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Legislative Council - Fifty-Third Parliament, Second Session (53-2)
2017-05-17 Daily Xml
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Motions

Oakden Mental Health Facility

The Hon. S.G. WADE (16:43): I move:

1. That a select committee of the Legislative Council be established to inquire into and report on matters relating to the management of the care of residents of the Older Persons Mental Health Service at Oakden since December 2007, with a particular focus on:

(a) the experience of residents and/or their families and carers as they raised concerns about the quality and safety of the care provided at Oakden;

(b) the effectiveness of statutory officers and other government employees appointed, in part or in whole, to monitor the quality and safety of care provided at Oakden, including:

(i) the Office of the Chief Psychiatrist;

(ii) the Office of the Public Advocate;

(iii) the Office of the Principal Community Visitor;

(iv) the Health and Community Services Complaints Commissioner; and

(v) the Mental Health Commissioner;

(c) the policy and practice of SA Health and the Northern Adelaide Local Health Network in responding to concerns raised about Oakden;

(d) the identification of any legislative or regulatory deficiencies in the oversight arrangements for Oakden that may have contributed to systemic problems at Oakden not being identified and addressed earlier;

(e) the identification of any deficiencies in culture, governance, staff recruitment and training, and management which may have contributed to lower quality and less safe older persons mental health services; and

(f) any other relevant matters.

2. That standing order No. 389 be so far suspended as to enable the chairperson of the committee to have a deliberative vote only.

3. That this council permits the select committee to authorise the disclosure or publication, as it sees fit, of any evidence or documents presented to the committee prior to such evidence being presented to the council.

4. That standing order No. 396 be suspended to enable strangers to be admitted when the select committee is examining witnesses unless the committee otherwise resolves, but they shall be excluded when the committee is deliberating.

The motion relates to seeking to establish a select committee in relation to the Older Persons Mental Health Service at Oakden. In recent days, the parliament and the public of South Australia have become aware of a decade of neglect and abuse in relation to that service, neglect that relates to a lack of planning. We saw a recommendation from the Cappo report that older persons mental health services be a particular focus of planning, and nothing was done.

We saw an attempt to develop a model of care, but the lack of leadership within SA Health, including a whole conga line of ministers, meant that that model of care went no further than a draft. We saw a decade of neglect in terms of capital investment. My understanding is that there were a number of capital renewal programs suggested in relation to Oakden and none of them got past the minister's desk.

We have learned of serious understaffing of this very challenging mental health service over a number of years and also, in terms of staffing, an appalling mix. Considering that this was one of the most challenging mental health services in the state, there was a serious lack of allied health support in particular.

Since the community has become aware of those issues, the Groves report—the Oakden review, as it is commonly known—has been released. That has led on to a whole series of other reviews. There is a commonwealth review of accreditation processes and SafeWork SA has announced a review of nursing homes, as I understand it, right across the state. SA Health has announced a clinical audit of aged-care services right across this state and, of course, there is a coronial inquest into the death of one of the residents at Oakden.

I note the calls by members of families that resources be made available to the Coroner to enable him to look at other deaths at Oakden. I also note the concerns of the Principal Community Visitor. He believes that a number of the deaths that occurred in the last 10 years need to be looked at again in terms of whether or not they raise issues that should be given consideration by the Coroner. As well as the Oakden report itself, there is a number of pieces of work that are being done to try to understand what has happened in the past decade and to try to make sure it does not happen again.

Very early after the release of the Oakden report on 20 April, the Hon. Kelly Vincent and I held a joint press conference outside the Oakden facility and called for a parliamentary committee to look at Oakden. Both the Hon. Kelly Vincent and I are members of the Joint Committee on Matters Relating to Elder Abuse, and we suggested that that would be an appropriate vehicle. We were pleased to note that, soon after, the member for Fisher, Nat Cook, who is the chair of the joint committee, endorsed the value of an inquiry. There are reports that the minister also indicated that she would welcome an inquiry.

My view is that the current terms of reference of the Joint Committee on Matters Relating to Elder Abuse do encompass the whole of the Oakden saga. Nonetheless, the government, through the member for Fisher, moved an amendment in the other place to add Oakden as a specific term of reference. Likewise, on behalf of the Liberal team, I moved an amendment in this place in our last sitting week to reinforce the fact that Oakden comes within the terms of reference by adding a specific term of reference.

In my speech on moving that amendment, I recognised that there was concern that the joint committee might get overwhelmed by the Oakden reference. Let us remember that when the Hon. Kelly Vincent and I suggested that the joint committee might take the task on, it was two days after the Oakden review was released. It would be fair to say that almost every day since has delivered yet another revelation that raises further concerns. So, the issues have become much more prolific. In that sense, the task that we were hoping the joint committee might be able to assist us with has become more challenging.

The Liberal team in the joint party room considered the best way forward at our meeting this week and resolved that the best way to do justice to both the broader issue of elder abuse and the specific issues in relation to Oakden is that we establish a separate select committee on elder abuse, so that is the motion that I am moving today in the Legislative Council.

I will briefly highlight how I would characterise these terms of reference. In drafting them, the Liberal team has been very respectful of the other inquiries that are going on. Also, to be frank, we are humble as to what value-add a parliamentary committee can give. In that regard, I would suggest that there are two particular themes in these terms of reference. The first theme is in relation to the role of statutory officers and other government employees in receiving concerns raised by residents and their families and carers, which of course is a significant responsibility of parliament. We appoint statutory officers, or at least relate to statutory officers, in their role as fully or partially independent officers, if you like, working with the parliament to provide oversight of the executive.

Point (c) in the terms of reference refers to the policy and practice of SA Health and the local health network in responding to those concerns. One thing that has been very chilling in the Oakden saga is the deafness of the local health network and the whole conga line of ministers in responding to the concerns as they were raised. I pay tribute to this council and particularly the leadership of the Hon. Michelle Lensink, who in 2009 fought the government to insist on amendments to the Mental Health Act to establish the role of the Principal Community Visitor to oversee mental health facilities.

When the histories are written—and we are far too close to it to know yet—I think the role of the Principal Community Visitor in exposing the neglect and abuse at Oakden will be seen as a significant contribution. To be frank, if this council did not assert its independence and insist on that role being established in 2009, I do not believe the role would exist even now. I would suggest that terms of reference (a) to (c) are very much appropriate for a parliament that invests its trust in officers, such as the Principal Community Visitor, to actually see why, since the Principal Community Visitor has been issuing reports since 2011, all the red flags were ignored.

There was a whole series of monthly reports since 2011. The parliamentary Select Committee on Transforming Health was advised by Jackie Hanson, the CEO of NALHN, last week that, in spite of all of those reports, only once did a concern in relation to Oakden manage to get itself onto the risk register of the local health network and that was only in the last quarter of last year. I suspect it got onto the risk register because the matter was already being escalated within the minister's office following a direct approach from the Principal Community Visitor to the minister in October 2016.

My understanding is that there was then a referral to the CEO from the minister's office in November and then meetings with the CEO of NALHN, the Chief Psychiatrist and the Deputy Chief Executive of Systems and Performance in December. If parliament wants to continue to put its trust in statutory officers to provide independent oversight, we have to be confident that the executive and the public sector is respectful and responsive to those officers as they do their work.

The next theme, I would again submit, is very much in the focus of the parliament in the sense that term of reference (d) focuses on any legislative or regulatory deficiencies in the oversight of Oakden that may have contributed to systemic problems at Oakden not being identified and addressed earlier. Term of reference (e) is in relation to the general culture, governance, staffing and management, and I believe it is appropriate that, as a parliament, we provide general oversight of the performance of the executive in providing quality and safe services.

In providing that oversight, I think it is very distressing that today we learned of yet another assault at the Oakden facility. That is the second assault that has come to public attention since the Oakden report was tabled on 20 April. The minister has been assuring us for months now that, even before the Oakden report was received, she was taking all the actions she needed to take to protect the Oakden residents, to the point that seven weeks ago, on 28 March, she told the House of Assembly:

…the Northern Adelaide Local Health Network was taking, and continues to take, immediate steps to ensure that the quality of care at Oakden is of the highest standard and that all residents are safe.

How chilling those words are now—'all residents are safe'. In spite of that, on 28 March, she made that statement. On 20April, she belatedly released the Groves report, yet on 9 May, a resident was reportedly assaulted and another yesterday, on 17 May. I believe that minister Vlahos has failed in her duty to protect patients and ensure that the services at Oakden are safe. It is a month since she received the Chief Psychiatrist's report and clearly she does not have the leadership capacity or the understanding of her portfolio to drive positive change.

I reiterate the calls of my leader, Steven Marshall, the member for Dunstan, on the Premier to sack the minister. She clearly has no intention of resigning. When she continues to fail in her duty to provide safe quality services to our most vulnerable elderly South Australians, I believe that the Premier and the minister are duty bound to have her relinquish her role. It is very important that we take immediate action to make the services safe and to start planning future services.

The fact that she has no grasp of her portfolio was demonstrated in the House of Assembly this week, or it might have been last week. On Tuesday, she managed to demonstrate that, if she had read the Oakden report, she certainly did not understand it. When the Leader of the Opposition in the other place asked her a question in relation to model of care, she queried whether he was referring to a report in a footnote. I am sorry: model of care is a chapter, 30 pages long. You cannot read the Oakden report and understand it and not realise that it is addressing models of care.

Again, in House of Assembly question time today, she was being quizzed about tier 7 clients. These are clients who have the most extreme form of behavioural and psychological symptoms of dementia. She clearly did not understand that the clear policy direction of the Chief Psychiatrist's report is that clients with tier 7 BPSD cannot be accommodated in the private nursing homes network: they need a specialist mental health service and that needs to be in the public sector. This minister clearly cannot deliver safe services. Clearly, she cannot manage or understand her portfolio. It would do this state a great service if she were relieved of her post.

Coming back to the terms of reference, obviously the failure of a whole series of ministers to provide leadership and appropriate management of services all contributed to a decade of neglect and abuse. I believe there are significant failures in management and in terms of policy and planning of service delivery. Certainly, very important issues need to be addressed.

Considering the array of select committees we have, I believe that the issues raised in relation to Oakden and older persons' mental health services generally are of such grave concern that this Legislative Council should take the step of establishing a select committee. In the context of the range of inquiries that are underway, it is very important that we do everything we can to make services safe for some of our most vulnerable elderly South Australians.

Debate adjourned on motion of Hon. J.M. Gazzola.

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