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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2009-11-18 Daily Xml
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ROYAL ADELAIDE HOSPITAL

Mrs REDMOND (Heysen—Leader of the Opposition) (14:24): My question is again to the Premier. Why has the government not listened to the experts when it comes to rebuilding the Royal Adelaide Hospital? Eminent orthopaedic surgeons, cardiologists, plastic surgeons, oncologists and pathologists, as well as—

Members interjecting:

The SPEAKER: Order!

Mrs REDMOND: —Australian Medical Association office holders have stated:

The state does not need a new hospital, and the RAH's patient accommodation could be upgraded for far less than the ballooning $1.7 billion cost.

Members interjecting:

The SPEAKER: Order! I will not have bickering. The Minister for Health.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:25): Thank you, Mr Speaker, and I thank the Leader of the Opposition for this question. Of course, in the process of deciding whether or not to rebuild the RAH on its existing site or on a fresh site, we sought advice from experts. We sought advice from experts in hospital design—

Mr Williams interjecting:

The SPEAKER: The member for MacKillop is warned.

The Hon. J.D. HILL: We sought advice from hospital experts, planning experts, architectural experts, engineering experts and medical experts. The clear advice—

Mrs Redmond interjecting:

The SPEAKER: The Leader of the Opposition has asked her question. She should at least be courteous to the Minister for Health whilst he is answering it. The Minister for Health.

The Hon. J.D. HILL: The expert advice to government—it was not the government's initiative: it was the expert advice to government—was that we needed a new central hospital in Adelaide, and I will tell members why. The existing hospital, the existing RAH site, as good as it has been over the 50, 60 or more years that it has provided services to the public of South Australia, is deficient in a number of ways, and let me go through those ways for the benefit of the house. First, the hospital is not big enough to provide services to the public of this state for the future. We know as a result of—

Mrs Redmond interjecting:

The SPEAKER: The Leader of the Opposition!

The Hon. J.D. HILL: The hospital is not big enough to provide services for the future of our state. Let me go through those issues—

Members interjecting:

The SPEAKER: Order! The Minister for Health is not engaging in debate. He is answering the question in a straightforward way. He should be heard with courtesy and not have to battle over the top of a barrage of interjections while he is attempting to do so. The Minister for Health.

The Hon. J.D. HILL: Thank you very much, Mr Speaker. This is a very important issue and I think the public and the community deserve to hear the government's position. I am trying to do that in an objective way and for the benefit of all members of the house. For the benefit of the opposition and the public, I am going through the issues that are problematic with the existing hospital site.

First amongst them, and not necessarily the most important, is the size and capacity of the existing hospital. It is not big enough to continue to provide services to our population as it grows. We have modelled the demands on the health system over a period of time—a 10-year plan—and we have analysed what is required to deliver health services to the public of South Australia by the year 2016. What we need to do is create an extra 250 beds in Adelaide for the public of South Australia. We are investing in extra beds at Lyell McEwin and the Flinders Medical Centre, but we need more beds at the Royal Adelaide Hospital. We see in the media from time to time stories about people who have not been able to move from the emergency department into a ward because there is a shortage of beds. We accept that is the case and we need to create extra capacity in the relatively short time between now and 2016. It is impossible, in our view, to properly create that extra capacity in that time frame on the existing site.

However, it is not only a matter of beds: it is a matter of the other parts of the hospital as well. The emergency department at the RAH is at capacity now. It cannot be expanded on its existing site. There is no room for it to move at the existing site. That is not something I say: that is what the emergency doctors tell me. That is what the experts tell me. We know that we need greater emergency department capacity. I think at the moment the capacity of the hospital is around 60,000 or 65,000 patients a year: it needs to be increased by 25 per cent. The new RAH on a new site will allow us to create an emergency department which will be able to treat that number of emergency department patients each year.

We also know that there are not enough intensive care unit beds at the existing hospital. They were upgraded a little while ago and they are not in bad condition, but there is not enough of them. You cannot expand the ICU section of the hospital at the moment on the existing site because it is landlocked. We need to increase—

Mr Pisoni interjecting:

The SPEAKER: The member for Unley is warned!

The Hon. J.D. HILL: We need to increase the amount of intensive care unit capacity by about 35 per cent. In addition, there is not enough capacity in the operating theatres at the hospital, in two ways, both in the number of operating theatres and also the size of the operating theatres. We need to increase the number of operating theatres from about 35 to 40 and, in addition, we need to increase the size of the operating theatres to enable doctors to perform the sorts of surgical procedures that will be more and more frequent in the future, and that means more technology and more people clustered around the patient during the procedure. That is what the experts have said to me, and that is what the experts have said to the government.

So, that is the first point: we need more capacity at the hospital. That is the prime reason for building on a new site. If we had extra land adjacent to the hospital we would be able to build on that land. The hospital is on a very small site, about 5.6 to 5.9 hectares. There is no room on that site to expand. On the railway site there are 13 hectares of land. We will build a hospital which will have a floor site of about eight or nine hectares, which will give us about five hectares of additional capacity to expand.

Mr Goldsworthy interjecting:

The SPEAKER: The member for Kavel is warned!

The Hon. J.D. HILL: The second point about the existing Royal Adelaide Hospital, which members may not be aware of and the public may not be aware of, which is absolutely vital, is that the services that are provided to the hospital, through electricity, gas, water, air conditioning, all of those services which are underground, out of the way, and cannot be seen, need to be replaced. The technologies that are required for running a new hospital into the future are not capable of being properly placed underneath the existing infrastructure. All of it needs to be taken out. The advice to me from the experts is that it is impossible to get the certain parts—

Ms Chapman interjecting:

The SPEAKER: The member for Bragg is warned!

The Hon. J.D. HILL: The infrastructure needs of the hospital cannot be readily addressed. The difficulties of getting access to those services, and even having sufficient space in there to put the new resources that are required, are just not there. The opposition's proposition, which was released today, as best I can read it, does not even go into that issue; they would leave the existing infrastructure arrangements in place. This is a serious deficiency in the hospital.

The third point I would make about the existing RAH is that it was developed over a period of time. Historically, decisions were made to place certain parts of the hospital in the positions which they are. It is not a planned hospital any more. It is a collection of bits which have been added together in an ad hoc way, a random way, and as a result of that it is a very inefficient hospital. It means that people have to walk across vast areas of territory to get to various parts of the hospital. It is an inefficient hospital.

On the advice to me from the experts, we would save, in terms of the recurrent cost of running the hospital, between $50 million and $100 million a year by having a rebuild. That is a significant saving, which means that we would have extra resources to put into health in our system.

The final point I would make relates to the question about what the experts say. I have spoken to the experts at the hospital. The head of the cancer unit at the hospital supports what we are doing. The head of intensive care at the hospital supports what we are doing. The head of the emergency department supports what we are doing. The head of surgery at the hospital supports what we are doing.

There is one group of doctors who do not support what we are doing. They have a political objective. They have said in public that they will run a campaign, they will form a political party, and they have said that they will give their preferences to the Liberal Party. That is what this is about. There is a political party being established, which will preference to the Liberal Party, that consists of a small range of doctors who are opposed to what we are proposing. Certain elements of the AMA, selectively quoted by the Leader of the Opposition—and the AMA is a broad church—support the RAH, and certain elements support what we are doing. So, it is misleading in the extreme to say that the AMA supports the propositions that the Liberal Party has put forward.

When you look at the propositions that the Liberal Party put forward today, one can only come to the conclusion that the Liberal Party is confused about what to do in relation to this hospital. When Mr Hamilton-Smith was the leader of the opposition he came up with three propositions, which he said he would consult the community about. They have now come up with a fourth proposition. I do not recall seeing this proposition put out for community consultation in any forum whatsoever. They have now come up with a—

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: The Liberal Party has now come up with a fourth proposition, which includes a 15-storey building on the site, which, as I understand it, would be outside the planning regime of the City of Adelaide. It would make it difficult for helicopters to land on the building. They are also still promoting a 12-storey building right at the front of the emergency department, where the car parking is now. It would mean that the emergency department would be inoperable for the entire time that that construction was to take place.

Anybody who has been to the RAH will know that the entrance to the emergency department at the moment is difficult enough to access. If you build a 12-storey building at that entrance, it would mean that the emergency department would be almost incapable of being used. In addition to this, a month ago on ABC Radio, on the Matthew Abraham and David Bevan program, the spokesperson for the opposition on health, Dr McFetridge, the member for Morphett, said that the Liberal Party plan was to build, for $1.4 billion, this particular hospital. Today, the Leader of the Opposition came out with a half price—

Mr Pisoni interjecting:

The SPEAKER: Order, the member for Unley!

The Hon. J.D. HILL: I'm sure we can find a cell in one for you, member for Unley. The opposition's plan today is for a $700 million rebuild. This is not saving a billion dollars; this is magic pudding kind of economics. This is not saving a billion dollars; what this is doing is not completing the job of rebuilding the RAH. It is a putting a small amount of investment in there. If they honestly believe that they can get, for $700 million, the things that they say they would put on that site, they are seriously confused and deluded.

You cannot build a 15-storey building and a 12-storey building and put car parking underground for 1,500 cars for that sum of money. This is magic pudding economics. The opposition is either seriously confused, seriously deluded, or they are deliberately misleading the public of South Australia.

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