Legislative Council Fifty-Fourth Parliament, Second Session (54-2) 54 2 Parliament of South Australia Legislative Council published Bills Bills Inquiry into Palliative Care Bill Inquiry into Palliative Care Bill Inquiry into Palliative Care Bill Second Reading Second Reading Adjourned debate on second reading. (Continued from 27 October 2021.) The Hon. J.A. DARLEY Legislative Council The Hon. J.A. DARLEY (23:33): I rise in support of the Inquiry into Palliative Care Bill 2021. I support the proposition by Labor that with voluntary assisted dying legislation we also need a robust, accessible palliative care system designed to meet people's needs. From those who were worried about the potential slippery slope with VAD, one would expect support for the need for excellence in palliative care to establish choice. I would argue it is a fundamental right of everyone in a humane, compassionate society to have equal access to the resources of a healthcare system, including high-quality palliative care. I certainly support the Labor amendment, that the inquiry can proceed immediately and be completed in a 12-month period to determine any gaps and have them addressed. The Hon. S.G. WADE Legislative Council Minister for Health and Wellbeing The Hon. S.G. WADE (Minister for Health and Wellbeing) (23:34): I wish to indicate that the government would prefer that the time frame established in the House of Assembly was maintained, but I know from speaking to colleagues that there is not support in this chamber for that matter. I think that is disappointing because if the honourable member's desire is to ensure that palliative care is given appropriate priority, as we establish the voluntary assisted dying regime, it makes sense to the government that that inquiry takes place once we actually know what the voluntary assisted dying regime means in detail and how it would interact with palliative care services. But, as I said, the house has indicated its view and I still intend to seek to amend the bill at clause 4(2). The Hon. C.M. SCRIVEN Legislative Council The Hon. C.M. SCRIVEN (23:36): I thank those members who have made contributions. As mentioned in the second reading explanation, the purpose of this is to ensure that we have a benchmark against which to measure palliative care, that we can see where the gaps are and we can see where things are working well and where things are not working well. Therefore, it is extremely important that we have that information as soon as possible. I will speak more to the amendment at the appropriate time, but I am pleased to hear that a number of members will support the amendment which would restore the bill to how it was originally introduced in the lower house by the member for Light, and would ensure that, instead of having a delay where an inquiry would not be completed probably until the end of 2024 and then considered by parliament in 2025, it would happen within the 12 months which the Health Performance Council has indicated it has the capacity to achieve. Bill read a second time. Committee Stage Committee Stage In committee. Clause 1 passed. Clause 2. The Hon. C.M. SCRIVEN Legislative Council The Hon. C.M. SCRIVEN: I move: Amendment No 1 [Scriven–1]— Page 2, lines 4 to 7—Delete clause 2 This clause deletes clause 2, which is in the bill as it has arrived in the Legislative Council. The clause that is currently there, which we seek to remove, is one that would mean that the act would not come into operation until December 2023. As I mentioned briefly in my wrap-up just a few moments ago, that means that we would probably not have the results of that inquiry until the end of 2024, to be considered by parliament in 2025. That is an unacceptable delay. As I mentioned, this is about seeing where palliative care is now and where it needs to be improved, and therefore I commend the amendment to the chamber. Clause negatived. Clause 3 passed. Clause 4. The Hon. S.G. WADE Legislative Council The Hon. S.G. WADE: I move: Amendment No 1 [HealthWell–1]— Page 2, lines 17 and 18 [clause 4(2)]—Delete subclause (2) The amendment seeks to remove clause 4(2) of the bill. Clause 4(2) provides that sections 11(3) and 11(4) of the Health Care Act do not apply in relation to the inquiry established by this act. To remind honourable members, section 11 of the Health Care Act sets out the functions of the Health Performance Council. Section 11(3) provides that the Health Performance Council must, in the performance of its functions, take into account the strategic objectives that have been set or adopted within the health portfolios. One has to ask: why does the Labor Party want to change the normal processes of the Health Performance Council, a council that it established in legislation? Why does it seek to prohibit the Health Performance Council taking into account government policies? The Health Performance Council has a clear role as an independent source of advice, but why does the opposition insist that they not take into account government plans? Likewise, the proposal in the bill is that section 11(4) of the Health Care Act not apply to this inquiry. Let's consider what that clause provides. That clause requires the Health Performance Council in providing any advice with respect to the provision of health services to take into account—again let me stress 'take into account'—the net benefit, the cost-effectiveness, the available resources, the net impact, the value placed on any relevant services. It is unclear for what reason the opposition proposes that these sections should be excluded in this bill. Given that these are the matters that the Health Performance Council is required to consider in all its reporting, why does Labor want to ignore the benefits, ignore the costs, ignore the value? The implication of excluding these requirements is that the inquiry into palliative care could ignore highly relevant government strategic objectives, such as the palliative end-of-life care strategic framework 2022-27, which is currently being finalised. The council would not be required to consider the cost-effectiveness of current services nor the impact on any other important health services. I believe that, if the Health Performance Council is being asked to provide useful advice on palliative care services, to require the Health Performance Council to exclude relevant considerations is to weaken the advice and make it less likely that that advice would be adopted. A key deliverable of the inquiry is to make funding recommendations for, and I quote, 'a world-class palliative care system in Australia'. Making such a recommendation without examining the cost-effectiveness of the service and value for money proposition, which is ordinarily required under all Health Performance Council reviews, potentially sets the inquiry up to make recommendations that cannot be operationalised or are not economically viable. Effectively, it sets the inquiry up to fail. I urge honourable members to support the amendment of the government. The Hon. C.M. SCRIVEN Legislative Council The Hon. C.M. SCRIVEN: I am glad to have the opportunity to respond to those questions posed in the minister's contribution. I draw members' attention to the exact wording of section 11(3) which the minister says should be included: HPC [the Health Performance Council] must, in the performance of its functions, take into account the strategic objectives that have been set or adopted within the Government's health portfolios. So not the plans as the minister referred to, but the strategic objectives. Clearly, that will constrain the inquiry. It will place it within the context of the government's strategic health objectives, rather than being able to present an objective assessment of current services and an objective assessment of what needs to be provided. The inquiry should be as wideranging as possible, not constrained by the current government's health performance. After all, surely it is not what is stated in a plan—with the minister indicating that plans should be taken into account—but what is actually delivered. I therefore encourage members to vote against this amendment and ensure that the investigation inquiry is not constrained. The Hon. S.G. WADE Legislative Council The Hon. S.G. WADE: A very hollow attack. 'Taken into account' is not 'constrained'. If that was the case, if the Health Performance Council's inquiries were constrained by the phrase 'taken into account', then why did Labor establish a white elephant? I also note the fact that the honourable Deputy Leader of the Opposition made no comment as to why Labor wants to exclude benefit, cost, impact and value. The Hon. C.M. SCRIVEN Legislative Council The Hon. C.M. SCRIVEN: I am surprised that the minister considers a response to his queries as an attack; however, be that as it may. I think the relevance is that we want an inquiry that can create a benchmark, they can look objectively at the entire system and see where the gaps are. Once that is established, then we can look at what the next steps are. Of course, by not including this, it does not prevent the Health Performance Council from making reference to any of those things, but what it does not do is constrain it to look at things such as the government's priorities instead of an objective assessment of the system as a whole. The committee divided on the amendment: Ayes	12 Noes	7 Majority	5 AYES Bonaros, C. Centofanti, N.J. Darley, J.A. Franks, T.A. Girolamo, H.M. Lee, J.S. Lensink, J.M.A. Lucas, R.I. Pangallo, F. Simms, R.A. Stephens, T.J. Wade, S.G. (teller) NOES Hanson, J.E. Hunter, I.K. Maher, K.J. Ngo, T.T. Pnevmatikos, I. Scriven, C.M. (teller) Wortley, R.P. PAIRS Hood, D.G.E. Bourke, E.S. Amendment thus carried; clause as amended passed. Title passed. Bill reported with amendment. Third Reading Third Reading The Hon. C.M. SCRIVEN Legislative Council The Hon. C.M. SCRIVEN (23:51): I move: That this bill be now read a third time. Bill read a third time and passed.