Question Time

Royal Adelaide Hospital

The Hon. K.J. MAHER (Leader of the Opposition) (14:17): I seek leave to make a brief explanation before asking a question of the Minister for Health and Wellbeing about hospital safety cover-ups.

Leave granted.

The Hon. K.J. MAHER: Yesterday, the minister admitted that he knew about a serious clinical safety issue at the Royal Adelaide Hospital, but chose not to inform the public. Today, it has been revealed that other surgeons had been using the same operating theatre that the infections occurred in and that these surgeons may not have known about this issue. My questions to the minister are:

1. Why did the minister make the decision not to inform the public about this issue?

2. Under what circumstances will the minister inform the public about serious clinical safety issues in hospitals?

3. Exactly when was the minister informed and how was he informed? Was it via a briefing or was it verbally, and by whom?

4. When the minister was informed last week of these major clinical safety issues, was he also informed that other surgeons may have been using these operating theatres and they didn't know about the infection issue?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:18): I thank the honourable member for his questions. First of all, I think he is quite wrong, or at least premature, to describe this as a major, serious clinical safety issue. I will just remind the council of what has been found. Clinicians at the Royal Adelaide Hospital, as part of their regular clinical governance processes, have maintained data in relation to the outcomes of their surgeries. What they noticed, as I understand it, in early May was that there was starting to emerge a trend in infections. A trend in this cohort can be relatively small numbers.

We are talking about the period from the opening of the new Royal Adelaide Hospital in September last year through to most recently. The data I have been given is that in the period there were 116 orthopaedic procedures. These are particularly hip and knee replacements. During that period, four patients were identified with infections out of that total of 116. That correlates to an infection rate of 3.45, which is significantly above the 1 per cent that you would expect, and it is monitored through the National Joint Replacement Registry.

I would make it clear to the house that the cause has not yet been identified. Considering we are talking about four in 116, I am advised that, considering it's such a small number, there is the potential for a part, if not all, of the impact to be statistical variance. CALHN is taking this—

Members interjecting:

The PRESIDENT: Order! Let the minister answer.

The Hon. S.G. WADE: CALHN is taking this matter seriously.

Members interjecting:

The PRESIDENT: Let the minister answer.

The Hon. S.G. WADE: What the clinicians did, quite responsibly, is they decided that the trend in infections needed further investigation. That further investigation is continuing. They have decided to take action to minimise the potential risk without knowing what the cause is. I think that is highly responsible. It is what we expect clinicians to do in a situation like this. CALHN—

Members interjecting:

The PRESIDENT: Order! Let the minister answer.

The Hon. S.G. WADE: CALHN (Central Adelaide Local Health Network) is reviewing the process end to end. This includes every aspect of the process, including instrument sterilisation, design features, scrubbing up procedures and so on. They have also taken a step to maximise patient safety by ensuring that infection prevention and control requirements are met within the areas where this surgery is performed. As a precaution, in recent weeks orthopaedic surgeons have postponed elective hip and knee replacement surgeries at the Royal Adelaide Hospital. That is a precautionary step. While the trend in infections is being investigated, I think it is quite responsible for the clinicians to take steps to minimise any potential risk.

In relation to the question of the member in relation to a decision to issue a statement, the newspaper this morning was quite incorrect to say that I decided not to make a statement. It has not been suggested—

Members interjecting:

The PRESIDENT: Order!

Members interjecting:

The PRESIDENT: Order! Leader of the Opposition, we do not need commentary. I was very kind allowing you to ask that question, because technically you are not supposed to put press statements in questions.

The Hon. S.G. WADE: The fact of the matter is that health alerts are normally issued by the department or by the local health network or by a particular public health officer. They are not normally issued by the minister. Considering that what is happening here is that clinicians are investigating the causes of a trend in infections, we are yet to know whether this is anything more than a statistical variance, and if there are clinical impacts, what they are. The steps being taken, in my view, are very responsible.