Royal North Shore Hospital Clinical Reference Group
Hospital Emergency Department Miscarriage Protocol

Mrs JILLIAN SKINNER: My question is directed to the Minister for Health. Yesterday in the House she praised the clinical reference group she set up at the Royal North Shore Hospital. In view of this, how does she respond to claims of Professor Stephen Hunyor, a cardiologist and member of that clinical reference group, that the miscarriage review is "another superficial quick fix, a quenching of the fire in a decaying institution and public health service"?

THE SPEAKER: Order! Members will come to order.

Ms REBA MEAGHER: The first point that needs to be clarified is that I did not establish the clinical reference group. The clinical reference group was established by the new chief executive of the North Sydney Central Coast Area Health Service. The doctors, whom I have met, who are participating in the clinical reference group have indicated their willingness to work with the new chief executive to develop a new management model and implement that new management model by doctors and the chief executive working together. That is the type of cooperation that we celebrate as we try to put the Royal North Shore Hospital back on the front foot.

THE SPEAKER: Order! I call the member for Murrumbidgee to order.

Ms REBA MEAGHER: I again make the point that we have received the very same type of cooperation from the nurses at the Royal North Shore Hospital. They have come together and formed a nursing task force to work with the chief executive to overcome the difficulties they experienced under the old management. It is that kind of cooperation and responsiveness by management, with doctors, nurses and managers working together to overcome the problems that were experienced—

Mrs Jillian Skinner: Point of order—

[Interruption]

THE SPEAKER: Order! The House will come to order. The Deputy Leader of the Opposition has the call. What is the point of order?

Mrs Jillian Skinner: My point of order is on relevance under Standing Order 129. I asked a specific question about a view expressed—

Ms REBA MEAGHER: I am happy to answer it.

THE SPEAKER: Order! I will hear the point of order.

Mrs Jillian Skinner: I asked a specific question about a view expressed by a member of the clinical reference group that the Minister for Health praised in Parliament yesterday. I asked the Minister to comment on this doctor's point of view.

THE SPEAKER: Order! The Minister's answer is relevant to the question.

Ms REBA MEAGHER: As the Deputy Leader of the Opposition would be aware, there are many points of view in health when we talk about varying models of care. That is why I established an investigation to be headed by Professor Bill Walters, the lead obstetrician at the Royal Hospital for Women—he is something of an expert in this area—along with the Chair of the Clinical Excellence Commission, Professor Cliff Hughes. They will undertake a review of how we can strengthen our system and provide models of care that afford women more compassion when they present to emergency departments threatening miscarriage. In fact, as evidence of the varying opinions in relation to these different matters I refer to a letter that I received from Di O'Halloran, Chair of the Royal Australian College of General Practitioners, New South Wales. She writes:

First, may I convey my appreciation—

Mr Adrian Piccoli: Point of order—

THE SPEAKER: Is this a different point of order to that raised by the Deputy Leader of the Opposition?

Mr Adrian Piccoli: It is a point of order on relevance that I am entitled to raise. I know that Government members do not like it.

THE SPEAKER: What is the point of order?

Mr Adrian Piccoli: My point of order relates to Standing Order 129. The question asked specifically about Professor Hunyor and the comments that he made regarding the panel. Mr Speaker, are you going to consider any issue relating to the Health portfolio to be relevant to the question? The previous Speaker was sacked and you were made Speaker because the Government wanted to change Parliament.

THE SPEAKER: Order! The member for Murrumbidgee will resume his seat.

[Interruption]

THE SPEAKER: Order! The member for Murrumbidgee will resume his seat. I call him to order for the second time.

[Interruption]

THE SPEAKER: Order! I call the member for Murrumbidgee to order for the third time. I have ruled in relation to the matter raised by the member for Murrumbidgee. I will not allow superfluous points of order to be taken in a deliberate attempt to disrupt question time. The Minister for Health has the call.

Ms REBA MEAGHER: I have received correspondence from the chair of the Royal Australian College of General Practitioners, who makes some very interesting points. She writes:

First, may I convey my appreciation of your Department's efforts to work more closely with general practitioners to trial new and more integrated models of care involving general practitioners and other community-based health professionals.

That is a good point. She continues:

The current difficulties being experienced by emergency departments in dealing with the clinical and emotional problems that can arise in early pregnancy is potentially a situation that would benefit from the development of such alternative approaches.

That is a representative view that varies from the position put forward by the Deputy Leader of the Opposition. But it does not stop there. I have also received correspondence from Pat Brodie, Professor of Midwifery Practice, Development and Research from the Sydney South West Area Health Service and the University of Technology, who is also President of the Australian College of Midwives, and from Caroline Homer, Professor of Midwifery, University of Technology, and President of the New South Wales Midwives Association.

THE SPEAKER: Order! I call the member for Epping to order.

Ms REBA MEAGHER: I accept that there are differing points of view in relation to this issue. But that is why we have established an expert inquiry to seek the views of all participants.

THE SPEAKER: Order! The Deputy Leader of the Opposition will cease interjecting.

Ms REBA MEAGHER: It is the role of the inquiry to take on board the varying points of view but, most importantly, to examine the varying models across the New South Wales health system and develop an alternative model of care that has as its fundamental principle the fact that we afford women more privacy and more dignity when they are confronting emotionally challenging situations, such as miscarriage. I am astounded that the Deputy Leader of the Opposition has questioned this approach to the extent that she has. I would have thought the New South Wales Opposition would join us in attempting to explore the fact that we can do it better. That is what this investigation is about.

THE SPEAKER: Order! I call the Deputy Leader of the Opposition to order for the second time.