Hospital Waiting Lists

The Hon. F. PANGALLO (15:04): I seek leave to make a brief explanation before asking a question of the Minister for Health and Wellbeing about hospital waiting lists.

Leave granted.

The Hon. F. PANGALLO: I have been informed by a leading Adelaide optician that at the Royal Adelaide Hospital there is a waiting list to get on the waiting list to see a specialist ophthalmologist. A constituent, Mr Anthony Di Giovanni, has also contacted me about the frustration and long delays caused by being bumped off waiting lists from one hospital, the RAH, to another, The Queen Elizabeth Hospital, to see an ear, nose and throat specialist. While on an RAH waiting list for over a year, Mr Di Giovanni's ear condition worsened to the point that he suffers from severe vertigo and is at serious risk of a fall. Mr Di Giovanni uses crutches for mobility because of another serious medical condition he has.

On 29 December, his GP wrote an updated referral that was requested by ENT at RAH, highlighting his worsening medical state, but instead of providing a priority placement at the RAH, Mr Di Giovanni was then demoted and transferred to The QEH's non-urgent waiting list.

My question to the minister is: can he provide the number of patients and waiting times, on both urgent and non-urgent lists, seeking appointments with specialists at all our major hospitals? Why are patients like Mr Di Giovanni being juggled between long hospital waiting lists, just to get specialist appointments? Is smoke-and-mirror shuffling being done to make it appear that SA Health's long waiting lists are actually being reduced? Is it correct that hospitals still require referrals, particularly from opticians, to be made using antiquated fax machines?

The PRESIDENT: There are a number of questions there. I am sure the minister will address them as best he can.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (15:06): Yes; thank you, Mr President. In relation to fax machines, it is fair to say that the medical profession is one of the custodians of technology that has long ago been disengaged by other industries, so fax machines are quite common in health services. There certainly is a move towards developing different platforms. Obviously, My Health Record is a good example of that, and in the NALHN area my understanding is that there is work being done on secure messaging. My understanding is that one of the reasons why medical professionals like fax machines is that they do reduce risk.

The honourable member is particularly talking about outpatient waiting times, as he put it, to get on the list. This is an issue that the Liberal team identified from opposition. The former Labor government wouldn't even publish that data. Rather than being held to account, they weren't even willing to tell people what was happening. One of the commitments we made from opposition is that we would publicly report. So from 1 July 2018, SA Health commenced publicly reporting median and maximum outpatient clinic waiting times by specialty and metropolitan hospital.

I highlighted the point about public accountability. I think that is very important, but it's also about consumer information. A consumer, if they know that the waiting list is longer at one facility than at another—and for that matter, if a medical practitioner knows that a waiting list is longer at one unit than at another—it may well affect their choice of location.

In terms of some of the recent progress in services, clinical services across all LHNs have been working to continually reduce their long waiting times for outpatient services. In terms of the period from March 2018 to September 2020, let me give you some examples of progress being made. I will focus on median waiting times.

The honourable member, I think, referred to ear, nose and throat, so he might be interested to know that the Royal Adelaide Hospital outpatient service for ear, nose and throat is reporting that the median wait time for their outpatient clinics has reduced from 44 months to 24 months. It is still too long, but I can tell you 24 is a lot less than 44. In relation to endocrinology at Lyell McEwin, for example, that has gone down from a median wait time of four months to three months.

There is certainly an eagerness to continue to improve our performance in outpatient waiting times, and that's why the department has launched an outpatient redesign program, which commenced in June 2020. My understanding is that it is being led by the Chief Medical Officer, Dr Mike Cusack, who would be well known to members for his exemplary work supporting Professor Nicola Spurrier as one of her Deputy Chief Public Health Officers. Another example of the good work Dr Cusack is doing is the leadership he is providing in that outpatient redesign program.

I know that, both in terms of the initiatives at the local health network level and the initiatives through the outpatient redesign program, one of the key opportunities to improve our performance is to improve the communication between the LHNs and the GPs. The honourable member quite rightly highlighted the relationship between his constituent and the constituent's GP. We rely on GPs to provide ongoing support, obviously, but also to keep us informed about the situation for their patient. A patient who might have been categorised as non-urgent may well become urgent. We rely on GPs to highlight that to us.

One of the other key opportunities being pursued by SA Health is to try to strengthen the partnership between the hospital-based clinicians and the community GPs. Often, it can be through consultation with a hospital-based clinician that a GP is supported to be able to provide the treatment that the patient needs. It doesn't necessarily need to have a hospital-based response. It is also an opportunity to make sure that any pre-work that could be done prior to the outpatient appointment is done in the hands of the GP. The honourable member mentioned ear, nose and throat—

The Hon. I.K. HUNTER: Point of order, Mr President: the honourable minister has been on his feet too long and is no longer making any sense at all.

Members interjecting:

The PRESIDENT: I do have a memory about the length of answers previously in this chamber. I am sure the minister is about to bring his answer to a conclusion, as I do want to get to other questions.

The Hon. S.G. WADE: I am happy to do that. I am just interested that the Labor opposition is less interested in health services than the Hon. Frank Pangallo. Anyway, just to wind up my comments, the point I was making about pre-work is that in the optical area, often you can go to a community-based service, like an optometrist, to get a test done that will be useful for an outpatient clinic.

The PRESIDENT: The Hon. Mr Pangallo has a supplementary.

The Hon. F. PANGALLO: It is, and it was a long way back.

The PRESIDENT: Before I call that, there are one or two devices that seem to be quite noisy in the chamber in recent times and I think we should learn how to turn them on to silent.