[12.33 p.m.]  Mrs ARMITAGE (Launceston) (by leave) - Mr President, in accordance with the provisions of standing order 32(3) I move -

That the Council does now adjourn for the purpose of discussing a matter of public importance, namely: 

The current crisis in the Launceston General Hospital emergency department and the public concerns surrounding it.

Mr PRESIDENT - In accordance with the Standing Orders, are there three members prepared to rise in support of the proposed motion? That being the case, I again refer all members to what was stated at the commencement of the morning,  that the duration of the debate shall not exceed two-and-a-half hours. There is no right of reply and at the conclusion of the debate the member for Launceston will seek leave to withdraw the motion.

[12.52 p.m.]

Ms FORREST (Murchison) - Mr Deputy President, I welcome the opportunity to speak on this important matter of health and not just at the LGH, but across the state. I become a bit tired of saying the same thing over and over, but I will say it again: it is an ongoing challenge providing health services that people expect in our state, but until we focus predominantly on keeping people out of hospitals, we are going to continue to see this problem.

We still do not see, in my view and the view of many others, enough focus on preventive health and keeping people out of hospital. If we can keep people, particularly those with chronic disease whose conditions deteriorate and find themselves in the ED, which is inevitably where they find themselves, whether it is the LGH, the Royal Hobart Hospital or –

Mr DEPUTY PRESIDENT - Order. I remind the member that Standing Orders are very specific in this case with regard to a matter of public importance, and it should relate to the matter which is raised regarding the current crisis at the LGH.

Ms FORREST -  Which is in the ED department or the LGH generally. It is the emergency department we are talking about, is it not, as I understand it?

Mr DEPUTY PRESIDENT - Yes.

Ms FORREST - What I am talking about, Mr Deputy President, is keeping people out of -

Mr DEPUTY PRESIDENT - We are not talking about state wide health issues at this stage. You should confine your comments to what is in this MPI.

Ms FORREST - I am talking about the pressure on the ED at the LGH that can only be addressed if we focus on preventive health and keeping people out of it. We see this pressure on any ED, but at the LGH ED every winter. It is the nature of it.  A significant proportion of people who turn up at the ED in the LGH, and others, have escalated chronic diseases. They take time to sort out while they are in the ED. As a result, some of them will need admission, but you have people with chronic diseases in the beds in the hospital that they are waiting to get into.

Mr Finch - What do you mean by escalated chronic diseases?

Ms FORREST - Their chronic disease deteriorates to the point they need admission to hospital. But if we had a better system to keep them out of hospital, they would not present at the ED in the first place. That is the point. I accept this is a challenge. It will always be a challenge, it is nothing new, and it will continue every year. I acknowledge the Leader's comments about things that the Government is doing at the LGH and other places. There is a number of areas that need to be looked at here to relieve the pressure on the EDs, particularly the LGH ED.

This has been talked about by the Government. We have talked about it in Estimates, better utilising some of our other health facilities in the region so that you can move people out of the beds in the hospital to avoid the bed blockage, to allow people, if they do need to present to the ED, to continue through and get a bed. They are freed up because they are not being blocked by people who could be somewhere else in the system.

The staff leaving the ED at the LGH - the member for Launceston talked about a number of concerns that have been raised there, and the Leader responded by saying there is a number that have retired or have cut back their hours. We cannot speak on all those reasons. Some of them may relate to the pressures they are under, but people will not stay working in a place where they do not feel valued, they do not feel respected or appreciated and they do not feel listened to.

It is important that the staff in the ED at the LGH, and anywhere else that is feeling this sort of pressure, are listened to because they will have some of the answers. They will know how things could be improved. There might be beds that are in the hospital that are there physically in a ward or area that is closed but you cannot just open up a bed to allow a patient from the ED to be moved into it if it is not staffed, so it is a much bigger problem.

The member for Launceston talked about the use of locums and overtime. Nurses and doctors will always say 'yes' if they are called to do an extra shift because they know what it is like to be in the ED when the proverbial is hitting the fan and there is no-one else to call. They might have already worked more than a full-time load, but you get the call and you know what it is like to be there, and you will say 'yes' and you will go in. You will be tired. You are potentially not in the best position physically or intellectually sometimes to make decisions about patient care, and that is when mistakes occur.

It is important that we prevent this. A lot of it comes back to employing more staff. The amount of money you spend in paying for locums and overtime, if that was redirected into more staff, it is a much better use of that money and you get better outcomes for everybody. There is no one simple solution; there is a whole range of solutions. I know the Leader spoke about this, and the minister also did a couple of weeks ago, some of the initiatives that have been put in place with the rapid response teams and the escalation processes which have been used, because we asked that, about the number of times the escalation process has been used at the LGH. Not a huge number but it has not been in place that long. If you are going to facilitate those escalation processes, you have to have the staff to back it up. If the staff are all tired from overtime it can escalate that situation but you still have to have somewhere for the people to move through. There is no one easy solution to this.

I appreciate the member for Launceston has brought it up as a matter of public importance because it is important to everyone in that area and across the state. Unless we address it proactively and look at the big picture, we are going to continue to see this time and time again. The most important thing is to keep people out of hospital in the first place so they do not present at the ED unless there is no other place for them. Unfortunately, it is the only place at times. That is where they end up.