SA Health has confirmed to InDaily the existence of an “internal working document” outlining “various opportunities” for savings identified by KordaMentha but says “no decisions have been made”.

The doctors’ union has asked SA Health to release the KordaMentha “Tranche 2 Savings” document but says authorities are refusing to do so, describing it as an “internal draft”.

SA Salaried Medical Officers Association chief industrial officer Bernadette Mulholland has sent a warning memo, seen by InDaily, to staff within the Central Adelaide Local Health Network, which includes the Royal Adelaide Hospital and Queen Elizabeth Hospital.

“SASMOA has received advice from clinicians that a CALHN document has been prepared regarding KordaMentha ‘Tranche 2 Savings’,” the memo says.

“SASMOA is advised that the document contains more cuts to clinical staff including doctors, nurses, allied health and administrative positions.

“The advice from the clinicians is that in their clinical opinion the cuts will have a significant impact on the safety of patients.

“SASMOA has requested a copy of the Tranche 2 Savings document and the CALHN CEO has confirmed it exists, but has described it as an ‘internal draft document’.”

KordaMentha was appointed in 2018 as administrators of CALHN as it faced a $300 million budget blowout, with plans to save $276 million in three years.

The contract was suspended in April last year because of the COVID pandemic, but the firm was brought in again later in the year to help rein in CALHN’s budget deficit.

Mulholland told members in her memo that CALHN CEO Lesley Dwyer had explained the document was “a starting point to consider savings and work place efficiencies”.

Mulholland said staff for Dwyer had advised the union in writing: “Given the work is in progress and we are still in the planning phase seeking to identify opportunities for further investigation, there have been no decisions made and therefore formal consultation is not possible at this point.”

Mulholland said Dwyer had further stated: “CALHN is not in a position to provide access to any document given we are in the planning phase. I can confirm that CALHN will meet all consultation requirements established in the various industrial instruments as and when applicable.”

SASMOA is now seeking the document through Freedom of Information laws.

“Cuts have consequences and the impacts in the real world are on patients and staff and already visible in the media every day,” Mulholland wrote to members.

“Proposing more cuts to staff in a system that is already in crisis because of previous cuts is ludicrous, dangerous and irresponsible public policy.”

SASMOA president Dr David Pope told InDaily that any further cuts would “just tumble the system into complete failure”.

“It’s absolutely untenable to have cuts like this being put forward when they system is in desperate need of more staff, more safe hours for medical staff and to be able to deal with the ambulance ramping as it currently exists,” he said.

Pope said the fact that SA Health was refusing to release the document “shows secrecy, it shows a disinterest and a disingenuous approach to the whole issue of our health system collapsing”.

“We are seeing doctors working extraordinarily long hours. It’s not counted in terms of shifts, it’s just continual work duty, which leads to fatigue and dangerous situations for patients as mistakes are being made,” he said.

“And we’re seeing very high levels of sick leave as a direct result of that because the level of stress and fatigue that staff are under.”

It comes as Adelaide hospitals again faced another day of extreme overcrowding and ramping with 118 patients waiting for a bed as at 8.30am.

Ten of those had been waiting for more than 24 hours.

Opposition health spokesman Chris Picton said by 9.30am the number of patients stuck waiting for a bed had grown to 120 patients.

Picton said the KordaMentha “Tranche 2 savings plan” was another blow for struggling hospital and clinicians.

“This will be a shock to everybody who’s been expecting the government to come forward with a plan of how they’re investing in the system but it seems the government is actually working on a plan for more savings for the system,” he told InDaily.

“It’s only going to make the situation much worse when we’re seeing ramping at record levels that have doubled over the past three years and Central Adelaide hospitals in the thick of it.”

Picton called on the State Government to be “up front” with clinicians and the public about its plan for hospital savings.

“How many more staff are going to have to be axed as part of this process?” he said.

“We know there’s still calls out for more redundancies to happen. We just really can’t afford any more frontline staff to be made redundant given the crisis we’re in.”

The nurses’ union said the health system needed significant investment, not cuts.

“Over the past week alone, we have been alerted to Flinders Medical Centre requesting or otherwise requiring at least 20 nursing and midwifery staff to work a double shift in one night,” said Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars.

“At the Women’s and Children’s Hospital one evening shift was staffed by seven double shifts.

“We are receiving reports of nurses and midwives being inundated with up to six text messages per day requesting that they ‘volunteer’ for additional shifts, notwithstanding that they have already fulfilled their contracted hours.”

When asked by reporters this afternoon about the matter, Wade said “I don’t know what you refer to”.

Questioned further, he said “the Central Adelaide Local Health Network continues to manage its budget”.

“I’m not aware of a re-engagement of KordaMentha,” he said.

Asked if he’d been kept in the dark about cost-cutting measures within CALHN, Wade said: “I have nothing more to add.”

Pressed again, he said: “It’s the ongoing responsibility of the local health network to manage its budget. I am expecting the management will do that.”

“I have nothing more to add.”

Wade said he would “seek a briefing” on the issue.

He offered no answer when asked if it was odd that he hadn’t been briefed already.

In a later statement to InDaily, the Minister said “under the Marshall Government, there are more doctors, nurses and midwives employed in South Australia than ever before”.

“There has been a net increase of more than 1000 frontline health staff since the 2018 election, according to the independent Auditor General’s figures,” Wade said.

“This includes a net increase of 90 more FTEs in CALHN.

“Once again, the independent Auditor General’s figures prove that Labor has no credibility when it comes to Health.

“Labor continues to misrepresent the work being done by KordaMentha. In any event, this analysis was done under their concluded contract.

“KordaMentha’s contract with CALHN expired in March.”

In a statement issued late this afternoon, a spokesperson for CALHN said “we continually review our services to ensure we provide the best care for our patients while delivering value for South Australians”.

“While no decisions have been made, an internal working document has been prepared that outlines various opportunities for CALHN to consider,” the spokesperson said.

“Opportunities were identified by KordaMentha as part of their contract which concluded earlier this year.

“These and other opportunities would be subject to all required consultation processes.”