of the State that are funded by the South Australian Government, or contracted by the Government to provide health services in these areas. When responding to out of hours or unscheduled callouts for emergency medical treatment these health practitioners must be accompanied by a second responder. The second responder will serve the role of accompanying the health practitioner on emergency callouts to reduce the chances of personal attack. These second responders may be local community members, another staff member from the health service or a person from another government agency. Second responders are already in use in remote areas of the Northern Territory and Queensland to accompanying remote area nurses on emergency callouts. The arrangements in these jurisdictions are by policy and not legislation. While this provides additional security for remote area nurses it has raised other issues. A review of remote area nurse safety in the Northern Territory following the murder of Mrs Woodford found that practices had not been formalised or documented in relation to staff safety. Staff surveyed stated that they usually considered the clinical needs of the client before their own safety. This highlights the dedication of our health workforce but this Government is not prepared to place the safety of our health workers at risk. The Northern Territory survey also found that remote area nurses were concerned that if they did not attend an emergency callout they could be legally liable or their registration could be put at risk. The legislation addresses this issue by providing, in the event that a second responder cannot be found and the health practitioner is unable to attend an emergency callout, they cannot be subject to any disciplinary action by a regulatory body. I am told that in the experience of the Northern Territory Department of Health in most emergency callouts a second responder can be found. I would hope that the same can be achieved in this State as the prospect of not attending to an emergency call is not one that is taken lightly by this Government and nor is it likely to be sit comfortable with health practitioners. I note that the Northern Territory survey highlighted that remote area nurses and managers were worried about client outcomes and community responses if the client deteriorated because the nurse died not attend, or if there were delays while contacting a second responder. This legislation will apply to all health services provided in a remote area of South Australia comprising the Anangu Pitjantjatjara Yankunytjatjara Lands, the Maralinga Tjarutja Lands, and those areas that fall outside of a council area, more commonly known as unincorporated South Australia. Should a health practitioner receive an out of hours or unscheduled callout for emergency treatment they will be required to go through a risk assessment to determine whether the service needs to be provided now or can wait until clinic hours. Should the health practitioner confirm that attendance is required on an emergency basis then a second responder will be contacted to accompany the practitioner. The second responder will arrange to meet the health practitioner at a designated point and accompany the practitioner until such time that the callout is completed. In the Northern Territory most second responders are persons from the local Aboriginal communities. The persons are able to provide further information to health practitioners about the local communities which over time increased the knowledge of practitioners working in the remote areas and allowed them to manage community relationships. This model is attractive for remote areas in South Australis and as part of the implementation of this legislation a process will be undertaken to engage with local Aboriginal communities to identify individuals to serve as second responders. I am told that many of the Aboriginal community groups were dismayed with what happened to Mrs Woodford and concerned about what this may mean for health service delivery to their communities. Given this I anticipate that the Government will be able to work closely with these communities to ensure that health practitioners will be able to provide services without fear for their own safety and security. Where second responders are unable to be provided by local communities the role will taken by other health service providers or staff from other government agencies. Health service providers in remote areas will also be required to have policies and procedures in place to ensure the safety and security of health practitioners. Many government health services already have policies in place for persons working alone or in isolation in remote areas. The legislation will require these policies to be reviewed at least every five years. Where the State Government has contracted with another provider to deliver health services in the remote areas the provider will be required to comply with all requirements of this legislation. The work of health practitioners in remote areas can be both rewarding and challenging. These practitioners are responsible for providing essential primary health care services and are the first point of contact for emergency medical issues. They will deal with everything from antenatal care to end-of-life care. Working in remote areas is not inherently dangerous. However, there are a number of factors such as isolation that can contribute to increased risks to health practitioners working in these areas. For those dedicated practitioners that are currently working in the remote areas of this State, and for those future practitioners who may work in these areas, this legislation allows them to work without fear that they may be assaulted or murdered. As I mentioned earlier this legislation has been called for by the community and professional bodies following the murder of Mrs Woodford. There has been no greater advocate than Mrs Woodford's husband who has asked governments and health authorities to implement 'Gayle's Law.' If I may quote Mr Keith Woodford: 'We must act to adequately protect nurses and medical staff in remote areas to ensure the crime that took Gayle away from us will never be allowed to happen again.' With this simple request I commend the Bill to Members. Explanation of Clauses Explanation of Clauses Part 1—Preliminary 1—Short title 2—Commencement 3—Amendment provisions These clauses are formal. Part 2—Amendment of Health Practitioner Regulation National Law (South Australia) Act 2010 4—Insertion of Part 5A This clause inserts new Part 5A into the Health Practitioner Regulation National Law (South Australia) Act 2010 as follows: Part 5A—Restrictions on single person attendances in remote areas Division 1—Preliminary 77A—Interpretation This clause defines terms and phrases used in the proposed Part. 77B—Interaction with other Acts This clause clarifies that the proposed Part is in addition to, and does not derogate from, the provisions any other Act or law. Division 2—Restrictions on single person attendances in remote areas 77C—Application of Division This clause describes the health practitioners, and callouts, to which the proposed Division applies. 77D—Second responders This clause sets out how a health practitioner engages a second responder, and makes procedural provisions in relation to second responders, including a power to make regulations regarding second responders. 77E—Health practitioner to be accompanied by second responder This clause prevents a health practitioner to whom the proposed Division applies from attending a callout to which the Division applies unless they are accompanied by a second responder. The clause sets out what it means for a health practitioner to be accompanied by a second responder. 77F—Limitation of liability This clause limits liability arising out of the operation of the proposed Part. Division 3—Providers of health services in remote areas to have policies and procedures to ensure safety and security of health practitioners 77G—Application of Division This clause sets out persons and bodies to whom the proposed Division applies. 77H—Providers of health services in remote areas to prepare or adopt policies and procedures for the safety and security of health practitioners This clause requires persons and bodies to whom the proposed Division applies to prepare or adopt policies and procedures designed to ensure the safety and security of health practitioners providing health services in remote areas on behalf of the State authority. 77I—Policies and procedures to be reviewed This clause requires persons and bodies to whom the proposed Division applies to review the policies and procedures required under new section 77H in accordance with the regulations. A review must be conducted at least once every 5 years. 77J—State authorities not to contract etc with non-compliant providers This clause prevents a State authority from contracting with providers of health services who are not compliant with the proposed Division, and requires contracts and agreements to contain provisions ensuring the provider will comply with proposed Division 2. 77K—Power of Minister on refusal etc to comply with Division This clause sets out steps the Minister can take if a State authority refuses or fails to comply with the proposed Division, including reporting the refusal or failure to Parliament. Division 4—Miscellaneous 77L—Exemption This clause provides the Minister with the power to exempt a specified person, or a specified class of persons, from the operation of a provision or provisions of the proposed Part. Debate adjourned on motion of Hon. D.W. Ridgway.