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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2013-03-21 Daily Xml
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CRIMINAL LAW CONSOLIDATION (AGGRAVATED OFFENCES) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 21 February 2013.)

Mr ODENWALDER (Little Para) (11:12): I rise to oppose this bill, but in doing so I have to say that the government agrees with the member for Waite's statement that hospitals can be difficult working environments and that the staff within hospitals can obviously face enormous pressures. In fact, I have seen it myself on many occasions in the emergency department of the Lyell McEwin. I have also seen at firsthand prisoners of the police, taken to hospital essentially for their own wellbeing, physically assaulting and more generally abusing hospital staff who are merely trying to provide medical help.

This is the reason for the government's decision earlier this year to extend the scope of prescribed occupations under the Criminal Law Consolidation (General) Regulations 2006 for the purposes of the CLCA. The regulations which came into effect on 10 March 2013 now include the following occupations: medical practitioner in a hospital; nurse or midwife in a hospital; persons assisting a medical practitioner, nurse or midwife acting in the course of his or her employment in a hospital.

This means that offences committed against persons acting in the course of those occupations will be treated as aggravated offences, and in fact are now. These regulations, I believe, address the majority of the concerns highlighted by the member for Waite and addressed by his bill. It is, however, important to note that the member for Waite's bill does include other occupations and other medical settings beyond those included in the current regulations.

It is my understanding that the government intends to continue its discussions with the medical profession as to whether there is good reason to further extend the regulations beyond that occurring earlier this year. The government prefers to approach this issue by regulation and for that reason opposes this bill.

Dr McFETRIDGE (Morphett) (11:13): I rise to support the member for Waite's bill. As the shadow minister for mental health and in my former role as the shadow minister for health, can I say how much admiration I have for our doctors and nurses in South Australia and all the ancillary staff who work in our hospitals and health services, for the work they do, the hours they work and the stress they are under. If you want to see the stress they are under, just go to the government's own websites and have a look at their own dashboards and see how overcrowded our hospitals really are today. Even this morning we were 14 mental health beds short in our major public hospitals.

Where are those mental health patients? The majority of them are stuck in EDs. The pressure that our doctors, nurses and health workers are under should not be in any way separated from the fact that people should be treating all members of society in a civil fashion and not wanting to assault them, but sometimes things do get out of hand. People with mental illnesses frequently react in ways that are completely unacceptable.

If they are unaware of the consequences of their actions through mental impairment, that is a particularly special case. But if there are people who are just angry, aggravated people who think that their wants and wishes and their will should reign supreme, and the way of achieving that is by intimidation, threats and bullying, that is not on. It is certainly not on with our health professionals when they are trying to do their very best to make sure that all South Australians receive the best health care possible.

This is the sort of legislation that we hope would not be necessary—but it is necessary. We need to have deterrents in there. We need to show these people who think that they can intimidate, bully (and bash in some cases) our professional workers and override the respect we have for them—whether it is the police, firemen, doctors, nurses, teachers and the whole range of people we value so much in our society delivering special services—that it is not going to be tolerated.

If it means that we are going to impose harsher penalties and that fines and terms of imprisonment are going to be changed, then that is not a bad thing to do. I think this government needs to look at its law and order policies and priorities and support the people who are, in many cases, a most vulnerable part of our society—and that is dealing with sick people.

I spoke to a lady yesterday whose son was in the Flinders Medical Centre emergency department for about six hours on Sunday night. She said that it was so overcrowded that people were waiting in ambulances and all the areas were full. People were getting angry and frustrated at the delays and the wait—and that is a different problem for this government to solve. However, there is no excuse for people who are frustrated and angry at waiting to take out their frustrations, anger and impatience on the people who are trying to do their very best to make sure that they are brought back to the peak of health.

This legislation is vital legislation for South Australia inasmuch as we need to attract doctors, nurses and ancillary health professionals to our health service in South Australia. We cannot always pay the very top wages that you see in other places, but if we can offer conditions where they know they are going to be respected and protected that is something we should be doing.

The government says that it is going to bring in regulations and change the legislation and keep talking—well, we have been hearing that for 11 years. We have been hearing excuse after excuse. We have been hearing plan after plan. Yesterday, we heard the Minister for Mental Health announce a quick investigation into mental health beds. I know for a fact, because I have been tweeting it since they put up the dashboards—and it has to be two years and might even be three years now—that there is just a rolling crisis in our health system. Look at the dashboards and you will see that the emergency departments are in the white and red zones most of the time.

The white zone is 125 per cent capacity or more. Any health professional will tell you that our hospitals are full at about 80 per cent capacity. The former minister for health said, 'No, 90 per cent capacity is fine.' If we could keep them at 90 per cent, that would be fine. It would perhaps even become acceptable with the care that our doctors and nurses are giving, but it is not happening. We are seeing every day on the government's own website that hospitals are overcrowded, that there are delays, and that there are completely unacceptable situations arising.

As a result of the government's inability to manage the health system, we see patients who are impatient, angry and upset and who think that they should be able to get their way, jump the queue and have some different sort of service by taking it out on the doctors and nurses and other health professionals. Any sort of verbal or physical assault is completely intolerable, and that is why this government should not just be saying, 'We are going to look at other legislation; we are going to have more discussions.'

That is too bad if you are at the A and E at the Royal Adelaide and some mental health patient or aggrieved drunk gives you a thump and then you are out of action and cannot do your job treating the many other people who have been waiting there patiently. It is not good enough for the government to say that it can delay. Those circumstances are happening. We saw the number of code blacks that the member for Waite raised, and I know that those figures are being fudged by this government. We know that there are lots of issues out there.

When we look at the patient safety reports that have been released, they no longer list the numbers of deaths and serious fractures as a result of falls in our hospitals. It will be interesting to see what happens with the single rooms at the new Royal Adelaide Hospital where the number of nurses to look after patients is going to increase. Are we going to see more angry patients, and more angry family members, because people are not getting the treatment that we would want them to have because of the increased numbers of staff required? It is going to be an interesting picture to watch.

The vast majority of people going through our public health system appreciate doctors and nurses, but we need to make sure that there are avenues and deterrents in place—which the member for Waite is trying to get through with this legislation—so that people who do overstep the line are dealt with as swiftly as they should be. Let us make sure that there is a deterrent and, also, that they are going to be treated in the way they would like to be, that is, those who do the right thing are treated well and those who do not pay the consequences.

I ask the government to look at this bill and make sure that they can say within their own hearts and minds that opposing, delaying, discussing or amending is the way we should be going. I think the member for Waite has done the right thing. He has brought this good legislation here and we should be doing something about it, and doing it now.

Mr GARDNER (Morialta) (11:21): I will endeavour to be brief to give the member for Waite the opportunity to respond before the allocated time is up. It is important for me to speak in favour of the Criminal Law Consolidation (Aggravated Offences) Amendment Bill, both from the perspective that I have in mind the many hundreds of healthcare workers and healthcare professionals who live in the electorate of Morialta, as well as a number of my family members who work in that field and have done historically.

The fact is that in our South Australian hospitals we have had over 5,000 code black events reported at metropolitan hospitals from the period 1 July 2011 to 30 June 2012—over 5,000, that is an extraordinary number. As the member for Waite has reported, it is probably significantly under-reported. I note the Stanley-Banks Adelaide University study which found that:

...individual desensitisation to violence in the workplace, nurses considering violence to be a part of the job, presence of mitigating and/or contributing factors, fear of retaliation from management/superiors and lack of support from hospital administrators...

This has led to the fact that nurses were often reluctant to report violence. So, that figure of 5,000 code blacks could, in fact, be significantly under-reporting the case. This bill will create an aggravated offence for many acts against healthcare professionals in the same way that there are aggravated offences against spouses, domestic partners, on-duty police, prison officers and so forth.

The added subsection in the bill requires that the victim was, at the time of the offence, acting in the course of his or her duties as a health practitioner at a hospital or health service, or an ambulance or a paramedic officer, and the offender committed the offence knowing that the victim was so acting.

The nature of the increased penalties, for example, are: unlawful threats to kill or endanger the life of another is increased from 10 to 12 years; unlawful threats to cause harm to another is increased from five to seven years; causing harm with intent increased from 10 to 13 years; causing serious harm with intent increased from 20 to 25 years; and so on. I think that these are appropriate increases but, most importantly, it sends the message to the community that we are standing with our healthcare professionals in what are, too often, very troubled situations with over 5,000 code blacks a year in our emergency departments.

As the member for Waite said, the bill comes to the house with the sole support of nurses, doctors and paramedics. By lifting penalties and broadening the scope of protection for clinical staff, the bill provides for the courts to sort through the facts and determine any legitimate defences case by case. The bill is necessary, the bill is sought by the medical professionals, the bill is fair and the bill is balanced, and I urge the house to support the bill.

Mr HAMILTON-SMITH (Waite) (11:24): I want to thank all members for their contribution to this very important bill which seeks to protect our doctors, our nurses and our health workers. Can I both express disappointment and also thanks to the government for its response. Firstly, with regard to thanks, can I say that I am pleased that the minister and the government caucus has dealt with the issue. I note that they do intend to take action on the problem by regulation, and they hope that that will go some way towards fixing the issue I have raised, and I think that that is a good thing. Can I also express disappointment that they have not sought to agree with the bill, which I think goes further than the proposed regulations to protect our hardworking medical staff.

In particular, I just want to remind the government that my bill was brought to the house with the full agreement of the AMA, the nurses and other stakeholders in the business of caring for those in pain and suffering, and that it sought to introduce legislation to protect them but also to extend that protection to those other than doctors and nurses working purely in a hospital setting. Can I just remind the house that the AMA, for example, in responding to my draft bill, reminded me that they felt that the definition of a health service should go beyond the hospital to include those health services provided outside a hospital setting.

Doctors visit people's homes and so do nurses. For example, they make the point: what about medical staff trying to treat a partially-intoxicated patient for dehydration or sunstroke at a tourist event or a major event like the Schützenfest? They felt that the scope of the legislation should be broader than just what goes on inside a major hospital. I think they made a fair point and my bill picked that up, and it also sought to consider paramedics and our ambulance officers. It also sought to include people such as I met when I was at Ceduna and went to the Ceduna hospital with the member for Flinders.

We met the Aboriginal healthcare workers working in the dry-out centre at Ceduna, where there is a very effective program for bringing in intoxicated people out of hours and helping them to dry out, etc. There are fantastic staff there, working to care for those people until they are in better shape and working very effectively with the police and the hospital. What about them? They are not in the main hospital setting, in the emergency department, and they also need protection. I am not sure that the government's regulations will extend that far, and that is why I am disappointed that they have decided not to accept the legislation.

I think, too, there is a little bit of one-upmanship here. I first came to this issue as shadow minister for health speaking to the nurses and, particularly at their annual general meeting, they said they wanted action taken. The then minister—the member for Kaurna—said he would do something and I said I would do something. I left it for several months and the then minister did nothing, so I decided to do something and I brought in this bill. Then, having brought in the bill and having brought the issue to the front of mind and got it on the agenda, the government was then spurred into action and has now decided that they will introduce some regulations.

I just say to the nurses and the medical profession that I think this is a reflection of the way the government thinks. They will do things if they feel like it, but otherwise they will only do things if prompted to act, either by some health crisis that appears in the media about emergency departments or elective waiting lists or some complaint from the medical profession or, in this case, by some action from the opposition that spurs them into action. I think that is disappointing because the message it sends is that the government, like a big elephant, will only move if prodded in the backside, and that is disappointing.

If nothing else, I hope that out of this private member's bill that I have brought to the house we do get some action. Can I ask the Minister for Health and the government for the courtesy of being kept informed about the regulations they plan to bring forward. I will brief our party room and we will be watchful. I ask that they consider the arguments I put forward in presenting my bill when they craft the regulations, so that what we finish up with is something that provides for a better working environment for our hardworking professionals to whom we owe so much.

Second reading negatived.

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