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Tasmanian Health Service

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Wednesday, 31 July 2019

Tags: Tasmanian Health Service, Ambulance Ramping, Ambulances

Dr WOODRUFF (Franklin) - Madam Speaker, having just seen the amendment there are certainly aspects of it that the Greens would support, including supporting the health workforce and thanking them for their dedication and service to Tasmania.

Madam SPEAKER - Can I just interrupt you for one second? I am regularly not provided with amendments, so can someone please get me a copy. Thank you, please proceed.

Dr WOODRUFF - Madam Speaker, I understand that position; it must be difficult. Although there are aspects of this amendment that we support, we do not support the principle of the majority of what is written here because it goes to the concerns I addressed by interjection when the minister was speaking, that what she has presented and what she is resorting to, unfortunately, is the worst of the PR and spin we have seen from the previous health minister over the last five years.

It is a deeply concerning turn of events that the new Health minister is using the same tactics and that the concerns of the health sector, patients in Tasmania and people who are concerned about being able to access the health care system when they need it, are not being taken seriously and this Government is simply not taking the issue of underfunding the hospital system seriously.

It is concerning that the minister clearly does not have what is required, what was agreed to at the Access Solutions meeting. People worked in good faith and constructively spent the day on 19 June talking about how to work collaboratively together, as she liked to say, and come up with solutions for the crisis that we have at the Royal Hobart Hospital in particular, but similar crises that are playing out at the Launceston General Hospital on a regular basis too. Those people came together constructively and the job of the Health minister was to go away and do certain things that was agreed to at the meeting by the end of July. Clearly what we are hearing from the minister is that she is back-pedalling as fast as possible. We are probably going to get some pathetic press release late on Friday afternoon that will have a whole lot of waffle without the detail and substance that was agreed to by the Government and the then health minister, Michael Ferguson, at the Access Solutions meeting. You cannot talk in this place about collaboration and not play your part.

Let me just run through, for people who are listening and for the Hansard, what was agreed by that meeting to be done by today, the end of July. It was about short-term actions before the end of July 2019. For the purposes for people who are watching online or reading the Hansard, I am reading from the Royal Hobart Hospital Access Solutions access plan produced by the Government as an output from the 19 June 2019 meeting in which members of the health sector came together.

The short-term actions that were to be completed by today included -

developing a plan for the number and type of additional beds that should be open immediately on the commissioning of K block on top of the existing beds that transfer into the facility;

implementing and ED decision authority, interim management plans, one-way referral and no right of refusal to facilitate the rapid transfer of emergency department patients to ward beds when available;

developing and implementing policy to mandate the entry of an estimated date of discharge for all patients within 24 hours of their admission to an inpatient bed;

developing and accountability and authority framework for each part of the patient's journey;

developing a community, an internal and external focused communications program to support patient flow in partnership with key stakeholders;

implementing weekly emergency department debriefing meetings, including relevant clinical staff, to improve patient flow;

scheduling engagement forums to hear staff-driven solutions, including with health professionals and other employees of the hospital;

convening a meeting with the key THS staff and aged-care providers to support community care options;

commencing discussions with key stakeholders, including Primary Health Tasmania and GPs, about how to progress ways in which patients can be better supported in the primary sector; and - most importantly;

prioritising relevant recommendations for implementation from the previous reports that have been done by independent bodies into the crisis we now have in the health system in Tasmania, including on matters such as criterion-led discharge, discharge planning, support for long-stay patients, consistent admissions and policies et cetera;

supporting the first 12 months of the THS Act and reviewing the THS governance to strengthen local decision-making authority and accountability; and

designing a cultural improvement program across the health system.

There were all actions agreed at the meeting to be done by today, to be publicly reported and to be made available to the people who participated in the meeting. These things were agreed to and we have a Health minister who, on her first real opportunity to speak to these things, is clearly demonstrating where she is headed - into the land of inaction, which was the last thing people at that meeting expected. You cannot have it both ways. You cannot talk about collaboration, you cannot want everybody in the system to be involved and speak together if you do not play your part. This Government is not playing its part.

We know who is really in charge of Health in the Cabinet. It is not this new minister, who is put up in the backbench and does not have the ability to negotiate with the Treasurer and hold steady against the continual attacks on the public health system made by this Liberal Government. The latest of these occurred when the Treasurer demanded that $50 million be found in the Royal Hobart Hospital's budget. He is going ahead with exacting cuts of 0.75 per cent of the Health budget, across the whole Health budget. This minister has demonstrated she does not have the capacity to push back against the tsunami, the brute force of the Treasurer who, despite all the evidence, collaboration and goodwill shown at the last minute by people in the community and the health sector.

These people have been brought to their knees and went very reluctantly with their last little bit of goodwill to give the Government one last chance to do what it said it was prepared to do. People went to that meeting with good spirit. I know because I was there and I went with good spirit on behalf of the Greens. I listened to other people and, although there was scepticism, there was a true attempt to try to find solutions, to be pragmatic, to try to find non-financial solutions. There were not ambit claims for new hospitals and opening wards; all those things could have been said but they were not. People exercised restraint and they were reasonable. They were pragmatic, they used their minds and attempted to come up with solutions. You were there, Madam Speaker, and you probably felt more skepticism than other people in the room. You raised issues and look at where we are - nowhere. If you missed the very first deadline, what does it say?

I personally know a gentleman over the age of 80 who, unfortunately, needed to go to emergency. He was seriously unwell on Friday night. He lives in the Huon Valley and he was taken by ambulance. It is another example of the same story, that is not changing. He went by ambulance; the ambulance paramedics were wonderful but they had to wait with him for six hours, ramped in the hallway. The volunteer and the paramedic were distressed because they could not leave and be available for anybody else who needed an ambulance in the south of Tasmania while they were stuck waiting. They could not do anything but stand there with him; that was their job and there was nothing for them to do. They knew there were people who could be on the phone needing an ambulance but there was nothing they could do about it. All night ambulances were tied up, waiting in the hallway on Friday night, just like we have heard for years. The gentleman was there for 36 hours, in the hallway, 85 years old and it turns out he had pneumonia and a serious urinary tract infection in a really desperate situation. It is fortunate he survived that ordeal. Other people do not.

Solutions were discussed. The minister has a responsibility not to palm this off in a press release. I happened to meet one of the registrars when I was walking recently. I met one of the registrars who wrote the letter to the executive, pleading for some concrete actions to be taken. Those registrars made 19 recommendations; very moderate, sensible, actionable things. Again, not calling for whole new wards, not asking for the sky but it seems that this Liberal Government is unable to put a fire in the belly and to make it happen. I wonder why that is, Madam Speaker? We find out they are stuck in an internal battle with the Treasurer, who wants to cut $50 million on top of all the other things being managed by the health system.

The Greens can find that money; we found that sort of money in the alternative budget. We are prepared to make the hard decisions, to prioritise the money into Health, to prioritise the money into protecting the environment, to prioritise the money into Education so that we can have proper mental health support for kids in schools, so that we can have integrated mental health, which is something that looks somehow as though it has been able to carve out a niche. I am really pleased we have a Mental Health minister who has a real commitment to furthering the work the sector has been doing for youths.

The money can be prioritised. There are things that we can choose not to fund; we have to make these decisions. We have to make these priorities and we have to put the basic health for people in crisis, being able to move into a hospital bed, forward in a timely fashion. We have to sort this stuff out. It is, according to the Access Solutions meeting, something that can be done.

We heard from the Australian College of Emergency Medicine, from the gentleman who was here from Victoria, that it is being done in other hospitals in other states. It is not impossible and not beyond the reach of well-off western countries to be able to move people into a hospital bed when they need one. We can do it. We are not choosing to prioritise that it happens.

I will not get a chance to speak again and I want to say that we have no problems in supporting Labor's motion. It manifestly describes the situation that we are in with the extreme pressure on the health system, the ambulance ramping which continues denying people in regional areas access to an ambulance when they need it because it is tied up in a hospital, and acknowledging that the health service cannot withstand any cuts. In fact, the reverse needs to happen. There needs to be more money prioritised into these areas.

We certainly do not and cannot support any cuts to the health budget.