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Legislative Council - Fifty-Third Parliament, Second Session (53-2)
2016-05-25 Daily Xml
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Modbury Hospital

The Hon. S.G. WADE (15:34): I rise to express concern at the government's downgrade of Modbury Hospital under its controversial Transforming Health plan. The government's focus on reducing the number of hospital beds to the national average is a key strategy in their budget savings plan. They plan to close around 670 hospital beds, which is equivalent to the size of the Royal Adelaide Hospital. Key to that strategy is closing three hospitals—the Repat, Hampstead and St Margaret's. As a result, Modbury will take on 32 rehabilitation beds.

Labor had a choice and Labor chose to slash front-line services, rather than reduce the waste and bureaucracy in SA Health. That decision will undermine the quality and accessibility to health care in the north and north-eastern suburbs for years to come. Since 1973, Modbury Hospital has faithfully served the local community in the north-eastern suburbs of Adelaide, providing a wide range of emergency and surgical services. Under Transforming Health, these crucial services will be lost, changing Modbury from a general community hospital to a centre for rehabilitation and day surgery. Modbury will no longer deal with life-threatening emergencies; they will be diverted away from Modbury or stabilised before transfer.

In an emergency, when minutes and even seconds can be crucial, patients and ambulance services will be forced to make critical decisions in chaotic circumstances. Choosing between the risk of being turned away at Modbury and using vital time to go further to Lyell McEwin where relevant treatment may be available, patients may well be forced to make life or death decisions which they simply do not have the medical knowledge to be able to undertake. We are very concerned at the downgrading of the Modbury emergency department and the establishment of two tiers of emergency departments in our metropolitan hospitals.

These concerns are broadly shared in the medical community. The AMA, SASMOA, the Royal Australasian College of Physicians and the Australasian College for Emergency Medicine have all expressed their opposition to some or all of the changes. Very recently, the Royal Australasian College of Surgeons head, Sonja Latzel, spoke of the risk to patients with potential airway blockages. The Ambulance Service is needing to operate a shuttle service for patients between Lyell McEwin and Modbury. Would that money not be better spent funding a full service emergency department at Modbury? Diverting patients to other hospitals will lead to fewer admissions to Modbury Hospital. In the longer term, I fear, the hospital may become unviable and will close.

Modbury will no longer have comprehensive medical and surgical services. Complex and emergency surgery will be undertaken at Lyell McEwin. The existing eight-bed high-dependency unit will be closed. Without a high-dependency unit, any patient who is seriously ill or who deteriorates in the emergency department or anywhere else in the hospital, will need to be transferred to a HDU or an ICU in another hospital. The closure of that unit will see a further loss of important specialist staff. As the availability of these and other specialist staff declines, so will the emergency department's capacity to diagnose and treat a range of cases. Without support, in the event of complications, patients with multiple conditions may need to be transferred to another hospital to undertake minor procedures.

In terms of the training space, there will be an overall loss of availability to teach and train medical students, specialist trainees and nurses. My understanding is that, even this year, Modbury will not be having interns. These changes are deeply concerning, particularly for local residents where appropriate medical treatment may depend on chaotic transfers between hospitals. Patients will be forced to travel further for treatment, placing a heavier burden on already strained emergency services and neighbouring hospitals. The changes at Modbury pose a risk to the efficiency of the whole health system, with alternative hospitals being forced to deal with the transfer of patients from Modbury.

The Lyell McEwin Hospital, where a majority of emergency cases are expected to be transferred, is already struggling to meet the increasing demand. For the past six days, the Lyell McEwin emergency department has spent at least an hour every day operating at code white. That is not just over capacity, that is seriously over capacity. It is clearly not enough to rely on already stressed emergency departments to accept the load from Modbury where there is not an adequate reallocation of resources to help with this influx of patients.

In conclusion, I put it to the council that the downgrade of Modbury Hospital is a breach of trust by this government. The government promised to protect Modbury Hospital, but it will no longer be a general community hospital, it will be a regional rehabilitation and day surgery centre. The people of the north-east have yet again been let down by this Labor government and the members who they elected to represent them here.

The PRESIDENT: Hopefully, the Hon. Mr Brokenshire, you have relieved yourself of all your frustrations and you are going to give us a very productive five minutes.

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