Tuesday 13 August 2019

Hansard of the Legislative Council
Consideration and Noting - Government Administration Committee A -
Acute Health Services - Final Report


Mr FINCH (Rosevears) - Madam Deputy President, I thank the member for Hobart, the chairman of our committee, for that summation.  He has covered most of the things of relevance in this motion.

I want to say how enjoyable it was for me to be involved with the member for Hobart and the member for Murchison - two people who have huge knowledge of the area in which we are functioning.  It was good for me to bask in their reflected glory.  They are a couple of machines.

Mr Valentine - I am not sure I agree, member for Rosevears.  I think I learnt a lot during this inquiry.

Mr FINCH - They work with a great deal of efficiency and efficacy, I might point out.  I knew I would get it in somewhere - even though it was elongated for reasons beyond our control in some circumstances over two years.  It was a long inquiry, but, as the member pointed out, the changes that came about and the observations made about what was submitted to us are really pleasing. 

We did not have to wait until the end of the report to get some semblance of understanding about what we were trying to achieve, and what people were suggesting could be achieved.  What we were trying to do was taken seriously, as was what we were trying to bring to the table in respect of our investigation.

If ever a committee inquiry were urgently needed, this one into acute health services was really a major priority, considering the concern being reflected to us from the community. 

However, there was one notable agreement, which you have alluded to, that was disappointing, as the committee noted -

The requested release of the KPMG Report to the Committee was protracted and frustrating to the work of the Inquiry.  ...

Further -

The refusal of the Minister to provide the Committee with a copy of the KPMG Report has hampered independent scrutiny of the demand factors impacting on the health budget and has limited its capacity to fully report against the Inquiry's Terms of Reference.

That was an unsatisfactory state of affairs, and I am not sure it was entirely necessary.  As you say, this is a circumstance that may be corrected in the future - or we just might need to reword the whole process of calling an inquiry, because if people can refuse to appear or present papers to an inquiry, well, it is just nonsense.  It just makes a nonsense of the process, and I suppose where we place the importance of these committee inquiries is just ignored. 

Hopefully, that circumstance can be scrutinised closely, and the importance of those words resonate to make sure it is agreed with and that we get the opportunity to have proper scrutiny of issues we have called inquiries for. 

I found the submission by the Australasian College for Emergency Medicine significant, and I want to quote from the introduction -

The data is clear - patients in Tasmanian emergency departments are more likely to be impacted by, or experience, access block.  Where access block occurs, ACEM considers it is indicative of a whole-of-hospital problem that is underpinned by systemic inefficiencies, such as a lack of inpatient resources (particularly beds and staff).  A measure of this systemic inefficiency is patients spending eight hours or more waiting in the emergency department, which is highest across Tasmanian, Northern Territory and Australian Capital Territory jurisdictions. Tasmanian patients are also more likely to experience waits longer than 24 hours in emergency departments compared to other Australian jurisdictions.

That is damning on the system.  So what is wrong with the Tasmanian system?  To reinforce the question, I will quote from the Australasian College for Emergency Medicine's submission -

Many patients in Tasmania wait for days in the emergency department, which is not designed or resourced to provide mental health care.  Emergency departments are full of physical hazards for people at risk of harm or self-harm.  The lack of certainty about how long people might have to wait for a bed or a transfer, and the stimulation from noise and lights of the emergency department environment, is harmful for people experiencing mental health crisis and behavioural disturbance.  The risks of violence, sedation or patients leaving without being treated also escalates the longer a patient waits. 

These circumstances combine to undermine rather than support their recovery, while also placing additional demands on already stretched emergency departments.

I thought that really encapsulated much of what we heard, as the member for Hobart said.  Also, I am comforted by the fact - as the Chairman is - that Jeremy Rockliff has been appointed to this position, to get more of an understanding, take control and look to where these circumstances might be supported and handled better in the future. 

We are hearing more and more about young people with mental health issues, and certainly depression is a major problem.  Just being a little discombobulated - there needs to be much support given to these people.  It is good Jeremy Rockliff has taken this job on.

That quote I gave then alone justifies Committee A's inquiry.  The findings and recommendations must be noted and acted on.  As the member for Hobart did, I thank the staff who worked with us.  We were a close‑knit team which was really good, just the three independent members - I suppose each representing an area of the state as figureheads - that three made it quite efficient but we also had terrific staff.

We had Jenny Mannering until she left to have a baby; I thought for one minute the baby would be in high school before we finished the report.  However, I am glad to say that is not the case.  Jenny was terrific in the early stages of establishing this committee.  Stuart Wright was superhuman in developing that understanding when he needed us to step into the breach and then guiding us through to the final stages of our report and, of course, our secretary, Julie Thompson.  A great team to work with.  I appreciated working on the committee with my colleagues.

I note this report.