Legislative Council Fifty-Fourth Parliament, First Session (54-1) 54 1 Parliament of South Australia Legislative Council published Question Time Ambulance Ramping Ambulance Ramping The Hon. K.J. MAHER Legislative Council Leader of the Opposition Ambulance Ramping The Hon. K.J. MAHER (Leader of the Opposition) (14:55): Thank you, Mr President. Does the minister accept that if he had immediately acted on the repeated warnings that ramping was the worst it had ever been some of these deaths might have been prevented? Members interjecting: The President Legislative Council The PRESIDENT: Let the minister answer. Members interjecting: The President Legislative Council The PRESIDENT: Leader of the Opposition, please! You asked a question; let the minister answer it. The Hon. S.G. WADE Legislative Council Minister for Health and Wellbeing The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:55): Ramping has been with us for a decade, and this report highlighted—this is the Hibbert report—its corrosive effect. While the report does not find that ramping caused these adverse incidents, the report highlights that ramping is a significant part of the context. Ramping has a direct impact of delaying care and tying up ambulance resources. The report highlights that ramping also has indirect impacts, such as affecting the decision-making of crews who may be less inclined to transport patients to hospital than they should be. The Hon. K.J. Maher Legislative Council The Hon. K.J. Maher: So no responsibility for you? The Hon. S.G. WADE Legislative Council The Hon. S.G. WADE: So what our clinician in front of us, member Maher, the Leader of the Opposition—whatever title he has managed to achieve. The clinician in front of us suggests that the best response to ambulance officers not applying good clinical protocols at the site of the 'treat not transport' or the transports 'against medical advice'—the best way to deal with that is to open a bed. What we say is that we want to manage the system as a whole, and part of managing the system as a whole is not just to rant about beds but work at every part of the patient journey. If we had done what the former Labor government did and after five years of adverse events, averaging 15 adverse events a year—28 in 2015. If we had just continued what they were doing and ignored the need to support our ambulance officers at the roadside—if we ignored our responsibilities to support our ambulance officers, like they did, we would continue to have poor clinical outcomes. Sure, we need to manage the bed stock, but we also need to support our ambulance officers. This is a former Labor government that significantly increased the workloads of team leaders within our Ambulance Service. What that meant was that individual ambulance officers did not feel as supported as they should have been to make decisions. One very immediate action of the Ambulance Service, which I strongly commend them for, was to make sure they strengthen the support they give to ambulance officers in the crews. So as of December, as part of the adverse clinical incidents, they said, 'If you're wanting to not transport a person'—a cert IV ambulance officer or a paramedic—'you need to have that confirmed by a senior clinician.' So 'treat not transport' is when the ambulance officer is suggesting that, in spite of the fact that a call has been made, they choose not to transport the person to hospital. AMA is 'against medical advice', which is when a patient suggests, in spite of the fact you have presented, 'I now don't want to go to hospital.' These are what the report highlighted. These are clinically risky situations. Of course our clinicians are extremely well trained to make those sorts of decisions, but in the context the report says we need to make sure that patient care is paramount, so the decision of the SAAS executive team was to strengthen their policy so that in both those situations that group of clinicians would seek confirmation by other clinicians. This government won't apologise for doing more than one thing at once; we can chew gum and walk. We are going to both support our ambulance officers to continue to develop the world-class ambulance service we have and also run our hospitals.