Topics: MRI licence



 Jake Hall-Evans: Thank you for coming along today. It’s a great day for residents in the western suburbs because after a decade of their health professionals lobbying for a MRI license at the Queen Elizabeth Hospital the Federal Government is here to announce the MRI licenses. So I’m joined today by Senator Simon Birmingham and Minister Wade from the State Government to make this announcement. Minister?


Simon Birmingham: Thanks so much Jake. It’s wonderful to be here with you, with Stephen Wade the South Australian Health Minister, with Matt Cowdrey the member for Colton and to really mark this occasion with of course the very many hardworking staff and patients and people who use and work here at the QEH. Thanks to the strength of the Australian economy our government is investing in an additional 50 MRI licences around Australia that’s 350 million dollars to support 50 new licences and we can afford that because we’ve got a strong economy, we’re bringing the budget back to surplus and we’re able to make these investments without increasing taxes on Australians. And I’m thrilled that one of the early licences is coming here to the QE age in Adelaide’s western suburbs. This is one of Adelaide’s main hospitals but it’s been neglected for far too long. Thankfully the Marshall Liberal Government have been working to revive services here at the QEH in this investment by the Liberal National government at a federal level in supporting a full licence for Medicare rebates of the MRI here at the QEH is going to complement that work of the Marshall Liberal Government. What we’re essentially doing here is providing around 300,000 people across Adelaide’s western suburbs with more accessible, more affordable MRI scans. That means that people will either be able to get their scans here without having to travel so far, or they’ll be able to get their scans here without being around 400 dollars out of pocket. That’s a real difference to the healthcare of these South Australians. We’re proud to have been able to make this difference and it’s come about thanks to the advocacy and lobbying of many. I know this was top of the list for Steven Marshall and Stephen Wade and the state Liberal government in their advocacy. Jake Hall Evans is here today because he’s personally been in touch with the Federal Health Minister, with me, and with other members of the federal government to make sure we understood just how important this facility is to South Australians and of course other South Australian Liberals, our candidate in Adelaide Sean Osborne, the member for Boothby Nicole Flint who’s going to take in at the next election communities coming right up into Glenelg have all been lobbying hard to make sure this service gets the support that it deserves. So today is one way we should mark it primarily as a win for clinicians for people working at the QEH and most importantly for the patients and people of the western suburbs who are going to get better, faster, cheaper access to critical health services as a result of this investment.


Stephen Wade: Under Labor’s Transforming Health Plan the QEH was downgraded. People had to travel further and wait longer to get the care they needed. I’m delighted that the Marshall Liberal Government is well on track to restore the QEH and this investment by the federal government for an MRI licence at the QEH will be an important part of strengthening the hospital. It will mean that people in the western suburbs will be able to get care close to home and they’ll have less out-of-pocket costs. I’m delighted that the National Liberal Party government at the federal level is working with the state government to strengthen the QEH so that it can have a brighter future. I appreciate the support that we had from Jake Hall-Evans in advocating for this licence and I appreciate the decision that’s been made by the federal government.


Journalist: I’ve got a question for the Federal Minister. Minister were you dragged to this position by Labor’s announcement in recent weeks around MRI services here at QEH?


Simon Birmingham: No we have had a budget in place to have this escalation in terms of MRI services right across the country and we’ve been going through a proper process and evaluating where best those services can be placed. As I said this was the top of the list for the South Australian Government in terms of the priorities they told us. So we’re listening to the State Government about what the South Australian health system needed and we had then people like Jake lobbying hard, he was joking with us before about the depth of family connections here. From his appendix being taken out, to his brother and sister being born here. So you’ve got local people telling us how clearly this is important but ultimately it’s been a case of proper process, proper budgeting, that gives you a strong economy and it means you can afford to do this without hiking taxes on people as Labor proposed and then a proper process to say where is it going to make the biggest difference for the community and for the 300000 people across Adelaide’s western suburbs. It’s going to make a very big difference for them.


Stephen Wade: It’s more than a decade since clinicians started advocating for an MRI license. Years of Labor neglect at both the state and federal level meant that this need hadn’t been met. I’m delighted that the Morrison government is delivering an important service to the people of the west.


Journalist: Minister Wade, just on some other matters. When were you first aware of this cluster of adverse events?


Stephen Wade: I was briefed in December 2018, last December.


Journalist: Is that when you knew that there were nine deaths?


Stephen Wade: As I said I was briefed, the SAS had already taken immediate action, they’d reviewed the cases individually and rolled out a series of changes to make sure that the patient care was front and centre when clinicians visited a patient. But they also introduced a systemic review. They wanted to look at the whole cluster and see if there were issues in relation to the ambulance service overall that could be improved. This stands in stark contrast to the former Labor government, in 2015 they had 28 confirmed adverse clinical events so far last year we’ve only got 12. The former Labor government didn’t undertake a systemic review, they didn’t deal with the matters as a public matter as we have. We think it’s very important that the systemic review was done, I commend the ambulance service for doing that. It’s a very important opportunity to improve patient care and safety.


Journalist: Have you approached the families of these nine cases?


Stephen Wade: The SAS has contacted each of the families in some cases it’s been difficult to make contact with people and in some cases interstate family are still being contacted. The SAS will continue to work with the families to openly disclose what happened.


Journalist: Are you particularly going to do it yourself?


Stephen Wade: No family has approached me to.

Journalist: Yes but if you’ve known since December, have you made any attempts yourself to try and contact families?


Stephen Wade: To be clear the contact with the family started after the events, that hasn’t been a recent phenomenon. This independent review is a systemic review, it’s not a part of the individual investigation that highlighted a whole range of issues where we can improve the quality and safety of our care. The ambulance service will roll out a quality care and safety program under the oversight of Associate Professor Hibbert, the independent reviewer. That will lead to a safer, better ambulance service going forward.


Journalist: Will you make an effort to meet with the families now?


Stephen Wade: No family member has approached me. The SAS is doing open disclosure with the families and providing the support that they need.


Journalist: Minister do you think there is a correlation between the decision to flex down and these instances that have happened over the last three months?


Stephen Wade: The bed closures at Flinders for example occurred at the end of December. These events were from August right through to December. The former Labor government closed more than 100 beds at the Repat they’d closed about 40 beds with the closure of Oakden. In That same period. we’re opening another 20 beds at the Repat, we secured another 20 beds that were scheduled to close at the end of December. This report highlights a whole series of issues that led to the adverse incidents. It doesn’t suggest that ramping was the cause of these incidents, it highlights the way that ramping is the context within which clinical management was corroded.


Journalist: FOI documents being unearthed day are suggesting that back in October ambulance response times are a third weren’t seen within the correct timeframes?


Stephen Wade: The independent review report highlights that we need to to monitor ambulance service with a whole range of indicators, response times is one, but their report actually highlights the concern about focusing on non-clinical targets. We need to make sure we have a balance of targets clinical response times increase and decrease over time. I will continue to make sure that that the ambulance service is supported to deliver on all its key parameters.


Journalist: How frequently are you briefed on ambulance response time?


Stephen Wade: In terms of the ambulance information that’s readily available on the on the dashboard and I’m in regular contact with the ambulance service. The governor will continue to work with the ambulance service to make sure that it’s got the support it needs. The head of the ambulance service last week indicated that he didn’t, he thought that the service had the resources to deliver on its current workload. You can always do better, and that is what the Ambulance Service is working to do.


Journalist: Is less than one third being seen on time in October acceptable?


Stephen Wade: I’ll look into the information you’re referring to there. The ambulance service continues to strive to improve on all of its key deliverables, response time is part of those but one of the issues highlighted by an independent reviewer was that non-clinical targets need to be kept in balance with clinical targets. We need to make sure that we’re keeping the patient care front and centre, and not being distracted by non-clinical targets.


Journalist: Can you put a timeframe on when ramping (indistinct)?


Stephen Wade: We are continuing to work to eliminate ramping. Let’s be clear, the former Labor government allowed ramping to fester for a decade. They had a review of ramping at Flinders Medical Centre in 2012 and in 2015, three years later, there was 28 adverse outcomes. The number of adverse outcomes last year which is confirmed at this stage at 12, compares with an average of 15 over the last five years. So adverse events do happen, what’s distinctive about this government is that we’ve gone to do a systematic review to see what we can learn to improve the ambulance service right across. This, I believe is a significant new approach by the ambulance service to make sure that we support our clinicians. We haven’t supported our paramedics and ambulance officers as well as we should, there’s been one of the issues highlighted by the report is that over recent years the number of ambulance officers and paramedics overseen by a team leader has significantly increased, I understand in the order of doubling. That makes it more difficult for clinicians on the ground to have the support they need to deliver quality care.


Journalist: But can you say when ambulance ramping won’t be a problem anymore?


Stephen Wade: The ambulance service Is continuing to work with all of the networks to reduce ramping, the Marshall Liberal Government is determined to eliminate ramping because what this report shows is that not only does ramping have the direct impact of tying up resources on the ramp, it also has the indirect impact of putting stress on the clinical management of patients at the ground. We are committed to rolling out further initiatives, there was a stop ramping summit in the middle of February already we’re seeing geriatricians in the ED at the Royal Adelaide having a positive impact. I will continue to roll out initiatives, I will continue to roll out increases in capacity to the government is in the late stages of finalising the master plan for the Repat that will be an important part of undoing the damage of transforming health. The former Labor government closed more than 100 beds in the southern region.


Journalist: Minister have you received a copy of a letter sent and co-signed by the salaried medical officers association and the ANF and also the (indistinct), what’s your response to what they have put to you?


Stephen Wade: I received the letter yesterday and I’ll be responding shortly.


Journalist: So will you meet their demands or their suggestions?


Stephen Wade: As I said I’ve ever received the letter I’ll be responding to it shortly.


Journalist: Have you read the letter, what’s your opinion of the letter?


Stephen Wade: Well I think that the letter is fair. It says it says that the former Labor government left us a mess. They expect us to deliver, that’s our commitment to the people of South Australia. I’ll respond to the letter shortly.


Journalist: Are you fearful of any industrial action?


Stephen Wade: I’d call on the unions to work with us to pursue a number of initiatives that we’ve put in place. The Hospital demand workshops that I held with the unions last year highlight a range of issues which we’re delivering on. For example one of the key requests of the nurses federation was that we we pursue criteria led discharge. Over years, the former Labor government did a pilot here, a pilot there, but did not roll it out. On Sunday we announced the rollout of a statewide criteria led discharge framework. Likewise the salaried medical officers association highlighted their concern about the lack of forensic mental health beds. We’ve rolled out, sorry rolling out ten more forensic mental health beds at Glenside but there was a specific request of that workshop to increase capacity and use the Repat. Since then we have added another 20 beds at the Repat and we’ve secured 20 that were scheduled to close.


Journalist: What about the ambulance employers association? Is there a need for more resources?


Stephen Wade: We are actively working with the ambulance service as we speak to assess their resource needs going forward. The Ambulance Service head said publicly last week that he believes that they’ve got the resources to cope with current workload. But it’s important that we we continue to grow the ambulance service. Last year we appointed 187 paramedics and ambulance officers, we’ll continue to make sure that the ambulance service has the resources it needs.


Journalist: Will you be launching a periodic review similar to this one that was just received?


Stephen Wade: Let’s be clear, the decision to launch this systemic review was the decision of the SAS executive team with my full support. I commend the that the leadership of David Place and his team to not just stop individual case reviews, as important as they are, but also take the opportunity to have a systemic review to see what lessons can be learned. There are a whole range of issues that have been identified by this review that could never have been highlighted by case by case review.


Journalist: But would you be suggesting to SAS that they should be doing this?


Stephen Wade: I’m not going to tell clinicians how to do their job. I’m just appreciative of the leadership being provided by David Place and his team. The fact that they took this step to have this systemic review will mean the South Australians will have a better ambulance service going forward.


Journalist: Minister what’s the current status of the Cassia Ward at the Women’s and Children’s Hospital?


Stephen Wade: The two wards, the Cassia and the short stay ward were merged during as part of the seasonal flex down at the Women’s and Children’s Hospital. I understand there was concerns in relation to the capacity of the hospital to deal with infectious cases during that period but I’m assured that there are rooms available for children who are assessed at being at risk. I would urge families who do you have any concerns to discuss it with their clinicians.


Journalist: What was the decision to merge those two words, what drove that decision?


Stephen Wade: My understanding is that this is a seasonal decision and that they will become freestanding again.


Journalist: Talking about seasonal decisions are we starting to see a strain on the health system from the heatwave?


Stephen Wade: Yesterday was a heavy day for presentations, there were more than 260 presentations to the Royal Adelaide. There was a period of ramping but the hospital coped relatively well considering it was a Monday on a hot day. I’m urging South Australians to make sure that they look after themselves look after others make sure they rehydrate and try and avoid being in the heat when they don’t need to be. We will continue as a health service to make sure that we’re ready to support people but a period of seven days does have the risk of particularly aggravating conditions for elderly people and people with chronic and complex conditions. So it is important that we all look out for one another, keep ourselves healthy.


Journalist: Is the system equipped to deal with this heatwave?


The local health networks have all been planning for this week just as they did for the extreme heat event at the end of January. The extreme heat event did highlight the stress that is put on the hospital system and it can be not just for the day of the event but for some time afterwards so we’ll continue to ready ourselves but we also urge people to look after themselves, to try and reduce the young the risk of them falling to heat effects.