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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2022-11-16 Daily Xml
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Flinders Medical Centre

Ms HUTCHESSON (Waite) (12:09): I move:

That this house—

(a) notes the vital importance of Flinders Medical Centre;

(b) notes with concern the findings of the Monaghan report, which identified the former Liberal government's proposal to reduce ramping;

(c) commends the Malinauskas Labor government for its significant commitments to expand Flinders Medical Centre's bed capacity, in a genuine effort to fix the ramping crisis;

(d) acknowledges the Malinauskas Labor government's commitments to expand Noarlunga Hospital, reducing pressure from the Flinders Medical Centre to further improve hospital flow; and

(e) further commends Labor's commitments to substantially increasing paramedic coverage in the south, with an additional 32 paramedics across an expanded Marion station and a brand-new Edwardstown station.

In 1983, my brother was born at Flinders Medical Centre and, 20 years later, my son was also born in the same ward. The hospital itself provides care and support for everybody in our community. It is one of the largest hospitals in southern Adelaide and its 5,000 highly skilled staff provide vital medical services for the local community.

The importance of the hospital and the care it provides to those living in the south should not be understated. Its emergency department, one of the busiest in South Australia, is one of the two major trauma centres in the state, providing round-the-clock emergency treatment to thousands of people every year. It is there for our community when they are most in need and is fundamental to providing health care for my electorate of Waite. In 2005, my son, my mother and my grandmother were all taken to the emergency department after a head-on car accident. My uncle and my mother-in-law spent many nights in the care of the team there and, in her final days, my mother-in-law was shown the utmost respect.

The former Liberal government's Southern Health Expansion Plan (SHEP) was an $86 million policy failure. At Flinders, SHEP simply relabelled inpatient beds as ED beds, highlighting a complete misunderstanding of the causes of the ambulance ramping crisis. This was only reinforced when the former Premier, the member for Dunstan, stood out the front of the Flinders ED and claimed that the upgrade would fix ramping almost immediately.

Early upon coming into government in March, an independent report by ED physician, Mark Monaghan, described the strategy as poorly conceived and implemented and was scathing of the unintended consequences. I quote:

This report demonstrated that despite a reduction in average ED presentations of approximately 10% and a reduction in admissions of approximately 20%, there had been a deterioration in:

ED length of stay (LOS) for both admitted and non admitted patients,

the average number of patients waiting for a bed at 8am each day,

the average time between admission request and ED departure,

inpatient LOS.

It is worth commenting that the suggestion that a larger ED would eliminate ramping demonstrates a lack of appreciation of both the causative factors and the whole of hospital ownership of ramping. Ramping remains a consequence and a marker of access block to inpatient beds.

This independent report confirmed that reallocating beds to the ED was a mistake and that the beds should revert back to inpatient use. We have accepted all of Dr Monaghan's recommendations either fully or in principle. Expanding an emergency department is not the silver bullet to fixing ambulance ramping. All it does is create a bigger funnel for consumers who have no inpatient bed to go to.

Under the former Liberal government's watch, we saw ramping drastically increase at a huge personal cost to those needing urgent care and their loved ones. SA Health data shows that in March 2018, the total number of hours it took for patients to be transferred from an ambulance to an ED was 750 hours, but in March 2022 that number rose to 2,712 hours.

Despite such a damning result, the former Liberal government made very few commitments to bolster our hospital infrastructure, our workforce or our Ambulance Service to a level that would make a difference. Our government has made it clear that our number one priority is addressing the ramping crisis we inherited, and we are delivering a generational investment to rebuild the health system.

Specific to Flinders Medical Centre, our government has taken the opportunity to partner with the federal Albanese government for a $400 million upgrade. This will refurbish some of our state's oldest hospital infrastructure. It will deliver up to 160 more beds across Flinders Medical Centre and the Repat, and it will create inpatient capacity that will allow flow through the emergency department. As the first stage of what is generational investment, this upgrade will deliver:

more mental health beds through the upgrade and expansion of the Margaret Tobin Centre, including intensive care and general ward beds;

new, modern operating theatres, increasing the capacity for emergency and elective surgery;

an expanded ICU, which has been under sustained pressure for some time;

expanded medical imaging, upgraded existing services and bringing angiography services in-house;

a brand-new eye surgery clinic, providing much-needed ophthalmology surgery and services such as for cataracts; and

upgraded aging wards and the creation of more single-bed rooms.

While this project is not expected to be completed until 2028, stage 1 has already begun. The Geriatric Evaluation and Management (GEM) Unit is moving from Flinders to the Repat, creating new fit-for-purpose facilities in line with existing services and marking the first enabling works of what will be historic investment into Flinders Medical Centre.

I also welcome the establishment of 24 mental health beds at Noarlunga Hospital. As our understanding of mental health has grown, it has become clear that we do not have the acute services we need to cope with the growing demand. More beds at Noarlunga, particularly beds targeted at complex conditions, mean fewer hospital transfers. Not only will that release some of the pressure from SA Ambulance but it also means those in the outer southern suburbs can get specialist care closer to home while taking some of the pressure off Flinders Medical Centre.

I am also very pleased that new ambos will come online at Edwardstown and Marion within this month, adding 32 paramedics who will be based locally and provide much-needed relief for the existing crews. This motion is an important acknowledgement of the ambitious health agenda that the Malinauskas Labor government has for the southern suburbs, and I want to again pass on my thanks to those frontline workers and healthcare professionals who continue to show up every day while we invest in the resources that they need.

Mrs HURN (Schubert) (12:16): I give notice to the house that I am moving an amendment to the motion as follows:

Delete sections (b), (c), (d) and (e) so that the motion now reads:

That this house—

(a) notes the vital importance of Flinders Medical Centre.

I do thank the member for Waite for putting forward this motion. It is very clear that this motion was put forward at a time when those opposite on the backbench were full of hope and optimism that they were part of a government that could actually deliver when it came to health in this state, but self-congratulatory palaver is not going to hide the fact that this government has not delivered a single thing when it comes to health in South Australia.

We know that our health system is under unprecedented stress, and in fact the government is failing to turn the dial one iota. I thought it would be interesting, for the benefit of the house, to go through a bit of a track record of the Labor government's time in office to date. Ambulances, our patients and our paramedics have been stuck outside our hospitals on the ramp for a total of—wait for it—24,189 hours, and that is just in the first seven or so months. That is the equivalent of more than two years; in fact, it is nearly three years.

The past seven months of this government have had the highest ramping on record each and every month ever in the history of South Australia. As I mentioned earlier, we know that our health system is under extraordinary pressure; in fact, I have stood in this place saying that, when the former government left office, it was very clear that we had much more work to do—much more—but we were always up-front and honest about the challenges that we faced in the health system.

Flinders, in particular, is under so much strain that there have been multiple safety reports conducted by the SA Salaried Medical Officers Association under the Work Health and Safety Act. There are two that I am going to refer to today, again for the benefit of members and particularly those opposite. On 25 May 2022, there was an inspection at Flinders. I will refer to some comments made in this report by SASMOA:

The EPH [which is the Entry Permit Holder] were advised by the doctor that in the doctor's view it was the worst day they had ever seen.

This is on 25 May. There is this one:

The whole staff were totally stressed and anxious as they were unable to do their job. This stress was made worse by the constant bombardment from the hospital executive to clear the ramp at the expense of the wait room.

That is pretty explosive stuff. I am going to get to the next safety report, which is from 15 June 2022 where it says, 'There were no spaces left to see life-threatening cases.' This is at Flinders Medical Centre, the subject of the motion that we are currently debating. The doctor advised, 'Today is the worst I've ever seen it. I seriously think someone could die today.'

The doctor describes the ED as being in chaos and reports that lack of flow through the ED was leading to patient safety being compromised, and that this has led and would lead to patients dying in the back of an ambulance. Then, of course, there was the dreadful case of a woman who was forced to lie on the floor of an emergency department as she waited for a bed. All of this was happening in the southern suburbs at Flinders Medical Centre—safety report after safety report after safety report.

Despite these shocking reports, the Labor government has made the somewhat interesting move to slash beds at the Flinders Medical Centre emergency department, and that is why one of the things we have been calling for is a hospital-by-hospital breakdown of the ramping data. A breakdown of hours at each hospital right across our health network we believe would justify, presumably, the Malinauskas government's commitment and decision to slash emergency department beds. If it has reduced ramping at Flinders, let's see the data. I think that South Australians deserve transparency when it comes to what is going on in their hospitals.

They wanted to know throughout the election campaign. In fact, it was those opposite who were constantly shining a light on what was happening in our hospitals right across South Australia, but now that the election has happened, now that ramping is the worst it has ever been in South Australia's history, radio silence—do not want to know about it.

Just last week, after questioning from the opposition, we learnt that storage spaces were being converted into beds at Flinders, that broom closets are now being converted into beds at Flinders—and those opposite expect that this side of the house is going to support some sort of self-congratulatory motion saying how fantastic they are on Flinders. It is just outrageous. That is one element when it comes to turning broom cupboards into beds. Let's now turn to the fact that elective surgery has been cancelled at Flinders. Elective surgery has been cancelled at Flinders because of the stress and the pressure that Flinders is under.

I am going to close my remarks fairly soon, but I would like to say that I empathise with those opposite and I do understand that it may be really difficult for those opposite to hear. I think that for the member for Waite in particular it would be really difficult to know that she is part of a government that have turned broom closets into beds. They have slashed emergency department beds at Flinders.

They have delivered and presided over the worst ramping statistics in South Australia's history, and it is hard because what do they say now? What do those opposite say when they go back to their local communities? They were in their communities throughout the election campaign saying, 'We will fix ramping in this state.' They said it at street-corner meetings. They said it when they were at their shopping centres. They said it when they were out doorknocking with the now Premier of South Australia.

They tapped into a central fear of South Australians, and that is that when you call for help no-one is coming for you. They were a part of the worst scare campaign in South Australia's history. Now they are stuck between a rock and a hard place. What do they say? What do those opposite say when their constituents are asking them how they are tracking with their central promise in health to fix ramping in this state? They say, 'Now we've realised it's a national problem,' or they say, 'We know that it's the worst that it's ever been, but we will get around to fixing it. It's just going to take a little bit more time than we thought.'

Those opposite will be held accountable at the next election because, I tell you what, this was one of the biggest fear campaigns. When you are part of one of the biggest fear campaigns in South Australia's history, there is an onus on you to actually deliver. Your track record at the moment is so appalling. They are not even the worst ramping stats in South Australia's history by a little bit—not even a little bit—but by 147 per cent. How can you look your constituents in the face? How can you do it? I just cannot imagine how you can do it. What we have found out—

Members interjecting:

Mrs HURN: I understand it is difficult for those opposite to hear because—

The ACTING SPEAKER (Mr Brown): The member will be heard in silence.

Mrs HURN: Thank you very much for your protection, sir. I understand it is difficult. It is really difficult to hear, and ultimately they are going to have to face their constituents when it comes to their promise to deliver on ramping. Their communities know that this is a litmus test for trust, and their communities know that this was a central promise when it comes to health here in South Australia. That is why we do not support these self-congratulatory platitudes on this side the house.

The Hon. C.J. PICTON (Kaurna—Minister for Health and Wellbeing) (12:26): I was driven to the chamber to speak on this motion and to congratulate the member for Waite on moving this motion and thank her for her passion and advocacy on behalf of her constituents and her desire to make sure that we have an expansion to Flinders Medical Centre that offers more beds and more services for people of the south who need it.

The Hon. B.I. Boyer: He doesn't want to hear it.

The Hon. C.J. PICTON: He does not want to hear it. That is in stark contrast to what the approach was previously. What the approach was previously at Flinders Medical Centre was not to expand beds, was not to put more services in, but was to relabel some beds from inpatient beds to emergency department beds. There was press conference after press conference from the member for Dunstan going out there saying, 'We are expanding the emergency department at Flinders.' What he did not say was, 'We are reducing the number of inpatient beds in the hospital. We are just relabelling these beds from inpatient to emergency department.'

Funnily enough, despite this promise that the member for Dunstan said would fix ramping almost immediately, there was not a fix to ramping after this happened. In fact, ramping got worse afterwards. How do we know that? Because the former government commissioned a report from Dr Mark Monaghan, who is an expert in the area of emergency departments and patient flows through hospitals. It was commissioned by the previous government and said clearly the situation got worse after this project went ahead. Relabelling beds from one to the other did not address the situation.

What has happened since is that we have implemented the recommendations that were made by that report that was commissioned by the previous government. We have the shadow minister saying, 'Oh, this is outrageous that emergency department beds are now inpatient department beds.' Of course she is saying we have somehow closed down beds, which is completely bogus. No beds have been closed down whatsoever. We have implemented the report recommendations that said that we should go back to how it was before, but, more than that, we actually need to increase the capacity of the hospital.

Shuffling the chairs on the Titanic is not the answer. We need more beds, we need a bigger hospital and we need to be able to help the flow through the emergency department. That is the critical issue when you have dozens of patients who are stuck, sometimes for days, waiting for beds in the hospital because they cannot get an inpatient bed. That is what leads to ramping happening, and that is what leads to people not being able to get an ambulance when they need one.

One of the first things we have done since being elected was actually work with the now incoming Albanese federal government not only to do what we said we were going to do at the election, which was increase the size of Flinders Medical Centre, but to go dramatically above that. We now have a plan to increase the size of Flinders Medical Centre by 136 beds. This is a massive expansion—a $400 million project between there and the Repat, where there will also be 24 beds that will be constructed to make sure that we have that additional capacity.

As per the motion that has been moved by the member for Waite, we are also increasing the ambulance services because we know that there are times—even when there is not ramping happening in the system—where we are still struggling to respond to emergency cases in the community on time. We saw the dramatic reduction over the past four years in the number of people who are getting an ambulance on time: from about 85 per cent to less than 50 per cent of people getting those priority 2 cases, lights and sirens cases, on time.

We need to turn that around. Not only do we need to address that by what is happening at the hospital and making sure there is capacity and flow at the hospital to prevent ramping but also we need to address that through more ambulance services. What was the previous government's approach to ambulance services? Well, they were just having a war with ambos—a complete war with ambos, a complete gaslighting of all their concerns, nothing to see here. They went four years, think, without a pay increase for our hardworking ambos.

We are increasing by 350 ambos across the system. We have already delivered extra crews in the Norwood area, and this month we will be adding additional crews in the Marion and Edwardstown areas as well to increase that capacity, which will particularly help people in the south, including around the electorate of the member for Waite. So it is a comprehensive plan to make sure that we can improve the capacity in our hospital system and improve the capacity of our ambulance system. Of course, it takes time to do these things, but we have a plan and we are implementing it to make sure that South Australians get the resources that they need.

We are also starting straightaway in terms of Flinders Medical Centre. We are putting in place an additional CT and an additional MRI machine. That is going to help in terms of the patient flow through the hospital, because people get stuck for a long time waiting for those CT and MRI scans. That both delays them in the emergency department and means that they are delayed in terms of their care in the ward, which leads to more bed blockage across the hospital. That is one of the critical things that we are working on.

One of the early works that will be happening will be in relation to the Margaret Tobin Centre at Flinders Medical Centre, which is the mental health facility there. That needs an expansion of beds available to it as well. That is going to be part of this package of works happening at Flinders Medical Centre.

We know at the moment we are facing another wave of COVID. Flinders is a hospital that does not have the single rooms that our other hospitals do, and so that makes it even more difficult to manage COVID in those situations. The other benefit of this package of works is going to be a significant increase in the number of single-bed rooms available at Flinders, which will help not only with COVID—which I suspect will be with us for some time—but also with future pandemics and other infectious diseases. There will also be improvements made to a whole range of different facilities at the hospital, including operating theatres.

I want to thank our hardworking doctors, nurses, paramedics and allied health professionals in Flinders Medical Centre and also across the health system more broadly, who have been working their guts out the past few years. The situation is still very serious in terms of our hospital system, and that is why these additional resources are so important—additional doctors and nurses, additional beds being constructed, additional ambulances and paramedics on the road. We need these additional resources to make sure that people can get the care that they need.

I want to thank the member for Waite for moving this motion. I look forward to working with her and her colleagues in the south who understand the importance of the Flinders Medical Centre and the resources in that area, and ultimately advocating on behalf of their patients to make sure that we as a government deliver on our promises—which we are doing and exceeding—but also making sure that patients can get the care that they need.

Mr TEAGUE (Heysen) (12:34): I rise to support the motion in its amended form. First, may I join with the Minister for Health in commending, thanking and expressing my gratitude to all those health workers who toil every day to apply their world-leading and transformative capacities to the range of diverse and complex health needs of South Australians.

We should be proud in South Australia to advertise the world-leading capacities of our health workers. It is our job in this place not to lead them down the garden path, to let them down or otherwise to leave them with inadequate supports, facilities and other provision to allow them to do the great work they do every single day, so I do share in those thanks.

It is in precisely that vein, and reflecting as I do on my own visits to those in the care of Flinders Medical Centre over recent months, that we are now called to reflect on the vital importance of Flinders Medical Centre and, from the point of view of the public debate, to reflect on the fact that we are living both in real time and we are living at a time in which health services in this state have been politicised perhaps like never before.

Therefore, it is well to reflect on those really startling and damning statistics that the shadow minister for health reflected on just a moment ago because we find those sitting on the government benches in this state parliament will thank—I think they would acknowledge this—as a large contributor to their success at the last election a campaign that focused singularly and squarely on a promise to end ramping in South Australia, a promise that was put in such populist terms that it was accompanied by a widespread chalking, I think it has been described as (the graffiti that was applied to ambulances), and a blanketing during an election campaign of a promise to end ramping in South Australia.

What we have seen, which continues as we know to tell the story about a failure to deal with the necessary ingredients that contribute to that, is not only the 24,189 hours of ramping over the last seven months, amounting to such a shocking strain on the capacity to serve, evidencing as it does difficulties that are not down to the availability of ambulances only but also all those steps through the system. For the purposes of this motion, key among them is the capacity of Flinders Medical Centre to be able to receive patients and to deal with their needs.

We live in real time and our health needs and therefore the health of Flinders Medical Centre and its capacities must be analysed in real time. Having made such a focus of this blanket promise, that if elected they will fix ramping, the government ought to be saying, 'Righto, as a measure of our commitment to that promise, we will more than ever look for ways to provide the people of South Australia with the means of analysing the facts.' As the shadow minister for health has indicated, that ought to extend to real-time disclosure of ramping, hospital to hospital, including the Flinders Medical Centre, to show what are the fruits of this government's policy approaches to solve this unprecedented, worse than ever ramping situation in the state.

We have heard the Minister for Health—as he said, driven to contribute to the debate—referring to a promised expansion of the Flinders Medical Centre. What we all know is that that promised expansion is years off, at best. If there is something that we have seen from this government, in what has now been several months for the South Australian community to have a close look at them, it is that this is a bit of a recurring theme.

There is a promise to do something and it might be happening, if we are lucky, within the forward estimates. In many cases, it looks like it is being pushed off beyond the end of the forward estimates. All we have, therefore, in many cases is a large-sounding dollar figure and an outcome that is projected many, many years away. It is not just the Flinders Medical Centre that has suffered from this; it is the north-south corridor, it is solutions long promised on the energy side, and the list goes on.

Promises years away to expand capacity at Flinders Medical Centre go nowhere to solving what a practitioner needs to do when they are forced to use a broom closet for a bed in real time. It goes nowhere to answering a medical officer who says, 'It's so bad here right now, this day, that you would be better off in South Africa,' in evidence that we have heard to the Legislative Review Committee.

In commending the amended motion to the house, I really do emphasise that if you are going to tell the people of South Australia that you are going to come to government off the back of your key promise being to end ramping in the state of South Australia, then you ought not to have to be dragged kicking and screaming to tell South Australians what the ramping figures are. Yet, that is what we have seen over now several months.

It also remains to be seen when exactly this government is going to even start taking responsibility for the vital importance of Flinders Medical Centre, let alone the rest of our health system in this state. We on this side of the house can be proud of confronting what are absolutely challenging, complex and difficult issues in the health space. That is undoubted, but we can be proud on this side of having called it as it is and of having taken steps in a measured and evidence-based way to bring about improvement.

The result of that was that we saw ramping at the end of last year and into the beginning of this year on a steep downward trajectory. What we have seen over recent months is ramping at record levels and continuing to grow. Yes, Flinders Medical Centre is vitally important to South Australia and we need a government that can apply policies to ensure that it is not thwarted in its important work. I commend the amended motion to the house.

Mr TELFER (Flinders) (12:43): I rise to speak on this motion on the Flinders Medical Centre and do so in the context of having spent a fair bit of time over recent weeks, through my work on the Legislative Review Committee, looking at the challenge of ramping and hearing from not just the CEO of the Department for Health but representatives from local health networks all across the state, hearing their evidence and hearing some of the stories from clinicians, from presentations from organisations such as SASMOA.

It was interesting last week, through the Legislative Review Committee process, to hear from the CEO of the Department for Health, and knowing that that very morning the data which was provided to the media in a drop that we heard was direct from the minister's office on some of the hospital-specific data when it comes to ramping numbers in South Australia—the evidence we heard was that it was not the Department for Health that was releasing this data, it was actually a media drop from the minister's office, seemingly that the Health Department was not even aware of until it happened.

This hospital-specific data was very interesting reading, and I think very valuable for members of our community to get an insight into some of the specific areas and some of the specific details when it comes to hospitals all across Adelaide. The hospital-specific data has been already well ventilated in the speeches that I have heard from this side, and it really is important to be able to highlight that there are inconsistencies all around Adelaide.

We heard that this hospital-specific data released by the minister is not of much use, according to the CEO of the Health Department. It is something that they believe they are not going to have a need to provide publicly. This data is obviously able to be produced, so we asked, 'Why shouldn't the people of South Australia have this insight?' It continues to be, through the evidence that we heard, the policy of the Department for Health that they will not be releasing that data, that we can know, on a hospital-by-hospital, case-by-case basis what is actually happening when it comes to ramping all across Adelaide.

That was a surprise. Obviously, the question had been asked previously of the CEO in previous committees. I understood that that data was not even able to be produced but, in fact, it has been produced, it has been provided to the minister and the minister decided for this once-off that they would be dropping it to one of their favourite media outlets—but the department decided that it is not going to continue on.

In the Legislative Review Committee we also heard from the Southern Adelaide Local Health Network CEO, specifically talking to her about the challenges that are being faced at the moment under this regime at the Flinders Medical Centre. I have been quite interested in the way that this process has been gone about. The hearings and the process that the Legislative Review Committee were partaking in were obviously started under a previous iterance of the Legislative Review Committee. Members of the committee from the previous parliament heard some evidence at that time that we, on the newly reinstated Legislative Review Committee, thought would be very pertinent for us to hear, and that we, as a new incoming committee, would like to hear evidence from similar witnesses.

For a government that was elected on a platform of ending ramping to be confronted with the highest level of ramping on record must be very confronting—those in government, both the frontbench and the backbench, made promises, and statements were made, not just from the now members of government but from their supporters, from the people who believed the rhetoric that was coming out of the mouths of those who were putting themselves forward for election. We have heard already that these numbers over the last few months have been at record highs. They were not higher than this under the previous government when apparently it was at crisis level, but now it is over and above.

Scarily, we heard from the Southern Adelaide LHN CEO that what they are having to turn to now is the use of what have been described as 'unconventional spaces' within hospitals. Unconventional spaces may include things like storage cupboards and broom cupboards, areas where cleaning products are stored at the other end and they have retrospectively fit in capacity to put beds and maybe put some oxygen in there so that people can actually breathe freely.

These unconventional spaces were worn as a badge of honour by the Southern Adelaide LHN CEO, but for me it was concerning. I can understand that certainly there are times when hospitals have the need for additional surge, when numbers are over and above what their capacity might be, and we know that there are steps that are put in place. We have seen the use of these unconventional spaces—like I said, broom cupboards, storage cupboards, any little room that might be available to fit a bed, to fit a patient in. These may be used in surge times, but it seems that there is more and more expectation that these unconventional spaces are used as ongoing capacity.

We see the evidence at that committee from the CEO of Southern Adelaide LHN that there has been the permanent conversion of some eight of these rooms, these unconventional spaces, and the outcome for patients is less than ideal. The evidence that was heard from the Legislative Review Committee certainly reiterated that: it is less than ideal for the patients.

Where is the plan? There is a lot of rhetoric that I hear coming from the government, and I worry that there is no real substance to it. We do also know that SALHN, Flinders Medical Centre, have patients who come to their area from outside their catchment and from regional areas, especially to the south, including the Fleurieu and the Limestone Coast. We hear that because of the lack of capacity, whether that is specialist or otherwise, in those areas, the number of patients coming from those parts of the state who are ending up at the Flinders Medical Centre is one which should have extra attention.

It does mean that there needs to be greater investment into some of the services provided in these regions to take the pressure off the likes of Flinders Medical Centre. If they are having patients come to them from a regional address, from regional areas, it just means that there are fewer people from within that catchment area who are going to be able to accommodated.

I would encourage every one of my colleagues in this place to really take into consideration that evidence that has been heard from the Legislative Review Committee, and the words spoken by the CEO of Health and also the CEO of the Southern Adelaide Local Health Network, because it is confronting and it is something that really needs attention—not platitudes but proper investment so we can see better outcomes for patients.

Mr McBRIDE (MacKillop) (12:53): It gives me great pleasure to follow on from the member for Flinders and his speech, as he is on the Legislative Review Committee, which I was on last term as well. I had the opportunity to be on the committee, and be part of the South Australia Ambulance Service Resourcing petition hearings that started in December 2021, and to hear from a number of witnesses through December and the following months prior to the election in March.

First of all, I want to pick up on the comments of the member for Heysen and the Minister for Health and acknowledge the extremely dedicated hard work of all our medical practitioners and professionals, the tough time they have had mainly since and through the pandemic and that things have not really recovered since.

It is interesting with this petition that there were 46 written submissions and 11 requests to provide oral evidence. We heard from 28 individual witnesses, and I think representatives from 12 organisations and government agencies were in the summary report so far that has been reported for the Legislative Review Committee, which I was obviously part of in the latter year or term of the 2018-22 electoral cycle.

In that process, one of the things I found very interesting was that it was acknowledged the Marshall government had increased moneys and efforts to address health and the shortages, to try to solve and obviously work through a pandemic. One thing that is obviously noted—and it is probably something I have learned over a number of years of being a farmer and having a wife who was a nurse—is that just because you pour money into the health system does not mean that you will get the answers you are looking for.

Something I want to note about this acknowledgement of the Labor government's bill—and obviously there is an amendment here—is that they want to congratulate themselves on some new beds in Flinders Medical Centre. I can understand that that could assist, but I think what has to be said for both sides of government in South Australia, and probably for other state jurisdictions, is there is a bigger game play or a bigger problem here than just more beds.

I think that community resilience is low and that the health requirements of people have increased. The number of people who are requiring the services of medical practitioners and specialists has increased immensely and there is a backlog that the pandemic created over two years of nearly shutdown time. Ambulance ramping, as noted by the member for Schubert, increased by 147 per cent since the new government has come to power, which highlights that this is an ongoing problem and is getting worse not better after a previous Liberal government tried to address it by opening the Repat centre, for example, which was closed by a former Labor government. Yet the problem still exists.

The ambulance industry went around the streets with badges and graffiti-type artwork on the side of ambulances, slamming the government of the time for ineffectiveness and problems within their system, but where is it now because the system still has the same problems? Why do they not have the same graffiti on the side of ambulances when the problem has not been addressed? I think that was very opportunistic.

It is very sad that a sector of society is inconsistent in their messaging if that messaging is important to win over and support their ambulance drivers and medicos and the like. Because the EDs are not functioning, then they should be consistent and still be saying today that it has not been addressed. Maybe it was because it was just before an election and perhaps they were hoodwinked into believing that somehow in March everything was going to change if a new government came to power, and there would suddenly be a shining light and the call and demand on our ambulances would just evaporate. Well, that has not happened. All I can highlight here is that this is a large society-type problem. It is a problem that stretches well beyond the boundaries of South Australia, and it will keep on going.

Moving out into my electorate of MacKillop, we do have a shortage of volunteers and ambulances. I heard the other day that, in Mount Gambier, a resident needed to wait six days in a waiting chair because he could not get a bed. This is only recently, and apparently the gentleman who was in the chair was the father of a nurse at the hospital. You would think that there might be some sort of bias or protection or advocating for a relative of a nurse at a hospital; they could not even assist him any better than what anyone else from the public had to endure.

There are some massive issues here. I think it is important that we continue to spend money building beds and making sure the infrastructure can cope and meet the needs of the South Australian population. I hope that the ramping does go away. Another thing to pick up from the inquiry is that there were 20,000 shifts of overtime—that was evidence given to the inquiry back in December by ambulance drivers—where they were having to work beyond their normal shift. Something that was highlighted for me is the fact that money is not the problem because they get time and a half and double time. I seek leave to continue my remarks.

Leave granted; debate adjourned.

Sitting suspended from 13:00 to 14:00.

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