Wednesday, 9 February 2022

Health Legislation Amendment (Quality and Safety) Bill 2021

Second reading

Debate resumed on motion of Mr FOLEY:

That this bill be now read a second time.

Ms KEALY (Lowan) (12:50): It is great to be back in Parliament this year—the fourth quarter, so to speak, the last year of our four-year parliamentary term—and to kick it off with the Health Legislation Amendment (Quality and Safety) Bill 2021. This of course is a long-awaited bill. It will involve a lot of changes that will arise out of the Targeting Zero report, which was undertaken by Stephen Duckett back in 2016. It was undertaken in response to a number of tragic deaths and a systemic pattern of deaths of babies and some sentinel events that were involved at the Djerriwarrh Health Services. The Duckett report has instituted a number of changes around clinical governance and quality and safety and other aspects to help revitalise and renew services and provide the supportive structure that health services desperately need.

It would be remiss of me not to mention that we are in the midst of this COVID pandemic, where all we have been talking about, it feels like, for the past two years has been around lockdowns and restrictions in relation to COVID and the daily numbers, the hospitalisation numbers and the ICU numbers. Of course at its heart this bill is around supporting our healthcare workers to do the very best job that they possibly can. I would like to give my thanks to all of the health workers who have worked exceptionally hard over the pandemic. They have done an excellent job in being the frontline response, whether they work in a hospital, in a vaccination clinic or in a respiratory clinic or whether they are a paramedic—even the people who are a step out of the direct health services, such as maternal and child health workers, who have been working from home or from an office and having to do assessments over the phone. These are very, very challenging times for everybody to try and make sure that the health and wellbeing of Victorians is not left behind in the midst of the many, many restrictions that we have had on our lives and the impacts that those restrictions have had on our ability to access health care, to access our elective surgery and to access mental health support and care when we need it. I would like to pass on again and reiterate my sincere thanks to everybody who has put their hand up and provided that extra level of support and encouragement and kept going in the face of other impacts on our health and wellbeing in Victoria. Thank you for all that you have done.

This bill will permit the Secretary of the Department of Health to appoint a chief quality and safety officer. This new officer will be responsible for conducting quality and safety reviews of health and ambulance services. These reviews will focus on systemic issues rather than individual fault. So it is most certainly around looking at patterns of governance and patterns of procedure or practice where there are faults, as opposed to looking at the individual fault of a particular healthcare worker. It is looking at the system and targeted at the system rather than at the individual.

The bill provides that health services may conduct a serious adverse patient safety event, or a SAPSE, review when one or more individuals are harmed and that harm falls under a class of events prescribed under the regulations. We are yet to see the regulations. We look forward to seeing those, and if any indication of what will be contained within those regulations can be made available to the Parliament, particularly to our upper house members before this bill goes to that place, then I would strongly encourage it, and I am hopeful that the minister’s office will be able to provide that indication of what the regulations may be.

This bill protects members of review panels and those providing information to reviews against liability to ensure openness and transparency when it comes to reporting and investigating adverse events. I think all of us in this place understand the importance of transparency when it comes to understanding decision-making and getting to the core of why issues are taking place. So I certainly do support this new-found support of transparency that the government seem to have found, and I encourage them to take that on board when they are looking at being fully transparent in relation to some of the decisions that they make on a day-to-day basis around restricting health care to individuals, restricting access to mental health support services and restricting people from being able to go to work or go to school, because they are the questions that everyday Victorians are asking. That is the transparency that Victorians want to see, and while we see that other departments and other organisations will now be legislated to provide that transparency, I ask the Victorian government to provide a similar level of transparency to everyday Victorians and answer the questions that they have about restrictions in health care over the past two years.

This bill introduces a new duty of candour that requires health and ambulance services to inform patients and their families when harm has occurred to a patient during their treatment. This is around full disclosure and making sure that no information is withheld from individuals so that they understand what happened to them or what happened to a loved one. It will not only assist them with their grieving process and understanding what went wrong but also help them to understand that there will be changes put in place that will amend the system so that hopefully what happened to them will not happen to somebody else, to another Victorian, in the future. Health and ambulance services are also required to apologise to patients and their families for any harm that occurs.

Again, I would love to see that duty of candour applied, or at least a requirement for the government to apologise to individuals who have been harmed by government decisions, particularly with a focus on what has happened over the past two years. There have been devastating effects on our community, particularly borne through in mental health statistics but certainly in other elements of health care where people have not been able to get the care that they needed when they needed it—whether it was waiting for an ambulance for hours, calling again and finding that the job had not been logged; an ambulance not even turning up; ambulances ramping and that paramedic workforce not being supported to make sure they can hand over patients in a timely manner; people leaving hospital before they get treated because they feel like they are going to be there for such a long period of time; people in acute mental health crisis in an emergency department for days waiting for a bed. This is not just adults, not that that is acceptable in any way, shape or form, but it is also children—children being put into adult mental health beds. These all have a catastrophic impact on an individual’s opportunity to deal with that mental health issue effectively, to avoid additional trauma from that experience. And for a physical ailment, where you are seeking medical support, any time that you wait to have that intervention can have long-term detrimental effects.

We need to see an apology from the government around that. We need an apology from the government around the 801 deaths that took place in those first restrictions, the first lot of lockdowns, in 2020. We still have not heard anything about the accountability and responsibility around that. We have never had an apology from the government about the extreme harm to mental health to all Victorians. In fact it is still deflected—that we still must stop the spread of the virus.

In a year—and two years now—where we have had the focus on the Royal Commission into Victoria’s Mental Health System, to still not have an apology because the government have not put the mental health of Victorians first is an absolute disgrace. So I encourage the government again, if it is going to put this requirement into legislation for health services to apologise for adverse events which have caused harm to people and patients who have come through their doors, to let us see similar requirements and a similar level of leadership and accountability from the Premier of this state and from the Minister for Health for all of the decisions they have made over the past two years that have negatively impacted Victorians through their health care and their mental health care, through their business, through their ability to provide a roof over their head and meals on the table for their family and even through their kids’ right to get to school. I endorse that, and I hope that this theme continues for other aspects of the government.

I go back again. I am realising that my time will be truncated into two sections today due to the lunch break. Duckett’s review, Targeting Zero, into health governance in Victoria has some very important points in it. I realise this is the last chance for recommendations. It is the final recommendation to be implemented. It is some six years after the original review. Duckett originally had the intent that it all should have been implemented within three years. The government has failed to deliver for everyday Victorians who want safe health care when they enter the hospital system. No-one plans to go to hospital. Nobody wants to go to hospital. But when you do go there you want to make sure that the people who are caring for you are well supported and provided with a governance framework that means you will leave a healthier person, a healthier individual. This report is damning of the department, and I urge the government to ensure that this is delivered appropriately and on time.

Sitting suspended 1.00 pm until 2.02 pm.

Business interrupted under sessional orders.

Ms Staley: On a point of order, Speaker, the person sitting above the clock is taking photos of the chamber.

The SPEAKER: I just remind members of the gallery—I think they have just been reminded—that photos are not permitted from the gallery. Thank you for raising that point of order.