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House of Assembly - Fifty-Fourth Parliament, Second Session (54-2)
2021-02-03 Daily Xml
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Women's and Children's Hospital

Mr PICTON (Kaurna) (12:13): I move:

That this house—

(a) notes that the Marshall Liberal government promised to open a new Women's and Children's Hospital in 2024 which is now at least two years delayed;

(b) notes that the government has refused to release the Women's and Children's Hospital Taskforce report and preliminary business case, finalised in March 2019, to hospital clinicians and patient families for feedback;

(c) recognises concerns voiced by doctors and other clinicians at the current Women's and Children's Hospital site about the lack of genuine consultation undertaken by the government on the new hospital;

(d) notes the government has failed to budget for the full cost of the new hospital project;

(e) notes the concern the initial plans for the new Women's and Children's Hospital briefed to Minister Wade last year indicated fewer overnight beds and significantly fewer parking spaces at the new site; and

(f) calls on the government to properly engage with clinicians on the new hospital project, and to deliver a hospital that offers world-class health care for the women and children of this state.

We should all be striving for the best quality healthcare services for the women and children of South Australia. That should be the number one priority for all of us.

Taking that on board, we have been supportive, in principle, of the government's desire to have a combined new women's and children's hospital, something that clearly has been an ambition we have had for some time. Clearly, in the last term of parliament, there were issues in terms of the ability to put that much on the space next to the Royal Adelaide Hospital, but the government, having received new advice in regard to the flight path information, have said that they are able to put more floors on that new site, which should enable the hospital to be built.

However, what we have seen over the course of the past three years is significant secrecy, significant hiding of information from key clinicians, not budgeting this project appropriately, and real concerns that clinicians and families have about what is actually going to be delivered and whether it is actually going to improve services for patients, their families and for the women and children of this state when the new hospital is developed.

I mentioned earlier that this process started in relation to a task force. The government were elected but they did not put a budget around it. They said that they would appoint a task force to work out the cost, to work out the number of beds, to work out the budget and to work out the services that would need to be provided. That task force was ably led by Mr Jim Birch who, as chair of that task force, brought together clinicians and experts and produced a report and a business case that was then set to be released to the public and to clinicians to guide the implementation of this project.

However, it has now been two years since the government received that task force report. We had questions on notice where the government previously committed to releasing that task force report when it was received, but for two years the government has kept secret that report outlining exactly what is needed on that site, exactly what the cost is going to be of the new hospital and exactly what services should be delivered at the new hospital. It is absolutely disgraceful that you would keep that information away from the clinicians, away from the families and away from the people who are going to be involved in the running of this hospital, particularly since you promised that this would be released and promised that this would be public information, including in answers on notice to the parliament.

This is absolutely the wrong approach to be taking when we should be talking to those clinicians and we should be clear about it. There is no reason why that report should be sitting there secretly. There is no reason why that cannot be released publicly so that everybody has the opportunity to see exactly what should be planned and should be part of that consultation.

We have been fighting the FOI process for the past two years to try to get access to that task force report. We do not yet have the task force report. We are currently at an appeal stage with the Ombudsman in regard to it. What we were able to get was a briefing that the minister got in 2019 that talked about some of the costs and some of the services that he was briefed would be part of the hospital.

That brings us to another important factor about this hospital development. This is the biggest hospital development that we have ever undertaken without a price tag attached to it. The government are saying that they are committed to this project but they will not even tell us how much this hospital is likely to cost. They will not put a figure on it. They will not put a figure in the budget.

All we have had in the budget is a down payment figure, whatever that is, of a comparatively small amount of money compared with what the likely cost of this new Women's and Children's Hospital is going to be. That means that the state budget figures essentially are not accurate because they do not account for the full amount over the forward estimates and beyond of the likely costs of this project. The public deserve to know what those costs are.

Clearly, the minister has been informed of estimates in regard to that. In April 2019, the minister was informed that the preliminary cost estimate of the new Women's and Children's Hospital is $1.895 billion, which is a very significant amount of money, particularly when you compare it to other hospitals around the country that are being built and when you consider the number of beds that will be part of the new Women's and Children's Hospital as well. There was a table attached to this briefing that said there would be 337 beds in the new Women's and Children's Hospital at a cost of almost $1.9 billion compared to the Royal Adelaide Hospital, which had 700 overnight and 800 total beds at a cost of $2.4 billion.

So the cost per bed of the new Women's and Children's Hospital is likely to be far in excess of what it was for the new Royal Adelaide Hospital. We all remember the significant bleating and carping that we heard from those opposite about the cost of the new Royal Adelaide Hospital, even though of course we now have a health minister in Stephen Wade who goes and does promotional videos for the consortium of the new RAH, saying what a great, world-class facility it is. It is certainly not what he said when he was in opposition.

The cost of that building per bed is significantly less than what the minister has been briefed the cost of the Women's and Children's Hospital is, which might be the reason he is refusing to release that preliminary business case that was undertaken by the task force two years ago. He is not only refusing to release it to the opposition or the media but refusing to release it to the clinicians, who are the ones who should be involved in the process and the running of this hospital.

The other factor that became apparent in this briefing we obtained under FOI is that what is being planned in terms of the number of beds is substantially fewer beds than are currently at the Women's and Children's Hospital site. If we look at the table that is included, the number of paediatric and adolescent overnight beds, currently at 183, would be set to reduce to 180. Despite the fact that our population is growing, despite the fact that there are more healthcare needs in our community, the government as of this time was planning on fewer paediatric and adolescent overnight beds as part of the hospital.

Then we look at the women's overnight beds, beds for women giving birth in the hospital: currently, there are 70 of those in the hospital. The government is planning a reduction of 10 of those beds. Almost 15 per cent of those beds would go under that $2 billion new hospital. While we are seeing very strong demand across our maternity services across Adelaide, the government is planning to build a new hospital that would include fewer beds for women who need that care in the Women's and Children's Hospital, which is absolutely staggering. Why would you plan such a facility and have fewer services and fewer beds available for people?

The other key factor that became apparent is that there would be fewer car parks available for women, children and their families. The minister was asked about this when this FOI document was released, and his answer was, 'We want people to catch public transport.' If you have a sick kid or if you are a woman who is giving birth, you are not catching a bus to the hospital. You need to be able to get there in your car and you need to be able to park at that hospital. We know that the current Women's and Children's Hospital site already has very significant limitations in terms of car parking. Nurses and patients there have great difficulty in getting a car park, but the government's plan so far is a reduction in the number of car parks available.

Not only do we have a ridiculously secretive process around how much this hospital is going to cost and what it is going to include, not even telling the clinicians that, but the information we have gleaned is that it is going to cost a lot, a huge amount, much more per bed than the new Royal Adelaide Hospital, yet actually deliver less in terms of overnight beds and car parking than what is currently available to it.

This is one of the key factors that has led to an uprising of concern from clinicians, from patients and families at the Women's and Children's Hospital. It has led to the Women's and Children's Hospital Alliance being formed, and I pay credit to Professor Svigos and the other people involved in that alliance. Dr Michael Rice has been a very noted person, a well-respected clinician in our community, and he has also raised concerns. Even Professor Warren Jones—who, obviously, could not be alleged is a supporter of the Labor Party—has been out raising very significant concerns about what the Liberal government is planning.

The clinicians are not being told what is going on, families are not being told what is going on, and they are hearing great concerns. The government is saying they are undertaking consultation, but the consultation being done does not give a level of detail for people to be kept abreast of what is actually being planned, what is actually going to affect them. The clinicians are not being given the detail of what they need due to the secrecy surrounding this issue.

Clearly this is also a hospital that is significantly delayed. The government very clearly, in black and white in their election promise, said that this hospital would be open in 2024. We are now in 2021 and there is no sign of construction starting, there is no sign even of a plan being finalised for this hospital—heck, we do not even have a figure in the budget on how much this hospital is going to cost.

There is clearly no way this hospital is going to be opening its doors in just three years' time. The government is now saying that this is maybe 2025, maybe 2026, maybe it is going to be even later. Clearly, by the government's own admission, it is one to two years delayed with potentially more delays after that. That shows the lack of planning we have had, the significant delays.

It is pretty clear that once the government got that task force report—and it is hard to tell exactly what panicked them without knowing what is in it—they then went into a state of paralysis for a good nine months before taking any action whatsoever on it, before they even engaged some consultants to work on it. Here we have this very critical piece of infrastructure for our state that is going nowhere fast, that has been shrouded in secrecy, and that has massive concerns from the community.

I mentioned Dr Michael Rice, who raised his concerns. He has raised very serious concerns about the cancer services for children in the current hospital, which he, of course, led for many years. The demands on those services are increasing and there are not enough beds available, and what we are seeing here is that there are going to be fewer beds in the future, despite the fact that we know the demand will be increasing—not least because of the work being undertaken at SAHMRI to provide more cancer care for the people of South Australia and around the country.

This hospital does have the support in principle of this side of the house, but we want to make sure it is a hospital that delivers for children, for women, for their families. The government's approach so far of fewer services, from what we have seen, of secrecy, not even telling us the cost, and of significant delays is a real point of concern for all South Australians.

Ms LUETHEN (King) (12:29): I move to amend the motion as follows:

In paragraph (a) delete the words 'notes that the Marshall Liberal government promised to open' and insert the words 'welcomes the Marshall Liberal government commitment to' in lieu thereof; and delete all words after 'Hospital' and insert the words 'co-located with the Royal Adelaide Hospital delivering world-class health care for the women and children of this state' in lieu thereof.

Delete paragraph (b).

In paragraph (c) delete all words after 'recognises' and insert the following words in lieu thereof: 'the consultation strategies being implemented by the Women's and Children's Health Network to consult consumers and clinicians, including $600,000 to support clinician engagement'.

In paragraph (d) delete all words after 'government' and insert the words 'has committed $685 million to the project'.

Delete paragraph (e).

Delete paragraph (f).

I will now speak on the motion moved by the member for Kaurna. Our health system should provide the very best care to patients and this is the goal of the Marshall Liberal government. This motion cannot pass in its intended form as it is yet another hypocritical attempt to distort the reality of what is really happening to improve the Women's and Children's Hospital health services.

As the Marshall Liberal government seeks to avoid repeating Labor's catastrophic transformation of South Australia's health system, it is proceeding with the new the Women's and Children's Hospital project in a manner that will deliver the best quality hospital for South Australians while being prudent with how it spends South Australian taxpayers' money. South Australians, as both taxpayers and health consumers, would expect nothing less.

It has been eight years since Labor announced a new Women's and Children's Hospital and four years since they abandoned their own project. In 2017, Labor broke their promise and downgraded the project to a women-only hospital, stranded indefinitely at the North Adelaide site. In contrast, the Marshall Liberal government has prioritised the new the Women's and Children's Hospital as an important asset and incredibly important services for our South Australian health system.

Here is the reality: in April 2018, the Marshall Liberal government established the new Women's and Children's Hospital task force. The objectives of the task force were to undertake statewide service planning with a view to determine the services to be provided at the new Women's and Children's Hospital, ascertain the approximate size requirements of the facility, conduct site analysis, identify a preferred location and estimated costs of the new Women's and Children's Hospital, and develop a project program.

The work completed by the task force is being used as an important foundation for the new Women's and Children's Hospital planning and will continue to be built upon during the development of the new Women's and Children's Hospital final business case. The task force work informed selection of the preferred site, being adjacent and linked to the RAH, and that the likely completion date would be 2025-26.

Two years ago, there were 398 treatment spaces at the current Women's and Children's Hospital. The Marshall Liberal government has been steadily increasing capacity since it came to government and currently there are 432 treatment spaces at the Women's and Children's Hospital. Preliminary planning for the new hospital has revealed 441 treatment spaces and over 1,215 car parks to be provided, increasing from the approximately 900 car parks at present—an increase in car parking.

If the member for Kaurna wants the new Women's and Children's Hospital delivered sooner, then he must demonstrate how he knows more about building hospitals than the Women's and Children's Hospital task force that expects the project to finish between 2025 and 2026. Although we concede that planning required for the ongoing COVID-19 pandemic has caused a slight delay to the new Women's and Children's Hospital project, this delay is modest compared with Labor's botched new Royal Adelaide Hospital project, delivered years late and half a billion over budget.

The member for Kaurna's motion is an attempt to conceal Labor's poor track record on health through more misinformation. Planning the new Women's and Children's Hospital is not as simple as the member for Kaurna would like it to be. While the new Women's and Children's Hospital preliminary business case provided a preliminary cost estimate, the government cannot settle on this project's final estimated cost until it settles the business case.

Without a fully developed business case, cost estimates rely on various assumptions and project scopes. Accordingly, the Marshall Liberal government will do its homework before delivering the new Women's and Children's to avoid the same cost blowouts, delays and design flaws that Labor oversaw throughout its disastrous Royal Adelaide Hospital project.

A key component of the final business case is assessing opportunities to utilise existing services and infrastructure arising from the new Women's and Children's co-location, the RAH and the Adelaide BioMed City. Co-locating the new Women's and Children's with the RAH will enable shared access to the RAH helipad, as well as the RAH critical care services. Further, several other services are being assessed to ensure that the new Women's and Children's planning captures efficiencies arising from the aforementioned co-location.

Another important factor in the new Women's and Children's planning is the need to accommodate the increased demand for birthing and paediatric outpatient services in Adelaide's northern suburbs, as indicated by population statistics showing that the northern suburbs have some of South Australia's highest population growth rates: 25 per cent of SA's population is expected to live in the northern suburbs by 2026. For these reasons, the new Women's and Children's will be complemented by expanded paediatric services at the Lyell McEwin Hospital, which provides important health services for constituents in my electorate of King.

The Marshall Liberal government is delivering on its commitment to construct a new Women's and Children's, and is delivering better local health services for the northern suburbs residents—including those in my electorate—with significant upgrades underway at Modbury Hospital and the Lyell McEwin Hospital.

Moreover, the member for Kaurna's motion incorrectly suggests that the government has not genuinely consulted regarding the new Women's and Children's Hospital and appears to indicate that the government is broadly uncommitted to delivering on the project. The new Women's and Children's project team is engaging with clinicians, staff and consumers on planning and design to ensure that we build a new hospital consistent with our community's needs.

A robust consultation process formally commenced in August 2020 seeing the establishment of seven advisory groups, approximately 93 project user groups and approximately 18 working groups. Clinicians, staff and consumers are members of these groups, and they provide full input into the project. All clinicians, staff and consumers who sought to be involved in consultation processes were also allocated to one or more user groups.

In particular, the project user groups documented the individual services and how they will be delivered in the future. Furthermore, workshops informing the new Women's and Children's clinical service plan and strategic design brief occurred from August to December 2020. Moreover, the government has invested further in the new Women's and Children's, bringing the current total investment to $685 million, including an unprecedented $600,000 for clinical engagement.

Ultimately, the new Women's and Children's construction will build on the Marshall Liberal government's landmark $1 billion hospital infrastructure program across metropolitan hospitals, which is easing pressure on the state's emergency departments and building better health services closer to the home for more South Australians.

The house must not pass this motion in its current form, as it attempts to distort the reality of the Marshall Liberal government's important progress in delivering on the new Women's and Children's project for all South Australians. When considering Labor's previously disastrous management of our state's health system, the new Women's and Children's project is not one that should be rushed through without adequate planning and consultation.

Our health system should provide the very best care to patients and put the wellbeing of South Australians' lives first at every stage of their life. I thank the Minister for Health and the task force for all the important work in planning they are doing to deliver better health services in South Australia.

Mr PICTON (Kaurna) (12:39): That was a pretty incredible spray from the member for King, and I indicate that the opposition and I will be absolutely opposed to those amendments, which completely, of course, change the meaning and take out any relevance or facts from what was being proposed in this motion.

Let's be very clear on a few points. This government has delayed this project. This was not a time line that I set or that anybody on this side set. This was their election promise. They promised that the new Women's and Children's Hospital would be open in 2024. The member talked about bad planning; well, this was their bad planning, if that is the case—that they said that this would be open in 2024 in black and white in their election promise.

That is now clearly out the window. They are now talking about potentially two years or maybe even more delayed, which is more delays than ever happened at the new Royal Adelaide Hospital, yet this hospital has not even started in terms of one sod being turned yet. This hospital has not yet even got a budget or a plan or a builder or a financial model or any factor that needs to happen, yet it is already two years delayed, and that is all because of them. This was their figure that they came up with.

It is also astonishing that the government are somehow claiming to their credit the fact that they are refusing to release a budget for this project, saying that they do not want to have a blowout. This is the sort of Orwellian idea that you can avoid a budget blowout by not having a budget at all: whatever it turns out is the cost, well that is what it was meant to be. This is not the way that public accountability of finances should work. This is not the way that the parliament should treat public finances. If the government is planning a project, it should have a budget for that project.

It is astonishing that potentially up to a $2 billion project does not have a budget that the government has set. While the member's amendment seeks to note that they will have $685 million committed to the project, I do not think anybody thinks that that is even close to what the cost of delivering the new Women's and Children's Hospital is going to be. The fact is that every day, every month, every year of additional delay to this project is only going to increase the cost for the ultimate delivery of this project. The government are in a neat Orwellian way trying to avoid any potential accountability for their budget blowout because of the fact that they are not even having a budget whatsoever.

In terms of the number of beds and the number of car parks, we see very clearly the only official information that has been released so far is that there are fewer beds being planned—fewer beds being planned for paediatric patients, fewer beds being planned for women and fewer car parks being planned. If the member has other information to dispute that, well, the member should release that information to the clinicians who want to be involved and be working on and understand this project.

Despite what the member says—that clinicians are being consulted—that is exactly the opposite of what those clinicians are saying. Those clinicians are in a furore about the fact that they are not being properly consulted, that the government is not telling them key information about this project. That is why they have gone to the lengths of forming a Women's and Children's Hospital Alliance. That is why we have seen this outpouring of concern from clinicians across the board at the hospital.

The fact that the member says $600,000 has been devoted to the consultation is frankly not nearly enough considering that this is almost a $2 billion project, and we need those clinicians, including senior clinicians, who of course are paid substantial funds, involved very heavily in this project, and they have not been to date—they are not involved.

This is a project without a budget. This is a project that is already delayed against the election promises of those opposite. This is a project that is clouded in secrecy. We did not hear one explanation from the member opposite as to why the government is keeping secret that business case, keeping secret that task force report, both of which the task force developed two years ago. Ultimately, we should be getting those details so that this can be a project that delivers for women and children in this state. Sadly, none of those key factors are in place, and we are very concerned about where this is heading.

Time expired.

Ayes 25

Noes 18

Majority 7

AYES
Basham, D.K.B. Bell, T.S. Brock, G.G.
Chapman, V.A. Cowdrey, M.J. Cregan, D.
Duluk, S. Ellis, F.J. Gardner, J.A.W.
Harvey, R.M. (teller) Knoll, S.K. Luethen, P.
Marshall, S.S. McBride, N. Murray, S.
Patterson, S.J.R. Pisoni, D.G. Power, C.
Sanderson, R. Speirs, D.J. Tarzia, V.A.
Treloar, P.A. van Holst Pellekaan, D.C. Whetstone, T.J.
Wingard, C.L.
NOES
Bettison, Z.L. Bignell, L.W.K. Boyer, B.I.
Brown, M.E. Close, S.E. Cook, N.F.
Gee, J.P. Hildyard, K.A. Hughes, E.J.
Koutsantonis, A. Malinauskas, P. Michaels, A.
Mullighan, S.C. Odenwalder, L.K. Piccolo, A.
Picton, C.J. (teller) Stinson, J.M. Wortley, D.
PAIRS
Pederick, A.S. Szakacs, J.K.

The house divided on the motion as amended:

Ayes 25

Noes 19

Majority 6

AYES
Basham, D.K.B. Bell, T.S. Brock, G.G.
Chapman, V.A. Cowdrey, M.J. Cregan, D.
Duluk, S. Ellis, F.J. Gardner, J.A.W.
Harvey, R.M. (teller) Knoll, S.K. Luethen, P.
Marshall, S.S. McBride, N. Murray, S.
Patterson, S.J.R. Pisoni, D.G. Power, C.
Sanderson, R. Speirs, D.J. Tarzia, V.A.
Treloar, P.A. van Holst Pellekaan, D.C. Whetstone, T.J.
Wingard, C.L.
NOES
Bedford, F.E. Bettison, Z.L. Bignell, L.W.K.
Boyer, B.I. Brown, M.E. Close, S.E.
Cook, N.F. Gee, J.P. Hildyard, K.A.
Hughes, E.J. Koutsantonis, A. Malinauskas, P.
Michaels, A. Mullighan, S.C. Odenwalder, L.K.
Piccolo, A. Picton, C.J. (teller) Stinson, J.M.
Wortley, D.
PAIRS
Pederick, A.S. Szakacs, J.K.

Motion as amended thus carried.

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