Hospitals, Rehabilitation Beds

07 Feb 2007 questionsarchive

I seek leave to make an explanation before asking the Minister for Mental Health and Substance Abuse a question about closed ward extended care rehabilitation beds

The Hon. J.M.A. LENSINK: A report was handed down by the Coroner following the inquest into the death of a man by the name of Renata Dooma, who suffered from chronic paranoid schizophrenia and who had a history of absconding from mental health facilities. He was treated in the Crammond Clinic for several months in 2005 but, because his treating consultant found him treatment resistant, he determined that Mr Dooma needed to receive treatment in a closed ward for an extended period of time. Indeed, Mr Dooma’s consultant gave evidence to the Coroner, as follows:

. . . it is very clear from my 19 years experience now in the area of psychiatry that people with more chronic illnesses actually take weeks, to months, or even longer to recover. Glenside is the only facility that provides the services required by Mr Dooma, but Glenside refused to admit him on the grounds that this system no longer exists.

The letter of reply from Glenside to the consultant is as follows:

. . . the service offering extended care for chronic clients no longer operates within the confines of Glenside Campus Rehabilitation Service.
Mr Dooma absconded from an open ward at Crammond Clinic on 20 September 2004. He was hit by a truck and subsequently died from his injuries. The Coroner found that the lack of closed ward extended care rehab beds contributed to his death. Further evidence, as published in the report, states that Dr Tony Davis, who is a senior psychiatrist with over 20 years’ experience in psychiatry at the Royal Adelaide, reviewed the management of Mr Dooma.

The report went on to state:

Dr Davis agreed with Dr Dhillon that Mr Dooma needed an extended care bed in a closed facility. In his experience, the demand for extended care beds is such that it means that patients who need them are either staying in acute wards or being released into the community. . . In Dr Davis’s view, South Australia has inadequate facilities to provide the type of supervision and assertive management required for patients likeMr Dooma. He elaborated as follows:

‘I think if you’re post-acute and really stabilised you can be managed by the community teams, but. . . in South Australia we just have not got adequate facilities. . .

The Coroner’s conclusion was as follows: Having reflected on the evidence on this topic, I consider that the process which has evolved regarding access to extended care beds is an insult to senior Psychiatrists in this State who are trying to act in the best interests of their patients. My questions are:

1. Is there or is there not a closed ward extended care rehabilitation service in South Australia?

2. How many beds does it have and how long is the waiting list?

3. Does the government have any plans to increase the number of closed ward extended care rehabilitation beds?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): Again, I bring to the attention of the chamber the importance of the reform agenda which the Commissioner of the Social Inclusion Board, Monsignor Cappo, was charged with putting together and which is before the government now. We are currently putting together an across departmental and government response to that. There are a number of issues. We know that our current system is deficient because of many decades of mismanagement, particularly in the previous decade.

During the eight years the former government was in office, it did nothing but allow our health services to be absolutely into the ground, which is an absolute disgrace. This government has worked very hard to rectify that situation in terms of opening new services such as the Margaret Tobin Centre, and the Repat Centre mental health beds.We have also committed to opening up the community rehabilitation centres, with three lots of 20 beds. So there are a number of services that we have put into place already. In terms of the needs of intensive care patients at Glenside, we believe that we have a wide range of intensive or acute services provided from that site enabling a wide range of treatments to be given.We certainly have intensive beds at Brentwood and Brentwood South and, of course, now at the Margaret Tobin Centre. In terms of the Secure Mental Health Rehabilitation Unit, again, we continue to plan for a 30-bed unit there. That is due to commence in 2008 and the completion is aimed for 2009.

We accept that our system is less than perfect. The opposition has had a large part to play in that. We have a very aggressive and active reform agenda to rectify those deficits. We are committed to reforming our mental health system, and we work tirelessly to ensure that all the needs of mental health patients are met.

Members interjecting:

The PRESIDENT: Order! The Hon. Ms Lensink has a supplementary question.

The Hon. J.M.A. LENSINK: When the minister referred to ‘a wide range of services at Glenside,’ can she confirm whether that does or does not include a closed ward extended care rehabilitation service?

The Hon. G.E. GAGO: Of course there continues to be extended care operating at Glenside. I understand it is currently operating at over 100 beds.

The Hon. J.M.A. LENSINK: Will the minister therefore reprimand Glenside for telling consultant psychiatrists within our mental health system that the service no longer operates?

The Hon. G.E. GAGO: That is the opinion of the honourable member. We know that she has come into this chamber with inaccurate advice before. I am happy to investigate that. I am happy to follow that up.