B.3 Legislative Assembly committee inquiries and reports Standing Committee on Health, Community and Social Services
|Assembly on the indicators it will use to measure the quality and the outcomes of care provided through the Canberra Hospital Emergency Department.||Agreed. The Government will provide a report for Assembly consideration noting the outcomes of the current processes underway to develop the basis for outcome measures for emergency department care. This process includes liaison with state and territory health authorities and a range of national bodies (such as the Australian Institute of Health and Welfare and the National Health Performance Authority). The report will note the work needed to fully develop, define, collect and report on any proposed measures. The Government will also take the results of this review to COAG for consideration in the establishment of new measures for Emergency Department care within the National Partnership Agreement on Improving Public Hospital Services.||The ACT is leading a process to establish new national emergency department outcome measures. The Australian Health Ministers’ Advisory Council has endorsed a proposal to establish a project in 2013‑14 to work with jurisdictions and relevant national bodies to develop options for AHMAC consideration in 2014. Some work has been undertaken by various bodies across Australia. This process will assist in consolidating efforts and providing a nationally consistent approach to ED outcome measurement.|
The Committee recommends
that the ACT Government engage with local midwife representatives to further develop an appropriate model
for a stand-alone birth centre.
|Not agreed. The planned sub acute hospital on the north side of Canberra will not have an associated nor a standalone birth centre as there needs to be provision for escalation upward to an acute facility for the purpose of managing obstetric emergencies. The Canberra Hospital has a birth centre and Calvary Public Hospital will also be progressing a continuity of midwifery care model which will provide improved access to midwifery care.||No further action required.|
The Committee recommends that the ACT Government continues to grow the proportion of health funding allocated to mental health services towards 12 per cent of the total ACT Budget.
|Agreed.||The ACT Government is progressively increasing the percentage of health funding allocated to mental health services. This has included a minimum annual allocation of $1 million in mental health growth funding in each of the last eight budgets, as well as construction and running costs of a new Adult Mental Health Inpatient Unit and Mental Health Assessment Unit at the Canberra Hospital. The ACT Government through the ALP–Greens Parliamentary Agreement on Government has committed to $35 million for mental health over the term of the eighth Legislative Assembly. This will support additional adult and older persons and new adolescent mental health inpatient beds, a secure mental health unit, additional community mental health services in both the public and community sector, youth-specific mental health services and suicide prevention-specific funding. During the term of the eighth Legislative Assembly the full roll-out of the National Disability Insurance Scheme will come into effect in the ACT. This will affect services currently provided through the Health budget, such as non-clinical supported accommodation, outreach support and vocational training. There will be significant opportunity for more people with serious and enduring mental illness to access these within the insurance-based system. The current mental health funding for these services will need to move into the ACT NDIS funding pool and hence impact on the apparent percentage of health funding allocated to mental health. The Commonwealth has also directly funded outreach and centre-based mental health services in the ACT that otherwise (e.g. in New Zealand) would have been counted in the ACT mental health budget (Personal Helpers and Mentors, PhaMS, and Day-to-Day Living programs).|
The Committee recommends that the ACT Minister for Health report to the Legislative Assembly on what level of in-patient services the ACT Government provides to adults suffering eating disorders, and where
ACT residents go if they need a higher level of service.
|Agreed.||Inpatient services are provided for adults suffering from eating disorders in the medical wards of both the Canberra Hospital and Calvary Hospital (to enable medical support for these clients). In terms of mental health care and support, clients are admitted to Ward 2N at Calvary Hospital. Other inpatient services are provided in the private sector in both the ACT and New South Wales. All services at these facilities are voluntary admissions.|
The Committee recommends the ACT Government advise the Legislative Assembly which local drug and alcohol services will be reduced as a result of cuts in Commonwealth funding, and what strategies will be implemented to cope with the unmet client need caused by these reductions.
|Not agreed. This matter should be referred to the Commonwealth Government.||No further action required.|
The Committee recommends
that all Alexander Maconochie Centre detainees with
Hepatitis C have timely access to Hepatitis C treatment, if they have the gene and body weight that makes them treatable with this treatment.
|Agreed in principle.||Justice Health Services currently treats 10 people for Hepatitis C infection at any time. As part of the treatment protocol, patients consent to serial testing for Hepatitis C virus. Admission to gain access to the treatment program includes an understanding of, and a commitment to, complete treatment; a reasonable body mass (as obesity is a predictor of poor treatment response); and the specific genotype of the person’s virus (genotypes 2 and 3 have better treatment outcomes). Potential patients ‘awaiting assessment for the treatment programs’ and those ‘awaiting admission to the treatment program’ are monitored with liver function testing at periods between six and 12 months. If there is a change in severity of the secondary liver effects, then re-prioritisation occurs, in consultation with the gastroenterology clinic at the Canberra Hospital. This is consistent with community standards.|
The Committee recommends that a needle and syringe program be trialled in the Alexander Maconochie Centre so as to prevent further spread of blood borne diseases.
|Agreed. On 15th August 2012, the Chief Minister released a draft blood borne virus management strategy for the Alexander Maconochie Centre which includes a proposal for detainees to be given regulated access to sterile injecting equipment on a ‘one-for-one’ exchange basis with the medical officer having responsibility for the equipment exchange. Consultation with industrial organisations on the proposed model for implementation will commence immediately to work through any concerns related to the model and to seek agreement with a view to the exchange being implemented in 2013.||Consultation is ongoing.|
|Recommendation||Government response||Directorate implementation|
The Committee recommends that the ACT Government establish a plan in consultation with ACTION to resolve the problems with accessing the Village Creek Centre by public transport.
|Agreed in principle. The relevant agencies will continue to look at ways to improve access to Village Creek by public transport.||RACC continued to meet with ACTION and Community Transport providers regarding public transport to Village Creek Centre. ACTION has now scheduled easy access, wheelchair-accessible buses for the majority of bus trips on Route 62 passing the centre on Summerland Circuit. Community Transport can be contacted to assist clients with transport. Scripting has been developed and provided to administration staff at Village Creek Centre so they can schedule appointments around client transport needs. The ACT Health Village Creek Centre website has been reviewed and provides updated information on transport options. ACTION has improved the safety of the Summerland Crescent bus stop by widening the access path and installing signage to direct passengers to the centre. There have been no direct complaints received by ACT Health relating to access to the Village Creek Centre by public transport since a Women’s Safety Audit was undertaken in July 2012.|
The Committee recommends the ACT Minister for Health update the Legislative Assembly on how and where funding from the National Partnership on a Commonwealth Dental Program will be targeted, and what changes will occur in delineation of staff roles.
|Agreed. Once the detail is worked through with the Commonwealth a report will be provided to the Assembly.||Dental are still progressing consultations with the Commonwealth regarding the NPA implementation plan. It is envisaged this will be finalised before the end of the calendar year.|
The Committee recommends that the ACT Government report to the Legislative Assembly when the issue of outstanding employee entitlements for Calvary Public Hospital staff is resolved, as soon as that occurs.
|Agreed.||The Health Directorate has referred this matter to the Chief Minister and Treasury Directorate for advice. This matter is still under consideration.|
The Committee recommends
ACT Health proactively establish networks and relationships between medical staff and private midwives at the Canberra Hospital so as to ensure birthing women, in the ACT, can access Medicare benefits for use of a private midwife pre- and post-birth.
|Agreed in principle. The Health Directorate is liaising with the one known privately practising midwife (PPM) to facilitate relationships with obstetricians and to foster engagement on her model of midwifery care. Professional Indemnity Insurance exemption for PPMs has now been extended to June 2015 and work has commenced nationally to develop collaborative relationships between PPMs and Health Services.||The ACT Maternity Services Network meets three-monthly to progress the implementation of jurisdictional actions in the Maternity Services Plan and other maternity issues, such as fostering collaborative arrangements between obstetricians and midwives. The Office of the Chief Nurse has recently allocated resources to commence the preliminary administrative changes so women can choose a private midwifery model of care at the Canberra Hospital.
This work has commenced.
The Committee recommends that the ACT Government (a) report to the Legislative Assembly on its proposed expenditure during the 2012‑13 financial year for alcohol and other drug services; and (b) clearly state its proposed expenditure for alcohol and other drug services in the budget papers for all future ACT Budgets.
|Part a) Agreed in principle, Part b) Noted. In relation to Part a), the Government will provide detail on drug and alcohol services that are funded in 2012‑13, however as with many health services there would be costs linked to drug and alcohol issues that are embedded in services including acute care, chronic disease, intensive care and cancer services. In relation to Part b), the Government will consider the detail to be provided in future budget papers in 2013. This consideration will address the impact of the agreed move to activity based funding on the current output structure for the Health Directorate.||This information was provided to the Select Committee on Estimates 2012‑13 in July 2012. See Estimates Question on Notice No. E12-124.|
Select Committee on Estimates 2013‑14
|Report No.||Title||Date presented|
|1||Inquiry into Appropriation Bill 2013–2014 and Appropriation (Office of the Legislative Assembly) Bill 2012–2013||Ongoing at 30 June 2013.|
|Recommendation||Government response||Directorate implementation|
|Not applicable.||Not applicable.||Not applicable.|