Appendix 1 (Voluntary Assisted Dying Board Annual Report 2022-23)

Voluntary Assisted Dying Review Board

Associate Professor Melanie Turner – Presiding Member

(1 September 2022 - 30 June 2025)

As a Psychiatrist in Inspections and Investigations for the Office of the Chief Psychiatrist, Associate Professor Turner reviews and assesses the quality and safety of psychiatric services for consumers and staff. She also works in private practice as a child and adolescent psychiatrist and is on the board of the Royal Australian and New Zealand College of Psychiatrists and the SA Medical Board. Associate Professor Turner also lectures at the University of Adelaide, is an examiner for the Australian Medical Council, and provides teaching to trainee doctors.

Ms Helen Walker – Deputy Presiding Member

(1 September 2022 - 30 June 2025)

Ms Walker is a specialist palliative care nurse holding post graduate qualifications in palliative care. Her professional interests are firmly based in the development of responsive and efficient health care services for Australians nearing the end of their lives regardless of location, ethnicity, gender or disease. Helen has held several senior Board appointments in Australia and was very proud to have been awarded Life Membership of Palliative Care SA in 2022.

The Hon John Dawkins

(1 September 2022 - 30 June 2025)

Mr Dawkins was a member of the SA Legislative Council representing the South Australian Division of the Liberal Party of Australia from 1997 until 2020. He served as an independent MLC, and as President, until March 2022. In 2018, Mr Dawkins was announced as the Premier’s Advocate for Suicide Prevention. He was a member of the Premier’s Council on Suicide Prevention and Chair of that Council until September 2020.

Dr Roger Hunt

(1 September 2022 - 30 June 2025)

With more than 38 years of experience as a clinician working in palliative care, Dr Hunt was a founding member of the Daw House Hospice and Director of the Western Adelaide Palliative Care Service. He has been awarded a Doctor of Medicine by published work. He has had extensive involvement in the introduction of voluntary assisted dying laws both interstate and in South Australia.

Mr Rainer Jozeps

(1 September 2022 - 30 June 2025)

Mr Jozeps has extensive Board experience both as Member and Chair and comes to the Review Board as a community representative, underpinned by his volunteer experience as a Lifeline Crisis Counsellor and as a support person for someone with an advanced neurodegenerative disorder. In addition to management consulting, Mr Jozeps provides wellbeing and pastoral support services for large corporate, government and not-for-profit organisations. He has an accomplished executive career in former roles as CEO at Legacy and the Adelaide Symphony Orchestra.

Mr Greg May

(1 September 2022 - 30 June 2025)

Mr May has had an extensive legal career, with 30 years in various roles at the South Australian office of Minter Ellison, including as Chairman, Chief Operating Partner, and General Counsel. He has recently retired after more than eight years in the role of Legal Profession Conduct Commissioner, an independent statutory agency of the Crown that helps to regulate the South Australian legal profession.

Ms Michele Smith OAM

(1 September 2022 - 30 June 2025)

Ms Smith is a Certified Healthcare Executive and Professional Company Director with 37 years’ experience in the health and human services industry. She is the inaugural Governing Board Chair of the Eyre Far North Local Health Network in SA, a Non-Executive Director of The Healthy Communities Foundation Australia, member of the SA State-wide Clinical Services Committee, and Non-Executive Director of Unity Housing Company. Ms Smith is also a Registered Nurse, Fellow of the Australasian College of Health Service Management, and member of the Australian Institute of Company Directors.

Ms Helen Stone

(1 September 2022 - 30 June 2025)

A Registered Pharmacist, Ms Stone is the current State and Territory Manager (SA/ NT Branch) for the Pharmaceutical Society of Australia. She has received grants, published articles, and led projects about the role of pharmacists in palliative care, COVID-19 management, and quality use of medicines in rural communities.

Introduction to the Review Board

The Review Board is an independent statutory body established under the Act to monitor matters related to voluntary assisted dying, promote compliance with the Act and promote continuous improvement regarding the quality and safety of voluntary assisted dying in South Australia.

The inaugural Review Board was appointed by the Minister for Health and Wellbeing on 1 September 2022 and met monthly as a shadow board until its full powers came into effect on 31 January 2023. The Board continues to meet monthly.

The Review Board engages with registered health practitioners, relevant groups and organisations, government agencies and the South Australian community to ensure a safe, accessible pathway for voluntary assisted dying that gives South Australians with a terminal illness choice at the end of life and ensures the integrity of the safeguards embedded in the Act.

The Review Board operates within a government context and is responsible for providing reports and advice regarding voluntary assisted dying to the South Australian Parliament, the Minister for Health and Wellbeing (the Minister) and the Chief Executive of SA Health. Terms and conditions of membership and board procedures are documented in the Review Board Charter endorsed by the Minister for Health and Wellbeing.

Since their appointment in September 2022 the Review Board have worked closely with the voluntary assisted dying teams in SA Health to establish and refine the governance, systems and processes required to enable the Board to effectively execute its functions and powers outlined under section 113 of the Act.

As with any newly established Statutory Board, this has involved continuous improvement due to the new concept and practice of voluntary assisted dying within the community, for the medical community and the health system as a whole.

Statutory role and function

The Review Board has the following functions as prescribed in section 113 of the Act:

  1. to monitor matters related to voluntary assisted dying;
  2. to review the exercise of any function or power under this Act;
  3. to provide reports to Parliament on the operation of this Act and any recommendations for the improvement of voluntary assisted dying;
  4. to promote compliance with the requirements of this Act by the provision of information in respect of voluntary assisted dying to registered health practitioners and members of the community;
  5. to refer any issue identified by the Board in relation to voluntary assisted dying that is relevant to the following persons or bodies:
      1. the Commissioner of Police;
      2. the Registrar;
      3. the Chief Executive;
      4. the State Coroner;
      5. the Australian Health Practitioner Regulation Agency;
  1. to promote continuous improvement in the quality and safety of voluntary assisted dying to those who exercise any function or power under this Act;
  2. to conduct analysis of, and carry out research in relation to, information or forms given to the Board in accordance with this Act;
  3. to provide information about voluntary assisted dying, and other matters identified by the Board in the performance of a function under this Act;
  4. to collect, use and disclose forms and information provided in accordance with this Act for the purposes of carrying out a function of the Board;
  5. to consult and engage with any of the following persons and groups in relation to voluntary assisted dying:
      1. the South Australian community;
      2. relevant groups or organisations;
      3. government departments and agencies;
      4. registered health practitioners who provide voluntary assisted dying services;
  1. to provide advice to the Minister or the Chief Executive in relation to the operation of this Act;
  2. to provide reports to the Minister or the Chief Executive in respect of any matter relevant to the functions of the Board as requested.

Organisational structure

The Voluntary Assisted Dying Review Board reports to the Minister for Health and Wellbeing, and is supported by a team and secretariat based in the Health Services Programs Branch in the Clinical System Support & Improvement Division in the Department for Health and Wellbeing.

Changes to the agency in 2022-23

The inaugural eight-member Voluntary Assisted Dying Review Board was appointed by the Minister for Health and Wellbeing on 1 September 2022. During 2022- 23 there were no changes to the Review Board’s structure and objectives as a result of internal reviews or machinery of government changes. Early in 2023-24 an additional Board member will be appointed to represent the needs of Aboriginal and Torres Strait Islander people in relation to voluntary assisted dying.

Legislation administered by the agency

The Voluntary Assisted Dying Act 2021.

Board Performance

The eight member Review Board meets once per month to monitor matters related to voluntary assisted dying in South Australia. During this reporting period the Review Board met 10 times including 5 times as a shadow board prior to commencing in their formal role on 31 January 2023. For this reporting period all Review Board meetings were fully attended or had one member absent.

The Review Board monitors matters related to voluntary assisted dying at monthly meetings through a comprehensive review of every closed patient episode in the Voluntary Assisted Dying Clinical Portal for compliance with the Act. During this reporting period the Review Board undertook a total of 39 compliance reviews.

The Review Board monitors the numbers of medical practitioners, feedback and complaints, media, communications, and engagement activities, data and statistics and risks and emerging issues.

To promote compliance the Act, the Review Board publishes quarterly reports containing information about voluntary assisted dying, feedback from the community and statistics for that quarter. Quarterly reports are available to view from the VAD Review Board webpage on the SA Health website. There has been a strong commitment to transparency, whilst protecting the privacy of individual patients.

The Review Board also has a role to refer any issue identified by the Board in relation to voluntary assisted dying that is relevant to the following persons or bodies: the Commissioner of Police; the Registrar; the Chief Executive; the State Coroner; the Australian Health Practitioner Regulation Agency. During this reporting period there were no issues identified by the Board referred to these bodies.

The Review Board identifies areas for improvement in the quality and safety of voluntary assisted dying through review of individual patient episodes at monthly Board meetings, review of data and statistics, and review of patient, family, and health practitioner feedback as well as contemporaneous information from staff working in voluntary assisted dying.

The Voluntary Assisted Dying Clinical Portal produces a range of reports based on data entered via mandatory forms submitted to the Board via the Portal by Medical Practitioners, Pharmacists, and the VAD Review Board Secretariat. As a new area of practice, research during this reporting period was limited however the Review Board was proud to see some research interest emerging and encourages the use of published data to support this.

Risk management

The Voluntary Assisted Dying Review Board approach to risk management is underpinned by the Department for Health and Wellbeing Risk Management Framework and Risk Appetite Statement.

The intent of risk management is to ensure the safety, continuity, sustainability, and communication of voluntary assisted dying in South Australia. Accordingly, the Review Board has a focus on ensuring adequate treatments and controls to mitigate identified risks.

To identify and monitor risk the Review Board monitors:

  • the community’s ability to access voluntary assisted dying in a timely manner, considering geographical spread, participation by health practitioners, access to medication and disadvantaged population groups
  • the integrity of the legislative safeguards, including safe and appropriate health practitioner conduct, coercion and safe use of the medication
  • the appropriate prescribing and administration of the medication to maintain medication safety and effectiveness
  • the provision of information, resources and training regarding end of life care services that is readily accessible to the community and enables informed choice
  • policies and education within health services and related organisations in aged care, disability, and other accommodation services
  • recruiting, retaining and sustaining medical practitioners and support service staff to meet the need for voluntary assisted dying, considering burnout and fatigue, administrative burden, training and remuneration

Controls and treatments are monitored on a quarterly basis to ensure that assessed risks are within the risk appetite framework. Controls and treatments focus on how the voluntary assisted dying operational and support services are establishing and improving statewide support services, funding to support access, health service policies, education of practitioners and the community, communications and awareness raising, data monitoring and systems approaches to operational processes.

Feedback and complaints

The Review Board welcomes feedback and personal reflections from patients, families, clinicians, and others involved in the voluntary assisted dying pathway. To support this, a Voluntary Assisted Dying Personal Reflection form (PDF 289KB) is available for download from the SA Health webpage.

All feedback regarding voluntary assisted dying provided to the Review Board and to the voluntary assisted dying teams by members of the community is entered into the SA Health Safety Learning System and is managed in accordance with the SA Health Consumer, Carer and Community Feedback and Complaints Management Strategic Framework.

During this reporting period there were 23 compliments, 6 suggestions, and 3 complaints submitted to the Safety Learning System regarding voluntary assisted dying. This feedback was provided by members of the community including patients, family members and medical practitioners and was submitted by the SA VAD Pharmacy Service, Care Navigator Service, VAD Liaisons and via Personal reflection forms submitted directly to the Review Board.

Feedback regarding voluntary assisted dying is monitored at monthly Review Board meetings and informs continuous improvement in the delivery of voluntary assisted dying in South Australia.

The Voluntary Assisted Dying Review Board is compliant with Premier and Cabinet Circular 039 – complaint management in the South Australian public sector.

The Voluntary Assisted Dying Review Board has communicated the content of PC 039 and the agency’s related complaints policies and procedures to employees.

Premiers Circular 13 (PC013) – Annual Reporting requirements

This Annual Report aligns with the circular where applicable, which sets out the requirement for annual reporting. These requirements are mandated for all South Australian Government agencies and entities which are presenting annual reports to the South Australian Parliament.

Voluntary Assisted Dying Act 2021 – Annual Reporting Requirements

Section 120(1), the Board must on or before 31 October in each year, report to the Minister on the performance of the Boards functions during the preceding financial year. Section 120(2) the Minister must, within 6 sitting days after receiving a report from the Board, have copies of the report laid before both Houses of Parliament.

This report constitutes delivery of the annual report under Section 120 of the Voluntary Assisted Dying Act 2021.

Contact us or provide feedback

For further information and updates about voluntary assisted dying please visit the Voluntary Assisted Dying webpage on the SA Health website.

If you are a patient, family member or clinician who would like to provide feedback about your experience of the voluntary assisted dying pathway the Review Board invites you to complete a personal reflection form or email the Review Board directly at Health. VADReviewBoard@sa.gov.au.