Hospital Funding | Parliamentary question without notice
10/09/2013
The Hon. K.L. VINCENT (16:56): I seek leave to make a brief explanation before asking the minister representing the Minister for Health and Ageing regarding cuts to the Women’s and Children’s Hospital and Modbury Hospital.
Leave granted.
The Hon. K.L. VINCENT: In the past 24 hours we have learnt that the Minister for Health will be cutting up to 82 full-time equivalent positions and up to 30 beds from the Women’s and Children’s Hospital. At the same time he plans to close paediatric services at the Modbury Hospital. These announcements follow a review by Deloitte following budgetary pressures within our health system. The review does not take into account clinical guidelines and outcomes. It is quantitative rather than qualitative.
The Women’s and Children’s Hospital provides specialist services to women and children who do not only live in Adelaide but who are also from all over the rural and regional areas of South Australia. This hospital provides services to the most complex cases which by their nature are more expensive to treat. It also provides high level services to children with the most difficult chronic or acute health conditions and illnesses and some with the most severe disabilities.
Since the Minister for Health made these announcements yesterday, the decision has been roundly criticised by the South Australian branches of the Nursing and Midwifery Federation (ANMF), the Australian Medical Association (AMA), the Royal College of Surgeons, and the Salaried Medical Officers Association (SASMOA) as completely missing the mark and for being cuts made for purely economic reasons without concern for the health outcomes of the people involved.
The SA Health website lists all these responses to the Deloitte report from the AMA (SA) and the ANMF (SA), the SA Child Health Clinical Network and the Australian New Zealand Neonatal Network, and they are also highly critical of the peer comparisons the Deloitte report makes. The Neonatal Network submissions point out that the Women’s and Children’s is unique in Australia in the service provided with a high case load of complex premature newborns.
As the Minister for Health’s colleague Premier Jay Weatherill frequently highlights, money spent in the first year of a child’s life on their health care and education, particularly if they have additional medical or disability related needs, is money spent today that will not only improve life outcomes personally for the child involved but save the health, education, housing, disability, corrections and justice budgets in the longer term.
Down the road from the Women’s and Children’s Hospital that services the most complex neonatal cases and the most challenging disability and health conditions in the state’s children, we have the Adelaide Oval redevelopment and a half-constructed bridge that are costing $580 million to South Australian taxpayers. I will not speculate what message this sends to South Australians but I do have some questions for the minister. My questions are:
1. Does the minister believe that watching AFL and cricket games in comfort is of higher priority than the health and wellbeing of South Australian children and mothers, particularly those with more complex needs?
2. Does the minister acknowledge the somewhat contradictory concept of making a $16.7 million cut to services on offer at our only purpose-specific Women’s and Children’s Hospital in South Australia while being prepared to waste up to $500,000 per year on housing—and I use the word ‘housing’ loosely—for people declared fit for discharge from hospitals because of the woeful communication and case management between state government departments of SA Health, housing and disability services?
3. Does the minister acknowledge that the continuing SA Health budget blowout could be better attributed to failings in the housing and disability portfolios to provide adequate transition to the community for adult patients at the Royal Adelaide Hospital and other metropolitan hospitals?
4. What cross-departmental action is the minister taking, or planning to take, to prevent adult patients from languishing in hospital beds when they are declared fit for discharge?
5. Does the minister agree that $1,000 extra per patient at the Women’s and Children’s Hospital seems a small amount of money in comparison to spending $450,000 on accommodating a single patient in the Royal Adelaide Hospital after they have been declared fit for discharge?
6. How many of the 82 job cuts at the Women’s and Children’s Hospital relate to medical, clinical and health staff?
7. How many children with disabilities, children from disadvantaged backgrounds, indigenous children and children from rural and regional areas will experience adverse health outcomes as a result of these cuts?
8. Were the administrative functions of the Women’s and Children’s Hospital and the cost of those removed for the purposes of analysis by Deloitte for the peer review?
9. Why did the Deloitte report not compare Adelaide’s Women’s and Children’s Hospital to Perth’s equivalent hospital, given the geographic challenge similarities?
The Hon. I.K. HUNTER (Minister for Sustainability, Environment and Conservation, Minister for Water and the River Murray, Minister for Aboriginal Affairs and Reconciliation) (17:01): I thank the honourable member for her most extensive list of questions. I understand that the Minister for Health and Ageing released a response to the recommendations of the Women’s and Children’s Hospital budget performance review this week. I understand that the review, conducted from February 2013 to June 2013, led by independent consultant firm Deloitte, focused on the performance and efficiency of the Women’s and Children’s Hospital services and included a six-week public consultation period.
I also understand that the review benchmarked the cost of providing inpatient services at the Women’s and Children’s Hospital against national peers using 2010-11 data. The results of this benchmarking identified that the hospital was 20 per cent less efficient than its national peers for inpatient costs—
The Hon. T.A. Franks interjecting:
The Hon. I.K. HUNTER: You don’t need to. I am on my feet.
The Hon. R.I. Lucas interjecting:
The Hon. I.K. HUNTER: I filibustered for 34 seconds. The Hon. Mr Lucas said I am filibustering, but I am filibustering for 34 seconds, and I am now continuing with the indulgence of the chamber. The greatest area of inefficiency compared with the benchmark peers was in the costs associated with how long a patient stays in hospital and other associated operating costs.
Improvements in medical knowledge and techniques have meant that we can now safely and comfortably discharge patients sooner than was the case five or even 10 years ago. I know from my previous experience—and my honourable leader would know as well—that you do not want to be in hospital any longer than you need to be. You are better off getting the treatment you need and being discharged by your clinician when you are ready to go rather than staying in hospital for an extended period of time.
Nevertheless, patients will only be discharged, I am advised, when it is clinically safe and appropriate to do so. The length of stay targets that the Women’s and Children’s Hospital is seeking to achieve are those of some interstate peer hospitals.
