22 March 2023
The Hon. R.A. SIMMS: Obtained leave and introduced a bill for an act to amend the Health Care Act 2008. Read a first time.
The Hon. R.A. SIMMS: I move:
That this bill be now read a second time.
The Health Care (Ambulance Response Targets) Amendment Bill 2023 seeks to establish clear targets for ambulance response times in our state. Ambulance services are the backbone of our healthcare system. When we or a loved one is facing a life-threatening situation we rely on our ambulance services to arrive promptly and to provide the care that we need. But how do we know whether or not we are likely to get an ambulance when we call one? One way is for us to measure ambulance response times.
Response times relate to the amount of time it takes for an ambulance to arrive at the scene of an emergency after receiving a call for help. It is an essential metric to measure the performance of our emergency medical services. The South Australian Ambulance Service already use performance indicators (KPIs) to measure their response times.
As referenced in this bill, they aim to respond to 60 per cent of priority 1 cases within eight minutes, and 95 per cent of priority 2 cases within 16 minutes. When I reference priority 1 cases, I am referring to those cases where an immediate life-saving intervention is required, while priority 2 cases relate to those where significant intervention within two or four hours of reporting is required.
In their submission to the Legislative Review Committee, the Ambulance Employees Association revealed that their response times have been in steady decline for priority 2 cases since 2014—in other words, spanning both the previous Labor government, the previous Liberal government and, of course, this government. The Malinauskas government already supply a data pack with all this information to the Ambulance Employees Association; however, this is for official use only, as I understand it, and permission is required from the minister before any such data is released.
The question of course comes to mind: why is this data not publicly available? The government has a responsibility to be open and transparent with the community about the performance of our emergency services. Publishing ambulance response times would allow the public to see whether or not these targets are being met. We would then be able to hold any government of the day to account on those targets. Making response times public would clearly demonstrate where there are problems in the system and whether those systemic issues are ramping or resources or indeed other problems.
Under this bill, the Minister for Health would be required to publish response times monthly on a website and table a report in the parliament within six sitting days. Through legislation, this bill would stabilise these targets so they cannot be downgraded by future governments. In other words, we would legislate ambulance response times for the very first time and hold the government to account in relation to their performance on these.
Ambulance response times and ramping are interconnected issues and let's not forget the Malinauskas government made a commitment to fix the ramping crisis. That was the commitment that they made to the people of South Australia just last year. I submit to you that simply improving ramping to 2018 levels, the level that it was at under the previous Labor administration, is not sufficient because we know that ramping was already unacceptably high at that time.
A better measure would be ambulance response times and, whilst I note that the Malinauskas government has recently ensured that the targets of the South Australian Ambulance Service are being met in the last month, that has not been consistently the case and certainly was not consistently the case under the previous Liberal government. What this bill seeks to do is require the government of the day to provide a report in terms of its performance in relation to that.
I should note also that I welcome the fact that the Minister for Health has given a commitment in the media to release this data, but let's legislate to ensure that that happens so the government of the day is not able to elect not to release data that is less favourable should circumstances change.
Ambulances are regularly delayed when they are waiting on the ramp outside hospitals because there are no available beds. This has a significant impact on ambulance response times as it means that ambulances are tied up waiting on the kerb at hospitals, rather than being able to respond to other emergencies, and of course we know that this can lead to delays in response times and potentially put lives at risk.
To tackle the issue of response times, the government needs to address the root cause, including ramping, which of course is a result of a lack of hospital capacity and resources. While ramping statistics are being published regularly on the state government website, I understand ambulance response times are not.
Similarly, on the SA Health website there are a number of dashboards that show real-time information about the status of emergency departments and how many ambulances have been waiting. The dashboard showed 21 ambulances were waiting longer than 30 minutes at the Royal Adelaide Hospital—that is the latest information that I have—and the average wait time was 88 minutes, in terms of getting an ambulance from Flinders Medical Centre. It showed that four major hospitals were at Code White, where all the emergency department's treatment rooms were currently being used.
However, what we do not see is whether or not the Ambulance Service itself is at operational capacity. OpStat White, or Operational Status White, is the term used for describing when the ambulance system itself is at operational capacity and it demonstrates whether or not resources are insufficient to maintain effective service delivery for high-acuity cases and patient safety may be impacted directly.
This bill calls for OpStat White to be published immediately, as is already done at a hospital level on the SA Health dashboards. These OpStat White codes are already used within the Ambulance Service and distributed as required, so it would not be onerous for this information to be made publicly available. This would allow people at the other end of the system, that is, the patient or the person who is in need of assistance, to be able to make a decision around what they do. In some instances, it may mean that they can call on a friend or family member to drive them, rather than waiting for an ambulance.
The Ambulance Employees Association has advocated for the real-time sharing of this information in line with other services, such as the Queensland Ambulance Service. In Queensland, this data is already published through an ambulance availability map. In Victoria, the ambulance service regularly posts updates on social media about the operational capacity, similar to the alerts that are put out by the CFS when an emergency fire breaks out.
By publishing when the Ambulance Service reaches its maximum capacity, patients would be able to make informed choices about their health care, and this is an important measure. The Greens believe that every South Australian should be entitled to the best healthcare system possible. It is vital that we set these targets in legislation so that future governments cannot simply downgrade the targets to suit their political aims or the circumstances of the day.
It is also vital that the government of the day, whether that be Labor or Liberal because both have failed in this regard, be held to account for their performance, and that is what this bill would do. This is about saving lives and it is also about ensuring that we provide members of the community with the information they need to assess the performance of the government in relation to health; after all, this is a vital KPI for any state government, whether that be Labor or Liberal.