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Legislative Council - Fifty-Fourth Parliament, Second Session (54-2)
2020-10-13 Daily Xml
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Patient Age Discrimination

The Hon. C. BONAROS (15:04): I seek leave to make a brief explanation before asking the Minister for Health and Wellbeing a question about concerns about age discrimination of patients by SA Health.

Leave granted.

The Hon. C. BONAROS: South Australians were shocked by the revelation of the contents of a leaked email by a senior SA Health bureaucrat suggesting that surgeons should say no to older patients or those with multiple health concerns. At its best the email, leaked by a whistleblower disturbed by its contents, is said to be an indication of a hospital administrator trying to influence the decision of frontline clinicians; at worst it is age discrimination of some of the most vulnerable people in our community.

Council on the Ageing chief executive Jane Mussared said that the email showed 'pure and simple ageism' within our public health system. At the time, the minister was said to be dismissive of the email claiming it was 'clumsy'. Then today we hear some patients, many of them elderly, are being forced to wait up to a decade to get an appointment to see a specialist in the public health system, even before they join the queue for surgery. My questions to the minister are:

1. Are waiting list statistics, like the ones I just mentioned, driving decision-making as outlined in the leaked email?

2. Was the minister concerned about the contents of the email?

3. Can the minister provide a more comprehensive, justifiable explanation for the email?

4. Does he believe the email is justified or reflects poorly on SA Health.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (15:06): I would like to thank the honourable member for her question. Could I immediately clarify that I was not dismissive of the email, and the reference to 'clumsy' was not my word. It was the phrase of the President of the Australian Medical Association, Dr Chris Moy, who described it as clumsy.

I want to be very clear: the Marshall Liberal government is committed to providing quality care to all South Australians, including older South Australians, and all patients who present to hospitals are treated in response to their clinical condition regardless of their age. I think the values of this government are reflected in the actions of this government.

This is the government that established an Adult Safeguarding Unit to make sure that vulnerable elderly South Australians had recourse. It is this government that is investing tens of millions of dollars in a world-class dementia village at the Repat. It is this government that has a nationally, if not internationally-lauded response to elderly South Australians in residential aged-care facilities in the context of COVID. My understanding is that we are the only jurisdiction that will, as a matter of process priority, transfer a COVID positive patient from a residential aged-care facility to hospital.

The honourable member asks me whether this particular email was part of the—

The Hon. I.K. Hunter interjecting:

The PRESIDENT: Order, the Hon. Mr Hunter!

The Hon. S.G. WADE: —if you like, response by the hospitals to the long waits for outpatients.

The Hon. I.K. Hunter interjecting:

The PRESIDENT: The Hon. Mr Hunter will be silent.

The Hon. S.G. WADE: In fact, it is actually linked—

The Hon. E.S. Bourke interjecting:

The PRESIDENT: Order! As will the Hon. Emily Bourke!

The Hon. S.G. WADE: —because it's part of a process to reduce the long waits.

The Hon. I.K. Hunter interjecting:

The PRESIDENT: Order!

The Hon. S.G. WADE: The honourable member asks me to unpack what the email was getting at, so let me do that. Key to providing quality care to older South Australians will also include providing quality care in surgical services—

The Hon. I.K. Hunter interjecting:

The PRESIDENT: The Hon. Mr Hunter will be silent.

The Hon. S.G. WADE: —and improving the patient's journey for them, from the GP to the outpatient clinic to the surgical list. One opportunity for improvement that the Central Adelaide Local Health Network has identified is improving the quality of the communication between the GP and the hospital-based specialists. That is really important because it is the GPs who know their patients best; they have access to information that they can provide—

The Hon. I.K. Hunter: And you just ignore it.

The PRESIDENT: Order!

The Hon. S.G. WADE: —which is key to enabling the hospital-based specialists to more accurately triage patients to ensure that no-one is left without advice or care. The process for seeking further information from GPs is a clinician-led process. In other words, it is the hospital-based clinician having a conversation with the GP.

The email, I am advised, was part of engaging clinicians actively in the triage of cases on the waiting lists, first of all to support the quality of care and, secondly, to address long waits. The email was sent by a clinical program delivery manager who, to be clear, is a clinician, not a bureaucrat, not an administrator. This lady was a clinician and she was requesting consultants to look at all the factors in their referrals in order to make a clinical judgement as to the care the patient needs. This government is committed to quality care for all South Australians, including older South Australians.

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