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House of Assembly - Fifty-Third Parliament, Second Session (53-2)
2015-09-23 Daily Xml
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Grievance Debate

Caesarean Section Standards

Mr WILLIAMS (MacKillop) (15:21): Unfortunately the Minister for Health does not fully understand what his responsibilities are, and he certainly does not understand the directives that are issued by his own department. I asked the minister several questions in question time today and he suggested that there is no such directive that mandates that there be four doctors available for emergency caesarean sections in South Australia.

The minister may not be aware of it, but I am sure it is on his department's website. I certainly have a copy of the 'Standards for Management of Category 1 Caesarean Section in SA', dated December 2011. Under the heading of Policy, in large print, is 'Directive: compliance is mandatory’, and it goes on:

These standards have been developed in accordance with contemporary professional, quality and safety standards and establish the minimum standards for the provision of health services for management of a Category 1 Caesarean Section in hospitals in South Australia

On the same page, it continues:

Applies to: All SA Health Portfolio, All Department of Health Divisions, All Health Regions …

It specifically names in the list Country Health SA. Page 12 of this 20-page document, spells out the list of staff that are required for a Category 1 emergency caesarean section to meet this standard.

There is no doubt following the minister's response to my questions today that this government is quite happy to have one set of standards apply in metropolitan Adelaide, one set of standards to look after the mothers and babies in the electorates that are represented by members who sit on that side of the house, and another set of standards that apply to those people who live in electorates represented by members on this side of the house. Country South Australia is yet again being treated as a second class community. I repeat that this directive states that the standards have been developed in accordance with safety standards.

I also have an email from the Director of Strategic Medical Initiatives, Country Health SA, who says that to suggest that this is a safety issue is strongly refuted by Country Health SA Local Health Network. What sort of a world do we live in where we have Health SA develop a standard to underpin the safety of mothers delivering babies in hospitals in South Australia, and yet we have Country Health SA, whose sole responsibility is to deliver those same services in non-metropolitan South Australia, say, 'We don't have to abide by that standard, notwithstanding that the documentation says that it's mandatory and it applies to us, and we don't accept that it's a safety issue'? I hope the minister will read these words that I am putting on the record right now, speak to some people in Country Health SA and ensure that the delivery of services in country South Australia is of the same standard as in metropolitan South Australia.

I note today the minister said that the doctors in Naracoorte (in my electorate) only provide emergency cover for obstetric services three weekends out of four. I am reliably informed, under the negotiations that have been going on with Country Health SA, that most of the items of differences have been clarified. One of them is that the doctors will indeed cover services four weekends out of four.

The other point I really want to make is that in country communities, in hospitals like the Naracoorte Hospital where the work is performed by local practising GPs, somewhere between 30 and 35 per cent of patients who go into those hospitals go in as private patients. The minister himself said today, 'We are quite keen to have private patients in public hospitals because it provides a revenue stream.' Somewhere between 30 and 35 per cent of patients in the Naracoorte Hospital are private patients, providing a significant revenue stream to Country Health SA.

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