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Advance Care Directives (Review) Amendment Bill

16 November 2023

The Hon. R.A. SIMMS (16:11): I rise to speak on behalf of the Greens on the Advance Care Directives (Review) Amendment Bill. This bill amends the Advance Care Directives Act as a response to some of the concerns that were raised as part of the 2019 Lacey review. The Lacey review, I understand, was established to assess the extent to which the objects of the Advance Care Directives Act 2013 were being achieved.

The report considered legislative amendments and made 29 clear recommendations to improve the implementation of the act. There are now some very sensible amendments to this bill. Digital copies are proposed to be included to bring the act into line with modern practices. Recommendation 5 from the Lacey review included permitting and promoting the use of digital copies of certified advance care directives and the Greens are pleased to see this modernisation of the system and, of course, reduction in the use of paper.

Communities from culturally and linguistically diverse backgrounds will now have clarity around the use of interpreters to prepare advance care directives where English is not their first language. There is also a measure that was recommended in the Lacey review, which found that the use of interpreters under the act is insufficiently regulated and is open to abuse and possible conflicts of interest, both of which undermine the integrity of the act and the possible validity of advance care directives.

The bill also sets out criteria to refer matters to the tribunal and allows for resolutions of disputes by the Public Advocate. On passage of the bill in the other place, we note the insertion of new clauses to amend sections 19 and 36. These two amendments provide additional clarity around people who have advance care directives and present to medical practitioners having self-harmed or attempted suicide.

We have had stakeholders reach out to us in relation to this inclusion in the bill. They have raised concerns about the potential undermining of autonomy on which the Advance Care Directives Act is based. One of the issues they raised is that the right to refuse health care is fundamental to the act. Indeed, I have considered those concerns in contemplating my position on this bill.

On the balance of the information that we have, however, the Greens believe that medical practitioners need clarity around the implications of advance care directives in responding to medical situations as a result of an attempted suicide situation or self-harm. The bill makes it clear that in cases where a health practitioner reasonably suspects that a person has attempted suicide or self-harmed, and that a health professional believes that their health care is necessary to save their life, the provision of the advance care directive is non-binding. The Greens believe in suicide prevention and believe there needs to be investment in programs to ensure that people who have attempted suicide are provided the support they need to prevent future attempts.

We have always been supportive of advance care directives. I think they play an important role in giving people choices around the latter stages of their lives. They also facilitate, I think, important and meaningful discussions within families and within friendship groups around some of those issues. On that basis, the Greens will be supporting the bill.

Public Health Bill: COVID-19 Direction Accountability and Oversight

19 May 2022

ROBERT SIMMS MLC: This is the amendment to establish the SA public health COVID-19 Direction Accountability and Oversight Committee. The intention behind this amendment is to ensure that there is maximum accountability and transparency in this bill. Like the Hon. Connie Bonaros, we had very clear feedback in the Greens that, were a bill like this to be legislated, it was really vital that the parliament have the opportunity to disallow new health directions, and that is what this committee does. It is a powerful committee in that it has all of the powers that a usual parliamentary committee has, but it will be able to review any new health directions relating to close contacts relating to COVID-positive people and be able to make recommendations to the houses of parliament for disallowance.

This, we believe, is a much more effective way of managing the pandemic directions in the long term. It provides an opportunity for parliament to really consider the impacts that these restrictions have on the health and wellbeing of South Australians. It has been based on the Victorian model, which is widely regarded as best practice. We understand there are, of course, some distinctions based on our different jurisdictions.

It is important to know that South Australia does not have a human rights charter to protect human rights, which is something the Victorian legislation has protected. Obviously, for us in the Greens we would love to see a human rights charter being put in place; that would be a very good accompaniment to the other legislation we are dealing with.

This committee will be made up of five members, two from the House of Assembly and three from the Legislative Council. The amendment would ensure there is a majority of non-government members. That is a really important inclusion worth highlighting, because it means the government is not in a position to dominate this committee. It means the committee will be able to provide frank, fearless advice, genuinely independent advice, direct to the parliament for its consideration.

The committee will be in place only for the duration of the bill. We agreed earlier today that would be six months. It will provide reports to each house of parliament, it will make recommendations to parliament. There is also a requirement that the minister will table a copy of any directions within two sitting days in each house, and that any such direction is then referred to the committee. As I stated, this allows for disallowance in both houses.

We think this is a really important addition. It is one that will provide better outcomes in terms of directions but also give the South Australian people a level of confidence that the parliament is having oversight over these important directions.

We talked a little bit about the evolving space of this pandemic. We have come out of the phase where these decisions were being made by health experts alone, and are now moving into another phase of the pandemic where politicians and the parliament need to be more actively involved. It is only appropriate that if the health minister is being charged with making these directions, the parliament has a role to play and that there is an independent oversight that operates outside of the government. We think this is a really important step in that regard.

Select Committee on Privatisation in SA Hands Down Report

17 November 2021

The Hon. R.A. SIMMS: I move:

That the report of the select committee be noted.

Very briefly, the privatisation committee was established back in May and handed down its report earlier this week. I would like to take this opportunity to thank the members of the committee for their efforts: the Hon. John Darley, the Hon. Heidi Girolamo, the Hon. Frank Pangallo and the Hon. Irene Pnevmatikos. I also acknowledge the contribution of the former member, the Hon. David Ridgway, who departed the committee in June. I acknowledge the work of Leslie Guy in the Secretariat and I want to thank her for all of her efforts in ensuring that the committee ran so smoothly and that we were able to provide a timely report to this chamber.

In terms of a brief summary, we received 22 submissions and there were six public hearings. The committee heard a range of evidence. In particular, it is clear that privatisation has had adverse impacts on services in South Australia and also on the experience of many staff working in public services that have been privatised.

The report made a range of recommendations for the future that would improve the accountability of private corporations that run public services and safeguard them against the sell-offs of our public services without due consideration of the impact. In terms of some of the key recommendations from the majority report, these include:

  • the establishment of an independent regulatory body to provide oversight over services that have been privatised;
  • the establishment of a standing parliamentary committee to review existing privatisations and make recommendations on any proposed privatisations prior to government approval;
  • subsidiaries of multinationals awarded contracts for delivering public services to publicly report on their domestic and international revenues and tax payments;
  • protections of employment standards for those working in government services that are privatised; and
  • a moratorium on further privatisations on government services until all recommendations are actioned.

That is just a snapshot of the recommendations. There were 13 recommendations in total, and I certainly think that if these were implemented they would greatly improve the transparency around privatisations in our state. With that, I conclude my remarks.

Voluntary Assisted Dying

5 May 2021

The Hon. R.A. SIMMS: I welcome the opportunity to speak on this important reform—voluntary assisted dying legislation. I thank the Hon. Kyam Maher for putting this on the agenda and for his leadership on this issue. This has been a long-term priority for the Greens, and members will be aware that Mark Parnell moved his own bill back in 2008 and again in 2010. Of course, this is the first time that I have had the opportunity to put my support for this reform on the public record, so I want to make a few remarks about that. I will be exercising my vote in favour of this bill.

Like many in our community, my support for this reform is based on my lived experience and my family's experience. My nanna, Norma, died more than a decade ago, after a long-term battle with Alzheimer's disease. She had the disease for more than 20 years. In her final years she had no quality of life at all. Her mother, my great-grandmother, also died of Alzheimer's disease, and I know, from when my nanna was in good health, this was not a death she wanted for herself. She talked often about not wanting to face the same death that her mother faced. During her final years she was in a vegetative state. She was in obvious distress. She was unable to eat without assistance. Her death was prolonged and it was certainly one that was without dignity.

Obviously, I recognise that the bill before us will not deal with people in my grandmother's situation. She would not have been able to provide consent. But seeing her suffering, prolonged as it was over many years, has solidified my belief that as legislators we need to do what we can to give people choice in their final days.

I will be exercising my vote in favour of the bill for all those who I have loved who have not had the right to die with dignity and all those South Australians who have not only had to endure the loss of a loved one but have also seen them die in prolonged suffering. No-one should have to endure that in modern Australia. My thoughts are with them tonight. It may be too late for us to help them but we can do something to help other South Australians in the future.

I want to acknowledge all those who have shared their experiences in recent days. These matters of life and death are always difficult to talk about. In particular, I was saddened to read the news in The Advertiser about Ceara Rickard's health. Ceara is somebody I went to university with. I remember her from my Flinders University days. To quote Ceara:

These laws are not about choosing death, but giving people a death that works for them when they are…dying and death is near.

As Ceara says:

The choice of whether I die is not one that I get to make. But how and when I die can be a choice and it is one that I should be free to make.

Those are her words. I really hope that this parliament respects Ceara's choice and the choice of all other South Australians to end their lives with dignity.