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

Select Committee on Transforming Health

The Hon. S.G. WADE (17:04): I move:

That the second interim report of the committee be noted.

The fate of Ward 17 symbolises the disaster that is Transforming Health. It highlights the flawed and disingenuous way that the government has used selective information and carefully structured processes in an effort to camouflage its controversial and unwarranted health cuts plan. It demonstrates repeatedly that the health plans that Labor is rolling out across Adelaide are not ultimately driven by a commitment to improve health outcomes, but by political expediency and Labor's inability to manage the state's budget and in particular the health budget.

In its first interim report, the committee exposed serious flaws in the way that the government had gone about deciding where to build the new centre for post-traumatic stress disorder services, in effect the rebuild of Ward 17. In that first report, the committee found it had been premature for the government to identify a site for the facility when a decision about the future use of the Repatriation General Hospital site at Daw Park had not yet been made, and that in doing so it was closing the door on opportunities to significantly improve the delivery of PTSD services and other health services on the Daw Park site as part of a veterans' and ageing health precinct.

The committee's first report also highlighted that the government had used its decision to withdraw health services from the Daw Park site to make it impossible for the ministerial expert panel to recommend that the government consider building the new Ward 17 at the Repat. For example, the government said that no SA Health services could remain on the site. What was galling for a number of members of the expert panel—10 of whom gave evidence to the committee—was the way the government tried to give the impression that the panel had been able to examine and seriously consider the possibility of rebuilding Ward 17 at Daw Park and the way that this pretence was portrayed in the panel's final report.

Equally galling for those members was the claim contained in the expert panel's final report to the minister that the decision to recommend that the new Ward 17 be built at Glenside had been unanimous. Evidence to the committee from some panel members, and documentation subsequently provided by SA Health, made it clear that this was not the case. The expert panel did not reach a unanimous decision as to where the new PTSD facility should be built. Its final report and the government's public statement should not have misled the community of South Australia that it was.

In the recommendations of the first interim report, the committee laid out a credible pathway that, if followed, would have enabled the government to get the process of identifying the best site for the new Ward 17 back on track. It had the opportunity to restore the veterans' and broader South Australian communities' confidence in a process where options were being properly considered. The government failed to adopt the recommendations contained in that report. It refused, in particular, to press the pause button, broaden the options, engage the commonwealth and review the decision. As it was, many South Australians, including many in the veterans' community, are not convinced that the correct site has been selected and feel that the process used to settle on the Glenside option was rushed, flawed and driven by the government's political imperatives to break its promise to never ever close the Repat.

Since the government made its announcement on 2 August last year, I have had the opportunity to discuss the proposal to move Ward 17 to Glenside with a number of men and women who hold senior roles in South Australian veterans' organisations and members of the veterans' community generally. Some of those discussions occurred within the context of the committee, some in others. Some of those veterans leaders have suggested to me that the veterans who camped on the steps of Parliament House for 161 nights last year were an unrepresentative fringe group when it comes to the Repat and were out of step with the bulk of the veterans' community.

One of the ways I responded to that suggestion was to remind the leaders that the Sunday Mail's annual Your Say SA survey report published in November last year found that 75 per cent of South Australians do not support the closure of the Repat. I simply put it to those leaders that I have no doubt that opposition to the closure would be higher, not lower, among South Australian veterans. The fact of the matter is that the small group of veterans who slept on the Parliament House steps under the dignified and courageous leadership of Augustinus Krikke I believe truly represented the views and hopes of the vast majority of South Australians, including the vast majority of the veterans' community, who want the Repat to stay open and for Ward 17 to be rebuilt on that site.

Reflecting on the courage and determination shown by Augustinus Krikke and his team leads me to reflect on that wider veterans' voice. I think that voice was not as strong as it might have been as a result of some confusion over the veterans consultation mechanisms and how they were tasked in advising the government on veterans' health matters.

Some evidence to the committee from veterans' health leaders suggested that the government had not engaged with the Veterans Health Advisory Committee on the issue of closing the Repat and relocating Ward 17 because the role of advising the Minister for Health on such matters had shifted to the Veterans Advisory Council instead. Not only is addressing veterans' health the Veterans Advisory Council's core business, the Veterans Advisory Council informed me that it had not taken over this responsibility. There seems to be a lack of clarity on the roles, and I feel that the voice of veterans would have been weaker as a result.

The committee also looked at how conflicts of interest were managed within the expert panel. I stress that the recognition and management of conflicts of interest does not impute any impropriety; the whole point of recognition and management is to avoid impropriety. There is no doubt that some members did have interest to manage. Veterans' leaders are busy people, and we all know that if you want something done, ask a busy person. Accordingly, some members had links with more than organisation, and those organisations had more than one set of interests. Those interests might have related to moving Ward 17 to Glenside or in relation to the sale of the Repat hospital site.

Although the committee was told that possible conflicts of interest had been recorded at an early meeting of the expert panel, no such record was produced by SA Health during the hearings. The committee asked SA Health to provide it with a copy of all the documentation pertaining to expert panel conflicts of interest. In its reply, SA Health advised that no such documentation exists.

It is disappointing that in the haste to get an outcome from the expert panel, SA Health did not take the time to properly document and manage this important aspect of the panel's work. Likewise, the committee was bemused at the lack of documentation that SA Health provided to support the operation of the panel. We believed, as a committee that it was important for the transparency of the decision-making process that such documents be kept.

Since the committee's second report was tabled back in February, the Public Works Committee of the other place has examined the government's plan to build its new PTSD facility at Glenside. The committee's report, which was tabled in the other place last week, included a minority report from two members of the opposition.

I would encourage council members to read that minority report, as it reinforces a number of the concerns that the select committee of this place identified in relation to how the government is planning to manage veterans with PTSD who also have other comorbidities. At the moment, those veterans are able to have those comorbidities dealt with onsite at the Repat in most cases. In future, if the new facility at Glenside goes ahead, those patients may well have to be shuttled back and forth to Flinders or the RAH, or quite possibly find that they will not be admitted to Glenside in the first place.

Indeed, during its appearance before the Public Works Committee, SA Health indicated that older veterans with PTSD who have other serious medical disorders might be sent to the older persons' mental health unit at Flinders instead. The select committee received evidence that around 75 per cent of the clients of Ward 17 have comorbidities.

Given that, and given that the majority of Ward 17's clients are Vietnam veterans, I am very concerned that the government's plan may well see the majority of Ward 17's existing clients lose access to specialist PTSD services. This is an appalling, unjust outcome. As a nation, we failed Vietnam veterans when they first returned home; we should not be letting them down again. This was, I understand, the first time in more than 4½ years that a Public Works Committee report included a minority report. Clearly, it is not something that is produced often or lightly.

In conclusion, I believe the committee has provided this council, the government and the community with a clear, balanced assessment of the pros and cons or the changes to post-traumatic stress disorder services. If the government continues with its current course, these reports will stand testament to their political, policy and health service delivery failure. I commend the motion to the council.

Debate adjourned on motion of Hon. J.S.L. Dawkins.

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