HELICOPTER RESCUE SERVICES
Matter of Public Importance
Mrs SKINNER (North Shore) [4.35]: My matter of public importance relates to the future of helicopter medical rescue services in New South Wales with five separate revisions of the tender to provide rescue helicopters and the plan to abolish CareFlight's medical retrieval team. Obviously, this matter is important to everyone, but none more than those for whom this service provides an essential tool in ensuring that their health needs are met in moments of trauma and crisis. For example, a 17-year-old Moss Vale girl became extremely ill after a picnic only this Monday. She was with her two brothers in the State's Southern Highlands. They walked to the Shoalhaven River from Long Point Lookout, and tried to negotiate the long climb out of the river gorge. It became very dark, and by 1 a.m. this young pregnant woman became very ill. One of her brothers walked out of the gorge and raised the alarm, but the ambulance could not gain access to the area because of rugged terrain. The National Roads and Motorists Association CareFlight rescue helicopter rescued this sick girl.
On Sunday, 28 April, two critically ill people were rescued from Bathurst. It is a pity that the honourable member for Bathurst is not in the Chamber, because those people who were rescued would hope that he is very concerned about the possibility of the unavailability of CareFlight to lift them from a distressing and dangerous situation. A man and a woman were airlifted from Bathurst to Royal Prince Alfred Hospital in separate flights, and the woman required ongoing care after suffering respiratory distress. Another example is a Kenthurst trail bike rider who was injured in an accident on Anzac Day. Last week a Korean tourist was rescued at night from Bondi. Burn and car crash patients were rescued in two separate incidents by the NRMA CareFlight helicopter from Nowra and Canowindra last week. The list goes on. These people are very concerned about the maintenance of helicopter retrieval services.
What has the Government done? Last August the Minister said that we would have two helicopter services in Sydney and another in Canberra. For some time calls have been made for a helicopter service in Canberra - which the Opposition supports - particularly since Dick Smith made a helicopter available for use by that service. After a long delay, the Minister said that a helicopter service will be available in Canberra, but at the
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expense of one of the Sydney services. That is simply not good enough. The people of Sydney, particularly western Sydney, and of country areas serviced by CareFlight, should not have their services reduced to provide an extra helicopter in Canberra. Additional services should be provided.
There is no question that CareFlight's future is in doubt, because the Minister has made it plain that he does not want to retain the independently run aeromedical retrieval services attached to CareFlight. In August last year expressions of interest to run the Sydney and Canberra services were called for by the Minister. It took until January for the three existing community-based services operating in Sydney to be invited to tender for the service, along with an international company. The Minister made up his mind in August, tenders were invited in January and since then the tender has been reviewed on five separate occasions. Tender arrangements and proposals are familiar procedures in my household. My husband has been very involved with tendering for large Commonwealth Government contracts over a long time. I have heard of nothing as ridiculous as five separate revisions of a tender. They were not simple revisions because of information being left out; they were major revisions.
In August last year the Minister announced that two helicopters would be required in Sydney, but the Government now requires a backup with a third helicopter. The unprofessional way in which the department has handled the process has raised doubt about the capability of the department and the Minister to decide how to ensure that a full helicopter medical retrieval service is available for the people of this State. A major consideration is the future of the CareFlight medical retrieval team. At the moment 20 doctors and medical staff are attached to the team. The department and the Minister have made clear that the bottom line is that the Government does not want the team to be independently run; it wants it to be under the control of the health department - more specifically, the Ambulance Service. This would change the focus of the service from clinical need to transport, which is not in the best interest of patients.
The CareFlight service has been evaluated and found to be of excellent quality and value, with standards second to none. The people of New South Wales deserve continuation of such a level of service. The Government funds only 44 per cent of the service. The rest is provided by major sponsors and individuals in the community who provide small amounts in gratitude to a service which has been of tremendous assistance when the needs of individuals have been great. I am not surprised that there is huge community support for CareFlight and the other community-based helicopters involved with Child Flight and the surf lifesaving organisations.
The doctors staffing the services are trained in the special requirements which the flying services involve. They are able to provide assistance to doctors in small country towns, regional centres and even suburban areas when doctors from the local hospital or medical practices are not available to accompany patients to the tertiary hospital to which they are transported. CareFlight is supported not only by the people who receive its service; it has enormous and documented support from people within the health department, hospitals, doctors and those who make it their business to ensure that the injured and sick have the best possible means of ensuring they are able to get to treatment which may make the difference between life and death or between complete recovery and part recovery. The Government's lack of determination about the location of the helicopters and who will provide the services is indicative of its lack of interest in how the helicopter services will continue to run.
People have also been disturbed that the Dick Smith helicopter, which was donated 10 months ago, is still sitting in a hangar. It has not been used for one medical retrieval. I am sure that the Minister will come up with a plausible explanation, that it has not been refitted to carry a stretcher and what have you. However, the Minister has not ensured progress of the tendering process so that the matter can be resolved. He has been delaying introduction of the service. The tender has been revised five times and there is no way that he can get out of that. The people of New South Wales have signed petitions in their thousands. They are giving the Minister the message loud and clear that they want the established medical retrieval team and the helicopter services guaranteed. [Time expired.]
Dr REFSHAUGE (Marrickville - Deputy Premier, Minister for Health, and Minister for Aboriginal Affairs) [4.45]: This is the first health matter raised for debate by the Opposition. It was raised yesterday by the shadow minister, knowing full well that I was representing the people of New South Wales at the memorial service for the Port Arthur massacre victims. It was an act of cowardice that the Opposition should be ashamed of and one that the Leader of the Opposition should not have allowed to occur. New South Wales presently has five helicopter retrieval services. Three of them service the residents of Sydney and the surrounding areas. The other two are located in Newcastle and Lismore. It is ironic that the Opposition has chosen to raise this matter. In 1994 the Fahey Liberal Government commissioned a review of New South Wales aeromedical services. The terms of reference for the review were to advise on the most appropriate - [Quorum formed.]
The terms of reference of the review commissioned in 1994 by the Fahey Government were to advise on the most appropriate organisational structure, management arrangements, aircraft and base locations, staffing requirements, standards, and financing and charging arrangements for the efficient and effective delivery of aeromedical services in New South Wales. In May 1995 the report of the review was released by the New South Wales health department for public consultation for two months. The recommendations
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of the review have been considered in the context of the best use of all forms of transport and networking, to achieve better management and utilisation of aeromedical services.
On 23 August 1995 the Government announced a joint development with the Australian Capital Territory Government of a rotary wing aeromedical service for the south-eastern region of New South Wales and the Australian Capital Territory. The establishment of this base is occurring in conjunction with a realignment of Sydney-based helicopter services. Helicopter services in Lismore and Newcastle will remain unchanged. Overall five helicopter services will continue to provide retrieval services for the residents of New South Wales. The configuration of helicopter services includes the location of the joint-funded service in Canberra and two bases located in Sydney. This will improve the existing aeromedical patient transport and retrieval system by providing better area coverage, more rapid response times, and improved services for patients in a greater area of New South Wales, including the south coast.
The contracts for the five helicopter retrieval services expired in December 1995. To enable a tender process to be undertaken, the contracts for all helicopter retrieval services were extended for six months. A further extension of contracts will enable the best possible contracts to be drawn up. Expressions of interest for the provision of Sydney- and Canberra-based services were called for in 1995. Responses were evaluated and a selective tender process was then commenced, with tenders being called in January 1996. An open tender process for the provision of Newcastle- and Lismore-based services has been undertaken simultaneously. Tenders closed on 1 February and are currently being evaluated.
With respect to the tender process, two tender documents were issued, one for the Australian Capital Territory and Sydney services which was conducted on a selective basis following a call for expressions of interest, and one for the Newcastle and Lismore services which was conducted on an open basis. As with any tender process, a period of review and clarification occurred. I am advised that central to this process was ensuring that full information was provided to all tenderers. Shortly after the tenders were issued two briefing sessions were held, one for the Australian Capital Territory and Sydney services and one for the two northern New South Wales services. During the briefing sessions the prospective tenderers asked questions of a technical nature. The Department of Health took these questions on notice as agreed at the outset of the meeting and subsequently issued addenda to the tender documents. Upon receipt of the tender submissions, a tender evaluation committee was formed and the process of reviewing the submissions commenced.
Some of the tenderers provided information in their submissions which required clarification. The department subsequently wrote to these tenderers seeking the necessary clarification. I understand that a number of the tenderers interpreted this as a revision of the tender, which in the view of the tender committee it was not. In response, a number of the tenderers sought a further briefing. The department acceded to this request and a further two briefing sessions were held, one for Sydney and the Australian Capital Territory services and one for the two northern New South Wales services. All tenderers were invited to these sessions. Again, transcripts of the briefing sessions were issued. The tenderers who were asked to provide clarifying information then submitted it to the department. To provide any further information would jeopardise the tender process which is in its final stages.
It should be pointed out to honourable members that the tender essentially called for the provision of aircraft, hangar and basing facilities, air crew and engineering services only. It did not call for the provision of medical staff. These will be provided for all operations by the New South Wales Department of Health, the New South Wales Ambulance Service or the Australian Capital Territory Department of Health and Community Care, and the Australian Capital Territory Ambulance Service. At present CareFlight is the only operator which employs and provides dedicated medical staff. The other four services simply provide the helicopter platform, with medical services being delivered by medical practitioners employed through the New South Wales health system.
For the information of honourable members CareFlight has advocated a proposal which involves contracting the medical team from CareFlight to deliver retrieval services. The difficulty with this approach is that it merely maintains the status quo and the cycle of instability that exists every time CareFlight is required to tender commercially for the provision of New South Wales aeromedical services. Clearly, there is valid rationale for the separation of the medical team and the vehicle operator. The doctors currently employed by CareFlight will be offered positions under the proposed arrangements. Obviously the decision to accept these positions will be up to the doctors.
It should be stressed that under the revised configuration of services in Sydney one base will be retained in the west of Sydney and the other in the east. Establishment of a medical retrieval unit is proposed to integrate and coordinate all aspects of medical retrieval. The unit is being developed in consultation with all involved parties including the CareFlight medical team. The medical retrieval unit will function as more than a team coordination centre. It will provide a functionally integrated adult emergency transport system allowing predictable and uniform system responsiveness, guidelines and protocol development, and employment of appropriate staff and staff mix, as
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well as the efficient use of resources and stable employment and service provision, independent of commercial or tender considerations.
It has been proposed that the medical retrieval unit and the air ambulance coordination centre be administratively linked. Again, this will not have an impact upon the location of the clinical bases in Sydney, which will continue to be located at the western and eastern helicopter sites. I am aware that concerns have been raised about CareFlight's accredited training positions. The Australasian College for Emergency Medicine and the Australian and New Zealand College of Anaesthetists have indicated to the department that the accredited registrar positions would be continued if accreditation requirements continue to be met, irrespective of the employing body. [Time expired.]
Mrs SKINNER (North Shore) [4.55], in reply: The Minister's response was clearly indicative of how much he cares about this issue. All he did was rattle off in the most monotonous tone possible a prepared script given to him by his bureaucrats. It was the most insincere delivery I have ever heard.
Dr Refshauge: ICAC.
Mrs SKINNER: Yes, the Independent Commission Against Corruption. I have got stuff on you for ICAC. The Minister said that there is instability in CareFlight. Watch out mate, ICAC. Instability! What an outrageous claim to make. All people who have been so complimentary about the medical retrieval teams that have been provided through CareFlight will be interested to hear the Minister's words on that. The Minister rattled off exactly what I have been saying about how the tender process was set up six months ago, extensions had been granted, but no decision made. The Minister supported what I was saying; that it is a matter of concern to people. It seems to me that the Minister has made up his mind, as has the department, that CareFlight will be pulled apart, as will the retrieval team.
Those services are absolutely critical for the assistance they provide to people, not only in western Sydney but in rural parts of New South Wales around the towns where I described rescues and retrievals to have taken place in recent times, such as Bathurst and Orange, and in the southern highlands. When people are seriously injured, sick, or in distress they need to get to a hospital as quickly as possible. The Minister knows full well, because of his background, that critical to the recovery is the time taken to get a person to hospital for tertiary treatment. The Minister was quite comfortable rattling off a script which said: do not worry, we do not need the specialist teams because the Department of Health will take it over - he knows jolly well that the hospitals and the department are having enormous difficulties in coping with demand. The hospitals that patients will be flying from will not be able to afford relief staff to accompany them. Hospitals in country towns and other places will not be able to afford doctors who are attending accident and ill-health sites to travel with these patients.
The Minister is doing a great disservice to people who rely heavily on helicopters for retrieval services. I do not know why the Minister had to rattle off a speech like that. I am sure he and his staff - and I see some of them here - must be getting phone calls, as I am, from doctors and patients in country towns who are concerned about the future of CareFlight. They must know that hundreds of people have been crawling over helicopters that have been on country tours. By making the helicopter retrieval services open and accessible, people have been providing financial support to keep CareFlight going. It is extraordinary that the Government, which is strapped for funds for health expenditure, would dismiss the future role of medical helicopter services that receive support from individuals in the community and from the corporate sector as well.
The Government pays only 44 per cent of the costs of running the service and it is anticipated that that figure will decrease. I would have thought that this is the type of service that the Government would encourage, not criticise. I thank the Minister for reminding me about the colleges which are very keen to ensure that the training provided by CareFlight is maintained. If there is instability and the service is not as good as I suggest it is, why has the Minister said that the Government will continue to provide that training? The Minister knows that the colleges are very complimentary about CareFlight and the service it provides, as are the more than 60,000 citizens who signed a petition. The Minister is rolling his eyes skywards because he really does not want to hear this, but the people of New South Wales who have been using CareFlight and who know what an excellent service it provides will give him the message. [Time expired.]
Discussion concluded.