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Minister's silence on budget cut questions is no answer to crisis

Opinion

Did Stephen Wade really not know that his department is considering major cost-cutting options from Australia’s best-known corporate liquidators? Jemma Chapman examines his perplexing performance at a press conference this week.

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Amid the ongoing, escalating crisis in the state’s health system, the minister overseeing it gave a media conference this week that deserves closer scrutiny.

The Monday media call was for Stephen Wade and SA Health officials to provide an update on the GP rollout of the COVID vaccine.

All was going as planned until 23 minutes in, when a journalist asked Wade about reports that his biggest local healthcare network had re-engaged in cost-cutting measures.

“I don’t know what you refer to,” replied a blank-looking Minister.

The journalist explained that the Opposition was claiming that corporate administration firm KordaMentha had been brought back in to look at more cost savings at the Central Adelaide Local Health Network.

Again, the Minister denied any knowledge.

Another journalist jumped in to elaborate that the questions related to a so-called “Tranche 2 Savings Plan” developed by KordaMentha and understood to recommend staff cuts at the Royal Adelaide and Queen Elizabeth hospitals. Here’s how it went from there:

Minister: The Central Adelaide Local Health Network continues to manage its budget. I’m not aware of a re-engagement of KordaMentha.

Journalist: So they’ve kept you in the dark about cost-cutting measures, have they?

Minister: I have nothing more to add.

Journalist: Would it surprise you that KordaMentha would be back in there looking at potentially making further savings?

Minister: It’s the ongoing responsibility of the local health network to manage its budget. I’m expecting the management will do that…

Journalist: But is that your desire as well Minister, are you comfortable with KordaMentha being in there potentially rolling out this cuts program?

Minister: I have nothing more to add.

Journalist: Who would have engaged KordaMentha, how does that process work?

Minister: I’m not going to seek to validate statements by the Opposition. The Opposition has proven to be misinformed time and time again in the past. I will seek a briefing.

Journalist: The doctors’ union says SA Health has confirmed the existence of the report, so it exists, so who would have ordered the report?

Minister: I have nothing more to add.

Journalist: Minister, you’ve got an opportunity to refute this, if this is wrong.

Minister: I’ve got an opportunity to get briefed.

Journalist: Is it not odd that you’re not briefed already?

Minister: (Long silence, staring into the middle distance)

Media Adviser: Any more questions?

Journalist: That was a question.

Minister: Yeah, I’ve got nothing more to add.

Journalist: But would it surprise you though, Minister?

Minister: As I said, it doesn’t surprise me that the local health networks – all of the local health networks – are constantly looking at opportunities to better manage their services, to stay within budget and to deliver high quality health services.

Journalist: So would this have an impact on its COVID response then?

Minister: It’s really important that all of our health services – including our COVID response – are effective, are cost efficient and delivered in a quality and safe way. We expect all of our local health networks to do that all of the time.

Journalist: At this time of ramping, do you think that people would find it quite unpalatable that potentially there was advice to cut clinicians or doctors at the RAH?

Minister: The local health networks continually improve their services…

Journalist: But is improving cutting?

Minister: Improving services relates to identifying opportunities to be more efficient, to be more effective, we expect local health networks to do that all the time.

Journalist: So being more efficient with less people?

Minister: I didn’t say that.

If you give the Minister the benefit of the doubt, it is odd – as suggested by the journalist at the press conference – that he doesn’t appear to know what is happening in his own besieged department.

At worst, he’s being evasive.

Adding to the mystery is that the Minister’s office had been sent an email by InDaily before the press conference with details of the Opposition’s claims about KordaMentha, as had SA Health.

Four hours after the press conference – and nearly six hours after the email was sent – SA Health confirmed in a statement the existence of an “internal working document” outlining “various opportunities” for savings identified by KordaMentha, but said “no decisions have been made”.

The statement went on to say the “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,” it stated.

It seemed bizarre when the Minister told reporters that he wasn’t aware that KordaMentha had been “re-engaged”, given The Advertiser reported it last October under the headline ‘Consultants KordaMentha make a return to rein in SA Health CALHN deficit’.

Perhaps he was referring to the fact – as we later learned from SA Health’s statement – that the contract with KordaMentha “concluded earlier this year”.

If so, why didn’t he just say that?

His lack of detail is intriguing, given that CALHN is currently actively considering cost-cutting measures proposed by the firm.

At a time when more sick people than ever are waiting extraordinarily long times in emergency departments and ramped in ambulances – and clinicians are crying out for more resources – the Health Minister should know if there’s a major cost-cutting exercise being considered for hospitals under his watch.

If he was aware at that press conference on Monday, his response was disingenuous.

If he didn’t know, some serious questions need to be asked about the communication – or lack thereof – in his department.

It’s a regular response for ministers – and the Premier, for that matter – to display ignorance when asked a question they don’t like.

Even more common is to attack the premise of the question, rather than answer it.

A cynic might suggest it’s a well-honed strategy to be deliberately kept in the dark on matters they’d rather not give details about.

With hospitals again critically overcrowded this week – all above capacity and another Code Yellow apparently called at Flinders Medical Centre signifying an internal “disaster mode” – cutting through the political spin is more important than ever.

Labor was forced into an uncomfortable admission of its own this week during an interview with ABC Radio Adelaide’s Ali Clarke the morning after Wade’s strange press conference performance.

Health spokesman Chris Picton was on the attack, accusing the Government of axing doctors and nurses, despite promising not to.

He was presented with a rebuttal statement from the Health Minister claiming “there are more doctors, nurses and midwives employed in South Australian than ever before.”

It prompted this direct question to Picton: “Are there more doctors, nurses and midwives employed here under the Marshall Government as opposed to when the Labor government was in charge?”

His reply: “That is correct but it is also correct that there is now less than there was a year ago. We’ve got 112 fewer nurses now than we did a year ago and we’re seeing the impact of that every single day.”

The Auditor-General’s annual report does indeed show that at June 30 in 2020 there were 13,416 nurses and midwives, compared to 13,528 in June 2019 – 112 fewer.

But, as the Minister points out, it also shows a net increase of more than 1000 health professionals as at June 30 in 2020 since the 2018 election.

Which begs the question – why is the system in such a dire state now?

It’s easy to get caught up in the statistics, but let’s not forget what should be at the centre of the debate – the patients and healthcare staff.

While, with an election looming, the ailing system has become unduly politicised, these questions are fundamentally important because they affect real people every day – people who don’t really care who’s in government or who won that day’s political argument, or even what the statistics show: people at their most vulnerable who need a functioning health system.

They deserve more transparency from the person in charge.

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