A few weeks ago, I got a front row seat (well, gurney) to witness how privileged we are to have such an outstanding group of professionals serving our community in the Royal Adelaide Hospital’s emergency department.

An unexpected post-operative infection had left me in increasing pain as I was trying to breathe. I was close enough to the hospital to be able to drive there and seek urgent help late one weekday evening.

Over the next 22 hours, not only did I get first-class care from a wonderfully-dedicated group of people, I also saw and heard what they face on any given evening.

The RAH emergency department really is the front line of some of the most challenging issues facing our community: alcohol and drug addiction, serious assaults, domestic violence, homelessness, severe mental health episodes, serious accidents and so on.
Initially I wondered why so many security staff seemed to be needed but I soon found out why. Sadly, there’s an undertone of violence that seems to be a fact of life for those staff. For example, in the early hours of the morning I witnessed a patient with mental health challenges screaming obscenities at staff and physically threatening them. The clinical and security staff did a superb job of containing the situation in a way that meant neither the patient nor staff were injured.

Leaving the acute episodes aside, staff also need to deal with the chronic resentment and impatience of members of the public who feel aggrieved when others with more serious conditions are seen first.

As I went through the experience I was so impressed with the respect and courtesy afforded by staff doing long or unusual hours with so many competing demands.

Business SA is often misunderstood as being “anti-public sector”. Perhaps that perception exists because we have long pointed to benchmarks showing our state’s public sector as the largest in Australia on a pro-rata basis with the associated massive payroll costs.

Business SA aspires for the state to have an efficient, effective and productive public sector. We have never simplistically plucked a figure out of the air as to what should be the right number of public sector workers. We know each agency and department needs to be considered on its own merits and measured on its ability to deliver the appropriate return for our community on the significant investment taxpayers have made.

Indeed, we accept that a proper review of specific public sector agencies may well reveal the need for an increase in the front-line staff who directly meet our community’s needs. But, to pay for that, savings and efficiencies need to be found in the vast administrative and management infrastructure that sits over those on the front line.

My time in emergency reminded me that we have outstanding people providing a world-class service, often in very challenging conditions. I hope sensible and ongoing reform in our public sector will further empower those on the front line to better serve their fellow South Australians.

This article was originally published in the South Australian Business Journal on Tuesday 19 March 2019.