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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2025-10-30 Daily Xml
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Auditor-General's Report

Auditor-General's Report

In committee.

(Continued from 29 October 2025.)

The CHAIR: I declare the examination of the Report of the Auditor-General 2024-25 open. I remind members that the committee is in normal session. Any questions have to be asked by members on their feet and all questions must be directly referenced to the Auditor-General's Report 2024-25 Report and Agency Statements for the year ending 2024-25, as published on the Auditor-General's website. I welcome the Minister for Trade and Investment and the member for Chaffey, and I call the member for Chaffey for questions. The 30 minutes start now.

Mr WHETSTONE: I refer to the trade and investment program expenses, DSD financial statement on page 12. The trade and investment program recorded $11.3 million in income but $41.1 million in expenses in 2024-25—a cost to government of $29.8 million. How is the government justifying that level of subsidy?

The Hon. J.K. SZAKACS: It is not a subsidy.

Mr WHETSTONE: Can you explain what the $29.8 million means, the cost to government?

The Hon. J.K. SZAKACS: I will do my best to answer the member's question with respect to the appropriations. I can confirm that there are no income-generating or income-recoverable matters contained within the member's broad question around the $29 million. But, largely, I can again give some examples of fees and services at $442,000 and grants and subsidies, a very small and limited approach, which is through our grant funding program, of $373.029 million. Other matters, of course, are employee-related expenses of $19.939 million. I am happy to go on should the member ask in another question, but it's not a subsidy: this is cost of service delivery.

Mr WHETSTONE: Under 'Leased property' of the financial statement, the lease of the Office of the Agent General in London expires in June 2027 and the lease of the Jinan trade office expires on 31 May 2028, with no option to renew the leases at the end of their terms. What are the plans for these offices at the conclusion of their leases?

The Hon. J.K. SZAKACS: Just for clarification, the page number?

Mr WHETSTONE: Page 36.

The Hon. J.K. SZAKACS: Thank you to my advisers: I am advised that the phrasing the Auditor-General has used indicates that under the current leasing arrangements there is not an immediate rollover right of renewal. However, I am also advised that we are well into negotiations with the appropriate owners to extend those leases. In particular, I note that South Australia's presence in London in the United Kingdom, at Australia House, is a particularly natural and competitive advantage that South Australia has in respect of our trade and investment ambitions and agenda and, as I said, I am advised that negotiations are well underway with respect to locking in a further long-term contract.

Mr WHETSTONE: Moving onto page 354, under Payroll: between July 2024 January 2025 only 68 per cent of bona fide certificates and 71 per cent of leave return reports were approved within the required timeframe. Minister, are you aware of any financial risks arising from these delayed reviews, such as overpayments or paying staff who have left DSD?

The Hon. J.K. SZAKACS: I am advised in the audit findings that there was obviously an identifiable risk as a result of these findings. However, with no compromise to payroll and a remedy has been immediately identified and executed by the department.

Mr WHETSTONE: How much was related to overpayments made, and has any of that been recovered?

The Hon. J.K. SZAKACS: With reference to which page?

Mr WHETSTONE: Page 354.

The Hon. J.K. SZAKACS: With respect to overpayments?

Mr WHETSTONE: If we read through Payroll, the Auditor-General has talked about bona fide certificates, as we have already talked about. He recommended that:

…DSD regularly remind its managers to promptly review these reports, particularly for areas with consistently lower compliance rates.

He also states:

DSD advised us that it is reviewing payroll reporting capabilities and increasing staff training and awareness for reviewing these reports.

The Hon. J.K. SZAKACS: I am very keen to tailor my response to the member's question specifically. The member asked about a remedy for overpayments, but I am perhaps missing this in the audit reports. But if there is a reference the member can refer to where the Auditor-General finds there were overpayments, I am happy to respond.

The CHAIR: Are you on page 354 of Part C: Agency audits?

Mr WHETSTONE: Yes, under Payroll. I have asked the minister: is he aware of any financial risks arising from these delayed reviews, such as overpayments or paying staff who had left DSD?

The Hon. J.K. SZAKACS: That was the member's previous question. In the second part of his question, he specifically asked about the remedies for overpayments. I am just trying to tailor the answer I have specifically to what he is asking me. Otherwise, I can say, in reiterating my previous answer, that all remedies have been undertaken by the department and the audit findings—insofar as I am advised or that I have read—make no reference to overpayments.

Mr WHETSTONE: Have there been any financial risks arising from delayed reviews?

The Hon. J.K. SZAKACS: Again, I am advised that, as the Auditor-General found, this was a timing issue. I can confirm to the member that there were no findings of payments to any individual who had left the department. The finding, as I am advised, has not created potential for material mis-statement within the department's financial statements, due to other compensating controls in place during the 2024-25 financial year, including the regular monitoring of actual results compared to budget and review of transactional errors.

Mr WHETSTONE: Minister, which areas of DSD had consistently lower compliance rates, as the Auditor-General states?

The Hon. J.K. SZAKACS: I am advised that there were no specific business units or responsibility portfolios within DSD that had a specific variance to compliance. There was a general non-compliance per the audit findings. But I can also advise the house that the audit office did note that 68 per cent of the department's bona fide certificates were reviewed within 14 days and 71 per cent of leave return reports were reviewed within 30 days, in that financial year.

Mr WHETSTONE: The Auditor-General has stated that there are issues with compliance rates. Is it workload? Has the amalgamation of four departments into one meant increased workload for payroll staff, or are other department staff or executives having to take on additional responsibilities?

The Hon. J.K. SZAKACS: I am advised by the chief executive that there were no resourcing issues. If there were to be any tempo issues, I use this opportunity to thank the department, from the government, and from me as minister. We have had an extraordinary tempo of engagement from the trade, investment, industry, innovation and science portfolios in the last 12 months. They have been working incredibly hard, in fact probably at a pace that has not been seen for some time and that is to capitalise on the unique and extraordinary opportunities economically before our state.

This is paying dividends for investment attraction in our markets, for export growth, and particularly in our markets where we have the most unique competitive advantage, and we are seeing records continue to be broken. But, as I am advised by the department, there are no resourcing matters that contributed to this other than it was an administrative matter that has now been remedied.

Mr WHETSTONE: Have staff had to take up additional responsibilities in other areas as a result of the amalgamation of the departments?

The Hon. J.K. SZAKACS: I am advised, no. I think perhaps in Estimates this year, I had a similar line of questioning from the member, and one which is very genuine because when it comes to the Department of State Development and the machinery of government changes which the government implemented to be fully operative from 1 July 2024-25 financial year, this was around driving economic outcomes for our state and not efficiencies.

I have the privilege of being the minister to inherit this and to drive this on behalf of the government in an environment where we are MoG-ing not based upon rationalising but rather based upon bringing some scale. I am sure that every minister from every side of politics at some time or another has overseen a MoG where there have been calls upon that minister or agency to find efficiencies as a result. We are not doing that. We have not done that. We are seeing the really important work that this MoG is delivering on behalf of the people of South Australia really paying dividends.

Mr WHETSTONE: Have any staff out of DSD had to take up any responsibility particularly relating to the algal bloom?

The Hon. J.K. SZAKACS: There have been no staff who have been moved out of DSD into other government agencies or roles, but it is consistent with that industry engagement piece that staff across the department undertake with industry that has been adjacent to and contributing to the efforts of the state government's algal bloom response, whether it be from the trade team, international team, the investment team, industry team, and more broadly.

I will pay credit to Chief Executive Adam Reid, who is here with me. In respect of leading responses on behalf of government and within government, DSD has been playing an exemplary role in driving the outcomes the government seeks to do to support industry, support workforce and support communities.

Again, I take this opportunity to thank each and every one of the people who work within DSD, because not for one moment as minister do I have any concern that anybody in that department does not see themselves as contributing to the whole-of-government response and the whole-of-portfolio response. They have done that, they are doing it well and I expect, subject to future environmental conditions but certainly consistent with our summer plan, that that contribution into the whole-of-government effort will continue for some time.

Mr WHETSTONE: I have no issues with the great work that the office of trade are doing, but I am looking for you to give me an understanding of how many people have been seconded to deal directly with the response to the algal bloom.

The Hon. J.K. SZAKACS: I did give you that response explicitly and directly in my final answer. I said none.

Mr WHETSTONE: No, you did not. We will move on to Part C, page 356, Supplies and services. Can you provide a breakdown of how the $6.7 million is spent across each of the 15 overseas offices?

The Hon. J.K. SZAKACS: I am happy to do that. I actually have that information to hand. This is across the 2024-25 year: $1,709,000, Shanghai; $516,000 in respect of China re-engagement specifically; $395,000, Hong Kong; $415,000, Korea; $334,000, San Francisco; $180,000, Kuala Lumpur; $386,000, Washington DC; $436,000, Houston; $387,000, Singapore; $579,000, New York; $907,000, Tokyo; $221,000, Guangzhou; $186,000, Chennai; $266,000, Mumbai; $300,000, Berlin; $418,000, Dubai; $177,000, Jinan; and $2,031,000, London. I am advised that is a combination of service delivery, employee costs, program delivery and rents.

Mr WHETSTONE: Of the 15 overseas offices that you have just talked about, is there any consideration of closing any of those offices?

The Hon. J.K. SZAKACS: No.

Mr WHETSTONE: I go to the Department of State Development financial statement, page 7. The minister responsible for Industry, Innovation and Science has a 25 per cent interest in SABRENet. Is there any current or future funding arising from the interest that the parliament should be aware of?

The Hon. J.K. SZAKACS: I can advise no.

Mr WHETSTONE: I go back to page 355, under income. Appropriation increased by $379 million in 2025 compared with last year. How much of that appropriation relates to each of the three transfers?

The Hon. J.K. SZAKACS: I can advise that the increase of $379 million from appropriations can be broken down into Skills SA at $336 million and the appropriation for trade and investment functions at $31.5 million, and that the material costs with respect to population were marginal.

Mr WHETSTONE: I have a couple of questions before I hand over to the member for Hammond. Under grants on page 29 of the financial statement, what grant programs did the $33 million for Industry, Innovation and Science grants cover, and how many were competitive?

The Hon. J.K. SZAKACS: I can advise the member that $10,924,000 was expended from the Research and Innovation Fund for which the fund was competitive. Adelaide University was in receipt of $10 million; StudyAdelaide was in receipt of $4.5 million; NCRIS received $4 million, which was competitive; EXCITE intermediaries was in receipt of $800,000; the Defence Industry Connection Program received $722,000; the defence supplier capability uplift pilot received $591,000, which was competitive; teaching professional scholarships, which I think was an election commitment, was delivered at $500,000; degree apprenticeships was in receipt of $450,000—I am very proud of that course; the multicultural tertiary course is another one, which is a great initiative supporting diverse communities at $250,000; SAYES received $133,000; and the manufacturing and innovation grants. That is it.

Mr WHETSTONE: So that is all of the applications that were successful?

The Hon. J.K. SZAKACS: No. I think the question you asked me was the breakdown of the grant streams.

Mr WHETSTONE: Are you able to shed any light on how many applications were received and how many applications were unsuccessful?

The Hon. J.K. SZAKACS: I am just taking advice from my adviser. We will take that on notice and provide the degree of information that we can with considerations of commercial-in-confidence and other probity matters.

Mr PEDERICK: Moving on to veterans, I refer to the Independent Auditor's Report on Defence SA, page 9, expenses and income by program. What is the source of the $25,000 received in grant funding in 2024 and 2025?

The Hon. J.K. SZAKACS: I am advised that that is incoming appropriations by way of grant from the Department of the Premier and Cabinet, which provides partial support for the ANZAC Day Commemoration Fund.

Mr PEDERICK: Can you tell me why the employee-related expenses have risen from $534,000 in 2024 to $660,000 in 2025?

The Hon. J.K. SZAKACS: In fact, I am very pleased to. This is a direct increase in successive budgets now to further fund the important work that Veterans SA undertakes. That has not just been around additional grant funding for grassroots and front line but additional funding in research, additional funding for commemoration, but perhaps most importantly the additional funding in respect to capacity. That capacity building is really important. I think we have spoken about it in estimates before.

One of the important pieces of work that this additional resourcing is able to undertake is the regional engagement, that is, engagement with parts of the veterans' community in parts of our state that have not traditionally or necessarily been able to be achieved because of the modest funding of Veterans SA. This has been as a direct result of additional funding—in fact, record funding—that our government has been able to undertake in the important work of veterans' support.

Mr PEDERICK: According to the table, Veterans SA allocated $911,000 in grant funding during the most recent financial year. How many grants in total were allocated?

The Hon. J.K. SZAKACS: I will take the specific number on notice, but it is across the ANZAC Day Commemoration Fund, 80th anniversary of World War II fund, Veterans SA community programs fund, Legacy Club grants, minor grants funding, Capacity Building Grant Fund and Commemorative Services Grant Fund. There are also new initiatives that we have undertaken in respect to scholarships for tertiary and further study of veterans. It is in the dozens, if not hundreds, but I will arrive at a final number across all of those and provide it to the member.

Mr PEDERICK: Thank you. In regard to that this was a significant increase in grant expenditure compared with the previous year. Can this be attributed to the 80th Anniversary of the end of World War II Grant Fund, or are there other reasons?

The Hon. J.K. SZAKACS: Yes, there was specific one-off grant funding that was consistent with the specific and special commemoration of the 80th anniversary of the end of World War II and, as the member said, the 80th anniversary fund was the single largest part of the additional grant funding for this financial year. However, there were other upticks as a result of new money being brought on or new initiatives which had been responding to need.

As I said, one of the initiatives that I think has been in this financial year was the scholarship and study support which we have implemented as a government. That was as a direct result of the advice and support from the VAC. One of the most critical times for us to get right as a government, as policy leaders, is that transition for veterans, and often the hardest thing for veterans in that transition is the change in income—the decrease in income for themselves and for their family. What this has been able to do is not just support those veterans with financial support during that transition but also sequence in with the other priorities we have as a government with respect to investment in skills and in particular in important workforce issues.

The member and I have spoken—and I take this opportunity to thank the member for his support; he is a very strong advocate for the veterans community—and I have the privilege as the minister of often and consistently doing what I do shoulder to shoulder with the member. Backing our veterans in to find them meaningful work is one of the most important things we can do.

Mr PEDERICK: Wow. Why have total assets gone from $127,000 in 2024 to $22,000 in 2025?

The Hon. J.K. SZAKACS: I will seek the specifics on notice, but I would anticipate that that would be a matter largely of depreciation of assets.

The CHAIR: The time allocated has expired. I thank the minister and also the members for Chaffey and Hammond. I welcome the Minister for Health and Wellbeing and also the members for Schubert and Frome. I call upon them for their questions.

Mrs HURN: Minister, just on page 82, 'Budget and performance', under Investment, the new Women's and Children's Hospital, the new Mount Barker hospital and the expansion of the Flinders Medical Centre all have delays in starting construction. How many months or years are each of these projects behind schedule? If you could just put some timeframes on how long those delays have been?

The Hon. C.J. PICTON: I am very happy to address this issue. Obviously we have talked somewhat about it in question time, but also it has been a topic in the media yesterday after the ABC's report focusing on this section of the report. In terms of all those three projects that have been highlighted, the advice that I have is that the projects are on track. The projects are on track for completion by the designated time. For the Women's and Children's Hospital, that is by the end of 2031; the new Mount Barker hospital, the end of 2027; and the Flinders Medical Centre expansion, by the end of 2028.

You can see with each of those projects that construction is well underway, with cranes up, workers on site, a whole lot of work happening. For each of those projects, there is a lot of work that needs to go into making sure that we get the design right and we get the clinical engagement right. In terms of some of the experts who spoke on this yesterday in the ABC's report, and I also note one of the infrastructure experts who was on ABC radio this morning as well, both pointed out that the time before construction starts is very important in terms of making sure you get the design right and the outcome right.

What happens in terms of the budget setting of different infrastructure projects is that, when they go into the budget, there is an allocation made not only for the overall project but for each financial year of where we expect how much of that budget will be allocated per financial year. It is true to say that when you look at those individual years there are often variances between year to year in terms of those infrastructure projects. It is true under this government, it was true under the previous government, and it was true under the government before that as you understand more in terms of what the specific construction timeline will be as you get further into the project.

That is what has happened here. The Auditor-General notes—does not criticise, I would note, just notes—that there have been variances in three of those projects where we spent less and one project where we spent more. If you look at the graph above that table, it makes very clear the overall spending compared with what the overall budget of our investing was in those years. There is very significant growth in the expenditure of the overall infrastructure budget compared with the 2021-22 financial year, which is clearly noted there.

The advice I have is that this graph demonstrates that we are some 16 per cent lower than where we expected to be in terms of what we are spending, and that compares with, I am advised, 38 per cent lower in 2021-22 on a much smaller base. So the huge amount extra that we are spending can be demonstrated clearly. There is a much more massive infrastructure delivery now compared with where we were three years ago and a smaller percentage of underspending compared to where we were on those projects.

So in answer to the question, I am very confident in terms of the advice I have received that all of those projects are on track. You can see the work that is happening on those projects, and we expect them to be delivered in the timeframes that we have previously outlined.

Mrs HURN: Very clearly it says the reason for the difference between the budget and actual for 2024-25 was a delay in starting construction. I appreciate the minister's focus on the end result. My question specifically is about how long that delay has been, and perhaps the minister could advise the house of the actual spend. The $125 million for the actual spend: what has that been spent on?

The Hon. C.J. PICTON: I think we will have to take the actual spend on notice, but I know the member is a member of the Public Works Committee—

Mrs Hurn interjecting:

The Hon. C.J. PICTON: You used to be.

Mrs Hurn interjecting:

The Hon. C.J. PICTON: Sorry—the member was a member of the Public Works Committee, where there have been a number of presentations in terms of this project. There have been a number of packages of works that have been approved by the Public Works Committee and presented to this parliament. I am advised that we have recognised $250 million of capital works in progress for the new Women's and Children's project, including around $125 million of additions in 2024-25. The $250 million mainly comprises $110 million in early work costs, including the construction of the car park; $70 million in professional services costs; and $17 million in utility infrastructure costs.

Other costs relate to the management of the project and other contractual arrangements, and relocation fees are included in that as well. So there are those two packages of works that we have brought through the Public Works Committee into the parliament for those early works, and that is what we are getting on and delivering. In terms of the other projects, I am happy to provide any further detail in terms of what those specific dollar amounts are for what is being delivered there. What was the first part of your question again?

Mrs HURN: How long have the delays been in starting construction?

The Hon. C.J. PICTON: I will see if there is any further information that we can provide there, but take the new Women's and Children's Hospital project: this was a project that was announced by Premier Weatherill in 2013 and has taken a very long time, over successive governments, to get to the point of actually being underway. You could say, in some respects, that the delay was actually close to a decade in terms of getting works undertaken, so I am not sure where you draw the line there.

We are very pleased that we now have work underway on that project. We have a great team who are working hard and engaging with our clinicians, and we are absolutely confident that this is going to deliver an excellent outcome for the women and children of this state for many decades into the future. I also note the comments of Bernadette Mulholland, representing the Salaried Medical Officers Association, last night on the news saying exactly that: that we need to get this project right. That is what this government is determined to do.

Mrs HURN: On page 84, the Auditor-General notes:

The consolidated entity's total expenses exceeded the original 2024-25 State Budget by $754 million, an 8% overspend.

But he says that is a good job, comparatively, to the last financial year, which was an overspend of 12 per cent. What meetings is the minister involved in to ensure that SA Health sticks to its budget?

The Hon. C.J. PICTON: I am very happy to talk about meetings because I have a lot of meetings. I have a very regular meeting with the chief executive of the Department for Health and Wellbeing in which we quite regularly talk about the budget for SA Health.

I also meet with all of our 10 local health network CEOs and board chairs. I meet with the CEO of SA Ambulance Service. I meet with the executive director of statewide clinical services. I meet with the CEOs of Preventive Health SA and the Commission on Excellence and Innovation in Health. I meet with our infrastructure team. I meet with our mental health team. Part of this job is many, many meetings. There are, effectively, 15 CEOs in SA Health who I meet with regularly. In addition to meetings that I have, there are a number of regular meetings that our various instruments of SA Health have with Treasury officials to monitor budget performance.

I think it is fair to say, of course, that this is an area of government that is demand driven. We see increases in demand facing our hospital system and we have to meet that demand. We try to do so as effectively as possible. We try to do so in the best, most prudent way for budget management as possible, but we also know that we have a responsibility to make sure that patients get the care they need.

As we are seeing an increase in the complexity of the patients who are presenting to us, that is leading to an increase in the complexity of the work that we are doing. As we are seeing barriers in terms of people being able to be discharged from our hospital system, we are seeing a really big increase in terms of what is classified under the national system as maintenance care patients. That is really one of the largest areas of growth that we are facing and that is putting pressure on our budget as well.

Having said that, I think—as the member has noted in the opening of her question—that while obviously there is still overspending occurring, we are seeing that head in a positive direction. We are seeing that improve, which is welcome. It is something that we are obviously keen to continue working on with Treasury, all our local health networks and all the instruments of the department to make sure we can balance getting patients the right care that they need but also as efficiently as possible for the budget.

Mrs HURN: At page 86, I have a couple of questions in relation to agency staff. The budget for agency staff was around $50 million but the actual expense was $200 million. Can you just talk the chamber through that and can you advise, with that $150 million discrepancy, how many additional nurses and doctors were employed via that agency staff—$150 million?

The Hon. C.J. PICTON: Obviously, agency staff is a critical area that we focus on in terms of our budget management issues, because we know it is a key pressure point. It is a pressure point which has been a pressure for a long time in terms of metropolitan hospitals, but we are seeing an increasing pressure in terms of regional hospitals in terms of nursing agency staff but also in terms of medical locum staff. The graph does demonstrate, as you say, that there has been an increase over a number of years. The biggest increase happened between the 2020-21 financial year and the 2021-22 financial year. That clearly showed the largest increase.

I advise that in terms of contractors for agency staff, we have seen some LHNs that are increasing and some that are decreasing. For example, we are seeing reductions in SALHN, WCHN, FUNLHN, and in the department itself. We have also seen some increases in others, in terms of CALHN, NALHN, BHF, Eyre and Far North, Limestone Coast, Yorke and Northern. This is something that is a key focus of that work that I mentioned before in terms of the work that happens between treasuries and our local health networks. It is monitored very closely. It is also a key area of focus for us in terms of making sure that we can replace our need for agency staff with employed staff.

Members will be aware that we have significantly increased the number of staff that we have employed across SA Health over the past three years: some 1,400 extra nurses FTE addition—not agency but actual employed staff. Similarly, there are over 680 additional medical staff FTE above attrition—employed staff, not locums.

One of the key elements of this is making sure that we are increasing the work that we are doing to employ additional staff upon graduation, so we can see record numbers of medical interns that we are bringing in. Over the past few years, we have seen record numbers of TPPPs—the Transition to Professional Practice Program nurses who come on board as well. That has to be a key strategy to make sure that we have our own pipeline of nurses and doctors without having to rely more and more on agency staff.

In addition, we are also, of course, targeting international recruitment. We have regional attraction incentives and flexible employment models. In particular, a key area of recruitment for us has been the United Kingdom, where we have been very successful in being able to recruit a number of doctors and nurses. We have seen a lot of applications from even just a recent trip that we have undertaken to the United Kingdom by a number of our officials taking part in job expos through the United Kingdom. So we see that as a really pivotal market in terms of building our workforce and hopefully replacing our need for much of this agency staff.

Mrs HURN: I refer to the same page but just down a little bit in terms of the fee for service. Obviously, there has been a pretty significant increase in fee for service for doctors, specialists, anaesthetists, allied health, dentists and radiologists during the last four years. It notes that fee for service has increased for a number of reasons. At the first dot point there it says that one reason is that surgeries are being delayed to manage inpatient numbers. How many surgeries have been delayed as a result of this?

The Hon. C.J. PICTON: We are not going to have that figure. We will have to take it on notice.

Mrs HURN: Another reason on page 87 was that the hospitals are unable to recruit medical officers and are relying on fee-for-service arrangements which have increased the cost. Does this speak to a large problem with vacancies for medical officers and, if so, can you advise the chamber how many vacancies there are?

The Hon. C.J. PICTON: I think we have previously discussed, whether it is in this forum or in estimates, or maybe even the department in Budget and Finance, how difficult it is for us to give an accurate number in terms of vacancies given our workforce systems across the various entities of the department. Clearly, when we can see such a significant increase in our medical workforce of over 680 additional staff above the rate of inflation over the past few years, that has led to us having a stronger and more stable medical workforce situation than we did previously. But, of course, we are competing with demand as well.

We have recently signed, sealed and delivered, and now it has been ratified by the SAET, a new enterprise bargaining agreement for our salaried medical officers, which we believe will make it even more attractive for people to be able to work for SA Health and its entities. Part of that is making sure that we can increase junior doctors of all levels under consultant salaries and part of it as well was about additional regional incentives to apply to doctors to work in our regions.

This adds to other key components of our workforce plan in terms of what we have seen in the Riverland Academy of Clinical Excellence. The Riverland Mallee Coorong Local Health Network has been able in the past few years to increase its medical staffing by 40 per cent, which is a huge increase. We are now looking to apply those lessons in terms of the rest of our system in making sure that we can roll out a Single Employer Model across all of SA Health.

In terms of regional contracts, which are obviously a part of this question, there has been a lot of work that has been undertaken between the Rural Support Service, which sits under the Barossa Hills Fleurieu Local Health Network that does work on behalf of all of our local health networks to strengthen our financial controls and our governance processes around our contracting, making sure that we are having in place appropriate contracting arrangements for those staff but also making sure that we can recruit additional staff to not rely on those contracting arrangements as well.

Another area I would highlight is the work that Yorke and Northern Local Health Network have been undertaking in recent years, leading to more salaried work undertaken and introducing an intern program in that region for the first time this year. They have recruited additional staff to work in emergency departments as salaried staff for the first time, and I think we are going to see in coming months and years that medical workforce in that region really significantly increase so that we can meet this need into the future.

Mrs HURN: On page 92, there are a few graphs there, but just focusing on the metropolitan LHNs, there has been a 2 per cent increase in emergency department presentations since 2022, but the percentage of patients who have been seen, treated, discharged or admitted within four hours has decreased by 8 per cent in that same period. Can you just explain that?

The Hon. C.J. PICTON: I am very happy to and I will try not to take the entire remaining time in doing so, but there are a lot of elements in terms of the pressure that our emergency departments face. That is a pretty open question.

The issue is not necessarily just the raw number of people, it is the complexity. There has been a lot of work done to try to reduce the number of people going to emergency departments, whether that is the work that we have done, including—harking back to the previous government—Priority Care Centres, other alternative care pathways, the Virtual Care Service. But now, in addition, Urgent Care Hubs, which we run, but also the urgent care centres, which the federal government runs, all of which have seen less pressure of the lower acuity patients compared to a number of years ago, but we are seeing increasing numbers of higher acuity patients.

Those patients obviously require more care, longer care and are more likely to require admitted care in hospital. At the same time, therefore, that increasing pressure for admitted patients has meant that our emergency departments are regularly facing a problem where they have a number of admitted patients who are waiting for a ward bed and that reduces their capacity to see other patients. So the more patients you have waiting for a bed in the rest of the hospital, who have been treated by the emergency department but are waiting for that ward bed, takes away from the other patients who need that bed in the emergency department.

That is why so much of what we have been delivering has been additional beds across the system to meet that need. Of course, the other challenge at the same time has been aged care—discharging people from hospital. We have seen that rise dramatically. Back when I first became minister there were about 60 people in that situation. This week we have just hit a new record of 296 people in that situation. That takes away beds and then flows right through the emergency department and those people waiting to be seen.

That is the pressure that we face in terms of our emergency departments. You can see, from that graph, there has been an increase in terms of the number of presentations we have seen in the past year. There has also been a big increase in terms of the number of presentations that have happened in our country LHNs as well. Clearly part of that is the ageing of the population, but all of those alternative care pathways that we have developed in the city do not apply in regional South Australia. The impact that has happened to primary care, after a decade of freezing the Medicare rebate and also issues in terms of GP workforce have clearly put more pressure on emergency departments in country South Australia too.

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