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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2012-06-12 Daily Xml
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EMERGENCY DEPARTMENTS

Mr HAMILTON-SMITH (Waite) (14:52): My question is to the Minister for Health and Ageing. Have the minister's statements to parliament that problems linked to overcrowding at emergency departments and the ramping or diversion of ambulances are restricted to Flinders Medical Centre been factual or correct? The minister told the house on 15 May in relation to emergency department overcrowding and ambulance ramping at Flinders Medical Centre that:

All of the other hospitals seem to manage without the problems that are occurring at Flinders.

However, Dr Tony Eliseo of the SA Faculty for Emergency Medicine told ABC radio on 21 May:

I know that at the Royal Adelaide Hospital and at the Lyell McEwin, in the last year, we have also had to ramp patients.

And doctors have announced just this week that due to overcrowding concerns at Lyell McEwin, linked to the minister's decision to axe 18 mental health beds, ambulances may be ramped forthwith.

The Hon. P.F. CONLON: Point of order. It was rather a lengthy explanation—

An honourable member interjecting:

The Hon. P.F. CONLON: No, I won't because the last part of it was pure argument. Overcrowding linked to those decisions. Now that is pure argument and you cannot expect the minister—

Members interjecting:

The SPEAKER: Order!

The Hon. P.F. CONLON: —not to engage in argument in response.

The SPEAKER: Thank you.

Members interjecting:

The SPEAKER: Order!

Members interjecting:

The Hon. P.F. CONLON: I am not actually appealing to you.

The SPEAKER: Order! Thank you, minister.

Members interjecting:

The SPEAKER: Order! It was a very lengthy explanation.

Members interjecting:

The SPEAKER: Order!

Members interjecting:

The SPEAKER: Order! Minister.

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:54): I thank the member for the question. His question, which contained a considerable amount of argument and interpretation, I will break into three parts.

Mr Hamilton-Smith interjecting:

The SPEAKER: Order!

Ms Chapman: You're not usually a scaredy cat.

The SPEAKER: Order!

Members interjecting:

The SPEAKER: Order! Minister.

The Hon. J.D. HILL: Thank you, and I thank the member for the question. His question, which contained a considerable amount of argument and interpretation, I'll break into three parts. The first part of the question was whether or not I had been truthful in my arguments to the house, and he implied that I had been dishonest by saying that ramping had not occurred in any other hospital. That is the implication of his question.

Mr HAMILTON-SMITH: Point of order, Madam Speaker: there was no such implication put in the question. I ask the minister to withdraw. I simply asked him: were the statements factual or correct? There was no assertion that he had deliberately misled the house at all, so I ask him to withdraw that remark.

Members interjecting:

Mr HAMILTON-SMITH: I ask him to withdraw that word, Madam Speaker. Talking about argument, John—

The SPEAKER: Minister, would you be prepared to withdraw that? It seems to have upset the member for Waite.

The Hon. J.D. HILL: I am not sure what it is that the member wishes me to withdraw. I am just simply making the point that he was implying in his question that somehow or another I had somehow misled the parliament, and I was saying that he—

Mr HAMILTON-SMITH: Point of order: there was no such implication. The question simply asked whether the minister's statements were factual or correct. He may have thought them to be correct, but I can tell you that doctors are of the view that they are not.

The SPEAKER: Thank you, member for Waite. It seems to be a matter of interpretation of the question. So, minister, could you please get on with your answer.

The Hon. J.D. HILL: Let me start again, Madam Speaker. There were three parts to the statement and question that the member made. The first one was whether I was accurate when I stated that the problems at Flinders were only at Flinders or were they elsewhere. Then the member for Waite—

Mrs Redmond interjecting:

The SPEAKER: The Leader of the Opposition, order!

The Hon. J.D. HILL: The member for Waite went on to say that ramping was occurring in other hospitals. I think the implication of that question is that somehow I was inaccurate when I referred to the problems only being at Flinders. Let me address the substance of the question. The issue at Flinders was about the dispute between the Ambulance Service and the ED over the admission of patients into the hospital. That had occurred on a number of occasions, and I attempted to do something about it by asking for a review of that particular set of circumstances, because I said to the house and I said in the media that they seem to be dealing with the problems at other hospitals and this is the only hospital at which it seems to be an issue. That is to do with that certain circumstance.

The second part of the question was whether I was aware that there was ramping at other hospitals. Well, let me address that. We asked the head of the Adelaide hospital emergency department whether or not ramping occurred at that hospital. He told my staff that, no, it did not, it was not the policy of the hospital, and to the best of his knowledge it had not occurred at that hospital. That is the head of the emergency department at that hospital. It may well be that another doctor who worked there has a different view or a different memory, but that is what the head of the emergency department, Dr Geoff Hughes, told my office. That is the circumstances at Royal Adelaide.

In relation to the third hospital, which is the Lyell McEwin, the emergency doctor who has been outspoken in the media, Dr David Pope, is the president of the doctors union SASMOA, and his union had been in the industrial relations court challenging my department's decision to close a number of beds in the southern suburbs and at Glenside, not in the northern suburbs. His application to the Industrial Relations Commission was before the commission from about April. Last week the Industrial Relations Commission dismissed their case and said the department had absolute right to close those beds down.

Bear in mind that that decision was based on something which was published in 2007 (the Stepping Up report) in which there was a trade-off. A number of acute beds closed down for a far greater number of out-of-hospital and in-hospital subacute beds. So that was a trade-off which was agreed to some five or six years ago. The doctors union attempted to stop that. They were unsuccessful. Then, on Friday afternoon, in the media at 5 o'clock, having sent a letter to the head of the Northern Adelaide Health Service during the daytime, which was unclear, Dr Pope said that he was going to take industrial action related to the closure of those beds at the ED.

How you could get the closure of hospital beds at Flinders Medical Centre affecting the ED at Lyell McEwin is beyond me, but nonetheless that is what he said. He has since changed his position somewhat. I have said on the public record, and in the media and in this house, that of all the hospitals in emergency department the hospital that I have most sympathy for is Lyell McEwin. The reason I have most sympathy for Lyell McEwin is because there are more beds to be built at Lyell McEwin. We are in the process of building those beds, and after we have completely finished the expansion of the Lyell McEwin Hospital there will be pressure in the emergency department.

We are trying to deal with those pressures through a whole range of mechanisms which I can happily share with the house, but there is no connection in my mind that I can see between closure of beds at Flinders Medical Centre and the Margaret Tobin Centre and any pressures at Lyell McEwin. There are pressures at Lyell McEwin, but they do not relate to that.

I will just say that it is our intention to work with the doctors and work with their representatives, as we have been doing, to make improvements right across the board, but I say to the house one more time: our emergency departments are amongst the very best performing in Australia. Seventy-six per cent of patients were seen on time up to April 2011-12. That is an improvement on 61 per cent who were seen on time in 2007-08. The national standard in 2010-11 was 70 per cent. We are ahead of the national standard. We are doing very well.

There is more to be done, but it is not so much in the emergency departments; it is in the rest of the hospital and having the flow-through of patients through the emergency departments into other spaces. There is a lot of reform that has to happen in that area and we are working hard at it.

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