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Legislative Council - Fifty-Fourth Parliament, First Session (54-1)
2018-11-07 Daily Xml
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Health Services

The Hon. C. BONAROS (16:03): I move:

1. That a select committee of the Legislative Council be established to inquire into and report on health services in South Australia, with particular reference to—

(a) the opportunities to improve the quality, accessibility and affordability of health services including through an increased focus on preventative health and primary health care;

(b) the South Australian experience around health reform in the state, specifically Transforming Health, EPAS, the reactivation of the Daw Park Repatriation Hospital and other related projects and/or programs;

(c) the federal government’s funding of state government services and the linking of other federally funded services in South Australia, such as Medicare funded GP services, Adelaide Primary Health Network and Country Primary Health Network;

(d) any related matters.

2. That standing order 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.

I rise to speak now on the motion. It is no secret that the state's public health system is in crisis. Today's front page news in The Advertiser that ambulance ramping at the new Royal Adelaide Hospital has reached flashpoint is a stark reminder of just how much. According to The Advertiser, all metropolitan hospitals were on Code White, meaning they were operating beyond their emergency department's official capacity on Monday and early on Tuesday.

To stress the point, the NRAH had a record 18 ambulances ramped in its car park, with patients waiting for a bed inside the ED, leaving fewer available for emergency calls. Clinicians due to finish shifts at 11pm were still working at 1.30am, unwilling to leave colleagues overwhelmed by demand. More than 100 patients were seeking help in the 71-cubicle RAH ED. Mental health patients awaiting a placement bed were stuck in the RAH ED for more than 40 hours after treatment, adding to delays for new arrivals. That was over a period of less than two days at only one hospital.

Of even more concern is the revelation from someone in the know that ambulance ramping is actually killing people. Giving evidence before a committee hearing into the mental health of emergency service workers, Ambulance Employees Association state secretary Phil Palmer revealed that two people died last year because ambulances were ramping outside overcrowded hospitals and were unavailable to respond to urgent cases. To quote Mr Palmer:

Last year we assert there were at least two deaths because there were 20-minute plus response times to what should have been an eight minute response time.

That is something you would expect in a Third World country, not in a prosperous and wealthy country like Australia or in our capital city. That alone is an appalling indictment on the current health of our public health system, but it gets worse—much worse, in fact. There is no way of knowing the total number of people who may have died or had significant setbacks to their treatment due to unacceptable flaws in our public health system. We have heard, ad nauseam, the woeful failings of Transforming Health, and I do not intend to take up the chamber's time now in further discussing that point. Similarly, the abject failure of the health system's trouble-plagued EPAS electronic patient record system needs no more comment from me, except to say: what an absolute waste of taxpayers' money.

To now learn that the system will be overhauled, or perhaps scrapped altogether, after more than $470 million has already been spent on it is an absolute disgrace. That is desperately needed money that could and should have been directed elsewhere into the health system. Acutely aware of this mess, SA-Best went to the state election calling for a royal commission into the state of the health system. We strongly believe a royal commission is warranted, but our call was emphatically shut down by both the major parties. I understand why Labor did not and still does not support it. After being in government for the past 16 years, they know where the corpses are. However, I was perplexed as to why the Liberals did not support our call, as a royal commission could have, once and for all, got to the bottom of the mess we now find ourselves in.

That said, I am hopeful that my motion for a select committee will be seen by everyone in this chamber as somewhat of a compromise. The crisis impacting our public health system is a matter of state importance. As such, it demands the support of everyone in this chamber, whatever their political allegiance. People are dying as a result, and more lives are literally being put at risk each and every day. The longer this crisis goes, the higher the toll. As crass as that sounds, it is true.

The government's recent claim that the state's largest health network—which includes the new Royal Adelaide Hospital—is gripped with a $300 million budget blowout has dire ramifications for all South Australians. It has the potential to be another State Bank-type disaster. I am not the only one who is saying that, and it is not being said lightly.

As we all know, an independent audit has found that the Central Adelaide Local Health Network, the state's largest health network, which includes the NRAH, faces a budget blowout of more than $300 million in the current financial year. Every South Australian taxpayer should be alarmed at the figure, as it will be them who will wear the financial burden of bailing out the health network. The new $2.4 billion Royal Adelaide Hospital has been a basket case from the day it opened. If it was a private entity, there is absolutely no doubt that it would have been shut down months ago. It is as simple as that.

SA taxpayers are already forking out more than $1 million a day for this disastrous project, and will continue to do so for the next 30-odd years. Now it will be forced to bail out the network to the tune of $300 million this year alone, almost another $1 million a day to keep the NRAH's doors open. That is just to keep the hospital's doors open. That is just not sustainable over the long term, and has all the markings of another State Bank disaster. The former Labor government must hang its head in shame; it cannot wipe clean its hands of the dire financial mess it has created. The NRAH was meant to be its legacy, and it may well be for all the wrong reasons.

The current Liberal government has inherited an absolute mess of a public health system, and it has been left to them to fix that mess, and fix that mess it must. The people of South Australia are absolutely depending on it. SA-Best has said from the outset that it is willing to work with the government in any way it can to ensure that a practical solution is found to ensure the hospital's doors remain open. That commitment remains, and for the record I have made that clear to the minister and to stakeholder groups that SA-Best has met with.

The first step is to establish a select committee to inquire into and report on health services in South Australia. The terms of reference for this inquiry have been drafted intentionally broad enough to cover all manner of health issues, and I envisage that the committee will be able to undertake this task on an ongoing basis, and look at referrals by way of instruction, to extend the terms of reference, if necessary, should the council agree.

As I have said, I think the terms of reference are ample in terms of covering the issues that SA-Best, other members of this place and stakeholder groups have highlighted as being critically important. Importantly, they recognise that, in order to look into the future, it is imperative that we also look back to identify the errors that were made and ensure they never happen again. Again, for the record, the terms for the inquiry are:

(a) the opportunities to improve the quality, accessibility and affordability of health services including through an increased focus on preventative health and primary health care;

(b) the South Australian experience around health reform in the state, specifically Transforming Health, EPAS, the reactivation of the Daw Park Repatriation Hospital and other related projects and/or programs;

(c) the federal government's funding of state government services and the linking of other federally funded services in South Australia, such as Medicare funded GP services, Adelaide Primary Health Network and Country Primary Health Network;

(d) any related matters.

As I said earlier, I sincerely hope my bid for a select committee into this most important matter will be seen as a sensible compromise for all parties. If we are truly genuine in our attempt to fix all the problems plaguing our health system, we must know the depth of what we are dealing with. We must remove the political motives and agendas; this is about people's lives and people's health and wellbeing.

What must not be forgotten through all this is that there are innocent victims. Earlier this year, in this chamber, my colleague the Hon. Frank Pangallo raised the tragic death of 18-year-old Kiera Maraldo. Kiera's death was completely unnecessary. She died in her sleep on 19 June from a genetic heart condition called Long QT syndrome, which had only been diagnosed on 13 January, after she collapsed on a night out and was taken to the new RAH. Doctors there had picked up an irregular heartbeat and told her grandparents, who raised her in care, along with Kiera's two siblings, that Kiera was an urgent category 1 patient.

After four days Kiera was discharged with medication and a heart monitor, and was referred to the Lyell McEwin Hospital to see a cardiac specialist. This is someone who was categorised as a category 1 urgent patient. The hospital told Kiera that she had to wait until the end of September, or it was suggested to her GP that she could see a specialist in Norwood sooner if she went as a private patient. But it was too late for Kiera.

While Long QT syndrome can cause sudden death and is incurable, it is treatable. Had Kiera got the treatment she needed as a matter of urgency, she would still be with us today. Our public health system has failed Kiera and her family. That is an absolute tragedy. I commend this motion to the house and hope that it is supported by both major parties and the crossbench.

Debate adjourned on motion of Hon. I.K. Hunter.

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