Wednesday, 27 September 2017
The New Royal Adelaide Hospital
The Hon. K.L. VINCENT: I seek leave to make a brief explanation before asking questions of the Minister for Health regarding the new Royal Adelaide Hospital, or NRAH.
The Hon. K.L. VINCENT: Following contact with my office from a number of constituents about the new Royal Adelaide Hospital, my questions are the following, and I should forewarn the minister they are unsurprisingly numerous:
- Why, despite repeated assurances from the NRAH transition team, does the emergency department car park at the ORAH hospital have eight disability car-parking spaces, yet the NRAH still has zero?
- Did two robots throw themselves into a lift shaft abyss at the NRAH?
- Did a plumber arrive at the NRAH ED last fortnight to install an underwater seal for a cardiac patient following an assumedly incorrectly labelled order by Spotless?
- Is the minister aware, and is it true, that a plastic container in the new thermal food heater at the NRAH caused the food heating system to go into a meltdown?
- Why are admitted patients going without meals? According to reports I am hearing, at the NRAH, because the EPAS system requires a dietician to log meal requests, this is resulting in family members having to bring food to their loved ones in hospital.
- Did the intensive care unit recently have to wait up to six hours for one unit of blood?
- Is there inadequate stock of basic essentials, such as intravenous saline, and some other commonly used medications on wards?
- Is it the case that vacated rooms are not being cleaned in a timely manner, further delaying the acceptance of new patients?
- How often are occupied patient rooms being cleaned?
- Is it true that there is not enough storage for equipment such as sterile scissors and forceps at the NRAH?
- Is it true that opening and closing blind magnets being shared between patient rooms—because not enough were supplied—means no infection control precautions are in place?
- Why do booms, which hold ventilators in place, not have an adequate breaking system, meaning that potentially if they are knocked they could pull the intubation out?
- When will a publicly available and accredited changing place toilet be installed at the NRAH to service the 14,000 South Australians with high-level accessible toilet needs and needs for high-level change facilities, and why was this not automatically built into a $2.3 billion facility?
- Finally, when will toileting, feeding and exercise areas for assistance dogs be installed at the NRAH?
The PRESIDENT: Order!
The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse): I thank the honourable member for her questions, of which there is an extensive number.
The Hon. K.L. Vincent: Fourteen.
The Hon. P. MALINAUSKAS: Fourteen. I will start by addressing at least one specific one, which I can comment on, and then I will try to deal with the rest of them generally. One of the questions in the middle was the plumber incident—
The PRESIDENT: Order!
The Hon. P. MALINAUSKAS: That has been subject to a degree of rumour, innuendo and speculation. I am happy to confirm to the house that I received advice on this incident last week, where I guess a communication issue meant that something was lost in translation regarding some of the services provided by Spotless. I think the chamber will be pleased to know that that issue has been rectified rather quickly. That answer probably speaks to my view about each of the issues that the Hon. Ms Vincent has raised.
Let me start from the outset and say that regarding issues around access to disability parking, and so forth, I have not received—and there were a number of issues that were specific to disability issues and access—any briefings regarding those issues up until this point. I am happy to do that. I would also say that, obviously acknowledging the Hon. Ms Vincent’s passion and advocacy for the disability sector generally, I would be very keen to hear how the NRAH is going with respect to those members within our community who do suffer from a disability, and make available staff from my office or from the department to engage directly with her office, if that has not already happened up to this point, to see whether we cannot have some answers provided to you quickly, in a way that might be more expeditious than the formal process of taking things on notice.
Generally, a large number of the questions that the Hon. Ms Vincent has raised do speak to what has been characterised as teething issues with the NRAH. First, much of that was expected. This is such a huge undertaking, such a substantial exercise, such an extraordinary transition going from a facility that we have been in for over 100 years to a brand spanking new facility, which is fundamentally different in a number of areas. So, we do expect transition and teething issues.
I guess my principal objective, as I said yesterday, is making sure that we have systems in place so that when those teething issues present themselves, or when queries or issues are raised, we are dealing with them in a way that represents a fix, but also represents it being done expeditiously. There are committees and systems in place to do that—I have established that upon making those inquiries.
A really important one that the Hon. Ms Vincent has touched on, of course, is meal delivery. Meals are important; we don’t want people going hungry. It has also been drawn to my attention by nurses and the ANMF directly that there is a clinical issue associated with meals being delivered on time. It is not just about satisfaction for the patient in terms of not going hungry or having a meal at a time that is too early. There is a genuine clinical issue, of course, because there are diabetics, issues about consumptions of medications that are supposed to occur systematically or periodically, and often medications need to be consumed with food, as all of us are aware.
Having meals delivered on time is an important function within the hospital. Earlier on there were not just one or two reports but a large number of reports that that was not happening as effectively as it should. I received an update on this yesterday because it is something that I want to be abreast of and something that I want to make sure is improving. Yesterday, I was very pleased to hear that there has been a substantial improvement when it comes to the speediness and timeliness of meals being delivered. That is not to say that there are still not odd incidents that are taking place within the hospital but all the advice to me—and there is a key metric, which I am trying to recall as I stand here, that measures on time—
The Hon. S.G. Wade: Three meals a day.
The Hon. P. MALINAUSKAS: It is not three meals a day, in that flippant remark from the honourable member opposite, but making sure that meals are delivered in a timely manner is really important.
The PRESIDENT: Order!
The Hon. K.L. VINCENT: Mr President, I would appreciate the opportunity to hear the answer to my question.
The PRESIDENT: I fully agree. I think members of the chamber ought to have respect for the honourable member wanting to listen to the answer to her question. Minister.
The Hon. P. MALINAUSKAS: There is a key metric that is measured, and the South Australian government does that on a regular basis because, of course, we have a contract with Celsus, that incorporates the Spotless Group, which does meal delivery in the NRAH. There is a key metric that is measured to ensure that they are meeting their contractual obligations which, in turn, affects the payments in terms of the contract. So, this is something that is measured and I was very glad to hear, as I said, when I received a briefing yesterday that this has improved dramatically over recent days. I want to be clear that there still needs to be improvement; accuracy of the meals is a variable as well, not just timeliness. So, it is about making sure that we get all of those things right.
In respect of one of the questions that was raised regarding one of the RAH-bots throwing itself down the lift shaft, I have not received a briefing along those lines. I am happy to make some inquiries and hopefully that is something we can quickly rule out. It is something that I would expect to have had drawn to my attention, if that was the case. I am not aware that that is something that has occurred.
One of the challenges, of course, is making sure that we take all of the information that is being fed back through a range of different ways within the community. I think there are some things that are rumour and innuendo. That is not surprising because it is something that is of great interest to the community. However, it is also true to say that there have been issues that have been raised in a way that, as I said, we expected, but we are dealing with them.
This is a huge facility. The Hon. Ms Vincent is right to point to the fact that it is an investment that is in excess of $2 billion. That is a lot of money and it is an amount that will be paid off and that we will be paying, as a state, for 30 years. However, this government believes that that investment is entirely appropriate. We now have a state-of-the-art facility that is the envy of many other jurisdictions around the country and, indeed, the envy of many people around the world. However, it is not the envy of the patients who use it.
The feedback that we are getting from a large number of patients who have been in this facility now for some time is that it represents a huge improvement on what they were subjected to previously. It is not just the amazing views, it is not just the outstanding fact that they have their own rooms and ensuite facilities and that family members can stay there—all those things are important—but it is also the outstanding staff who work there. They are doing their level best to make sure that these teething issues are dealt with. I am really glad to hear that that is occurring.
In the meeting that I had with the ANMF this morning, they referred to the fact that there have been substantial improvements. That is an independent source—it is not the department—that has the reputation of being honest and transparent about sharing their reflections. I do not think the ANMF can be accused of mincing their words when it comes to providing feedback to the government. They reported to me that there has been some improvement, so that is a good thing and we want to make sure that it continues. I also want to put on the record my thanks to all those people who are working so incredibly hard to ensure that that continues.