SA-BEST's priorities include:
- Continue our call for a Royal Commission into South Australia’s public health system;
- Establish a cardiac surgery unit at the Women’s and Children’s Hospital to bring it into line with all other mainland states;
- Reinstatement of funding of the Infant Therapeutic Reunification Service;
- Adequate funding of the current Women’s and Children’s Hospital;
- Improve the current structural and functional design of the new Women’s and Children’s Hospital to increase patient accommodation and clinical services;
- Oppose any further privatisation or outsourcing of all public health services;
- Safe working hours and workplaces, including mandated staffing level ratios and breaks between shifts;
- Implementation and monitoring of a Workplace Bullying and Harassment Policy within SA Health;
- A mandated transfer of care of policy to ensure the transfer of care for a patient occurs within 30 minutes of arrival at a hospital;
- Mental health crisis in South Australia (see our mental health priorities);
- Increased investment in public health, prevention and promotion; and
- Minimum Unit Pricing for alcohol sales.
A Royal Commission
As part of the 2018 state election, SA-BEST called for a Royal Commission into South Australia's public health system. Both major parties rejected that call. The incoming Liberal Government argued it would step right in and fix the problems and brought in administrators.
We all know health is at crisis point some four years on. COVID-19 has exposed even more cracks in our health system.
Over that time, SA-BEST has driven the health agenda in the state primarily through a Parliamentary Select Committee established by SA-BEST and which Connie chairs.
Sadly, the Committee has exposed the parlous condition of our buckling public health system.
Numerous clinicians, nurses, medical experts and people with lived experiences from our public health system have been queuing at the door to give evidence before the Committee which emphatically points to a declining system.
At every turn, the government has been dismissive of the crises they reveal, to the point of arrogance.
SA-BEST continues to use its position of influence to push for a Royal Commission.
The Committee has been told point blank people have died unnecessarily in our public health system due to flaws, inconsistencies, and a lack of staffing and services.
For a state as rich as prosperous of South Australia – in a country as economically strong as Australia – that is totally unacceptable. Our doctors, nurses, ambos, frontline staff are exhausted and at breaking point. COVID-19 has pushed an already fatigued and overworked workforce to the brink.
SA-BEST wants that inquiry to be conducted by health experts of the highest authority and expertise.
We will insist an interim is report delivered to government and Parliament within six months and a final report six months after that.
We want that inquiry to look at every scandal - those that are already known, and those still hidden.
We will also want a Royal Commission to give an early opportunity for whistle-blowers to step forward, and for patients and families to tell of their experiences of a health system that has so badly failed many people – as has occurred in the Select Committee.
A Royal Commission will come at a cost, but money well spent to get more value out of our huge health budget.
We must uncover the root causes of systemic failure. Only then will we have the evidence and the policy review that will allow real progress to be made.
Alongside the Royal Commission, SA-BEST will also work with professional medical associations, health experts and practitioners – like it has over the past four years - to refocus health spending with a priority on patient safety, equity of access, a strong public health workforce and a more accountable and transparent health system.
One of SA-BEST’s top priorities is the establishment of cardiac surgery at the Women’s and Children’s Hospital to bring it into line with all other mainland states.
The unspeakable and tragic death of four cardiac babies is a state disgrace. There is no logic when every other mainland capital city has a hospital that undertakes paediatric heart surgery.
It defies logic that when a critically sick child is fighting for their life awaiting potentially life-saving heart surgery, we put them in a plane and fly them to Melbourne for treatment, not to mention uprooting their families who have to accompany them for protracted periods. We know that in most cases this results in families and their children becoming separated between jurisdictions.
You don’t have to be a parent to understand the unimaginable trauma on the child and their parents.
Once established, this would be cost effective and will avoid the expense, disruption and hazards of transferring our sick cardiac infants and children interstate for surgery and other life saving procedures.
The new hospital will never be state of the art or world class unless some way is found to accommodate advanced cardiac care and surgery and no family or child should be put through the trauma of being transferred interstate for potentially life-saving treatment and surgery.
Current Women’s and Children’s Hospital
The current Women’s and Children’s Hospital is chronically underfunded and under-resourced. The fabric, equipment and clinical services will not survive another fix years before the new hospital is available.
An investment of around $100 million is need to make it safe in the interim. There are critical problems in patient care in the Emergency Department, cancer services and mental health. Nursing and medical Staff shortages are a major contributor.
New Women’s and Children’s Hospital
Means must be found to improve the current structural and functional design of the new Women’s and Children’s Hospital to increase patient accommodation and clinical services.
The current design is inadequate and unsafe because of the fragmentation of acute and essential facilities, such as operation theatres and ICU on different levels. The hospital will be unfit for purpose by the time it opens. There is no prospect for further expansion or inclusion of new tertiary services.
SA-BEST will press for an urgent review of the structure and design to try to find more room and support substantial extra funding to make this happen.
Infant Therapeutic Reunification Service
The first 1000 days of life are critically important and have lifelong health and wellbeing ramifications. In fact they can change the trajectory of a child’s life altogether. Infant trauma is the most preventable risk factor for mental health problems later in life. These kids are on a trajectory of ending up in the child protection system.
The Infant Therapeutic Reunification Service operated from 2011 to 2020 at a cost of under $200,000. It beggars belief the government would allow it to be axed! There is now no comparable state-wide service for vulnerable infants and families. SA-BEST will use its position to insist on the urgent reinstatement of this critical service as a priority.
Safe working hours and workplaces
SA-BEST supports mandated staffing levels ratios, particularly for nurses and midwives.
We continue to hear reports of staff working double shifts and excessive overtime which is unsafe for both staff and patients. Inexperienced or under-skilled staff are being asked to fulfill tasks to make up for the short fall of workers on shift.
Domestic and Family violence is a major public health problem. One in six women have experienced physical or sexual violence by their current or previous intimate partner as have one in 16 men.
Nurses and midwives are at the coalface of the trauma caused by domestic and family violence each and every day. Educational support and effective strategies must be expanded to support the workforce in its support of others and to protect against this workplace hazard.
SA-BEST will use its position to insist on legislation protecting workers against violence and the implementation and monitoring of a Workplace Bullying and Harassment Policy within SA Health.
Build the capacity of the public health workforce into the future and beyond COVID-19
The COVID-19 pandemic has exposed more cracks in our health care system. Now is the time to learn from our mistakes and future proof our public health system – starting with building the capacity of the workforce.
For too long we have watched our bright graduates disappear interstate for better job opportunities and a depletion of skills and expertise as graduates and mid-career professionals bore the brunt of job cuts and insecure work.
Workforce renewal must not only focus on increasing the number of graduates and increasing funding for advancing skills and leadership training, but also reverse the casualisation of the workforce.
As a member of the Legislative Review Committee, Connie has heard first hand harrowing evidence of the ambulance ramping crisis in South Australia.
Patients should not be made to wait for hours on end in ambulances outside our hospitals. It is simply unacceptable.
SA-BEST will insist on a mandated transfer of care of policy to ensure the transfer of care for a patient occurs within 30 minutes of arrival at a hospital.
To achieve this, appropriate staffing and resourcing levels must be maintained in our hospitals – something which, at present is clearly lacking.
Increased investment in public health, prevention and promotion
Disease prevention and health promotion is a proven strategy and should be the foundation upon which our health care system is built. Australia wide, only around $2 billion or $89 per person is spent on prevention each year by all governments. In that same year here in South Australia, the spend per head was a mere $58.
Programs targeted at increasing physical activity and tackling obesity and diabetes prevalence, reducing the smoking rate and preventing or reducing the harmful use of drugs and alcohol have a real impact and require continued and increased government investment.
The National Preventative Health Strategy 2021-2030 has set a target of 5% of total health expenditure across commonwealth, state and territory governments by 2030. SA-BEST fully supports increased government investment to bring us in line with worldwide best practice of at least 5%. We consider this is a modest target and should increase incrementally over time.
An important focus of this increased investment should be on the promotion of mental health and prevention of mental illness, including early intervention programs in schools.
$3.41 billion is lost in federal excise every year from illicit tobacco sales. It is little wonder business is booming for the black-market tobacco trade especially organised crime, given the laughable penalties that apply. That is excise that could be going towards our health budgets which are ultimately impacted by chronic diseases associated with smoking.
Smoking is one of the largest preventable causes of disease and death.
There is no dispute smoking is detrimental to South Australians and a drain on the public health system.
Illicit tobacco consumption is booming. In its 2019 report, KPMG reported a massive 47.6% increase in the consumption of illicit tobacco in Australia from the previous year. This amounted to 20% of the total combined market.
The health ramifications of the consumption of unregulated products which have likely been manufactured overseas at low cost are unknown.
We have already introduced a bill into Parliament that addresses the severely inadequate penalties currently prescribed in the Tobacco and E-Cigarette Products Act 1997 (SA) to increase the expiation fee from $500 to $1,250 and the maximum penalty from $10,000 to $50,000.
Right now, our laws are so inconsistent and weak when it comes to illicit tobacco that you are likely to get a tougher penalty including an imprisonment term for attempting to smuggle a packet of cigarettes into a correctional facility than you are profiting off illicit tobacco sales.
Minimum Unit Pricing
SA-BEST is fully committed to reducing the level of alcohol related harm in South Australia. That is why we strongly support a Minimum Unit Pricing for alcohol sold or offered for sale in South Australia as a measure for minimising alcohol harm.
We know there is a direct correlation between alcohol and domestic and family violence with over a third of intimate partner violent incidents involving alcohol.
Since the introduction of a MUP of $1.30 per standard drink in the Northern Territory in October 2018, the early signs of the independent review one year on are promising - with a reduction in the sale of cask wine by 50%. Alcohol-related road crashes causing injury or fatality, assault, attendance by ambulance and emergency department presentations have also reduced in the time.