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Legislative Council - Fifty-Fourth Parliament, First Session (54-1)
2019-10-29 Daily Xml
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Ambulance Ramping

The Hon. C. BONAROS (15:20): I seek leave to make a brief explanation before asking the Minister for Health and Wellbeing a question about SA Health.

Leave granted.

The Hon. C. BONAROS: Yesterday, it was revealed that a patient died after being stuck in an ambulance outside the RAH earlier this year, the second claimed ramping-related death in 12 months. This follows the Independent Commissioner Against Corruption recently going public about his concerns over alleged corruption and maladministration within SA Health, and it comes on top of the recent revelation that CALHN's new data integrity unit mysteriously stumbled on $54 million missing from its accounts. All of this has occurred in an environment where the NRAH is virtually terminal and professional bean counters have been called in to stop it from going bankrupt. My questions to the minister are:

1. What is it going to take for this government to consider the need for a royal commission into SA Health, given the grave extent of the issues that have occurred to date?

2. Does the minister support the call for Commissioner Lander to appear before a select committee on health services to provide evidence about the concerns that he has raised?

3. Does the minister believe that the taxpayers of South Australia, those who fund SA Health's annual budget, have a right to know more details about the commissioner's concerns?

4. Does the minister believe that his government has a responsibility to the very same taxpayers that their taxpayer funds are being spent as effectively and as efficiently as possible?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (15:22): I thank the honourable member for her question. I might take this opportunity to challenge an assertion made in the member's introduction because I don't want it left unaddressed. She asserted that a patient died on the ramp earlier this year. In the case that was highlighted yesterday, the patient did not die on the ramp. A subsequent investigation did not make any specific recommendations related to the way that the patient was treated and, as is normal process, the matter has been referred to the Coroner.

However, I took the member's general comments as an indication of her often-expressed view of significant problems in SA Health and, on that, the member and I completely agree. I believe that SA Health needed fundamental reform when we were elected and that is what we embarked on. It was very early in my time as minister that I met with the ICAC commissioner and he expressed his concern about the culture and management of SA Health. It was in the context of those concerns and the concerns that I brought into this portfolio as minister that the government, of which I am part, invested $18 million in the KordaMentha cultural and financial recovery plan.

I stress the naming of that plan: financial and organisational recovery. Right from the word go, KordaMentha recognised that what was needed in SA Health was not just a financial recovery plan, it needed to have a cultural element. For example, one of the four priorities in the recovery plan was to specifically deal with 'culture and governance'. There was a need for management restructure, with clearer lines of accountability. That has been done. There was a need for better record keeping and management of those records. We saw the benefit of that in terms of the significant improvement of coding. It is like, as I said to this house earlier, a plumber running around the countryside providing a service but not bothering to put in invoices.

The honourable member had some particular questions, so let me address those. The honourable member challenged me as to whether I would support a royal commission. My party does not support a royal commission, and we were elected on that basis. The honourable member's party went to the last election arguing for a royal commission. We did not support a royal commission because the case was too urgent. A royal commission takes a significant amount of money, a significant amount of time to consider matters, and we didn't believe it was the best way to respond.

I have already mentioned the KordaMentha initiative as a major opportunity to improve the culture and governance of SA Health. Another initiative we introduced, as the Marshall Liberal government, was to decentralise, to introduce board governance. Unlike the former Labor government, which spent 16 years centralising and centralising, we thought it was naive to think that a bunch of bureaucrats in Adelaide could provide effective oversight of 40,000 employees scattered across the state.

We are devolving power to local networks with local boards. Those local boards are substantially populated from people from beyond the health industry. They also bring a range of skills in terms of legal/commercial/human resources skills. They also have working with them risk and audit committees. We believe that board governance will significantly improve the culture and governance of SA Health.

The honourable member asked me whether I supported Commissioner Lander attending the parliamentary committee: it is completely up to the parliamentary committee who they invite; it is completely up to Commissioner Lander to consider which invitations he accepts. In terms of the question in relation to more detail, the government certainly welcomes the commissioner's statement last week in a letter, where he detailed some of his particular concerns. They related to the employment of medical officers and properly accounting for their time and services, administration of rights of private practice, conflicts of interest, record keeping, management of clinicians and cultural issues.

The commissioner indicated in that letter that he will be providing a report to this parliament in December, and I can assure you that I am very keen to see that report and to gain from the insights that the commissioner has developed through six years in the role and the engagement in more than 1,000 complaints related to SA Health.

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