Wednesday, 9 February 2022

Elective surgery

Ms BRITNELL (South-West Coast) (17:30): I grieve for the people of Victoria. I grieve for the 80 000 people on the public health waiting list waiting for surgeries—vital elective surgeries—people who are needing knee replacements, hip replacements, colonoscopies, biopsies and cleft palate operations like we heard about from the member for Lowan earlier today. These are not minor surgeries; they are often major surgeries, and they are often surgeries that are helping people who are in considerable pain to be able to continue managing their activities of daily living, like walking, showering and being able to manage at home alone, and not be dependent on others. These are people who are often on significant drugs like anti-inflammatories that carry with them a risk of gastrointestinal bleeds—not insignificant stuff. They also carry with them, these conditions, pain—from needing a knee replacement or hip replacement or any orthopaedic-type surgeries on shoulders and the like—for which you often need drugs like Endone, which carry with them a really big risk of long-term addiction. When you are on those sorts of drugs for pain you need to be on them, and when you are on them for over two years, like we are seeing, you are in for a battle to get off them.

This is a really significant situation. Now, we have 80 000 people on the waiting list waiting for these significant elective—vital—surgeries. I hear in this place all the time the language of the Minister for Health when he says, ‘It’s a global pandemic’ and ‘It’s a wickedly infectious virus’. It is a global pandemic, and it is a very infectious virus, but this is not the reason that we have the blown-out waiting lists, that we have had the longest lockdowns, that we have had the most deaths and that we have the wooden spoon for many of the things that you would measure when you look at this pandemic. But in Victoria that is where we are, compared with every other state. It is mismanagement because of the restrictions this government has put in place. The doctors, the surgeons, are saying, ‘We know a better way out. Just listen to us’. How many times have we heard—I certainly have from surgeons and clinician friends that I know—the government will not listen to them. They will not involve them in the discussions. These are people who, often, have had 30-plus years practising, and they know the system intricately. They are absolutely flabbergasted. These are people who do their jobs because they care. We saw on Facebook just a couple of days ago Dr Richard Bloom—actually it would be ‘Mr Richard Bloom’; he is a surgeon and that is how we refer to our surgeons, as esteemed, highly qualified professionals—saying, ‘I’m ready to operate. My team is ready to operate. My patients need me.’ So bad is Victoria’s mismanaged system that we are in a code brown. No-one in the other states is in a code brown—no-one.

This Premier knows health well. He was the health minister for three years before he was the Premier. That is 11 years. He knows the system well. He knows what the Productivity Commission told us this last week—that we are the most underfunded health system per capita and per patient in this nation. And that is not as a result of the pandemic—because we can hide behind the wicked virus, we can hide behind the global pandemic or we can compare ourselves to the other states and we can see that we have done very badly. The Minister for Health knows it, the Premier knows it and the Productivity Commission have highlighted it.

Two years ago we were told—and we were all very concerned, rightfully so; we did not know what the future looked like with this pandemic—that we had 4000 ICU beds promised, and we did need them. And let me tell you one of the reasons I would suspect we are not allowed to have surgery. It is because when you have surgery—a knee replacement—you can often lose quite a lot of blood and you may need to be in ICU for the night. Mark from Greensborough, who I met at the weekend, a man in his 50s, has been diagnosed with throat cancer. He has had half of his soft palate removed. He has had chemotherapy. He is currently on immunotherapy. I was out sailing with him actually, so he is healthy. He said to me, ‘I need vital treatment, but I have to have an ICU bed available, and I can’t have it’. He may not survive that. So that is not even one of those 80 000, but there are many others. Just this last week I was speaking to a friend who is a physician, a cardiologist, a haematologist, a very highly qualified gentlemen, and I said to him, ‘I’m so worried about all these people who are putting off colonoscopies and other screening procedures that we’ve done in the health profession to improve outcomes for health. I am so worried we are going to have so many stage 3 cancers, stage 4 cancers that shouldn’t have been. They should have been a benign polyp that was removed before it became malignant’, and he said to me, ‘Roma, we’re already seeing it, and they’re just not listening to us’. It is outrageous.

Now, I know nurses are exhausted, clearly. I speak to nurses a lot, and I know they have done an amazing job and they have had 12 hours out in PPE in hot conditions swabbing. And I know girls who have been called into the COVID symptom management hotline, and they are trying to diagnose patients’ oxygen saturations by talking to them over the phone—really tough stuff—and making calls where they are not sure whether the person will be okay tomorrow. I know it is serious, but I also believe they are exhausted because of mismanagement, because I also hear from nurses who have been on the nurse bank for three months and have not had a shift. I also know that there are 16 000 people, me included, who right at the start responded to the call-out for health professionals who could offer skills.

Mr R Smith: Did you get a call?

Ms BRITNELL: I have not had a call.

Mr R Smith: How long ago?

Ms BRITNELL: 18 months ago—16 000 of us; maybe some have. I am more than qualified to swab. Now you remember Christmas two years ago—not last Christmas, the one before. We had to shut down PCR clinics because the nurses were exhausted. Well, hello! Do you know how many swabs I have done? I could have stepped in. I reckon I would have needed about half a day of training to show me the procedures of where to document, how to get the cars through, but no-one would have had to show me how to swab.

And I did my training last week online for being able to make sure I am qualified to give a vaccination. I passed, got the certificate. I am not looking for a job. I have got a role. I have not been looking for a job for a long time. This is a role to me. But I am ready to step up and help, like many others are. So there are people around to help with the exhaustion. It is about management. The doctors are saying it. The nurses are saying it. Yes, we can focus on the ones that are exhausted. That is because it has been poorly managed.

My constituents from South West Healthcare, many of them, go to Geelong, to Ballarat, to Melbourne. We do not have cardiothoracics, and rightfully so. I would not want that in the Warrnambool area or Portland. We do not have the support teams. And I would not want the children that need really highly qualified neurosurgeons being anywhere else but the Royal Children’s Hospital. So many of my constituents are on that list. Many of them are in pain. I think I mentioned Tanya from Portland, who last week the Nine News highlighted: a 36-year-old woman who needed a colonoscopy two years ago and finally had it. Yes, stage 3. Thirty-six—stage 3 cancer.

So this Premier says, ‘We’ll fix the health system’. He has had 18 months, nearly two years. It is two years actually. It is two years. Yes. We were locked down in February, wasn’t it?

Mr R Smith: March.

Ms BRITNELL: March? Okay—nearly two years. And that was when we were promised. I am so frustrated by people saying, ‘But, you know, it’s a pandemic, Roma. We didn’t know what was going to happen’. Well, I will tell you right here and now that we have been planning for pandemics in departments for a long time. I participated in pandemic planning in 2005. It was called project Minotaur, and I sat in a room with ambulance officers—this was an agricultural planning one. We had ambulance officers, teachers, police, people from every department, so we could manage an outbreak, if it occurred, of a particular disease. If the ag department was doing it for a zoonotic disease or any other disease, I am pretty confident the Department of Health was doing it as well. And I am told they had, but they threw out the plan.

I keep saying I am sick of hearing the emotive words ‘global pandemic’—like it is the globe’s fault, it is not Victoria’s fault. No, it is not Victoria’s fault that we have a pandemic, but it is Victoria’s fault that we are being mismanaged. And that is what I continually say—mismanagement. The health system extends to the ambulances. I am hearing people all over the place who are calling for ambulances and not getting them. Just a few weeks ago I had a phone call from a nurse, and her husband is a nurse. She gave birth, went home and had a postpartum haemorrhage—a pretty significant event. She knew that; she is highly qualified. She lost 2.5 litres—a significant amount of blood—and rang the ambulance. Her pulse was getting weak and thready. She knew what was happening. She was getting breathless. They were panicking. Ambulances kept dropping out. It is a long story—she has actually gone to the minister about that. But it is not good enough, and that is why she contacted me—because she is worried about other people. Lucky she knew what was happening. Lucky she knew that it is really hard to stop a bleed from a uterus without surgery, without some diathermy. If she had not, she probably would have just stayed at home. She had to drive herself—well, her husband had to drive her and a nine-week-old baby or two-week-old baby to hospital. She would have died. That is how significant that one was. She did not, luckily, because she was a nurse and she knew what was happening.

When I was training—35 years ago I reckon it must be now; it is getting on. Maybe it was 30 years ago. I do not do maths for a very good reason; I do not want to know. But when I was training—I am cardiac trained—one thing I learned, particularly when I did my cardiac training, is that you never let a patient drive themselves to hospital. Member for Melton, you will remember this. I am sure you gave the same advice to patients or people you knew up the street. If you have got cardiac or chest pain, do not drive yourself. It is actually irresponsible: you will kill someone if you have a cardiac arrest—standard stuff. People do not know what chest pain is. With chest pain, you never have pain; you have a feeling of crushing or you have a deep sensation that runs down your arm. When you ask people if they have got chest pain, they always say no. You have got to be very clever about how you ask or you will miss it. So we are asking people to drive themselves to hospital with what they might describe as indigestion or even a broken arm or abdominal pain. It could be an ectopic pregnancy, and they could actually have a massive haemorrhage and lose consciousness—and this happens. That is why we have an ambulance service. That is why we are lucky, I used to say, in a western country.

I cannot believe what has happened to our ambulance service. If the upper house do not get that motion through this week to make sure we have an inquiry into ESTA—the very fact that we have the Department of Justice and Community Safety, is it, managing ESTA when ambulance is health, there has got to be a disconnect as a result of that. It is not my role to try and pick that up—to try and work that out—but something is dreadfully wrong. The government just keep saying, ‘It’s because of the global pandemic’. It is actually because of mismanagement, and many surgeons are coming out and saying it. Dig deeper. Of course you can hide behind the exhaustion and the global pandemic and emotive language, or you can say, ‘We have had two years’.

We were promised 4000 ICU beds. We have got the worst funded health service in the state. We have failed, with the longest lockdowns and the largest death list as well, and 80 000 people are on the surgery waiting list—growing, I might add, by 1000 people a week. By Easter there will be 90 000. This is not a government that cares. This is callous, and we have not even touched on IVF. What government thought that they would shut down IVF? You cannot press pause on IVF. There was no health advice, clearly, because how they were they able to reverse it? They said they did not have the resources two days earlier, and suddenly they started again and the resources suddenly appeared—‘Oh, because we knew that the nurses were all told to go on holidays’. It makes no sense. But it was cruel beyond the pale—cruel like those with hips who are struggling to walk or who are unable to keep fit and healthy and age well, which is what we had done in this state so bloody well. That is what I worked at in my career to achieve. It was for people to age well and to age at home and to grow old and live well in the ending years of their life.