Six months after Labor’s ramping pledge, the signs aren’t great | David Penberthy

When you make fixing ramping your whole election campaign, you have no choice but to fix ramping, writes David Penberthy.

A few weeks ago I was at dinner at a French restaurant when I bumped into former health minister Stephen Wade who spent all four years in that role during the life of the Marshall government. Mr Wade had the maniacally giggly demeanour of a condemned man who had just learned he had been pardoned from death row.

I asked him if he missed the monthly press conferences about hospital ramping and the early morning interviews on breakfast radio where he would arrive armed with a stack of papers in a pre-emptive attempt to fend off any incoming question. “Miss it? he laughed. “Like a hole in the head!”

It’s amazing what no longer having the crappiest job in government can do to a man. The chablis seems crisper, the duck confit tastier, the sun shines brighter.

Just six months into the life of the Malinauskas government and the reality of being in charge has well and truly kicked in. It is in the area of health – the toughest portfolio in government – where reality is biting hardest.

There is a consensus across politics in this state that it would be nothing short of a miracle if the Liberals are able to get themselves off the mat and reclaim government in 2026. The collapse in the suburban Liberal vote combined with the loss of traditional conservative seats to country independents means the Liberals will be fighting a probably unwinnable war on two fronts.

The one thing that has the capacity to change that is the issue which more than any decided the last election – ambulance ramping.

Freed former South Australian Health Minister Stephen Wade. Picture: David Mariuz

While the pall of Covid and its management by the previous government altered the dynamics of the campaign, the one policy issue which dominated was that of ramping. Indeed in Labor’s mind, no other policy mattered.

When it came to opposing the Liberals’ planned entertainment centre, or announcing new funds for ambulance headquarters in the regions and the CBD, every major Labor promise came back to one central point – our hospitals are overcrowded and ramping will continue to be a problem without more beds, more staff, more funds.

The key question between now and 2026 will be what has actually changed.

I know we are only six months on from the election and these things will take time to address given how badly ramping blew out on the Marshall government’s watch. Having said that, it is fair to say that for the Malinauskas Government the early signs are not good, as ramping over the past four months has been vastly worse than at any stage during the Marshall government.

On the Liberals’ watch, ramping hit a new high in May last year of 2800 hours and remained around that level through winter before hitting another record of 2868 hours in October.

Unpleasant numbers, sure, but a walk in the park compared to the past four months, where the ramping figures stood at 3412 hours in May, 3838 hours in June, 3647 hours in July and 3763 hours in August.

That’s a new SA record – four of them, in fact – all on the watch of the Malinauskas government, and without any of the theatrics of ambulances being chalked or the union running aggressive daily commentary about what a disgrace it all is.

I spoke to Health Minister Chris Picton about these figures last week. Like Mr Wade before him, he is a good bloke and a hardworking guy, and his answers were honest. They go to the complexities of managing the health system and are worth recording here, with one snarky point I will save for the conclusion.

“We absolutely and completely agree that the situation is not acceptable,” Mr Picton said.

“It’s a factor of blockages in the system and the demand on the system. What we have seen over the last few months is the system trying to deal with a combination of Covid, lack of primary care, lack of beds in the hospital system and an increase in the acuity of patients. There has been a continuation of what we have seen over the last four years which is a straight line of ramping going up.”

Mr Picton said a big factor in the increase was the lack of GPs which was affecting the hospital system at both ends.

South Australian Premier Peter Malinauskas and Health Minister Chris Picton at the Women’s and Children’s Hospital. Picture: NCA NewsWire / Naomi Jellicoe

“Not only does that mean that more people turn up at hospital who would otherwise go to a GP, worse than that it also means that people can’t get primary care when they need it, so they end up at hospital in a much sicker state than they would otherwise have been if they got care earlier,” he said.

“We have opened up every possible bed in SA Health that we have in the health system. More than that we have gone to the private sector to buy over 160 private hospital beds that we are using now. We are sparing no expense and using every possible lever to put patients into beds but that’s not even enough. We just don’t have enough capacity but we have got plans to build more capacity with another 550 beds across the system. But obviously that takes time.”

It all makes perfect sense. It also sounds like a perfect rendition of the exact kind of thing Stephen Wade spent the past four years saying.

The politics of this are such that Labor made such a huge play of fixing ramping it now has absolutely no choice but to fix it.

You can’t win an election based on such a massive central promise and then fall short.

And while there is plenty of time to turn things around, in a political sense, the aforementioned figures are for Labor the equivalent of being four goals behind heading towards quarter time.

The one upside of course for Chris Picton is at the end of it all, there’s always great food and wine to be enjoyed, as you pinch yourself realising the nightmare is finally over.