Legislative Council: Wednesday, November 30, 2022


Renal Dialysis Services

The Hon. I. PNEVMATIKOS (15:35): I am going to speak about dialysis in the private hospital system. I have already addressed this chamber on the issue of renal dysfunction and kidney disease from a personal perspective. My own personal journey has allowed me to gain an insight into the dialysis services and treatments available to South Australians that I would not have gained otherwise.

During this process it has become apparent to me that an appreciation is lacking of the limited capacity of services when compared with the needs of patients. The number of people with kidney dysfunction and failure who receive dialysis has been doubling between 2000 and 2020 from 6,400 to 14,600, and this number continues to rise. We do not have either the bed or chair capacity to address current demand, let alone any increase in demand that is forecast, based on the current trends.

The main provider of dialysis services in the state is the public health system. This system is overburdened and financially constrained from providing services to reflect community needs. If we turn our eye to the private system we see a severe failure to meet these needs when it comes to dialysis. In metropolitan Adelaide there are two private Fresenius clinics operating in Payneham and Brighton. They each offer dialysis services for private patients. These two main facilities are the only ones that have a substantive capacity to provide dialysis. Each clinic provides 28 chairs. They not only provide to private patients but also manage a large public patient overflow upon referral from public hospitals and subsidised by the government.

Let us consider private hospitals. A very brief survey conducted by my office identified 18 private hospitals in metropolitan and regional South Australia. None of these hospitals provide dialysis for members of the public who have private health insurance. Only two of the private hospitals that we identified provide intensive care dialysis for those patients who are already hospitalised for elective surgery or urgent treatment that may be unrelated to their kidney dysfunction.

A patient experiencing renal dysfunction, however, requires dialysis regularly in order to stay alive. These hospitals all informed us that patients are referred to a tertiary hospital for ongoing dialysis services. Primarily, they are being referred to the Royal Adelaide Hospital. We have a cooperative arrangement that exists between private and public health systems in this state. Private hospitals are falling short of their duty of care to provide health services to the privately insured members of the community. The function of private hospitals has a direct impact on public ones. The failure of private hospitals has a direct impact on public ones.

I do not want to ignore the fact that private hospitals as organisations have a profit incentive and responsibility; however, they are still running a hospital, and a hospital exists to provide care. Health decisions and services to the community are of just as much importance to a private hospital as they are to a public one.