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Speaker 1: Hey, Well, the Royal Adelaide Hospital has been given a

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Speaker 1: couple of weeks to get on top of an intervention

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Speaker 1: order put out by Safe Work Essay following an inspection

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Speaker 1: of the hospital last week, and the Salary Medical Officers

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Speaker 1: Association here in essay submitted its inspection results to Safe

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Speaker 1: Work Essay. I understand after it had done its own

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Speaker 1: assessment and basically, as we've spoken before with Bernadette mal

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Speaker 1: Holland from the essay, Salary Medical Officers Association staffer stress broken.

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Speaker 1: We've often heard that word being used and struggling to

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Speaker 1: cope with just the never ending demands of the ed area.

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Speaker 1: In the new Bernadette maul Holland Essay, Salary Medical Officers

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Speaker 1: Association on the line, Bernadette, good.

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Speaker 2: Morning, good morning.

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Speaker 1: Can you ever recall an intervention order put out by

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Speaker 1: Safe Work say on any emergency.

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Speaker 3: Department from any of the inspections that PASMO has undertaken.

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Speaker 3: I don't recall any improvement notices that have been placed

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Speaker 3: as a result from Safe Work on a particular work site.

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Speaker 3: So for us this is quite significant, and it also

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Speaker 3: suggests that what we're reporting to the employer is also

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Speaker 3: being seen by an external government agency about the concerns

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Speaker 3: that medical officers have been sharing with the community and

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Speaker 3: with their employer for a number of years now.

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Speaker 1: How do they fix this because as you know, millions

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Speaker 1: have been thrown at this by successive governments to try

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Speaker 1: and get on top of the situation there. Can it

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Speaker 1: be fixed by I think the date is July nine,

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Speaker 1: It is July nine for the RATA to get on

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Speaker 1: top of it. Can it be done?

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Speaker 3: Coming back to your original question, the issue around the

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Speaker 3: successive governments who have trained money at the services. I

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Speaker 3: think we all forget about the times where they actually

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Speaker 3: there was a lot of cut to our hospital system

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Speaker 3: and unfortunately this government is reaping the outcomes of those changes,

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Speaker 3: those cuts and all of those issues. Because I've been

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Speaker 3: doing these reports now for a decade almost and it's

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Speaker 3: been a constant scene, so things haven't changed. But what

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Speaker 3: we're trying to see, what we want to be able

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Speaker 3: to see is some solutions for the whole of hospital,

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Speaker 3: for our emergency department around the psychosocial issues that are

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Speaker 3: coming to our medical stuff and other conditions as well

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Speaker 3: that are impacting on their mental health. And what we've

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Speaker 3: actually just had probably I think it was on the

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Speaker 3: twenty fifth of December. This government put in place new

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Speaker 3: regulations that recognize issues aiming to our working environments that

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Speaker 3: impact on people's mental health. Now that's been a game changer.

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Speaker 3: Certainly that could be a reason. I'm unclear why Safe Work,

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Speaker 3: given that this is not the first time that we've

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Speaker 3: actually reported these concerns in our hospital system, why Safe

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Speaker 3: Work have gone to see it. We can only we

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Speaker 3: can only assume it's because for the first time they

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Speaker 3: are actually acknowledging that because of the environment we're now under,

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Speaker 3: it is causing great concern for our conditions. It's causing

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Speaker 3: great concern for our community. But these demands and the

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Speaker 3: failure to resource these demands and resource the community health

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Speaker 3: system is now impacting significantly on the health and work

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Speaker 3: of our conditions and we need to address it.

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Speaker 1: Every time we've spoken, Bernadette, you've said the system is broken,

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Speaker 1: that it's never been as bad, You've never seen it

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Speaker 1: as bad as it is, And every time we speak

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Speaker 1: it's seems to be worse than it was the last time.

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Speaker 1: And the endless code whites where there are more people

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Speaker 1: waiting in the department, in the emergency department to be

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Speaker 1: treated more people than beds available to treat the men.

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Speaker 1: It is one of the key things. So I don't

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Speaker 1: know how that could ever be overcome unless we have

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Speaker 1: well an overflow somewhere another hospital.

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Speaker 3: And I think it's really I think it's really important

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Speaker 3: that this wasn't This isn't something that's just come upon us.

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Speaker 3: We all were very much aware what was actually happening

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Speaker 3: in our community and the needs of our community. In fairness,

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Speaker 3: I don't think anyone expected a pandemic, but we knew

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Speaker 3: this was coming. We have seen over the last decade

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Speaker 3: the growing number of access block in our emergency departments.

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Speaker 3: And it's not just the Royal at They hospital. We

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Speaker 3: knew that our back of house our wards were really

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Speaker 3: fall to the brim with very, very sick patients. And

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Speaker 3: yet we've waited to the eleventh hour and we're chipping

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Speaker 3: over the cliff and that's not what we want in

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Speaker 3: South Australia for our community. And to your other questions,

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Speaker 3: do I think that we can resolve the damage that

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Speaker 3: this is having on our conditions by the seventh of July? No,

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Speaker 3: I don't, but at least we need to have the

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Speaker 3: conversation as to what is the resourcing because we don't

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Speaker 3: have these conversations. What is the resourceing? What is the

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Speaker 3: minimum number of a maximum number of beds? Why are

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Speaker 3: our patient clinics not working? Why are our gps leaving

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Speaker 3: the system? Why are all of these things happening? And

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Speaker 3: I think really that conversation needs to be had with

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Speaker 3: the community and with the government, and with the opposition

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Speaker 3: and with the federal government. We are only the meat

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Speaker 3: in the stadiies of what is a very large and

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Speaker 3: fairly damaged system, and now it's now impacting on our coinitions.

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Speaker 3: We want to be was to ensure that our conditions

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Speaker 3: get through this at least get through this next winter,

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Speaker 3: and make sure that their health and wellbeing has looked

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Speaker 3: after and careful.

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Speaker 1: Are you aware of any resignations over well, even over

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Speaker 1: the course of this year, people who have left the

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Speaker 1: system saying I'm burned out, I can't do this anymore.

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Speaker 3: Yeah, look we do. What we actually what we're actually

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Speaker 3: seeing is our doctors, particularly ours that may only have

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Speaker 3: a couple of years left within the public system, actually

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Speaker 3: opting out of the system and moving into more locome

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Speaker 3: work and are doing that because they can control their

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Speaker 3: hours there's less pressure on them to be able to

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Speaker 3: come and go and they contribute the work that they do.

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Speaker 3: One of the significant problems that we have in our

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Speaker 3: house system is looking at well, what is the minimum

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Speaker 3: number of doctors that we actually need and work towards

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Speaker 3: day in and day out. I get calls from our

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Speaker 3: members saying, look, we just don't have enough doctors in

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Speaker 3: our system to be able to meet the demand, meet

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Speaker 3: the community's expectations. And there is a real reluctance by

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Speaker 3: the administration to actually fund that additional medical resource that's necessary. Now,

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Speaker 3: this isn't a play for This isn't a play for

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Speaker 3: additional workforce. We need them. It's up for government, it's

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Speaker 3: up the community to have the debate. What is it

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Speaker 3: that our health system is going to look like and

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Speaker 3: what are our expectations and if we need a better

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Speaker 3: health system, how are we going to fund that?

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Speaker 2: All right, it's really.

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Speaker 3: Important to do this.

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Speaker 1: But thank you for your time this morning. Thank you,

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Speaker 1: But adetmul Holland SA Salary Medical Officers Association. We did

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Speaker 1: ask the Minister Chris Pickton to come on he's unavailable,

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Speaker 1: but on the line is doctor Emma McMahon. Who is

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Speaker 1: CEO of the Central Adelaide Local Health Network, Doctor McMahon,

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Speaker 1: Good morning, Thank you for coming on. How are we

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Speaker 1: going to fix this? Are you confident by July ninth

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Speaker 1: you'll be able to have this intervention order solved?

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Speaker 2: Good morning, Matthew. Look, firstly, I just want to take

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Speaker 2: the opportunity to sank our amazing staff at the Royal

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Speaker 2: Adelaide and across Carlin and particularly in our emergency department,

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Speaker 2: to our the front door to our community and do

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Speaker 2: such an amazing job at looking after people when they

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Speaker 2: turn up to the emergency department who are often very

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Speaker 2: sick and very vulnerable. So I've worked in a number

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Speaker 2: of jurisdictions and I've been so impressed in my last

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Speaker 2: few months here in Adelaide at particularly the Royal Adelaide

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Speaker 2: and the Emergency Department.

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Speaker 1: What are you impressed at? Because I mean, if you're

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Speaker 1: that impressed, why is an intervention order issued by Safe

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Speaker 1: Work Essay?

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Speaker 2: So Safe Work Essay came and had a look at

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Speaker 2: our emergency department, and look, I welcome them asking us

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Speaker 2: the questions because it's so important for us to look

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Speaker 2: after the well being of our staff. We've got a

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Speaker 2: very comprehensive wellbeing program in our emergency department where I

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Speaker 2: support our staff. But as we've just heard Bernadette saying,

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Speaker 2: as we know there's a huge amount of pressure in

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Speaker 2: our emergency departments as patients turn up and as we

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Speaker 2: can't flow them through the whole system of health, through

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Speaker 2: the hospitals and back into the community. We've been asked

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Speaker 2: to produce evidence that we have things in place to

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Speaker 2: improve the system and to look after our stuff. And

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Speaker 2: I'm confident that we will have the evidence to present

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Speaker 2: back to Safe Work to show them that working really

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Speaker 2: closely with our clinicians to improve and continue to improve

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Speaker 2: to make their workplace better.

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Speaker 1: Isn't it less an issue of being impressed and more

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Speaker 1: of one of shame that a hospital department, an emergency

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Speaker 1: department has been issued in intervention order by Safe Work essay,

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Speaker 1: a situation that certainly I never can recall before here

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Speaker 1: in South Australia, Bernadette Mamulholland doing her role for ten years.

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Speaker 1: Hasn't happened over that period, and I doubt it's happened

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Speaker 1: prior to that, and I certainly can't recall it ever

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Speaker 1: in my time covering stories around Adelaide, that's nothing to

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Speaker 1: be impressed about.

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Speaker 2: When I said I was impressed, I'm impressed at the

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Speaker 2: professionalism of our staff and the compassion that they show

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Speaker 2: for our patients in our community. We are absolutely taking

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Speaker 2: the improvement notice and the ast to produce evidence very seriously.

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Speaker 2: The well being of our staff, their ability to look

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Speaker 2: after our patients and our community community is an absolute

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Speaker 2: highest priority for us at Carlin and for me as

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Speaker 2: the chief executive. So I am confident in our team

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Speaker 2: that we will work together to listen to our clinicians,

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Speaker 2: work with our clinicians to make sure that our workplace

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Speaker 2: is safe so that we can keep our community safe.

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Speaker 1: But with the greatest respect, doctor, I mean that sounds

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Speaker 1: like your mission statement, and that's fine, But practically doctors

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Speaker 1: are burnt out. And we know this. This isn't a

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Speaker 1: new thing. I've heard this many times before in speaking

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Speaker 1: with Sasmara and others who are involved in various angles

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Speaker 1: of various parts of the hospital, that people there are

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Speaker 1: burnt out. Staff can't cope. Many resignations you heard over

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Speaker 1: a period of time, Bernadette Maulholland, So how do you

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Speaker 1: go about fixing it? I mean saying, you know, you're

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Speaker 1: impressed with the people. There's wonderful and I'm sure they're

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Speaker 1: doing their hardest. So I don't have any criticisms with

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Speaker 1: any experience that family members of mine have had with

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Speaker 1: the RA. It's been excellent. Once you're in, once you're

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Speaker 1: in as a patient, you get the best possible care,

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Speaker 1: There's no doubting that. But governments have thrown millions of

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Speaker 1: dollars at fixing emergency departments, not just at the RA

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Speaker 1: but around the system, as you're well aware, and it

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Speaker 1: comes to the point that safe work there say have

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Speaker 1: then got to say this is not a safe environment.

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Speaker 1: Things need to change, and all that money we've gone nowhere.

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Speaker 1: So how will it change? How will this get better?

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Speaker 2: So recently I met with a scene of clinicians, including

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Speaker 2: several senior doctors in the emergency Department Royal Later and

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Speaker 2: I asked them what do we need to do to

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Speaker 2: support you to improve it? And they've identified areas that

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Speaker 2: they want to improve and we've been working really closely

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Speaker 2: with them and in these clinician led initiatives we're actually

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Speaker 2: making a difference.

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Speaker 1: And so when I say, I'm what are those areas?

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Speaker 1: What are those areas, what do they want to.

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Speaker 2: Improve, So they want to improve flow through the emergency department.

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Speaker 2: We're working really hard to improve flow, as Bernadette mentioned,

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Speaker 2: right through the whole of the hospital, and we're also

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Speaker 2: investing in how we can support patients more in the

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Speaker 2: community with our hospital avoidance, with our hospital in the home,

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Speaker 2: with working with organizations like my Home Hospitals. The solution

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Speaker 2: isn't just in the emergency department. The solution is right

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Speaker 2: through the whole system, both the hospital system and the community.

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Speaker 2: It's a complex, big problem, but it's so important that

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Speaker 2: we fix it.

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Speaker 1: You're absolutely right, that is exactly it. But that goes

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Speaker 1: back to my point. We have thrown millions at making

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Speaker 1: this work, at improving the flow, helping people avoid hospital,

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Speaker 1: millions of dollars over a long period of time, over

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Speaker 1: successive governments, and we're at the point today that safe

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Speaker 1: workers say come in and say, well, not good enough.

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Speaker 1: For the first time ever, that's that's really poor.

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Speaker 2: It's a it's a really challenging problem to solve and

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Speaker 2: I think, as Bernadette said, this has been coming for

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Speaker 2: a while and it's not unique to the South Australian system.

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Speaker 2: This is an international phenomena. I think the most important

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Speaker 2: thing here is to listen to the clinicians who are

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Speaker 2: on the ground, who know what works best, to understand

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Speaker 2: the environment and know how to deliver care the best.

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Speaker 2: And so that's what I'm doing, is I'm working with

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Speaker 2: the clinicians and listening to the clinicians.

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Speaker 1: You know.

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Speaker 2: I spoke to the rah Ed head of you know

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Speaker 2: earlier this week to check in and say, hey, I've

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Speaker 2: heard some good things. I've also heard it's been challenging.

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Speaker 2: What can I do to support you? So, you know,

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Speaker 2: having you know, relatively recently been a practicing clinician myself,

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Speaker 2: I think the clinician voice is so important in this

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Speaker 2: and I, you know, listening to Bernadette, that's what she's saying.

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Speaker 2: She's saying, this is what our clinicians are saying. And

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Speaker 2: I'm saying, I agree. We should listen to them and

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Speaker 2: we should work with them to improve the system.

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Speaker 1: Heard that before many times I've got to say, Doctr.

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Speaker 1: Mcmahn and well, at least you're doing that. That's that's

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Speaker 1: the start. And they're telling you things that we've known

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Speaker 1: all along. Got to improve the flow. It's a matter

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Speaker 1: of finding beds and people to staff those beds. Ultimately,

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Speaker 1: isn't it.

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Speaker 2: I think it's a combination of both said and being

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Speaker 2: able to support people in their homes and in the community,

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Speaker 2: all of which is challenging. But we're working really hard

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Speaker 2: and we're making some inroads.

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Speaker 1: What are you going to tell Safe Work say, if

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Speaker 1: you you've got till the ninth of July, what happens

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Speaker 1: beyond that? If things don't change and we're only a

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Speaker 1: month into winter, If this time next month things are worse,

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Speaker 1: what are you going to be doing? And saying?

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Speaker 2: I we will work with Safe Work. They have experienced

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Speaker 2: in this area and they will We will listen to

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Speaker 2: the questions that they ask, we will produce the evidence,

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Speaker 2: and where our systems aren't working, will look to see

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Speaker 2: how we can improve them.

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Speaker 1: All right, doctor McMahon, appreciate your time. Thank you, Thank

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Speaker 1: you Matthew CEO of the Central Adelaide Local Health Network.

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Speaker 1: Doctor Emma McMahon