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Legislative Council - Fifty-Fourth Parliament, First Session (54-1)
2018-07-25 Daily Xml
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SA Health

The Hon. F. PANGALLO (14:57): I seek leave to make a brief explanation before asking the Minister for Health and Wellbeing a question in relation to patients in our hospital system.

Leave granted.

The Hon. F. PANGALLO: At a Budget and Finance Committee hearing this week, SA Health's new chief executive, Chris McGowan—

The PRESIDENT: Mr Pangallo, you cannot refer to the proceedings of a committee. You could cast your question in a particular way to put your point. I will leave it to you.

The Hon. F. PANGALLO: Thank you, Mr President. It has been revealed that between 30 and 40 per cent of people occupying hospital beds today should not be there. My questions to the minister are:

1. Who are these patients and how many are elderly people who have been shifted there by aged-care facilities?

2. Does the figure also represent the number of patients in our hospital system needing palliative care?

3. Will the department now seriously look at funding more community or home-based palliative care?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:58): I thank the honourable member for his question. I don't think it would have been referring to palliative care patients. I certainly accept the point the Hon. Frank Pangallo makes that there is a marked divergence between the preference of Australians to die in their own home and the number who actually do. My recollection is that 70 per cent of Australians would like to die at home when, in fact, the reverse is the case: about 30 per cent die at home. So there is a lot to be done to give people choice in terms of the place of the delivery of their care.

In terms of groups in that 30 per cent estimate, I'm sure he was including people who are, shall we say, in care awaiting placement, people who have completed their medical treatment and who are awaiting their next care placement: for example, the National Disability Insurance Scheme.

My understanding is that the number of people who are waiting for a National Disability Insurance Scheme or, shall we say, a disability service provision, has more than doubled in the last year. For example, in the Southern Adelaide Local Health Network, there are 40 to 50 people who are in that care awaiting placement situation. It will be partly people who are waiting for either a granting of an NDIS entitlement or people who are yet to, shall we say, put the services in place.

It will also include people who are awaiting residential aged care. Again, there is a significant delay. It varies from time to time. There is a significant delay in, first of all, the ability for people to get ACAT assessments so that their eligibility for residential aged care can be determined and then, once the eligibility is confirmed, being able to actually secure an appropriate residential aged-care placement.

The other group that I think is commonly referred to in that group is the guardianship group. It was my privilege recently to meet with the Public Advocate actually at James Nash House so that I could see the context of the client that she was advocating for. It is not uncommon for people to have extended stays in forensic mental health facilities and other acute facilities as they wait for a more appropriate next step. I have heard of cases of people waiting more than a year. A lot of people can go through a hospital bed in a year, so if a person with a disability or a person with, shall we say, a care need, a person needing residential aged care or the like can't get a placement for a year, it is not good for them and it is not good for the system.

That was certainly a part of what the chief executive was highlighting. It is very important that we not only make sure that we have enough services in the hospital system—inpatient beds and otherwise—but also make good use of them. Certainly, having people in inpatient beds who don't need medical treatment is not a good use of health resources.

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