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House of Assembly - Fifty-Second Parliament, First Session (52-1)
2011-03-23 Daily Xml
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Question Time

HOSPITAL EMERGENCY DEPARTMENTS

Mrs REDMOND (Heysen—Leader of the Opposition) (14:42): My question is to the Minister for Health. Why has the government failed to deliver upon its election promise of having 95 per cent of emergency department patients seen within four hours when data for the Adelaide Health Service reveals that only 56 per cent of patients, on average, were seen within four hours and, at The Queen Elizabeth Hospital, only 26 per cent were seen within four hours?

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for Mental Health and Substance Abuse, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (14:42): I am very pleased that the Leader of the Opposition would ask this question, because it highlights that the government—this party—has a target to make sure that 95 per cent of patients are seen and treated within four hours—

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: We have a target to make sure that 95 per cent—

An honourable member interjecting:

The Hon. J.D. HILL: Yes, that's right. They've got a small target, they've got a small heart and they've got a small-minded approach to everything in this state. Small, very small, that's what it's about.

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: But this side of the house, Madam Speaker, has a target to make sure that 95 per cent of patients who go to the emergency department are seen, treated and either discharged or admitted into a hospital bed over the course of this government. So, I think it is interesting of course that, at a one-year interval, we should be asked this question. It was never our intention that we would have this achieved in the first year.

Members interjecting:

The Hon. J.D. HILL: They mock, but they have absolutely no substance behind their mocking.

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: If they had a policy which they could go out to the public and defend as something superior to the one that we have, then maybe we could have a discussion about this. We have a target to achieve this and we have done much, which I am more than happy to go through for the benefit of the house, to implement this. In 2005-06, 62 per cent of patients were seen in time in our metropolitan public hospitals. This improved—

Mr Marshall interjecting:

The SPEAKER: The member for Norwood will be quiet.

The Hon. J.D. HILL: This improved to 66.9 per cent in 2009-10, despite there being 11.4 per cent (that is nearly 40,000) more presentations. So we are seeing more people more quickly, getting more attention, through our public hospitals than ever before. This increased to an even better rate of 70.7 per cent achieved by our metropolitan public hospitals over the three busy months of winter last year. As the member said, a key government election commitment allocated $111 million over four years, aimed at ensuring that 95 per cent of patients presented to emergency departments are seen, treated and either admitted to a hospital ward or discharged within four hours by June 2013. This strategy is also aligned to the current national health reform agenda, which the opposition opposes. Strategies to improve access to health services include:

implementing models of care such as acute medical units to support emergency departments, so that patients who will need a stay in hospital can be moved straight into an acute medical unit bed rather than have to wait in the emergency department;

improving access to diagnostic services—we want diagnostic services to operate around the clock rather than just during office hours;

implementing the emergency department information technology system;

improving health literacy;

increasing support for discharge planning;

increasing workforce capacity by employing more doctors, nurses and other staff across metropolitan hospitals. This includes more senior staff after hours, and that is something we have to negotiate with the union representing doctors, because this is a change to their working conditions; and

enhancing access to diagnostic services to support emergency departments.

Capacity across our public hospital system will also be increased by more than 250 additional beds through major capital works at the Royal Adelaide, the Lyell McEwin and Modbury hospitals (of course, the Modbury hospital site was attacked yesterday by the opposition). That is in addition to the extra 200 beds that we have already brought on line.

In terms of reducing demand, measures that have been introduced, or are being planned as part of the Health Care Plan to reduce hospital demand—because it is not only about trying to deal with supply, it is trying to reduce the supply where we can—include:

the development of additional GP Plus healthcare centres and networks at Elizabeth and Marion, in addition to centres already open at Woodville, Morphett Vale and Aldinga;

two GP Plus super clinics are being built at Modbury and Noarlunga in collaboration with the commonwealth;

the payment of additional extended care paramedics to provide treatment to patients in their homes. This is a really important thing: extended care paramedics can go to the home of someone who is ill to treat them there rather than having to take them to an emergency department; and

the introduction of an enhanced range of healthcare packages—

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: —to reduce emergency department attendances. The health advice line, HealthDirect Australia, is also assisting busy hospital emergency departments by allowing South Australians access to high-quality health services over the phone.

The strategies that have been implemented have resulted in some success in slowing the growth in emergency department demand. For example, the annual average growth rate in emergency department presentations between 2004-05 and 2007-08 was 4.9 per cent. If this growth rate had remained unchanged, 401,000-plus emergency department presentations would have been expected in 2009-10. This is 27,325 more than the actual end of year figure of 373,700. In other words, we have been able to reduce growth in demand for emergency departments.

Further, it is projected that there will be approximately 382,600 emergency department presentations in 2010-11, using year-to-date December 2010 results. This is around 38,000 less presentations than if the 4.9 per cent growth had been continued. So we are on track to achieve that target. We are working very—

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: Madam Speaker, we have a target, and we are happy to be judged on how well—

Members interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: —we achieve that target. We have a time frame to achieve that target, we have extra resources to put in to help us achieve that target. What do the Liberals have? They have no target, they have no plan. They have a small target approach, a small mind, and a very small heart.

Members interjecting:

The SPEAKER: Order!

Mr Venning interjecting:

The SPEAKER: Order! The member for Schubert will behave.

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