Health Care (Governance) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 10 September 2020.)

The Hon. C. BONAROS (12:36): I rise to speak in support of the second reading of the bill. Last year I spoke at length on the previous version of this bill, which did not pass the lower house before parliament was prorogued. The main provisions of this bill effectively are the same. The government has chosen not to pursue the conflict of interest provisions, which I spoke to at length in this round of debate, but they are still pursuing other more substantive changes, such as the dissolution of the Health Performance Council, for one. In relation to that Health Performance Council, we continue to have concerns about how the performance of SA Health will be monitored with the removal of the council.

The proposed dissolution is of great concern to the stakeholders we have consulted with to date. The council has provided independent and objective oversight of the South Australian health system since its inception in 2008. With all that has transpired in SA Health, it is our view that it is imperative that there be a mechanism for this oversight. They serve an extremely useful purpose and, if it was abolished, we would not have access to some of the same impartial information that we do now—impartial information such as the report released in July into mental health in South Australia, monitoring access and outcomes.

In September, the council continued its research on institutional racism by releasing a second report auditing South Australian Local Health Networks. That latest report found evidence of very high institutional racism in all local health networks, bar the Women's and Children's Hospital, which returned a moderate score. It is hoped that this very important research will, once again, encourage those boards to make improvements to not only their corporate governance in respect of discrimination and institutional racism but also their cultures. I have seen one of the first reports done in relation to this, which was the subject of evidence provided to a committee; I have seen the government's responses to that sort of evidence.

What concerned me most was that we had a council like this undertaking this most important role, preparing a report, highlighting the incidence of, in this case, racism and discrimination in the health system. I have to say that the government's response to that left me somewhat speechless. It was a couple of paragraphs basically saying, 'We don't condone racism.' Well, that may very well be the case, but you are being told it exists and you are being told that it is rampant in some areas of SA Health. If that is the best response that you can come up with, then that is extremely alarming.

The minister cited the fact that the council met only every four weeks as evidence of its worthlessness. He is happy with alternative checks and balances in place. However, as I have just highlighted, in one instance only, where very solid evidence was provided of a problem that simply has not been addressed, we do not consider a strong case has been made for the council's dismantling in the absence of an equally independent replacement.

I note that new appointments were made to the council in August for six months. Once again, I invite the minister to heed the advice of stakeholders, stakeholders like SACOSS, to put forward an alternative option if this government is insistent on abolishing the current council, an alternative that would incorporate key aspects of the functions and other accountability measures which are at risk of being lost. My door is always open. I know that the minister has made himself extremely accessible and amenable in this debate, and I expect that we will continue those discussions if this bill is to see a smooth passage through this place.

Then, of course, there is the issue of the Mental Health Commission. It is clear the minister does not agree that the commission needs to be enshrined in the health act. We have had this debate as well previously. I think he has said he would rather see it evolve organically over time. In any event, he considers that the most appropriate place for the amendment is the Mental Health Act. My problem with this, I suppose, is that we have not seen any legislation which amends the Mental Health Act and we have had nine months to do so.

The minister has cited the appointment of three part-time Mental Health Commissioners until January 2023 as evidence that the government is taking the commission seriously. However, if the government and the minister are true to their word in terms of taking this seriously, I think there is an expectation that this would be enshrined in legislation with the equivalent powers, independence and resourcing that you would expect that to come with, even if it was not in this bill. I do not think this is a big ask. It is a small ask, and as long as it goes unanswered, I doubt will continue to prevail regarding the government's insistence.

Without stating the bleeding obvious, we have a mental health crisis in this jurisdiction and, dare I say, as a result of COVID we have not seen the worst of it. I do not think we have even scratched the surface. SA is not alone in this. Just yesterday, it was revealed that more than a million—a million—Australians have sought mental health treatment during the pandemic, with ongoing lockdowns in other jurisdictions, especially Victoria, resulting in that number expected to increase dramatically.

Health Minister Hunt responded yesterday to these figures, saying that they were of significant concern, that they are severe and devastating. He said that the Morrison government recognises it is a chilling time for many Australians, with the effects of the COVID-19 pandemic on daily life, and it has taken its toll on the life of many individuals and communities, and again especially Victoria.

Closer to home in SA, Mental Health Commissioner David Kelly has been absolutely scathing in calling for an end to the COVID-19 response legislation and criticising its effects on vulnerable individuals. I do think those comments need to be taken in context, because he also acknowledges that they were made in a very urgent situation.

Much to the surprise of many of us, though, we found out just recently that the commission was not consulted on those measures before we rushed it through this place in April. We all did everything in our power, I understand, to get these laws in place. We all acknowledge the urgency of that situation and the fact that that meant we acted without acknowledging the full impacts of some of those measures on some, particularly our most vulnerable members of the community. That has certainly been highlighted with us now and goes to show the importance of the work that the commission does.

Just four days ago, it was reported that psychiatric consultations with medical professionals and emergency departments have increased so dramatically it is now labelled the 'hidden epidemic'—the 'third wave', if you like. Meanwhile, it is expected to take at least four or five years for the strain of the past seven months to even remotely recover. Our young adults, our unemployed, our rural communities—whose waiting lists are at breaking points—our small businesses, people working from home, carers and our kids have all experienced unprecedented levels of vulnerability during this time.

Our Chief Psychiatrist, Dr John Brayley, acknowledges this. Our three commissioners acknowledge this. Our clinicians acknowledge this. The AMA SA and SASMOA acknowledge this. We need to be doing the same. It is against this backdrop that the government has chosen to not enshrine the commission in legislation but, more importantly, has chosen not to take any action to ensure that it is done in the Mental Health Act, if that is where we consider it more appropriately placed.

I am not confident that allowing South Australians to continue to evolve organically is not without risks in the future and I do not think any of the stakeholders I have met with and spoken to, including some I have mentioned, are any more confident than I am. I have indicated, and again I say to the minister, that I am more than happy to work with the government in relation to getting this bill right, but I think these are the most contentious aspects that we really need to look at more closely.

They are just some of the concerns that have been raised with me, and other members have raised concerns that have been outlined by other stakeholders, which I really think we need to take on board. I think every stakeholder I have spoken to to date has indicated a willingness to work with us, with the government and with the opposition to get this legislation right if it is going to pass this place.

With those words, I do support the second reading of this bill. I welcome the opportunity to have those further discussions with the minister and, of course, the continued discussions with the stakeholders in relation to the concerns that have been raised with us to date.

Debate adjourned on motion of Hon. D.G.E. Hood.

Sitting suspended from 12:49 to 14:15.