The Hon. T.A. FRANKS (15:18): I seek leave to make a brief explanation before addressing a question without notice to the Minister for Health and Wellbeing on the topic of hospital visitation restrictions as a result of the COVID-19 pandemic.
The Hon. T.A. FRANKS: Based on the public web pages of hospitals across our state, it would appear that each hospital is providing quite different information to its visitors and that the onus of decision-making on who is able to go and visit a loved one in hospital in fact is sitting with doctors and nurses. I have been told that at one hospital at least, patients there are only allowed to have one visitor per 24-hour period—one visitor per day.
That means that those patients are having to choose each day who is allowed to visit them, and this is causing extreme emotional distress, particularly since these restrictions persist when we are seeing an easing of other restrictions across the state. I am aware of where family members have passed away without family being able to say their goodbyes.
During the recent evidence to the COVID response committee we also heard from doctors and nurses directly that it is being left to them to tell families that only one visitor in that particular case is allowed. Indeed, this causes quite a range of distress at several hospitals. To quote Bernadette Mulholland, the senior industrial officer for the South Australian Salaried Medical Officers Association:
…it has been an ongoing discussion in the Royal Adelaide Hospital and the QEH…that it is left up to doctors and nurses to be able to tell families. It is not done at the entrance. They come in—
visitors to their loved ones—
quite agitated, to the service…
And then it is the doctor who has to tell them that they need to turn away and that there can only be one person.
I note however, though, that this one person per day rule does not apply across all hospitals. It appears to be that different local health networks have made different decisions. I also note that the AHPPC has provided no overall guidance and SA Health has not provided any guidance to the individual LHNs. My questions to the minister are:
1. What, if any, guidance, rules and directions have been given for our hospitals with regard to this matter?
2. In terms of this sensitive issue, can SA Health, through the minister, provide some clarity, so that doctors and nurses aren't being put in the position where they are placed in unnecessary conflict from this confusion?
The Hon. S.G. WADE (Minister for Health and Wellbeing) (15:20): I thank the honourable member for her question. On the one hand, I want to associate with the concern that we continue to provide compassionate access to hospitals for visitors and family, but I also want to say that this government has taken a decentralised approach to health governance, so LHNs in this area are developing their own policies.
It would not surprise me if a particular LHN had different policies for different sites. For example, a site such as the Royal Adelaide Hospital, which on the one hand is a COVID testing facility and a COVID treatment facility, also has significant numbers of both inpatient and outpatient cohorts that are vulnerable. The challenge at, for example, the Hampstead Rehabilitation Centre would be very different to the challenge at the Royal Adelaide. Whilst acknowledging that the LHNs might have different policies between each other, I would also not be surprised if particular LHNs had different policies for different sites.
I do acknowledge that there is perhaps a higher level of restrictions than would be consistent with the stage of the pandemic. My understanding is that the Department for Health and Wellbeing has sought advice from all local health networks about both their visitor policies and also their concierge services. I think the honourable member was referring to them being greeted at the front door. That is what we commonly call concierge services, where people might be being asked if they have been overseas, if they have been interstate, if they have any symptoms, and particularly asking them to take the opportunity to cleanse their hands and so forth.
We are, if you like, doing a scan to see what are the policies. To be frank, I suspect it will still tend to fall on the clinicians at the unit level to have a conversation with family, because particularly at a big facility like the Royal Adelaide Hospital there would be—
The Hon. T.A. Franks: Let's talk about the Lyell McEwin.
The Hon. S.G. WADE: Okay. It would differ for different hospitals, but it may be that a particular hospital would not be able to manage that level of information at the concierge level. I will take the honourable member's question on point, and I will certainly take the opportunity to refer the honourable member's question and explanation to the officers who are doing the scan.
I would also like to take the opportunity to say that, particularly with vulnerable cohorts, I think we need to get used to the idea that there will be some quite unusual restrictions on for some time. For example, in residential aged-care facilities I don't see those restrictions coming off anytime soon. The federal and state governments have worked very cooperatively. I am not just meaning the Morrison government and the Marshall government; I mean all of the state and territory governments have worked strongly with the federal government to help the residential aged-care sector to get the balance right.
On the one hand, we want to have strong infection control to protect a vulnerable cohort and, at the same time, we don't want to impact on the quality of care that we are providing in terms of what are, after all, people's homes. It directly relates to the point the honourable member is making: we have situations where people are writing to me about visitor requirements in the birthing context, and that is a special time that will never come again, so these are not unimportant policies, but there are policies in place in our hospitals—and I think they will be in place for quite some time—which disrupt what people might normally hope for in a birthing experience or in a broader care experience.
I certainly acknowledge the honourable member's point, that SA Health and its network of services could perhaps revisit some of its visitor policies and concierge policies, and I will certainly undertake to refer the honourable member's remarks to the relevant officers.