There’s no shortage of Australian Rules fans in South Australian government ranks.

This is the administration which did a deal with the AFL to bring a whole round of games to SA.

Even Premier Peter Malinauskas has described himself as a “pretty average footballer”, thanks to the time he spent playing at Adelaide University in the amateur league.

And if a four-year parliamentary term were to be broken down like a match, we would now be into the third quarter — often dubbed the “premiership quarter”.

When it comes to its handling of the state’s public health system, on some key measures, Labor is arguably being beaten at this point of the contest.

It’s a rare event to have the state’s whole public hospital system plunged into a “code yellow”, or “internal disaster”, like it was on Thursday afternoon.

The measure has been used on a hospital-by-hospital basis recently to handle demand, such as at Flinders Medical Centre in March, but historically it’s not often seen across all metropolitan and country sites.

And it’s expected to last for a week.

Ramping has again hit record highs.(Facebook: Ambulance Employees Association)

The decision has triggered the cancellation, or pausing (as SA Health described it), of non-urgent elective surgeries throughout the state to try and ease the burden on the system.

As Health Minister Chris Picton told reporters on Friday, it’s a system which has recently faced “unprecedented pressure”.

“We are seeing at the moment a significant wave of COVID and flu, RSV and other respiratory infections,” he said.

That might be the case, but a problem he — and the state government more broadly — has is that Labor elevated health as a major political issue as it swept to power at the 2022 election.

“Labor will fix the ramping crisis” was a slogan central to the party’s successful campaign.

Labor swept to power partly on the basis of its promise to fix ramping.(ABC News)

Since then, the headline monthly ramping figure — the number of hours patients and crews spend stuck outside emergency departments — has remained well above where it was when Labor took power.

In May ambulances spent a record 4,773 hours ramped, an increase of more than 1,300 hours on April.

In the past week, many of Adelaide emergency departments have operated at or over capacity, with the time people spent waiting to be seen blowing out by hours.

The “fix” pledged of ahead the March 2022 poll appears to be a long way off.

SA Health chief executive Robyn Lawrence conceded on ABC Radio Adelaide on Friday that even intensive care units had been full for the last few weeks.

This is all happening despite billions of extra dollars being allocated to health in the state government’s first two budgets, with the next instalment to be delivered this Thursday.

And yet the system is apparently bursting at the seams with every available bed open and out-of-hospital care “maximised”, according to Dr Lawrence, in addition to the elective surgery “pause.”

SA Health chief executive Robyn Lawrence said every available had been bed opened and out-of-hospital care had been “maximised”.(ABC News: Lincoln Rothall)

Multiple issues seem to have converged to get the system into such a state at this point in time, ahead of winter.

Simply, it could be described as not enough people leaving hospitals, with more people trying to get in and fewer staff being able to treat them all.

The inability to discharge people from hospitals back into the community, particularly aged care or NDIS patients, remains a significant challenge for SA Health, but not one unique to South Australia.

At the other end of the hospital system, officials say there’s been an increase in presentations to SA emergency departments, with the aforementioned wave of respiratory and COVID-19 infections blamed for that in recent weeks.

For some context, on Friday Dr Lawrence said there were 200 more patients in the state’s hospitals than at this time in 2023.

At the same time, about 270 SA Health staff are currently off sick with COVID-19.

When it comes to turning the performance of the health system around, another challenge the state government has is that there are issues out of its control which impact the results seen in public hospitals.

It cannot control what the federal government does with primary health, Medicare, the NDIS or aged care.

Chris Picton said the system had recently faced “unprecedented pressure”.(ABC News: Che Chorley)

And it cannot control how viruses move through the community, nor the rise of new variants of COVID-19.

As play moves further into the “premiership” quarter of this parliamentary term, the state government will likely put even more weight — and expectation — into its plan to open 150 more hospital beds by the end of this year to deliver improvements.

It will hope that builds on the better results which have been seen with ambulance response times since then 2022 state election — something the government wants to be used as a measure of its success.

They’ve gone from 50.4 per cent to 72.5 per cent of jobs seen within the 8-minute target time for priority 1 calls, and 40.9 per cent to 66.7 per cent in the 16-minute target for priority 2 jobs.

Plus, it has already started to open additional hospital beds in recent months, including at Flinders Medical Centre.

Additional hospital beds recently opened at Flinders Medical Centre.(ABC News: Che Chorley)

Labor has put time, effort and energy into health since taking office, with the premier and his ministers repeatedly stating it will take time to deliver improvements.

It’s a high-stakes game which is being played. There’s time left in it, but the clock is ticking.

But it also could be a game the government ultimately may not be able to win because of the standard it set for itself with the community.

And the electorate might not be as willing to give Labor another chance when the siren sounds in March 2026 if the party led by a “pretty average footballer” doesn’t deliver on its health agenda.