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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2008-11-12 Daily Xml
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ELECTIVE SURGERY

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (14:52): My question is again to the Minister for Health. Did he consider extending the surgical times at the Queen Elizabeth Hospital beyond 3.30pm before contracting Aspen Medical to perform additional elective surgery procedures at a cost of more than $1 million?

On the minister's information, Aspen Medical will be performing 210 elective surgical procedures at the Queen Elizabeth Hospital over the next four months and will be paid approximately $1 million. Surgical teams at the Queen Elizabeth Hospital currently do not start any new cases after 3.30pm, whereas in the private hospitals (currently) they perform similar surgical procedures until 6 or 7 in the evening.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:52): I thank the deputy leader for that question. I will give some basic background and then come to the point of the question. SA Health has contracted Aspen Medical, which is an Australian company, to perform 210 elective surgery procedures over the next four months. As I pointed out earlier, we do about 40,000 or so, so it is a very small proportion.

Aspen has a long history of providing short and medium-term medical care in areas of need in Australia, Asia and the Pacific, working across a broad spectrum, from medical services in remote areas to running an emergency department in Queensland. So, they are a well credentialled, established, properly organised group.

The procedures will be mostly in the areas of urology, plastics and general surgery and will be undertaken at the QEH, as the member said. This hospital has a strong future as a centre for high volume elective surgery, caring for the population of the western suburbs. The procedures will be funded from the extra one-off $13.6 million that the commonwealth government has given the state as part of its campaign to get surgery to patients on the long-term waiting list.

We are under obligation to the commonwealth government to comply with this requirement by the end of this calendar year. That is, essentially, why we have gone to the private market to complete these procedures.

While we are working hard to recruit more surgeons, anaesthetists and emergency specialists, this recruitment will take some time, and we do not want to lose the opportunity provided by the commonwealth through these funds. When the funding was announced earlier this year, I did indicate that we might seek support from the private sector, and I flagged this again in October of this year.

We, obviously, aim to do all of the work in-house and 99 per cent of it is being done that way. However, if it became necessary, I would not rule out using the private sector again. I think we need to be pragmatic about this because we do not want people to wait longer than necessary for elective surgery. If it is a choice between doing it in-house or getting it done more quickly in the private sector, I would go for putting patients first, and I was pleased that the AMA made a similar point. In addition to the extra federal money, of course, the state has put in $55 million over four years from 2006-07 to fund more elective surgery. All this extra money has pushed resources pretty hard.

The result has been a 12.3 per cent increase, or 4,384 procedures more than the number undertaken during the last year of the former Liberal government. That is a big increase over that period of time. In fact, across the public hospital system up to September this year, an additional 2,009 elective surgical operations have been completed compared to the same period last year. There has been a 51.3 per cent reduction in the number of overdue patients between September 2007 and September 2008. I make no apologies for pushing this as hard as we can.

We went to Aspen. We did contemplate going into one of the private hospitals. I note that, during the week, the honourable member said that I should have taken the work to a private hospital. Well, that was an option we considered, but Aspen was a cheaper option, because what Aspen will do is provide us with the doctors who will come into the hospital to work with our existing staff and our existing theatres.

The question about why we do not do it longer is really not the essence of the problem. The problem has been getting staff who can do it in the time frame, that is, before the end of the year. The department, certainly, tried very hard to work with the profession to get the work done in the required time, and it just was not able to be done. We had an issue earlier this year. We thought we would not be able to get through all the orthopaedic work, but the orthopaedic surgeons got together and worked out how they could do it, and they have been doing overtime work and the rest of it.

One of the issues for some of this work—and I think it is in the plastics area; I think the plastic surgeons are getting through their work reasonably quickly—is having anaesthetists available to do the work. I think that, in the case of plastics (I stand to be corrected; I might be wrong in this), Aspen will bring in the anaesthetists and that will allow the plastic surgeons who operate out of the QEH to do that work. I think that with respect to some of the surgical work we are proposing to do, again, the anaesthetists will be there to assist the surgeons in South Australia.

All the detail of this is being worked through. This is a pragmatic approach to a problem. It is a kind of one-off problem in a sense because the commonwealth government gave us extra money to get rid of the long waits. These are patients who have often been waiting for a very long time. Their need is not necessarily urgent. Someone is always coming into the system who needs a procedure done more urgently, so others get pushed to the bottom of the list because doctors quite rightly determine which order patients are treated in, based on need. This funding, in a sense, is creating a separate list of those who have been waiting a long time, and that is why we need to do it in this way.

I do not apologise for doing it. I think it is a pragmatic way of getting the appropriate outcome. I have to say that most of the other states have done similar things, not necessarily with Aspen but certainly using the private sector to get some of the work done.

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