LOUISE MILLER-FROST, MEMBER FOR BOOTHBY: Welcome to beautiful Boothby, it is a scorching hot day and I'm here with Minister Mark Butler and Minister Chris Picton. My background, working in the health sector, I really understand how important it is that people have access to primary care when they need it, that it's accessible. And I'm very excited about our announcement today. Minister Butler.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thank you, Louise and thanks to ForHealth for hosting us today at one of the Priority Care Centres that's doing much of the work that is intended to be done in perhaps a broader way through Labor’s Urgent Care promise from the last election. I’m really pleased to be here with the South Australian Health Minister, a long-time friend and colleague of mine, Chris Picton. Thanks to all the staff and the doctors here for explaining just what a difference a service like this can make.
We know, and I know Louise has talked to me a lot about this after feedback from her constituents in the south of Adelaide, that it's never been harder to see a doctor than it is right now across Australia. After 10 years of cuts and neglect to Medicare, added to the pressures of a pandemic, people are finding it extraordinarily difficult to get in to see a doctor and when they do, they're often paying gap fees that are higher than ever before in the Medicare era. This is a particular challenge when you have one of those non-life-threatening emergencies: you get a foreign object to the eye, your child falls off the skateboard and then busts their arm. If you can't find a doctor who is properly equipped to deal with an emergency like that, too often people find that their only alternative is to go into a hospital emergency department. Now we know across the country, about half of all ED presentations, that's about 4 million ED presentations every single year, are what are classified as non-urgent or semi-urgent, many of them could quite adequately be dealt with out in the community without a wait in emergency departments across the country, which might be six, seven, even eight hours for a non-urgent presentation. That's why we're committed to delivering 50 Urgent Care services across the country, including five services here in South Australia.
Today, I'm announcing the Expressions of Interest for those five South Australian services will open on Friday and be open for a month. So, closing on the 24th of March this year. One service will be in the Mount Gambier region, one will be in this region - southern metro in Adelaide - there'll be a service in the outer north and the outer south, and one in Adelaide City. These are five locations that were broadly announced during the election campaign in May last year. These services will make it easy to see a doctor for those non-life-threatening emergencies. It’ll be great for patients across Australia but importantly, it will also take much needed pressure off our stressed overburdened emergency departments, which across the country are dealing with unprecedented levels of pressure. I want to say that this model will be open from 8am to 10pm at night, so very extended hours, with highly qualified doctors and nurses and other allied health professionals on site able to deal with those non-life-threatening emergencies. They’ll also have services like pathology, diagnostic imaging, so X-ray or CT scans and the like, available to them as well. They'll be available to walk-in patients, so you won't need to make an appointment, you won't need to be on the books of that service. And importantly, they will be completely free of charge. So, fully bulk billed, without any gap fee whatsoever.
Lastly, can I just thank the South Australian Government for the extraordinary level of cooperation that they've shown in designing this model. They've obviously got experience with great Priority Care Centres like this one here in Marion. But we've really worked very hard with all state governments over the last several months, first of all to get the locations of these services right, but also get to get the operational rules right. Meaning they have to deal with non-life-threatening emergencies, not just a general GP presentation, and they also have to have really clear protocols between the service on the one hand, local hospitals and ambulance services, on the other so people are clear about where they should be getting their treatment. We are really pleased to make this announcement. We’re very grateful for the support we've gotten in developing this model from the South Australian Government. And also always Louise Miller-Frost has just been such a powerful, relentless advocate for better health care services in Adelaide South. I might just hand over to Chris Picton, before we take any questions.
SOUTH AUSTRALIAN MINISTER FOR HEALTH, CHRIS PICTON: Thank you very much Mark. And it's great to have Mark here, obviously he's mostly in Adelaide, but to make a really exciting announcement from the Commonwealth Government of investment in primary care, urgent care, across Adelaide. We know how difficult it is for so many people in the community to see a GP when they need one. For many of those cases, unfortunately, people have no other option but to go to an emergency department. To have the federal government investing in these Urgent Care Centres across South Australia will give people that ability to go somewhere other than having to wait in the emergency department to get that treatment.
Obviously, as people know, there's a whole range of issues that need to be addressed through Medicare and primary health care. I know Mark is working through those issues in the Strengthening Medicare Taskforce. But this is one measure that will help, particularly in terms of what's being announced in terms of the location of these clinics for this EOI. To have them in the outer northern suburbs, the outer southern suburbs, the inner southern suburbs, and in the city, roughly aligns to where we see a lot of presentations at hospitals, the Lyle McEwen hospital, Flinders Medical Centre, Noarlunga Hospital and Royal Adelaide Hospital. So this will give people that option in terms of where they present.
It's great to be here at the Marion Domain, which provides a significant amount of GP services for the southern suburbs, and importantly, is a Priority Care Centre. And a Priority Care Centre is something that SA Health supports for practices through Adelaide and lining the outer fringe area of the city as well, to provide where we can divert some people, who are going by an ambulance or have presented at emergency department, who can get treatment from GPs and nursing teams at one of these centres instead. It is an important service. And we've obviously used some of the learnings and working with Mark and his team on developing the Urgent Care Centre. But importantly, this is a different model as well, because this is a model that will allow people not just to be diverted from an ambulance, but to be able to come directly to one of these centres and present there, which will give people that greater option. And the thing that I'm really excited about as well, is the Commonwealth saying that part of the tender is going to be those after-hours services as well. Because we know how difficult it is for people to get those services after hours. If you've got an issue, after hours, there's very little options sometimes, other than having to go to the emergency department. So they have this alternative of these Urgent Care Centres, is going to be greatly beneficial for South Australians who need that care and for the health system overall.
DR MAX ADAMS, MARION PRIORITY CARE CENTRE: I've been working Marion Priority Care Centre for two years. I came from working at Noarlunga ED and working in general practice. And prior to that, working in Norway, and a similar system to this one where we're working in urgent care or priority care. The main advantage I've seen in working at a place like this is that we're able to reverse triage patients who previously would have waited many, many hours in ED - somewhere between four and 12 hours on average - and get them seen within an hour. Usually, it's within 20 minutes, which is commendable. It's the same at every Priority Care Centre probably, but it certainly pays tribute to the motivation we've got here and also the teamwork that, that our teams has put into the way things are run at this local site. I think what's going to happen now is that with more sites being created around Adelaide, we're going to see increasing referrals to these places, which means we're going to help out the emergency departments more, we're going to help out general practitioners more, we're going to help a part of the system that really hasn't been working very well, and certainly not going to be treading on anybody else's toes. There's going to be a relief for the emergency department. It's going to be a relief for the general practitioners and I know that because it already has been for the last two years - that's the feedback we are regularly getting.
JOURNALIST: In your experience, obviously working on both sides in the hospitals and now this side of it, how much of a burden will this take off those EDs trying to go in there and unclog that system?
DR ADAMS: There's a couple of things: one is how much it's going to relieve EDs and another is how much it's going to relieve individuals in society. I think when it comes to the emergency departments, what we're going to see is that they're going to be able to focus their resources more towards the high end, higher acuity, life threatening emergencies. And, and when it comes to individuals, it means that they're going to be able to get seen quicker, much quicker, in a much more comfortable environment for them and much more convenient environment for them, for non-life-threatening emergencies. So it just hasn't made sense that the system has evolved over the last 30 years to have both non-life threatening and life threatening emergencies all going into the same bottleneck. And it really makes sense to be able to separate them again.
JOURNALIST: Minister Picton, with that in mind of trying to relieve pressure off the hospital system - any pressure off the hospital system is welcomed pressure off the hospital system. But could this potentially then bottleneck in here, with just walk-ins and non-referrals?
PICTON: Look, as I said, I think that there has to be a whole range of things that need to be done. It's not just one single initiative that's going to address the issues across the system. And it is a system which interacts between the primary care system, the Medicare system that Mark runs and the hospital system that we run, you know, patients obviously interacting between the two, there is an impact between those two. But more investments that we can see in terms of primary care, obviously relieve some of the burden on the emergency departments. It also means if people can't get into the GP, people can't get that primary care, then they end up sicker, and sometimes they've got no choice but to be one of those very urgent, life-threatening cases at an emergency Department. So, the importance of primary care is not just about diverting people who otherwise don't need to be at an emergency department. And it's also about providing that care quicker, before people's conditions become more serious, and they've got no other choice but to go to the emergency department.
JOURNALIST: The Opposition is basically saying that this is just a rebrand of a policy that they that they had in place?
PICTON: I mean, that's yet again, another bogus claim from the Liberal Party who have no policies. This is a new service that is completely different in that people will be able to come to this service without having to have that referral from an ambulance or emergency department. That's going to be a welcome relief to so many South Australians. It's disappointing to hear the Liberal Party are opposed. And Mark might want to explain some of the differences between the models, as well. But the Priority Care Centres may well apply for this service, but if they do become a Priority Care Centre and an Urgent Care Centre, then that will be two different services that they'll be running - additional level of service - and importantly for the patients, a very different service in terms of you'll be able to go straight there to get that service.
JOURNALIST: With the Primary Care Centres, there is a possibility that people may be presenting, and their problems are actually better suited to an ED, and that could be life threatening. How are people going to know how to differentiate when their symptoms need what service?
PICTON: I might even ask a medical colleague behind me to explain what they do in those circumstances, but what happens -
JOURNALIST: But surely the government puts out some sort of -
PICTON: - I will answer that. There’s a process and we have skilled clinicians at every stage of the process. In terms of the Primary Care Centres, there's work done between the ambulance service and the staff who work at this clinic, and the other Priority Care Centres, to make sure that they can properly assess the patient and properly triage the patient for somebody to be able to manage, here at the site. But there's always the risk of somebody who's presenting to their GP, who was able to get an urgent appointment at their normal GP for the centre to manage, and they always have to be close connections. That's why it's really welcome that the Commonwealth Government in designing this programme, have been working closely with the states and hospital system across the country. Importantly, in each of those areas, we'll be working between the local health network, the hospitals, and these new Urgent Care Clinics. Because no system is an island, we need them to work together to make sure that care can be provided for patients.
DR CAROLYN ROESLER, REGIONAL CLINICAL DIRECTOR: I’m a GP in Elizabeth, I also work in the Priority Care Centre, and in public ED. So, I'm in that 360 view of how the urgent care and how priority care is helping. So back to your question, specifically, we have very strict criteria of what obviously, the capacity of the Priority Care Centres and the Urgent Care Centres can do. That's been well established. And we definitely have the ability to triage patients early, and we would absolutely get those patients to hospital if we felt. But having said that, because of COVID, and because of the inaccessibility of GP appointments, the acuity of patient load coming into priority care and urgent care is definitely getting greater. So, even more reason to have really good pathways. And one of the greatest things is with Noarlunga we have pathways that avoid patients going back to emergency if they have an appendicitis, an abscess, we have direct admission pathways, which have really been of great benefit. So, the really sick that should be there are not going back to emergency to restart the wait again, they're actually getting streamlined into beds, avoiding the whole ED scenario. And I think the skill set of nurses that we have from the public system, and the skill set of doctors that we have in Elizabeth are obviously we're able to make those calls very early. But by default, we are seeing very sick people because they can't have our appointments, coming into urgent care and certainly emergency. But as I pledge for GPs, obviously these urgent cares are enabling the GPs in the North to concentrate on preventative care and treating chronic illness, and for the elderly that have really been forgotten and isolated. The urgent cares are enabling them to come in and get face to face consultation which is worth its weight in gold.
JOURNALIST: Well, yes, obviously the health professionals know exactly what to do each situation. But how is someone, how is the average person at home going to know which service to go to, depending on their situation? Like, is the government going to educate people on what services do?
BUTLER: We've been working very closely with all state governments, we've had officials working for several months to ensure that we have good operational protocols between the systems and usually someone will make a phone call if they're concerned about emergency, they'll find one of the referral services - Healthdirect is the federal health referral service. The phone service that is used by many, many Australians every single day and there will be very clear referral pathways, as there are right now, to emergency departments from the trained nurses who staff the Healthdirect phone lines to determine whether or not there's an urgent care service in the person - in the patient's – region, and whether the presentation they're making to Healthdirect would be appropriate for a referral to an urgent care service instead of suggesting the person visit the emergency department.
JOURNALIST: Sorry, Minister Butler for just one more question. With a facility like this that may transfer from a PCC into a UCC, what would be the process? Would it be, quite literally, close at five o'clock on the Friday as one facility and open up at 9am as a new facility on a Saturday? Or how would that potentially work?
BUTLER: Firstly, there's an Expression of Interest process that will be run by the Primary Health Network. So they will determine who the successful bidder is in a particular region. But if, hypothetically, it were a Priority Care Centre from South Australia, or one of the urgent care centres that have opened very, very recently, in recent months, for example, in a couple of other states, then we'd have to sit down with the relevant state government and work out the way to ensure that our investment adds sufficient value. So that we're not crossing over each other's territory, we're actually going to enhance the service that's already in place here at Marion. We'll sit down in good faith with the South Australian Government in the hypothetical event that a Priority Care Centre is successful through the EOI process, make sure that adds real value, real capacity to the existing service here in the south. But also make sure that it's streamlined and that's efficient and effective.
JOURNALIST: Essentially it wouldn't be closing down a facility for a period of time to then adopt to the new model?
BUTLER: No. In the event that this happens, we'll make sure that the two services are integrated seamlessly. So, from the front, whether it's a patient or whether it's a local hospital or local ambulance service, they'll notice no difference. They'll just see a vastly enhanced service in the south.
JOURNALIST: Expressions of Interest are set to close towards the end of March. When are you seeing these UCCs open up across the state?
BUTLER: We're determined to see the 50 services delivered this year in 2023. For example, we've put out Expressions of Interest in two tranches in Western Australia for three of those services in that state to open this side of the 30th of June, and additional services in the second half of the year. It ultimately will depend, in part, on the ability of the successful applicants to stand up their service quickly. But we'll be making it clear that, whatever is the case, we expect these services to be delivered in 2023.
JOURNALIST: Is there a rough estimate of how much this is going to cost?
BUTLER: We committed $135 million, put in place in the October Budget, to start the process of delivering these services, and we'll make sure they're properly resourced.
JOURNALIST: And are you going to build new facilities? Or are you hoping to just use existing ones?
BUTLER: No, we're very clear, we're not interested in building new facilities. We're seeking interest from existing services like this one, but other existing GP practices, community health services, in some areas Aboriginal Medical Services may be interested in applying for this. We're interested in leveraging existing practices that want to take the step that Max described, to really add an additional level of service to their community.
PICTON: A real life example, from my own family a few months ago, after hours a family member was very sick, called Health Direct, which we certainly encourage people across the community to do. They were appropriately triaged by a nurse and then a GP through Health Direct on the phone. But the answer was: well, you need to see a doctor immediately, and there's nowhere open, so you've got no other option that to call an ambulance or go to emergency. So those are the sorts of situations where we've got those trained staff who help on Health Direct. But after hours, there's limited options in terms of where they can send people. Now we're giving them another tool, that they'll be able to use one of these Urgent Care Centres to help them get patients treated.
JOURNALIST: Minister, the rehash of Ash the Ambo, from the state opposition late yesterday, your take on that, considering that she was a paid actress?
PICTON: This is absolutely embarrassing from the Liberal Party of David Speirs, I mean, this is clearly a paid actress. We don't know where she's from, she might not even be from South Australia, don’t know who she is. And what she's saying in this ad is complete baldfaced lies. So, this is a Liberal Party that's got nothing positive to offer whatsoever. When they were in office, they made 200 nurses redundant. And now they're just taking pot-shots with a paid actor and a fake ambulance, rather than putting out any policies, whatsoever. I mean, you know, to now go out today and attack these additional clinics that will be opening up across South Australia just shows how out of touch they are with South Australians that they would oppose additional investments in our healthcare system. So, I think rather than making some silly fake ads with paid actors, they should actually work on some health policies and actually do something constructive, while we're making these additional investments with the Commonwealth Government.
JOURNALIST: Despite the fact that it is an actor, there is no denying that ramping is still a huge issue. So, it shouldn't really matter who is putting the message out there.
PICTON: But the key thing is, you know, we are making the investments to address this situation, and we acknowledge the issues in the health care system. And we are committed to absolutely addressing them. We said this was going to take time, we are making the investments in our hospital system, our mental health care system, working with the Commonwealth on the primary care system. And all we hear from the opposition is opposition to everything. What is their positive proposal that they're saying, in addition? I mean, compared to them, we're not privatising things, we're not bringing in corporate liquidators, we're not making staff redundant. We're just making investment after investment to address the situation in our healthcare system. And they've got absolutely nothing to offer except some fake paid actor ads. Thanks everybody.