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Legislative Council - Fifty-Third Parliament, Second Session (53-2)
2017-05-10 Daily Xml
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Parliamentary Committees

Joint Committee on Matters Relating to Elder Abuse

The Hon. S.G. WADE (16:03): I move:

1. That it be an instruction to the Joint Committee on Matters Relating to Elder Abuse in South Australia that its terms of reference be amended by leaving out at the end of paragraph (j) the word 'and' and paragraph (k) and inserting the following new paragraphs—

'(k) occurrences of elder abuse at the Oakden Older Persons Mental Health Service;

(l) the effectiveness and accountability of the management of the Oakden Older Persons Mental Health Service, including the management of Northern Adelaide Local Health Network, SA Health, parliamentary secretaries and ministers, in the prevention of and responding to elder abuse;

(m) the effectiveness of the Principal Community Visitor, the Chief Psychiatrist, the Public Advocate, the Coroner’s Court, the Mental Health Commissioner and the Health and Community Services Complaints Commissioner in highlighting and responding to issues in relation to the Oakden Older Persons Mental Health Service and policy and practice of SA Health and the Northern Adelaide Local Health Network in responding to concerns raised;

(n) the policy, practice and training on the reporting of elder abuse in the Northern Adelaide Local Health Network and SA Health and its relationship to the Safety Learning System, reporting of possible criminal acts to police and protocols of alerts to the minister;

(o) the policy, practice, training and reporting of elder abuse and the effectiveness of responses to elder abuse in the Oakden Older Persons Mental Health Service; and

(p) any other related matter.'

2. That a message be sent to the House of Assembly transmitting the foregoing and requesting its concurrence thereto.

The motion I am moving today seeks to add to the terms of reference of the Joint Committee on Matters Relating to Elder Abuse in South Australia. It follows a public call from the Hon. Kelly Vincent and myself for the committee on elder abuse to look at the situation in relation to the Oakden Older Persons Mental Health Service.

Let's remember that elder abuse is fundamentally defined as abuse of an older person where the person is in a position of trust. For example, it is most commonly seen in the context of perhaps a child or a partner and whether or not they have committed abuse in a position of trust. The other context of elder abuse, which was highlighted last year by the case of Noleen Hausler, was the abuse that can occur within residential aged care and had been seen to occur in the Mitcham residential aged-care facility.

The committee was established originally on the initiative of the Hon. Kelly Vincent making a referral to the Social Development Committee and then working in cooperation with the member for Fisher in the other place to develop terms of reference in relation to a joint committee. Since the committee was established, the Oakden situation has emerged and I believe it is appropriate that the committee look at issues in relation to Oakden.

If elder abuse is about abuse in the context of a trust relationship, that is exactly what we have when it comes to government-provided health care, government-provided aged care and, in this context, a facility that provides both. I acknowledge that both the member for Fisher, who is the chair of the committee, and the minister have indicated their openness to Oakden being considered by this committee. The member for Fisher has indicated that she will also move a motion in the other place to add to the terms of reference, so it may well be that we blend the elements of the two motions so that the committee can have clarity in its focus.

I indicate to members that, to facilitate this process in what is, after all, the final sitting year of this parliament, I propose that my motion be put to a vote next Wednesday. I look forward to discussions with the Hon. Nat Cook, the Hon. Kelly Vincent and any other member to see if we can blend the terms of reference to cover all the relevant points. In that context, I would like to highlight the relevance of some of the terms of reference that I am proposing. Element (k), which talks about the occurrences of elder abuse at the Oakden Older Persons Mental Health Service, gives an opportunity for families and other stakeholders to present evidence to the committee that they think is relevant in relation to Oakden.

The second element talks about the effectiveness and accountability of the management of the Oakden service, including the management by the local health network, SA Health, parliamentary secretaries and ministers in the prevention of, and response to, elder abuse. I am concerned that there has been too much focus on staff on the site and not enough focus on the wider responsibilities of management and ministers, whether that be at the local health network level, the SA Health network level or in the executive.

In that regard, I am mindful of the fact that the Principal Community Visitor's reports, which would have been submitted in relation to the Oakden facilities since 2011, go to the executive director of mental health—or whatever position title they have gone by, from time to time—within the Northern Adelaide Local Health Network, which, of course, also had a different title from time to time. I think people are saying, 'Well, if we've got these oversight bodies, and the Principal Community Visitor is making monthly reports and raising concerns, what have management been doing about it?'

That leads me on to the next point, which is proposed term of reference (m), which talks about the effectiveness of the Principal Community Visitor and a whole series of what I would call oversight bodies in highlighting and responding to issues at Oakden and then goes on to state:

…and policy and practice of SA Health and the Northern Adelaide Local Health Network in responding to concerns raised;

In that context I was interested in an interchange that occurred in the House of Assembly earlier today—in fact, a little over an hour ago. The Leader of the Opposition, the member for Dunstan, asked minister Vlahos, 'Did the minister act upon the very specific recommendation'—of the Principal Community Visitor—'regarding Oakden?' The minister's response—and I appreciate that this is only draft Hansard—was, 'I would have to reread the community visitor's report before I answer that question.' I found that non-answer absolutely stunning.

Let's remember that it is four weeks since the government received the Chief Psychiatrist's report, it is three weeks since that report was made public—10 April—and I think anybody would agree that there has been intense scrutiny in relation to the Oakden matter, and yet a report that was given to the minister on 30 September, addressed to the Hon. Leesa Vlahos, signed by Morris Corcoran, dated 30 September 2016, tabled in the parliament, as I understand it, in December with a specific recommendation about Oakden, is not even on the minister's radar. Let me read an excerpt from the report:

The CVS holds significant concerns regarding Oakden Services for Older People which has arisen from both visit reports and a range of individual investigations that have been undertaken as a result of specific complaints that we have made on behalf of individuals and families.

Then the report goes on about the concerns that the Principal Community Visitor has in terms of the staffing. It states:

Staff at Oakden have explained they receive the most challenging clients of the acute wards, yet the mental health unit has lost a number of Allied Health roles, particularly the Social Worker role who was responsible to secure appropriate accommodation for clients and the psychologist who has worked on behavioural plans. This has placed pressure on the leadership to take on additional responsibilities to fulfil what these Allied Health roles offered.

Community Visitors and the CVS office have received concerns from three families regarding the treatment and care of their loved ones at Oakden. These have included reported frequent falls, observed bruising, medication errors, increased sleepiness, drowsiness, and reported decline of daily functioning. It was also commented that there are not enough staff available on wards, and it has been reported that Oakden use 1 staff member to 4 client ratio, whereas acute units may use 1 staff member to 3 client ratio. Staff and senior leaders within this unit are highly dedicated and strive to do the best they can with the limited resources available.

A specific recommendation from the Principal Community Visitor to the minister is:

That a review is undertaken of the clinical hours in contrast to patient acuity at Older Persons Mental Health Services at Oakden to ensure the provision of quality and safe care to patients residing in this facility.

What I think was fundamentally disturbing about the minister's response in the house today was that it was not even on her radar that the Principal Community Visitor had issued a report which indicated his concerns about care at Oakden and about the need to improve staffing. Coming back to my proposed terms of reference, term of reference (m) says not only do we need to ask how effective have the oversight bodies been but also how responsive has management and the minister been.

I could be corrected but my understanding is that the only oversight body where a government is required on a consistent basis to respond is in relation to coronial inquests into the deaths of Aboriginal people in custody. My understanding is that there was a report on progress requirement in relation to the Mullighan inquiries, both the first Mullighan inquiry and the APY Mullighan inquiry, which I think was a five-year progress report requirement, but now that, as I understand it, both of those five years have expired my understanding is that the requirement to report to coronial inquests is, if you like, the only mandated response.

It may not be feasible or appropriate for every recommendation from every oversight body to have a mandated response, but I do think it is appropriate that we ask, in the context of the Oakden situation. It is all well and good for parliament to put oversight bodies in place but, if we are not having a conversation between the parliament, the executive and the oversight bodies, what is the point? If oversight bodies can put up red flags and nobody is looking for the flags, are we actually doing anything effective to protect vulnerable people?

The next two terms of reference I am suggesting are what I would call sister provisions. The whole essence of my additional terms of reference is to try to make sure that we do not just look at the Oakden precinct, but that we look at Oakden in the context of its wider local health network, management, SA Health management and executive oversight.

Suggested terms of reference (n) and (o) relate to similar matters in terms of the reporting of elder abuse, but (n) puts it in the context of the policy, practice and training on the reporting of elder abuse in the Northern Adelaide Local Health Network and SA Health, and (o) talks about it in the context of Oakden itself. It is very important that elder abuse is identified and reported. The Chief Psychiatrist highlights problems that his review identified, both in Oakden and beyond. He was particularly concerned, for example, with the failure to report elder abuse, which was contrary to SA Health policies.

In conclusion, as I said at the beginning, this committee was established very much at the instigation of the Hon. Kelly Vincent and the member for Fisher, and has been working very cooperatively and positively. We believe that the Oakden matter would have come within the original terms of reference in any event but, considering the limited time between now and the next election, we thought that it would be helpful for the parliament to put on the record some of the key issues that need to be considered.

In that context, as I said at the beginning, I am keen to talk to the Hon. Kelly Vincent, the member for Fisher and any other member about blending and refining the terms of reference and also, if you like, to be realistic about the assessment of the task. If in those discussions it is considered that a select committee might be a more expeditious way to progress these matters, that may well be the case.

After all, with all due respect, the reason the select committee has got it is that the Social Development Committee was overwhelmed. We do not want a leapfrogging of workloads. The issues are what is important and not which vehicle carries them. I commend my motion to the council and indicate that my door is open for any discussions on how we can best take steps to protect South Australians from elder abuse in future.

Debate adjourned on motion of Hon. J.A. Darley.

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