Reforming paediatric health services, naming public places after reconciliation advocates, and decreasing the printing of the ACT Government’s newsletter were among the business debated at the Legislative Assembly on Wednesday.

Liberals: Reform paediatric health services

Leanne Castley (Canberra Liberals) called on the ACT Government to immediately improve the early warning system for paediatric patients, following the recent deaths of five-year-old Rozalia Spadafora and 13-year-old Brian Lovelock.

“The government must do everything it can to stop children dying in hospitals,” Ms Castley said.

Canberra Hospital’s early warning system, the Paediatric Early Warning Score (PEWS), should be tweaked, the Australian Medical Association (AMA) ACT has stated. The current system is based on an aggregate score which determines how often a patient is monitored.

Ms Castley proposed that the government introduce a new protocol, as the AMA ACT has suggested, to escalate the care of a deteriorating child based on a single vital sign – such as increased heart rate, blood pressure, temperature. Monitoring would be increased from four-hourly to half-hourly.

That simple point trigger, Ms Castley argued, would be more sensitive to deteriorating children, and escalate the frequency of observations and the call for additional care.

Ms Castley also wanted the government to investigate early warning systems in NSW (Between the Flags) and Victoria (ViCTOR), which AMA ACT president Professor Walter Abhayaratna considers are better than those in the ACT.

• Canberra Liberals call for urgent review of ACT paediatric services (19 September)
• Call for urgent review of Canberra Hospital paediatric care (7 September)

“What the Labor-Greens government can do and what it must do is improve health care for our most vulnerable, our sick and deteriorating kids, to ensure the best services are provided to them,” Ms Castley said. “Nothing less. This would be the most appropriate tribute to these grieving families to show the government genuinely cares about improving health care. This is what Canberrans elect their governments to do.”

Health minister Rachel Stephen-Smith amended Ms Castley’s motion entirely.

She stated that the current PEWS system already uses individual vital sign scores (including heart rate, blood pressure, temperature, respiratory rate, and oxygen saturations), as well as an increasing score, to trigger an escalation pathway for clinical review and management of the patient.

The Call and Respond Early (CARE) for Patient Safety program enables patients, carers, and families to escalate concerns around clinical deterioration.

Ms Stephen-Smith also listed several reviews, either recent or underway.

Clinicians from the Emergency Department, Intensive Care Unit, Paediatrics, Medical Emergency Team, and Anaesthetics have met for a year to review policy and procedure for the care of deteriorating and critically ill children, and in particular the early warning system before the Digital Health Record is implemented in November.

An external review of Canberra Health Services’ (CHS) Paediatric Services was conducted last year, resulting in the CHS Paediatric Organisation and Service Plan 2021-2023 that outlines recommendations and actions being implemented at CHS.

Canberra Health Services underwent an organisation-wide accreditation by independent assessors in June. It met the National Safety and Quality Health Services Standards across all aspects of paediatric service provision, including all actions under Standard Eight: Recognising and Responding to Acute Deterioration.

Ms Stephen-Smith will convene a Child and Adolescent Clinical Services Expert Panel to finalise the Territory-wide Child and Adolescent Clinical Services Plan. This Panel will review and monitor implementation of existing recommendations and priorities, including recommendations from the CHS Paediatric Organisation and Service Plan 2021-2023.

Ms Castley said it was “extremely disappointing” the Government did not agree with her motion.

Labor: Public places to be named after reconciliation, not colonisation

ACT public place names can be named after people famous in colonisation – which Dr Marisa Paterson (Labor) considers offensive to many.

Last November, she introduced a bill to amend the Public Place Names Act 1989. Under that legislation, the minister may name public places after people famous in Australian exploration, navigation, pioneering, colonisation, administration, politics, education, science or letters.

Dr Paterson proposed that ‘colonisation’ should be struck out, and replaced with ‘reconciliation’.

“The amendments of this Bill alone won’t bring about reconciliation, but they will highlight and celebrate those who have and who are continuing to affect positive change.”

Her bill passed, with support from both the Greens and the Liberals.

• ACT place names will honour reconciliation (20 September)
• Public places to recognise reconciliation (30 November 2021)

Dr Paterson argued that the death of the Queen, “the figurehead of colonialism across the Commonwealth”, meant it was time “to no longer hold colonisation and colonisers in the ACT in high esteem – to tell the truth about our history”.

The MLA said that her motion was a small but significant step towards a path for justice and reconciliation.

“I’m pleased to be playing a part in helping bring about greater awareness of those who have contributed in many different ways to our important path to reconciliation, and who continue to do so.

“We have much unfinished business in reconciliation in this country, and we all have a part to play in the truth-telling and healing process as we move to a referendum for the Voice to Parliament and treaty.”

Liberals: Government newsletter should be wound back

The ACT Government publishes its newsletter, Our CBR, 11 times a year, and delivers it to every household in the ACT. Mark Parton (Canberra Liberals) wanted the government to wind back distribution of the magazine from monthly to quarterly (as it was before the 2016 election).

Mr Parton considered the current rate of publication and delivery both fiscally irresponsible and wasteful.

Over the course of the four-year electoral term, he estimated, the government would print 8.4 million copies – enough copies to reach all the way from the ACT to Perth and back. Printing and distributing the magazine, he said, cost nearly $3 million and more than 2,000 trees over those four years. Given the ACT Government had banned single-use plastics to protect the environment, he considered printing the magazine was hypocritical.

Since the newsletter is available online, he argued the government should highlight that Canberrans can access that fact more prominently in the hardcopy newsletter.

• Liberals: Our CBR newsletter is wasteful (21 September)

Mr Parton’s motion was rejected.

In his amendments, Chief Minister Andrew Barr noted that Our CBR was one of the most preferred methods for Canberrans, particularly older citizens, to receive government communication.

The newsletter had recently changed to non-recycled, imported paper stock sourced from sustainably managed forests, due to supply issues with 100 per cent recycled, coated paper sourced overseas.

Under Mr Barr’s amendments, the government will move back to 100 per cent recycled, coated paper for Our CBR as soon as it is financially viable; and will highlight the ability for Canberrans to access the newsletter online more prominently in other government communication channels.

“The reason this government wants to cling on to the Our CBR newsletter in this form is this is campaign material which isn’t included in the expenditure cap in an election year and it’s political propaganda which is paid for entirely by the taxpayer,” Mr Parton said. “I can sort of understand why they want to hang on to it.”

Liberals: Freedom of Information Bill tabled

Elizabeth Lee (Canberra Liberals) presented a Bill for an Act to amend the Freedom of Information Act 2016 to require the government to publicly release records within 30 business days after Cabinet consideration.

Debate was adjourned to the next sitting.

• Elizabeth Lee will present Freedom of Information bill (20 September)

Also on the topic of freedom of information, Chris Steel, Special Minister of State, presented a bill to increase the timeframe for ACT Government Directorates to process FOI requests from the statutory 20 working days to 30 working days, arguing this would give more time to process requests.

“You can’t fix a problem by ignoring the root causes,” Liberal MLA Peter Cain said. “This is not a solution; this is moving the goal posts, so the problem is no longer flagged.”

A Deloitte Report from 2020 found all directorates took more than 30 working days to process requests; only one directorate processed requests within 20 working days; and the Liberals calculated their requests took an average of 40 days, Mr Cain said.

“The minister has not acknowledged or responded to issues identified by the 2020 Deloitte report in the FOI process – including inadequate staffing numbers, staffing models, ICT infrastructure, and the current threshold for ‘partial release’.”

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