'He said, she said' - Health Debate recap

TOPIC 1 – RAMPING

Question: Do you have a target for ramping in 2027, what is it and how will you achieve it?

Minister Picton

• Did not provide a specific target.
• Reaffirmed his commitment to address the problem, saying: ‘There is no doubt we still have the ambition to fix the ramping crisis’.
• Identified access block as ‘the key issue’ and reiterated Labor’s slogan that they are ‘building a bigger health system’.
• Highlighted Labor’s commitment to deliver an extra 1,300 aged care beds for older South Australians, including transforming the old Women’s and Children’s Hospital site into a dedicated Health and Aged Care Precinct.

Shadow Minister Girolamo

• Did not provide a specific target.
• Said: ‘We are not going to promise to fix the ramping crisis’.
• Reiterated the Liberal Party’s slogan, saying: ‘We will put our best foot forward when it comes to creating a better health system’.
• Identified Liberal policies designed to improve access to primary care, including: 
  • scrapping payroll tax on GPs
  • grants for GPs to stay open out of hours
  • $40,000 incentives to attract GPs from overseas and interstate
• Spoke about preventive health measures and ‘making sure workforce is looked after’, without providing specifics.

TOPIC 2 – HOSPITAL LOGJAM

Question: Both of you have proposed different futures for the current Women’s and Children’s (WCH) site – one centred on aged care redevelopment with private partners (Labor), the other on transitional care to decompress hospitals (Liberal). When would beds from your proposal realistically come online?

Shadow Minister Girolamo

• Did not provide a specific timeline, beyond saying a Liberal Government would meet with clinicians to discuss plans for the WCH within its first 100 days in office.
• Could not provide costings for the project, saying: ‘It will be provided in the lead‑up to the election’.

Minister Picton

• Did not provide a specific timeline.
• Attacked the Liberal Party’s plan over what he called a ‘startling lack of detail’ and said it would cost well above $1 billion to upgrade the WCH and an additional $800 million over four years to run it as a transition care facility.
• Did not answer how much the Labor Government is paying to fund and expand its own transition care facilities, but said it was ‘within the SA Health budget’.

Follow‑up question: Where will the workforce come from, and what will be the recurrent cost to taxpayers?

Shadow Minister Girolamo

• Could not provide details about where the workforce will come from to staff a transitional facility.
• Did not provide details about the recurrent cost to taxpayers.
• Criticised Labor’s plan, saying ‘it will cost a fortune’ to demolish the existing WCH and build a new aged-care precinct.

Minister Picton

• Said Labor has been ‘running an aggressive overseas recruitment program’ to attract doctors from overseas.
• Said that since coming to power, Labor has recruited an additional 680 full‑time equivalent doctors.
• Did not provide details about the recurrent cost to taxpayers.

TOPIC 3 – WORKFORCE PLANNING

Question to Minister: Where are these additional doctors? How many are consultant specialists versus junior doctors in training, and how many are deployed in primary care roles versus acute hospital settings?

Minister Picton

• Did not provide a specific breakdown outlining the location of additional doctors, their roles, or their workforce settings.
• Highlighted Labor’s commitment to partner with Flinders University to build a new educational facility next to Mount Gambier Hospital, which he says will support a doubling of medical students on site from 60 to 120 a year.

Follow‑up question to Minister: If we have employed additional doctors, nurses and allied health workers, why have we not seen improvements in ramping, elective surgery access or outpatient wait times?

Minister Picton

• Said 9,000 more operations were performed last year than in the final year of the Liberal Marshall Government.
• Said South Australia is in ‘a race with elective surgery’ because of the state’s growing population and the increasing number of patients relying on the public, rather than private, health system.

Question to the Shadow Minister: If elected in March, does a Liberal Government have a workforce plan and deployment strategy to ensure better access and shorter wait times during your first year in government?

Shadow Minister Girolamo

• Acknowledged that ‘South Australia needs more doctors’ and ‘getting workforce right is key’, but did not provide details of a workforce plan.
• Outlined the Liberal Party’s policies of attracting GPs to South Australia with $40,000 incentives and offering a $20,000 bonus to SA Health staff who return to the system.

TOPIC 4 – GP ACCESS

Question to Shadow Minister: You’ve committed to expanding after‑hours GP appointments. How will you measure whether that reduces avoidable hospital presentations?

Shadow Minister Girolamo

• Detailed a plan to offer grants of $150,000 to up to 80 practices, allowing them to open on Sunday mornings and until 8pm on weekdays.
• Confirmed it is a trial only and it will be up to individual practices to apply.
• Did not explain how success would be measured or how it would be assessed against hospital presentations.

Question to Minister: Will you match this policy?

Minister Picton

• Confirmed Labor will not match the policy.
• Said the trial will ‘not make a significant difference’ and will move appointments available at other times into incentivised timeslots.
• Said ‘we absolutely back our GPs’ and they are ‘an incredibly important part of the health system’, but they are ‘the responsibility of the federal government’.
• Said the role of the state is to support GPs through the Virtual Care System, My Home Hospital and working with the federal government to support Urgent Care Centres.

Follow‑up question: What specific state levers will you pull to improve regional GP access, and what measurable change should regional patients and hospitals expect?

Shadow Minister Girolamo

• Referred again to incentives to attract GPs to South Australia from interstate and overseas and said she ‘would hope many would go to our regions’.
• Did not provide details of a specific policy that would incentivise doctors to work regionally.

Minister Picton

• Reiterated the Government’s commitment to partner with Flinders University to build a new educational facility next to Mount Gambier Hospital, which he says ‘will lead to a pipeline of new doctors in the regions’.
• When challenged about the fact that doctors trained there may not enter the workforce for a decade or longer, he could not provide a specific date and said: ‘I don’t think it’s a problem to have a long‑term vision’.
• Voiced support for the Single Employer Model (SEM), which he said has been ‘working well in the Riverland’. He reiterated it is being expanded across the state without explaining which LHNs.
• Did not answer how regional patients and hospitals can measure change or policy success.

TOPIC 5 – PAYROLL TAX

Question to the Minister: What is your policy rationale for applying payroll tax, especially on general practice, when patients rely on general practices and other practices?

Minister Picton

• Repeated the Government’s line that Labor didn’t change the payroll tax rules, but rather ‘the interpretation changed’.
• Highlighted that the Government introduced exemptions for bulk‑billed services, describing them as a ‘much more generous proposition than what happens in a number of other states’.

TOPIC 6 – ELECTIVE SURGERY

Question to the Minister: Will you reduce the number of patients on elective surgery and outpatient waiting lists within the next term of government, and will you commit to a target?

Minister Picton

• Said: ‘We want to reduce every list that we possibly can’.
• Did not provide a target.
• Said the Government has invested $9 billion extra into the healthcare system, resulting in more operations and more doctors and nurses working in the system.
• Referring to the Liberal Party, he said: ‘If we return to the days of cuts, redundancies and corporate liquidators’ that will mean cuts to beds and elective surgeries.

Question to Shadow Minister: Has the Minister got a point?

Shadow Minister Girolamo

• Said: ‘Labor has been in government for 20 of the last 24 years and has to take accountability and responsibility for the state of the health system’.
• Highlighted record ramping and the closing of the Repat Hospital as indicators of Labor’s ‘poor performance’.
• Did not provide a Liberal target for reducing elective surgery waiting lists.

TOPIC 7 – COMMUNITY MENTAL HEALTH

Question: What funded, state‑led commitments will you make to expand community mental health and psychosocial services – not just crisis infrastructure – and over what timeframe should the public expect unmet need to start reducing?

Minister Picton

• Said the Malinauskas Government increased funding to community mental health services by 40% in its first three years.
• Acknowledged: ‘There’s no doubt that there’s still a lot more we need to do’.
• Said Labor has boosted community mental health teams, added new Medicare mental health services and is about to open a new crisis stabilisation centre adjacent to the Lyell McEwin Hospital.
• Said the Government restored a Mental Health Commission in South Australia.
• Said an agreement with the Commonwealth is key to addressing the concern nationally.
• Could not provide a timeframe for when unmet need will begin to be reduced.

Shadow Minister Girolamo

• Said: ‘We’ll have more to say when it comes to mental health,’ but did not explain what.
• Did not provide a timeline for when a Liberal Government would address the unmet gap.

TOPIC 8 – NEW WOMEN’S AND CHILDREN’S HOSPITAL

Question to the Minister: Does the Government value the input of clinicians at the current WCH into design? If it does, will you commit to recording it, acknowledging it and responding to it, even if you are not able to deliver it?

Minister Picton

• Said: ‘Absolutely we are committed to engaging properly with clinicians’, and said the evidence is that Labor moved the site after clinicians said the previous proposed site was too small.
• Did not commit to documenting and responding to clinician input.

Question to Shadow Minister: The Liberal Party has criticised the Government over the timeline of the new WCH. What will you do differently? When will it be delivered? Will you listen to clinician input?

Shadow Minister Girolamo

• Said: ‘We will always listen to clinicians’.
• Did not provide further detail about what a Liberal Government would do differently.

TOPIC 9 – PHARMACY SCOPE

Question to the Minister: How can you guarantee that pharmacists’ training is going to be adequate? How can you guarantee patient follow‑up and safety, and governance over what happens when things go wrong?

Minister Picton

• Said: ‘We want every health professional in the system to be operating at the top of their scope of practice — and that includes doctors’.
• Highlighted Labor’s policy of allowing GPs to diagnose ADHD and acknowledged that the policy is not universally popular with other specialists.
• Said pharmacists will have to complete a year‑long postgraduate training course offered by the University of Adelaide and will be supervised afterwards.
• Did not provide details about how that supervision will be conducted.

Question to Shadow Minister: What is the Liberal Party’s position on pharmacy scope of practice?

Shadow Minister Girolamo

• Said: ‘We’ve got a different approach to Labor, we want to make sure people can access a GP to make sure patients receive that continuity of care’.
• Said: ‘We’re not on the same page when it comes to what the Minister is proposing’.
• When asked if she supports the pharmacy scope of practice expansion, she said: ‘That is not a policy of ours, that is something we are working through and we’ve got a number of weeks leading up to the election, but our focus is on GPs’.