Outpatient Services

The Hon. R.P. WORTLEY (14:50): My question is to the Minister for Health and Wellbeing regarding outpatients. In view of the minister's announcement over the weekend, including pushing long-wait outpatient referrals back to GPs:

1. Will a patient who is referred back to their GP be removed from the outpatient waiting list?

2. How many patients currently on the outpatient waiting list are expected to be referred back to their GPs?

3. If the patients are referred back to their GPs but an appointment never happens or the GP disagrees, will people retain their place or go to the back of the queue?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:51): I thank the honourable member for his question. The honourable member might assist me in remembering his litany of questions. I think it is important to stress that the hospital system expects that people will stay engaged with their GPs. That is an assumption in the health system because we rely on GPs to continually monitor a condition and that, if it becomes accentuated, the hospital is alerted. That is a really important part of clinical urgency.

What the statewide audit is seeking to add is not imposing GPs on the process but is, in relation to a particular cohort, asking the clinicians to undertake a clinical review. Let me stress: this is the patient's own GP. I am advised that a minority of clients are on the waitlist for more than three years. We are inviting the patients who are in that category to go back to their GP. It won't affect their position on the list. It's just good clinical practice.

It will ensure that the clinical information is up to date so that we can correctly categorise the patient. Not only might symptoms have worsened and therefore the clinical urgency needs to be upgraded but it might have gone the other way. Symptoms might have dissipated and the GP says to himself or herself, 'Perhaps a referral to an outpatient clinic is no longer necessary.' I think one of the real values of encouraging people to stay engaged with their GP is the active management of cases. It supports appropriate referral pathways.

For example, it has been suggested that more patients could come clinic-ready to a clinic if they took the opportunity to have some of the preparatory work done by non hospital-based services. For example, with eye problems, one of the screenings that can be done in a hospital can also be done by optometrists. If a client in that class is alerted to that opportunity, it will actually facilitate their progress through the clinic.

Perhaps even more important in terms of ongoing management of the case is care in the meantime. These clients we are particularly highlighting are those who have been on the list for three years or more, and many of them may well benefit from care while they are waiting. For example, they may benefit from a home modification. They might benefit from physiotherapy. I am confident that this clinical review, with more active management of cases waiting, will lead to better outcomes for patients and it will facilitate their progress through the outpatient progress.

I appreciate that the Labor Party wants to highlight the problems in the outpatient waiting lists. This was a problem that they ensured was invisible because they studiously avoided publishing outpatient waiting times. We committed to publishing outpatient waiting times. We did that within months of being elected and we continue to do it. That is really important information for both clinicians and patients. If you know that the average waiting time for a particular clinic in a particular hospital is significantly longer than other clinics in other hospitals, perhaps you might seek to be referred to another hospital. If you know that under a Labor government you are facing a 16-year wait—

The Hon. D.W. Ridgway: How long?

The Hon. S.G. WADE: Sixteen years. The maximum wait time for an outpatient clinic under Labor was 16 years. We have brought that down by 40 per cent. But this project, this statewide clinical audit, indicates that we are determined to continue that progress so that South Australians can get the care they need.

The PRESIDENT: Supplementary arising out of the original answer, the Hon. Mr Wortley.