Thursday, 10 February 2022

Bills

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 CUPPER (Mildura) (16:02): It is my pleasure to rise in support of the Health Legislation Amendment (Quality and Safety) Bill 2021. The importance of quality and safety in our hospitals does not escape me. More than any other region in the state we know what it takes to make a hospital safe. It takes a strong legislative framework and a system of management that promotes high standards of care and compassion. The return of Mildura Base Hospital to public management brought our management system into alignment with the legislative ethos of public health care, and the government’s initiative in this bill enhances that ethos even further, giving validation and reinforcement to the safety revolution already underway at Mildura Base Public Hospital.

My electorate was home to Victoria’s only privatised public hospital right up until 2020. In the heyday of neoliberalism, health bureaucrats of the day could be forgiven for thinking that you could outsource the provision of medical care and naturally a commitment to safety and quality would follow. But soon afterwards, in the proceeding years, it became very clear that paying a private company to run a public hospital would not extend to genuine care and compassion for either frontline staff or patients, nor an interest in learning and improving from their experiences. For the first 12 years of the privatised hospital, for the most part, patients and families who experienced safety issues suffered in silence and isolation. It was difficult for any one individual to know the true scale of the safety problem, with hospital management typically telling individuals that their experience was an anomaly and that every hospital has its bad days.

Aside from the occasional quip—for example, from our then National Party federal MP who stated that he would not send his dead dog there after a member of his family was poorly treated—there was not a firm catalyst for the community to come together and compare notes about their safety experiences. But that catalyst came in 2012 when the late, great Dr Kevin Chambers, an internationally renowned surgeon based in Mildura, blew the whistle on the catastrophe that was the privatised Mildura Base Hospital. He knew what the general community was at that time unaware of, that negotiations for the renewal of the 20-year contract were due to begin and he was concerned that the government was counting on quietly renewing it. He knew this would not be in the community’s interest, because he had a front row seat to the privatisation experiment and he saw with his own eyes a slow, steady and dangerous decline in standards of care since privatisation began.

He knew that patient safety was at stake along with recruitment, remuneration and retention of staff. On his own initiative he wrote a memo to the community and letterboxed it as widely as he could, warning of the impending renegotiation. It prompted the formation of a community advocacy committee, known as Reclaim the Base, led by a series of chairs, including former mayor Peter Byrne, former councillor Jill Joslyn and current Wentworth councillor Jo Rodda. The first order of business was a public forum where Dr Chambers and two of his medical colleagues addressed the community about the failure of privatisation and the need to get out of the contract. Hundreds showed up to that public forum, and they were all relieved to learn that their safety concerns were not a figment of their imaginations but a very real and widespread problem that was causing unnecessary pain and distress, all in the name of profit for shareholders.

Dr Chambers, Dr Barry Doughty and Dr Vasa Skorupanovic along with other key community activists took massive risks to question a model at a time when powerful corporate interests, backed by the then coalition government, pushed back hard. Legal threats, demotions and public ridicule were among the tools deployed to silence the debate. Dr Kevin Chambers’s access to the theatre was cut back. But the tactics did not work. The community had started comparing notes on hospital safety, and the notes were not good.

The Mallee has a long history of political stoicism and will put up with a fair bit for a fair while, but once the flood wall bursts there is no stopping it, and we determined to fight for as long as it took. It would be a long fight, but this was not our first rodeo—our train activists can vouch for that. It was difficult for anyone, even Dr Chambers, to make the safety argument, however, because anecdotal accounts were really all we had. This was because monitoring systems that produce numerical statistical measures were calibrated to monitor publicly managed hospitals. These systems did not anticipate or account for factors such as the impact of the profit incentive, the corporate approach to risk mitigation and the absence of a community board of management that is specially attuned to community needs and safety issues.

It was not until a group of incredibly brave doctors, a nurse and a clinic administrator met—in secret, to protect their jobs—with a senior government minister in the Andrews government in early 2019 that the safety concerns, long expressed by patients, were finally vindicated, acknowledged and acted upon. I remember the words spoken to me by that minister on the way out of that meeting, and they said, ‘That was compelling. There are safety issues at other public hospitals but nothing like this’. It was a pivotal moment. Someone was finally listening, and our community was being heard. It vindicated the conclusions of seminal research from the UK in relation to safety which found that you ignore patient accounts at your peril.

On 23 August 2019 news broke on social media that Mildura Base Hospital would be returning to public management. The news was announced prematurely after local media had broken the embargo, and that was only because the news spread like wildfire once elated staff were notified. Then at midnight on 15 September 2020 the hospital was finally returned to public management. It was a triumph for democracy, but it was also a triumph for patient safety.

Since the return of Mildura Base Hospital to public management the most evident change has been its renewed commitment to safety. In the past 12 to 14 months the leadership team at Mildura Base Public Hospital—led by the first public board in 20 years, a dynamo CEO in Terry Welch and director of patient safety Andrea Floyd—have implemented a raft of strategies, including a new patient safety program, where patient safety information and awareness is proactively provided to staff every month, with content targeting key risks of patient care and how to improve patient safety and experience; a new bedside handover protocol on all shifts in all areas, where patients are engaged in the shift-to-shift handover and can ask questions; patient safety rounding, where hourly rounding is deliberately and proactively calibrated to meeting patient safety and care needs; and patient experience meetings, which are conversations between patients and senior managers about safety issues and adverse experiences, often in patients’ own homes. The meetings allow patients and families to get the hearing they deserve, and all issues raised are investigated and responses are provided. There is a family test, which is actively promoted as a cultural thing, which requires staff to reflect on how they would view the patient’s experience if that patient were a member of their own family to encourage adherence to kind, compassionate, thorough, attuned and empathetic practice standards; and there is the patient story program, which involves the preparation and presentation of video stories of patient experiences as part of regular professional development, and the videos identify the impact that the care issue presented and help to reinforce that family test message.

This change in culture driven by public healthcare values and excellent internal leadership will be strengthened and reinforced by the elements of this bill—for example, the establishment of the statutory office of the chief quality and safety officer; the establishment of the processes and protections for quality and safety reviews of health service entities by that chief quality and safety officer; the creation of a new statutory duty of candour, requiring health service entities to apologise and provide specified information to a patient impacted by a serious adverse patient safety event; an extension of protections for apologies offered by health service entities; and the introduction of new protections for internal investigations and reviews conducted by health service entities in relation to prescribed events.

These measures are a great leap forward for hospital safety in our state, and the synergies between the legislation and the safety revolution at Mildura Base Public Hospital are obvious. We thank the Andrews government for bringing Mildura Base Public Hospital back into public management and for its continued focus on patient safety across the state.

Mr TAYLOR (Bayswater) (16:11): It is fantastic to—

Mr Rowswell interjected.

Mr TAYLOR: Thanks, mate. What do they call this?

Mr Rowswell: A tie.

Mr TAYLOR: No, no. What is the pattern on it?

Mr Fowles: Paisley.

Mr TAYLOR: Paisley. Thank you, member for Sandringham and member for Burwood, for the clarification on my tie, and the Minister for Planning for telling me to get on with it. What a way to start my first contribution in 2022. I tell you what, you could take a summary of that 30 seconds, and maybe they will say in years to come this was my contribution in Parliament.

It is fantastic to rise and make a contribution in 2022, and there is no better way to start than to make a contribution on a health-related matter bill and to speak in favour of the Health Legislation Amendment (Quality and Safety) Bill 2021. It is all very well and good for us parliamentarians, in our representation of Victorians in this place of Parliament, to take credit where we can, but I always like to thank the good Minister for Health; his team; importantly, the department, who have no doubt put countless hours—many, many hours of work—into this really critical piece of legislation; and all of the people that have contributed to this work, and I will get a bit into that in a tick.

I just want to acknowledge the absolute bravery and courage of the member for Tarneit. It takes a lot to share what the member for Tarneit shared about her personal story and the difference that legislation like this perhaps could have made in her circumstances and will do, as we know, for people moving forward. It was really, really brave of her to do what she did in this Parliament yesterday. And it is always wonderful to hear from the member for Melton about his experiences and how this will make a difference for everyday Victorians, and I thank the member for Melton for always sharing and being open and honest about his previous role as a paramedic.

I do want to just pay particular thanks to our healthcare heroes. This is a health-related bill, and our nurses, our paramedics, our doctors, our frontline healthcare staff continue to do amazing work, incredible work. I want to say, straight off the bat, a big thankyou to our healthcare workers not just locally in my area, in Bayswater and Knox, but right across this state for the amazing work they continue to do in trying circumstances. I am grateful that this bill will hopefully make their work that much easier, in making a safe workplace not just for them but for the care that they provide to patients. Our nurses and healthcare staff helped to build this legislation, based on the review that was done, because who knows safety better in hospitals and our healthcare settings than those who work in them?

A small anecdote I want to share with this place is about a nurse. I was out at a mobile office very recently, and I started getting heckled—let us say verbally abused—quite insistently by someone I will describe as an anti-vaxxer. As if our healthcare heroes have not done enough, have not stood up enough for themselves and for their patients—and done incredibly well in doing that—this nurse turned around and started telling this anti-vaxxer to calm down, saying, ‘I see it—get vaccinated’. They know safety and they know what a difference it makes to get vaccinated, and the work they put into this is all about safety and looking after patients and looking after our healthcare settings. I have got to tell you other community members turned around and came to my defence. I did not flee from the fight. I was there, and I was making sure that this person was being respectful to our healthcare workers. But it was just incredible and goes to show the efforts and the extremes to which our healthcare workers will defend themselves, their colleagues and their patients, so I thank our healthcare workers greatly.

Of course the overall purpose of this bill is to improve the quality and safety of health provisions in Victoria and facilitate more person-centred and accountable service provision in a number of ways: by increasing Safer Care Victoria’s ability to identify and assess quality and safety risks and support remediation, mitigation and improvement where risks are found; by encouraging and facilitating full and frank participation in candour and serious adverse patient safety event review processes to drive continuous improvement of quality and safety; by helping to foster an open and honest culture in health services by elevating obligations for open disclosure, candour and apologies; and by ensuring the Victorian Perioperative Consultative Council has the requisite independent powers and protections to operate effectively to reduce perioperative mortality.

We know that this bill is yet another example of the Andrews Labor government delivering on our commitment to improve the quality and safety of Victoria’s health system, which I have flagged probably half a dozen times already. You know, safety is at the absolute core of this bill—and of course patient safety and staff as well. And when we look at our commitment, this government’s commitment—hearing from the member for Mildura just before about our commitment to support the Mildura community—I am very proud to report some significant progress on supporting the safety of patients and backing in health care locally in my part of the world as well.

You know, there are a lot of things to be proud about, but something that sometimes flies under the radar—perhaps not for the last two or three years—is the provision of aged care. We do public aged care pretty bloody well here. It is not perfect; nothing is perfect. But I am so proud that we are building a state-of-the-art facility—this thing is incredible—in the heart of Wantirna, on the corner of Boronia Road and Mountain Highway. I was out there. It is practically nearly finished. We will open this facility in April this year—about April, they tell me. I was there. It has got bathrooms for every suite, spacious suites—I am told sometimes double or triple what is standardly available now—four stories, open space, cafes and little memory boxes. It is pandemic proof, so we can actually keep things out. I know a number of my colleagues have been there. I was very lucky to see it closer towards the back end, and it has just been incredible to see the progress that has been made. To understand, to know and to get a sense from the healthcare professionals who took us around with the CEO of Eastern Health and to understand the difference in the quality of life and the dignity that will be restored for the elderly residents was just awe inspiring, and I am very proud this government has invested around $82 million to deliver the facility.

Particularly on another matter close to home, I know the Deputy Premier, who is not here, has loved this hospital for a very, very long time. It is 81 years old—I went to its 80th birthday party; it had a birthday—but the Angliss Hospital is very much loved. It is a bigger hospital, but it has still got that community hospital vibe. It has been an absolute pleasure over the course of the journey to get to know the healthcare workers there. And look, they needed an upgrade of facilities, and I am very proud to report that planning is very much in its advanced stages for a major expansion of the Angliss Hospital—some $100 million to deliver a number of new ward beds, a number of new operating suites and a new central sterilisation services department. I remembered that one; I stuffed that a few times in a video I tried to film. It is going to be absolutely state of the art, and it is going to ensure that we provide the best health care locally—not something you have to travel into the city for. Everyone should have the best health care locally without having to travel hours and hours and minutes and so on. This is an incredible project at the Angliss Hospital, and this bill is really another chapter in the story of how this government works with healthcare professionals and works with the sector to provide a first-class healthcare system in Victoria.

This bill does of course represent the final stage of legislative reform arising from the 2016 report Targeting Zero on the review of hospital safety and quality assurance in Victoria led by Professor Stephen Duckett. Targeting Zero was commissioned by the Minister for Health following the discovery of a cluster of tragically avoidable perinatal deaths at Djerriwarrh Health Services. We know the Targeting Zero review provided us with a detailed and extensive analysis of how the health department oversees and supports quality and safety of care across the Victorian health system, with ‘safety first’ being the mentality very much these days across the workforce—and so it rightfully should be. It certainly was when I was in the Victoria Police force—safety first, well and truly. We know it captured the views and experiences of patients, clinicians, hospital managers and boards about how to make Victoria’s health care safer. Gaps and failings in quality and safety systems were highlighted as well as the need for action and leadership to achieve change and prioritise patient safety. We know in 2016 the then Minister for Health committed in principle to adopting all the recommendations of Targeting Zero, including those which require legislative change, and we know that these reforms are the most significant overhaul of Victoria’s health system in decades.

This legislation will strengthen the role of Safer Care Victoria. This will foster an open and honest culture in health services. It is going to make our hospitals, our healthcare settings safer than they have ever been. It will encourage and facilitate full and frank participation in safety reviews. Of course as we know, as other members have detailed in this place Victoria should always strive to be at the forefront of health care in Australia and internationally. We know that many prerequisites for high-quality safe care are already in place here.

I will finish with the words of the minister from his second-reading speech and simply say that this bill is about openness, honesty and transparency. It builds trust between patients and health practitioners and improves quality and safety outcomes. It also leads to more learning and improvements that build a stronger and more accountable health system to benefit all Victorians. Like the minister, I commend the bill to the house.

Ms BRITNELL (South-West Coast) (16:21): I rise today to speak on the Health Legislation Amendment (Quality and Safety) Bill 2021, but before I begin I would like to acknowledge the hardworking health professionals who have been working absolutely under enormous pressure in a system that is not well funded—but I will get into that in a minute—and putting them into extraordinary circumstances. I am very lucky to know many of the nurses who work very hard across South-West Coast, my electorate, particularly at South West Healthcare, where I trained. I would like to acknowledge today that in Queen’s Hall is one of my friends who I trained with, Catie Asling, an exceptional nurse who has both theatre training and midwifery training under her belt. Catie and I, as I said, trained together, and it has been interesting listening to stories of my colleagues. Thanks, Catie, for the hard work you have been doing. I know you did 12 hours in PPE, which is hot in any circumstances, and swabbed my son and my daughter-in-law throughout the last 12 months and just spent three weeks in the COVID intensive care ward at South West Healthcare. You are one of many that I would like to thank and acknowledge. She is sitting out there with a couple of my dairy colleagues, so I had better acknowledge Rod and Lesley Sheen as well.

I think it is really important that we acknowledge the hard work of the health professionals, and this bill is a health bill that actually does a few things, but I am going to highlight two things, and the first one is that the bill permits 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, and these reviews will focus on systemic issues rather than the individual fault. Now, the question I ask is: is this bill an admission that the policies and procedures in place at health services right now are insufficient to deal with patient treatment problems? The question really is: why is a chief quality and safety officer needed? I would suggest that if we look at the Productivity Commission’s report, it highlights just this week that we as the state of Victoria are the most underfunded state for health of anywhere in this nation. We have the least health funding per capita, per patient, of any other state. This is not because of the pandemic. This, according to the Productivity Commission, began long before the pandemic.

We have got a Premier who was the Minister for Health for three years and then became the Premier, so he knows very intricately the health system and he knows that he has not done his job. Yes, we absolutely are in a pandemic, and yes, we need to do things differently than we did two years ago, but the reason the health system is under pressure is the mismanagement of this government. I back that up with the statement that if we had have had the 4000 ICU beds when they were promised to us, we would not have the waiting lists we have today for surgery, because many of those surgeries cannot be done, because you have to have sometimes an ICU backup, and there is just not the capacity because we have not had that promise delivered on.

I will move on now to the second point I want to highlight in this bill, and it is about when we have had an incident—and these do happen, because nothing is perfect—and the doctor or the health organisation, the hospital, is able to issue an apology to the person without compromising themselves, without fear of incriminating themselves. I actually think this is very important.

When people go through a health situation it is a really, really vulnerable time in your life, and if something goes wrong or you believe something has gone wrong and people go to ground and do not actually give you a decent explanation, it is very, very hard for people to process and move to an acceptance stage and work with what the problem has left them with, or some people might lose someone, a family member, or they might actually—you know. I have seen it many, many times, and people just find it very, very disturbing. So I think this is really good, and I think it is really important. It is psychologically important to have an apology when you deserve one.

I think it is really a good segue to talk about the apology that is needed to go from the Premier and the health minister and the Labor state government to the 801 families who lost loved ones at the start of the pandemic as a result of the failure of this government to recognise that you do not put people in charge of quarantine who have no infection control training. I mean, really? That is the most basic thing. I do not—well, I do know why they did it. It was all about giving jobs to the boys. What on earth was this government thinking? And 801 people died. So that is one of the first apologies that might hopefully happen, and what about apologising to all the people now who are on a waiting list—80 000 people on waiting lists for vital elective surgery.

It is not just the people on waiting lists, because that is going to grow. It is going to be a thousand next week on top of that and another thousand. By Easter it will be 90 000. I worry about the people who have put off things and are not on waiting lists. Those people who have a colonoscopy every two years, they have thought ‘I can’t go to the doctor. We’ve been told not to do that. There are other people out there more important than me. I’ll be fine’. And lo and behold, I am really worried about the fact that they will not be. Instead of having a polyp that was precancerous they get told they have got stage 3 cancer, and they begin their chemotherapy, and they begin their bowel resection and whatever treatment has to happen, and their life is more than likely severely shortened. And that is really not good.

I spoke to a very esteemed gentleman from my part of the world just last week, one of our senior clinicians, a senior physician. I said this to him, and he said, ‘We are already seeing it, Roma’, and he told me about a lady who got seen by telehealth because she thought she had sciatica. And you cannot really examine a patient really well. Telehealth is good, but when you need to go in, you need to go in, and the doctors were not able to do that. So she saw someone for her sciatica, which turned out to be a primary osteosarcoma in her hip, and by the time this fellow saw her she had a fungating cancer in her breast. That means the cancer broke through the skin and was oozing, a revolting wound, from her breast. You do not see that anymore. I saw that years ago. You do not see that anymore. We are seeing things again that we should not be seeing, and I think about all the men in the country. It has been so goddamn hard to train them to get to see doctors, to prioritise their health, to attend to their prostates before they have a problem that is untreatable. That is so important. That has been a really big campaign. Well, I can guarantee you most of the farmers I know would have put that off, and we will see so many cancers that we will not be able to treat.

I just cannot not mention either this callous decision that the government made about IVF, putting in-vitro fertilisation treatments on hold. These women have little chance, these families have a little window to be able to have these babies, and the government did not think—obviously—because they said it was about resources. But the minute the community went into an uproar, they reversed it. So it was all about politics, because if it was about resources, which they said it was, because they did not have enough nurses, suddenly we found out all the nurses had been put on holidays, and the decision was reversed. Well, sorry, but you are going to have a hard time telling anyone that that was a decision that was based on health advice: (a) because no-one will show us this health advice, and (b) how can the health advice then be flipped within two days and suddenly the resources appear? I am sorry. I can only think it is just pure callousness. That is all I can imagine. There are so many examples. I could go on for so long.

You know, in question time we heard about the mother-baby unit in Gippsland that has lost funding. This is when women who have postnatal depression or a mental health crisis—sometimes extremely sick—have to be hospitalised, and they cannot be hospitalised with their babies unless they are in a mother-baby unit. But let us just cut the funding for that.

The minister goes on about maternal and child health nurses. Like, that is a different subject, Minister. You must know that. And you have stopped that until 12 March anyway. I just cannot understand the callous, callous behaviour that this health minister is responsible for. The Premier, as I say, knows the system, and he is absolutely callous.

Mr FREGON (Mount Waverley) (16:31): It is my pleasure to rise today to speak on the Health Legislation Amendment (Quality and Safety) Bill 2021. I, like with the previous member’s contribution, will also start by thanking and acknowledging the very hard work of our healthcare workers. I think that we will in years to come really look back at this time and the amount of effort that all healthcare workers—from surgeons to orderlies to nurses to everybody—pitched in.

I know I, like other members, have had conversations with many. I remember back to what probably would have been April last year—not last year, the year before; it has been a while. It was during the first real lockdown. It might have been May. Anyway, the nurse called me and was trying to relay what she was going through every day and how it was affecting her. She lived with her family. They had kids. They lived in the Mount Waverley district. She was living separately from the rest of her family. She was wearing full PPE every day, as all of our healthcare workers and ambos and everyone else has been doing. When she got home from her shift it would take her an hour, going through the back door and the laundry, to get out of the scrubs and whatever else—you know, the uniform and the PPE. She would shower. She would do all that, all separately. Her tea would be ready in, again, a separate part of the house. She would eat by herself. She would basically sort of wave at the kids through a window, go to bed, get up in the morning and do it all over again. That was then, and I would imagine that that woman has spent many, many, many days since in similar situations, like others that I have spoken to.

They keep going back. They are exhausted, but they are still going. Because as much as we would wish it to be over, the pandemic is still with us. It is not the same as it was two years ago, thankfully. We have got vaccines. We understand more about the virus. We understand the benefits of masks and air purifiers. Different variants have changed the results, but it is still going, and obviously for anyone who is involved on the patient side of our healthcare system it is a different environment than we would normally be used to.

Surely it is common sense for all of us to understand the pressures on the system that we have—and it is a fantastic healthcare system—the pressures of this virus, of the length of time that we have dealt with it. It is under strain. That is why we have a code brown at the moment. It is all very well to say, ‘Well, where are the 4000 ICU beds?’, and make that argument. That is fine, but you need staff to have them, and you also need to produce the ICU beds when you need them. If there were another 200 ICU beds sitting there empty with staff just waiting at the end of the bed saying, ‘Well, eventually someone’ll need it and will come’, then you would be saying, ‘You’re wasting staff, you’re wasting money’. Pick your argument. The reality is if we needed them, they would be there.

Mr Battin: You’ve just gone to a code brown because you needed them.

Mr FREGON: No, it is people. It is people.

Mr Battin interjected.

The DEPUTY SPEAKER: Order! Member for Gembrook! Through the Chair, please.

Mr FREGON: Sorry, Deputy Speaker, through the Chair, yes.

Mr Battin: I think you should sit down because you’re embarrassing the Labor Party.

Mr FREGON: The member for Gembrook talks about embarrassment—

The DEPUTY SPEAKER: Order! Member for Gembrook! Member for Mount Waverley, through the Chair, and I would ask the member for Mount Waverley not to respond to interjections.

Mr FREGON: Okay, I will not respond. I will try and use some candour, which brings us back to the bill. A bit of candour today would be a good thing.

These healthcare workers have done amazing work day after day. I have had family members who have been involved in our healthcare system from the other side over the course of the last couple of years, and it is hard when you have got a loved one in hospital. In my case it was my father and my mother could not go. It is hard. Like, that is really tough. But also you have got to understand—surely we understand, most of us—that you cannot just act like it is normal, because it is not.

This bill creates a statutory duty of candour, while we are on the subject, of which an apology will be a mandatory requirement. As other members have said, making an apology may not fix whatever error has occurred when it does occur, but it will not hurt, especially the people who that error has happened to. Making it mandatory and adopting the duty of candour law and continuing the work of reform that this government has done in this space acknowledges that that apology is important to people.

We have seen apologies from governments over the years, and there have been arguments about public government apologies. Some have said, ‘We don’t want to apologise because that means we are accepting fault’ or guilt or whatever. I think of the apology to the stolen generation in this way: this country struggled with that apology for a very long time in the sense that, ‘If we make this apology, the sky will fall down’. Well, Prime Minister Rudd made that apology, and the sky did not fall down. But I would argue that many, many Australians received that apology and that it was a very worthwhile thing to do for our country. Similarly, just this week we have had an apology in Canberra about the treatment of staffers in Canberra, and again the sky has not fallen down.

It is important to acknowledge when mistakes happen because, as other members have said, mistakes do happen. It does not matter if you are dealing with a once-in-a-century pandemic and you have got all of the stresses of everyone shifting into gear and setting up a quarantine system in a weekend or whatever, mistakes will happen. Acknowledge that. When you acknowledge those mistakes and you work on it—and I will quickly go to this before the end—the other side of that is to give the feedback to the patient in question so that not only does the apology happen and we acknowledge the mistake but also we can say, ‘This is what we’re going to do to try and make sure this doesn’t happen to the next person’. And that is a moving feast. That is a continual work. I mean, we are all in here following a long line of people who have been in this room because the job is not done today. We will be back in two weeks, and then there will be others in here and there will be others in here. And this continues because we will never get it perfect, but we continue to turn up and try. And we work at it.

So this bill also establishes the chief quality and safety officer and grants the statutory officer the power to review health service entities, including authorisations to inspect and audit hospitals. The officer will create guidelines for health services that are publicly available—more transparency. These guidelines will cover topics in the public’s best interests, such as emerging risks and trends, and outline recommended clinical practice.

This is another good step forward in public health policy and implementation by the Andrews government, and I commend the bill to the house.

Mr SOUTHWICK (Caulfield) (16:41): I rise to speak on the Health Legislation Amendment (Quality and Safety) Bill 2021, and I say that today we actually should not be talking about amendments, but we should be talking about a complete overhaul of the health system. The health system in Victoria is absolutely broken. It is a mess. It is a disgrace. This government has had and this Premier has had 15 years—11 of which he was either the Premier or the health minister—to fix the health system.

We hear from the government that all of the problems that we are currently experiencing are due to COVID, all of the waiting lists, the lack of answering by the Emergency Services Telecommunications Authority (ESTA) of our 000 calls, our ambulance wait times, the elective surgery—80 000 people on the waitlist. It just keeps skyrocketing. It was at 65 000 a year ago. Each day that the government has cancelled elective surgery is another day where we see patient after patient added to that list, and these are real people. These are real stories.

We have heard each day the Minister for Health being asked questions, whether about a young child with a cleft palate who needs an operation desperately—not in six months time but tomorrow—and without that operation will have a lifetime of issues and complications. And what does the health minister say? ‘Well, I’m not going to talk specifics, but let me give you some statistics’. Well, that family does not need statistics. That family needs answers. They need our surgeries to have the ability to open.

We have had so many examples of that, where we have had the private system wanting to open the doors, the elective surgeries, the doctors, the nurses, wanting to help, but they are being turned away. The government has completely turned their back on those willing to help. At a time when you would think the government would actually open their arms and say, ‘We will take whatever help we can get’, this government has turned its back. They have turned their back on so many, like Richard Bloom. His wife went to school with me. She is also a surgeon. Both Richard and Lisa and many others have made the point that they have their surgeries, they have their staff, they have their team available, but they cannot operate. They cannot work. You have got many of these doctors and nurses sitting at home doing gardening because they cannot actually do surgery.

Mr Edbrooke interjected.

Mr SOUTHWICK: Now, the member for Frankston talks about ‘on the bill’. This is about the health situation, the crisis that we face here in this state. That is what this bill is about, and it is disgraceful, the mess that it is in. Look again at our ESTA wait times. I was talking to one of the journalists yesterday, who said to me—

Mr Wynne interjected.

Mr SOUTHWICK: Yes, an ABC journalist yesterday that said to me that she fears actually calling 000 for the sheer matter of somebody being on the other line to take the call. This is an essential service. This is something where you want someone on the other end to actually take that call. You want somebody to be available. Now, this is not a joke. This is quite serious.

Mr Fowles interjected.

Mr SOUTHWICK: And the member for Burwood laughs.

The DEPUTY SPEAKER: The member for Caulfield, through the Chair.

Mr SOUTHWICK: Deputy Speaker, the member for Burwood laughs.

The DEPUTY SPEAKER: I ask the member not to respond to interjections.

Mr SOUTHWICK: Can I give an example, in my electorate of Caulfield, where somebody had to wait 6 hours for an ambulance—Christina Lackmann died. That is what happened to her. It is not a laughing matter—from this fool. She died. And that is the situation of the health system here in Victoria. It is broken. None of the members in this house on the government side should be laughing right now. They need to take things very seriously. When you have got no confidence that somebody is going to be at the other end to take the call to 000, when you are unsure whether an ambulance is going to turn up and when you are unsure whether you are going to be able to find a bed available to treat you, then we should all be taking things very, very seriously.

I want to put on record the great work that our healthcare workers have been doing in a very stressful situation. They are overworked, they are at their wits’ end and they are stressed. I have had so many nurses, doctors and healthcare workers contact me at their absolute wits’ end in terms of what they are doing. But let us not forget the government—and the Premier, as health minister for 11 or Premier—have had 11 of 15 years to fix this. This is not a COVID situation, this is a health crisis. This is broken.

Mr Wynne interjected.

Mr SOUTHWICK: The fact of the matter is that we have gone from code reds, Minister for Planning, to code browns. It does not matter what code you want to call it, it is code broken. That is what it is.

Mr Wynne interjected.

Mr SOUTHWICK: The Minister for Planning interjects, but every other state is managing their situation and is able to deal with elective surgeries and what have you. We do not have—

Mr Wynne: Is that right?

Mr SOUTHWICK: Minister for Planning, how many other code browns are happening around the country at the moment? The state of Victoria is the only place with a code brown. This state is broken. It is the only state in Australia that has a code brown. It is absolutely Victoria that is broken. You only have to ask people that are waiting. We have rolled them out, not for a media stunt but for an answer. That is what these people want and expect—an answer—and the Minister for Health is not giving them one.

Mr Edbrooke: On a point of order, Deputy Speaker, on relevance, in the time left available to the member I would ask you to bring him back to the bill and the reforms in that bill.

The DEPUTY SPEAKER: It has been quite a ranging debate in the last 45 minutes, but I do ask the member for Caulfield to come back to the bill.

Mr SOUTHWICK: Part of what this bill talks about is the ability to make an apology when a situation in a health system happens to the point where you can apologise to those that have been affected. I very much think that regarding the bill the Premier and this government should be making an apology—firstly, for the 801 lives that were lost only in Victoria, not in any other state. Due to bad decisions made with hotel quarantine 801 people have died. Have those families and loved ones been contacted and received an apology from the Premier and those ministers? Have they? I put that point.

Four thousand ICU beds were promised. Now we are in a code brown and we have been in a code red. The member for Mount Waverley said, ‘If you wanted them, we could get them’. Well, we are in a code brown at the moment—we have had code reds and I do not know how many other codes we are going to have or invent—and the member for Mount Waverley casually says, ‘Well, you know, if we need them, we’ll find them’. What a joke. It is an absolute disgrace, this failed government, on something you would think should be a number one priority.

We have had another talk about how we are in the middle of a pandemic. I 100 per cent accept that, and that is why all of the resources and efforts should have been directed towards them. We have been in a pandemic for two years. This did not happen overnight. For two years we have been in a pandemic. We have had a health system that has failed for a lot longer than that. If you look at even being able to deal with all of our contact tracing and all the rest of it through health, it failed. New South Wales were able to contact, track and trace with no problems at all. It was done. What did Victoria do? Victoria sent departmental officials to New South Wales after they had used fax machines and paper and pen to do their contact tracking. That is what they did, and they still did not get it right. There has been lots of failure with this health system and it needs an overhaul. We should not be having amendments today. We should have a complete rewrite of our health system in this state. Nothing more would do for those people that have lost their lives. Nothing more would do for the 80 000 people that are on a waitlist. Nothing more would do for Christina, who had to wait 6 hours and died waiting for an ambulance, and her family. And that is not all; the list just continues.

Now, this government when we had ambulance issues were very, very keen to roll out the ambulances and all the rest of it and say, ‘What are you going to do in terms of ambulances?’. We saw all of that during the election when we had been there for four years. But do you know what? They have had 15 years—18 actually—and what has happened? Nothing. Their health system has failed. Their health system is a mess. Most importantly, Victorians have been let down. This is dire straits. This is life and death, and the government needs to actually do something. They should stop patting themselves on the back, stop saying how great things are. Things are a mess. They have failed—absolutely failed— and they have let down Victorians. The government have let down Victorians, our health system is an absolute mess and this government should be ashamed of themselves.

Mr EDBROOKE (Frankston) (16:51): I really need to get Kevin Sheedy’s number. I really need to have a talk to Sheeds. I need to know what he said because it really has not worked. We heard an amazing soliloquy from those opposite about failure, about giving up. Where would we be if we just said, ‘Let it rip’? We have heard facts—well, so-called facts—from those opposite about apologies to people who have died who have been under federal jurisdiction. It is amazing to me that as we sit here now—and it is so ironic, because we are actually putting a bill through this house to improve health and safety and what is delivered in the health sector to the Victorian community—we have got people who cannot even speak on this bill but who say the system is broken.

From a personal perspective, Deputy Speaker, you and I have both been on a committee together, the Family and Community Development Committee, and we heard those firsthand personal accounts from people—usually a minority I think, but still it matters—that had not had the service that they thought they would get in the health system, in the judicial system, but more so in the Family and Community Development Committee it was those perinatal services. We heard from parents who, and I am sure you did at the time too, were owed an apology and an explanation of what went on, but they were denied that because of the legal issues surrounding it. I have seen it locally with a local government representative that would not speak to the wife of someone who passed away at Frankston motocross track because of the liability they might incur if they spoke to them and the words ‘we apologise’, ‘we are sorry’ and some measure of candour, openness, frankness—some honesty—came out.

This bill supports the last tranche of key recommendations from Dr Stephen Duckett in the review of hospital safety and quality assurance in Victoria. The aim of this bill is to establish a chief quality and safety officer; introduce a statutory duty of candour, with no liability attached to that as well; introduce protections for apologies and serious adverse patient safety event reviews; and introduce powers for the Victorian Perioperative Consultative Council. These are all very important powers, and I am sure people on this side of the house who have read the bill would actually agree with them. This is improving our health system.

Now, it has been a wideranging debate, and during this debate I think you would have been a bit troubled at times to hear that there are people who do not believe that COVID is a global issue. There are many other nations and states going through what we are going through. Is it imperfect? Yes, it is imperfect. It is a little bit like any crisis, where there are a lot of new facts being introduced into the crisis and we have to respond to them, and that is what has been happening. To hear members on the other side of the chamber still comparing Victoria to New South Wales when you consider what is happening there at the moment is a little bit off-taste, I would say, but also it is not sticking to the facts.

I want to talk about a very positive incident that I was involved in at San Remo on 1 February this year. There is this great app, the GoodSAM app. Not many people seem to know about it, but many people who do are in the emergency services sector. It is an app, so if you are a former police officer, firefighter or ambo, in your spare time, if there is a code zero call—that is, someone with no pulse and no heartbeat and no breathing—and those services are called, if it is within your area, your app will be activated and you will be told the address and you can go there and help. I had just been for a surf. I was coming back to my son’s, across the Phillip Island bridge, and this app went off. I said to my son, ‘I’ll just press accept’. It turned out that it was a seven-year-old drowning. The family was only two blocks away, and we responded, I guess you could say, and ended up assisting. The child has made a full recovery, I am led to believe, but the pertinent point of this tale is that I reckon I was doing CPR for all of 4 minutes before the first ambulance arrived in San Remo. This ambo—Michael, I think he was—was amazing, just an amazing character and an amazingly skilled operator. What he did would be an education for many people in this house who want to talk all the time about the issues. There will always be issues or always be problems. When someone has a cardiac arrest or someone needs help, it is never something you can plan 100 per cent for. But there are people in this house that would be surprised to hear that this ambulance rocked up in a very, very quick time. On the scene almost at the same time was Victoria Police. The helicopter actually responded and landed close by, and the child, the seven-year-old, was airlifted to the Royal Children’s, I think.

It is fine to be sitting here and be critical of these people and be critical of the services they operate in and say, ‘It’s broken. We can’t do anything about it’, without anyone saying, ‘Yes, this is imperfect. There is a crisis with COVID. It is everywhere. People are trying to deal with this internationally. We have to adapt and overcome’. And that is what this government has done. Without playing political games, that is what every government in Australia—with the exception of the feds, I think—have done. They have had to adapt and overcome. To some extent, yes, you can say it has been a trial, with something we have not gone through before. But certainly to cherrypick these cases—these very sad cases at times—and say, ‘The system is not operating properly’ and that the people in that system are not operating properly and helping our community I find detrimental to the message that should be getting out to the community. There is never anyone that says, ‘Oh, wow. That ambulance turned up quicker than I thought it would’—of course not. It is always going to be: ‘That ambulance didn’t come quick enough’, because when you dial 000, when you need something, when you need an operation, you need it now. That is part of us. That is the human condition. That is the ego. But I can say from a personal perspective and as perhaps one of only a few people in here that could say it: my experience on 1 January this year was that the ambulance turned up like that and the police turned up like that. We were working together, and the skills those people displayed were amazing. We should celebrate that.

Yes, we should be very critical and look at where the system is not going right, but to say that it is ruined, it is terrible—well, those things are just too easy to say. Kevin Sheedy is not a bloke to be messed with, I would say, but he did not get into the Liberal caucus the other morning and say, ‘You guys are buggered. It’s gone. It’s a failure. Just clear it out’. You need to work on things, and I am sure he actually said that to you. And that is the same with a lot of the systems. We have to change and adapt to the challenges that are put forward, and it is a government that is fluid and can do that and change opinions and make good leadership decisions, not just try and please people, that does that.

Once again, can I just thank the amazing emergency services and our nurses—everyone in the health sector that has just gone above and beyond during this COVID crisis. It has been long, it has been tough. But every time we hear something hand picked out, something critical that happened, and we are not celebrating their success, we hear people, like we have heard, saying, ‘The system’s a failure’, when it is just not.

The DEPUTY SPEAKER: Order! The time set down for consideration of items on the government business program has arrived and I am required to interrupt business.

Motion agreed to.

Read second time.

Third reading

Motion agreed to.

Read third time.

The DEPUTY SPEAKER: The bill will now be sent to the Legislative Council and their agreement requested.