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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2023-02-23 Daily Xml
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Public Works Committee: Flinders Medical Centre Imaging Expansion and Repat Health Precinct Geriatric Evaluation and Management Service Development

Mr BROWN (Florey) (11:11): I move:

That the 21st report of the committee, entitled 'Flinders Medical Centre imaging expansion and Repat Health Precinct geriatric evaluation and management service development', be noted.

The submission from the Southern Area Local Health Network in the Department for Health and Wellbeing (SA Health) proposes two public works: firstly, a major expansion of SA Medical Imaging services at the Flinders Medical Centre and, secondly, a comprehensive expansion and refurbishment of the Repat Health Precinct's Tarin Kowt building. These two projects are key components of the broader Southern Area Health Direction, a transformational strategy to significantly expand access to health services, respond to current and future clinical demand and address outdated infrastructure in Southern Adelaide. The total capital value of these two initiatives is $48.75 million.

With approximately 600 beds, Flinders Medical Centre is the largest hospital providing services to the southern metropolitan area, with its ED being one of the two major trauma centres in South Australia. The hospital offers a range of acute inpatient, outpatient and allied health services and is uniquely a whole-of-life hospital, providing specialist neonatal services through to palliative care. The Southern Area Local Health Network is observing an increasingly ageing population and an increase in health conditions associated with an older demographic. The Flinders Medical Centre is suffering subsequent strain on services that these projects will help to alleviate.

SA Medical Imaging delivers specialist medical imaging services in metropolitan public hospitals and in select regional hospitals and health services. Currently, it provides services in Flinders Medical Centre and is the only quaternary hospital providing medical imaging to patients of all ages. Previous works in 2020-21 expanded the hospital's emergency department but did not provide any additional support to cater for the subsequent impact on imaging services.

The submitted plans outline a major expansion of SA Medical Imaging services in radiology and nuclear medicine, adjacent to the outpatient clinics on level 2 of Flinders Medical Centre. It will provide additional CT, MRI and ultrasound capacities and introduce a new positron emission tomography (PET) scan service. PET is the standard imaging for oncology diagnosis and cancer treatments. These works are costed at $22.75 million.

The proposed expansion of SA Medical Imaging services will significantly benefit all South Australians. The additional equipment will deliver an estimated 60 per cent increase in CT scans and an estimated 110 per cent increase in MRI scans per year compared with current service levels. An additional 3,000 ultrasound booking slots will become available to patients.

The installation of the PET scan facility is a major improvement for the people of the southern suburbs. Currently, this service is only offered at the Royal Adelaide Hospital. The expansion will create more efficient patient flows through the emergency department, and assist the Flinders Centre for Innovation in Cancer, to provide world-class research and quality of care. To achieve these outcomes, SA Medical Imaging plans to refurbish a former physiotherapy space on level 2 of the Flinders Medical Centre.

The new facilities will provide patient holding bays and dedicated injection rooms for PET scan patients, as well as new CT, MRI and ultrasound rooms. The public works will provide supporting preparation spaces, including patient change rooms, anaesthesia and radiography rooms, a hot lab and supporting isotope store, and a dedicated patient waiting area with reception, staffroom, office and utilities. There will also be two private consult rooms and offices for clinical consultation, clinical workrooms, equipment and medical consumable stores, clean and dirty utility rooms, and secure drug-storage facilities.

The service expansion will be delivered over two stages, to enable the new CT and MRI scanners to become operational and improve flows through the emergency department. Construction for this phase of the project was due to commence earlier this year, and hopefully will be clinically operational by August 2023. The second stage of medical imaging works comprises construction of additional ultrasound rooms and the new PET service suite. Construction for this phase will commence after the completion of the CT and MRI suites, and hopefully be clinically operational by June 2024.

The second public work proposed by the Southern Area Local Health Network is the expansion and refurbishment of the Tarin Kowt building at the Repat Health Precinct, also known as the Repat. Established in 1941, the Repat was constructed by the commonwealth government to cater for returned service men and women. Having recently celebrated its 80th anniversary, the Repat has operated a wide range of high-quality, specialised healthcare services to the community of southern Adelaide. More recently, the Repat has focused strongly on delivering specialised subacute care, including rehabilitation services, care for patients with complex dementia needs and transition care programs.

The Repat site consists of heritage-listed buildings, purpose-built buildings and other facilities ranging in their ability to be repurposed. Between 2019 and 2022, significant construction and refurbishment was conducted at the Repat with a budget of $115 million. The present works are costed at $26 million. The works are necessary to accommodate the transfer of an existing 26-bed geriatric evaluation and management (GEM) service, to be relocated from the Flinders Medical Centre to the Repat. This unit offers specialist geriatric rehabilitation services, providing comprehensive care, assessment and planning for older people in consultation with carers.

Transferring the GEM service will free up acute-bed capacity at the Flinders Medical Centre, with minimal recommissioning required for the current ward. It will move patients from a less appropriate undersized ward to a purpose-built facility, incorporating dementia-friendly design principles in a more homelike environment. A specialist heritage consultant will be engaged to follow the adaptive re-use principles that preserve the Repat's heritage value.

The Tarin Kowt building will be comprehensively refurbished and expanded to accommodate the 26-bed GEM facility. This will specifically incorporate 16 single bedrooms with ensuites, including two for bariatric patients; three double bedrooms for treating couples; and one four-bed high observation bay for patients requiring elevated levels of clinical observation. This will be particularly useful for staff to monitor people prone to strokes or other conditions.

The public works will also incorporate a communal lounge and dining area, a secondary lounge and a private sensory area. Patients will receive rehabilitation and physiotherapy in a gymnasium and allied health space. Staff will work at new stations with line of sight to patient rooms and communal areas. They will also receive new clinical workrooms, offices and a meeting room, a secure medication room, clean and dirty utility spaces and equipment stores.

SA Health recognises that providing a facility with good environmental qualities will provide a positive environment and workplace for staff and patients, supporting better healthcare outcomes and improved wellbeing. Similarly, it is appreciated that a facility that consumes less energy, reduces waste and encourages re-use of resources will provide benefits in reduced costs and environmental impact.

The project team have established formal processes to ensure that ecologically sustainable development strategies are incorporated into the project during all phases. SA Health confirms that engagement and consultation have been key themes during the concept planning stage, and consultation with various stakeholders will continue throughout the construction period.

The committee has examined written and oral evidence in relation to this project. Witnesses who appeared before the committee were: Ms Kerrie Freeman, Chief Executive Officer, Southern Adelaide Local Health Network; Mr Mark Filipowicz, then Acting Executive Director Infrastructure, Department for Health and Wellbeing; and Mr John Harrison, Director, Building Projects Across Government Services, Department for Infrastructure and Transport. I thank the witnesses for their time.

Based upon the evidence considered, and pursuant to section 12C of the Parliamentary Committees Act 1991, the Public Works Committee reports to parliament that it recommends the proposed public works.

Mrs HURN (Schubert) (11:20): I thank the member for Florey for such a detailed assessment of these two projects that came through the Public Works Committee. Doing so in such detail allows me to touch on some of the points and other remarks I was hoping to make, particularly when it comes to the Repat, because we on this side certainly understand the value of the Repat hospital, unlike those opposite who wanted to flog it off to a private investor. Who was the minister at the time?

Mr BROWN: Point of order.

The SPEAKER: Order! Member for Schubert, there is a point of order which I will hear under 134.

Mr BROWN: I ask the member for Schubert to withdraw that accusation that I wanted to flog the Repat off to private investors.

Members interjecting:

The SPEAKER: Order! Member for Schubert, you may choose to withdraw and apologise.

Mrs HURN: I withdraw and apologise, and I will reframe: unlike those opposite, and the former Labor government, who had a plan to flog off the Repat hospital site to a private developer. As I was saying, it has not quite come to my mind who was the health minister at the time—oh, it was the member for Croydon, the now Premier of South Australia, none other than the Premier.

We on this side of the house, the Liberal Party in South Australia, have always stood up for the Repat. We listened to the calls of so many South Australians who called on us to tear up this contract and bring back health services to the Repat site and save it from sale—and that is exactly what we did. In fact, over 85,000 South Australians signed a petition begging us, urging us, to save the Repat site from private development.

They campaigned outside on the steps here at Parliament House for nearly 200 days; for 200 days these veterans, who wanted to see the Repat utilised for health services, camped outside on the steps of Parliament House, sharing their stories, and heartbroken that their only hope of seeing the Repat saved was the election of a Liberal government in 2018. That was their only option, because the then Labor government had turned its back on the people of the Repat and on their services.

In 2018 we were elected, I am pleased to report. We threw out Labor's plan and took a very different approach. We injected millions into reactivating the Repat into the modern health facility it is today. It is a state-of-the-art health hub with services to care for brain and spinal rehab patients and older mental health and dementia patients as well. It is a fantastic space

To see the Repat—which I believe is genuinely a really important legacy of Steven Marshall and his time as Premier and of Stephen Wade as health minister at the time—and to see these services at the Repat continue to expand is of great importance, not just for those living in the south of the city, in the south of South Australia, but for everyone in the state. To see this come to light really shows what a government can do when it wants to turn its mind to it. I would like to acknowledge as well the former member for Elder, Carolyn Power, who did such a great job in ensuring that the services came back to that site for her community.

On to the Flinders Medical Centre, which as the member for Florey pointed out is one of the largest emergency departments in the state. With the record ramping that we are experiencing in South Australia, it is unfortunately not surprising that Flinders is almost buckling under the pressure, under the weight of ramping in this state.

We have seen the dreadful case of a woman left lying on the floor of the ED, waiting for a bed. We learnt that storage spaces had been turned into beds at Flinders and that broom cupboards have been converted into beds. I think that is an abysmal display of the current state of our health system, so when we look at these types of projects that are coming on line I do hope that this can alleviate some of the pressure. We are naturally keen to support services like this, the medical imaging expansion, particularly in the hope that it can alleviate the pressure.

I would like to read out some of the things that are part of the report. As part of this program, we are going to be seeing more MRI. We are going to be seeing improvement in the bed block, which I think is fantastic, and it will also be providing equipment to assist the Flinders Centre for Innovation in Cancer with research and quality of care.

With all of that in mind and the hope that it will really improve ramping in South Australia, hopefully it will improve the patient experience and ensure that people are not forced to lie on the floor waiting for a bed in the emergency department at Flinders. With those remarks, I certainly welcome the progress through the Public Works Committee. I thank the member for Florey for his lovely presidency of that committee and for putting all the detail onto the house's record.

Mr BROWN (Florey) (11:26): I would just like to thank the member for Schubert for her contribution. Whilst I did not necessarily agree with all of it, I thought it was good of her to give everyone a bit of a historical perspective on what she thinks has happened at the Repat and also for her to speak so highly of what this government is doing to invest further in better services at the Repatriation General Hospital and the Flinders Medical Centre. With those words, I commend the report to the house.

Motion carried.

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