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International Nurses Day

18 May 2023

The Hon. R.A. SIMMS (17:05): I rise to speak in favour of this motion. I want to thank the Hon. Mr Martin for putting this forward. It is a worthy matter for this chamber to discuss and a good opportunity for us to reflect on the huge contribution that nurses make to our state.

Every year on 12 May the world comes together to celebrate the nursing profession on International Nurses Day. The nursing profession has had a long and tumultuous past few years, with the onset of COVID-19 and all the challenges that has posed for our health sector. International Nurses Day is a time to reflect and to celebrate the breadth of skill and contributions that nurses make to their communities.

Nurses play an essential role in society. They play a central role in delivering health care. Nurses advocate for health promotion and educate patients and the public on the prevention of illness and injury. They provide care, they assist in cure, they participate in rehabilitation and they provide support. No other healthcare professional has had such a broad and far-reaching role. But nurses do much more than just care for individuals, they have always been at the forefront of change in health care and in public health.

Nurses innovate. Florence Nightingale, who the Hon. Iren Pnevmatikos talked about earlier, is regarded as the founder of modern nursing and remembered as The Lady with the Lamp. Yet, she also collected data to prove that the main cause, by far, of fatalities in the Crimean War was not enemy fire but infections attributed to improper sanitation. She was a pioneering statistician and possibly the first person in history to use graphs and charts to persuade politicians to act.

Nurses provide ongoing assessment of people's health. Their round-the-clock presence, observation skills and vigilance allow doctors to make better diagnoses and propose better treatments. Many lives have been saved because an attentive nurse picked up on an early warning sign of an upcoming crisis such as a cardiac arrest or respiratory failure.

The theme for this year's International Nurses Day is A Voice to Lead: Our Nurses. Our Future. Set by the International Council of Nurses, the 2023 theme addresses the global health challenges exacerbated by the shortage of nurses. Nurses are crucial in all parts of health care, whether it be acute, preventative, primary or community care.

Even before the COVID-19 pandemic, Australia faced critical nursing shortages, caused in part by the shrinking supply of nursing school graduates and a significant decline in the number of nurses who have been able to migrate from other countries. I note the government has announced some initiatives in that regard in recent days and we certainly welcome that.

We need to increase nurse staffing to patient ratios and skill mixes to ensure that patient safety, better health outcomes, higher recruitment retention, continued professional development and adequate training of staff are all being provided for. InDaily reported last year that nearly 75 per cent of nurses work unpaid overtime and 25 per cent work double shifts.

Our health system is at risk of further nursing shortages due to the longer term impacts of the COVID-19 pandemic. In June 2022, the South Australian Greens called for a one-off $3,000 thank you payment to healthcare workers in recognition of their heavy lifting during the pandemic. According to the McKinsey 2021 Future of Work in Nursing Survey, one-fifth of Australia's registered nurses say they intend to leave their current role in the next 12 months—one-fifth. Forty-one per cent of these nurses say they are planning to move countries or to leave direct care roles altogether. By 2025, anywhere from 20,000 to 40,000 nursing positions could be left unfilled in Australia and that poses significant challenges for our health system.

Surveyed nurses cited a desire to seek higher pay as the number one reason driving them to leave the profession; however, having a positive work environment, caring teammates, a safe space and a sense of purpose is important to nurses wanting to remain in the profession. Mitigating the risk of severe nursing shortages requires a comprehensive all-of-government approach. We need to redesign the training pipeline to attract greater numbers of potential nurses to Australia and to the sector. Retention is the most powerful lever we have to address the short-term supply gap; however, merely offering competitive compensation is not enough.

To excite and better engage nurses, stakeholders need to work together to pilot practices to increase nurses' autonomy, to recognise them more effectively and to build goodwill. To attract nursing staff, employers, the health industry and governments need to foster better ways of working for nurses. Employers need to consider the composition and capabilities of care teams to better utilise existing skill sets and qualifications.

We need to learn from the lessons of the pandemic and translate these into actions for the future that ensure nurses are protected, respected and valued. I certainly want to use this opportunity to put on public record my thanks on behalf of the Greens for the great work that nurses have done and continue to do to keep our state safe and healthy. I commend the motion.

Motion: Covid-19 Response Committee

3 May 2023

Adjourned debate on motion of Hon. R.A. Simms:

  1. That a select committee of the Legislative Council be established to monitor and scrutinise all matters relating to the management of the COVID-19 response including:

(a) government responses to outbreaks or emerging threats;

(b) public information campaigns;

(c) prevention and mitigation measures;

(d) implemented restrictions and safety measures;

(e) vaccination programs;

(f) infection testing;

(g) contact tracing;

(h) treatments;

(i) interactions with other jurisdictions;

(j) advice provided to the state government;

(k) impact on specific demographic groups;

(l) learnings from previous responses; and

(m) any other related matters.

  1. That this council permits the select committee to authorise the disclosure or publication, as it sees fit, of any evidence or documents presented to the committee prior to such evidence being presented to the council.

(Continued from 22 March 2023.)

The Hon. R.A. SIMMS: I want to thank all members for their contributions and for their support in establishing this committee. I have spoken previously about the genesis of the committee and the process leading up to the establishment of the joint parliamentary committee. One of the key recommendations that the parliamentary committee made was that there be an ongoing committee of the parliament to look at the implications of COVID outbreaks, to look at what we have done previously, but also to look at the response of government, so I am pleased to see that this committee will be reconstituted.

As someone who has had COVID-19 twice, I am very interested in seeing what we can do to try to stop the spread of this virus, as I know all members of parliament are.

The Hon. I.K. Hunter: Wear a mask.

The Hon. R.A. SIMMS: I hear the Hon. Mr Hunter say, 'Wear a mask.' He is a great advocate for that and I should be inspired by his example. Obviously, we all have a responsibility to do what we can to try to eradicate this virus, and I am sure this committee will play an important role in terms of reviewing the government response. With that, I conclude my remarks and thank members for their support.

Motion carried.

The Hon. R.A. SIMMS: I move:

That the select committee consist of the Hon. E.S. Bourke, the Hon. L.A. Henderson, the Hon. J.E. Hanson, the Hon. B.R. Hood and the mover.

Motion carried.

The Hon. R.A. SIMMS: I move:

That the select committee have power to send for persons, papers and records, to adjourn from place to place and report on 28 June 2023.

Motion carried.

Motion: COVID-19 Response

22 March 2023

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

1. That a select committee of the Legislative Council be established to monitor and scrutinise all matters relating to the management of the COVID-19 response including:

(a) government responses to outbreaks or emerging threats;

(b) public information campaigns;

(c) prevention and mitigation measures;

(d) implemented restrictions and safety measures;

(e) vaccination programs;

(f) infection testing;

(g) contact tracing;

(h) treatments;

(i) interactions with other jurisdictions;

(j) advice provided to the state government;

(k) impact on specific demographic groups;

(l) learnings from previous responses; and

(m) any other related matters.

2. That this council permits the select committee to authorise the disclosure or publication, as it sees fit, of any evidence or documents presented to the committee prior to such evidence being presented to the council.

The purpose of this motion is fairly clear, that is, to establish a select committee of this council to monitor and scrutinise matters relating to the management of COVID-19. The range of matters within the remit of the committee are outlined in the motion, so I will not go through them all, but in particular the committee would be looking at government responses to outbreaks or emerging threats, public information campaigns, prevention and mitigation measures, vaccination, contact tracing, treatments, any advice provided to the state government, learnings from previous responses and other related matters.

The genesis for this proposal is the joint parliamentary committee that was established looking into COVID last year, following the inclusion of COVID in the Public Health Act. Members may recall that the Greens had negotiated effectively with the Malinauskas government to ensure that we established that committee as an important accountability measure to look at how the COVID response was unfolding in our state.

The committee concluded in November. One of the recommendations of the committee was that there be an ongoing parliamentary committee to look into COVID and the state response, so this motion is consistent with that recommendation. I have had preliminary discussions with the Labor Party and the Liberal Party and others, and I understand that there is broad support in the parliament for what is being proposed. I intend to bring this to a vote in the next sitting period. With that, I conclude my remarks.

Introducing The Ambulance Response Targets Amendment Bill

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.

Second Reading

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.

Motion: End Youth Suicide Week

8 March 2023

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

That this council—

1. Acknowledges that 13-17 February 2023 marked End Youth Suicide Week;

2. Notes that one in four young Australians experience a mental health issue each year;

3. Notes that suicide is the leading cause of death for young people aged 14 to 25 and that approximately nine young people die by suicide every day; and

4. Recognises the valuable work of the Youth Insearch Foundation to reduce the incidence of crime, violence, drug and alcohol abuse, self-harm, and suicide in young people.

This motion seeks to acknowledge that 13 to 17 February 2023 was End Youth Suicide Week, and notes that one in four young Australians experience a mental health issue every year. It notes that suicide is the leading cause of death for young people aged 14 to 25, and that approximately nine young people die by suicide every day. It recognises the valuable work of the Youth Insearch Foundation to reduce the incidence of crime, violence, drug and alcohol abuse, self-harm and suicide in young people.

Many young people in Australia today are impacted by the problems stemming from poverty, broken and dysfunctional homes, domestic violence, sexual, physical and emotional abuse, death and grief, substance addiction and other traumatic events. As a consequence, many of these young people can struggle with education, employment, homelessness, and mental illness and find themselves turning to self-harm, suicidal ideation, drug and alcohol abuse, crime and violence.

But, also, we know that many young people take their own lives despite receiving significant support from family and friends, and that is a truly shocking and devastating thing for our community. Sadly, in Australia, suicide is the leading cause of death among those aged 14 to 25, and over one in three deaths of young people aged 14 to 25 are by suicide. In fact, approximately nine young people die by suicide in Australia every day. What is most heartbreaking is that this number continues to grow year by year.

I know, within my own social circle, I have seen the terrible effects that can flow from death by suicide, the terrible effect that has for family and friends left behind. Youth suicide in Australia disproportionately affects Indigenous, Aboriginal and Torres Strait Islander peoples, the LGBTIQ+ community, and young people living in rural and remote areas. These are truly awful statistics.

Fortunately, there are organisations, like Youth Insearch, that shine a light on this issue and provide early intervention and support. Established in 1985, Youth Insearch is an independent not-for-profit peer-led youth intervention organisation dedicated to supporting at-risk youth overcome trauma and mental health issues, protecting them against suicide, and drug and alcohol abuse.

Youth Insearch runs one of the most successful youth intervention programs in our country. The program was developed together with young people back in 1985. The Youth Insearch program is an award-winning, proven, comprehensive early intervention program that consists of counselling, support, mentoring and empowerment for at-risk young people who are aged 14 to 20 and is delivered through weekend workshops, support groups, peer support, leadership and individual care.

The program works by allowing young people to confront and deal with the reality of the pain in their lives. By drawing on the resources of other young people and their experiences, the organisation is able to address the real problems or the underlying issues that many of these young people may face. About 30 per cent of young people who have attended the Youth Insearch program are Aboriginal and Torres Strait Islander and 10 per cent are culturally and linguistically diverse.

I understand that Youth Insearch leaders come from these diverse backgrounds and are all trained in cultural sensitivity as part of their work. In its 37 years of operation, Insearch has helped almost 32,000 young people rebuild their lives, and it has assisted a thousand young people across our country each year.

An independent external review commissioned by the New South Wales government found positive outcomes across multiple behaviour and wellbeing measures and found that the program had a sustained positive impact on these issues over time. Some of the reported positive outcomes included less trouble with police and crime, higher self-esteem, improved family relationships, reduced suicidal thoughts and attempts, reduced alcohol and drug use, and better attendance and attitude towards education.

Youth Insearch run an End Youth Suicide Week, which is a campaign to encourage the community and young people to defy the stigma associated with mental health and to have supportive conversations about suicide with their friends, families and communities. End Youth Suicide Week this year ran from Monday 13 to Friday 17 February.

I commend Youth Insearch for their success in combating youth suicide and for moving young people from trauma to triumph, and I congratulate them on a successful End Youth Suicide Week. I do hope that the week has led people to have conversations within their communities and improved awareness around suicide and has led to young people at risk being connected to the support that they need. With that, I commend the motion.

Matter of Interest: Fast Track Cities Program

22 February 2023

The Hon. R.A. SIMMS: This afternoon, I rise to speak about Adelaide's membership of the Fast-Track Cities network. The Fast-Track Cities initiative is comprised of a global network of cities and councils around the world, supported by the International Association of Providers of AIDS Care, the Joint United Nations Programme on HIV/AIDS, the United Nations Human Settlement Programme and the City of Paris.

The Fast-Track Cities initiative was launched in the City of Paris on World AIDS Day in 2014, and since then it has grown to include 276 cities worldwide, including Adelaide. Fast-Track Cities are committed to an ambitious set of targets that are outlined in the Paris and Seville Declarations to end the HIV epidemic. These targets are:

to ensure that 95 per cent of people living with HIV know their status;

to ensure that 95 per cent of people who know their HIV positive status are on antiviral therapy; and

to ensure that 95 per cent of people on antiviral therapy are with suppressed HIV viral loads.

Fast-Track Cities benefit from a range of supports, including:

capacity building for clinical and service providers, community-based organisations and affected communities;

technical assistance for health departments on data generation, monitoring and reporting;

implementation planning for key stakeholders;

eliminating HIV-related stigma in healthcare settings; and

assessing quality of life among communities of people who are living with HIV.

The Paris Declaration was signed by the then Minister for Health and Wellbeing, the Hon. Stephen Wade MLC, at the opening night of Silhouettes: Fashion in the Shadow of HIV/AIDS at the David Roache Foundation House Museum on 29 January 2022, making Adelaide the third Australian city to join this important network. I do want to recognise the Hon. Stephen Wade's leadership in that regard. I recognise that he has since resigned from this chamber.

The International Association of Providers of AIDS Care are partnering with the South Australian Mobilisation and Empowerment for Sexual Health service (SAMESH) to advance the Fast-Track Cities objectives in Adelaide. Thorne Harbour Health, previously the Victorian AIDS Council, and SHINE SA have been working together to deliver the SAMESH sexual health service in South Australia since 2015.

I had an opportunity to meet with Carolyn Gillespie, the Director of Services at Thorne Harbour Health, and Thomas Jessup, the LGBTI Mental Health and Wellbeing Policy Analyst at Thorne Harbour Health, last week to discuss the Fast-Track Cities program, and I would like to acknowledge the work that has been done by them and others in this space. I understand that SAMESH provides support, education and training about sexual health and HIV for men who have sex with men and people who live with HIV, as well as services for the broader LGBTIQ community in South Australia.

SAMESH runs a number of programs designed to prevent new HIV infections. One such program worth highlighting in this chamber is Rapido, Adelaide's first ever rapid HIV testing service. This service offers free, less confronting testing experiences for gay, bisexual or other men who have sex with men, including trans and gender diverse people. The service is peer led—that is, the people who are administering the service are trained individuals who identify as gay, bi or trans themselves. The test involves a simple finger prick and, as a result, an outcome is produced in just 20 minutes, which is a pretty remarkable innovation to have available in this state.

Another program is the CONNECT project, which provides free HIV self-testing kits. Participants are required to answer a few questions and provide a mobile phone number where a code can be sent to access a free HIV self-test. Participants can access the self-testing kits from CONNECT vending machines either by entering the code from their phones or by scanning a QR code. While HIV diagnoses in Australia have hit an all-time low and the country is in sight of eliminating HIV transmissions by 2030, now is not the time to take our foot off the accelerator.

The Greens will be closely monitoring the progress of the state government in terms of HIV elimination and ensuring that we achieve the objectives of the Fast-Track Cities program. We certainly recognise the significance of South Australia and Adelaide signing up, and it is incumbent on us to ensure that the resources and the leadership follow.

Motion: CanTEST Health and Drug Checking Service

22 February 2023

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

That this council—

1. Notes that CanTEST Health and Drug Checking Service:

(a) is Australia's first fixed-site health and drug checking service, launched by the Australian Capital Territory government as a six-month pilot on 21 July 2022, and has been extended for another six months;

(b) provides a confidential pill-testing service that analyses contents of drugs to help service users better understand the unknown and potentially dangerous substances in illicit drugs; and

(c) provides appropriate information, counselling and advice to service users based on their specific test result, to encourage choices that reduce overall drug use and the harms associated with taking illicit drugs.

2. Recognises that drug checking is a harm reduction service that leads to most users of the service opting to discard tainted drugs.

3. Calls on the Malinauskas government to establish the fixed-site health and drug checking service in South Australia.

This motion calls for this council to recognise the CanTEST Health and Drug Checking Service, which is Australia's first fixed-site health and drug checking service, launched by the Australian Capital Territory government as a six-month pilot on 21 July 2022. This motion calls for the council to recognise that that has been extended for another six months, and notes the benefit of this service, and calls on the Malinauskas government to establish a similar fixed-site health and drug checking service in South Australia. This is an issue that I have raised many times in this parliament.

According to the Australian Bureau of Statistics, in 2021 there were 1,704 drug-induced deaths in Australia. In many of these cases the person took a substance that was stronger than expected or had a dangerous contaminant in it that they did not know about. The composition of illicit drugs is varied and highly unpredictable. Makers of these illicit substances often cut pills with other substances or include more dangerous drugs entirely.

These drug-induced deaths could possibly have been avoided through pill testing. The purpose of the pill testing is threefold: to prevent people from using unusually strong or contaminated drugs, to communicate messages around safer drug use and reducing harm, and to improve user knowledge on how certain drugs can affect them. Through conversations with experts on the results of chemical analysis of pills, pill testing better manages the service user's risks and helps service users make an informed decisions about whether they still want to take the drug.

In addition to preventing avoidable deaths, pill testing can create an opportunity for confidential conversations about harm reduction, counselling and support services between drug users and testing staff. For some people this might be the first chance they have to talk with health services about their drug use, and pill testing provides a unique opportunity to do this in a safe and non-judgemental space.

Pill testing can help detect when a drugs market is circulating potentially more dangerous substances. This is particularly useful for emergency services and can provide an early warning system, alerting the public to dangerous drugs that might be circulating in the community. Pill testing can also collect information on drug use trends in festival and nightlife environments. This information can be used to help build research and knowledge to assist police and health services in reducing drug-related harms in these settings.

There is a large body of evidence from across the globe which shows that pill testing can alter drug-taking behaviour, potentially saving lives and reducing harm. A report from the Checkit! program in Austria reported that 50 per cent of people self-reported that the results of the test affected their consumption. Most users reported that they would wait for a result before taking the drug and when presented with a bad result, two-thirds said they would not consume the substance and would inform their friends. A similar study in the Netherlands conducted by the Addiction Research Institute found that if the test results were unexpected, many respondents would choose not to take the pill.

There is a range of research in this regard that I think is worthy of consideration by the government. It is my hope that they consider what is happening in the ACT and that they roll out a similar program in our state. I think to do so would be of great value to people in our community and would indeed save lives.

Question: Regional Health Services

9 February 2023

The Hon. R.A. SIMMS: I seek leave to make a brief explanation before addressing a question without notice to the Minister for Regional Development on the topic of regional health services.

Leave granted.

The Hon. R.A. SIMMS: It was reported yesterday that SA Pathology was restructuring, with 30 nurses being moved to other parts of the healthcare system. Eight of those nurses are from regional areas. This morning, on ABC radio, Elizabeth Dabars from the Nursing and Midwifery Federation said, and I quote:

This proposal looks to completely eliminate a nursing presence out in country South Australia.

'Completely eliminate', Mr President. My question to the minister, therefore, is:

1. Does the minister believe that having no SA Pathology nurses in regional communities is acceptable?

2. What action is she taking to ensure that this calamity is averted?

The Hon. C.M. SCRIVEN (Minister for Primary Industries and Regional Development, Minister for Forest Industries): I thank the honourable member for his question. I am happy to check, but I think the item to which he is referring is a consultation paper rather than a decision of the government. However, health, of course, is looked after by my colleague in the other place so I am more than happy to refer that direct question to him and bring back a response for the honourable member.

I am in frequent discussions with my colleagues in the other place about the various portfolio areas that they have responsibility for but which, of course, have direct impacts on regional South Australia. Some of the feedback that I have had in my many visits around the state have been positive in terms of the election commitments that were made by the Malinauskas Labor government, which we are in the process of fulfilling in terms of giving health a very high priority. In terms of this particular matter, I am happy to bring back an answer.



Reply received on 21 March 2023:


The Hon. C.M. SCRIVEN (Minister for Primary Industries and Regional Development, Minister for Forest Industries): The Minister for Health and Wellbeing has been advised:

SA Pathology has commenced consultation on the delivery of pre-analytical services across the state, including all functions of pathology testing before the specimen reaches the laboratory. No decision has been made on the final structure.

There will be no redundancies as part of this proposal.

Matter of Interest: Pill Testing

30 November 2022

The Hon. R.A. SIMMS: I rise to speak on the matter of pill testing. I travelled to the ACT back in October to visit Australia's first fixed-site pill testing service. The CanTEST Health and Drug Checking Service was initiated by the Labor-Greens government in the ACT as a six-month pilot. Drug testing and pill testing have long been seen as harm minimisation approaches. Supported by the South Australian Network of Drug and Alcohol Services and their interstate counterparts, drug checking services can prevent immediate harm, increase education and awareness and alert authorities to new substances.

Harm reduction has also been acknowledged at a federal level as a key component of the National Drug Strategy. According to the 2016 National Drug Strategy Household Survey, 3.1 million Australians had used illicit drugs at some point in their lives. Shifting to a health-based approach meets the reality that many in our community are already using drugs. This is not about trying to condone the use of illicit substances but it is recognising that people are already using these substances and we need to do what we can to save lives.

The Greens believe that harm minimisation is the most appropriate way to reduce the adverse health, social and economic consequences of drug and substance abuse. Drug testing and pill testing is used in over 20 countries across Europe, the Americas and New Zealand. It has been used as part of a harm reduction strategy for over five decades. Consecutive studies have also revealed widespread support for pill testing in the community. In 2019, 57 per cent of Australians supported pill testing but only 27 per cent were revealed to be directly opposed, according to opinion polls.

Drug testing is supported by a range of public health organisations, including the Public Health Association, the Australian Medical Association, the Pharmaceutical Society of Australia and the Royal Australasian College of Physicians. I know that the conservative media often try to paint pill testing as some sort of radical concept, but I would hardly describe the AMA as a radical left-wing organisation.

At the CanTEST site I visited in the ACT, people can access the service between 10am and 1pm on Thursdays and 6pm and 9pm on Fridays. It is a free, confidential service. No ID is required, and all data is de-identified. Service users feel safe being anonymous, and they can seek advice in a non-threatening way. I must say I was really impressed with the level of service that is provided. It is an STI testing clinic as well, so someone can get themselves tested for STIs as well as ensure that any substances they have in their possession are tested.

They are also advised at this service that it is not safe to take any illicit substances. They are discouraged from doing so, and they are encouraged to think about a plan around what they might do if they are taking these substances. It is certainly not the case that, if a substance is tested and is confirmed to be what the visitor considers it to be, they are just told, 'Go on, have a great night. Off you go.' That is not the focus of this service.

The CanTEST trial has produced some really interesting results. In the six-month trial, they have tested 232 samples and provided 294 alcohol and other drug interventions. Of those who visited, 17 per cent chose to voluntarily discard their samples after the testing showed that there was already a minimisation of the risk of harm.

Some of the samples were found to be less pure than the client expected, and some of the substances contained none of the anticipated ingredients. One supposed sample of methamphetamine was found to contain no methamphetamine and only sugar, while a sample of cocaine was found to contain only methamphetamine. Purity of cocaine and heroin was between 5 per cent and 71 per cent in the samples tested at the site. Much of the MDMA contained caffeine, and 20 per cent of the MDMA samples were not even MDMA at all.

The statistics tell us a few important stories. Firstly, harm minimisation is already taking place as clients of the service were already surrendering their samples after testing. Secondly, people's expectations of their substances did not always match their samples. Finally, the data revealed that this is a really valuable service for health professionals and law enforcement agencies. By understanding what drugs are available on the market, we can better create strategies for managing and minimising risk to individuals and the community. I encourage the government to consider the trial and take action.


Question: Supporting Aids Health Care in SA

1 December 2022

The Hon. R.A. SIMMS: I seek leave to make a brief explanation before addressing a question without notice to the minister representing the Minister for Health on the topic of World AIDS Day.

Leave granted.

The Hon. R.A. SIMMS: Today, 1 December, is World AIDS Day, a day to raise awareness about issues surrounding HIV and AIDS and a day to show support for people living with HIV and to commemorate those who have died. According to the Australian Federation of AIDS Organisations, there are an estimated 29,000 people currently living with HIV in Australia. Since 2016, notifications of HIV have declined by 37 per cent. This decline has been attributed to beneficial interventions in prevention, diagnosis and treatments.

In Adelaide, people living with HIV can access a number of services, in particular through the O'Brien Street clinic. Earlier this year, it was announced that the O'Brien Street clinic would be relocating the services to a new location. The O'Brien Street clinic provides health services for more than 250 HIV positive patients, plus many more with complex health needs. The service is discreet and conveniently located. A report, along with recommendations, I understand, has been submitted to CALHN by Professor Judith Dwyer regarding the relocation of these services. My question to the minister therefore is:

1. What are the latest approaches to the prevention, diagnosis and treatment for HIV and AIDS in South Australia?

2. Can the Attorney-General, representing the health minister, provide an update on the relocation of the services of the O'Brien Street clinic?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector): I thank the honourable member for his question and acknowledge the important role that he has played in the community in his advocacy, not just at a state level but previously at a local government and at a federal government level. I know the honourable member has advocated in areas of HIV prevention in terms of funding for sexual health services and treatment, so I acknowledge the leadership the Hon. Robert Simms has taken in this area. I will be most pleased to pass his questions on to the health minister in another place and bring back a reply.


Reply received on 7 February 2023:

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector): The Minister for Health and Wellbeing has advised:

1. The South Australian public health response to HIV is guided by the National HIV Strategy, a framework for a coordinated national approach to this important public health issue building on decades of successful partnerships between government, community, clinicians and researchers.

The South Australian government remains firmly committed to achieving the goals and targets of the National HIV Strategy, including the elimination of HIV transmission in South Australia by 2030. Thanks to scientific advances and the tireless efforts of health workers and community organisations, this goal is now not only realistic but within reach.

In recent years, the rollout of HIV preventive medications (PrEP) has contributed significantly to reducing transmission. It is estimated that around 1,500 South Australians were prescribed HIV PrEP during 2022. Uptake continues to increase on the back of concerted efforts to expand our network of PrEP prescribing clinicians, and to educate the community on the importance of this and other HIV prevention strategies.

Secondly, reducing time to diagnosis and treatment initiation is also key to Australia's HIV elimination efforts. To this end, there has been continued innovation in diverse and accessible testing models. In South Australia, members of the community may access rapid and self-testing options, in addition to visiting their GP or sexual health clinic.

Finally, being on treatment enables people living with HIV to reduce their viral load to an undetectable level. This concept, known as 'U=U', not only enables people living with HIV to enjoy a long, healthy life, it also means they cannot transmit their infection to their sexual partners. Thanks to community mobilisation as well as investment in patient-centred models of care and support services, the majority of South Australians living with HIV are on treatment and 'undetectable'.

2. The Central Adelaide Local Health Network is currently considering new locations for the practice.

An O'Brien Street practice relocation planning group has been established to oversee the move to a new location. This group includes O'Brien Street patient representatives and the practice's senior medical practitioner, as well as representatives from other government and non-government service providers.