Empty chair at bed shortage summit highlights state-federal tensions

The South Australian government says an absence of 500 aged care beds is contributing to hospital ramping spikes.

It says double the number of federally-funded beds would be needed to alleviate demand, but the Commonwealth government says the states turned down an $2 billion reform offer.

The issue was discussed at a meeting between the SA government, health and union officials today but the federal aged care minister Sam Rae could not make the summit.

South Australia's worst-ever ambulance ramping hours in August would have been reduced by two thirds had there been no aged care bedblock, the state government has claimed at a health meeting intended to increase pressure on Canberra.

SA Health Minister Blair Boyer presented the modelling at a meeting of state government, health and union officials in Adelaide this morning, amid tensions with the federal government over the national shortage of aged care beds.

Those tensions were on full display in the form of an empty chair set aside for federal aged care minister Sam Rae, who was unable to attend but whose absence was made more conspicuous by a vacant space bearing his name between SA Premier Peter Malinauskas and SA Ambulance Service CEO Rob Elliott.

In August, ambulance ramping hours in South Australia hit 5,891 — the highest on record, and more than double the highest monthly figure reached under the Liberal government that was defeated by Mr Malinauskas's Labor at the 2022 state election.

Prior to that victory, Labor had prominently promised to "fix the ramping crisis", and has since repeatedly blamed consistently high ramping on a shortage of federal aged care beds for patients transferring out of hospital care.

Mr Boyer told the meeting, entitled the "federal aged care crisis", that the number of patients in public hospital beds who were unable to transfer to aged care beds was currently around 500 and could further increase to almost 700 during next year's winter peak.

He said modelling showed ramping hours would have been slashed this year had those beds been available.

"What if we had, magically, all that capacity back? What if today the system had the 500 beds, that are out of action, available to us again?," he asked rhetorically.

"One of the most powerful stats we have is the winter demand period we've just had, where it almost peaked at 6,000 hours — and would have been below 2,000 hours had we had all the capacity available to us.

Earlier, Mr Boyer told 891 ABC Adelaide that federal minister Sam Rae had been invited to the meeting, but that "he couldn't make it".

The ABC understands that the minister was only given a few days' notice of the meeting and that a scheduling issue prevented his attendance, but that a counteroffer was made to meet with Mr Boyer in Canberra.

The federal government has defended its aged care spending record, saying it was "not wasting a moment" to bring new residential aged care beds "online".

"Earlier this year, we announced the outcomes of an Expression of Interest process which will unlock $134.5 million to deliver 268 new residential aged care beds across five Adelaide sites, improving access to care and helping ease hospital discharge pressures," a spokesperson said.

"We're supporting the construction of around 5,000 additional residential aged care beds each year."

The state government said double that number was needed.

But the federal government also said the states had knocked back opportunities to contribute to solutions.

"When states told us delayed discharge was their biggest pressure point, we listened and put $2 billion on the table ringfenced for aged care services, through the National Health Reform Agreement. The states rejected it and took the money for hospitals instead," the federal spokesperson said.

Asked whether he was doing political damage to his federal Labor colleagues by being outspoken on the issue, Mr Boyer replied, "I doubt it's winning me any fans".

"Do I sit back because I'm afraid of being a bit unpopular with some of my colleagues and pull my punches? I'm not going to do that," he said.

State opposition health spokesperson Jack Batty said today's meeting was welcomed provided it did not turn "into another talkfest".

"We really need more than summits, we need commitments, we need deadlines, we need actual results," he said.

"So often this minister's default response to really serious policy challenges is another round table or a summit. He had a crisis summit last week about this."

Mr Malinauskas likened the high demand on aged care beds to a freight train that been in motion for "decades" and had "now arrived at the station".

"The country's not ready for it," he told Radio National earlier today.

"There are a range of decisions that were made frankly during the course of the Abbott years that unwound various policy measures that had been introduced to prevent this from occurring and the consequences of it are now playing out."