Question Time

Ambulance Services

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 regarding ambulances.

Leave granted.

The Hon. K.J. MAHER: A review into ambulance delays within the SA Ambulance Service revealed the system is 'suboptimal' and also 'overwhelmed'. At least two patient deaths were connected with lengthy ambulance response times late last year. This report identified 38 adverse incidents linked to delays occurring over just five months. At the time of these incidents, our three major emergency departments were either full or overflowing, with an average of 17 ambulances ramped outside each of these hospitals. One hospital had 25 ramped ambulances.

The report also revealed an escalation in incidents related to ambulance delays and under-resourcing. Monthly incidents didn't just slightly increase or even double, incidents tripled from 5 September last year to 15 November. My questions to the minister are:

1. Why are adverse incidents related to ambulance under-resourcing and ramping increasing so dramatically under the minister's watch?

2. Does the minister take some responsibility for the two deaths and eight near misses identified in the report?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:18): I think it's important to make the point that the review that the honourable member is referring to was a review that was initiated by the Chief Executive of the Ambulance Service. He saw evidence of a cluster of cases of concern. As always, SAAS was on the front foot and the Ambulance Service undertook a review of the cases. I think that demonstrates SAAS's commitment to constantly improving their service.

I think it's important to keep this in context too. The Ambulance Service in terms of the cluster of cases, which obviously came through the reporting system within the Ambulance Service, involved 38 cases; 38 cases where a delayed response could have led to a poor outcome. That is less than one-tenth of 1 per cent of cases. The Ambulance Service quite rightly, having seen a cluster, saw the opportunity to try to have insight into what may be happening in these cases.

A quarter of the cases involved patients with a poor medical outcome or significant condition. Two of the individuals died as a result of their conditions, but I would make the point that one of those was much later and in hospital. Individuals were significantly sick and it's not possible to say that one thing caused their deterioration, but my thoughts are with the families and with the ambulance crews who supported them.

As I said, the Ambulance Service is a leading Australian ambulance service. My understanding is that it was the first ambulance service in Australia to be accredited. I don't know whether other ambulance services have followed in their footsteps, but that culture of constantly reviewing its operations to ensure quality and safety is part of the culture, part of the DNA, of the Ambulance Service.

The review highlighted a number of issues, including the monitoring of waiting patients. The particular cohort was in the non-emergency cases but it was trying to get a line of sight as to what was happening with patients while they were waiting. It highlighted issues in terms of the monitoring of waiting patients, the priority categorisation of patients and the availability of ambulances. So the Ambulance Service has commissioned the review. The chief executive officer is now ensuring that that goes to the clinical governance committee.

But even while that process is continuing, my conversations with the chief executive are that he is keen to take early opportunities to address the issues that were raised. For example, in terms of monitoring of waiting patients, one of the initiatives of the Ambulance Service under chief executive David Place has been to establish a clinical telephone assessment service. My understanding is that the chief executive is exploring the opportunity for that service to support, if you like, the dispatch role in terms of monitoring the waiting patients.