Motion: Modbury Hospital


Mr GARDNER (Morialta) (11:29): I move:

That this house—

(a) condemns the Weatherill Labor government's decision to cut services at Modbury Hospital and in particular, the removal of emergency surgery, the downgrading of the hospital's emergency department and the closure of its high dependency unit;

(b) notes that as a consequence of these changes, life-threatening emergencies are now diverted to the Lyell McEwin Hospital and other hospitals and, accordingly, that some north-eastern Adelaide residents now have to travel further and wait longer to access emergency department services; and

(c) recognises that Labor government's Transforming Health plan is changing the focus of Modbury Hospital from a general community hospital for the people of the north-eastern suburbs to an elective surgery and rehabilitation centre for the whole of northern Adelaide.

This is a very important motion for the people of my electorate, particularly those living in Highbury (north of the river) and some of the Hills communities for which Modbury Hospital is often the first hospital of call. It is also important for residents of Rostrevor, Athelstone and all the other suburbs in Morialta because there are flow-on effects of the changes to Modbury, as there are across the whole of the north-eastern suburbs.

This is a tremendously important motion for the people of the north-east, and the lack of interest from the government in dealing with the challenges that Modbury Hospital is now facing is notable. I fear that the lack of interest from the government would come as an absolute shock to residents of the north-east, who turned up at their polling booths at the last election in seats like Newland, Florey and probably Wright—I was not on the polling booth so I did not see—to see signs put out by the Labor Party which said 'Save Modbury Hospital, Vote Labor'.

Of course, what does the Labor Party do when they attain government? They betray the people of the north-east. They cut services to Modbury Hospital. They portrayed themselves before the election as the saviours and champions of Modbury Hospital and then displayed their true character after the election when, just as they did at the Repat and at Noarlunga, they were willing to betray those communities, and instead of supporting those services, they withdrew them.

Labor's downgrade of key services at Modbury Hospital is part of its discredited Transforming Health experiment. Under Transforming Health, Modbury Hospital will no longer be a general community hospital; it is becoming a centre for rehabilitation, day surgery and outpatients. Before Transforming Health, life-threatening emergencies were treated on-site. After Transforming Health, life-threatening emergencies are diverted away from Modbury, or are stabilised and then transferred.

Before Transforming Health, there was a high dependency unit on site. After Transforming Health, there is no ICU or HDU backup on site. Before Transforming Health, there was a 24-hour emergency surgery at Modbury. After Transforming Health, there is no emergency surgery, no 24-hour on-site anaesthetic service or theatre team. Before Transforming Health, there were acute surgical wards. After Transforming Health, there are no acute surgical wards. Before Transforming Health, there was access to a range of medical wards, but after Transforming Health they have lost two-thirds of their medical beds and now only short-stay, low-acuity beds are available.

Before Transforming Health, there were acute cardiology beds. Now there are no cardiology admissions. At the 2014 election, Labor promised a $46 million upgrade of Modbury Hospital. That budget was subsequently cut by $14 million. Before the 2014 election, a redeveloped Modbury emergency department opened with 40 treatment and assessment bays. Now, there are only 29 bays operating. Downgrade after downgrade, cut after cut: that is what this government has done to Modbury Hospital. That is what this Labor Party has done to the people of the north-east—not with them, but to them.

The emergency department has been downgraded. Modbury's emergency department no longer deals with life-threatening cases which would involve hospital admission. Lyell McEwin is so overcrowded that it was subject to a safety notice in late 2016, and it frequently diverts patients to Modbury. The dedicated ambulance shuttle from Modbury to Lyell McEwin stopped operating on 31 March. The number of patients who attend the Modbury ED has not changed significantly and the cases seen by the ED are more complex, not less. As Dr Davidson, head of the Modbury emergency department said in October last year:

…we now have no acute services beyond the ED, other than general medicine, so the loss of intensive care and anaesthetics, particularly out-of-hours, makes a difference to the care that the ED specialists can provide.

SA Health's own data has confirmed that, under Transforming Health, the performance of the Northern Adelaide Local Health Network has deteriorated. Modbury's surgery focuses on day surgery involving up to 23-hour hospitalisation, only about one-third of Modbury's previous load. Without critical backup for both treatment and diagnosis, emergency cases have to be diverted to other hospitals. Older patients and other complex cases are more likely to have care scheduled at another hospital. Again, quoting Dr Davidson last year:

…basic hospital admissions can no longer be admitted at Modbury Hospital…

Many country hospitals have access to general surgeons, and not to be able to offer this basic service, to me, is a failure of adequate care.

We also understand that the ED is having trouble recruiting staff and covering overnight shifts. There has been a loss of ability to train and teach medical students, specialist trainees and nurses. Again from Dr Davidson:

…there is still the daily battle for staff, managing problems, and morale is at an all-time low.

When Transforming Health was announced, Modbury Hospital was going to host an eye hospital for the whole of Adelaide. The government has cancelled those plans and now has no plans for an eye hospital. SA Health has recently tried to withdraw the inpatient medical emergency team and have the emergency department staff take on the hospital emergency call-out role. It is dangerous to plan for senior ED staff to leave their patients in an emergency department and be busy for hours in a separate building.

Under Transforming Health, under this government, the cardiac inpatient unit at Modbury Hospital was closed. The member for Playford promised that cardiac outpatient clinics would continue. In a news release dated 7 October 2015, he stated:

…all current specialty outpatient services accessed at Modbury Hospital will remain…

Initially, the outpatient department still performed echocardiograms, stress tests and urgent clinics for chest pain. Until around a month ago, the hospital offered urgent clinics for chest pain each week. The chest pain quick access clinic has been terminated: now, a cardiologist visits Modbury once a fortnight.

In the 2017 budget, Labor promised $250 million for The Queen Elizabeth Hospital as they scrapped Transforming Health, but only $9 million for Modbury Hospital. Labor plans to build a $9 million eight-bed emergency extended care unit at Modbury by 2020. The unit may act as a holding bay for patients awaiting transfer. It will not undo the significant negative impact that Labor's chaotic Transforming Health agenda has had on Modbury Hospital.

I was very pleased several weeks ago when the Liberal Party announced a series of policies to improve services at Modbury Hospital if we are successful in the election in March next year. After the Liberal Party policy was released, the government announced a review of Modbury services in September 2017. The government said that it would take two weeks: it has still not settled. At Modbury Hospital, the main impact has been in the area of surgical services. Complex surgery has been transferred to Lyell McEwin and other hospitals, emergency surgery has been withdrawn and the HDU has been closed. The lack of an HDU means that often less complex surgery cannot be provided at Modbury because the person has other high-risk factors, particularly a person with asthma or an elderly person.

A Marshall Liberal government will invest $20 million in Modbury Hospital to begin undoing the damage of Transforming Health and reassert Modbury's role as a community hospital. If we are elected, we will establish a four-bed high dependency unit at Modbury Hospital. It would reduce risk to patients with more than one condition, making more procedures possible at the hospital. It would provide a base for a medical emergency team within the hospital. It would reduce the need for ambulance transfers to other hospitals. It would ease the pressure on the Modbury emergency department, and it would ease the pressure on Lyell McEwin.

A Marshall Liberal government will also support surgical teams on site to undertake emergency surgery for both emergency department presentations and patients within the hospital who need critical care. We would redistribute its surgical services across the northern hospitals, with Modbury taking a larger volume of the lower complexity surgery. The redistribution will be driven by the new health board, allowing people to get care closer to home and easing overcrowding at the Lyell McEwin. We will increase the length of stay allowed for surgical inpatients at Modbury from 23 hours to 72 hours. If the hospital admission criteria were made more flexible, a larger range of cases could be undertaken at Modbury because the risk of a longer stay can be managed at Modbury.

Modbury Hospital is an important hospital for the people of the north-eastern suburbs. It is a hospital that anyone living in the north-east is likely to have had contact with. I had contact there for the first time in 1989, in I think year 6 or thereabouts, when I broke my arm at a child's birthday party that the Minister for Transport and I were both at, I was taken to Modbury Hospital and given excellent care. It has certainly always been a positive connection in my life and my family's life.

So many people in the north-east use these services. When I speak to the Liberal candidate for Newland, Dr Richard Harvey, he often tells me about the impact and importance of Modbury Hospital for his family and the important role it has played in the life of his three children. Modbury Hospital is tremendously important, but what state has this government brought it to? Let me tell you: this morning, at 8am, every inpatient bed at both Modbury and the Lyell McEwin Hospital was occupied. Modbury Hospital had 123 inpatients, three more than the hospital's all-beds capacity of 120. Lyell McEwin had 421 inpatients and one patient waiting for a bed, 45 more than the hospital's all-beds capacity of 377.

When every treatment bay is being used in an emergency department, a Code White is declared. On Monday afternoon, 30 October this year, the Lyell McEwin ED was Code White for 16 hours straight. During that period, the Modbury Hospital ED was also Code White for seven hours straight. Yesterday, Wednesday 1 November 2017, the Lyell McEwin ED was Code White for 12 hours straight. During that period, the Modbury Hospital emergency department was also over capacity for six hours straight. These are the consequences of what has been wrought by this government upon the people of South Australia, the people of the north-east and Modbury Hospital.

This is a government supported by marginal seat members of parliament who campaigned on defending Modbury Hospital. The only person on that side of the house who seems to be coming even close to taking an interest in defending the needs of their constituents and the residents of Modbury Hospital is the member for Florey, who has had to leave the Labor Party in order to do so. The fact that the Labor Party is so desperate to get her back, I think we have seen, has led to them now having a review—a review that was promised with results to be delivered in two weeks and improvements to come, fixing the errors wrought through the Transforming Health process. It was promised weeks ago that it would be within two weeks and it has not come up yet. The government obviously is still deciding how much they want to put towards reclaiming the member for Florey.

While it would be a worthy outcome if all these political machinations did indeed result in better services for my constituents and constituents across the north-east, is it not telling about this sort of government that we have in South Australia that this Labor government's only reason that it is being dragged kicking and screaming to returning these services to the people of the north-east is that they want the member for Florey to be the Labor candidate for that seat? What an appalling indictment of the government. They should have known that they went to the last election with their posters, with their A-frames, with their corflutes saying, 'Vote Labor in Newland. Vote Labor in Wright to save Modbury Hospital,' and then they, of course, are the architects of its destruction by cutting and withdrawing services.

This motion is important. It calls attention to the failure of those members to stand up for their community and the failure of this government to deliver the services needed by people in the north-east. If the government does not want to vote for or against this today, if the government wants to move it off, or if the government wants to move against it, then this is the standard to which they will be held to account. I hope that the review the government is putting in place to try to satisfy the member for Florey will indeed see good outcomes for our constituents and our residents, but what an indictment that it has taken this long. I note that they still have not promised to do anything as a result of it. They still have not even delivered this review. I commend the motion to the house and I hope all members will support it.