HANSARD
SITTING CALENDAR
SEARCH
LIVE BROADCAST
Hansard Dynamic Member Index
House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2025-11-12 Daily Xml
Contents
Xml

Statutes Amendment (Health and Wellbeing) Bill

Committee Stage

In committee.

(Continued from 11 November 2025.)

Clauses 22 and 23 passed.

Clause 24.

Mrs HURN: In relation to clause 24, this took up a little bit of time in the briefing that we had from SA Health, which we were really grateful for. One thing that we had concerns with at first blush was whether the clarification that a person is not obliged provide information requested by a conciliator would result in less information being provided through that conciliator process. We were broadly happy with the feedback that was given by SA Health, but, minister, would you be able to confirm whether you are confident that this change or this clarification will not result in a delay to South Australians getting answers through the Health and Community Services Complaints Commission?

The Hon. C.J. PICTON: The short answer is yes, we are confident. My understanding—I am sure I will be corrected if I am wrong—is that the commissioner currently has a range of powers in terms of being able to ask for information; the conciliator does not.

Technically, at the moment, if there was an issue in terms of the conciliator being able to get access to the information that they needed to undertake the conciliation, then they could go back to the commissioner, get the commissioner to issue their formal request for information, then it goes back to the conciliator. That would all take a lot longer. This would actually hopefully make things shorter in the event that information and that power needed to be used.

Mrs HURN: Minister, can you confirm what types of matters are dealt with by conciliator?

The Hon. C.J. PICTON: I think one of the key elements of the Health and Community Services Complaints Commission is getting predominantly patients and clinicians together. I think everyone understands that in a healthcare system with 50,000 people working and hundreds of thousands of patients, sometimes things will go wrong and there will be complaints that need to be addressed.

In many of those cases, what the patient is most looking for is to be heard and to have the opportunity for the people involved in their health care to understand what impacted them and to learn from it and improve things for other patients in the future. That is obviously one of the key elements of all the commission's work. One of the key elements of what that conciliation would be is bringing together those parties so they have the opportunity to hear and hopefully act on the complaint that had been made.

Mrs HURN: Probably a supplementary to that: noting that this is just one tool that the commissioner has to get to the bottom of complaints, can you just explain what types of cases, what types of complaints, would go through the conciliator process as opposed to the other tools that there are?

The Hon. C.J. PICTON: I think that is up to the commissioner and their judgement in terms of how they would allocate their resources. There is a whole variety of different types of complaints that the commissioner gets. Some, I think, would fall into the category of potentially vexatious or minor issues that can be sort of noted. Perhaps some can be dealt with sometimes by an exchange of letters. Some can be dealt with by way of asking the health service themselves to address it and look into it.

I guess this is sort of the next step up from that, where you want to bring together those parties through the commission. But then there are obviously in the legislation more serious powers that the commissioner has to undertake reports in terms of some systemic issues. I remember a report that the commissioner did, maybe five or so years ago, in relation to what happened at Hampstead in terms of the treatment of some patients there. That is at the higher end in terms of where there are systemic issues that the commissioner can act on.

Mrs HURN: On the same clause, one of the things that came out through the briefing is the fact that the act is silent on the obligation to provide information or not. It was mentioned that that leads to delays in the conciliator process. What are some of the lengths of delays that have been experienced by people trying to get answers through this process?

The Hon. C.J. PICTON: That obviously would be on a very case-by-case basis. I am not sure it is something the Health and Community Services Complaints Commission would have ready access to data on. We will see if that is possible. If that is possible, we will provide it between the houses, but I think that is unlikely to be the case. This is feedback that we have had from the commissioner and the commissioner's office in terms of the need to strengthen these provisions to give more certainty and hopefully streamline this. Obviously, we hope to reduce delays.

Clause passed.

Clause 25 passed.

Clause 26.

Mrs HURN: Obviously, I am happy to ask this question in a different spot, but it just speaks to the establishment of the incorporated health service here. The clause I am speaking to is about the definition. Can the minister speak to what ambitions the government has to establish an incorporated health service and whether you have any services in mind?

The Hon. C.J. PICTON: The short answer is we do not, but we know that this is a feature in other states where there can be health services created that do not have hospitals attached to them. The legislation, as it stands at the moment, is quite specific in terms of hospitals being our local health networks. I think that we are moving into an age where the traditional model of the vast majority of those health services being delivered within a hospital is changing. We are seeing a lot more services being delivered in the community, a lot more services being delivered virtually and given that we were opening up the legislation, we thought it was prudent to add that there could be the ability to establish effectively a local health network but without a hospital attached to it.

We do not have plans to do that at this stage, but we think that it is something that down the track, particularly as we see more and more investment in things like virtual care, My Home Hospital and Hospital in the Home services, our future government might consider establishing a service. The current legislation is very prescriptive in terms of a hospital being attached to those, so to allow flexibility for that into the future, we think that with all the protections and all the board features that would sit around a hospital that the same thing could be applied to a health service that does not have a hospital. Hence this change, which obviously is reflected in a number of different clauses in the bill.

Mrs HURN: What would be the process of establishing the incorporated health service? What type of feedback would you take on board? Would that be led by clinicians? Could the minister talk the house through that?

The Hon. C.J. PICTON: Obviously it is slightly hypothetical, but if it were me I would want to seek feedback on that from clinicians. I would want to seek feedback on that from community. Obviously, if it were an area in which some of those services are currently being conducted within a particular local health network you would want to seek feedback from that local health network and its board as well but, ultimately, that would be a decision for government in terms of how to structure those health services.

At the moment, I have the ability to change our structure of local health networks across the state. I very deliberately have not done that in the 3½ or so years that I have been the minister. I have seen it as important to try to settle the bureaucracy because there has been quite a revolving door of change of how the health service has been organised under successive governments over many, many years. I have viewed it probably as more important to try to get on and improve the service offering rather than changing the governance arrangements.

That does not mean that there might not be a prudent time at some stage in the future to look at that again. There is obviously the ability in the current legislation for that to happen. I do not have any current plans to do that. As I said, I have kept all those 10 local health network structures, boundaries and boards in place over the past 3½ years that I have been the minister so that we have had some level of stability in terms of the governance arrangements for SA Health.

Mrs HURN: Just one more question to round this out, if I may. Has there been any modelling on what type of budgetary impact this might have with the establishment of new statewide services under the incorporated services?

The Hon. C.J. PICTON: No, there has not been modelling undertaken but I would imagine that this would be, in the context of the size of the almost $10 billion health budget, relatively minor. We know that there are currently boards in place. We currently have a governance team that provides support for those boards that is already in place. That would not need to be replicated if there were to be a change in the future.

I think the budgetary impact would be whatever the services are that you are seeking to grow. That is where the cost would be. Taking that example of virtual care services, I think that is something that needs to increase into the future. That is happening not just here but around the country. I think that that increase in expenditure in that area is going to need to happen whether or not you change the governance approach to it. I expect that any governance changes to it would be relatively minor in the context of the cost of delivering those services.

Clause passed.

Clauses 27 to 56 passed.

Clause 57.

Mrs HURN: Clause 57(6), section 93(3)(fd). This one is about confidentiality and some of the proposed amendments there. It states:

(fd) disclosing information to the Minister or persons employed or engaged to work for the Minister for the purposes of the Minister handling a complaint made by the person to whom the information relates (or by their personal representative) about health services the person has received…

Can you confirm, minister, does that mean that anyone who is employed by your ministerial office is able to receive information or is there going to be a certain designated person within your office to handle those matters?

The Hon. C.J. PICTON: Yes, that would be somebody who works in my office rather than a designated person. Let me step back to where this came from. In fact, I just put a post up today about it being 20 years since I first worked for John Hill when he was the health minister. Similar to now, you would get many letters from people in the public. Somebody would write to him and ask for their case to be investigated. The ministerial office would investigate that case and prepare a draft response for the minister of what happened in terms of that person's treatment, care or whatever the issue was.

Somewhere along the way over the past two decades there formed a view on an interpretation of the Health Care Act that, if somebody wrote to the minister, they were not able to then get access to information to be able to respond to it unless that person then separately signed another form saying that they were happy for that to happen. I think this caused considerable confusion from members of the public who thought that they had written to the minister and surely the minister would be able to look into those issues. It added delay in terms of helping people with their issues that they wanted to be resolved.

In the meantime, the chief executive saw fit to provide an exemption under the Health Care Act for the minister to look into issues where that person themselves had raised a complaint or an issue with the minister asking for that to be looked into. What we are seeking to do is to codify that, and I think it is a sensible change. What it would not apply to is the other predominant issue that we get correspondence of, which is if you or another member of parliament or if a person's advocate, carer or a concerned resident raises an issue on behalf of another person. We would then still insist that that person then go back and have a form signed, because we would not be 100 per cent sure that that person had the authority.

However, when it is coming from a person directly, I think that there is clearly an implied permission that they want that issue looked into. Hence, not only the minister personally would need that but also the minister's office. If we do not have that protection in place, then either you have to go through a whole rigmarole around it or the health service and everyone who works for the health service is able to look into it, everyone except for the minister and their office under that interpretation of the legislation. I think this helps to codify what we are currently working with with that exemption. It codifies what most people would regard as common sense and hopefully means that people are able to get their issues looked into in a more expeditious manner.

Mrs HURN: Just picking up on something that the minister said about 'implied permission'. Can you just talk us through that? Say, for instance, if you are at a supermarket—and you would have many people come up to talk to you about the state of the health system at the moment—and you get the name of a constituent or someone from South Australia who has spoken to you in your capacity as health minister, you know their name, would you then be able to go to the health department and say, 'Joe Blow from the street raised this issue with me. Can you provide that information?' Or does it need to be explicitly written and does there need to be a direct request for a case to be investigated? I felt pretty comfortable with it until you said 'implied permission'.

The Hon. C.J. PICTON: I think this section is quite clear in terms of handling a complaint made by the person. If a person is making a complaint and they want that information looked into, to the minister, then this would allow the minister to make sure that they could get the information to look into that matter. I think it is quite a straightforward matter. We certainly are not seeking to extend it beyond the bounds of other people who have not made a complaint to the minister. When there are third parties involved, I think that it is still appropriate that we go through another process as well; but this is a relatively straightforward amendment.

Mrs HURN: Again following up on that, does there need to be a specific request for investigation? You would receive a number of complaints in general, and complaints in general often have a name attached to them. Does there need to be an explicit request for you as the minister to seek information from the department? If someone sends you an email talking about their experience in general but they are not saying, 'Minister, can you please get me an answer as to what occurred?', does there need to be an explicit request for an investigation to happen, or is it just by the nature of getting an email about a complaint in the health system, which you would get from time to time? There seems to be a slight grey area there: is there a form of words that is required, what is the trigger point, or is it just if anyone in South Australia contacts you about the health system, you can follow it up?

The Hon. C.J. PICTON: This is handling a complaint by the person or, what I should have added before, by a personal representative. There is a very specific subclass of those people, which includes a guardian, a medical agent or a substitute decision-maker, so that is very limited. It would not be a matter of writing in and saying, 'We have a complaint that we think that the health system is lousy.' It would be a complaint about a specific issue that they are raising in terms of their care. Obviously, that is the vast majority of cases, and the vast majority of people's expectation when they do that is that the matter will be looked into appropriately, and this will allow that to happen.

Mr TEAGUE: Perhaps an overarching question: this is an amendment to the longstanding provisions applying to a person engaged in the operation of the act. Is there any particular set of circumstances that has caused the government to supplement what is already in the range of exceptions, or has this arisen in response to advice generally? Forgive me if I have missed anything along the way.

The Hon. C.J. PICTON: Perhaps the member the Heysen, I am sure for good reasons, was not here when we were talking about this earlier in that previously there were no restrictions on the minister looking into particular issues, and that happened very regularly.

At some stage in the past few years there had been an interpretation of the Health Care Act made to say that, if you wrote in saying, 'I had a lousy experience in the Mount Barker hospital and I am really concerned about this, minister,' the minister, whether it be me or Stephen Wade or whoever, could not write back unless we sent you back another form asking for you to sign that. That is something that did not used to be in place previously and, because of the additional rigamarole involved in that and what it meant for people's delay in getting the information that they sought and the delays in having their issues addressed, the chief executive has already provided an exemption under the legislation to allow for this specific case to occur. That has been in operation for some time and since we are opening up the act, we sought to codify this and to add this section in there to make it clear.

Mr TEAGUE: It is fair to say the history of the sections does not go back very far, and it has been chipped away at each several years since about 2012. If there is an opportunity while we are opening the act—and bear in mind those of us private members who are engaging in a similar receipt and referral process—is there not merit in extending the provisions that relate to the minister to all of those representatives, including private members, and in turn their capacity to take matters up to the minister?

The Hon. C.J. PICTON: We have not put that in here but I think that might be something to consider down the track in that the other significant point of delay causing issues, in terms of where there are steps involved in addressing people's concerns, is where one of the other 45 of us here will raise something with me and, because of the Health Care Act, we demand that a certain type of form is filled in at that stage. I think most electorate offices are generally okay with that now and are adept at that but it is not uncommon that it is not filled in correctly or there are issues with it and then we have to send it back and go back and forth, and that takes quite a considerable time sometimes.

Down the track could we consider a situation whereby, if a member of parliament has raised an issue, we have enough faith in members of parliament that they have only done so if they have got the permission from somebody and then that would be a manner in which that matter could be investigated, without those additional steps and rigamarole that could well be considered into the future.

I have not countenanced that. What we are looking at here is only where somebody has directly raised their own issue and I think that that makes sense. It certainly does not make sense to people when we were going back to them and adding additional steps for them which delayed following up their issue.

Clause passed.

Clauses 58 to 62 passed.

Clause 63.

Ms PRATT: Minister, following on from your previous answer, I see the language is the same in clause 57(6)(fd) and in the Mental Health Act in section 63. Clause 57(6) (fd) provides:

disclosing information to the Minister or persons employed or engaged to work for the Minister...

Given that this is being inserted into the Mental Health Act, can you explain why anyone other than yourself might require this amendment? When we see people employed by the minister, what would their role and purpose be?

The Hon. C.J. PICTON: This obviously means the people who are helping to handle the complaint, so ministerial liaison officers, advisers, etc., who work in the office. Mighty as I regard myself, I cannot personally write every letter and draft every single letter. I know that is a significant revelation. We do have a team of people who help do that work, which I of course review and make sure I am happy with before I sign it. If you did not have the ability for other people who work in the minister's office to be able to help look into people's cases and provide that advice to the minister, then it basically would be as good as not having the clause at all.

Ms PRATT: Just a clarification on that please, minister: where a number of us have electorate officers, we understand the flow between an electorate office, electorate office staff, ministerial advisors, public servants and the communication that flows between a broad team of people who work for the minister. In reference to the Mental Health Act, what provisions are there that protect the confidentiality of that information being shared with staff? Of course ministers are busy, but this is not housing, it is not roads and it is not infrastructure, so I am looking for clarification: where these pieces of information are going to be about crisis management, what are the protections in place?

The Hon. C.J. PICTON: I have a couple of points. Firstly, people would only have information on a need-to-know basis, and it is only where a person has raised that complaint personally and it has clearly been raised personally with the minister that this section would be activated.

Secondly, people who work in ministers' offices—the same as for people who work in hospitals and the same as for people who work in various other elements of the public sector—have to comply with a whole range of different elements of confidentiality and provisions, whether that be in the Health Care Act or in other elements of public sector legislation. There are significant penalties in place in terms of if people were to misuse that information. So this is quite limited in terms of the scope to which this would apply.

I think a minister's office—similar to a Health chief executive's office and similar to any other minister's office—deals with a lot of personal information about people. The vast majority of other ministers do not have provisions in relation to these sorts of matters. Clearly Health has a higher bar of information, and that is entirely appropriate. There are additional confidentiality provisions in the Health Care Act that do not apply to other agencies, and that is entirely appropriate. They would apply to people who work in the minister's office in the same way that they would apply to other public sector employees in the health system, and everybody needs to make sure that they are very careful about the use of confidentiality and the use of personal information.

That is certainly the expectation for people who work in my team, as I am sure it was the expectation for people who worked when Minister Wade was the minister and as I am sure it was the expectation when you were chief of staff to the child protection minister. I am sure you dealt with some serious and confidential matters in those days.

No matter which party is in government, I think the vast majority of people who work in ministers' offices are very cautious and very careful about the confidential nature of the work that they are doing, and also mindful of the legislative provisions that would be in place if they were to breach that.

Mrs HURN: Just on the same section, can you just clarify, minister, does this relate to people who are employed by SA Health and work within your ministerial office or does it extend to those in your electorate office employed by DTF? Likewise, where does it fit being a media adviser? I am not sure of your exact situation, but the media advisers to health ministers from time to time tend to be employed out of the Office of the Premier. Does this provision extend to only those who are employed by SA Health within your ministerial office?

The Hon. C.J. PICTON: I think I can rule out somebody who works in an electorate office of a minister. I do not think that this would apply to them because they are not engaged by the minister; they are engaged by that local member of parliament. Similar to being the previous government, all the personal staff of a minister are contracted by the Premier and so hence this is in relation to people who are employed or engaged for that minister. That would either be the personal staff under that particular provision of the Public Sector Act that I cannot quite remember at this stage or other public servants who are seconded from the department to work in the minister's office.

Mrs HURN: For ultimate clarification, this is only for people who are employed by the minister not for someone who is employed by the Premier?

The Hon. C.J. PICTON: No. To clarify, all the personal staff are employed directly by the Premier and some would be engaged to work in the minister's office and to work for the minister. Hence, the way that this section has been drafted is for people who are either employed or engaged to work for the minister under whichever of those provisions it is. One other point that I think is worth making is that this is for the purposes of the minister handling a complaint. I think that needs to be stressed very clearly. It is not for a general purpose, there is not a general power here, it is a person who is making a complaint on their own behalf to the minister.

Clause passed.

Remaining clauses (64 to 70) and title passed.

Bill reported without amendment.

Third Reading

The Hon. C.J. PICTON (Kaurna—Minister for Health and Wellbeing) (16:58): I move:

That this bill be now read a third time.

Bill read a third time and passed.

PARLIAMENTARY BUSINESS
MEMBERS
GET INVOLVED
ABOUT PARLIAMENT
VISIT
LEGISLATIVE COUNCIL
HOUSE OF ASSEMBLY
CONTACT