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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2008-09-25 Daily Xml
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HOSPITAL EMERGENCY DEPARTMENTS

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (14:40): My question is to the Minister for Health. Why did he claim that, as a result of the government-funded advertising campaign, there had been a 7.1 per cent reduction in presentations at emergency departments when today emergency department doctors have refuted the minister's claims and confirmed the lack of government resourcing for emergency departments? Today, on ABC Radio, Mr Tony Eliseo from the Royal Adelaide Hospital said:

Certainly, the figures that we have show that access blocks have never been worse. Certainly, this week at one of the major hospitals, there were 81 patients in the emergency department which only has 41 beds, and 41 of those 81 patients were admitted and waiting for an inpatient bed.

He went on to say:

Even though the government has come out and said that this media campaign which was put on television earlier this—well, in the last few months which I—which have repeatedly shown, these media campaigns have been shown not to have any impact at all on access blocks. That's what has frustrated us, that we hear that there has been a reduction in presentations and I've looked at the September figures for the—well, for one of the major hospitals in this state for September last year versus September this year, and there has been only a one per cent change in the number of people waiting to be seen.

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:42): The Deputy Leader of the Opposition asked why I said yesterday that the advertising campaign had reduced the number of attendances at emergency hospitals by 7 per cent. I did not actually say that. What I said was that a range of factors contributed to there being a 7 per cent reduction over the winter months in emergency departments. Those factors included our advertising campaign, and I will get into the detail of that. That is what I said yesterday, and we always have to work from the basis of truth, Deputy Leader of the Opposition—always from the basis of truth.

Members interjecting:

The Hon. J.D. HILL: Read the Hansard. I said yesterday that there had been a decline in the presentations to emergency departments in city hospitals over the winter months, that is, June, July and August, but not September.

Ms Chapman interjecting:

The Hon. J.D. HILL: You asked the question, and I am answering it for you. It will take time, however, as you have to go through the building blocks to get to the point you want to be at. We talked about winter, which is June, July and August, and not September, which you and he quoted. I said that, over those three months, there had been a reduction of 7 per cent in presentations to emergency departments.

The causes were: first, there was less flu around this year compared with last year (which I said yesterday); secondly, more elderly people have been vaccinated, more people over the age of 65 have been vaccinated; and, thirdly, we had put in place a $35 million Hospital at Home package to help people who had chronic disease and those who were subject to falls and were 'frequent flyers', as the health system refers to them, that is, people who are in and out of emergency departments all the time. We are dealing with more of those patients in their homes, so fewer of them go to hospitals. Fourthly, we had an advertising campaign, which operated over the month of August.

In relation to the advertising campaign, I said that the figures showed that there was a 16.5 per cent reduction (95 patients a day) in the lower urgency categories—that is, categories 4 and 5—attending hospitals during the month of August.

Mr Hamilton-Smith interjecting:

The Hon. J.D. HILL: The Leader of the Opposition says that the doctors did not agree. He was talking about the month of September. I was talking about the month—

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: Let me talk about September.

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: The deputy leader's question was based on the assumption that somehow or other I was misleading the parliament and misleading the house. I made the point that I was talking about the winter months of June, July and August. Our advertising campaign had a profound effect on the presentations of lower urgency cases in the month of August. We stopped the campaign at the end of August and, as a result, I assume that the presentations have gone back to normal levels.

If there has been a decline in presentations in September this year compared to September last year, that is a good thing, too. I would wish that it were more than 1 per cent but, if it is 1 per cent, that is an improvement on previous years. We know that, year on year, presentations at emergency departments across our hospitals have continued to go up, so we are doing everything we possibly can to get those presentations down. What the doctor was talking about today was not about presentations: he was talking about admissions. Our advertising campaign was not focused on admissions: it was focused on presentations. However, I am happy to inform the house what we are doing in relation to creating greater access to hospital beds.

Primarily, the main thing that we have done, and will continue to do, is to open more beds. Since we have been in government, over the last six years we have opened approximately 250 beds in the metropolitan area, and our building program—including Flinders Medical Centre, Lyell McEwin and the Marjorie Jackson-Nelson—will create an extra 250 beds. We have also undertaken, as part of the enterprise bargaining arrangements with the doctor's union, to put on an extra 20 emergency doctors across our emergency departments.

In addition to that, we have made commitments to them to set targets for the throughput of patients going from the emergency department to being admitted. For example, the initial target is for 50 per cent of people being admitted within two hours of admission and 70 per cent being admitted within four hours of admission, building up over the next 12 months so that 99 per cent of people are admitted within eight hours of the admission request. We are working on that immediately so that, within 12 months, we have 90 per cent of people admitted within four hours. So, they are stretch targets. They are difficult targets for us to reach, but it relies on our reforming the way we manage emergency departments.

For example, the Flinders Medical Centre—with a $153 million rebuild—is having a rebuilt emergency section which will increase capacity from 55,000 to 70,000 emergency department patients each year. We will reorganise that so that the model of treatment used will be similar to the model that is now used in London hospitals. As I have told the house before, we sent some clinicians over there to have a look at how that should happen. So, we have a range of processes in place to fix the bed blocking.

One of the things that we most need in relation to bed blocking is to find appropriate accommodation for people who do not need to be in hospital. That means greater investment in aged care facilities and greater investment in disability beds. These are areas where we are looking to the commonwealth government for greater resources. We believe that the commonwealth will come to the party on this because, before the last election, the Rudd government—the then opposition—promised to invest more heavily in clearing beds and creating places in the community for people who are otherwise kept in hospital. It is a terrible thing for a person to be in hospital when they do not need to be there. Apart from blocking the bed, it is not in their best interests. So, we are working through all those arrangements.

In relation to the winter strategy, it did work: there were fewer presentations to the hospital. However, it was never intended to fix the bed blockage issue; that is another problem, and we are dealing with that in other ways. We are dealing with it, and we are making progress.

I would say to the citizens of the state that we are very lucky in South Australia to have an excellent health system. In Australia, we have survival rates amongst the very best in the world, from a whole range of conditions. People in our state live longer than most other people in the world. The life expectancy in South Australia is second only to the Japanese, and that is because of a whole range of factors, including an excellent health system.

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