Modbury Hospital

The Hon. S.G. WADE (Minister for Health and Wellbeing) (15:05): I seek leave to make a ministerial statement.

Leave granted.

The Hon. S.G. WADE: The Marshall Liberal government is committed to establishing a high dependency unit to support the expansion of services at Modbury Hospital. Since being appointed, I have met twice with groups of clinicians at Modbury to discuss service developments at the hospital. Following those discussions, the government is developing plans to expand in a staged way the range, volume and complexity of surgical procedures at Modbury Hospital.

When the council last met on 21 June 2018, the Leader of the Opposition asserted in a question that I had misled parliament in answer to a question regarding the Modbury Hospital high dependency unit. He contrasted a tabled answer to a question on notice with a statement taken out of context to suggest that I had told this council that the advice I received from my department did not raise concerns in relation to a stand-alone high dependency unit at Modbury. The written answer stated:

I can confirm I received advice from SA Health indicating in the absence of establishing a new intensive care unit at Modbury Hospital, appropriate levels of clinical safety may not be achieved with the establishment of a stand-alone high dependency unit.

That statement is consistent with my earlier statements to the council. On 15 May 2018, I advised the council that:

There was advice from the department that raised concerns about patient safety in relation to an HDU.

I restated that fact on 17 May. In the answer to the question on notice tabled in this place, I confirmed that I have received advice that appropriate levels of clinical safety may not be achieved with the establishment of a stand-alone high dependency unit. The leader has asked about the nature of the advice. For the sake of clarity, I advise the council that the key concerns raised in the briefings were:

the cost of establishing and operating an HDU, both capital and recurrent;

the cost of establishing specialist care to support an HDU;

the ongoing need for patients to be transferred to the Lyell McEwin or Royal Adelaide Hospital for specialist care, following high dependency unit care;

staff may be tempted to manage seriously unwell patients on site rather than transfer them expeditiously to a more appropriate setting;

recruiting staff to the Modbury HDU in the past was problematic, increasing the use of agency staff which may increase the risk to clinical safety;

the potential low volume of patients requiring the HDU may mean clinicians are unable to maintain their skill set to safely care for patients, unless NALHN clinicians rotated between Modbury and Lyell McEwin hospitals;

a small HDU at Modbury Hospital would not be accredited for training by the College of Intensive Care Medicine, making it difficult to attract appropriately skilled staff; and

smaller high dependency units often have worse clinical outcomes than larger units.

I will continue to engage with clinicians to ensure that these and any other issues are addressed as we deliver on our commitment to the people of the north-eastern suburbs to establish a high-quality, clinically safe, high dependency unit at Modbury Hospital.